Pragmatic oriented data interoperability for smart healthcare information systems

Smart healthcare is a complex domain for systems integration due to human and technical factors and heterogeneous data sources involved. As a part of smart city, it is such a complex area where clinical functions require smartness of multi-systems collaborations for effective communications among departments, and radiology is one of the areas highly relies on intelligent information integration and communication. Therefore, it faces many challenges regarding integration and its interoperability such as information collision, heterogeneous data sources, policy obstacles, and procedure mismanagement. The purpose of this study is to conduct an analysis of data, semantic, and pragmatic interoperability of systems integration in radiology department, and to develop a pragmatic interoperability framework for guiding the integration. We select an on-going project at a local hospital for undertaking our case study. The project is to achieve data sharing and interoperability among Radiology Information Systems (RIS), Electronic Patient Record (EPR), and Picture Archiving and Communication Systems (PACS). Qualitative data collection and analysis methods are used. The data sources consisted of documentation including publications and internal working papers, one year of non-participant observations and 37 interviews with radiologists, clinicians, directors of IT services, referring clinicians, radiographers, receptionists and secretary. We identified four primary phases of data analysis process for the case study: requirements and barriers identification, integration approach, interoperability measurements, and knowledge foundations. Each phase is discussed and supported by qualitative data. Through the analysis we also develop a pragmatic interoperability framework that summaries the empirical findings and proposes recommendations for guiding the integration in the radiology context.

Research data management and openness: the role of data sharing in developing institutional policies and practices

Purpose: To investigate the relationship between research data management (RDM) and data sharing in the formulation of RDM policies and development of practices in higher education institutions (HEIs). Design/methodology/approach: Two strands of work were undertaken sequentially: firstly, content analysis of 37 RDM policies from UK HEIs; secondly, two detailed case studies of institutions with different approaches to RDM based on semi-structured interviews with staff involved in the development of RDM policy and services. The data are interpreted using insights from Actor Network Theory. Findings: RDM policy formation and service development has created a complex set of networks within and beyond institutions involving different professional groups with widely varying priorities shaping activities. Data sharing is considered an important activity in the policies and services of HEIs studied, but its prominence can in most cases be attributed to the positions adopted by large research funders. Research limitations/implications: The case studies, as research based on qualitative data, cannot be assumed to be universally applicable but do illustrate a variety of issues and challenges experienced more generally, particularly in the UK. Practical implications: The research may help to inform development of policy and practice in RDM in HEIs and funder organisations. Originality/value: This paper makes an early contribution to the RDM literature on the specific topic of the relationship between RDM policy and services, and openness – a topic which to date has received limited attention.

Missing steps in a staircase: a qualitative study of the perspectives of key stakeholders on the use of adaptive designs in confirmatory trials

Background Despite the promising benefits of adaptive designs (ADs), their routine use, especially in confirmatory trials, is lagging behind the prominence given to them in the statistical literature. Much of the previous research to understand barriers and potential facilitators to the use of ADs has been driven from a pharmaceutical drug development perspective, with little focus on trials in the public sector. In this paper, we explore key stakeholders’ experiences, perceptions and views on barriers and facilitators to the use of ADs in publicly funded confirmatory trials. Methods Semi-structured, in-depth interviews of key stakeholders in clinical trials research (CTU directors, funding board and panel members, statisticians, regulators, chief investigators, data monitoring committee members and health economists) were conducted through telephone or face-to-face sessions, predominantly in the UK. We purposively selected participants sequentially to optimise maximum variation in views and experiences. We employed the framework approach to analyse the qualitative data. Results We interviewed 27 participants. We found some of the perceived barriers to be: lack of knowledge and experience coupled with paucity of case studies, lack of applied training, degree of reluctance to use ADs, lack of bridge funding and time to support design work, lack of statistical expertise, some anxiety about the impact of early trial stopping on researchers’ employment contracts, lack of understanding of acceptable scope of ADs and when ADs are appropriate, and statistical and practical complexities. Reluctance to use ADs seemed to be influenced by: therapeutic area, unfamiliarity, concerns about their robustness in decision-making and acceptability of findings to change practice, perceived complexities and proposed type of AD, among others. Conclusions There are still considerable multifaceted, individual and organisational obstacles to be addressed to improve uptake, and successful implementation of ADs when appropriate. Nevertheless, inferred positive change in attitudes and receptiveness towards the appropriate use of ADs by public funders are supportive and are a stepping stone for the future utilisation of ADs by researchers.

Big Data and ecosystem research programmes

The size and complexity of data sets generated within ecosystem-level programmes merits their capture, curation, storage and analysis, synthesis and visualisation using Big Data approaches. This review looks at previous attempts to organise and analyse such data through the International Biological Programme and draws on the mistakes made and the lessons learned for effective Big Data approaches to current Research Councils United Kingdom (RCUK) ecosystem-level programmes, using Biodiversity and Ecosystem Service Sustainability (BESS) and Environmental Virtual Observatory Pilot (EVOp) as exemplars. The challenges raised by such data are identified, explored and suggestions are made for the two major issues of extending analyses across different spatio-temporal scales and for the effective integration of quantitative and qualitative data.

Young caregivers in the context of the HIV/AIDS pandemic in sub-Saharan Africa

Against a background of rising adult mortality and morbidity in the context of the HIV/AIDS pandemic in sub-Saharan Africa, this paper provides both quantitative and qualitative evidence for the existence of a largely neglected group of young people with increased responsibility for caregiving. Using questionnaire surveys, focus groups, storyboards and in-depth interviews in three studies across Southern and Eastern Africa some young people in Lesotho, Tanzania and Zimbabwe are found to devote considerable time and energy to caring for sick members of their households. Examination of the tasks carried out by these youngsters finds them to be burdened beyond usual familial and societal expectations of children's 'normal' contributions to the reproduction of households via domestic chores and suchlike. It is concluded that these young people can be described as 'young carers'. The three studies are presented to illuminate different sociospatial aspects of caregiving by young people. First, using qualitative data from Lesotho the range of caring tasks young caregivers; perform for care recipients - usually a grandmother, parent, or sibling - is identified. Second, the impact caregiving responsibilities have on children's primary school attendance is examined using survey data from Tanzania. Third, the wider negative and positive impacts of caregiving including loss of friends and gaining of emotional maturity for young carers and their households is explored with in-depth individual interviews from Zimbabwe. Finally, suggestions are made for further research to deepen understanding of the geographies of caring within the context of the population geographies of the HIV/AIDS pandemic in sub-Saharan Africa and beyond. Copyright (c) 2006 John Wiley & Sons, Ltd.

The influence of project complexity on estimating accuracy

With the rapid development in technology over recent years, construction, in common with many areas of industry, has become increasingly complex. It would, therefore, seem to be important to develop and extend the understanding of complexity so that industry in general and in this case the construction industry can work with greater accuracy and efficiency to provide clients with a better service. This paper aims to generate a definition of complexity and a method for its measurement in order to assess its influence upon the accuracy of the quantity surveying profession in UK new build office construction. Quantitative data came from an analysis of twenty projects of varying size and value and qualitative data came from interviews with professional quantity surveyors. The findings highlight the difficulty in defining and measuring project complexity. The correlation between accuracy and complexity was not straightforward, being subjected to many extraneous variables, particularly the impact of project size. Further research is required to develop a better measure of complexity. This is in order to improve the response of quantity surveyors, so that an appropriate level of effort can be applied to individual projects, permitting greater accuracy and enabling better resource planning within the profession.

Effective livelihood adaptation to climate change disturbance: scale dimensions of practice in Mozambique

Natural resource-dependent societies in developing countries are facing increased pressures linked to global climate change. While social-ecological systems evolve to accommodate variability, there is growing evidence that changes in drought, storm and flood extremes are increasing exposure of currently vulnerable populations. In many countries in Africa, these pressures are compounded by disruption to institutions and variability in livelihoods and income. The interactions of both rapid and slow onset livelihood disturbance contribute to enduring poverty and slow processes of rural livelihood renewal across a complex landscape. We explore cross-scale dynamics in coping and adaptation response, drawing on qualitative data from a case study in Mozambique. The research characterises the engagements across multiple institutional scales and the types of agents involved, providing insight into emergent conditions for adaptation to climate change in rural economies, The analysis explores local responses to climate shocks, food security and poverty reduction, through informal institutions, forms of livelihood diversification and collective land-use systems that allow reciprocity, flexibility and the ability to buffer shocks. However, the analysis shows that agricultural initiatives have helped to facilitate effective livelihood renewal, through the reorganisation of social institutions and opportunities for communication, innovation and micro-credit. Although there are challenges to mainstreaming adaptation at different scales, this research shows why it is critical to assess how policies can protect conditions for emergence of livelihood transformation. (C) 2008 Elsevier Ltd. All rights reserved.

Attitudes of landscape professionals towards naturalistic versus formal urban landscapes in the UK

The last 30 years have seen a tide of interest sweeping across Europe in the development of nature in cities, and an increasing amount of landscape development in urban areas has involved the use of 'naturalistic' styles. This is an increasing attempt to find ways for urbanism and nature to co-exist. However, there have been considerable discussions among professionals regarding the advantages and disadvantages of 'naturalistic' styles in urban areas. This research examines professional attitudes to 'naturalistic' landscape styles in Britain, in contrast to more traditional, formal landscape styles, and aims to find out whether the interest in natural landscapes is really a fashion among landscape professionals. A self-administered postal survey was carried out using both quantitative and qualitative data collection techniques and analysis. The survey included 500 professionals from parks and recreation departments of local authorities, private landscape practices and conservation trusts, and resulted in a satisfactory response rate of 53 %. The results of this study suggested that professionals recognise most of the values attached to naturalistic landscapes in urban areas. However, possible benefits that natural areas may have for urban people are not attached to naturalistic landscapes alone. The study also revealed that the naturalistic style is highly popular among conservation trusts but is less so among professionals from local authorities and private landscape practices who seem to appreciate both styles and believe that these styles are not separable from each other and should co-exist in an urban environment. (C) 2006 Elsevier B.V. All rights reserved.

Hitting emissions targets with (statistical) confidence in multi-instrument Emissions Trading Schemes

A means of assessing, monitoring and controlling aggregate emissions from multi-instrument Emissions Trading Schemes is proposed. The approach allows contributions from different instruments with different forms of emissions targets to be integrated. Where Emissions Trading Schemes are helping meet specific national targets, the approach allows the entry requirements of new participants to be calculated and set at a level that will achieve these targets. The approach is multi-levelled, and may be extended downwards to support pooling of participants within instruments, or upwards to embed Emissions Trading Schemes within a wider suite of policies and measures with hard and soft targets. Aggregate emissions from each instrument are treated stochastically. Emissions from the scheme as a whole are then the joint probability distribution formed by integrating the emissions from its instruments. Because a Bayesian approach is adopted, qualitative and semi-qualitative data from expert opinion can be used where quantitative data is not currently available, or is incomplete. This approach helps government retain sufficient control over emissions trading scheme targets to allow them to meet their emissions reduction obligations, while minimising the need for retrospectively adjusting existing participants’ conditions of entry. This maintains participant confidence, while providing the necessary policy levers for good governance.

A study of students' metacognitive beliefs about foreign language study and their impact on learning

This article reports on an investigation into the language learning beliefs of students of French in England, aged 16 to 18. It focuses on qualitative data from two groups of learners (10 in total). While both groups had broadly similar levels of achievement in French in terns of examination success, they dffered greatly in the self-image they had of themselves as language learners, with one group displaying low levels of self-eficacy beliefs regarding the possibility of future success. The implica tions of such beliefs for students' levels of motivation and persistence are discussed, together with their possible causes. The article concludes by suggesting changes in classroom practice that might help students develop a more positive image of them selves as language learners.

Changing Standards? Children's awareness and knowledge of features of written standard English at ages 10-11

This paper reports the findings of a small-scale research project, which investigated the levels of awareness and knowledge of written standard English of 10- and 11-year-old children in two English primary schools over a six-year period, coinciding with the implementation in the schools of the National Literacy Strategy (NLS). A questionnaire was used to provide quantitative and qualitative data relating to: features of writing which were recognised as standard or non-standard; children's understanding of technical terminology; variations between boys' and girls' performance; and the impact of the NLS over time. The findings reveal variations in levels of recognition of different non-standard features, differences between girls' and boys' recognition, possible examples of language change, but no evidence of a positive impact of the NLS. The implications of these findings are discussed both in terms of changes in educational standards and changes to standard English.

Psychological response to later life widowhood: coping and the effects of gender

The study examined the effects of psychological response and gender on coping with late life widowhood. Forty-six men and 46 women (55 years +) were interviewed about their experiences of widowhood. Participants were classified as to whether they were coping well or less well. Data were analyzed using grounded theory, content. analysis, and three-way loglinear analyses. Loglinear analyses revealed three-way interactions for Gender, Coping, and Response. Men who report feeling upset or selfish are more likely to be coping, as are women who report being comfortable alone. There were two-way interactions between Coping and Response and Gender and Response. Participants who talk to their dead spouse are more Rely to be coping than those who do not. Those who "keep themselves to themselves" are more likely not to be coping than those who do not. Gender differences, were found in psychological response. Differences were also found between those who coped and those who coped less well. The study has enabled the synthesis of quantitative and qualitative data to present a more complete view of late life widowhood than has previously been possible. In addition, the article draws attention to the importance of distinguishing between the effects of bereavement and those of widowhood.

Securing provision for children with autistic spectrum disorders: the views of parents

An original questionnaire was designed to seek the perspectives of parents about the process of securing appropriate educational provision for their child with autism spectrum disorder. In total, 738 responses were analysed using both quantative and qualitative data. Although a broad range of opinion was evidenced and a clear majority of families were happy with the end decision of placement, most families were significantly less happy with the process to determine that provision. Most families found this process difficult to navigate and frustrating. This caused a high level of stress for a significant proportion of families. Implications for practice are discussed.