The need for a more sustainable approach to water consumption has increasingly gained attention in the last decade. The domestic sector accounts for over half of abstracted water in the UK and, as such, has become a major target for water efficiency interventions. Current research and water efficiency interventions are dominated by a positivist approach, focusing on a limited range of factors that can be quantitatively measured. This thesis questions the dominant approach and argues that a more holistic overview of water efficiency can be achieved through the consideration of socio-technical and behavioural theories. Taking a more constructivist approach, this research draws on four theories from socio-technical and behavioural fields and combines them to create a framework for the analysis of water efficiency interventions. The framework is applied to two case studies, exploring water users' perceptions of water, water supply, personal water use, and their responses to the water efficiency interventions. The case studies were selected to provide examples of current mainstream approaches to water demand management. Research methods used included semi-structured interviews and observation. The research findings support the argument that the current dominant approach to domestic water efficiency interventions is limited and, in some cases, ineffectual. Issues of trust, knowledge, motivation and the relationships between water users and water companies were raised. The thesis concludes that the use of a constructivist perspective could help to provide a more effective approach to understanding and improving water demand management.

O processo de seleção de uma tecnologia de tratamento de esgoto envolve a análise de diferentes fatores como as características dos efluentes brutos, demanda por energia e material humano qualificado, disponibilidade de terreno, condições climáticas, geração de subprodutos e sua destinação final e capacidade suporte dos cursos d’água receptores, dentre outros. O processo de seleção torna-se mais complexo quando conduzido no âmbito de uma bacia hidrográfica, uma vez que deverão ser considerados corpos d’águas com diferentes capacidades de autodepuração e a disposição final de efluentes com diferentes vazões e condições de qualidade. Este trabalho teve como objetivo central estabelecer uma metodologia que permita a seleção de sistemas de tratamento, no âmbito de bacias hidrográficas, considerando o emprego combinado de modelagem matemática de qualidade de água, técnica de otimização e método de análise multicriterial. Ainda que aplicável a quaisquer bacias hidrográficas, a metodologia proposta foi aplicada à Bacia Hidrográfica do Rio Pardo, curso d´água localizado na porção sul do estado do Espírito Santo. Eficiências mínimas de remoção de matéria orgânica, estimadas com emprego combinado de modelo matemático de qualidade de água e técnica de otimização, permitiram a pré-seleção dos sistemas de tratamento de esgoto, observadas a manutenção dos padrões de qualidade dos corpos d’água e/ou dos efluentes e a equidade no esforço de tratamento entre os diferentes sistemas objetos da seleção. Uma pesquisa qualitativa, conduzida por grupos focados, permitiu a validação dos subsistemas sociotécnicos (Ambiental, Tecnológico, Operação e Social) e dos critérios de seleção. A partir do emprego do método baseado na Teoria de Utilidade Multiatributo (MAUT) foi apropriado um Índice Sociotécnico que permitiu estabelecer, por localidade da área de estudo, o ranking das tecnologias de tratamento de esgoto pré-selecionadas. Para as sedes municipais de Ibatiba e Iúna (maiores aglomerados urbanos da área de estudo), o Índice Sociotécnico conduziu à priorização de variações dos sistemas de lodos ativados ou de tanque sépticos com biodisco como opções de tratamento. Para a sede do município de Irupi e para os povoados de Santíssima Trindade e Nossa Senhora das Graças, função da capacidade de autodepuração dos cursos d’água e/ou dos pequenos contingentes populacionais, o Índice Sociotécnico conduziu à priorização de sistemas mais simples, como diferentes variações do sistema de lagoas de estabilização. / The selection process of a sewage treatment technology involves the analyses of different factors, such as, the characteristics of raw effluents, electricity and qualified human material demand, land availability, weather conditions, production of by-products and final destination and bearing capacity of water resources, among others. The selection process becomes more complex when carried out in a river basin ambit, once water bodies with capacities of selfdepuration and the final destination of effluents with different outflows and quality conditions must be taken into consideration. This work’s main goal was to establish a methodology that enabled the selection of systems of treatment, in river basin ambits, considering the combined use of water quality mathematical modelling, optimization technique and the method of multicriterial analysis. Even applicable to any river basin, the methodology proposed was applied to Rio Pardo river basin, watercourse located in the south of Espírito Santo State. Minimum efficiencies of organic material removal, estimated with the combined use of water quality mathematical modelling and optimization technique, allowed the pre-selection of sewage treatment systems, observed the maintenance of quality standards of water bodies and/or effluents and the equity regarding the treatment effort among the selection’s objects systems. A qualitative research, conducted by focus groups, allowed the validation of socio-technical subsystems (Environmental. Technological, Operation and Social) and the selection criteria. By using the method based on the Multi-attribute Utility Theory (MAUT), an Environmental Index was settled in order to allow the establishment, according to the study area location, of a ranking of pre-selected sewage treatment technologies. For the municipal headquarters in Ibatiba and Iúna (the biggest urban settlements within the study area), the Environmental Index conducted the prioritization of systems variations of activated sludge or septic tank with biodiscs as options for treatment. As for the municipal headquarter in Irupi and the Santíssima Trindade and Nossa Senhora das Graças villages, the self-depuration capacity function of the watercourses and/or small population contingent, the Environmental Index led to the prioritization of more simple systems, with different variations of the stabilization ponds system.

A necessidade das empresas em aumentar sua eficiência produtiva tem despertado a atenção para a temática da produção enxuta (PE) desde a década de 90. No entanto, é notória a crescente elevação da complexidade organizacional atualmente, de tal forma que os sistemas produtivos estão cada vez mais conectados e sujeitos à imprevisibilidade e dinamismo do ambiente externo. Nesse sentido, estudos recentes apontam que a complexidade é responsável por restringir o avanço das práticas enxutas. Contudo, estes estudos não se encontram apoiados pela teoria da complexidade, o que é inconsistente, visto que a complexidade também pode assumir um papel importante na sustentação da PE. Assim, a pesquisa apresentada nesta tese de doutorado teve como objetivo caracterizar e avaliar as relações entre a produção enxuta e a complexidade dos sistemas sócio-técnicos onde a mesma é implantada. A estratégia de pesquisa foi dividida em três etapas: pesquisa exploratória; descritiva; e explicativa. Na primeira fase, uma revisão sistemática da literatura foi conduzida para evidenciar o estado da arte em relação à temática e as lacunas de conhecimento existentes. Após, um estudo na forma de survey buscouse caracterizar como as empresas com maior nível de adoção dos princípios enxutos diferem-se das demais em relação à complexidade de seus sistemas. Por último, a etapa explicativa buscou através de um estudo de caso identificar e avaliar as lacunas entre a PE como imaginada e como de fato realizada, destacando-se o papel da complexidade nestas lacunas. Esta pesquisa apresenta contribuições acadêmicas e práticas ao descrever e avaliar como a PE se relaciona com a complexidade dos sistemas sócio-técnicos, levando-se em conta a natureza distinta desses sistemas. / The need of companies to increase productive efficiency has been paying attention to the issue of lean production since the 1990s. However, the increasing organizational complexity is evident today, so that production systems are more connected and subject to the unpredictability and dynamism of the external environment. In this sense, recent studies indicate that complexity is responsible for restricting the advance of lean practices. However, these studies are not supported by complexity theory, which is inconsistent, since complexity may also play an important role in sustaining PE. Thus, the research presented in this doctoral thesis aimed to characterize and evaluate the relations between lean production and the complexity of the socio-technical systems where it is adopted. The research strategy was divided into three stages: exploratory research; descriptive; and explanatory. In the first phase, a systematic review of the literature was conducted to show the state of the art in relation to the theme and the existing knowledge gaps. Afterwards, a study in the form of a survey sought to characterize how companies with a higher level of lean principles adoption differ from others in relation to the complexity of their systems. Finally, the explanatory step sought through a case study to identify and evaluate the gaps between lean as imagined and lean as actually done, highlighting the role of complexity in these gaps. This research presents academic and practical contributions by describing and evaluating how LP is related to the complexity of socio-technical systems, taking into account the distinct nature of these systems.

The research presented in this thesis demonstrates the qualitative modelling of an advanced service delivered by a Product Service System (PSS) through the use of a socio-technical systems-based approach. The created model represents dependencies between functions and organisations, and can be used as basis for a quantitative cost model. Focus is on how one particular example of advanced services, namely availability is delivered in an industrial context. Following a review of multi-disciplinary literature and the outline of a suitable methodological approach, a detailed case study of the delivery of an exemplar piece of avionics equipment by BAE Systems and GE Aviation to the UK Royal Air Force is described. This research shows that the delivery of avionics availability through a PSS has organisational, contractual and functional facets that overlap and influence each other. Multiple qualitative models represent the investigated setting, from a functional and from an organisational perspective. Top-level functions ‘Analysis & Optimisation’, ‘Administration’ and ‘Delivery’ are identified. The results show distinctive similarities and differences between GE Aviation and BAE Systems including a variety of parallel contracts, organisational segmentation and tensions between relationships and contractual obligations. The findings suggest that understanding a PSS as a socio-technical system is crucial for modelling the PSS and the cost associated with it. This is particularly important when the aim is to continuously control and manage costs rather than the creation of a one-off forecast. The contribution of this work to the existing body of knowledge, primarily within the domain of cost engineering is twofold: First the creation of qualitative models of an existing PSS delivering avionics availability to show “what is a PSS”, and second a methodologically robust approach that takes into account the sociotechnical character of PSS to demonstrate “how to know about PSS”.

Serviços de saúde são reconhecidamente sistemas socio-técnicos complexos (SSTC) tendo em vista sua dinamicidade, diversidade, incerteza e interações entre os diversos elementos que os compõe. Outra característica importante dos SSTC é a resiliência, fundamental para manter os sistemas em funcionamento. Estudar a resiliência em SSTC é objetivo da Engenharia de Resiliência (ER), novo paradigma para gestão de segurança, com enfoque na análise do trabalho real. Esta tese explora o papel complementar de duas práticas com influência na resiliência em SSTC: o desenvolvimento de habilidades de resiliência (HR) e os procedimentos operacionais padronizados (POPs). Há um entendimento que, mesmo com procedimentos operacionais padronizados, existe uma variabilidade inerente ao SSTC, tornando impossível que o procedimento atenda a todas as situações. Este estudo tem como principal questão de pesquisa: como integrar a gestão de procedimentos operacionais padronizados ao desenvolvimento de HR em serviços de emergência hospitalar? E como objetivo principal: propor um modelo para integração entre gestão de POP e desenvolvimento de HR, enfatizando serviço de emergência hospitalar Os objetivos específicos são: (a) identificar, analisar e traçar um panorama sobre estudos na área da saúde com a ótica da ER; (b) identificar a origem das HR. A abordagem norteadora da tese é o Design Science Research que, com sua natureza prescritiva, busca desenvolver o conhecimento por meio da construção de artefatos. A tese está estruturada em três fases, que resultam em três artigos: (i) ―Contribuições da Engenharia de Resiliência para a Saúde: uma Revisão Sistemática‖, tem como principal objetivo identificar e entender como os conceitos de ER vem sendo utilizados na área da saúde; (ii) ―Habilidades de resiliência como fenômeno emergente: um estudo em departamentos de emergência no Brasil e nos Estados Unidos‖, tem como objetivo responder ao questionamento ―de onde emergem as habilidades de resiliência‖; (iii) ―Procedimentos e capacitação: recursos para ação trabalhando em conjunto para apoiar a resiliência de sistemas sócio-técnicos complexos‖, que responde a pergunta ―como integrar melhoria de POP e desenvolvimento de HR?‖. Assim, o último artigo atende o principal objetivo da tese ao propor modelo de integração entre POP e capacitações em HR. / Health services are admittedly complex socio-technical systems (CSS) considering their dynamism, diversity, uncertainty and interactions between the various elements that compose them. Another important feature of the CSS is resilience. It is critical to keep systems running. The goal of Resilience Engineering is to study resilience, the new paradigm for safety management, focusing on the analysis of current work. This thesis approaches the complementary role of two practices that influence the resilience CSS: the development of resilience skills (RS) and standard operational procedures (SOPs). There is an understanding that even with the use of SOPs, there is variability in the CSS, making it impossible for the procedure to meet all situations. This study's main research question is: how to integrate the SOP management and RS development in hospital emergency room services? The main objective of the study is: to suggest a model to integrate SOP management and RS development, with emphasis in hospital emergency room. The specific objectives are: (a) identify, analyze and give an overview of studies in health care according to Resilience Engineering; (b) identify the origens of the RS The guiding approach of this thesis is the Design Science Research which, due to its prescriptive nature, seeks to develop knowledge by building artifacts. The thesis is structured in three phases, resulting in three items: (i) ―A Systematic Review on Resilience Engineering contributions for Health Care‖ aims to identify and understand how concepts of Resilience Engineering have been used in health services (ii) "Resilience skills as emergent phenomena: a study of emergency departments in Brazil and the United States" aims to answer the question "where do resilience skills come from"; (iii) ―Procedures and training: resources for action working together to support the resilience in CSS‖, which answers the question "how to integrate SOP improvement and resilience skills development?". Thus, the last article serves the main objective of the thesis that is to suggest an integration model between SOP and RS training.

O setor de assistência à saúde atualmente, carece de técnicas de gerenciamento que visem a melhoria dos processos, permitindo a redução de custos ao otimizar os recursos existentes. O sistema de saúde, classificado como um sistema complexo devido a diversidade de interações não-lineares que apresenta, vem sendo estudado sob a ótica da engenharia de resiliência que enfatiza a necessidade de regular o seu funcionamento diante de uma situação adversa. Por sua vez, a resiliência é facilitada por meio do uso de folgas, que fornecem recursos reservas para lidar com as variabilidades. Ao passo que as folgas são importantes para manter a resiliência, também podem ser recursos ociosos que tendem a mascarar as variabilidades, quando em excesso. Portanto, um equilíbrio deve ser considerado entre o mínimo necessário para manter a resiliência do sistema e o máximo que não venha a se enquadrar como desperdício de recursos. Para isso, esse trabalho desenvolve e aplica uma framework que visa analisar qualitativa e quantitativamente as folgas a fim de reprojetar o sistema sócio-técnico complexo. O estudo foi realizado numa maternidade, referência no atendimento privado. Os processos de atravessamento do fluxo de valor da paciente foram mapeados, permitindo a identificação de 17 fontes de variabilidade e 20 recursos de folga. O reprojeto do sistema de trabalho envolveu a classificação das folgas entre os requisitos levantados, de maneira a priorizar as variabilidades menos cobertas pelas folgas. A framework se mostrou eficaz ao elencar as prioridades no redesenho das folgas e variabilidades, a fim de tornar o sistema estudado mais resiliente. / The healthcare sector currently lacks management techniques that aim to improve processes, allowing cost reduction by optimizing existing resources. The health system, classified as a complex system due to the diversity of nonlinear interactions that it presents, has been studied from the point of view of resilience engineering that emphasizes the need to regulate its functioning in the face of an adverse situation. In turn, resilience is facilitated through the use of slack, which provide reserve resources to deal with variability. While slack are important to maintaining resilience, it can also be idle resources that tend to mask variability when in excess. Therefore, a balance must be considered between the minimum necessary to maintain the resilience of the system and the maximum that doesn’t fit as a waste of resources. For this, this work develops and applies a framework that aims to analyze qualitatively and quantitatively the slack in order to redesign the complex socio-technical system. The study was performed in a maternity hospital, that is a reference in private care. The processes of flow of the patient's value were mapped, allowing the identification of 17 sources of variability and 20 resources of slack. The redesign of the work system involved the classification of slack between the requisites raised, in order to prioritize the variabilities less covered by the slack. The framework proved to be effective in highlighting the priorities in the redesign of the slack and variabilities, in order to make the studied system more resilient.

We asked whether the design of a Science Data Repository (SDR) can influence data sharing behaviour in small scientific collaborations. We hypothesised that an SDR can influence data-sharing behaviour when its design considers the context of data-sharing. We proposed an alternative approach to those documented in the literature, employing a combination of socio-technical empirical and analytical methods for context capturing, and choice architecture for context incorporation. To evaluate the approach we applied it to design features in a Scientific Data Repository for a population of small scientific collaborations within the Life Sciences. The application of this thesis' approach consisted of an exploratory case study, a review of factors associated with data sharing, the definition of design claims, and implementation of a set of design features. We collected data using interviews with members of the collaborations and designers of the SDR; as well as obtaining the data-logs from the collaborations' SDR. We evaluated the resulting design features using an asynchronous web experiment. We found that using the empirical approach to context capturing we are able to effectively identify factors associated with data sharing in the small scientific collaborations. Moreover, we identified a number of limitations on the application of the analytical approach to context capturing. Furthermore, we found that the Choice Architecture based procedure for context incorporation can define effective design features in Science Data Repositories. In this work, we show that we can facilitate data-sharing by incorporating context into the design of a Science Data Repository, and identified a set of restrictions to use our approach. The approach proposed in this thesis can be used by practitioners wishing to improve data sharing in an SDR. Contributions, such as the survey of factors associated with data sharing behaviour, can be used by researchers to understand the problems associated with data sharing in small scientific collaborations.

Transições sociotecnológicas são processos de modificação e substituição de regimes sociotecnológicos, estruturas sociais que englobam sistemas tecnológicos e produtivos, bem como políticas públicas, sistemas econômicos e significados simbólicos associados. A transição sociotecnológica tem sido discutida como um caminho para o desenvolvimento sustentável, dada a possibilidade de substituição de regimes sociotecnologicos vigentes por regimes que representem menores impactos sociais e ambientais. Apesar da atenção que a transição sustentável tem recebido em anos recentes, observa-se na literatura uma lacuna no estudo da função de agência na transição. O objetivo da presente pesquisa é analisar a agência no processo de transição sociotecnológica sustentável, e a principal contribuição está na proposição de um modelo conceitual estruturado para a explicação desta agência. No desenvolvimento do modelo adotou-se a perspectiva multinível, a qual estuda a transição a partir de três diferentes níveis de análise: nicho, regime e cenário. O modelo está consolidado em três ideias centrais, que se constituíram em hipóteses de trabalho no desenvolvimento da pesquisa. Propõe-se como primeira hipótese que a agência na transição seria distribuída, resultando de uma ação coletiva do nicho. Propõe-se também como segunda hipótese de trabalho que a agência seria exercida por meio da construção pelos atores nicho de um sistema de narrativas, o qual direcionaria as expectativas dos demais atores, bem como o compromisso resultante destas expectativas. Por fim, propõe-se como terceira hipótese que expectativas e compromisso seriam continuamente ajustados pelo desempenho do sistema, e a principal medida de desempenho na transição tecnológica estaria na capacidade do nicho em desenvolver aprendizado. Adotou-se no desenvolvimento da pesquisa uma abordagem multimétodo, a partir de um posicionamento epistemológico de complexidade organizacional; outra contribuição significativa de pesquisa está no tratamento metodológico adotado no teste do modelo proposto. O modelo conceitual proposto foi operacionalizado em uma fase de pesquisa qualitativa, a partir de em análise de conteúdo de narrativas socialmente construídas, e outra quantitativa, através de modelagem computacional por meio de um sistema multiagente. Para o desenvolvimento destas fases adotou-se como objeto de pesquisa o nicho de energia eólica brasileiro, o qual se entende como uma transição em andamento dado seu expressivo crescimento recente. Na fase qualitativa de pesquisa buscou-se caracterizar os processos discursivos envolvidos em transições tecnológicas sustentáveis. Observou-se que narrativas atuaram no estabelecimento de expectativas sobre nicho tecnológico, defendendo a existência de grande potencial de geração no Brasil, e a sustentabilidade da geração de energia eólica. A caracterização de narrativas resultado da fase qualitativa de pesquisa foi adotada na fase quantitativa de pesquisa como base para o desenvolvimento do processo de modelagem e simulação. O modelo computacional foi considerado como valido dada sua capacidade de representar o processo de constituição de um nicho tecnológico, e as três hipóteses de trabalho que consolidam o modelo conceitual proposto foram testadas por meio deste modelo. Os resultados de simulação observados dão suporte à aceitação das primeira e segunda hipóteses, embora indiquem pela rejeição da terceira. A principal implicação dos achados está na sugestão que a transição sustentável deve ser entendida como um processo iminentemente coletivo, não podendo ser conduzida de forma isolada por um único agente. / Socio-technological transitions are processes of change and replacement of socio-technical regimes, social structures that include technological and production systems, as well as the associated public policies, economic systems and symbolic meanings. Socio-technical transitions have been discussed as a path to sustainable development, due to the opportunity of replacement of incumbent socio-technical regimes by regimes that account for lesser social and environmental impacts. Despite the attention that sustainable transitions have recently received, it is observed in the literature a gap in the study of agency in the transition. The aim of this research is to analyze agency in the socio-technical transition to sustainability, and the main contribution is the proposition of a structured conceptual model in order to explain this agency. In developing the model, it was adopted the multi-level perspective, which studies the transition through three different levels of analysis: niche, regime and landscape. The model is consolidated in three core ideas, which constituted themselves in working hypotheses for the development of research. At first, it is proposed a first hypothesis the adoption of a conception of distributed agency, resulting from a collective action of the niche. It is also proposed as second work hypothesis that agency would be exerted through the construction by the social actors of the niche of a system of narratives, which would direct the expectations of other actors, as well as the commitment resulting from these expectations. Finally, it is proposed as the third work hypothesis that expectations and commitment would be continuously adjusted by system performance, and the main performance measure in the sociotechnical transition would be in the ability of the niche to develop learning. It was adopted in the research a multimethod design, from an epistemology of organizational complexity; another significant contribution of the research is the methodological approach adopted in testing the proposed model. The proposed conceptual model was operationalized in a qualitative research phase, using a content analysis of socially constructed narratives, and other quantitative phase, by means of computational modeling using a multi-agent system. To the development of these phases it was adopted as a research subject the Brazilian wind energy niche, which is understood as a transition in progress, given its significant recent growth. In qualitative research phase, we attempted to characterize the discursive processes involved in sustainable technological transitions. It was observed that narratives have acted in establishing expectations about technological niche, defending the existence of a large generation potential in Brazil, and the sustainability of wind power generation. The characterization of narratives resulting of the qualitative research phase was adopted in the quantitative phase as the basis for the development of modeling and simulation process. The computational model was considered valid, given its ability to represent the process of establishment of a technological niche. The three working hypotheses that consolidate the proposed conceptual model were tested using this model. The observed simulation results supported the acceptance of the first and second hypotheses, while indicating the rejection of the third one. The main implication of the findings is the suggestion that the transition to sustainability must be considered as a collective process, and cannot be conducted by a single individual agent.

Cette recherche s’intéresse aux effets induits par les dispositifs numériques de partage social sur les pratiques de collaboration, de communication et de médiation d’étudiants, dans un contexte situé de formation à distance. L’objectif est d’appréhender le processus de collaboration à l’origine de l’apprenance collective qui s’illustre dans les communautés d’apprentissage, constituées en marge de l’institution académique. Notre approche empirique par systématique hypothético-déductive est une observation netnographique menée auprès d’individus inscrits en Bachelor et Mastère dans un centre de formation privé. Notre corpus est composé de 1405 messages recueillis sur les forums de la plateforme institutionnelle et sur Facebook ou Google+ pour les groupes communautaires à l’initiative des étudiants. Nous recourons à une catégorisation de l’activité d’apprentissage suivant quatre dimensions intrinsèques à l’intervention des usagers sur les forums. Les phénomènes observés sont analysés suivant trois variables dépendantes : la temporalité, la reconnaissance sociale et le pouvoir hiérarchique. Notre ancrage est la théorie critique des médias de l’école de Francfort. Nous faisons l’hypothèse que les dispositifs sociotechniques d’information et de communication participent de l’horizontalisation des usages estudiantins. Nos observations de terrain révèlent en effet que les apprenants préfèrent s’en remettre à leurs pairs plutôt que solliciter l’institution ou les tuteurs en ligne. S’ils privilégient leur disponibilité indéfectible, ils accordent une plus grande importance à leur réactivité. Nous pensons que le clivage qui oppose l’environnement académique à la sphère estudiantine est pour partie le fait de deux temporalités distinctes. L’une verticale, celle de l’environnement numérique de travail (ENT), l’autre plus horizontale, caractérisée par les échanges entre pairs au sein de l’environnement personnel d’apprentissage (EPA). L’asynchronisme qui résulte de ces deux dispositifs engendre des effets de détournement d’usage par lesquels les étudiants exportent les ressources institutionnelles vers leur communauté. Mais l’analyse des praxis communautaires révèle d’autres artefacts induits par les technologies numériques. Qu’il s’agisse de désintermédiation ou d’accélération temporelle, ces usagers attirés par le modèle a hiérarchique, se retrouvent à leur insu dans un processus de domination sociale. Nous soulignons les effets pernicieux liés à l’accélération temporelle particulièrement prégnante dans la génération d’étudiants observée. / This research is interested in the effects led by the digital devices plans of social sharing on the pratices of collaboration, communication and mediation of students in context of distance learning. The goal is the understand the origin of the collaborative process of collective apprenance which is illustrated in the communities of apprenticeship outside the academic institution. A netnographic observation is conducted whith Bachelor and Master's degree in a private training center ; our corpus is made of 1405 messages taken in the forums of the institutional platform and on Facebook or Google +. We assume the information and communication sociotechnical devices participate in the horizontalisation of student's practices. We highlight the paradox of these learning communities which are, unwittingly, in a process of social domination by having choosing a priori a decentralized structure

Long waitlists and growing numbers of unattached patients are indicative of a Canadian healthcare system which is unable to address the demands of a growing and aging population. Health information technology is one solution offering respite, but brings its own issues. Health information technology includes primary care physician office systems, telehealth and jurisdictional EHRs integrated through interoperability standards to share data across care providers. This dissertation explores effects that health information technology has on primary care. Literature reviews provided context of health information systems adoption. Surveys and semi-structured interviews gathered information from health system actors. Workflow analysis illustrated how technology could change physician office workflow. Exam room observations illustrated how technology affects proxemics and haptics in the patient encounter. This research derived change management models which quantified substantial change management costs related to adoption of physician office systems. We found that physicians have concerns over how health information technology will affect efficiency, financial, quality, liability, safety and other factors. Physicians in smaller suburban physician offices take little time to select a system for their needs. Urban, academic and hospital physicians spend more time networking with colleagues and devote funds to project management and training. Our studies showed that stronger professional networks, more complete training, a managed approach to implementation and in-house technical support are more influential in facilitating adoption than remuneration models. Telemedicine can improve quality of care, the referral process for family physicians and access to services for patients. Teledermatology was shown to make significant improvements in access to services for patients, but referring physicians are concerned about their liability if they follow the recommendations of a dermatologist who has not seen their patient face-to-face. Certification organizations mitigate liability, procurement and financial risk to qualifying family physicians by pre-qualifying vendor solutions, coaching physicians through procurement and reimbursing family physicians for purchasing an approved system. We found that centralization plays a key role in adoption of health information systems at the jurisdictional and primary care level. Online scheduling can reduce human resource requirements used in scheduling, if the system is well implemented, well documented and easy to use. / Engineering Management