Global ETD Search

371	Immigration, Literacy, and Mobility: A Critical Ethnographic Study of Well-educated Chinese Immigrants’ Trajectories in Canada Wang, Lurong 13 June 2011 (has links) This dissertation interrogates the deficit assumptions about English proficiency of skilled immigrants who were recruited by Canadian governments between the late 1990s and early 2000s. Through the lens of literacy as social practice, the eighteen-month ethnographic qualitative research explores the sequential experiences of settlement and economic integration of seven well-educated Chinese immigrant professionals. The analytical framework is built on sociocultural approaches to literacy and learning, as well as the theories of discourses and language reproduction. Using multiple data sources (observations, conversational interviews, journal and diary entries, photographs, documents, and artifacts collected in everyday lives), I document many different ways that well-educated Chinese immigrants take advantage of their language and literacy skills in English across several social domains of home, school, job market, and workplace. Examining the trans-contextual patterning of the participants’ language and literacy activities reveals that immigrant professionals use literacy as assistance in seeking, negotiating, and taking hold of resources and opportunities within certain social settings. However, my data show that their language and literacy engagements might not always generate positive consequences for social networks, job opportunities, and upward economic mobility. Close analyses of processes and outcomes of the participants’ engagements across these discursive discourses make it very clear that the monolithic assumptions of the dominant language shape and reinforce structural barriers by constraining their social participation, decision making, and learning practice, and thereby make literacy’s consequences unpredictable. The deficit model of language proficiency serves the grounds for linguistic stereotypes and economic marginalization, which produces profoundly consequential effects on immigrants’ pathways as they strive for having access to resources and opportunities in the new society. My analyses illuminate the ways that language and literacy create the complex web of discursive spaces wherein institutional agendas and personal desires are intertwined and collide in complex ways that constitute conditions and processes of social and economic mobility of immigrant populations. Based on these analyses, I argue that immigrants’ successful integration into a host country is not about the mastery of the technical skills in the dominant language. Rather, it is largely about the recognition and acceptance of the value of their language use and literacy practice as they attempt to partake in the globalized new economy. situated learning and literacy practice multimodal uses of language and literacy social domains and discursive discourses language and literacy in the workplace discourse analysis consequences of literacy literacy, positioning, power relations social reproduction and categorization language and literacy in the job market reading and writing literacy and orality literacy artifacts home, school, job market, workplace gatekeeping process, social selection 0516 0282 0275 0727 0535 0340 0747 0628 0326 0745
372	Immigration, Literacy, and Mobility: A Critical Ethnographic Study of Well-educated Chinese Immigrants’ Trajectories in Canada Wang, Lurong 13 June 2011 (has links) This dissertation interrogates the deficit assumptions about English proficiency of skilled immigrants who were recruited by Canadian governments between the late 1990s and early 2000s. Through the lens of literacy as social practice, the eighteen-month ethnographic qualitative research explores the sequential experiences of settlement and economic integration of seven well-educated Chinese immigrant professionals. The analytical framework is built on sociocultural approaches to literacy and learning, as well as the theories of discourses and language reproduction. Using multiple data sources (observations, conversational interviews, journal and diary entries, photographs, documents, and artifacts collected in everyday lives), I document many different ways that well-educated Chinese immigrants take advantage of their language and literacy skills in English across several social domains of home, school, job market, and workplace. Examining the trans-contextual patterning of the participants’ language and literacy activities reveals that immigrant professionals use literacy as assistance in seeking, negotiating, and taking hold of resources and opportunities within certain social settings. However, my data show that their language and literacy engagements might not always generate positive consequences for social networks, job opportunities, and upward economic mobility. Close analyses of processes and outcomes of the participants’ engagements across these discursive discourses make it very clear that the monolithic assumptions of the dominant language shape and reinforce structural barriers by constraining their social participation, decision making, and learning practice, and thereby make literacy’s consequences unpredictable. The deficit model of language proficiency serves the grounds for linguistic stereotypes and economic marginalization, which produces profoundly consequential effects on immigrants’ pathways as they strive for having access to resources and opportunities in the new society. My analyses illuminate the ways that language and literacy create the complex web of discursive spaces wherein institutional agendas and personal desires are intertwined and collide in complex ways that constitute conditions and processes of social and economic mobility of immigrant populations. Based on these analyses, I argue that immigrants’ successful integration into a host country is not about the mastery of the technical skills in the dominant language. Rather, it is largely about the recognition and acceptance of the value of their language use and literacy practice as they attempt to partake in the globalized new economy. situated learning and literacy practice multimodal uses of language and literacy social domains and discursive discourses language and literacy in the workplace discourse analysis consequences of literacy literacy, positioning, power relations social reproduction and categorization language and literacy in the job market reading and writing literacy and orality literacy artifacts home, school, job market, workplace gatekeeping process, social selection 0516 0282 0275 0727 0535 0340 0747 0628 0326 0745
373	Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital Lucas, D. Pulane 24 April 2013 (has links) Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs. Disruptive Disruptive Innovation Theory Disruptive Transformations Disruptive Innovation Innovation Technology Technological Innovation Medical Innovation Medical Technology Medical Advancement Laparoscopy Laparoscopic Surgery open surgery appendectomy cholecystectomy bariatric surgery weight loss surgery appendectomies cholecystectomies inpatient outpatient ambulatory ambulatory surgery ambulatory surgery center acute care general hospital hospital acute care hospital general hospital health care healthcare hospital industry health care industry Clayton Christensen Clayton M Christensen Michael Porter Harvard Business School Virginia Commonwealth University CMS Health policy public policy public administration organizational theory organization theory Population Ecology Theory Competitive Strategy policy analysis John Kimberly Organization Size Structural Inertia liability of smallness health spending health care cost specialty medical facility open system niche width dynamic outpatient department technology shift surgical setting surgical setting shift medical facility shift substitution threat health system system level analysis Ecological Approach hospital trends ambulatory surgery trends reimbursement rate Medicare CMS coverage decision P J DiMaggio DiMaggio and Powell w w Powell Hannan and Freeman M T Hannan Organizational change minimally invasive surgery less invasive surgery Prospective Payment System Outpatient Prospective Payment System entreprenuerial physician health care organization health care management Roice Luke Carl Ameringer new technology surgical utilization elective surgery Medicare Payment Advisory Commission MedPAC coverage decision trends in surgery abdominal surgery surgical variation physician-owned physician ownership physician autonomy outpatient clinic utilization trends unnecessary surgery Pfeffer Salancik technology diffusion redefining health care interdisciplinary research health care delivery panel design diffusion of hospital technology state variation regional variation local health care market government intervention medical facility health care capacity focused factory advances in health care physician organization relationship hospital competition medical specialization hospital expansion medical arms race integrated care integrated health system J E Wennberg health care transformation reimbursement scheme surgical volume Florida Wisconsin policy making health policy analysis competitive dynamics center of excellence intervening factor service line competition service-line competition surgical reimbursement innovative business model innovative technology environmental influence established firm new market entrant patient safety sophisticated technology Harvard Divinity School Social and Behavioral Sciences

Page generated in 0.1116 seconds