The Sharing Economy in Cities : Institutionalisation and Sustainability

The sharing economy is a novel way of distributing physical resources facilitated by online platforms where temporary access is given to goods owned by peers or organisations. It has become prominent in urban areas where a large accumulation of resources in close proximity and the ubiquity of information and communications technology enable it to grow. Its emergence has had various impacts on existing urban systems that are essential for the well-functioning of cities. There is therefore value in exploring its institutionalisation in specific urban contexts.This PhD dissertation aims to advance understanding on (i) how two key actor groups, urban sharing organisations and municipal governments, work to shape the development of the sharing economy in cities, and (ii) which sustainability claims they use to shape this process. The study draws on 150 interviews with key sharing economy actors collected during mobile research labs in six cities: London, Berlin, Amsterdam, Malmö, San Francisco, and Toronto. The research gaps are further assessed by combining four theoretical angles: institutional work, governance theory, framing theory, and sustainability science. It was found that urban sharing organisations engage in both institutional creation and disruption when attempting to institutionalise sharing practices in cities. These modes of institutional work vary among the different organisations, and impact which sharing practices become institutionalised and which existing institutions become disrupted. As a response to the emergence of the sharing economy in cities, municipal governments have developed a portfolio of governance mechanisms. When they steer the development of urban sharing organisations, they engage in outward governance. When they define who they are in relation to the sharing economy, and direct their efforts towards their own actions, it is referred to as inward governance. Often, urban sharing organisations and municipal governments use sustainability framings to co-create the sharing economy in cities. These framings are also explored in this thesis.The study underlines that the diversity of sharing economy business models, existing institutional arrangements in cities, urban sustainability issues, and institutional work of key actors are some of the key factors influencing institutionalisation of the sharing economy in cities. These factors also determine how the sharing economy will impact urban sustainability in the future

Cooking quality in potatoes depending on cultivation measures and specific gravity

Matpotatis är en livsmedelsråvara där den specifika vikten är direkt avgörande för kokegenskaperna och kvaliteten. På grund av varierande kokkvalitet hos matpotatis blev vi kontaktade av Skånes Potatisodlarförening för att göra en dokumentation om hur odlarna bedriver sina matpotatisodlingar och för att försöka hitta ett samband mellan odlingsåtgärder och kokkvalitet i matpotatisen. Genom styrd bevattning, val av gödselmängder och jordmån är teorin att man kan påverka den specifika viktens utveckling under växtperioden och därmed kokkvaliteten. I projektet deltog 12 odlare, utspridda i hela Skåne, och en odlare i södra Halland. Projektet inleddes med att åka ut till alla odlarna och utföra en skriftlig dokumentation om hur odlingarna bedrivs och vilka strategier som odlarna hade inför säsongen. Under odlingssäsongen besöktes varje odlare en gång per vecka och prov togs ut för att bestämma den specifika vikten hos potatisen från olika delar av fälten. Målet var att följa den specifika viktens utveckling under olika förhållanden, såsom nederbörd, bevattning, gödsling och jordmåner. Under odlingssäsongen bestämdes matpotatisens specifika vikt genom ”sjunkprovsmetoden”. I denna metod vägs en exakt mängd potatis upp och sedan sänker man ner potatisen i ett vattenbad. Därefter mäter man hur mycket vatten som potatisen trycker undan och får genom avläsning i en översättningstabell reda på den specifika vikten. Både i samband med blastdödning och upptagning lämnades prover till SMAK för bestämning av specifik vikt och kokanalyser. För potatissorten Sava som studerades hos 5 odlare fanns större möjligheter att dra slutsatser om riktvärdet för den specifika vikten så att bra kokegenskaper uppnås. Studien tyder på att 1075 för den specifika vikten hos Sava är ett rimligt mål att satsa på för att få bra egenskaper och rätt kokkvalitet. Efter genomfört arbete har vi inte kunnat identifiera några speciella odlingsåtgärder som vi med säkerhet kan säga påverka kokresultatet p.g.a. studiens översiktliga upplägg. Däremot tror vi att många variabler påverkar resultatet, bland annat vatten- och kvävetillgången, hur blastdödningen utförs samt hur snabbt potatisen slutar växa efter att blastdödningen utförts och om potatisen börjar växa om igen efter blastdödningen. Det finns en viss antydan till att tyngre jord leder till en högre specifik vikt, men detta är inte helt entydigt.Potatoes are a raw material where the specific gravity content is crucial for the cooking quality. We were contacted because of the variation in cooking qualities by the “Skånes Potato Growers Union” to perform a survey on how potato is grown and to try and find a relation between farming methods and cooking qualities. The theory is that thru controlled irrigation, the choice of fertilizers and soil structure, the cooking quality and the specific gravity content, development during the growing season can be affected. There are 12 growers participating in this project, scattered all over Skåne and one in southern Halland. We started the project by visiting all the farmers to perform a written documentation about how the farmers grow their potatoes and which strategies they had before the growth season. During the growing season each field was visited every week and samples were taken from different parts of the field for determination of the specific gravity. The aim was to follow the development of the specific gravity content during different conditions such as rainfall, irrigation, fertilization and soil structure. During the growth season the specific gravity content is determined by the potato hydrometer, a certain weight of potatoes is measured and then lowered into a bucket of water. The amount of water that is pushed away by the potatoes is measured and by using a translation table the specific gravity content can be determined. One sample is taken at the same time as haulm killing and one sample is taken at the time of harvesting and both were sent to SMAK for cooking analysis. 5 growers had the potato variety Sava and beacuse of this, the possibilities to draw more accurate results on what specific gravity recommendations that are needed to obtain good cooking quality, were larger. The study indicates that the aim of 1075 for specific gravity of Sava, is a resonable aim to obtain the correct cooking quality. We have not been able to idetify any specific cultivations measures after completing this study that directly affects the results, because of the overall layout of the study. On the other hand we believe that a lot of variables affects the results and the most important variables are water- and nitrogensupply. Other cultivation measures that we believe play an important role are the way haulm killing is done and how quickly the potatoes actually dies after this as well as if the potatoes starts to grow again after the defoliation. It seems like that soil with higher claycontent might lead to higher specific gravity but this is not univocally

Outcome of probe-based confocal laser endomicroscopy (pCLE) during endoscopic retrograde cholangiopancreatography: a single-center prospective study in 45 patients

Background: Diagnosis of pre-malignant and malignant lesions in the bile duct and the pancreas is sometimes cumbersome. This applies in particular to intraductal papillary mucinous neoplasia (IPMN) and bile duct strictures in primary sclerosing cholangitis (PSC). Aims: To evaluate in a prospective cohort study the sensitivity and specificity of probe-based confocal laser microscopy (pCLE) during endoscopic retrograde cholangiopancreatography (ERCP). Methods: We performed pCLE together with mother-baby endoscopy (SpyGlass) during 50 ERCP sessions in 45 patients. The Miami and Paris criteria were applied. Clinical diagnosis via imaging was compared to pCLE and the final pathological diagnosis from surgically-resected, biopsy, or cytology specimens. Patients were followed up for at least 1 year. Results: We were able to perform pCLE in all patients. Prior to endoscopy, the diagnosis was benign in 23 patients and undetermined (suspicious) in 16 patients, while six patients had an unequivocal diagnosis of malignancy. Sensitivity was 91% and specificity 52%. The positive (PPV) and negative predictive value (NPV) was 82% and 100%, respectively. Apart from mild post-ERCP pancreatitis in two patients, no complications occurred. Conclusions: Our study showed that pCLE is a safe, expert endoscopic method with high technical feasibility, high sensitivity and high NPV. It provided diagnostic information that can be helpful for decisions on patient management, especially in the case of IPMN and unclear pancreatic lesions, in individuals whom are at increased risk for pancreatic cancer

Validity of a virtual reality endoscopic retrograde cholangiopancreatography simulator: can it distinguish experts from novices?

BackgroundThere is a lack of evidence regarding the effectiveness of virtual simulators as a means to acquire hands-on exposure to endoscopic retrograde cholangiopancreatography (ERCP). The present study aimed to assess the outcome and construct validity of virtual ERCP when training on the GI II Mentor simulator.MethodsA group of seven experienced endoscopists were compared with 31 novices. After a short introduction, they were requested to carry out three virtual ERCP procedures: diagnosing and removing a common bile duct (CBD) stone; diagnosing and taking brush cytology from a hilar stenosis; and, finally, diagnosing and treating a cystic leakage with a BD stent. For each task, the total time required to complete the task, time required to correctly view the papilla, total time of irradiation, time to deep cannulation, time to define diagnosis, time to complete sphincterotomy, and time to complete the respective intervention were measured. Cannulation of the BD, correct diagnosis, sphincterotomy, and time to complete intervention were assessed by an assessor blinded to the status of the endoscopist who performed the virtual ERCP.ResultsThe time required to visualize the papilla and to cannulate deeply when removing the BD stone was significantly shorter for the experts (both p < 0.05). The time to visualize the papilla, cannulate deeply, reach a diagnosis, complete sphincterotomy, and complete the intervention was significantly shorter for the experts when managing cystic leakage (all p < 0.05). In diagnosing and taking brush cytology from a hilar stenosis, there was only a trend toward the experts needing less time for the deep cannulation of the BD (p = 0.077).ConclusionThe performance differed between experts and novices, especially in the management of cystic leakage. This corroborates the construct validity of the GI II Mentor simulator

Gender plays no role in student ability to perform on computer-based examinations

BACKGROUND: To see if there is a difference in performance when students switch from traditional paper-and-pencil examinations to computer-based examinations, and to determine whether there are gender differences in student performance in these two examination formats. METHODS: This study involved first year medical students at the University of Illinois at Urbana-Champaign over three Academic Years 2002–03/2003–04 and 2003–05. Comparisons of student performance by overall class and gender were made. Specific comparisons within courses that utilized both the paper-and-pencil and computer formats were analyzed. RESULTS: Overall performance scores for students among the various Academic Years revealed no differences between exams given in the traditional pen-and-paper and computer formats. Further, when we looked specifically for gender differences in performance between these two testing formats, we found none. CONCLUSION: The format for examinations in the courses analyzed does not affect student performance. We find no evidence for gender differences in performance on exams on pen-and-paper or computer-based exams

Correlation between morphological and functional liver volume in each sector using integrated SPECT/CT imaging by computed tomography and technetium-99m galactosyl serum albumin scintigraphy in patients with various diseases who had undergone hepatectomy

OBJECTIVES: The aim of the study was to accurately examine the functional volume (RI-vol) of the hepatic segments on single photon emission computed tomography/computed tomography (CT) fusion imaging by technetium-99m galactosyl human serum albumin scintigraphy and compare it with the RI-vol and morphological volume obtained on computed tomography (CT-vol). METHODS: In 60 patients with various liver background statuses who had undergone hepatectomy, the RI-vol and CT-vol were examined in each sector using imaging analysis. The values from a control group (n=91) were used as reference data. RESULTS: The mean RI-vol and CT-vol of the right liver were 64±10 and 63±6%, respectively, whereas the values for the left liver were 36±10 and 37±6%, respectively. Compared with the control group, the ratios in each hemiliver were similar. The mean RI-vol and CT-vol for each sector were also similar, and significant positive correlations were identified between the two volumes (P<0.01). In four patients with hepatic tumors involving the main hepatic vessels or the bile duct and in 10 patients who had undergone portal vein embolization, the actual RI-vol in the injured sector was significantly decreased compared with CT-vol (P<0.05). There were marked changes in functional volume in segment 6+7 and segment 2+3 after portal vein embolization (P<0.05). CONCLUSION: Volumetric measurement using single photon emission computed tomography/CT imaging with technetium-99m galactosyl human serum albumin scintigraphy is useful for evaluating the functional volume in separated livers and offers a good reflection of the background liver status

Serious Gaming and Gamification interventions for health professional education

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effectiveness of Serious Gaming and Gamification interventions for delivering pre- and post-registration health professional education compared with traditional learning, other types of eLearning, or other Serious Gaming and Gamification interventions. We will primarily assess the impact of these interventions on students' knowledge, skills, professional attitudes and satisfaction

Preoperative biliary drainage by plastic or self-expandable metal stents in patients with periampullary tumors: results of a randomized clinical study

Background and study aims Preoperative biliary drainage in patients with periampullary tumors and jaundice has been popularized to improve the quality of life and minimize the risks associated with subsequent radical surgery. The aim of this study was to investigate the possible superiority of self-expandable metal stents (SEMS) over plastic stents, by comparing the amount of bacteria in intraoperatively collected bile and using this variable as a proxy for the efficacy of the respective biliary drainage modalities. Patients and methods In this randomized clinical trial, 92 patients with obstructive jaundice were enrolled; 45 were allocated to the plastic stent group and 47 to the SEMS group. The primary outcome was the extent and magnitude of biliary bacterial growth at the time of surgical exploration. Secondary outcomes were: macroscopic grading of inflammation of the stented bile ducts, occurrence of adverse events after stenting, stent dysfunction, recognized surgical complexities, and incidence of postoperative complications. Results The patients were well matched regarding clinical and disease-specific characteristics. At surgery, there were no group differences in the bacterial amount and composition of the bile cultures or the perceived difficulty of surgical dissection. During the preoperative biliary drainage period, more instances of stent dysfunction requiring stent replacement were recorded in the plastic stent group (19 % vs. 0 %; P = 0.03). Postoperative complications in patients who underwent curative surgery were more common in patients with plastic stents (72 % vs. 52 %), among which clinically significant leakage from the pancreatic anastomoses seemed to predominate (12 % vs. 3.7 %); however, none of these differences in postoperative adverse events reached statistical significance. Conclusion This randomized clinical study was unable to demonstrate any superiority of SEMS in the efficacy of preoperative bile drainage, as assessed by the amount of bacteria in the intraoperatively collected bile. However, some data in favor of SEMS were observed among the clinical secondary outcomes variables (preoperative stent exchange rates) without increases in local inflammatory reactions

Will the Playstation generation become better endoscopic surgeons?

A frequently heard comment is that the current "Playstation generation" will have superior baseline psychomotor skills. However, research has provided inconsistent results on this matter. The purpose of this study was to investigate whether the "Playstation generation" shows superior baseline psychomotor skills for endoscopic surgery on a virtual reality simulator. The 46 study participants were interns (mean age 24 years) of the department of surgery and schoolchildren (mean age 12.5 years) of the first year of a secondary school. Participants were divided into four groups: 10 interns with videogame experience and 10 without, 13 schoolchildren with videogame experience and 13 without. They performed four tasks twice on a virtual reality simulator for basic endoscopic skills. The one-way analysis of variance (ANOVA) with post hoc test Tukey-Bonferroni and the independent Student's t test were used to determine differences in mean scores. Interns with videogame experience scored significantly higher on total score (93 vs. 74.5; p=0.014) compared with interns without this experience. There was a nonsignificant difference in mean total scores between the group of schoolchildren with and those without videogame experience (61.69 vs. 55.46; p=0.411). The same accounts for interns with regard to mean scores on efficiency (50.7 vs. 38.9; p=0.011) and speed (18.8 vs. 14.3; p=0.023). In the group of schoolchildren, there was no statistical difference for efficiency (32.69 vs. 27.31; p=0.218) or speed (13.92 vs. 13.15; p=0.54). The scores concerning precision parameters did not differ for interns (23.5 vs. 21.3; p=0.79) or for schoolchildren (mean 15.08 vs. 15; p=0.979). Our study results did not predict an advantage of videogame experience in children with regard to superior psychomotor skills for endoscopic surgery. However, at adult age, a difference in favor of gaming is present. The next generation of surgeons might benefit from videogame experience during their childhoo