2,682 research outputs found
The role of nursing in multimorbidity care
Background
Multimorbidity (the co-occurrence of two or more chronic conditions in the same person) affects around one in three persons, and it is strongly associated with a range of negative outcomes including worsening physical function, increased health care use, and premature death. Due to the way healthcare is provided to people with multimorbidity, treatment can become burdensome, fragmented and inefficient. In people with palliative conditions, multimorbidity is increasingly common. Better models of care are needed.
Methods
A mixed-methods programme of research designed to inform the development of a nurse-led intervention for people with multimorbidity and palliative conditions. A mixed-methods systematic review explored nurse-led interventions for multimorbidity and their effects on outcomes. A cross-sectional study of 63,328 emergency department attenders explored the association between multimorbidity, complex multimorbidity (â„3 conditions affecting â„3 body systems), and disease-burden on healthcare use and inpatient mortality. A focussed ethnographic study of people with multimorbidity and life-limiting conditions and their carers (n=12) explored the concept of treatment burden.
Findings
Nurse-led interventions for people with multimorbidity generally focus on care coordination (i.e., case management or transitional care); patients view them positively, but they do not reliably reduce health care use or costs. Multimorbidity and complex multimorbidity were significantly associated with admission from the emergency department and reattendance within 30 and 90 days. The association was greater in those with more conditions. There was no association with inpatient mortality. People with multimorbidity and palliative conditions experienced treatment burden in a manner consistent with existing theoretical models. This thesis also noted the effect of uncertainty on the balance between capacity and workload and proposes a model of how these concepts relate to one another.
Discussion
This thesis addresses a gap in what is known about the role of nurses in providing care to the growing number of people with multimorbidity. A theory-based nurse-led intervention is proposed which prioritises managing treatment burden and uncertainty.
Conclusions
Nursing in an age of multimorbidity necessitates a perspective shift which conceptualises chronic conditions as multiple overlapping phenomena situated within an individual. The role of the nurse should be to help patients navigate the complexity of living with multiple chronic conditions
On the real world practice of Behaviour Driven Development
Surveys of industry practice over the last decade suggest that Behaviour Driven Development is a popular Agile practice. For example, 19% of respondents to the 14th State of Agile annual survey reported using BDD, placing it in the top 13 practices reported. As well as potential benefits, the adoption of BDD necessarily involves an additional cost of writing and maintaining Gherkin features and scenarios, and (if used for acceptance testing,) the associated step functions. Yet there is a lack of published literature exploring how BDD is used in practice and the challenges experienced by real world software development efforts. This gap is significant because without understanding current real world practice, it is hard to identify opportunities to address and mitigate challenges. In order to address this research gap concerning the challenges of using BDD, this thesis reports on a research project which explored: (a) the challenges of applying agile and undertaking requirements engineering in a real world context; (b) the challenges of applying BDD specifically and (c) the application of BDD in open-source projects to understand challenges in this different context.
For this purpose, we progressively conducted two case studies, two series of interviews, four iterations of action research, and an empirical study. The first case study was conducted in an avionics company to discover the challenges of using an agile process in a large scale safety critical project environment. Since requirements management was found to be one of the biggest challenges during the case study, we decided to investigate BDD because of its reputation for requirements management. The second case study was conducted in the company with an aim to discover the challenges of using BDD in real life. The case study was complemented with an empirical study of the practice of BDD in open source projects, taking a study sample from the GitHub open source collaboration site.
As a result of this Ph.D research, we were able to discover: (i) challenges of using an agile process in a large scale safety-critical organisation, (ii) current state of BDD in practice, (iii) technical limitations of Gherkin (i.e., the language for writing requirements in BDD), (iv) challenges of using BDD in a real project, (v) bad smells in the Gherkin specifications of open source projects on GitHub. We also presented a brief comparison between the theoretical description of BDD and BDD in practice. This research, therefore, presents the results of lessons learned from BDD in practice, and serves as a guide for software practitioners planning on using BDD in their projects
Protecting Privacy in Indian Schools: Regulating AI-based Technologies' Design, Development and Deployment
Education is one of the priority areas for the Indian government, where Artificial Intelligence (AI) technologies are touted to bring digital transformation. Several Indian states have also started deploying facial recognition-enabled CCTV cameras, emotion recognition technologies, fingerprint scanners, and Radio frequency identification tags in their schools to provide personalised recommendations, ensure student security, and predict the drop-out rate of students but also provide 360-degree information of a student. Further, Integrating Aadhaar (digital identity card that works on biometric data) across AI technologies and learning and management systems (LMS) renders schools a âpanopticonâ.
Certain technologies or systems like Aadhaar, CCTV cameras, GPS Systems, RFID tags, and learning management systems are used primarily for continuous data collection, storage, and retention purposes. Though they cannot be termed AI technologies per se, they are fundamental for designing and developing AI systems like facial, fingerprint, and emotion recognition technologies. The large amount of student data collected speedily through the former technologies is used to create an algorithm for the latter-stated AI systems. Once algorithms are processed using machine learning (ML) techniques, they learn correlations between multiple datasets predicting each studentâs identity, decisions, grades, learning growth, tendency to drop out, and other behavioural characteristics. Such autonomous and repetitive collection, processing, storage, and retention of student data without effective data protection legislation endangers student privacy.
The algorithmic predictions by AI technologies are an avatar of the data fed into the system. An AI technology is as good as the person collecting the data, processing it for a relevant and valuable output, and regularly evaluating the inputs going inside an AI model. An AI model can produce inaccurate predictions if the person overlooks any relevant data. However, the state, school administrations and parentsâ belief in AI technologies as a panacea to student security and educational development overlooks the context in which âdata practicesâ are conducted. A right to privacy in an AI age is inextricably connected to data practices where data gets âcookedâ. Thus, data protection legislation operating without understanding and regulating such data practices will remain ineffective in safeguarding privacy.
The thesis undergoes interdisciplinary research that enables a better understanding of the interplay of data practices of AI technologies with social practices of an Indian school, which the present Indian data protection legislation overlooks, endangering studentsâ privacy from designing and developing to deploying stages of an AI model. The thesis recommends the Indian legislature frame better legislation equipped for the AI/ML age and the Indian judiciary on evaluating the legality and reasonability of designing, developing, and deploying such technologies in schools
âSo what if ChatGPT wrote it?â Multidisciplinary perspectives on opportunities, challenges and implications of generative conversational AI for research, practice and policy
Transformative artificially intelligent tools, such as ChatGPT, designed to generate sophisticated text indistinguishable from that produced by a human, are applicable across a wide range of contexts. The technology presents opportunities as well as, often ethical and legal, challenges, and has the potential for both positive and negative impacts for organisations, society, and individuals. Offering multi-disciplinary insight into some of these, this article brings together 43 contributions from experts in fields such as computer science, marketing, information systems, education, policy, hospitality and tourism, management, publishing, and nursing. The contributors acknowledge ChatGPTâs capabilities to enhance productivity and suggest that it is likely to offer significant gains in the banking, hospitality and tourism, and information technology industries, and enhance business activities, such as management and marketing. Nevertheless, they also consider its limitations, disruptions to practices, threats to privacy and security, and consequences of biases, misuse, and misinformation. However, opinion is split on whether ChatGPTâs use should be restricted or legislated. Drawing on these contributions, the article identifies questions requiring further research across three thematic areas: knowledge, transparency, and ethics; digital transformation of organisations and societies; and teaching, learning, and scholarly research. The avenues for further research include: identifying skills, resources, and capabilities needed to handle generative AI; examining biases of generative AI attributable to training datasets and processes; exploring business and societal contexts best suited for generative AI implementation; determining optimal combinations of human and generative AI for various tasks; identifying ways to assess accuracy of text produced by generative AI; and uncovering the ethical and legal issues in using generative AI across different contexts
Challenges in the Design and Implementation of IoT Testbeds in Smart-Cities : A Systematic Review
Advancements in wireless communication and the increased accessibility to low-cost sensing and data processing IoT technologies have increased the research and development of urban monitoring systems. Most smart city research projects rely on deploying proprietary IoT testbeds for indoor and outdoor data collection. Such testbeds typically rely on a three-tier architecture composed of the Endpoint, the Edge, and the Cloud. Managing the system's operation whilst considering the security and privacy challenges that emerge, such as data privacy controls, network security, and security updates on the devices, is challenging. This work presents a systematic study of the challenges of developing, deploying and managing urban monitoring testbeds, as experienced in a series of urban monitoring research projects, followed by an analysis of the relevant literature. By identifying the challenges in the various projects and organising them under the V-model development lifecycle levels, we provide a reference guide for future projects. Understanding the challenges early on will facilitate current and future smart-cities IoT research projects to reduce implementation time and deliver secure and resilient testbeds
Essays on Manufacturersâ IT Capabilities for Digital Servitization
Over the last decades, studies have found that transformational drivers affect how firms innovate their business models (Chesbrough, 2010; Massa et al., 2016). In markets in which physical products become commodities, the servitization of business models is a transformational driver for firms (Wise & Baumgartner, 1999). For its part, digitalization increases the potential to reshape business models through novel use cases of technology (Yoo et al., 2010). Recently, digitalization was found to extend the opportunities from servitization through digital technologies as digital servitization (Paschou et al., 2020). Digital servitization describes a firmâs shift from product-centric offerings to service-centric offerings with the help of novel IT assets (Naik et al., 2020). The manufacturing industry provides promising examples of firms with portfolios of physical offerings that might undergo such a transformational shift (Baines et al., 2017).
So far, digital servitization research focuses primarily on four topics: re-defining the notion of servitization in the context of digitalization, identifying digital servitization value drivers, linking the transformation to specific technologies, and deriving how novel service offerings arise (Paschou et al., 2020; Zhou & Song, 2021).
Despite the breadth of digital servitization research, how firms can shift to service-centric offerings remains unclear (KohtamÀki et al., 2019). Specifically, research lacks studies on the prerequisites and mechanisms that link theory with evidence on achieving IT-enabled service innovation (Paschou et al., 2020). Further, how firms must organize to build and operate IT-enabled services around these technologies remains unclear (Paschou et al., 2020). In a recent report on the manufacturing industry, practitioners confirm these gaps and associate them with a lack of managerial and technical knowledge (Illner et al., 2020).
A theoretical lens that helps to address these shortcomings is the knowledge-based theory. It suggests that knowledge is the primary rationale, so that a firm benefits from its assets (Grant, 1996b; Nonaka, 1994). The knowledge-based theory understands a capability as a directed application of knowledge in a firmâs activities (Grant, 1996b; Nonaka, 1994). In the context of digitalization, firms require IT capabilities based on knowledge of how to capitalize on IT assets (Lee et al., 2015). Digital servitization research finds that IT capabilities are critical for identifying, adapting, and exploiting IT-enabled service innovations (Johansson et al., 2019). Still, little extant research informs firms that undergo digital servitization about which IT capabilities can help to strengthen their competitive advantage (Coreynen et al., 2017).
Even though IT capabilities may be necessary for success in innovating IT-enabled services, the required knowledge needs to be disseminated effectively throughout an organization (Foss et al., 2014; Grant, 1996a; Nonaka, 1994). The organizational control theory offers a theoretical perspective about knowledge dissemination mechanisms, which can be horizontal or vertical (Ouchi, 1979). Horizontal knowledge dissemination mechanisms depend on codifying processes in rules or measuring process outputs through indicators, while the locus of exerting these rules and indicators determines the vertical knowledge dissemination. The IT innovation and IT governance literature refers to these knowledge dissemination mechanisms as formalization of IT activities and centralization of IT decision-making (Weill, 2004; Winkler & Brown, 2013; Zmud, 1982). However, how to orchestrate knowledge, particularly for IT capabilities, in firms that undergo digital servitization is not yet clear (KohtamĂ€ki et al., 2019; MĂŒnch et al., 2022; Sjödin et al., 2020).
Against this background, this dissertation addresses how manufacturers organize their IT capabilities while encountering the transformational drivers of digital servitization by answering the following overarching research question:
How can manufacturers organize their IT capabilities to capitalize on digital servitization? (References to be found in the full text):List of abbreviations in synopsis............................................................................................................V
Part I: Synopsis of the dissertation..........................................................................................................11
Motivation.......................................................................................................................................12
Research design...............................................................................................................................22.
1Conceptual approach and research objectives....................................................................22.
2Research methodologies and methods................................................................................4
3Structure of the dissertation.............................................................................................................5
3.1Systematization of the papers.............................................................................................5
3.2Paper1: Revisiting the concept of IT capabilities in the era of digitalization....................7
3.3Paper2: Short and sweet âMultiple mini case studies as a form of rigorous case studyresearch...............................................................................................................................9
3.4Paper3: Linking IT capabilities and competitive advantage of servitized business models..........................................................................................................................................11
3.5Paper4: From selling machinery to hybrid offerings âOrganizational impact of digitalservitization on manufacturing firms................................................................................11
3.6Paper5: Manufacturersâ IT-enabled service innovation success as a multifacetedphenomenon: A configurational study..............................................................................13
3.7Paper6: The missing piece âCalibration of qualitative data for qualitative comparativeanalyses in IS research......................................................................................................14
3.8Paper7: Prerequisites and causal recipes for manufacturersâ success in innovating ITenabled services................................................................................................................16
4Conclusion.....................................................................................................................................19
4.1Resultssummary...............................................................................................................19
4.2Contributions....................................................................................................................20
4.2.1Theoretical contributions......................................................................................20
4.2.2Methodological contribution................................................................................21
4.2.3Practical contribution............................................................................................21
4.3Limitations and future research........................................................................................22
5References.....................................................................................................................................24
Part II: Papers of the dissertation...........................................................................................................29
Paper1: Revisiting the concept of IT capabilities in the era of digitalization.......................................30
Paper2: Short and sweet âMultiple mini case studies as a form of rigorous case study research.......41
Paper3: Linking IT capabilities and competitive advantage of servitized business model..................64
Paper4: From selling machinery to hybrid offerings âOrganizational impact of digital servitization on manufacturing firms......................................................................................................................80
Paper5: Manufacturersâ IT-enabled service innovation success as a multifaceted phenomenon: A configurational study...................................................................................................................108
Paper6: The missing piece âCalibration of qualitative data for qualitative comparative analyses in IS research........................................................................................................................................119
Paper7: Prerequisites and causal recipes for manufacturersâ success in innovating IT-enabled services.....................................................................................................................................................136
Overview of the digital appendix on CD.............................................................................................17
The ethics and politics of deportation in Europe
Defence date: 19 February 2019Examining Board:
Professor Rainer Bauböck, European University Institute (Supervisor); Professor Matthew Gibney, University of Oxford;
Professor Iseult Honohan, University College Dublin;
Professor Jennifer Welsh, McGill University (formerly European University Institute)This thesis explores key empirical and normative questions prompted by deportation policies and practices in the contemporary European context. The core empirical research question the thesis seeks to address is: what explains the shape of deportation regimes in European liberal democracies? The core normative research question is: how should we evaluate these deportation regimes morally? The two parts of the thesis address each of these questions in turn. To explain contemporary European deportation regimes, the four chapters of the first part of the thesis investigate them from a historical and multilevel perspective. (âExpulsion Old and Newâ) starts by comparing contemporary deportation practices to earlier forms of forced removal such as criminal banishment, political exile, poor law expulsion, and collective expulsions on a religious or ethnic basis, highlighting how contemporary deportation echoes some of the purposes of these earlier forms of expulsion. (âDivergences in Deportationâ) looks at some major differences between European countries in how, and how much, deportation is used as a policy instrument today, concluding that they can be roughly grouped into four regime types, namely lenient, selective, symbolically strict and coercively strict. The next two chapters investigate how non-national levels of government are involved in shaping deportation in the European context. (âEuropeanising Expulsionâ) traces how the institutions of the European Union have come to both restrain and facilitate or incentivise member statesâ deportation practices in fundamental ways. (âLocalities of Belongingâ) describes how provincial and municipal governments are increasingly assertive in frustrating deportations, effectively shielding individuals or entire categories of people from the reach of national deportation efforts, while in other cases local governments pressure the national level into instigating deportation proceedings against unwanted residents. The chapters argue that such efforts on both the supranational and local levels must be explained with reference to supranational and local conceptions of membership that are part of a multilevel citizenship structure yet can, and often do, come apart from the national conception of belonging. The second part of the thesis addresses the second research question by discussing the normative issues deportation gives rise to. (âDeportability, Domicile and the Human Right to Stayâ) argues that a moral and legal status of non-deportability should be extended beyond citizenship to all those who have established effective domicile, or long-term and permanent residence, in the national territory. (âDeportation without Domination?â) argues that deportation can and should be applied in a way that does not dominate those it subjects by ensuring its non-arbitrary application through a limiting of executive discretion and by establishing proportionality testing in deportation procedures. (âResisting Unjust Deportationâ) investigates what can and should be done in the face of unjust national deportation regimes, proposing that a normative framework for morally justified antideportation resistance must start by differentiating between the various individual and institutional agents of resistance before specifying how their right or duty to resist a particular deportation depends on motivational, epistemic and relational conditions
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