Explaing users’ technology acceptance through national cultural values in the hospital context

Background: Current research demonstrates that health information technology can improve the efciency and quality of health services. However, many implementation projects have failed due to behavioural problems associated with technology usages, such as underuse, resistance, sabotage, and even rejection by potential users. Therefore, user acceptance was one of the main factors contributing to the success of health information technology implementation. However, research suggests that behavioural models do not universally hold across cultures. The present article considers national cultural values (power distance, uncertainty avoidance, individualism/collectivism, masculinity/femininity, and time orientation) as individual diference variables that afect user behaviour and incorporates them into the Technology Acceptance Model (TAM) as moderators of technology acceptance relationships. Therefore, this research analyses which national cultural values afect technology acceptance behaviour in hospitals. Methods: The authors develop and test seven hypotheses regarding this relationship using the partial least squares (PLS) technique, a structural equation modelling method. The authors collected data from 160 questionnaires completed by clinicians and non-clinicians working in one hospital. Results: The fndings show that uncertainty avoidance, masculinity/femininity, and time orientation are the national cultural values that afect technology acceptance in hospitals. In particular, individuals with masculine cultural values, higher uncertainty avoidance, and a long-term orientation infuence behavioural intention to use technology. Conclusion: The bureaucratic model still decisively characterises the Italian health sector and consequently afects the choices of frms and workers, including the choice of technology adoption. Cultural values of masculinity, risk aversion, and long-term orientation afect intention to use through social norms rather than through perceived utility

Design Science in Information Systems Research: foundational and evolutionary aspects

Academic research on design science in IS field has proliferated significantly over the last two decades. From Simon research to nowadays, the importance of design science is well recognized in the IS literature. However, despite the IS literature is paying more attention on this topic, there is no extensive analysis of a comprehensive set of sources has been performed in order to explore this emerging body of knowledge. The aim of this study is to understand the state of design science in ISR by performing a survey of the existing body of knowledge. Using several online database literature searches, we obtained 245 publications for data analysis. A comprehensive list of references is presented together with a roadmap for performing a bibliographic analysis. Our analysis provides useful insights for IS practitioners and researchers on the major historical trends that can guide future research in this fertile area of inquiry

070-I * TRIBECA STUDY: (TRI)FECTA (B)IOPROSTHESES (E)VALUATION VERSUS (C)ARPENTIER MAGNA-EASE IN (A)ORTIC POSITION

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Adult cardiac surgery outcomes: role of the pump type

This study was carried out to evaluate whether the type of pump used for cardiopulmonary bypass (CPB; roller vs. centrifugal) can affect mortality or the neurological outcomes of adult cardiac surgery patients

Access to administrative documents and to public sector information in Italy

Law No. 241 of 1990 on administrative procedure (Italian APA) established general rules on the right of access to administrative documents for the first time in the Italian legal system, which partly reproduced rules defined in sectorial legislations. From such very restrictive regime of access to administrative documents\u2014lately accompanied by a rather demagogical obligation imposed on public administrations to disclose a set of information in the context of the so-called open data policies\u2014Italy has recently moved forth to public access to data and documents held by public administrations

Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate

Background: The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia. Methods: 81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay. Results: Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI. Conclusion: CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control

Physiological aspects of the determination of comprehensive arterial inflows in the lower abdomen assessed by Doppler ultrasound

Non-invasive measurement of splanchnic hemodynamics has been utilized in the clinical setting for diagnosis of gastro-intestinal disease, and for determining reserve blood flow (BF) distribution. However, previous studies that measured BF in a "single vessel with small size volume", such as the superior mesenteric and coeliac arteries, were concerned solely with the target organ in the gastrointestinal area, and therefore evaluation of alterations in these single arterial BFs under various states was sometimes limited to "small blood volumes", even though there was a relatively large change in flow. BF in the lower abdomen (BFAb) is potentially a useful indicator of the influence of comprehensive BF redistribution in cardiovascular and hepato-gastrointestinal disease, in the postprandial period, and in relation to physical exercise. BFAb can be determined theoretically using Doppler ultrasound by subtracting BF in the bilateral proximal femoral arteries (FAs) from BF in the upper abdominal aorta (Ao) above the coeliac trunk. Prior to acceptance of this method of determining a true BFAb value, it is necessary to obtain validated normal physiological data that represent the hemodynamic relationship between the three arteries. In determining BFAb, relative reliability was acceptably high (range in intra-class correlation coefficient: 0.85-0.97) for three arterial hemodynamic parameters (blood velocity, vessel diameter, and BF) in three repeated measurements obtained over three different days. Bland-Altman analysis of the three repeated measurements revealed that day-to-day physiological variation (potentially including measurement error) was within the acceptable minimum range (95% of confidence interval), calculated as the difference in hemodynamics between two measurements. Mean BF (ml/min) was 2951 ± 767 in Ao, 316 ± 97 in left FA, 313 ± 83 in right FA, and 2323 ± 703 in BFAb, which is in agreement with a previous study that measured the sum of BF in the major part of the coeliac, mesenteric, and renal arteries. This review presents the methodological concept that underlies BFAb, and aspects of its day-to-day relative reliability in terms of the hemodynamics of the three target arteries, relationship with body surface area, respiratory effects, and potential clinical usefulness and application, in relation to data previously reported in original dedicated research