This thesis explores the potential of visual information and communication technologies (ICTs) for collaboration in emergency care. The thesis consists of four studies exploring future technology, 3D telepresence technology for medical consultation (3DMC), from several different methodological and analytical perspectives. Together the studies provide a broad view of the potential benefits, risks and implications of using visual technologies for collaboration in emergency care. The results show that paramedic-physician collaboration via 3DMC might have some benefits for patient care, both in the immediate patient care situation and beyond, for example, when coordinating transport and resources; improving understanding between different actors; and in developing paramedic competence and confidence in their skills. However, collaboration is heavily impacted by physicians’ and paramedics’ respective work practices which are situated in very different physical, professional and organizational contexts. Adding a visual dimension to this collaboration presents unique challenges for the overall design, development, implementation, and appropriation process. Thus, the thesis emphasizes the importance of understanding both the individual users as well as the complex overall image which, although often neglected or ignored, is crucial to understand when developing and introducing new technology that is successful and justified in the overall context while also being useful and meaningful for the individual users. / <p>Academic dissertation for the Degree of Doctor of Philosophy in Library and Information Science at the University of Gothenburg and the University of Borås to be publicly defended on Thursday 19 September 2013 at 13:15 in the auditorium at Simonsland, University of Borås, Skaraborgsvägen 3, Borås.</p>

Since the 1990 the use of Electronic Patient Records (EPR) in health services has become increasingly prevalent world wide. EPR has become an important aspect of the continuous improvement of patient care. Transferring all patient records from paper based to electronic is now a priority for many health services. The research reported in this thesis is sponsored by Hamad Medical Corporation (HMC) to provide opportunity to explore the potential role for EPR in the Medical Records Department. The study has been designed to gain better understanding of the users perspectives with regard to the use of patient records. In order to analyse and understand the complex dynamic involved in the management and use of patient records, it was recognised that systems thinking offered an appropriate framework for this research. Soft System Methodology (SSM) was therefore applied to the analysis of the data and used to inform the development of a conceptual model. Using SSM in combination with the structured questionnaire survey and telephone semi-structured interview, triangulation of methods was achieved. Use of these generated rich data revealing for example the general dissatisfaction expressed with the existing manual patient records system, the lack of confidentiality, poor legibility, shortage of space and the frequent misfiling of records. The need to address these problems has informed the strategic plan for the development and implementation of EPR for HMC. The research has successfully addressed the stated aims and research questions and guided the formulation of proposals for improvements.

Este trabalho apresenta os métodos consensuais como uma proposta para reduzir as insatisfações das pessoas envolvidas no processo de levantamento de requisitos e respeitar as dimensões humanas e sociais já no inicio do ciclo de vida de um sistema sociotécnico, considerando a aderência desses métodos às demais fases do ciclo de vida. / This text proposes the use of consensual methods to reduce people dissatisfaction in take part of requirement elicitation process and indentify, and respect, the human and social dimensions since the beginning of a sociotechnical system life cycle, evaluating the adhesion of these methods to the other phases of the lifecycle.

A tese apresenta o estudo de natureza exploratória do processo de produção partilhada de saberes e apropriação de dispositivo de informação desenvolvido com mestres e aprendizes da cultura de tradição oral. A travessia pelas -veredas da informação? neste território simbólico diferenciado foi delineada com base em três pilares: a) construção de trama conceitual, que contempla o desenvolvimento diacrônico dos processos mnemotécnicos, desde os primórdios até a contemporaneidade, demonstrando como determinados autores ao longo da história participam do jogo de forças sociais, disputando formas, possibilidades, arranjos e ordenamento do conhecimento; b) apresentação do contexto social de pesquisa e respectivo universo simbólico-cultural dos mestres Griôs da tradição oral, por meio de abordagem epistêmica que perpassa pelo reconhecimento ontológico das bibliotecas vivas; c) criação de rede sociotécnica para gestão de dispositivo, com base no conceito operacional de -produção partilhada de saberes? para solução de demandas por apropriação e circulação social de informações. A obra resulta de um diálogo na fronteira entre o legado das culturas de tradição oral e as novas tecnologias da escrita, em que experimentamos uma relação com o saber, voluntária e coletiva, da ciência como artesanato. A materialização da produção partilhada de saberes se deu no fazer prático (savoir-faire) por meio do qual os sujeitos do saber aprenderam a conhecer e a fazer juntos. Descreve o método empregado no processo de criação de um -dispositivo antropotécnico?, entendido como prótese virtual das bibliotecas vivas, lugar de memória, empoderamento e protagonismo social dos mestres e aprendizes da tradição oral, configurado de forma integrada e colaborativa, com abertura para a inovação social estratégica e as trocas simbólicas com os atores de outros pontos de cultura/memória, do Brasil e do mundo. / The thesis presents the exploratory study of the process of shared production of knowledge and appropriation of information device developed with masters and apprentices (teachers and learners) of the culture of oral tradition. The crossing of the -information paths? in this differentiated symbolic territory was based on three pillars: a) construction of a conceptual framework, which contemplates the diachronic development of mnemonic processes, from the earliest times to the present time, demonstrating how certain authors throughout (along) the history participate in the game of social forces, disputing forms, possibilities, arrangements and ordering of knowledge; b) presentation of the social context of research and the respective symbolic-cultural universe of the masters Griôs of oral tradition, through an epistemic approach that permeates the ontological recognition of living libraries; c) creation of a sociotechnical network for device management, based on the operational concept of -shared production of knowledge? to solve demands for appropriation and social circulation of information. The work results from a dialogue at the border between the legacy of cultures of oral tradition and the new technologies of writing, in which we experience a relationship with the voluntary and collective knowledge, of the science as craft. The materialization of the shared production of knowledge took place in the practical way (savoir-faire) through which the subjects of knowledge learned to know and to do together. Describes the method used in the process of creating an -anthropotechnical device?, understood as virtual prosthesis of living libraries, place of memory, empowerment and social protagonists, the masters and learners of oral tradition, configured in an integrated and collaborative\'s way, with openness to innovation social and symbolic exchanges with the actors of other points of culture / memory, of Brazil and of the world.

Este trabalho apresenta os métodos consensuais como uma proposta para reduzir as insatisfações das pessoas envolvidas no processo de levantamento de requisitos e respeitar as dimensões humanas e sociais já no inicio do ciclo de vida de um sistema sociotécnico, considerando a aderência desses métodos às demais fases do ciclo de vida. / This text proposes the use of consensual methods to reduce people dissatisfaction in take part of requirement elicitation process and indentify, and respect, the human and social dimensions since the beginning of a sociotechnical system life cycle, evaluating the adhesion of these methods to the other phases of the lifecycle.

Provisioning Internet services remains an area of concern for Internet service providers. Despite investments to improve resources and technology, the understanding of sociotechnical factors that influence the service-provisioning life cycle remains limited. The purpose of this case study was to evaluate the influence of sociotechnical factors associated with telecom service provisioning and to explore the critical success and failure factors, specifically in the telecommunication industry of Kuwait. Guided by sociotechnical systems theory, this qualitative exploratory case study approach examined a purposeful sample of 19 participants comprising of managers, engineers, and technicians who had the knowledge and experience of the service-provisioning life cycle. Semistructured interviews, project logs, and a self-created follow-up questionnaire were the primary sources of data. Thematic analysis techniques assisted in coding the data and developing themes, which resulted in a set of critical success and failure factors that influence the service-provisioning life cycle. Cross-functional communication, risk management practices, infrastructure availability, and employee skill development were among the emergent factors that influenced the service implementation. Internet service providers may use the results from this study to improve the service-provisioning life cycle. Successful implementations will promote an environment of positive social change that will increase employee motivation, productivity, and employee morale.

The purpose of research aid is to contribute to development in different ways through the use of research. Sarec (the Swedish Agency for Research Cooperation with Developing Countries) was one of the pioneers within state research aid, and existed between 1975 and 2008. This dissertation studies Sarec’s policy from a historical perspective with the help of official documents and interviews with former directors. Discourse theory together with concepts from Science and Technology Studies comprise the theoretical framework of the study. One of the central questions asked is how the view of the relationship between research and development has changed over time. One of the conclusions is that there are two main policy discourses that are established early on and that can be traced throughout the entire period studied. The two discourses share the starting point that modern science can contribute to development and that national research capacity is an important component in this. The localist discourse represents a more multifaceted view of how research can contribute to development, and what that development consist of. It is more explicitly anti-colonialist and to a greater degree prioritizes the local context as basis for decisions regarding support. The universalist discourse places less emphasis on where knowledge is produced since it can be used anywhere, as long as the right structures and priorities are in place. The discourses reflect different views of knowledge and development. Some decades one discourse dominates over the other, and other decades they are more equal. / Forskningsbistånd har som syfte att bidra till att forskning på olika sätt leder till utveckling. Sarec (the Swedish Agency for Research Cooperation with Developing Countries) var en av pionjärerna inom statligt forskningsbistånd och existerade mellan 1975 och 2008. I denna avhandling studeras Sarecs policy ur ett historiskt perspektiv med hjälp av offentliga dokument och intervjuer med före detta chefer. Diskursteori tillsammans med begrepp från teknik- och vetenskapsstudier utgör det teoretiska ramverket för studien. Frågor som ställs är till exempel hur synen på relationen mellan forskning och utveckling har förändrats över tid. En av slutsatserna är att det finns två stora policydiskurser som etableras tidigt och som går att följa under hela perioden. Båda innefattar en stark tro på modern vetenskap och dess möjlighet att bidra till utveckling, samt på att forskningskapacitet är en viktig komponent i detta. Den lokalistiska diskursen representerar en mer mångfacetterad syn på hur forskning kan bidra till utveckling samt vad denna utveckling är. Den är mer explicit antikolonialistisk i sin ansats och prioriterar i högre grad den lokala kontexten som grund för beslut kring stöd. Den universalistiska diskursen betonar att det spelar mindre roll var kunskapen produceras eftersom den kan nyttjas varsomhelst, bara rätt strukturer och prioriteringar finns på plats. Diskurserna speglar olika syn på kunskap och utveckling. Vissa årtionden dominerar en diskurs över den andra, och andra årtionden är de mer jämbördiga.

It is agreed that greenhouse gas (GHG) emissions from energy and transport systems must be reduced. Technical means exist to reduce GHG emissions from these sources. However, these emission-reduction measures are not implemented to a high enough degree. In this thesis, it is assumed that this is because the reduction of GHG emissions from energy and transport systems is a wicked problem. Unlike a tame problem, which has an unambiguous definition and a finite number of well-defined solutions, a wicked problem is difficult to define, and its solutions are often intertwined with the problem. The “wickedness” of a wicked problem lies in the extreme difficulty of solving the problem, rather than in the problem itself. In this thesis, the wicked problem of reducing GHG emissions from energy and transport systems is studied by applying a sociotechnical systems approach to the introduction of renewable vehicle fuels, the production and use of biogas, the introduction of electric vehicles, and the sustainability of district heating. In addition, this thesis discusses how energy issues are approached in different contexts, and what implications different actions can have on GHG emissions. The analysis shows that a sociotechnical approach to energy systems analysis can offer insights with regard to how system boundaries are handled within GHG-emission assessments and energy and transport policy. By problematising the use of system boundaries in GHG-emission assessments, this thesis explains how attempts to reduce GHG emissions could add to the wicked problem of GHGemission reductions from energy and transport systems. GHG-emission assessments can give very different results depending on system boundaries. While these results can be used in attempts to solve this wicked problem, they can also contribute to complicating it. As solutions to wicked problems are mainly found in policy, the use of system boundaries in policy is studied. Results show that narrow system boundaries in energy and transport policy can hamper sustainable development of energy and transport systems. The use of wider system boundaries could facilitate approaches to solve the wicked problem of reducing GHG emissions from energy and transport systems by making the consequences and effects of policy actions more clearly visible. / Det är välkänt att energi- och transportsystemens utsläpp av växthusgaser måste minska. Tekniska förutsättningar för att minska utsläppen av växthusgaser från användning av energi och transporter existerar. Ändå genomförs inte åtgärder för att minska utsläpp av växthusgaser i tillräcklig utsträckning. I föreliggande avhandling antas detta bero på att minskandet av utsläpp av växthusgaser från energi- och transportsystem är ett ’wicked problem’. Ett sådant problem är svårdefinierat och motståndskraftigt mot lösningar, eftersom lösningarna ofta är sammanflätade med problemet. I avhandlingen studeras frågan om hur utsläpp av växthusgaser från energi- och transportsystem kan minska. Introduktion av förnybara drivmedel, produktion och användning av biogas, introduktion av elbilar, samt hållbarhet i fjärrvärmesystem är områden som studeras med hjälp av ett sociotekniskt angreppssätt. Detta innebär att teknik studeras som en integrerad del av samhället, där teknik både påverkar och påverkas av aktörer och sociala strukturer. Analysen visar att ett sociotekniskt angreppssätt kan ge insikter om hur systemgränser hanteras inom energisystemforskning samt inom energi- och transportpolicy. Värderingar av växthusgasutsläpp, som utförs inom energisystemforskning, kan ge vitt skilda resultat beroende på hur det studerade systemet avgränsats. Resultaten kan användas i försök att minska utsläpp av växthusgaser från energi- och transportsystem, men detta kan leda till att problemet försvåras ytterligare. I avhandlingen förklaras detta genom problematisering av systemavgränsningar i värderingar av växthusgasutsläpp. Eftersom lösningar på ’wicked problems’ oftast återfinns inom policy, studeras även systemavgränsningar i policy. Det visas att snäva systemgränser inom energi- och transportpolicy kan hindra hållbar utveckling av energi- och transportsystem. Vidgade systemgränser skulle kunna underlätta ansatser att minska utsläpp av växthusgaser från energi och transportsystem genom att synliggöra konsekvenser och effekter av policyåtgärder.

This thesis problematizes the concept of usefulness, in part by taking questions to the extreme. The starting point is the contemporary view of usefulness, a view that remains within a traditional paradigm of technical rationality in which important aspects are disregarded or not perceived because they are not part of the equation. For scrutiny of technological usefulness that is a socially situated phenomenon regarding physical systems, neither interpretivist nor positivist research approaches are sufficient. Both views are required. Critical Realism supports such duality, facilitating the combination of elements from different paradigms, and provides methodological guidelines for doing this. The critical realist approach makes it possible to transcend the boundaries of technical rationality and contribute an alternative definition of usefulness that takes into account also the situated, the contextual, and the unpredictable. The aim is that this definition will contribute to a transformation of society. Concepts related to usefulness, such as predictability, controllability, effectiveness, and safety, are revisited, redefined, or complemented. Underlying aspects and mechanisms are explored and tensions identified, resulting in a theoretical contribution with models and frameworks explaining what is argued to be the true nature of usefulness. Potentiality is suggested as a complementary concept to effectiveness, similar to how resilience complements safety. Situated usefulness is then defined using these four concepts. The phenomenon known as situation awareness is scrutinized as well, and complemented by system awareness and the thesis title concept, edge awareness. Four cases, two airline crashes and two nuclear power plant events, and three future scenarios, constitute the empirical contribution. The analysis shows that the contributed frameworks and redefinition of usefulness facilitate different or extended explanations of all four events, and that future cases lack considerations of situated usefulness. Research implications center on the human role and our responsibilities in relation to the technology that we use, and on the meaning of concepts defining this role. We are situated human beings. Our role is to be involved and responsible, a role requiring awareness and controllability. The escalating ubiquity and the character of computerized technological systems make therefore the quest for edge awareness more important than ever.

Due to the digitalization era and challenges faced by the healthcare sector, Medical Information Systems are now being extensively used at hospitals. The implementation of the systems is a complex task which entails a need for careful considerations from a managerial view, since the main purpose with implementing the systems is for managerial control. One of the things management should consider is the professional aspect. The nursing profession is a highly specific one, and this could implicate special considerations. The aim of this master’s thesis is to take on a sociotechnical approach towards the implementation of Medical Information Systems and investigate how the nursing profession is affecting the implementation process, and what it may implicate for hospital management. To answer the research question a qualitative approach has been chosen. The empirical data has been gathered through semi-structured interviews with nurses from the case organization. The result implies that the nursing profession have a substantial impact on the implementation process. Instead of embracing the instructions and support offered by management, the nurses develop their own way of working within the system.