1,577 research outputs found

    Patient portals: Development and outcomes in integrated and fragmented health systems

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    Patient portals: Development and outcomes in integrated and fragmented health systems

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    Regional Governance, Institutions and Development

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    Across the world, the regional level is becoming increasingly important in economic development with a proliferation of regionally based initiatives. This has important consequences for how institutional capacity is able to take and influence decisions with regard to the long-term future development of particular localities: in short the patterns of regional governance. This book focuses on two relevant aspects: (i) the question of governance - how does the ongoing process of institution-building affect the ways in which the regions and localities are governed, including questions of democracy, participation, regional self-determination, public-private partnerships and accountability; and (ii) what are the consequences of new modes of governance and institutional change for regional development strategies and policies, particularly in the context of large-scale industrial restructuring and city-region and urban regeneration.https://researchrepository.wvu.edu/rri-web-book/1029/thumbnail.jp

    Perceptions of power in the contemporary american novel

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    Tese (doutorado) - Universidade Federal de Santa Catarina, Florianópolis, 1996.Este estudo tenta delinear como o poder - tanto institutional quanto representacional - é percebido na ficção norte-americana do período pós-guerra até o presente. O trabalho examina romancistas representativos e analisa uma série de trabalhos individuais dentro de seu conteúdo histórico. Na primeira parte, teorias sócio-políticas sobre o poder fornecem o suporte teórico para detectar como o poder é visto nos romances. A segunda parte discute o romance político pós-guerra, Gore Vidal e Norman Mailer, entre outros. Constata-se que uma percepção de poder Weberiana (adversarial) de poder por parte dos romancistas da segunda parte é substuída por uma visão Foucaltiana (poder insidiosamente filtrado) por parte dos romancistas da terceira parte, o que corresponde a transformação da sociedade contemporânea, sua política e cultura no capitalismo multinacional, durante e depois dos anos 60

    Local governance and economic development: re-figuring state regulation in the Scottish Highlands

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    This thesis examines the politics of local, governance in the Scottish Highlands, taking the Highlands and Islands Enterprise (HIE) network - made up of a central core and 10 Local Enterprise Companies (LECs) - as its institutional focus. It synthesises regulationist approaches and neo-Marxist state theory to explain LECs as part of a broader process of re-regulation under consecutive Conservative governments. LECs are unelected, business-led agencies operating at the local level. The political discourse through which LECs were established and promoted created expectations of local autonomy among business representatives that clashed with the centralising tendencies of Thatcherism. The thesis examines how the resultant tension between local initiative and central control has been worked out within the HIE network. It relies on data collected from seventy semi-structured interviews with representatives of HIE, LECs, local authorities, businesses and community groups. The initial chapters introduce the research and consider key methodological issues, set out the theoretical framework, and review the practices of the Highlands and Islands Development Board (HIDB, HIE's successor). The thesis then explores the key tension between local initiative and central control, explaining how it has been mediated and resolved through routine institutional practices. It also examines HIE-LECs relations with other key agencies, notably local authorities, through selected examples of multi-agency partnerships and assesses LECs' local accountability and representativeness. Finally, a concluding chapter sets out the main findings and considers their implications. While key managerial 'technologies' such as targeting, audit and financial controls allow central government to monitor and steer the HIE network, the thesis argues that the authoritative resources of the HIE core - grounded in the combination of local knowledge and technical expertise inherited from the HIDB - enables it to adapt key aspects of the operating regime to its own purposes. Local autonomy is limited by the relative centralisation of the Network, and LECs operate in a system of structured flexibility in which their scope to adapt policy to local conditions is constrained by state rules and procedures. In emphasising that local autonomy is limited by hierarchical mechanisms of control, the thesis argues that local governance in the Scottish Highlands continues to be underpinned by government. It also points to the limits of the regulation approach and neo-Marxist state theory as theoretical perspectives, suggesting that neo-Foucauldian writings on govemmentality are useful in providing stronger analytical purchase on the specific mechanisms and procedures through which state regulation is practised

    Can relational coordination help inter-organizational networks overcome challenges to coordination in patient portals?

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    Purpose: Delivering comprehensive patient portals in fragmented delivery systems depends on coordination among a network of healthcare organizations. Inter-organizational coordination is fraught with challenges, mainly due to a lack of organizational, technological, and geographical proximity between network participants. This paper assesses the extent to which application of Relational Coordination Theory (RCT) can ameliorate these challenges. Approach: We conducted a conceptual analysis of the usefulness of RCT and the applicability of the Relational Model of Organizational Change to patient portal networks. Findings: Relational coordination can mitigate challenges caused by lack of organizational and technological proximity among participants in a patient portal network. The Relational Model of Organizational Change is useful to improve relational coordination. However, some organization redesign interventions proposed in the Model may not be directly applicable to patient portal networks due to lack of geographical proximity among network participants. Conclusion: We suggest three propositions regarding the relationships among relational coordination, organizational and technological proximity, and cost of coordination in an inter-organizational portal network. If future research provides empirical support for these propositions and identifies appropriate adaptations of the Relational Model of Organizational Change for inter-organizational contexts, portal network leaders should strive to strengthen relational coordination in their networks

    AN EXAMINATION OF VALUE ENHANCING ENTERPRISE RISK MANAGEMENT IMPLEMENTATION FRAMEWORK FOR MALAYSIAN PUBLIC LISTED COMPANIES

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    Enterprise risk management or ERM is fast ascending the corporate agenda globally. Its relevancy and popularity as a management technique are abetted by the changing business practices and burgeoning regulatory requirements on risk management. ERM is defined as the process of identifying and analyzing risk from an integrated, company-wide perspective in a structured and disciplined approach in aligmng strategy, processes, people, technology and knowledge with a purpose of evaluating and managing the uncertainties facing the enterprise as it creates value. ERM essentially lays concern for managing the firm's specific risk apart from the systematic risks. However, the neo-classical finance theory (NCFT) postulates that managing firm-specific risk is irrelevant. Nonetheless, this notion is in stark contrast to the phenomenon of increased acceptance of ERM by industry practitioners. As such, this thesis attempts to propose an ERM implementation framework to theorize a model that captures the causal relationships of the risks that are strategically associated with the firms' business performance and the cost of capital, e.g. risk premium. This thesis highlights the notion of managing firms' unsystematic (specific) risk via an ERM implementation framework that leads to the enhancement of shareholders' value. The mechanism through which the firms' value enhancement takes place is theorized by a strategic conceptualization of risk premium model. The model cites managing the firm's three classes of unsystematic risk, namely tactical risk, strategic risk, and normative risk. The specific aims of this thesis are fourfold: (i) to examine the depth of penetration of ERM practices among the public listed companies in Malaysia; (ii) to examine how an effective impiementation process of ERM will bring about value-enhancing outcome to Malaysia public listed companies (PLCs); (iii) to analyze the value proposition hypotheses of corporate risk management as the determinants for ERM practices; and (iv) to investigate the validity of the theorized value creation transmission mechanism of the proposed ERM framework via the strategic conceptualization of risk premium model. The data is collected through questionnaires survey from 128 PLCs on the Malaysian stock exchange. Variables in the questionnaire are measured in 5-point Likert's scale. The analyses encompass factor analysis and structural equation modeling (SEM). Outcomes of the factor analysis provide inputs (the measurement model) for the SEM analysis. The SEM validates the theorized causal relationships among the three constructs, i.e. ERM implementation challenge, ERM implementation intensity, andperceivedERM benefitmeasures: The modified model incorporates a second-order factor model which presents improved overall goodness-of-fit values than the proposed model. Apart from that, the analytic also comprises bivariate correlation analysis of hypotheses testing in relation to the various aspects of: (i) the value maximization theory of ERM practices; and (ii) the value creation transmission mechanism of the proposed ERM implementation framework. The analysis results conclude the following: (i) that all causal relationships (structural model) under SEM examination indicate significant parameters; (ii) that ERM implementation has significant positive associations with value maximization theories of risk management; (iii) that ERM implementation has significant positive effects in reducing the firm's tactical and strategic risks with the consequence of lowering the firm's risk premium

    The Economics of Corrections: An Exposition

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    The purpose of this dissertation is to present an exposition of the applications of economics to corrections. The approach includes a synthesis of knowledge in the area, suggestions on how economics might be further brought to bear on correctional issues, and recommendations for future research. The overall framework is one of policy analysis, in which objective, scientifically-based information is used in the action setting of public programs. A review of the history of corrections is included to provide an appreciation for the multiple, conflicting goals under which corrections functions today. A review of the state-of-the-art in corrections provides a sense of the magnitude of the populations, activities, and expenditures which characterize this component of the criminal justice system. The role and contributions of cost, comparative cost, cost-effectiveness, and cost-benefit analysis are extensively surveyed, illustrating the substantial existing knowledge of correctional inputs and the lesser state of output measures and valuation. Economic research on institutions (prisons and jails) is reviewed and critiqued. Preliminary findings on correctional cost functions, the nature of marginal and average costs for state and federal institutions are reviewed and policy recommendations discussed. Prison industries are discussed in the context of opportunity costs, human resource accounting, and the need for goal specification prior to further analysis. Corrections in the community is analyzed from an economic perspective; private sector service providers, subsidy programs, and offender restitution, fees, and financial aid are reviewed from both the viewpoint of current research findings and the potential for additional economic research. Contributions and recommendations are examined for their feasibility in a policy setting and suggestions are offered to improve future research and widen the application of economics to corrections

    Wild but wired? The construction of society and technology in rural Strathclyde.

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    This study critically examines the co-construction of society and technology in rural Strathclyde during the late 1990s. A range of uses of information and communications technology (ICT) - spanning employment, community development and education – is accounted for, in a variety of highly localised settings on the islands of Arran, Islay and Jura and the Kintyre peninsula. Explanation is offered as to why certain outcomes have been arrived at. The reflexive relationship between technology and society is then highlighted, as it is shown that the challenge of introducing ICT to the region has affected change in local governance structures, catalysing new partnerships while challenging existing power relations. Building upon recent work in rural studies relating to the post-productivist countryside, theories derived from the sociology of science (specifically Social Construction of Technology and Actor Network Theory approaches) are employed in an attempt to heighten understanding of local sensitivity to 'globalising' technologies. A qualitative methodology is employed, consisting of depth interviews conducted with leading local actors throughout 1997 and 1998. The narratives give insight into these actors' beliefs and motivation as they have attempted to guide the innovation, diffusion and application of ICT in the region. Critical insight is sought as to how their frequently conflicting understanding of rural needs acts as a constraint upon the contingency of technical development locally, prompting certain courses of action to be favoured above others. The study draws more generally upon the experiences of rural Strathclyde to build a model of local sensitivity to technical change in the countryside. It is argued that the power to act rests in many hands and that those local actors who possess the necessary skills and resources to act as 'conduits' - linking local and 'global' circuits of production and consumption - do not always behave in ways that optimise local outcomes. Only under certain conditions can the effective deployment of ICT enable 'powerful' localities to act competitively 'at a distance' in seeking new trade and investment. It is argued that failure to appreciate the diversity of possible local responses to the provision of ICT has sometimes left policy-makers with exaggerated expectations for technically driven rural restructuring
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