Further evidence for the agreement between patients with stroke and their proxies on the Frenchay Activities Index

Objective: To determine item, subscale and total score agreement on the Frenchay Activities Index (FAI) between stroke patients and proxies six months after discharge from rehabilitation. Design: Prospective study design. Setting/subjects: Fifty patient-proxy pairs, interviewed separately, in the patient's residence. Main outcome measures: Modified FAI using 13 items. Individual FAI items, subscales and total score agreement as measured by weighted kappa and intraclass correlation coefficients (ICC). Results: Excellent agreement was found for the total FAI (ICC 0.87, 95% confidence interval (CI) 0.78-0.93), and domestic (ICC 0.85, 95% CI 0.73-0.91) and outdoor (ICC 0.87, 95% CI 0.78-0.95) subscales, with moderate agreement found for the work/leisure subscale (ICC 0.63, 95% CI 0.34-0.78). For the individual FAI items, good, moderate, fair and poor agreement was found for five, three, four and one item, respectively. The best agreement was for objective items of preparing meals, washing-up, washing clothes, shopping and driving. The poorest agreement was for participation in hobbies, social outings and heavy housework. Scoring biases associated with patient or proxy demographic characteristics were found. Female proxies, and those who were spouses, scored patients lower on domestic activities; male patients, and those who were younger, scored themselves higher on outdoor activities and higher patient FIM scores were positively correlated with higher FAI scores. Conclusions: While total and subscale agreement on the FAI was high, individual item agreement varied. Proxy scores should be used with caution due to bias.

WTO oriented telecommunications reform in the Socialist Republic of Vietnam

Socialist Republic of Vietnam's reform process in the telecommunications sector - obligations imposed on Vietnam by the Bilateral Trade Agreement (BTA) - the regulatory framework required by the General Agreement on Trade in Services (GATS) and the associated, telecommunications-specific WTO agreements - institutional and political problems that may hinder full implementation of these international obligations.

A Computational Framework for Institutional Agency

This paper provides a computational framework, based on Defeasible Logic, to capture some aspects of institutional agency. Our background is Kanger-Lindahl-P\"orn account of organised interaction, which describes this interaction within a multi-modal logical setting. This work focuses in particular on the notions of counts-as link and on those of attempt and of personal and direct action to realise states of affairs. We show how standard Defeasible Logic can be extended to represent these concepts: the resulting system preserves some basic properties commonly attributed to them. In addition, the framework enjoys nice computational properties, as it turns out that the extension of any theory can be computed in time linear to the size of the theory itself.

The use of strategic visioning to enhance local tourism planning in periphery communities

Tourism has had a profound impact upon destinations worldwide, and although this impact has been positive for many destinations, there are numerous examples where tourism has adversely impacted upon the environment and social fabric of the destination community (Coccossis 1996; Murphy 1985). The negative impacts of tourism have been attributed, among other things, to inadequate or non-existent planning for development (Gunn 1994; Hall2000). This has led to increased calls for tourism planning to offset some of the negative impacts that tourism can have on the destination community. While a number of approaches have been advocated, a collaborative philosophy, based on the principles of sustainability, is more likely to result in acceptable and successful policies and programmes for tourism destinations (Farrell1986; Jamal & Getz 1995; Maitland 2002; Minca & Getz 1995). Such an approach focuses on cooperation and broader based participation in tourism planning and decision-making between stakeholders to lead to agreement on planning directions and goals, with one of the primary objectives of collaborative arrangements being to develop a strategic vision for a destination (Bramwell & Lane 2000). [Extract from introduction]

Refinements in stress echocardiographic techniques improve inter-institutional agreement in interpretation of dobutamine stress echocardiograms

Aims To determine the degree of inter-institutional agreement in the assessment of dobutamine stress echocardiograms using modern stress echo cardiographic technology in combination with standardized data acquisition and assessment criteria. Method and Results Among six experienced institutions, 150 dobutamine stress echocardiograms (dobutamine up to 40 mug.kg(-1) min(-1) and atropine up to I mg) were performed on patients with suspected coronary artery disease using fundamental and harmonic imaging following a consistent digital acquisition protocol. Each dobutamine stress echocardiogram was assessed at every institution regarding endocardial visibility and left ventricular wall motion without knowledge of any other data using standardized reading criteria. No patients were excluded due to poor image quality or inadequate stress level. Coronary angiography was performed within 4 weeks. Coronary angiography demonstrated significant coronary artery disease (less than or equal to50% diameter stenosis) in 87 patients. Using harmonic imaging an average of 5.2+/-0.9 institutions agreed on dobutamine stress echocardiogram results as being normal or abnormal (mean kappa 0.55; 95% CI 0.50-0.60). Agreement was higher in patients with no (equal assessment of dobutamine stress echocardiogram results by 5.5 +/- 0.8 institutions) or three-vessel coronary artery disease (5.4 +/- 0.8 institutions) and lower in one- or two- vessel disease (5.0 +/- 0.9 and 5.2 +/- 1.0 institutions, respectively-, P=0.041). Disagreement on test results was greater in only minor wall motion abnormalities. Agreement on dobutamine stress echocardiogram results was lower using fundamental imaging (mean kappa 0.49; 95% CI 0.44-0.54; P

Using a problem detection study (PDS) to identify and compare health care provider and consumer views of antihypertensive therapy

The objectives of this study were to ascertain consumer knowledge and behaviour about hypertension and treatment and to compare these with health care providers' perceptions (of 'most' consumers). The design for the study was a problem detection study (PDS): focus groups and then survey. Focus groups and survey participants were convenience samples of consumers, doctors, nurses and pharmacists. The main outcome measures were agreement on a 5-point Likert scale with statements about consumers' knowledge and behaviour about high blood pressure and medication. The survey identified areas of consensus and disagreement between consumers and health providers. While general knowledge and concordance with antihypertensive therapy among consumers was good, consequences such as eye and kidney disease, interactions with herbal medicines, and how to deal with missing a dose were less well known. Side effects were a problem for over one-quarter of participants, and cost was a problem in continuing therapy. Half the consumers had not received sufficient written information. Providers overall disagreed that most consumers have an adequate understanding of the condition. They agreed that most consumers adhere to therapy and can manage medicines; and about their own profession's role in information provision and condition management. Consumers confirmed positive provider behaviour, suggesting opportunities for greater communication between providers about actions taken with their consumers. In conclusion, the PDS methodology was useful in identifying consumer opinions. Differences between consumer and provider responses were marked, with consumers generally rating their knowledge and behaviour above providers' ratings of 'most' consumers. There are clear gaps to be targeted to improve the outcomes of hypertension therapy.

Norm modifications in defeasible logic

This paper proposes a framework based on Defeasible Logic (DL) to reason about normative modifications. We show how to express them in DL and how the logic deals with conflicts between temporalised normative modifications. Some comments will be given with regard to the phenomenon of retroactivity.

Towards user profiling for web recommendation

Collaborative recommendation is one of widely used recommendation systems, which recommend items to visitor on a basis of referring other's preference that is similar to current user. User profiling technique upon Web transaction data is able to capture such informative knowledge of user task or interest. With the discovered usage pattern information, it is likely to recommend Web users more preferred content or customize the Web presentation to visitors via collaborative recommendation. In addition, it is helpful to identify the underlying relationships among Web users, items as well as latent tasks during Web mining period. In this paper, we propose a Web recommendation framework based on user profiling technique. In this approach, we employ Probabilistic Latent Semantic Analysis (PLSA) to model the co-occurrence activities and develop a modified k-means clustering algorithm to build user profiles as the representatives of usage patterns. Moreover, the hidden task model is derived by characterizing the meaningful latent factor space. With the discovered user profiles, we then choose the most matched profile, which possesses the closely similar preference to current user and make collaborative recommendation based on the corresponding page weights appeared in the selected user profile. The preliminary experimental results performed on real world data sets show that the proposed approach is capable of making recommendation accurately and efficiently.

Pockets of flexibility in workflow specification

Workflow technology is currently being deployed in quite diverse domains. However, the element of change is present in some degree and form in almost all domains. A workflow implementation that does not support the process of change will not benefit the organization in the long run. Change can be manifested in different forms in workflow processes. In this paper, we first present a categorization of workflow change characteristics and divide workflow processes into dynamic, adaptive and flexible processes. We define flexibility as the ability of the workflow process to execute on the basis of a loosely, or partially specified model, where the full specification of the model is made at runtime, and may be unique to each instance. To provide a modeling framework that offers true flexibility, we need to consider the factors, which influence the paths of (unique) instances together with the process definition. We advocate an approach that aims at making the process of change part of the workflow process itself. We introduce the notion of an open instance that consists of a core process and several pockets of flexibility, and present a framework based on this notion, which makes use of special build activities that provide the functionality to integrate the process of defining a change, into the open workflow instance.

Reconceptualising social sustainability in urban development

Although the social dimension is often cited as the third leg of triple bottom line sustainability, there is at present general agreement on the difficulty of saying just what social sustainability is and how it can be related to enivironmental sustainability. This paper proposes that a sociotechnical understanding of the relationship beween human behaviour and technical developments provides a way of making the social dimension accessible to engineers, designers and developers. We draw on early work in master planned urban developments to show how a sociotechnical model, married to a life cycle assessment approach can help us understand and design for effective and efficient implementation of sustainability systems

Relationships of extant lower Brachycera (Diptera): a quantitative synthesis of morphological characters

With over 80 000 described species, Brachycera represent one of the most diverse clades of organisms with a Mesozoic origin. Larvae of the majority of early lineages are detritivores or carnivores. However, Brachycera are ecologically innovative and they now employ a diverse range of feeding strategies. Brachyceran relationships have been the subject of numerous qualitative analyses using morphological characters. These analyses are often based on characters from one or a few character systems and general agreement on relationships has been elusive. In order to understand the evolution of basal brachyceran lineages, 101 discrete morphological characters were scored and compiled into a single data set. Terminals were scored at the family level, and the data set includes characters from larvae, pupae and adults, internal and external morphology, and male and female terminalia. The results show that all infraorders of Brachycera are monophyletic, but there is little evidence for relationships between the infraorders. Stratiomyomorpha, Tabanomorpha, and Xylophagomorpha together form the sister group to Muscomorpha. Xylophagomorpha and Tabanomorpha are sister groups. Within Muscomorpha, the paraphyletic Nemestrinoidea form the two most basal lineages. There is weak evidence for the monophyly of Asiloidea, and Hilarimorphidae appear to be more closely related to Eremoneura than other muscomorphs. Apsilocephalidae, Scenopinidae and Therevidae form a clade of Asiloidea. This phylogenetic evidence is consistent with the contemporaneous differentiation of the main brachyceran lineages in the early Jurassic. The first major radiation of Muscomorpha were asiloids and they may have diversified in response to the radiation of angiosperms in the early Cretaceous.

Predicting plant leaf area production: shoot assimilate accumulation and partitioning, and leaf area ratio, are stable for a wide range of sorghum population densities

Predicting plant leaf area production is required for modelling carbon balance and tiller dynamics in plant canopies. Plant leaf area production can be studied using a framework based on radiation intercepted, radiation use efficiency (RUE) and leaf area ratio (LAR) (ratio of leaf area to net above-ground biomass). The objective of this study was to test this framework for predicting leaf area production of sorghum during vegetative development by examining the stability of the contributing components over a large range of plant density. Four densities, varying from 2 to 16 plants m(-2), were implemented in a field experiment. Plants were either allowed to tiller or were maintained as uniculm by systematic tiller removal. In all cases, intercepted radiation was recorded daily and leaf area and shoot dry matter partitioning were quantified weekly at individual culm level. Up to anthesis, a unique relationship applied between fraction of intercepted radiation and leaf area index, and between shoot dry weight accumulation and amount of intercepted radiation, regardless of plant density. Partitioning of shoot assimilate between leaf, stem and head was also common across treatments up to anthesis, at both plant and culm levels. The relationship with thermal time (TT) from emergence of specific leaf area (SLA) and LAR of tillering plants did not change with plant density. In contrast, SLA of uniculm plants was appreciably lower under low-density conditions at any given TT from emergence. This was interpreted as a consequence of assimilate surplus arising from the inability of the plant to compensate by increasing the leaf area a culm could produce. It is argued that the stability of the extinction coefficient, RUE and plant LAR of tillering plants observed in these conditions provides a reliable way to predict leaf area production regardless of plant density. Crown Copyright (C) 2002 Published by Elsevier Science B.V. All rights reserved.

Putting the group back into unions: A social psychological contribution to understanding union support

Industrial relations research that attempts to grapple with individuals' union-related sentiments and activities often draws on one of two traditions of psychological research—the individual-level factors tradition (for example, personality and attitude-behaviour relations) and the social context tradition (for example, frustration-aggression and relative deprivation). This paper provides an overview of research conducted from within these traditions to explain union-related phenomena and identifies some of the limitations that arise as a consequence of a shared tendency to treat people in an atomistic fashion. The paper argues for an understanding of the psychological processes that underpin group-based action. To this end, it elaborates a theoretical framework based on social identity theory and self-categorisation theory that would allow us to examine the dynamic interplay between the individual, their cognitions and their environment. The paper concludes with a brief discussion of a specific case of union mobilisation, to indicate how this theoretical framework might aid empirical analysis.