Seven HCI Grand Challenges

This article aims to investigate the Grand Challenges which arise in the current and emerging landscape of rapid technological evolution towards more intelligent interactive technologies, coupled with increased and widened societal needs, as well as individual and collective expectations that HCI, as a discipline, is called upon to address. A perspective oriented to humane and social values is adopted, formulating the challenges in terms of the impact of emerging intelligent interactive technologies on human life both at the individual and societal levels. Seven Grand Challenges are identified and presented in this article: Human-Technology Symbiosis; Human-Environment Interactions; Ethics, Privacy and Security; Well-being, Health and Eudaimonia; Accessibility and Universal Access; Learning and Creativity; and Social Organization and Democracy. Although not exhaustive, they summarize the views and research priorities of an international interdisciplinary group of experts, reflecting different scientific perspectives, methodological approaches and application domains. Each identified Grand Challenge is analyzed in terms of: concept and problem definition; main research issues involved and state of the art; and associated emerging requirements

Holistic System Design for Distributed National eHealth Services

publishedVersio

Value-adding Activities of Operational Risk Management Methodologies: A South African Perspective

Operational risk management forms a crucial part of management and since the early 1990s this practice has escalated rapidly due to various reasons, such as an increase in the regulatory requirements and risk-related incidents. For example, the requirements of the Public Finance Management Act 1 of 1999 and the Municipal Finance Management Act 56 of 2003, which require institutions to implement and maintain effective, efficient and transparent systems of risk management and control. Incidents, such as the fall of the VBS Mutual Bank, also indicated problems with adequate operational risk management. The development and implementation of operational risk management methodologies could add value to the management of operational risk exposures and adhere to specific regulatory requirements. However, it seems that operational risk methodologies are currently only used for compliance and not used appropriately. This article investigates the value-adding activities of risk methodologies which can contribute to ensure an effective operational risk management. These activities are empirically confirmed by means of a survey which also identified a gap between the envisaged value and its current implementation by organisations. It is foreseen that this research could support the enhancement of the operational risk management methodologies to improve the operational risk management of private and public organisations.Finance, Risk Management and Bankin

SOTL in the South

Abstract: Please refer to full text to view abstract

Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa

Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention.Thesis (PhD) -- Faculty of Health Sciences, 202

Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa

Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention.Thesis (PhD) -- Faculty of Health Sciences, 202

Leading Towards Voice and Innovation: The Role of Psychological Contract

Background: Empirical evidence generally suggests that psychological contract breach (PCB) leads to negative outcomes. However, some literature argues that, occasionally, PCB leads to positive outcomes. Aim: To empirically determine when these positive outcomes occur, focusing on the role of psychological contract (PC) and leadership style (LS), and outcomes such as employ voice (EV) and innovative work behaviour (IWB). Method: A cross-sectional survey design was adopted, using reputable questionnaires on PC, PCB, EV, IWB, and leadership styles. Correlation analyses were used to test direct links within the model, while regression analyses were used to test for the moderation effects. Results: Data with acceptable psychometric properties were collected from 11 organisations (N=620). The results revealed that PCB does not lead to substantial changes in IWB. PCB correlated positively with prohibitive EV, but did not influence promotive EV, which was a significant driver of IWB. Leadership styles were weak predictors of EV and IWB, and LS only partially moderated the PCB-EV relationship. Conclusion: PCB did not lead to positive outcomes. Neither did LS influencing the relationships between PCB and EV or IWB. Further, LS only partially influenced the relationships between variables, and not in a manner which positively influence IWB

Assuming Data Integrity and Empirical Evidence to The Contrary

Background: Not all respondents to surveys apply their minds or understand the posed questions, and as such provide answers which lack coherence, and this threatens the integrity of the research. Casual inspection and limited research of the 10-item Big Five Inventory (BFI-10), included in the dataset of the World Values Survey (WVS), suggested that random responses may be common. Objective: To specify the percentage of cases in the BRI-10 which include incoherent or contradictory responses and to test the extent to which the removal of these cases will improve the quality of the dataset. Method: The WVS data on the BFI-10, measuring the Big Five Personality (B5P), in South Africa (N=3 531), was used. Incoherent or contradictory responses were removed. Then the cases from the cleaned-up dataset were analysed for their theoretical validity. Results: Only 1 612 (45.7%) cases were identified as not including incoherent or contradictory responses. The cleaned-up data did not mirror the B5P- structure, as was envisaged. The test for common method bias was negative. Conclusion: In most cases the responses were incoherent. Cleaning up the data did not improve the psychometric properties of the BFI-10. This raises concerns about the quality of the WVS data, the BFI-10, and the universality of B5P-theory. Given these results, it would be unwise to use the BFI-10 in South Africa. Researchers are alerted to do a proper assessment of the psychometric properties of instruments before they use it, particularly in a cross-cultural setting

Representing and Redefining Specialised Knowledge: Medical Discourse

This volume brings together five selected papers on medical discourse which show how specialised medical corpora provide a framework that helps those engaging with medical discourse to determine how the everyday and the specialised combine to shape the discourse of medical professionals and non-medical communities in relation to both long and short-term factors. The papers contribute, in an exemplary way, to illustrating the shifting boundaries in today’s society between the two major poles making up the medical discourse cline: healthcare discourse at the one end, which records the demand for personalised therapies and individual medical services; and clinical discourse the other, which documents research into society’s collective medical needs

A comparative analysis of financial management practices at a district level in South Africa

A Thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy. Johannesburg, 2017.Background: Effective financial management is required across developed and developing countries which face the dilemma of curbing health expenditure yet ensuring the delivery of quality health services. The health system in South Africa (SA) is no exception, and is described as facing a number of challenges ranging from service delivery to budgetary issues. Prior literature indicates that decentralisation in the country has been marred with numerous financial management challenges associated with health districts e.g. insufficient control/ authority delegated to the districts and a lack of skilled staff. Much literature has documented difficulties related to decentralised financial management both in SA and globally, yet these challenges continue to persist. The primary aim of this study is to provide a comparative analysis of financial management realities between two districts in province x of SA. It differs to previous studies, in that it has examined financial management through an organisational approach, drawing on a multitude of theoretical underpinnings including the sociocultural perspective, structures (rules, resources enacted through routines) and agency – actions of individuals (staff) going against and manoeuvring constraints. The organisational perspective extends to understanding hardware which refers to tangible aspects in the health system e.g. information technology (IT) or resources and software elements such as communication or interrelationships. The study draws out actual financial management routines linked to key processes (planning, resource allocation and budgeting and evaluation) as well as its associated challenges and successes at a district level. Finally, the thesis has set out to address gaps in decentralisation literature, by considering contextual influences such as history, politics and centralised bodies, particularly the Provincial Department of Health (PDoH). Methods: A qualitative research approach including a multiple case-study design was used. Primary data collection commenced in March 2014 and was completed in April 2015. A total of 58 participants were included in the study. Purposive sampling techniques were useful in identifying key participants involved in financial management at a district level. Key respondents at a sub-district and provincial level (PDoH) linked to district financial management, other support functions and external stakeholders from Non-Governmental Organisations (NGOs) were included. An in-depth interview was carried out with each participant and follow-up interviews were done when necessary. This was followed by non-participant and participant observations being conducted in each study site, which allowed for data triangulation. Ethical approval was granted by the relevant university, provincial and district boards. Rigorous thematic content analysis was carried out. Findings: The study begins by describing and providing a brief overview of key financial processes carried out in each district, for example District Health Planning (DHP) or the District Health Expenditure Review (DHER). Essentially these were the everyday routinised tasks or realities examined. In both districts, namely Indawo and Isikhala, weaknesses included expenditure tracking difficulties or financial management challenges such as payment delays or difficulties linked to centralised processes carried out by PDoH. Despite similarities, there were notable differences in the way most of these processes were carried out. For example in Indawo, poor planning and budget motivation processes as well as a ‘culture of compliance’ to meet prescribed processes were reported. In Isikhala, there was better coordination, oversight and engagement of these tasks e.g. province considering the district’s annual budget motivation to be one of the best. However, the findings reveal that even though prescribed financial tasks are carried out, effective financial management was still not achieved in both districts –difficulties with expenditure tracking. Procurement procedures require approval based on availability of financial resources; however requests were approved in both districts irrespective of budget availability. The thesis then shifted a step further to understanding these realities, particularly why dysfunctional routines such as poor planning or compliance to tasks persist and where the mechanisms for improvement/ strengthening lie. Findings revealed why the two districts differ in relation to carrying out these tasks. Structuration theory developed by Giddens (1984) considers the relationship between structure and agency in society (defined above). This thesis further expanded structuration theory to the notion of a structuration nexus–consisting of four key components of financial management, namely; structure, agency, hardware and software. The theory argues that in this case structure (rules and resources) similar to hardware are enacted through routine financial tasks necessary to shape human behaviour and organisational functioning. However, poorly coordinated routines were reported to exist and constantly enforced in system, especially in the case of Indawo. Agency within the nexus refers to individual actors and their actions to either reinforce such practices or transform them i.e. question, change and implement effective financial management. Health system concepts which refer to resources or equipment, such as IT / hardware elements were found to affect routines from being effectively carried out in both districts. While software, particularly communication including teamwork, motivation and personal development, was found to propel agency to deal with constraints, find solutions and shift some of the dysfunctional financial practices reported in Isikhala. Findings further revealed strategies for nurturing software, particularly informal learning through strategies such as delegation in Isikhala finance unit. However, while weaknesses and successes were noted in districts, they were inherently linked to the centralised level. Provincial participants provided insight into the rationale for centralisation of some financial functions. One of the primary reasons cited was the lack of district capacity and high levels of over expenditure in the province x making centralisation of some functions a perceived necessity. Although benefits of centralisation and expected gains were not realised as the central level itself was reported to have several weaknesses such as a loss of institutional memory (loss of skills in post-apartheid SA) or poor communication between units (software). Agency and system change at both levels were further compounded by political factors, post-apartheid restructuring and trade unionism which also affected routinised finance practices in both districts – poorly performing staff not being held accountable of political influences over vendor selection which increased financial costs. Conclusion and Recommendations: The country’s National Health Insurance (NHI) policy re-emphasises the importance of decentralisation and effective financial management. However, the NHI policy offers few recommendations or details around actually strengthening this core district function. This thesis offers a comprehensive account of district financial management and strategies for its improvement particularly linked to its adopted organisational perspectives and nurturing software factors (teamwork, communication, better relationships). The study moves beyond describing challenges associated with key financial routines, to offering a novel understanding in the SA context around why these practices exist and what are the factors necessary to transform practices which do not render effective financial management. Findings reveal that the four crucial elements of the structuration nexus (hardware, software, structure and agency) are particularly important in shaping financial management. It further argues and shows that these elements, if present, can contribute to organisational functioning within the health system, yet these elements are not necessarily considered during policy processes. Findings from the Isikhala finance unit points to specific practical strategies to nurture software in organisations - informal learning and delegation strategies linked to staff motivation and development. Lastly, financial management offered a lens to understanding decentralisation processes, specifically cognisant of its interlinkages and interdependent to functioning centralised levels and the complexities associated with contextual factors (history/ apartheid). Racial redress through key policies and legislation are undoubtedly important in addressing SA’s past injustices, however has further complicated the decentralisation process, compounded by the role of politics and trade unionism which also need consideration. In essence, this thesis has shown what elements are necessary and need to be nurtured not just for financial management but for health systems functioning. Key words: Decentralisation, District Financial Management, South AfricaLG201