Investigating the adoption of enterprise application integration in healthcare organisations using an actor-oriented approach

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This dissertation focuses on Enterprise Application Integration (EAI) adoption in healthcare organisations. EAI has emerged to support organisations overcoming their integration problems and it has been adopted by many organisations in various sectors. Despite its importance, the healthcare domain develops EAI solutions at a slower pace and it can be characterised as a laggard comparing to other sectors. The small number of EAI applications in healthcare has resulted in limited research in this area with many issues, like its adoption requiring further investigation. The normative literature analyses the factors that influence EAI adoption in healthcare (MAESTRO model) but it has not yet explored the role of actors during the adoption process. This dissertation makes a step forward and contributes to the body of knowledge as it: (a) highlights the role of healthcare actors and attitudes towards EAI adoption, (b) introduces an actor-oriented approach, (c) derives and proposes a structured method, named Individual, Group, Organisational, Human, Controllers, Acceptors, Providers, Supporters (IGOHcaps), to model how actors might be identified (structured because such a rationale is explicable and such a method is more readily usable when transferred to others), (d) identifies those actors involved in this process, by using the proposed IGOHcaps method and (e) combines the actor-oriented approach with the factors influencing EAI adoption. The author claims that such an approach is significant and novel as: (a) it extends established norms for EAI adoption, by incorporating an actor-oriented analysis and (b) the actors' differing views emerging could enable decision making bodies to produce more robust proposals for EAI adoption. The author discusses the application of this approach by using a qualitative, interpretive, multiple case study research strategy. Empirical data collected from two case organisations show that such an approach contributes towards more robust decisions for EAI adoption and indicates that it is acceptable by the organisations and the interviewees (actors), participated in this research. Despite these results cannot be generalised, they can allow others to relate their views with the ones reported in this dissertation. This dissertation introduces tests and presents a novel approach and model for EAI adoption in healthcare and contributes to the body of knowledge by extending the literature.Funding for this work was obtained from the Brunel University School of Information Systems, Computing and Mathematics

Hydrological Response of a Permeable Pavement Laboratory Rig for Stormwater Management.

Nowadays there is an increasing amount of everyday flood incidents around the world, the impact of which poses a challenge on the society, economy and environment. Under the Water Framework Directive (2000/60/EC), green infrastructure provided by sustainable drainage systems (SuDS) is the recommended policy to manage and treat storm water. This paper presents experimental work carried out in the laboratory on a permeable pavement rig, investigating mainly the short-term hydrology of the pavement, and the way that runoff percolates through the structure during simulated rainfall events. Results showed high flood mitigation capacity, encouraging further investigation of this type of SuDS

Brief Announcement: Providing End-to-End Secure Communication in Low-Power Wide Area Networks

Recent technologies for low-rate, long-range transmission in unlicensed sub-GHz frequency bands enables the realization of Long-range Wide Area Network. Despite the rapid uptake of LPWANs, security concerns arising from the open architecture and usage of the unlicensed band are also growing. While the current LPWAN deployments include basic techniques to deal with end-to-end encryption there are specific security issues that arise due to the overall architecture and protocol layer design. In this paper, a new scheme to establish end-to-end secure communication in long-range IoT deployments is introduced. The advantages over the existing approaches and architectural design are presented in the context of typical smart cities application scenarios

Pseudopeptidic ligands: exploring the self-assembly of isopthaloylbisglycine (H2IBG) and divalent metal ions

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Ritual in Prehistory; Definition and Identification. Religious Insights in Early Prehistoric Cyprus.

Prehistoric archaeology has had major difficulties in identifying ritual practices. The history of archaeological approaches ranges from a total repudiation of the capability of the discipline to recognise and analyse ritual activities in the past, to absolute acceptance of all identified prehistoric patterns as ritual. Even within a postmodern apprehension of the world, where deconstruction of all established perceptions seems to have reached an end point, prehistoric archaeology has never successfully constructed a notion of ritual in prehistory. Acknowledging that ritual definition and identification is a problem of the modern western archaeologist, this thesis identifies the root of the problem in methods of thinking deeply rooted in western civilization, in our cultural schemata, and in approaches to archaeology that only superficially observe the problem rather than confront and resolve it. In seeking a resolution, this work proposes a structural dismantling of the problem and its recomposition from its basics. The thesis proposes a middle-range theory based on structuralism and pragmatics and a method of meticulous contextual and relational analysis for the identification and interpretation of ritual practices in prehistory. As a starting point, death is identified as the quintessential category for the exploration of a mytho-logic system and its subsequent definition. The treatment of the dead is recognised as the ideal starting point for an examination of the archaeological record in quest for ritual. Ritual structural elements identified in the context of burial are used subsequently for the identification of non-death ritual practices. The identification of religious practices in Early Prehistoric Cyprus reveals a vibrant ritualpracticing culture contrary to previous commonly accepted observations. Structured depositions in ritually empowered containers; ritual transport; hoarding; symbolic abandonment; ritual sealing; ritual burning; ritual use of burials for the creation of liminality; construction of highly symbolic structures and subsequent attribution of agency to them, all constitute religious practices attested by this thesis for the Cypriot PPNB and Aceramic Neolithic. This identification of ritual in Early Prehistoric Cyprus enables the exploration of this culture’s mytho-logic. The thesis demonstrates how early Cypriots viewed their world and their position in it. Finally, this research offers new perspectives in recognising past socio-cultural realities through the examination of ritual practices

Atypical Bacteria and Macrolides in Asthma

<p/> <p><it>Chlamydophila pneumoniae </it>and <it>Mycoplasma pneumoniae </it>are common pathogens causing acute illness in both the upper and lower airways. Several observations are supportive of a possible causative role of these pathogens in asthma; however, more evidence is required before this becomes meaningful in clinical practice. Atypical bacteria can enhance airway hyperresponsiveness and inflammation, both of which have been associated with exacerbations in patients with preexisting asthma. It is less clear whether the above mechanisms might also be responsible for the development of asthma. Difficulties in accurately diagnosing these infections contribute to such uncertainty. In the present report, evidence of the involvement of <it>Chlamydophila </it>and <it>Mycoplasma </it>infection in the development and the progression of asthma are reviewed.</p

Revisiting the firm, industry, and country effects on profitability under recessionary and expansion periods: a multilevel analysis

Despite voluminous past research, the relevance of firm, industry, and country effects on profitability, particularly under adverse contexts, is still unclear. We reconcile institutional theory with the resource‐based view and industrial organization economics to investigate the effects of economic adversity, such as the 2008 global economic crisis. Using a three‐level random coefficient model, we examine 15,008 firms across 10 emerging and 10 developed countries for the 2005–2011 period. We find that firm effects become stronger under adversity, whereas industry effects become weaker, as well as country main and interaction effects, particularly among the emerging economies. These findings confirm our assumptions that the firm's own fate is, to a great extent, self‐determined; a reality that is even more pronounced during periods of extreme economic hardship

Biotransformation of citalopram: Insights from identification of transformation products by LC-QToF-MS

Biodegradation is considered to be the key process for the elimination of the majority of pharmaceuticals in the environment. During wastewater treatment or once they are disposed in the aquatic environment, pharmaceuticals may transformed to new, structurally-related compounds which are called transformation products (TPs). Since most of these compounds are unknowns, their identification is essential not only to provide a comprehensive risk assessment on micropollutants in the environment, but also to design improved removal technologies for (pseudo)persistent trace contaminants. In this study, batch reactors seeded with activated sludge from the WWTP of Athens were set up to assess biotic, abiotic and sorption losses of a SSRI drug, citalopram. TPs were identified by reversed-phase liquid chromatography quadrupole-time-of-flight mass spectrometry (RPLC-QToF-MS). Hydrophilic interaction liquid chromatography (HILIC) was also used as a complementary, orthogonal, technique for the identified TPs, instead of NMR. A workflow for suspect and non-target screening was developed. A suspect list of possible TPs was compiled by literature and in silico prediction tools (EAWAG-BBD Pathway Prediction System and Bruker’s Metabolite Predict). Structure elucidation of TPs was based on accurate mass and isotopic pattern measurements and interpretation of MS/MS spectra by the observed fragmentation pattern and library-spectrum match. In total, thirteen TPs were identified. Four out of them were fully identified and confirmed by reference standards (desmethylcitalopram, citalopram amide, citalopram carboxylic acid and 3-oxo-citalopram). A probable structure based on diagnostic evidence and tentative candidates were proposed for the additional five and four TPs, respectively. Finally, a transformation pathway based on the identified compounds was presented