Abstract The 2009 American Recovery and Reinvestment Act has earmarked 27 billion dollars to promote the adoption of Health Information Technologies (HIT) in the US, and to gain access to these funds, providers must document “Meaningful Use” during the care process. While individual HIT use according to lean measures, including meaningful use, is prevalent in the IS literature, few studies have incorporated rich measures to account for the task, the technology, and the user in a team context. This dissertation conceptualizes Team Deep Structure Use of Computerized Provider Order Entry (CPOE) as an IT- enabled coordination mechanism, and Relational Coordination as the inherent ability of clinical teams to coordinate care spontaneously using informal, relationship based mechanisms. IT-enabled and Relational Coordination mechanisms are each evaluated across five maximally different patient conditions to simultaneously examine their impact on our outcome measure, Patient Satisfaction with the clinical care team. The extant literature has established a deep understanding of IT adoption shortly after implementation, yet the literature is silent on the antecedents of IT use according to rich measures well after the shake down phase, a period in which the majority of organizations operate. We incorporate the Adaptive Structuration Theory (AST) constructs of Faithfulness of Appropriation, and Consensus on Appropriation as the focal antecedents of Deep Structure Use of the clinical system by team members. To our knowledge, no prior research has linked these two AST constructs to clinical outcomes through the incorporation of a rich use mediator such as Deep Structure Use of a Health IT. To test our model, we relied on survey responses from 555 physicians, nurses and mid-levels which had cared for 261 patients across five patient conditions, ranging from vaginal birth, to organ transplant, as well as pneumonia, knee/hip replacement and cardiovascular surgery. Our results confirm that the Adaptive Structuration constructs of Faithfulness of Appropriation and Consensus on Appropriation, generate positive and statistically significant path coefficients predicting Team Deep Structure Use of CPOE. We also report differential effects on Patient Satisfaction with the care team resulting from technology use. Results range from a significant positive path coefficient (.285) associated with higher Team Deep Structure Use on combined Pneumonia and Organ Transplant teams, to a significant negative path coefficient (-.174) on cardiovascular surgery teams. As expected, Pneumonia, Organ Transplant and Cardiovascular Surgery teams all reported positive effects on Patient Satisfaction with the care team as a result of higher Relational Coordination scores. For teams caring for patient conditions consistently associated with a shorter length of stay, including vaginal birth and knee/hip replacement, higher reported use of IT- enabled, or Relational Coordination mechanisms, did not result in a significant increase in Patient Satisfaction. This dissertation contributes to the growing Health IT literature, and has practical implications for clinicians, hospital administrators and Health IT professionals. This dissertation is the first to operationalize a rich measure of use of an HIT by clinical teams, and to simultaneously measure the impact of IT enabled and Relational Coordination mechanisms on Patient Satisfaction. Secondly, through the introduction of Adaptive Structuration constructs, our model establishes a methodology for predicting rich, nuanced use in teams well after the initial shake down phase associated with recent HIT implementation. Through the juxtaposition of the impact of IT-enabled and Relational Coordination mechanisms across patient conditions, practitioners can design interventions and adjust the level of resources applied to process improvement accordingly.

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With the coming era of Internet and knowledge economy, the importance of IS/IT(information systems/information technology) to enterprises can not be overemphasized. However, if IS/IT couldn¡¦t be implemented successfully and brings its performance into full play, the effectiveness and usefulness of IS/IT are unmeaningful. The implementation of IS/IT in an organization is a complicated and dynamic process, which is effected by a variety of factors. For instance, technical factors, the psychological and behavior factors of users, even the cultural, political, economic, and institutional factors rest on the level of organization or environment may all cause the critical effects of implementing IS/IT. For the purpose of understanding the whole picture of IS/IT implementation process, this study integrates the perspective of contradiction/opposition into Structuration Theory and then proposes an interpretive framework, which can contribute to the interpretation of how and why the organization changes and develops. The framework can be used to identify the mechanism behind changing events and the context connected with them, therefore, we can adequately make sense of the complicated and dynamic social process of IS/IT implementation. By distinguishing the contradiction/opposition between structures of agents, between social structures, and between agent structure and social structure, the study interprets how and why agents respond to the enabling/constraint forces caused by structures. According to this, we can understand the unique structuration of IS/IT implementation process in an organization. For the application of the integrated framework, this study adopts qualitative research methodology and the framework for guidance to study an intensive case of ERP implementation. Through the data collection and analysis, this study identifies all of the contradiction/opposition between social entities, and the enabling/constraint social forces during the process of ERP implementation. The result reveals that the severe contradictions/oppositions between social entities caused the failure of the ERP project in Phase I. Entering the Phase II, in addition to the transformation of some structures of social entities, the new forming MIS structure exercised its political and expert power to make ERP system finally perform well. In Phase III, the case company went back to the previous stable status, because the ERP project ended and main project members withdrew. At the end of the paper, this study proposes some conclusions and suggestions for practitioners and academia, and also shows the limitation of the study.

Due to the fast development of IT, quick change of market demand and collaboration in business operation between companies, departments, and individuals, the concept of collaborative commerce has drawn much attention gradually. However, the tools of collaborative commerce used in the past, just like PDM and CPD, are merely used for control in a single stage; despite functions of data management and collaborative design are more capable of doing cross-function work. New PLM solutions can recover the disadvantages of past collaborative commerce tools in the new product development process, make the RD control link from spot to line, in order to control process effectively, establish operation standard, and accumulate experiences of new product design and manufacture. During the process of implementing IT, although not perfect in the beginning, enterprises will find the problems out only when users apply IT and find some problems which don¡¦t be found before implementing IT. It is just the purpose of enterprises to take advantage of implementing IT to review business processes. Technology and organization should make an adaptation in order to solve these problems and the key way to judge the IT to be successful or fail is to see whether IT and organization make a good adaptation. There are few successful cases applying PLM solution to support new product development process in Taiwan; moreover, manufacturing industry is the most representative of industries in Taiwan. For this reason, manufacturing enterprises which have implemented PLM solution and succeeded in closing the case are chosen for case studies, and based on adaptive structuration perspective to research the adaptation done by three structures of technology, organization, and task after PLM solutions are implemented into enterprises. Through this research to find that the adaptation degree is different in the interaction and appropriation between technology, organization, and task. Discrepancy events will also produced in the adaptation process. The key factors to decide whether enterprises take advantage of implementing IS to get advantage are the degree of solving discrepancy events by enterprises. In order to make enterprises get more competitive advantages through implementing PLM solution, the manager should realize more deeply that what changes are result from IT implemented in enterprises and what reason to make this change, so as to know well what advantages PLM solution make.

Le (Ga,Mn)As est un matériau de choix pour l'électronique de spin, étant à la fois semiconducteur et ferromagnétique, à la suite de l'interaction d'échange entre les spins des atomes de manganèse (3d5-4s2), et ceux des trous qu'ils apportent. Sa température de Curie (Tc) se situe typiquement entre 50 et 150 K.<br />Afin de découpler les dopages magnétique ([Mn]) et électrique (p), une technique de passivation par hydrogène a été développée, pour former des complexes (Mn,H) électriquement neutres. Ses effets magnétiques (apparition d'une phase paramagnétique), électriques (diminution de p) et structuraux sur la couche ont tout d'abord été étudiés. <br />Puis, des échantillons de dopage croissant ont été fabriqués grâce à ce procédé, pour des couches en tension ou en compression. Un bon accord avec les prévisions de la théorie de champ moyen a été obtenu pour l'évolution de leur anisotropie magnétique, et de leurs Tc en fonction de la contrainte épitaxiale, et de la densité de porteurs.<br />Une dernière étude s'est penchée sur les domaines magnétiques et les mécanismes de renversement d'aimantation de couches continues, puis de microstructures monodomaines aimantées perpendiculairement au plan. Un procédé de passivation locale par hydrogénation a été développé pour structurer magnétiquement des couches de (Ga,Mn)As (taille minimale des motifs ~ 200 nm). Il a entre autres permis d'abaisser fortement les champs de retournement d'aimantation de réseaux de plots microniques, par rapport à ceux obtenus dans des structures fabriquées par gravure. Enfin, des résultats préliminaires de déplacement de parois de domaines par un champ magnétique ou un courant polarisé ont été obtenus dans des pistes structurées par hydrogénation.

L'augmentation des contraintes de coût, délai et qualité, et de la complexité des projets rend de plus en plus difficile la visualisation, et donc la compréhension de ce qui se passe et de ce qu'il faut faire.<br />À partir d'informations incomplètes et peu sûres et sous une pression constante, il est difficile aujourd'hui de prendre des décisions fiables, notamment dans l'élaboration du projet, ce qui peut avoir de graves conséquences sur le succès du projet.<br />Le travail de recherche, appliqué chez PSA Peugeot-Citroën, a donné les résultats suivants :<br />Création d'un référentiel projet qui identifie les objets constituant un projet et son environnement, les interactions entre ces objets, à l'intérieur d'un projet ou entre projets ou entre projets et autres entités, et les caractéristiques internes de description de ces objets,<br />Description de trois opérateurs de base de l'élaboration de projet, qui contribuent à rationaliser les méthodes de conception de projet,<br />Intégration de ces informations et méthodes dans un support unique qui :<br />Formalise une information jusque là pas toujours disponible, sur les interactions que chacun a avec son environnement direct, et sur les caractéristiques décrivant la situation de chacun,<br />Structure cette information en un format standard, permettant une interactivité et une représentation graphique poussée tenant en un écran (1 A4),<br />Aide à la prise de décision; <br />par l'apport d'informations supplémentaires et plus fiables, <br />par l'apport de méthodologie pour le déroulement des processus de décision dans l'élaboration de projet, à savoir pour la décomposition, l'affectation et la gestion de l'état d'avancement. Cela fiabilise le processus de décision,<br />Met en relation des personnes et crée des échanges, voire des réseaux qui permettent d'étudier notamment des chaînes d'influence et de contribution, ce qui contribue à décloisonner les métiers et les supports de communication, du type organigramme des tâches ou planning,<br />Permet de mieux évaluer l'impact d'un changement ou d'une décision, par la visualisation des réactions en cascade initiées par les interactions identifiées,<br />Permet de partager les représentations et les perceptions des personnes, afin de profiter de la richesse qu'il y a à récupérer des autres.

The implementation of planned organizational change is ultimately a communication-related phenomenon, and as such, it is imperative that organizational communication scholars examine the interactions surrounding EHR implementation and understand how users (e.g. healthcare practitioners) utilize, evaluate, and deliberate this new technological innovation. Previous research on planned organizational change has called for researchers to adopt a more dynamic perspective that emphasizes the active agency of organizational members throughout implementation processes and focuses on informal implementers and change reinvention (work-arounds) as individuals actively reinterpret and personalize their work roles during implementation socialization. This dissertation seeks to fill this gap in research by demonstrating how communication between doctors, nurses, and other health professionals affects the adoption, maintenance, alternation, modification, or rejection of EHR systems within health care organizations. To delve into these inquiries and examine the intersecting domains of medical informatics and organizational communication research, this dissertation proceeds in the following manner: First, a literature review, capitalizing on Laurie Lewis’s work in planned organizational change and social constructionist views of technology use in organizations, outlines the assumptions that undergird this research. Next, this dissertation builds a model that predicts the communicative and structural antecedents of the study outcome variables, which include 1) organizational resistance to EHR implementation, 2) employees’ perception of EHR implementation success, 3) levels of change reinvention—or work-arounds—due to change initiatives and activities, and 4) employees’ perceptions of the quality of the organizational communication surrounding the change. Hypotheses guiding the model specification are provided and are followed by a description of the empirical methods and procedures that were utilized to explore the variable relationships. Results of the SEM model suggest that work-arounds could play a mediating role governing the relationship between informal social influence and the outcome variables in the study. In addition, one-way ANOVAs and multiple regression analyses reveal that physicians are the most resistant to EHR implementation and perceived change communication quality positively predicts perceived EHR implementation success and perceived relative advantage of EHR and negatively predicts employee resistance. A discussion of the expected and unexpected results is offered in addition to study limitation and future directions. / text

Results from archaeological survey provide new insights into the origins of variation among the prehistoric Native American societies that occupied the Chickasawhatchee Swamp of southwestern Georgia. Through macroregional comparison, these insights are broadly applicable to the Eastern Woodlands societies that existed across the southeastern U.S. between A.D. 150 and 1600. Theoretical frameworks concerning landscape ecology, inter-regional exchange, and agency and structure provide the organizing structure for a multi-scalar view of change that contradicts earlier models.Within the Chickasawhatchee Swamp, survey, mapping, and excavation data present a complex regional settlement system. Within the swamp, a few large settlements were occupied for the long-term, in spite of the absence of monumental architecture. Smaller surrounding sites were periodically abandoned. At the swamp's edge, several subregions were organized around civic-ceremonial mound sites. At these edges, mound sites and surrounding subregions were abandoned simultaneously. Instead of being driven by changes in political complexity, residential mobility cycles were consistent through time and related to the region's heterogeneous landscape.Macroregional spatial data comparing mound locations through time support data from the Chickasawhatchee Swamp and confirm hypotheses relating mound construction and transitional landscapes. New data emphasize continuity in inter-regional exchange networks and contradict earlier views in which the emergence of hierarchical political structures were a transformational process that fundamentally altered Eastern Woodlands political economies. Temporal continuity and spatial variation are instead most evident.

This thesis studies youth from different perspectives. These are the life phaseand the generational perspectives, which have been studied via questions of establishment and individualisation. The main question is whether young people are different because they have not made socially important transitions into adulthood or if they are different because they have grown up under different circumstances than earlier generations. The consequences of the outcome are important because they can indicate what kind of society young people will reproduce. The following conclusions are drawn: First, there are clear effects of social structurations (class of origin and gender) in the lives of young people. They affect the distribution of attitudes towards welfare state expenditures as well as the economic effects in a long-term perspective. Second, there is rather weak importance of role transitions in relation to what young people believe is important for adulthood, role transitions’ importance for the distribution of attitudes towards the welfare state as well as role transitions’ importance in a long-term perspective. Third, increasing age and subtle socialisation processes may be an explanation to the rather weak meaning of role transitions, cause adjustments to surrounding contexts and people’s expectations. It is concluded that the life phase perspective is a more accurate way of viewing young people, mainly because of the impact of social structurations, which are believed to contribute to continuous reproduction rather than complete change of society.

Les " gels attractifs " constituent une catégorie particulière de fluides complexes. Ces gels sont formés à partir d'une suspension de particules attractives en faible concentration volumique. La microstructure du gel est très facilement modifiée par l'application d'une contrainte. Ainsi, il est possible de structurer ces gels par un cisaillement dans une géométrie suffisamment confinée. Nous avons étudié en détail ce phénomène dans des gels de noirs de carbone ainsi que dans des suspensions de billes de verre dans de l'huile rendues attractives par la présence d'une faible quantité d'eau. Nous avons reproduit ce phénomène dans des simulations numériques de dynamique moléculaire, ce qui permet d'étudier les conditions nécessaires à l'apparition de telles structures. Enfin, en géométrie peu confinée, le mécanisme de rupture et d'écoulement de ces gels en volume est complexe puisque leur rupture est en perpétuelle compétition avec leurcinétique de reformation. Nous avons étudié la rupture des gels de noir de carbone en couplant des techniques classiques de rhéologie avec une technique de mesure locale de déplacement par ultrasons. Ces expériences nous ont permis d'établir un lien entre le comportement global du matériau (sa rhéologie macroscopique) et la dynamique locale de fluidification.