Core capabilities of Chinese community health service centers: a dynamic capabilities approach

With China's population aging, rapid urbanization and social transformation, people's demand for multi-level and diversified medical services is growing rapidly. Insufficient allocation of CHSC medical resource and medical service lower capability still exist. Patients lack confidence in the medical service of CHSC. The service quality of community health service directly affects the accessibility, timeliness and effectiveness of residents' health management. It is necessary to strengthening the core capability building and improve the service efficiency of CHSC. Core capability by referring to relevant literatures and combined with expert correspondence of Delphi method. We constructed the index evaluation system of CHSC core capability with 5 first level indicators, 14 secondary indicators and 60 tertiary measurable items. This study selected 64 CHSCs in the main urban area of Shenyang city as the research object. Data were collected through questionnaires and interviews. A total of 1895 valid questionnaires were collected. The structural equation model was established by AMOS software. Several conclusions are achieved as follows: 1) the results of empirical research verify the rationality of the research model constructed in this study; 2) dynamic capability is the key influencing factor of the core capability of community health service center, and other affecting factors include management capability, service capability, organizational culture and organizational resources; 3) exploratory innovation in dynamic capability, strategic orientation in organizational culture, external electronic system integration in management capability and the training expenses spent to improve the quality and capability of employees are closely related to the core capability of community health service centers. The research results of this study are to construct the core capability index system of CHSC, to provide a basis for the standardized evaluation of CHSC service capability by health administrative governments.Com o envelhecimento da população da China, a urbanização rápida e a transformação social, a procura das pessoas por serviços médicos diversificados cresceu rapidamente. A alocação de recursos médicos aos Centros de Saúde Comunitários (CSC) é insuficiente, o problema da fraca qualidade de serviço médico persiste e os pacientes não confiam no nível médico dos centros de saúde da comunidade. A qualidade do serviço comunitário de saúde afeta diretamente a acessibilidade, a oportunidade e a eficácia da gestão da saúde dos residentes. Torna-se necessário reforçar a construção do núcleo de competência do CHSC e melhorar a eficiência dos serviços dos CSC. Este estudo analisa a literatura relevante no país e no estrangeiro, e a aplicação do método de Delphi identificou cinco indicadores primários, 14 dimensões secundárias e 60 itens mensuráveis para a construção do sistema de avaliação do índice de competência central dos CHSC. Este estudo selecionou 64 CHSC em Shenyang como objeto de pesquisa, e recolheu um total de 1895 questionários válidos, e aplicou o modelo de equações estruturais utilizando o software AMOS. Do estudo realizado retiramos algumas conclusões: 1) os resultados da pesquisa empírica confirmam a racionalidade do modelo que utilizamos; 2) a habilidade dinâmica é o fator que mais influencia as capacidades fulcrais dos centros comunitários de saúde, os outros fatores são a capacidade de gestão, a capacidade de serviço, a cultura organizacional e os recursos organizacionais; 3) a inovação exploratória na habilidade dinâmica, a orientação estratégica na cultura organizacional; um sistema electrónico na capacidade de gestão e as despesas em formação para melhorar a qualidade dos empregados estão fortemente relacionadas com as capacidades fulcrais dos centros de saúde comunitários. O resultado desta pesquisa consubstanciou-se na construção de um sistema de índice de competência central dos centros de saúde da comunidade, e forneceu uma base que permite aos departamentos administrativos de saúde padronizar a avaliação da competência do serviço CSC

Technology Enabled Social Responsibility Projects and an Empirical Test of CSR\u27s Impact on Firm Performance

Multinational firms publish annual corporate social responsibility (CSR) reports to signal to stakeholders they are ‘doing better by doing good.’ However, many firms have not effectively integrated technology with CSR to generate impactful long-term solutions. The era of mindful consumption is about creating hi-tech opportunities to satisfy consumers as well as limit resource use. In this research we examine how CSR is revolutionized by technology. We present research based on in-depth conversations with experts and illustrative case studies on how AI is disrupting the world of CSR. Specifically, we examine how the latest technologies in artificial intelligence (AI) and machine learning (ML) are changing perspectives on CSR for countries, industries, firms, and nongovernmental organizations (NGOs). We present an extended stakeholder framework to display the way technology is fundamentally changing how international business is conducted. This research also quantitatively examines the financial impact that CSR has on tangible returns for multinational enterprises (MNEs). Through the lens of institutional theory, we examine which industries CSR and sustainability yield the most beneficial returns over time

The adoption intention of travel-related app: a framework integrating perceived characteristics of innovation and software quality

This thesis aims to analyze the views of customers who have great appetite for tourism on the tourism application. According to the perception characteristics of technology acceptance model, innovation diffusion theory and software quality model, the thesis sets up the research model and puts forward the corresponding research hypothesis on the combination of current research results. In the manner of questionnaire design and collection and data processing, data analysis and hypothesis verification will be conducted by the use of structural equation model. The research result implies that application design attributes and application performance features are key to promote the adoption of mobile travel application. In addition, this research broadens our horizons on the accidental impact of application attributes on adoption behavior through adding user gender as a variable to the model, and increases an awesome theoretical basis for future research in this field.Esta tese tem como objetivo analisar as visões de potenciais turistas com grande interesse por aplicações turísticas. De acordo com as características de percepção do modelo de aceitação de tecnologia, teoria da difusão da inovação e modelo de qualidade de software, a tese estabelece o modelo de investigação e propõe hipóteses de investigação correspondentes, sobre a combinação de resultados da pesquisa atual. Uma vez realizado o desenho do questionário e feita a recolha e processamento de dados, a análise de dados e a verificação de hipóteses foram conduzidas pelo uso do modelo de equações estruturais. O resultado da pesquisa implica que os atributos de design do aplicativo e os recursos de desempenho do aplicativo são fundamentais para promover a adoção do aplicativo móvel de viagem. Além disso, esta pesquisa amplia os horizontes sobre o impacto acidental de atributos de aplicação no comportamento de adoção, adicionando o gênero do usuário como uma variável ao modelo, e aumenta uma importante base teórica para pesquisas futuras neste campo

Developing management goals and associated assessment methods for Sweden’s nationally managed fish stocks : a project synthesis

This report summarizes and synthesizes results from the Swedish Agency of Marine and Water Management (SwAM, or HaV) funded project “Förvaltningsmål för nationella arter (Management goals for nationally managed species)”. The objectives of the project have been to promote the development of management goals and associated status assessment methods and indicators, as well as reference points, for some nationally managed fish stocks both in coastal as well as freshwater areas. The report focusses largely on species and stocks that can be defined as data-poor. Such stocks are characterised by marked limitations in data availability and/or resources allocated to detailed analytical stock projections. Data-poor stocks also often lack carefully formulated management goals and associated methods and indicators for assessing stock status. In this report, we provide an overview of potential assessment methods and indicators and try to synthesise how they work and what the strengths and weaknesses are by applying them to selected data poor stocks such as pikeperch, pike, whitefish, and vendace. We also discuss how they relate to different potential management goals and provide recommendations for their application. We grouped the indicators and assessment methods by the three categories that are now used in the yearly status assessment framework provided by SLU Aqua (Resursöversikten/Fiskbarometern) – i) mortality, ii) abundance/biomass and iii) size/age structure. The results are also described for these three main categories of assessment indicators. Included is also a status report from a size- and age-based population dynamics model (Stock Synthesis 3) that is being developed for pikeperch in Lake Hjälmaren.An important experience from the project is that to improve the assessment methods for Swedish national fish stocks, it is important that managers develop both general as well as more detailed quantitative goals for the individual stocks. This should ideally be conducted in various forms of collaboration with the main stakeholders and scientists involved with assessment as participatory processes foster legitimacy. Carefully articulated management goals, which are possible to translate into quantitative targets, will facilitate the development of various approaches and methods to monitor stock statuses. Given the strong and complex interactions of fish and their environments it is also important to consider other pressures than fisheries when developing indicators and assessment methods.Our synthesis highlights a number of areas where the assessment of data-poor stocks can be improved:1. Apply precautionary principles for data-limited stocks, particularly ones that are known to be vulnerable to exploitation.2. Tailor approaches to how fisheries are managed in Sweden. Swedish nationally managed fish stocks are not managed by quotas (with one exception, vendace in the Bothnian Bay) and do not aim for maximum sustainable yield. Instead, the coastal and inland fisheries are managed by regulating the effort in the small-scale commercial fisheries (number of fishers/licenses and amount of gear). Regulation of recreational and subsistence fisheries effort, in terms of licenses or number of fishers) is not applied, nor possible since the fisheries is lacking obligatory notification and reporting systems. All national fisheries, however, are regulated by various technical measures (closed areas, size-limits, bag-limits, gear restrictions etc). Thus, goals and assessment methods that result in harvest limits or quota recommendations expressed in e.g. biomass/numbers are difficult to use as basis for management. Instead, there is a need for alternative management goals and associated assessment methods.3. Use best practice methods and indicators and adapt as scientific knowledge is developed. Data-limited methods are developing rapidly, and new methods/approaches are proposed in the scientific literature every year. It is thus important to be updated on the most recent developments. 4. Clearly describe limitations/assumptions of methods used. It is important to be aware of and critically evaluate the assumptions underlying the analyses, and to carefully communicate uncertainty together with the stock status assessment.5. Be particularly careful with low sample numbers. Many indicators and methods can be applied also on small sample sizes, however, the accuracy and precision of the estimates risk being low in such cases.6. Accept that there is no "gold standard" for fisheries assessment. Each case study is unique and needs to be balanced against data availability, local needs and other important factors. This also means that analysts need to be careful when using generic reference levels or “borrowing” data from other stocks.7. If possible, use several different methods/indicators. Although several indicators aim to measure similar aspects of the stock, small methodological differences can support the overall interpretation of individual indicator values. It is particularly important to incorporate many aspects and indicators (size/age/abundance/mortality) in order to produce a balanced assessment.8. Develop means of communication. Indicators and goals should be easy to understand. However, interpretation of results from multi-indicator frameworks can be challenging. There is thus a need for finding ways of communication that can convey complicated results in a simple-to-understand manner.9. For details on additional improvements, we refer the reader to the sub-header “recommendations for the future” found under each chapter.The implementation of Stock Synthesis for pikeperch in Lake Hjälmaren showed that it is possible to develop a more ambitious and detailed stock assessment model for a relatively data-poor stock. The model results partly support earlier interpretations of the development of the stock and the importance of the changes in regulations in 2001 (increased minimum size, increased mesh size and reduced mortality of undersized pikeperch). Before the model can be implemented and used for practical management, a number of actions for improvement are needed, which are highlighted in the relevant chapter. The most important next step is establishing management goals and reference levels for this stock. We recommend that such a dialogue is initiated by managers. The fisheries management goals should consider both biomass, fisheries mortality and size-based targets.To conclude, we stress the importance of improving all ongoing aspects related to the assessments of data-poor Swedish stocks. Strong local stocks and sustainable fisheries are vital for a variety of fisheries-related businesses and practices, particularly in rural areas, providing economical and societal value. Fishes also have important roles in aquatic food-webs and it is important that ecological values are managed wisely in order to reach targets for water quality, ecosystem structure and diversity. Given the strong and complex interactions of fish and their environments it is also important to consider other pressures than fisheries when developing indicators and assessment methods

Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria

There is increasing pressure for low and middle-income countries to move towards achieving universal healthcare coverage (UHC). According to WHO (2013), UHC guarantees the right to affordable health care for every individual, without financial hardship. The Director-General to the World Health Organization, Margaret Chan (WHO, 2010 p. 1), says UHC “is the single most powerful concept that public health has to offer”.In recent years, UHC has come onto the policy agenda, but Nigeria has been criticised for its slow progress. This study investigates why and how the UHC policy is developed by focusing on the roles and interactions of policy actors, their policy setting, and ‘how’ their actions influence the policy process and outcome of UHC so far in Nigeria. It will provide evidence of Nigeria’s policy process that will enhance the understanding of the politics of such health care policy implementation processes, which is fundamental to the success of policy networks of UHC in low- and middle-income settings.This is an empirical study using a mixed method approach involving quantitative and qualitative research components. The study combines the social network analysis (the quantitative component) with a more general policy process framework (the qualitative component). Data collected between March 2016 and February 2017 involved face-to-face structured interviews, face-to-face semi-structured interviews and documentary analysis to identify members of relevant policy networks and describe the pattern of relationships and influence within the UHC discourse.The SNA analysis displayed a full structural network taxonomy of the UHC policy process and identified key members of the UHC discourse into four key institutions and organisations- such as the power actors, peripheral actors, gatekeepers or brokers, isolated actors, and policy actors connected to the power actors.The theoretical policy process framework highlights five key gaps that exist as challenges and obstacles which impedes the implementation process of UHC Nigeria. These challenges and obstacles include, changing political climate, concerns about system capacity and finance, poor coordination between federal and state levels, corruption and problems with the private sector – HMOs. These challenges and obstacles limit the government’s ability to provide social and financial risk protection and access to quality health services to vulnerable Nigerian communities.Drawing on the theoretical framework and intervention, this thesis concludes that the political, policy, financial and organizational constraints of the health system limit UHC Nigeria implementation progress. Addressing the reasons why these issues ensue would be helpful in taking strategic steps towards achieving financial protection and access to basic health services through UHC for many Nigerians

Responsive environments: Participants and protagonists

This PhD research project builds on thirteen years of enquiries as an academic practitioner, developing/critiquing interactive audio-visuals. This approach interweaves theory and practice so that both build on each other. It responds to the need for principles that inter-relate people, digital technologies and environments. The concept of “responsive environments” (RE) is offered as a starting point for the development of principles focusing on people within these environments. A responsive environment is “responsive” in the sense that some form of computer technologies are present and sensing/recording/reacting to people, and an “environment” in the sense that these activities are located in a place and that that place matters in terms of setting the scene, housing the technology and providing a context for the users/visitors. Common themes were extracted from the literature review to draw together previous and, for the most part, separate attempts at theory/practice relating to RE. These themes were complemented by research into contemporaneous activities in the areas of Augmented Reality, Mixed Reality and Locative Media to provided enhancements to the development of three practice projects. These enhancements together with the incorporation of Moore and Anderson’s concepts of “patient”, “actor”, “reciprocator” and “referee” as roles available to those encountering REs led to specific research questions regarding roles, positions, opportunities for repurposing content, learning experiences, the use of sound, visuals and presence, and the assessment of values represented in and through a responsive environment. In each case these questions shift the emphasis of the research towards the experiencing of REs and what they enable rather than the technologies used only. The use of Schwartz and Halegoua’s concept of the “spatial self” further focuses attention of the value in connecting digital expression with real spaces through an RE. This has led to a proposed conceptual framework and principles of practice that can be applied in the area of study of RE to nurture opportunities for participants and protagonists. The latter term is proposed as a means of acknowledging opportunities to make content/concepts in an RE as well as obtain and use them by participation. These opportunities are supported by both synchronous and asynchronous interactions through digital layers using online social media platforms. These platforms enable the archiving of content in a digital layer and/or possibilities for continued social interaction through a digital social layer in relation to the responsive environment. The incorporation of synchronous and asynchronous interactions through digital layers is a major contribution to the concept of REs. A further contribution is the use of the pioneering work of Gordon Pask in both the practice and theory of cybernetics as informing the concept of REs. Pask provided a formulation that expressed how content/concepts could be produced through relationships between people, computers and environments. This approach has been mirrored in other disciplines thus giving additional credence to its value. This discovery provides the impetus for further research, by academic practitioners and others, in this developing area of study

How to use lean thinking to improve knowledge management performance of manufacturing supply chains

This thesis aims to eliminate inefficient knowledge management activities and use Lean Principles as guidance to improve knowledge management performance in manufacturing supply chains. In order to achieve this aim, this research examines the causal relationships between Knowledge Management Processes (KMPs), 4 Lean-KM Wastes and 2 Lean-KM Principles in different countries, industries and company sizes. This thesis employs a quantitative method. A theoretical model is built on rigorous literature reviews of supply chain knowledge management and Lean thinking studies, in-depth discussions, item review and pilot study with experts to signify ambiguity or misunderstanding with the items and to suggest modifications. The proposed model is empirically tested with survey data using 359 responses from two types of manufacturing industries (i.e. machinery and electronics manufacturing and food and drink industry), two types of business sizes (i.e. SMEs and Large companies), and two countries (i.e. China and the US). The key output is a framework for Lean-Knowledge Management Processes (Lean-KMPs). With regard to the findings of the empirical research, three main constructs were successfully validated as multi-dimensional constructs. The results from path model analysis shows that most of the sub-hypotheses are supported. Only three of them were rejected in both aggregated-level path model analysis and multi-group analysis. The results have proven the four Lean-KM Wastes and two Lean-KM Principles having negative and positive effects on KMPs, respectively. The detailed findings of this thesis include five parts. Firstly, with respect to Knowledge Acquisition (KA), badly designed information systems are the biggest obstacles for improving the performance of KA. Identification and Usage of Valuable Information and Knowledge (IUVI) and Encouraging Information and Knowledge Flow (EIKF) are two factors that can enhance KA. In addition, big companies should build trustful relationships and improve the accessibility of required information with their supply chain. Secondly, concerning the performance of Knowledge Selection (KS), companies should only retain the most valuable information for avoiding overloaded databases, and information provider need to understand receiver’s requirement and provide the most relevant information, so that could help receivers to store that information more effectively and also make the retrieval of it much easier. Thirdly, for enhancing the performance of Knowledge Generation (KG), companies should gather business information as comprehensive as possible. In addition, Low Quality Information (LQI) and Insufficient Knowledge Inventory (IKI) are two negative factors which could diminish the performance of KG. Moreover, the results also reveal that small or less resourceful companies should focus more on improving the information quality over quantity. Furthermore, well-developed IT systems, IUVI, and EIKF are important positive factors for large and/or machinery and electronics manufacturing’s KG performance. Fourthly, as for Knowledge Internalisation (KI), IUVI and EIKF are two positive factors to the performance of KI. While Inappropriate Information System (IIS) is the biggest obstacle of KI. Lastly, regarding to Knowledge Externalisation (KE), the results indicate that LQI and IKI are two negative factors to KE and IUVI is the only positive factor to KE. This thesis synthesises Lean thinking, supply chain integration, and knowledge management to develop a comprehensive approach to improve the knowledge management performance of manufacturing supply chains. It has four theoretical contributions: 1) developed Lean-KMPs model and 19 hypotheses to improve the KM performance of manufacturing supply chains; 2) developed 4 Lean-KM wastes and 2 Lean-KM Principles based on the Lean thinking for manufacturing supply chain KM; 3) identified and developed 5 latent constructs for KMPs and 30 corresponding indicators to accurately measure companies’ KM performance; 4) conducted industry-specific empirical studies, collected 359 useful data from different countries, different industries and different sized companies, and conducted three pairs of multi-group analyses based on these different contexts. Various manufacturing companies in both heavy and light industries would benefit from applying the results of this study to improve their KM performance. The results also suggest that manufacturing practitioners should use a comprehensive approach to improve knowledge management processes in order to make sure that critical information and knowledge flow seamlessly and efficiently among their supply chain members, further to achieve successful supply chain integration

Rapid testing of service innovations in general practice: an evaluation of the Primary Care Home model in Newham

Meeting abstract P27: Rapid testing of service innovations in general practice: an evaluation of the Primary Care Home model in Newha

Corporate social responsibility disclosure (CSRD): a case study of Pakistan

The overall purpose of this research is to understand the quantity (i.e. magnitude and breadth) and quality of Corporate Social Responsibility (CSR hereafter) disclosure and its dimensions: environment, human resource, products and consumer and community involvement; and the factors (both observable and non-observable) which influence CSR disclosure and its dimensions in the annual reports by corporations listed at Karachi Stock Exchange (KSE hereafter) of Pakistan. This research uses three widely used theories: legitimacy, stakeholder, and institutional theory to explain the disclosure results. This study used content analysis and survey (questionnaire) methods to collect the required data. In examining the quantity of CSR disclosure, the results revealed that the sampled companies paid more attention to human resource and community involvement related practices (see Chapter 6). Further, the results revealed a significant increase in the quantity of CSR disclosure and its dimensions in 2011. In investigating the quality of CSR disclosure, the majority of the sampled companies made declarative types of disclosure (i.e. aims and actions indicators) and mainly focused on good news (e.g. donations to schools, establishment of hospitals, and sponsorship for environmental awareness programmes etc.). Overall the quality of CSR disclosure was found to be very poor. However the quality of CSR disclosure and its dimensions has improved with the passage of time (2008-2011) (see Chapter 6). Further the results revealed that company’s social visibility (proxied by company size, profitability, environmental sensitivity, and multinational subsidiary) and CSR promoting institutions (i.e. CSR Pakistan, CSRCP, WWF, UNGC, CSR standard setting institutions) are major determinants of CSR disclosure, while corporate governance and financial stakeholders are weak determinants of CSR disclosure and its dimensions (see Chapter 7). In exploring the non-observable factors influencing the CSR disclosure, the results showed that ‘to build company image’, the chairman’s, regulatory institutions’, shareholders’, and non-executive directors’ concerns are the most important factors considered in the decision to disclose CSR information in the annual reports. In investigating the factors considered to be important influences on the magnitude, breadth, and quality of CSR disclosure, the researcher developed three regression models (CSR disclosure extent, CSR disclosure level, and CSR disclosure quality). The results revealed that companies which are operating in an environmentally sensitive sector or want to build company image place substantial importance on CSR issues, cover a range of CSR issues, and provide a relatively rich quality disclosure. In addition to this, the researcher found that a lack of CSR education and CSR reporting support, insufficiency of shareholders demand for CSR information, inadequacy of customers’ interest in CSR information, meagreness of regulatory requirements, and fear of public reaction to sensitive information were perceived to be the major reasons for non-disclosure of CSR information in Pakistan (see Chapter 8). The results revealed that the joint consideration of legitimacy, stakeholder, and institutional theory provides the rich insights and better explains the results than the consideration of a single theory (see Chapter 9)