Evaluation of the Electronic Patient Record system acquisition process

Sähköiset potilastietojärjestelmät ovat yleistyneet Suomen perus- ja erikoisterveydenhuollossa viimeisen kymmenen vuoden aikana. Tietojärjestelmien käyttöönottojen myötä on julkisuuteen tullut myös paljon niihin liittyviä ongelmia. Tässä työssä arvioidaan Etelä-Pohjanmaan sairaanhoitopiirin SÄHKE-projektissa käytettyjä projektinhallintakäytäntöjä. Työssä pyritään löytämään projektihallintamenetelmien kehityskohteita, joilla pystyttäisiin välttämään vastaavanlaisissa projekteissa esiintyviä ongelmia ja kehittämään projektin menetelmiä parantamaan projektin seurattavuutta ja toimintatehokuutta. Työ jakautuu kolmeen osaan. Taustaselvitysosuudessa perehdytään ohjelmistoprojektien elinkaarimalleihin ja terveydenhuollon tietojärjestelmien kehitystä Suomessa esitellään lyhyesti. Seuraavassa osassa käydään läpi SÄHKE-projektin tapahtumat vuosina 2000-2009. Arviointiosuudessa verrataan SÄHKE-projektissa käytettyjä ohjelmistohankintakäytäntöjä CMMI-ACQ -ohjelmistohankintaprosessin arviointimallin prosessialueisiin. Arvioinnin tuloksena SÄHKE-projektin ohjelmistohankintamenetelmistä löytyi paljon kehitettävää. Tärkeimmäksi kehitysalueeksi tunnistettiin vaatimustenhallinta, koska se on perusta kaikille muille prosessialueille. SÄHKE-projektin tyyppisille projekteille suositeltiin vaatimushallinnan toimenpiteiden lisäksi elinkaarimallin määrittämistä, hankintasopimuksen ylläpitoa ja järjestelmällisemmän sekä tarkemman projektisuunnittelun ylläpitämistä. Tulokset ovat hyödynnettävissä vielä vuosia jatkuvissa sähköisten potilastietojärjestelmien käyttöönotoissa, järjestelmävaihdoissa ja muutoshankkeissa. /Kir10The use of electronic patient record systems (EPR) has been increased during the past ten years in Finnish heal care sector. Many problems related to the information system have been reported at the same time. This thesis evaluates project management processes of the SÄHKE-project in Etelä-Pohjanmaa hospital district. The goal is to find development areas of the project management processes to avoid similar problems in corresponding projects and to develop methods to improve project tracking and efficiency. The thesis is divided into three parts. In the background study part, life cycle models of the software projects are explored. Development of the information systems in Finnish health care is introduced briefly. The history of SÄHKE-project from the years 2000-2009 is presented in the next part. In the evaluation part, the software acquisition processes of SÄHKE-project are compared against the process areas of CMMI-ACQmodel. The evaluation indicates that many process areas of SÄHKE-project software acquisition could be improved. The most important section to develop was requirement management which is the basis for the rest of the process areas. The other recommended actions for the projects like SÄHKE were definition of the life cycle model, maintenance of supplier agreement and maintenance of precise project plan. The result of this evaluation can be utilized in on-going EPR implementations, system changes and development activities

Conditional cash transfers and social development in rural Brazil : social movements and structural change in the state of São Paulo

140 leaves ; 29 cm.Includes abstract.Includes bibliographical references (leaves 131-140).Recent policy initiatives in Brazil have been highlighted as a solution to overcoming high levels of inequality in the country and promoting inclusive development. The evidence has been apparent in the rapid reduction in poverty levels and growing middle-class. In the rural context, Brazil is initiating an ambitious food security framework complimentary to the attack on poverty, at the same time, supporting industrial agriculture for export. Historically, it is from this dual approach that social movements have arisen out of the need for agrarian reform. This thesis explores the role of rural social movements in transforming the agrarian structure in Brazil. Utilizing the state of Sao Paulo as a case study, the argument articulates the importance of social movements in undertaking agrarian reform and promoting pro-poor social policies. Field research was carried out in order to illustrate this dynamic as well as hear from the rural poor and policy-makers alike

The New Migration Law: Migrants, Refugees, and Citizens in an Anxious Age

Once every generation or so, entire fields of law require a full reset. We need to step back from the fray and rethink basic premises, ask new questions, and even recast the role of law itself. This moment has come for the law governing migration. Seasoned observers of immigration and refugee law have developed answers to core questions that emerged a generation ago. But now these observers often talk past each other, and their answers often fail to engage coherently with the daunting challenges posed by migration in this anxious age. To try to do better, I undertake four inquiries. In isolation they may seem familiar, but I combine them here in new ways to find a path forward. The first and second inquiries rethink approaches to immigration law that emerged in the twentieth century, but can be too narrow to answer today\u27s and tomorrow\u27s pressing questions. The third and fourth inquiries show how the new migration law should push past its traditional boundaries. By rethinking what migration law is, I offer a roadmap for understanding migrants, refugees, and citizens now and into the future

A Comparative Look at Entity Framework Code First

The motivation behind this project is to examine what “Entity Framework Code First” is bringing to the world of object relational mappers and data access and how it compares to the more traditional methods of the past. The problem is whether Entity Framework’s high level of abstraction from the database schema is useful to the developers in reducing code development or if traditional approaches with their robust, custom data layers provide developers with an overall better performance. To analyze Entity Framework, a real-world business web application was developed implementing an Entity Framework Code First approach to data access. Using this implementation of a business application, comparisons were drawn between Entity Framework and more traditional data access techniques. The results of the research conclude that while it does have some criticisms, Entity Framework is an improvement upon traditional approaches. It greatly reduces the time spent writing code for the application’s data access layer, makes managing database relationships and data objects easier, provides a level of abstraction to isolate the database from the developer’s application, and translates queries at runtime allowing minimal code impact with regards to database storage changes

Plantation Economy Model as Developed by Lloyd Best and Kari Polanyi Levitt: The Case of Jamaica

Lloyd Best and Kari Polanyi Levitt created the Theory of the Plantation Economy as an analytical tool for understanding the causes of underdevelopment in the Caribbean region. The theory provides a break from the classical understanding of developing economies as simply pre-industrialized societies. Instead, the theory tracks uneven development through analysis of metropole-hinterland relations, which account for the legacy of slavery, colonialism, and mercantilism on the structure of the global economy. In doing so, Plantation Theory is able to draw a clear link between underdevelopment in the hinterland and development in the metropole. Examining the usefulness of the Theory of Plantation Economy when applied to the Jamaican economy allows this paper to provide a comprehensive picture of Jamaica’s economic history. A picture which examines the unique structural legacy left by mercantilism and the ‘plantation system’ on economic agents and institutions. This paper examines issues associated with dependent export-led economies. It also tracks the movement of global capital and the transformation of the economic enterprise through the lens of the Jamaica economy

Developing a framework for education policy analysis : the case of the Western Cape's textbook procurement policy

Bibliography: pages 105-109.This study develops a conceptual framework for policy analysis and uses it as the basis for an analytical framework to describe the Western Cape's textbook procurement policy (WCTPP). The study starts by defining policy as a purposeful intervention with key attributes, these being: intention; action; practice; status; resources and capacity; and power. The conceptual framework attempts to answer the question, "Are there features which consistently characterise the policy-making process and do the factors which gave shape to policy consistently fall into particular categories?" The framework suggests factors which shape, locate and give rise to policy can be described in terms of contexts and frames which denote arenas within which policy can be constrained or enabled, politically and practically. The key contexts necessary for policy analysis are spatial and historical and the key frames are the frame of discourses of state, the resources/ capacity frame and the legislative/ regulatory frame. The key features characterising policy are that policy-making is characterised by fluidity and that policy is the expression of a balance or a compromise of interests. The framework is then used to develop an analytic framework for the WCTPP. The analysis attempts to answer the question, "What are the key features of this policy and what factors have shaped its emergence?" The analysis suggests that as the WCTPP was conceived, developed and translated into practice within the province, it has a coherence not always possible within an education system characterised by national/ provincial policy fragmentation. As a policy, it is shaped by the relatively well-resourced province from which it emerges. The analysis shows that resources and capacity are a factor at all the sites (department private sector suppliers and schools) involved in the state-private sector partnership that is exemplified in this policy. This policy is given form by the selective recruitment of divergent discourse of the state with two key discourses being manifest, these being that of a democratic, developmental state which sets parameters to and regulates the private sector, and a neo-liberal state, which supports free market forces. Through the legislative/regulatory frame the analysis also shows the inter-dependence of the WCTPP and other policies. The key features which characterise policy-making are portrayed as its on-going nature, and the fact that this policy represents a fragile balancing of competing interests. Educational interests harness commercial interests for educational ends. The analysis allows for a description of the policy that expresses both its functionality and its fragility. The study concludes that the framework developed provides for a dynamic iteration thus illustrating that policy analysis requires an understanding of how policy develops out of the interplay between the contexts, frames and features identified

Dissolving Nature/Nurture: Development as Coupled Interaction

For many, the Nature/Nurture approach to development is a quaint figment of the past. We have moved on, one might think; everyone thinks that both categories are important for development, not merely one. The reality, however, is not so simple. In this dissertation, I argue that contemporary biology has not succeeded in getting out from under the shadow of Nature/Nurture, despite everyone being some sort of interactionist about development. The central aim of my project is to offer a form of developmental interactionism worth having, which succeeds in shedding the pernicious aspects of Nature/Nurture. I begin by giving an overview of several candidate notions of interaction. One particularly promising notion is coupled interaction, where multiple variables co-determine each others\u27 products, and cannot be well understood in isolation. I follow this up by examining the Central Dogma of genetics, and argue that the evidence supports the Extended Genome Thesis – the notion that the genome partially extends beyond the body in a sense that is analogous to coupled interaction. I then extend the analysis to the inherited/acquired distinction and argue that the distinction is meaningless. Traits are not inherited wholesale; they must be constructed anew in ontogeny. This means there is not a principled difference between whether the trait is inherited or acquired. My project culminates with an argument that the Nature/Nurture distinction itself is incoherent, based on the available evidence. The world simply isn\u27t separable into distinct categories in the way Nature/Nurture implies; the reality tramples these conceptual boundaries. Neither category can do the work traditionally ascribed to it without its counterpart, and so those results should be understood as emerging from a coupled system. This system transcends the traditional internal/external divide, and so cannot be decomposed. Thus, Nature/Nurture is incoherent because there is no real difference between the components of one category and the components of another. Instead, the parts are coupled to form the ontogenetic (developmental) niche. To round out the project, I canvas some areas of science that I think are worth keeping a close eye on, given their capacity to enhance or harm the way understand development

A Structured Systemic Framework for Software Development

The purpose of this research was to develop and apply a systems-based framework for the analysis of software development project performance. Software development project performance is measured at the project level; that is, cost, schedule, and product quality that affect the overall project. To date, most performance improvement efforts have been focused on individual processes within the overall software development system. Making improvements to sub-elements, processes, or sub-systems without regard for the overall project is a classic misbehavior entered into by practitioners who fail to use a holistic, systemic approach. Attempts to improve sub-system behavior are at odds with The Principle of Sub-optimization. (van Gigch, 1974) The traditional method of predicting software development project performance, in terms of sub-system performance is too restrictive. A new holistic, systemic view based on systems principles offers a more robust way to look at performance. This research addressed this gap in the systems and software body of knowledge by developing a generalizable and transportable framework for software project performance that is based on systems principles. A rigorous mixed-method research methodology, employing both inductive and case study methods, was used to develop and validate the framework. Two research questions were identified as integral to increasing the understanding of a systems-based framework. (1) How does systems theory apply to the analysis of software development project performance? (2) What results from the application of a systems-based analysis framework for analyzing performance on a software development project? Using Discoverers\u27 Induction (Whewell, 1858), a systems-based framework for the analysis of software development project performance was constructed, adding to the systems and software body of knowledge and substantiating a comprehensive and unambiguous theoretical construct for software development. Then, the framework was applied to two completed software development projects to support validation. The structured systemic framework shows significant promise for contribution to software practitioners by indicating future software development project performance. The research also made a contribution in the area of research methodologies by resurrecting William Whewell\u27s Discoverers\u27 Induction (1858) and furthering the use of the case study method in the engineering management and systems engineering domain, areas where their application has been very limited

Korean bank regulation and supervision: crisis and reform (a critical evaluation with recommendations).

PhDThis thesis presents a critical analysis and evaluation of the current Korean banking regulatory and supervisory system. The objective is to identif' continuing structural weaknesses of the Korean banking system and to suggest areas of regulatory and supervisory system reform. The focus of this analysis and evaluation is centred around the following three questions: (1) Who should be the regulator? (2) What substantive standards of supervision should be applied? and (3) Administratively, in what manner should these standarus be applied? Finally, the causes, responses, and implications for reform as to the recent Korean financial crisis are discussed. The Korean banking system has been characterised as a "governmental control system" for credit allocation. This system, with lax prudential regulation and supervision, creates inevitable problems for the banks. For example, Korean banks have been largely precluded from true market and commercially oriented practices and have been exposed to significant credit and other risks due to governmental policy directed lending and other non-commercially induced banking practices. The main theme of this thesis is that Korea's reformed and restructured regulatory and supervisory system should be structurally removed from undue governmental and political interference; that is, should be sufficiently divorced and protected from governmental economic policy objectives and, more generally, from objectives that are inconsistent with "safety and soundness" based banking regulatory and supervisory objectives and with market oriented practices. Balancing this structural independence and market orientation, a reformed and restructured system should provide a high degree of transparency and accountability. Reform should aim not only at establishing effective supervisory standards, but also at ensuring effective monitoring and enforcement. A first step to the reform is for the government to define and adhere to a primary policy objective of banking policy, i.e. "financial stability" through sound and effective Korean banking regulation and supervision. To achieve such financial stability, Korea will need to implement appropriate measures that can ensure that the banking system is "safe and sound", consistently with evolving international standards; that banks are free from undue governmental and political interference and control; and that the banking system operates within a competitive and commercially driven market environment. The financial crisis in 1997 has demonstrated many of the current weaknesses of the Korean financial system. The need for certainty of process, for a clear, realistic and transparent timetable for restructuring, and for an effective exit policy for troubled commercial banks, are some of the lessons to be learned from this crisis