Telemedicine is the use of information and communication technology to provide clinical health care at a distance. This approach is usually adopted to bridge the distance in rural settings, but it is also a method to meet demographical and economical challenges. Västerbotten, a sparsely populated county with an ageing population, is in leading edge when it comes to telemedicine. The purpose of this report was to examine the diffusion and the inventory of telemedicine in the county council of Västerbotten from a geographical perspective. To gain a deeper understanding of diffusion and inventory of telemedicine, my purpose was also to examine these processes from an international and national perspective. Telemedicine and diffusion as concepts, and how these have been portrayed in the literature were studied, as well as the driving forces behind, and the barriers to further diffusion of telemedicine. The main focus in the report was telemedicine in the county council of Västerbotten and their ongoing inventory of telemedicine. The background of the inventory, how it is being performed and what the results have been up to this date were investigated. All these aspects were performed through interviews. An important factor to successful implementation of telemedicine, is the use of comprehensive and systematic performed evaluations of telemedicine activities. The inventory performed by the county council of Västerbotten is an important contribution to the lack of evidence in this area. Although, a major barrier to successful implementation and further diffusion of telemedicine, appears to be attitudes among health care staff.

Within Canada’s federal correctional system, prison-hospitals provide both in-patient and ambulatory services to incarcerated male offenders. With at least 12% of incarcerated men being identified at intake as having a mental health disorder, the need for these services is significant (Sampson, Gascon, Glen, Louie & Rosenfeldt, 2007). While some description of the mental health services provided, internal operational reviews, and external health services accreditation surveys of these prison-hospitals are available, there has been very little attention paid to the challenge of trying to balance the dual correctional and mental health mandates of these facilities. Research in comparable facilities and services in the United States describe mental health care as a ‘non-system’ of care and state that mental health staff receive very little system-wide direction regarding the provision of services (Cruser & Diamond, 1996; Elliot, 1997). This is a study that critically analyses how mental health care has become subordinated to correctional and security priorities in a Canadian prison-hospital. Five key elements identified in the policy implementation literature are used to explicate the everyday experiences of frontline staff as they work to provide mental health services in this correctional environment. The thesis argues that the mental health work of frontline prison staff is subverted by a lack of vision for mental health care within organizational policy structures, allowing the detailed correctional policy structures to become the dominant force in implementation and decision making. Using the theory and method of institutional ethnography developed by sociologist Dorothy Smith, the analysis displays how the everyday activities of frontline staff are systematically organized by routine organizational policy structures to advance the correctional mandate of the prison-hospital while mental health care has slowly declined. The study finds that mental health care is socially organized as a ‘zero-sum game’. As policy texts have concerted and coordinated the everyday activities of frontline staff in predictable ways, gains for the correctional and security priorities of the prison-hospital have meant significant and repeated losses for mental health care. However, there are ‘windows of opportunity’ for frontline staff to advance the mental health mandate of the prison-hospital if they work together. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2010-04-28 14:46:36.212

No description available.

The purpose of this study is to examine what factors have been affecting the implementation of IFRSs in Bangladesh from 1998 to 2010. The study seeks to answer these specific research questions: (1) What is the relative impact of accounting regulatory frameworks and politico-institutional factors on the implementation of IFRSs in Bangladesh?; 2(a): How do (i) training opportunities in the accounting profession and (ii) the state of corruption, as outcomes of culture in Bangladesh, affect the implementation of IFRSs?; 2(b): What other country specific factors are affecting implementation of IFRSs?; (3) How does a study of implementing IFRSs help to build an understanding of a theory of the role of the state in accounting change in a developing country such as Bangladesh? This study adopts a mixed methodology in which interviews over two years (2010-2011) are conducted and documentary analyses of IFRSs-related enforcement documents (1998-2010) are evaluated to identify the possible obstacles for implementing IFRSs in Bangladesh. In relation to RQ-1, the study finds that politico-institutional factors are stronger and more dominant factors than accounting regulatory frameworks for impeding IFRSs implementation in Bangladesh. A lack of co-operation among the institutional bodies has existed in both democratic and military-backed government eras (the military-backed government ruled for 19 years out of 40 years of independence in Bangladesh). However, the military-backed government was effective compared to the democratic government in terms of taking action against companies identified as being corrupt. There is evidence of ‘blaming culture’ with the state institutions and the professional bodies blaming each other regarding the IFRSs implementation process. With respect to RQ-2(a), deficiencies in the training opportunities in accounting profession and high levels of corruption are inhibiting IFRSs implementation. Interviewees comment that professional curricula contain limited content on IFRSs and there are limited training opportunities for accountants in the majority of companies. Looser enforcement of the laws is found during the periods of democratic government. However, the levels of corruption were lower during the military-backed government. Regarding RQ-2(b), some country specific factors are also identified in this study: a lack of qualified accountants; a lack of interest in IFRSs by managers of some companies; a culture of secrecy; and higher costs of IFRSs compliance with lower benefits for small companies. In terms of RQ-3, this study contributes to IFRSs implementation as an example of accounting change in a developing country by applying a Weberian view of the theory of the role of the state. Additionally, this study considers the state-society relationship employing institutional dynamics (Dillard et al., 2004). In particular, outcomes of accounting change in Bangladesh are observed from state and individual organisation levels. However, the influence of the organisation field level is unknown in this research because industry lobbying groups were not interviewed. Since the role of the state is vague in prior accounting research, this study discusses roles of the state (i.e. the state approves experts to write rules; it consults with various stakeholders; it enforces outcomes; it is accountable to its citizens; and it engages with donor agencies) in a developing country’s experience during the process of accounting change. Extending Weber’s (1958)[1904], (1968)[1922] argument on state-society, the study finds that for a state in an era of democratic government, politico-institutional factors and corruption (as an indication of societal values) may be more important and concentrated factors than for a state under a military-backed government in terms of impeding IFRSs implementation. The study reveals that all roles of the state have negative influences on accounting change. However, interviewees’ initial concerns about the roles of donor agencies are transformed into concerns about the democratic government’s failure to implement IFRSs. The implications of the study are relevant to policy makers, practitioners and users of financial information. Although the study is based on Bangladesh, the results of the study are expected to be relevant to other developing countries experiencing similar phases of IFRSs implementation.

No description available.

Det har sedan länge funnits en problematik kring att säkerställa barn och ungas välmående och rättssäkerhet i den sociala barnavården. År 2005 gjordes en dokumentär som fick namnet Stulen barndom. Dokumentären belyste hur vanvården i svenska barnhem sett ut historiskt samt hur det fortfarande kan se ut i dagens samhälle. Denna dokumentär kombinerat med olika utredningar och rapporter resulterade i att Socialstyrelsen år 2012 tillsatte nya riktlinjer för den sociala barnavården, med förhoppning att uppnå högre säkerhet för barn och ungdomar som är placerade i HVB (hem för vård eller boende). Syftet med studien är att undersöka i vilken omfattning de nya riktlinjerna implementerats i tre HVB-verksamheter inom Västerbottens län. Studien belyser hur föreståndare och personal upplever att det är att arbeta i en verksamhet efter de nya riktlinjernas tillkomst. Detta kommer att undersökas utifrån implementeringsteori och driftperspektiv. Studien är uppbyggd av kvalitativ metod och är genomförd med hjälp av intervjuer där tre olika HVB undersöks. Vår sammanfattande slutsats är att det är avsevärt lite som förändrats i verksamheterna som resultat av riktlinjernas tillkomst. En slutsats är också att implementationen av riktlinjerna har gått tillväga på skilda sätt i varje verksamhet.

In the context of Human Resource Management (HRM), organisations have been increasingly encouraged to implement a range of practices which, it is argued, will improve their competitiveness in the global market place. Thus, change initiatives within organisations follow one after the other. Yet, although there is apparent acceptance among practitioners and academics that evaluation is a crucial step in any process of continual improvement the reality is often that little has been done to assess the impact and degree of success of each initiative before organisations progress to the next. However, despite wide acknowledgement within the literature that is a significant problem there are few explanations offered and little evidence of any in-depth empirical exploration of the issues involved. This thesis reports on a study which sought to identify and explain the factors which created barriers to evaluation. Using a case study approach the research explored the reality of the evaluation process as it occurred in three UK public sector organisations, each of which was seeking to evaluate a Human Resource Management (HRM) change initiative. Two distinct types of barrier were found to exist which were labelled primary and secondary. As anticipated, there were barriers (secondary) that arose during an evaluation process that related to the choices made about purpose, process and responsibility and which made it difficult for 'good' (thorough, unbiased, relevant) evaluation to occur. However, of greater significance was the discovery in all three organisations of other factors (primary barriers) which, in combination, created a context in which the failure to undertake formal evaluation could be justified as a reasoned, and reasonable, action on the part of managers thereby offering an explanation for why such evaluations are rare. These primary barriers relate to the organisational and individual value placed on the act of evaluating and the learning that occurs as a result of any findings, including the way that it informs the change. Among those responsible for the initiation and implementation of the initiative (normally those who have control of the resources necessary to enable formal evaluation to take place), informal evaluation of the initiative and the context in which it occurred determined the perceived degree of need for formal evaluation to take place. Past experience, observation and shared perceptions suggested that formal evaluation activity was neither valued nor required by the organisation and was likely to have negative personal consequences. Matters are further clouded by an academic and practitioner literature which actively promotes the benefits of HRM strategies, supported by simplistic prescriptions for success, while the majority of empirical studies offer examples which substantiate these claims. In each of the cases reported here the nature of the chosen HRM initiative was assumed to be inherently good, something which would inevitably benefit the organisation in some way, by those responsible for its adoption and implementation thus making formal assessment unnecessary. The research clearly identifies the complexity of the barriers; each type having its roots in different factors that need to be addressed in a variety of ways if they are to be overcome and thus enable the organisation is to achieve the collective, and productive, learning from experience increasingly called for by the management literature. Until evaluation is valued at senior levels and accompanied by the necessary incentives, responsibilities, resources and rewards, wider perception of it as an important and valued activity is unlikely to become an active reality. Thus, the failure to learn from experience, to share understanding and to achieve both continuous improvement and greater levels of success in the management of change will continue. It is also clear that the same academic literature which is currently advocating a key role for HR and evaluation in the context of change needs to offer more in the way of information, guidance and support to make a positive contribution to the changes in perception that are required.

No description available.

As Canada continues its drive towards a national electronic health record the costs are mounting. With 256 projects underway the question has to be asked: what are the true costs of such an endeavor? Success hinges on cooperation at all levels and adequate funding in place to see it to completion. Has Canada taken into full consideration the impact that this project will have in the long run? One small part of a much larger project in rural Alberta puts a face on the huge undertaking. Nurses in one former health region adopted not only an Order Entry module but also began using computers for the first time in order to do their work. Nurses are one of the key end-user groups actually inputting the information into these systems. Is data entry something nurses need to be concerned with at all especially at the Order Entry level?

Zugl.: München, Universiẗat, Diss., 2007.