Fully smart cities: Analysis of the city to Smart City transformation process

Ever since the birth of the Smart City paradigm, a wide variety of initiatives have sprung up involving this phenomenon: best practices, projects, pilot projects, transformation plans, models, standards, indicators, measuring systems, etc. The question to ask, applicable to any government official, city planner or researcher, is whether this effect is being felt in how cities are transforming, or whether, in contrast, it is not very realistic to speak of cities imbued with this level of intelligence. Many cities are eager to define themselves as smart, but the variety, complexity and scope of the projects needed for this transformation indicate that the change process is longer than it seems. If our goal is to carry out a comparative analysis of this progress among cities by using the number of projects executed and their scope as a reference for the transformation, we could find such a task inconsequential due to the huge differences and characteristics that define a city. We believe that the subject needs simplification (simpler, more practical models) and a new approach. This paper presents a detailed analysis of the smart city transformation process in Spain and provides a support model that helps us understand the changes and the speed at which they are being implemented. To this end we define a set of elements of change called "transformation factors" that group a city's smartness into one of three levels (Low/Medium/Fully) and more homogeneously identify the level of advancement of this process. © 2016 IEEE.

Evaluation of the impact of nursing clinics in the rheumatology services

Nursing clinics in rheumatology (NCRs) are organisational care models that provide care centred within the scope of a nurse’s abilities. To analyse the impact of NCR in the rheumatology services, national multicenter observational prospective cohort studied 1-year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence of: (1) office itself; (2) at least one dedicated nurse; and (3) its own appointment schedule. Variables included were (baseline, 6 and 12 months): (a) test to evaluate clinical activity of the disease, research and training, infrastructure of unit and resources of NCR and (b) tests to evaluate socio-demographics, work productivity (WPAI), use of services and treatments and quality of life. A total of 393 rheumatoid arthritis and ankylosing spondylitis patients were included: 181 NCR and 212 not NCR, corresponding to 39 units, 21 with NCR and 18 without NCR (age 53 + 11.8 vs 56 + 13.5 years). Statistically significant differences were found in patients attended in sites without NCR, at some of the visits (baseline, 6 or 12 months), for the following parameters: higher CRP level (5.9 mg/l ± 8.3 vs 4.8 mg/l ± 7.8; p < 0.005), global disease evaluation by the patient (3.6 ± 2.3 vs 3.1 ± 2.4), physician (2.9 ± 2.1 vs 2.3 ± 2.1; p < 0.05), use of primary care consultations (2.7 ± 5.4 vs 1.4 ± 2.3; p < 0.001) and worse work productivity. The presence of NCR in the rheumatology services contributes to improve some clinical outcomes, a lower frequency of primary care consultations and better work productivity of patients with rheumatic diseases.