Access to Technology and Data in Smart Cities for South African Digital Citizens

Lack of access to technologies and quality data are key challenges for reducing the digital divide and developing digital citizens to support Smart City initiatives. This paper reviews efforts towards Smart Cities and access to smart technology and Open Data in developed economies globally and in South Africa. Reviews of literature and websites were conducted and the Qualitative Content Analysis method was used to analyse the data. The contributions are the commonalities and differences between Smart City initiatives in developed economies and in South Africa. The findings revealed that in developed countries the focus was mainly on e-services, citizen engagement, Intelligent Transport Systems and energy systems. They provided city-wide connectivity and addressed integration and interoperability challenges. The technologies included large IoT sensors and WiFi in-motion networks incorporating internationally accepted standards. Initiatives in South Africa were less mature, mostly in the initial stages and are not addressing other more urgent needs of the country such as water, food, shelter and education. Collaboration with best practice Smart Cities is needed to provide support to current and future initiatives in South Africa and for the development of African digital citizens

An enterprise architecture for environmental information management and reporting

Organisations globally are communicating their environmental sustainability impact to stakeholders by means of the widely used sustainability report. A key benefit of environmental sustainability reporting is that organisations can gain a positive reputation when these reports are presented to stakeholders. Organisations in South Africa are faced with many challenges regarding managing sustainability information and producing an environmental sustainability report. Two of the primary challenges are the many diverse standards for sustainability reporting and data quality issues. Information Technology (IT) can be used to support and improve the process of sustainability reporting but it is important to align the environmental sustainability strategies with the strategies of business and also with the IT strategy to avoid silos of information and reporting. Enterprise Architecture (EA) can be used to solve alignment problems since it supports business-IT alignment. EA is defined by the International Standards Organisation (ISO) as “The fundamental concepts or properties of a system in its environment embodied in its elements, relationships, and in the principles of its design and evolution”. It can be argued, therefore, that EA can be used to support environmental sustainability information management and the reporting process by means of its support of improved business-IT alignment and ultimately integrated systems. The main objective of this study is to investigate how EA can be used to support environmental information management (EIM) and reporting. A survey study of thirty one prominent South African organisations was undertaken in order to investigate the status of their EA adoption and environmental reporting and EIM processes. An EA for EIM Toolkit and a set of guidelines are proposed which can provide support for EIM through the use of EA. These guidelines were proposed based on best-practice for each of the three process levels of an organisation, namely, the strategic level, the operational level and the technological level. The toolkit and guidelines were derived from theory and the results of the industry survey were then validated by an in-depth analysis of a case study consisting of multiple cases with key employees of seven South African organisations which have proved to be successful at EA and EIM and reporting. The results of the case study show that the EA for EIM Toolkit and related guidelines can assist organisations to align their environmental sustainability strategies with their organisational and IT strategies

A value alignment smart city stakeholder model

The concept of a Smart City has evolved over the last three decades and has attracted the increasing interest of the scientific research community. Unfortunately, many Smart City projects and initiatives do not provide the value expected by all the stakeholders. Many of the reasons for this relate to a lack of data management, data integration, data access and stakeholder participation. People are an integral part of any city’s ecosystem, and the Smart City concept was introduced to address the challenges of an ever-growing global population leading to the risk of depletion of economic, environmental and social resources. The problem addressed in this study is based on the challenges preventing the creation of the value of smart cities or stakeholders. Limited research has been published on the status of Smart City initiatives or on the impact of various success factors on the potential value creation for stakeholders including citizens. Studies on initiatives in developing countries, such as South Africa are even less. Whilst some challenges and constraints related to smart cities in Africa have been reported, there are no studies reporting on initiatives across the data value chain that consider all types of stakeholders, nor the impact of these initiatives. This study addressed this gap in research and designed a theoretical Value Alignment Smart City Stakeholder (VASCS) Model based on a Systematic Literature Review and a review of related theories. The model has important components that should form part of any Smart City project or Smart City initiative. These five main components are: 1) nine Smart City dimensions with related success factors; 2) four stakeholder roles (enablers, providers, utilisers and users); 3) the data value chain; and 4) the five phases of stakeholder benefits/value realisation that can be linked to; 5) stakeholder value alignment. This study applied the VASCS Model to Smart City initiatives in two case studies in the Eastern Cape Province of South Africa, which were the Nelson Mandela Bay and Buffalo City to investigate and understand the status of such initiatives and the alignment of value thereof. The stakeholder interviews were conducted in two rounds with various stakeholders of Smart City initiatives, referred to as cases in the two case studies. An expert review of the VASCS Model was conducted with eight experts in the field of Information Systems and Smart Cities. The findings of this review served to confirm the components of the model, with only minor improvements recommended. It was confirmed that all of the components need to be considered in planning Smart City projects. The first round consisted of six interviews with enablers and providers and the second round consisted of 22 interviews with users, utilisers and citizens. The interviews investigated the value and impact experienced by stakeholders of these initiatives, with a particular focus on the users, utilisers and citizens of the cases. The interview data was transcribed and qualitatively analysed by using Atlas.tiand Excel. The data was analysed according to the Technological, Organisational and Environmental theory constructs and other identified themes. The interview analysis findings revealed several drivers for these initiatives, which were primarily cost reduction, integration and quality assurance. The results also highlighted access to resources, such as technical skills as a challenge. Another challenge identified was connectivity related to access to data and the digital and physical divide that can impact decision making. The main benefits of Smart City initiatives highlighted were the provision of infrastructure, education and training and digitalisation. The theoretical contribution of this study is the VASCS Model, which can assist other researchers and practitioners with knowledge of the factors, drivers, challenges and value obtained in Smart City initiatives. The model has two supplementary components: A Stakeholder Classification Model and a Smart City Success Factor Evaluation Template. The practical contribution of this study is the potential use of the VASCS Model by practitioners, city management, researchers and other stakeholders, who can use the model, with the related model and template for planning and evaluating Smart City initiatives. The model can be used to classify the digital activities according to a Smart City’s success factors while evaluating the value created by these activities. The impact of these initiatives can then be assessed through value realisation and alignment for stakeholders. The scientific contribution is the adoption of the model to the cases in the Eastern Cape. To reveal in depth, rich, interview findings that provide important lessons learnt relating to the value created for the stakeholders and the addition of these findings to the body of knowledge.Thesis (PhD) -- Faculty of Science, School of Computer Science, Mathematics, Physics and Statistics, 202

A value alignment smart city stakeholder model

The concept of a Smart Cityhas evolved over the last three decades and has attracted the increasing interest of the scientific research community. Unfortunately,many Smart City projects and initiatives do not provide the value expected byall the stakeholders. Many of the reasons for this relate to a lack of data management, data integration, data access and stakeholder participation. People are an integral part of any city’s ecosystem, and the Smart Cityconcept was introduced to address the challenges of an ever-growing global population leading to the risk of depletion of economic, environmental and social resources.The problem addressed in this study is based on the challengespreventing the creation ofthevalueof smart citiesfor stakeholders. Limited research has been published on the status of Smart Cityinitiatives or on the impact of various success factors on the potential value creation for stakeholders including citizens. Studies on initiatives in developing countries,such as South Africa are even less. Whilst some challenges and constraints related to smart cities in Africa have been reported, there are no studies reporting on initiatives across the data value chain that consider all types of stakeholders,northe impact of these initiatives. This study addressed this gap in research and designed a theoretical Value Alignment Smart CityStakeholder (VASCS) Model based on a Systematic Literature Review and a review of related theories. The model has important components that should form part of any Smart Cityproject or Smart Cityinitiative. These five main components are: 1)nine Smart Citydimensionswith related success factors;2)four stakeholder roles(enablers, providers, utilisers and users);3) the data value chain;and 4)the five phases of stakeholder benefits/value realisation that can be linked to; 5) stakeholder valuealignment. Thisstudy applied the VASCSModel to Smart Cityinitiatives in two case studiesin the Eastern Cape Province of SouthAfrica, which werethe Nelson Mandela Bay andBuffalo Cityto investigate and understand the status of such initiatives and the alignment of value thereof.Thestakeholder interviews were conducted in two rounds with various stakeholders of Smart City initiatives, referred to as casesin the two casestudies. Anexpert review of the VASCS Model was conducted witheight experts in the field of Information Systems and Smart Cities. The findings of this review served to confirm the components of the model, with only minor improvements recommended.It was confirmed that all of the components need to be considered in planning Smart City projects. vThe first round consisted of six interviews with enablers and providers and the second round consisted of 22 interviewswith users, utilisers and citizens. The interviews investigatedthe value and impact experienced by stakeholdersof these initiatives, with a particular focus on the users, utilisersand citizensof the cases. The interview data was transcribed and qualitatively analysedbyusing Atlas.tiand Excel. The data was analysedaccording to the Technological, Organisational and Environmental theory constructs and other identifiedthemes. The interview analysis findings revealed several drivers for these initiatives, which wereprimarily cost reduction, integration and quality assurance. The results also highlighted access to resources,such as technical skillsas a challenge. Another challengeidentified wasconnectivity related to access to data and the digital and physical divide that canimpact decision making. The main benefits of Smart Cityinitiatives highlighted were the provision of infrastructure, education and training and digitalisation.The theoretical contribution of this study is the VASCS Model, which can assist other researchersand practitionerswith knowledge of the factors, drivers, challenges andvalue obtained in Smart Cityinitiatives. The model has two supplementary components: AStakeholder Classification Model and a Smart CitySuccess Factor Evaluation Template.The practical contribution of this study is the potential use of the VASCS Modelby practitioners, city management, researchers and other stakeholders, who can use the model, with the related modeland templatefor planning and evaluating Smart Cityinitiatives. The model can be used to classify the digital activities according to a Smart City’s success factors while evaluating the value created by these activities. The impact of these initiatives can then be assessed through value realisation and alignment for stakeholders. The scientific contribution is the adoption of the modeltothe cases in the Eastern Cape.To reveal in depth, rich,interview findings that provide important lessons learnt relating to the value created for the stakeholders and the addition of these findings to the body of knowledge.Thesis (PhD) -- Faculty of Science, School of Computer Science, Mathematics, Physics and Statistics, 202

Comparison of two percutaneous tracheostomy techniques, guide wire dilating forceps and Ciaglia Blue Rhino: a sequential cohort study

INTRODUCTION: To evaluate and compare the peri-operative and postoperative complications of the two most frequently used percutaneous tracheostomy techniques, namely guide wire dilating forceps (GWDF) and Ciaglia Blue Rhino (CBR). METHODS: A sequential cohort study with comparison of short-term and long-term peri-operative and postoperative complications was performed in the intensive care unit of the University Medical Centre in Nijmegen, The Netherlands. In the period 1997–2000, 171 patients underwent a tracheostomy with the GWDF technique and, in the period 2000–2003, a further 171 patients with the CBR technique. All complications were prospectively registered on a standard form. RESULTS: There was no significant difference in major complications, either peri-operative or postoperative. We found a significant difference in minor peri-operative complications (P < 0.01) and minor late complications (P < 0.05). CONCLUSION: Despite a difference in minor complications between GWDF and CBR, both techniques seem equally reliable

Factors associated with successful rehabilitation in older adults: A systematic review and best evidence synthesis

Purpose; Returning to community living is an indicator for successful rehabilitation in older adults admittedto geriatric rehabilitation. Predicting successful rehabilitation could contribute to the deployment of earlydischarge planning, and leads to a more custom-made rehabilitation trajectory. This review aims to presentan overview of factors associated with successful rehabilitation following inpatient geriatric rehabilitation.Method; A systematic literature review was conducted in PubMed, CINAHL and Embase. Extracted factorswere analysed via Bakker’s five levels of evidence.Results; Nine studies with methodological quality of good to moderate were included. For 13 of the 18 extractedfactors, limited (n=3),moderate (n=5) and conflicting (n=5) evidence found a significant association.Conclusions; Caregiver, comorbidities, motor-function, nutritional status, time from onset are significantlyrelated to successful rehabilitation. These factors could support healthcare professionals to indicate successfulrehabilitation at admission and contributes to deployment of early discharge planning and developmentof more custom-made rehabilitation trajectories.Public Health and primary careGeriatrics in primary car

Unraveling SSc Pathophysiology; The Myofibroblast

Systemic sclerosis (SSc) is a severe auto-immune disease, characterized by vasculopathy and fibrosis of connective tissues. SSc has a high morbidity and mortality and unfortunately no disease modifying therapy is currently available. A key cell in the pathophysiology of SSc is the myofibroblast. Myofibroblasts are fibroblasts with contractile properties that produce a large amount of pro-fibrotic extracellular matrix molecules such as collagen type I. In this narrative review we will discuss the presence, formation, and role of myofibroblasts in SSc, and how these processes are stimulated and mediated by cells of the (innate) immune system such as mast cells and T helper 2 lymphocytes. Furthermore, current novel therapeutic approaches to target myofibroblasts will be highlighted for future perspective

Costimulation Blockade in Kidney Transplant Recipients

Costimulation between T cells and antigen-presenting cells is essential for the regulation of an effective alloimmune response and is not targeted with the conventional immunosuppressive therapy after kidney transplantation. Costimulation blockade therapy with biologicals allows precise targeting of the immune response but without non-immune adverse events. Multiple costimulation blockade approaches have been developed that inhibit the alloimmune response in kidney transplant recipients with varying degrees of success. Belatacept, an immunosuppressive drug that selectively targets the CD28-CD80/CD86 pathway, is the only costimulation blockade therapy that is currently approved for kidney transplant recipients. In the last decade, belatacept therapy has been shown to be a promising therapy in subgroups of kidney transplant recipients; however, the widespread use of belatacept has been tempered by an increased risk of acute kidney transplant rejection. The purpose of this review is to provide an overview of the costimulation blockade therapies that are currently in use or being developed for kidney transplant indications