/pdf/research-design-qualitative-quantitative-and-mixed-methods-1m92m1x5gg.pdf

Research Design: Qualitative, Quantitative, and Mixed Methods Approaches

As the term “smart city” gains wider and wider currency, there is still confusion about what a smart city is, especially since several similar terms are often used interchangeably. This paper aims to clarify the meaning of the word “smart” in the context of cities through an approach based on an in-depth literature review of relevant studies as well as official documents of international institutions. It also identifies the main dimensions and elements characterizing a smart city. The different metrics of urban smartness are reviewed to show the need for a shared definition of what constitutes a smart city, what are its features, and how it performs in comparison to traditional cities. Furthermore, performance measures and initiatives in a few smart cities are identified.

Smart Cities: Definitions, Dimensions, Performance, and Initiatives

Models that depict innovation as a smooth, well-behaved linear process badly misspecify the nature and direction of the causal factors at work. Innovation is complex, uncertain, somewhat disorderly, and subject to changes of many sorts. Innovation is also difficult to measure and demands close coordination of adequate technical knowledge and excellent market judgment in order to satisfy economic, technological, and other types of constraints—all simultaneously. The process of innovation must be viewed as a series of changes in a complete system not only of hardware, but also of market environment, production facilities and knowledge, and the social contexts of the innovation organization.

An Overview of Innovation

What makes organizations so similar? We contend that the engine of rationalization and bureaucratization has moved from the competitive marketplace to the state and the professions. Once a set of organizations emerges as a field, a paradox arises: rational actors make their organizations increasingly similar as they try to change them. We describe three isomorphic processes-coercive, mimetic, and normative—leading to this outcome. We then specify hypotheses about the impact of resource centralization and dependency, goal ambiguity and technical uncertainty, and professionalization and structuration on isomorphic change. Finally, we suggest implications for theories of organizations and social change.

The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields (Chinese Translation)

Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial

“BEQUEST: Sustainability Assessment, the Framework and Directory of Methods”

Contents: Introduction, Mark Deakin, Robert Dixon-Gough and Reinfried Mansberger Partnership, process, and planning in estuary management: the case of the Lower Thames, Robert Home Land reform in developing countries: legal and institutional aspects, Alec McEwen International land management: aspects on education and training, Reinfried Mansberger and Erwin Heine Land fragmentation in Central Europe: how and whether to use Western experience, Terry van Dijk The implementation framework of legal systems, Ninel Jasmine Sadjadi Mediation in land consolidation and in boundary disputes, JA,rn Rognes and Per KA[yen]re Sky Policy instruments in the changing context of Dutch land development, DaniA"lle Groetelaers and Willem Korthals Altes Modelling the development of sustainable communities in Edinburgh's South East wedge, Mark Deakin The redevelopment of the railway lands of London's King's Cross: actors, agendas, and processes, Emmanuel Mutale BEQUEST: sustainable urban development, the framework, and directory of assessment methods, Mark Deakin and Steve Curwell Object model for temporal changes in geographical information systems, Abdul Adamu, Souhiel Khaddaj and Munir Morad Using GIS techniques to evaluate community sustainability in open forestlands in sub-Saharan Africa, Yang Li, Alan Grainger, Zoltan Hesley, Ole Hofstad, Prem Lal Sankhayan, Ousmane Diallo and Aku O'Kting'Ati Community participation in rural and urban development, Robert Dixon-Gough, Reinfried Mansberger and Mark Deakin Index.

Methodologies, Models and Instruments for Rural and Urban Land Management

The paper examines the architecture and services of the e-learning platform and describes how the knowledge management system designed for IntelCities is supported by the IP’s digital library. It suggests the e-Learning platform, 
knowledge management system and digital library developed under the IP provides the intelligence cities need to integrate them as a platform of semantically-rich e-Governance services. That is to say, an integrated platform of semantically rich e-Governance services with the intelligence which cities need to meet the expectations citizens have about the quality of such electronically enhanced products. The paper begins by outlining the integrated model of electronically enhanced governance (eGov) services adopted to represent the front-end, middleware and back-office functions of the IntelCities’ e-Learning, knowledge management (KM) and digital library. Having done this, the paper shall report on the search for an intelligent solution to the IP’s learning needs, knowledge transfer and capacity building requirements. It shall then go on to discuss the information technology (IT) underlying the solution adopted by the IP to integrate the electronically enhanced eGov services hosted on the eCity platform with the legacy systems operated by the public administrations involved in the project. From here the discussion shall then go on to examine how the e-Learning platform, KM system and digital library developed by the IP as back-office functions have been integrated into the IntelCities middleware and delivered as frontend services to citizens.

The IntelCities e-Learning Platform, Knowledge Management System and Digital Library for Semantically-Rich e-Governance Services

Hospital Episode Statistics (HES; http://www.hesonline.nhs.uk/) provide a national database for England that aims to capture all clinical activity in the National Health Service (NHS). The data are a valuable resource for surgical research and can be used for activity analysis, allowing comparisons of throughput and outcomes. HES are collated yearly by the Department of Health in England and contain information on every hospital attendance or admission. Data are collected as episodes. Each episode is a period of care in hospital under one consultant. Most patients only have one episode during an admission (or spell) but some will have multiple episodes and linking these to remove duplicates is often necessary. Although the data collected are for administrative purposes, information on patient diagnosis, operative procedure and outcome is available, making HES a valuable tool for research and audit.

The data are anonymised and this allows their widespread use without the need for patient consent. Requests for data that contain sensitive information (ie information that cannot identify a patient but is specific to a particular individual, such as date of birth) involve a more rigorous request process.

HESID is an anonymous and unique patient identifier derived from a patient’s NHS number, date of birth, sex and postcode.1 It allows the linking of different episodes that are from the same patient. These can be on the same admission or following further admissions to the same or another hospital. Essentially, the care of a patient may be followed across time and throughout England without breaking anonymity. HESID therefore provides a powerful method for assessing long-term outcome following surgical intervention. For example, readmissions at a later date with complications or sequelae of surgery can be picked up even if they occur at another hospital. Furthermore, HES can now be linked to the mortality data available from the Office for National Statistics, allowing deaths that occur outside hospital to be identified.2

Section 251 of the NHS Act 2006 (originally enacted under Section 60 of the Health and Social Care Act 2001) allows the common law duty of confidentiality to be set aside in specific circumstances where anonymised information is not sufficient and where patient consent is not practicable.3 In the case of a research study, this requires an application via the Integrated Research Application System or directly, in the case of service evaluation, to the National Information Governance Board for Health and Social Care. Using Section 251, it is possible to link HES using information that identifies a patient to other databases and to examine longer term outcome.

Details with regard to the consultant responsible for a case are also contained in the HES dataset. These are based on the consultant’s General Medical Council number, which is then anonymised. There are, however, no details on the operating surgeon and this remains a major omission.

Studies based on HES generate strong and polarised reactions among clinicians, mostly with regard to accuracy of coding. In fact, the reality is rather mixed.4 The accuracy of diagnostic and operative coding has improved over recent years, particularly for common operations as demonstrated in an annual national audit undertaken by the Department of Health and published for the first time in 2008.5 This audit did, however, show that there were significant coding irregularities, especially in certain trusts.

The coding issues themselves can be complex. There may be a coding error involving a diagnostic or a procedure code, or else administrative codes (eg the method of discharge or date of admission/discharge) may be incorrect. Often, however, the code that is used may be incorrect but only in a small way. For instance, the use of a code for laparoscopic cholecystectomy, when the code for laparoscopic cholecystectomy with on-table cholangiography should have been used. Moreover, depth of coding may vary. A patient admitted with a modest degree of ischaemia of a limb, for angiography, could conceivably be coded in exactly the same manner as a patient admitted with critical limb ischaemia with associated gangrene and sepsis. The coding is not incorrect but the lack of subsidiary codes fails to delineate the true clinical situation.

Although studies based on HES are cohort studies, they differ from the usual cohort studies in that the cohort represents almost all activity in the area of study in England as the contribution of the private sector is relatively small and NHS patients undergoing surgery in the private sector are included.

Furthermore, one has to consider the context of conclusions that are drawn from studies using HES. If findings are of a general nature (eg that patients in England with acute pancreatitis secondary to gallstones are not getting their cholecystectomy within the guidelines issued by the British Society of Gastroenterology), then even a relatively high coding error rate at some hospitals or even all hospitals will not detract markedly from the overall conclusions if significant deviation can be shown.6

However, if conclusions are of a much more specific nature (eg that hospital A is doing better than hospital B), then any conclusions drawn may well be incorrect unless it can be shown that the coding in hospital A is equivalent to the coding in hospital B. Thus, HES can usefully be used to test hypotheses nationally but at the current time must be used with caution when measuring individual hospital or clinician activity.6

This has not stopped the appearance of reports that evaluate clinical and surgical performance, for example the Dr Foster Hospital Guide.7 Many groups, including our own, are seeking to develop new metrics based on HES that can be usefully used to measure surgical care and outcome.

These are issues that need much greater discussion in the medical profession as it is unlikely that there will be any major changes in the method of diagnostic and operative coding. Although these are revised on a regular basis to reflect changing clinical practice, general agreement on standard ways of coding common procedures could be obtained easily through the specialty associations. Clinicians should understand and become engaged in the coding of their patients and the quality of the data that is returned on their behalf,8 not only to ensure good quality data for research but to safeguard the reputation of their hospital or surgical team.

https://publishing.rcseng.ac.uk/doi/pdfplus/10.1308/003588412X13373405385250

Surgical research and activity analysis using Hospital Episode Statistics

This chapter develops the notion of the intelligent city as the smart provider of electronically-enhanced services. Set within the ongoing debate about competitive cities, it identifies how the growing interest in the notion of intelligent cities has led universities to explore the possibilities of using ‘communities of practice’ (CoPs) as a way of drawing upon the work-based learning such knowledge-based organizations offer to be smart in developing integrated models of e-government (eGov) services. It reports on the attempts made by a consortium of leading European cities to use the intelligence of CoPs as the organizational means to be smart in developing models of eGov services capable of integrating the e-learning needs, knowledge transfer requirements, and capacity building commitments of their socially-inclusive and participatory urban regeneration programmes. DOI: 10.4018/978-1-61350-174-0.ch005

Mark Deakin

Papers

“BEQUEST: Sustainability Assessment, the Framework and Directory of Methods”

Methodologies, Models and Instruments for Rural and Urban Land Management

The IntelCities e-Learning Platform, Knowledge Management System and Digital Library for Semantically-Rich e-Governance Services

Surgical research and activity analysis using Hospital Episode Statistics

From Intelligent to Smart Cities: CoPs as organizations for developing integrated models of eGovernment Services