Knowledge-based clinical pathway for medical quality improvement

Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis of clinical pathways is a promising strategy to improve medical quality effectively. However, the clinical pathway knowledge has not been fully integrated into treatment process and thus cannot provide comprehensive support to the actual work practice. Therefore this paper proposes a knowledgebased clinical pathway management method which contributes to make use of clinical knowledge to support and optimize medical practice. We have developed a knowledgebased clinical pathway management system to demonstrate how the clinical pathway knowledge comprehensively supports the treatment process. The experiences from the use of this system show that the treatment quality can be effectively improved by the extracted and classified clinical pathway knowledge, seamless integration of patient-specific clinical pathway recommendations with medical tasks and the evaluating pathway deviations for optimization.

A knowledge-driven management approach to environmental-conscious construction

This paper aims to introduce a knowledge-based managemental prototype entitled Eþ for environmental-conscious construction relied on an integration of current environmental management tools in construction area. The overall objective of developing the Eþ prototype is to facilitate selectively reusing the retrievable knowledge in construction engineering and management areas assembled from previous projects for the best practice in environmental-conscious construction. The methodologies adopted in previous and ongoing research related to the development of the Eþ belong to the operations research area and the information technology area, including literature review, questionnaire survey and interview, statistical analysis, system analysis and development, experimental research and simulation, and so on. The content presented in this paper includes an advanced Eþ prototype, a comprehensive review of environmental management tools integrated to the Eþ prototype, and an experimental case study of the implementation of the Eþ prototype. It is expected that the adoption and implementation of the Eþ prototype can effectively facilitate contractors to improve their environmental performance in the lifecycle of projectbased construction and to reduce adverse environmental impacts due to the deployment of various engineering and management processes at each construction stage.

An analytic knowledge network process for construction entrepreneurship education

Purpose - The purpose of this paper is to provide a quantitative multicriteria decision-making approach to knowledge management in construction entrepreneurship education by means of an analytic knowledge network process (KANP) Design/methodology/approach- The KANP approach in the study integrates a standard industrial classification with the analytic network process (ANP). For the construction entrepreneurship education, a decision-making model named KANP.CEEM is built to apply the KANP method in the evaluation of teaching cases to facilitate the case method, which is widely adopted in entrepreneurship education at business schools. Findings- The study finds that there are eight clusters and 178 nodes in the KANP.CEEM model, and experimental research on the evaluation of teaching cases discloses that the KANP method is effective in conducting knowledge management to the entrepreneurship education. Research limitations/implications- As an experimental research, this paper ignores the concordance between a selected standard classification and others, which perhaps limits the usefulness of KANP.CEEM model elsewhere. Practical implications- As the KANP.CEEM model is built based on the standard classification codes and the embedded ANP, it is thus expected that the model has a wide potential in evaluating knowledge-based teaching materials for any education purpose with a background from the construction industry, and can be used by both faculty and students. Originality/value- This paper fulfils a knowledge management need and offers a practical tool for an academic starting out on the development of knowledge-based teaching cases and other teaching materials or for a student going through the case studies and other learning materials.

Promoting sustainability: Efficacy and adoption of tobacco-based insecticides in Nigeria

The promotion of technologies seen to be aiding in the attainment of agricultural sustainability has been Popular amongst Northern-based development donors for many years. One of these, botanical insecticides (e.g., those based on neem, Pyrethrum and tobacco) have been a particular favorite as they are equated with being 'natural' and hence less damaging to human health and the environment. This paper describes the outcome of interactions between one non-government organisation (NGO), the Diocesan Development Services (DDS), based in Kogi State, Nigeria, and a major development donor based in Europe that led to the establishment of a programme designed to promote the Virtues of a tobacco-based insecticide to small-scale farmers. The Tobacco Insecticide Programme (TIP) began in the late 1980s and ended in 200 1, absorbing significant quantities of resource in the process. TIP began with exploratory investigations of efficacy on the DDS seed multiplication farm followed by stages of researcher-managed and farmer-managed on-farm trials. A survey in 2002 assessed adoption of the technology by farmers. While yield benefits from using the insecticide were nearly always positive and statistically significant relative to an untreated control, they were not as good as commercial insecticides. However, adoption of the tobacco insecticide by local farmers was poor. The paper discusses the reasons for poor adoption, including relative benefits in gross margin, and uses the TIP example to explore the differing power relationships that exist between donors, their field partners and farmers. (C) 2004 by The Haworth Press, Inc. All rights reserved.

Analysing institutional partnerships in development: a contract between equals or a loaded process?

Partnerships are complex, diverse and subtle relationships, the nature of which changes with time, but they are vital for the functioning of the development chain. This paper reviews the meaning of partnership between development institutions as well as some of the main approaches taken to analyse the relationships. The latter typically revolve around analyses based on power, discourse, interdependence and functionality. The paper makes the case for taking a multianalytical approach to understanding partnership but points out three problem areas: identifying acceptable/unacceptable trade-offs between characteristics of partnership, the analysis of multicomponent partnerships (where one partner has a number of other partners) and the analysis of long-term partnership. The latter is especially problematic for long-term partnerships between donors and field agencies that share an underlying commitment based on religious beliefs. These problems with current methods of analysing partnership are highlighted by focusing upon the Catholic Church-based development chain, linking donors in the North (Europe) and their field partners in the South (Abuja Ecclesiastical Province, Nigeria). It explores a narrated history of a relationship with a single donor spanning 35 years from the perspective of one partner (the field agency).

Uses of airborne scanning laser altimetry for river flood modelling and coastal geomorphology

Two ongoing projects at ESSC that involve the development of new techniques for extracting information from airborne LiDAR data and combining this information with environmental models will be discussed. The first project in conjunction with Bristol University is aiming to improve 2-D river flood flow models by using remote sensing to provide distributed data for model calibration and validation. Airborne LiDAR can provide such models with a dense and accurate floodplain topography together with vegetation heights for parameterisation of model friction. The vegetation height data can be used to specify a friction factor at each node of a model’s finite element mesh. A LiDAR range image segmenter has been developed which converts a LiDAR image into separate raster maps of surface topography and vegetation height for use in the model. Satellite and airborne SAR data have been used to measure flood extent remotely in order to validate the modelled flood extent. Methods have also been developed for improving the models by decomposing the model’s finite element mesh to reflect floodplain features such as hedges and trees having different frictional properties to their surroundings. Originally developed for rural floodplains, the segmenter is currently being extended to provide DEMs and friction parameter maps for urban floods, by fusing the LiDAR data with digital map data. The second project is concerned with the extraction of tidal channel networks from LiDAR. These networks are important features of the inter-tidal zone, and play a key role in tidal propagation and in the evolution of salt-marshes and tidal flats. The study of their morphology is currently an active area of research, and a number of theories related to networks have been developed which require validation using dense and extensive observations of network forms and cross-sections. The conventional method of measuring networks is cumbersome and subjective, involving manual digitisation of aerial photographs in conjunction with field measurement of channel depths and widths for selected parts of the network. A semi-automatic technique has been developed to extract networks from LiDAR data of the inter-tidal zone. A multi-level knowledge-based approach has been implemented, whereby low level algorithms first extract channel fragments based mainly on image properties then a high level processing stage improves the network using domain knowledge. The approach adopted at low level uses multi-scale edge detection to detect channel edges, then associates adjacent anti-parallel edges together to form channels. The higher level processing includes a channel repair mechanism.

Role of knowledge in managing construction change

Purpose-Unplanned changes in construction projects are common and lead to disruptive effects such as project delays, cost overruns and quality deviations. Rework due to unplanned changes can cost 10-15 per cent of contract value. By managing these changes more effectively, these disruptive effects can be minimised. Previous research has approached this problem from an information-processing view. In this knowledge age, the purpose of this paper is to argue that effective change management can be brought about by better understanding the significant role of knowledge during change situations. Design/methodology/approach - Within this knowledge-based context, the question of how construction project teams manage knowledge during unplanned change in the construction phase within collaborative team settings is investigated through a selected case study sample within the UK construction industry. Findings- Case study findings conclude that different forms of knowledge are created and shared between project team members during change events which is very much socially constructed and centred on tacit knowledge and experience of project personnel. Originality/value- Building on the case study findings the paper finally offers a model that represents the role of knowledge during managing project change.

Modelling: promoting creativity whilst forging links between science education and design and technology education

Educational reforms in many countries currently call for the development of knowledge-based societies. In particular, emphasis is placed on the promotion of creativity, especially in the areas of science education and of design and technology education. In this paper, perceptions of the nature of creativity and of the conditions for its realization are discussed. The notion of modelling as a creative act is outlined and the scope for using modelling as a bridge between science education and design and technology education explored. A model for the creative act of modelling is proposed and its major aspects elaborated upon. Finally, strategies for forging links between the two subjects are outlined.

Mid-term evaluation of African Technology Policy Studies Network Phase VI Strategic Plan: for the period January 1, 2009 to December 31, 2010

The African Technology Policy Studies Network (ATPS) is a multidisciplinary network of researchers, private sector actors, policymakers and civil society. ATPS has the vision to become the leading international centre of excellence and reference in science, technology and innovation (STI) systems research, training and capacity building, communication and sensitization, knowledge brokerage, policy advocacy and outreach in Africa. It has a Regional Secretariat in Nairobi Kenya, and operates through national chapters in 29 countries (including 27 in Africa and two Chapters in the United Kingdom and USA for Africans in the Diaspora) with an expansion plan to cover the entire continent by 2015. The ATPS Phase VI Strategic Plan aims to improve the understanding and functioning of STI processes and systems to strengthen the learning capacity, social responses, and governance of STI for addressing Africa's development challenges, with a specific focus on the Millennium Development Goals (MDGs). A team of external evaluators carried out a midterm review to assess the effectiveness and efficiency of the implementation of the Strategic Plan for the period January 1, 2009 to December 31, 2010. The evaluation methodology involved multiple quantitative and qualitative methods to assess the qualitative and quantitative inputs (human resources, financial resources, time, etc.) into ATPS activities (both thematic and facilitative) and their tangible and intangible outputs, outcomes and impacts. Methods included a questionnaire survey of ATPS members and stakeholders, key informant interviews, and focus group discussions (FGDs) with members in six countries. Effectiveness of Programmes Under all six strategic goals, very good progress has been made towards planned outputs and outcomes. This is evidenced by key performance indicators (KPIs) generated from desk review, ratings from the survey respondents, and the themes that run through the FGDs. Institutional and Programme Cost Effectiveness Institutional Effectiveness: assessment of institutional effectiveness suggests that adequate management frameworks are in place and are being used effectively and transparently. Also technical and financial accounting mechanisms are being followed in accordance with grant agreements and with global good practice. This is evidenced by KPIs generated from desk review. Programme Cost Effectiveness: assessment of cost-effectiveness of execution of programmes shows that organisational structure is efficient, delivering high quality, relevant research at relatively low cost by international standards. The evidence includes KPIs from desk review: administrative costs to programme cost ratio has fallen steadily, to around 10%; average size of research grants is modest, without compromising quality. There is high level of pro bono input by ATPS members. ATPS Programmes Strategic Evaluation ATPS research and STI related activities are indeed unique and well aligned with STI issues and needs facing Africa and globally. The multi-disciplinary and trans-boundary nature of the research activities are creating a unique group of research scientists. The ATPS approach to research and STI issues is paving the way for the so called Third Generation University (3GU). Understanding this unique positioning, an increasing number of international multilateral agencies are seeking partnership with ATPS. ATPS is seeing an increasing level of funding commitments by Donor Partners. Recommendations for ATPS Continued Growth and Effectiveness On-going reform of ATPS administrative structure to continue The on-going reforms that have taken place within the Board, Regional Secretariat, and at the National Chapter coordination levels are welcomed. Such reform should continue until fully functional corporate governance policy and practices are fully established and implemented across the ATPS governance structures. This will further strengthen ATPS to achieve the vision of being the leading STI policy brokerage organization in Africa. Although training in corporate governance has been carried out for all sectors of ATPS leadership structure in recent time, there is some evidence that these systems have not yet been fully implemented effectively within all the governance structures of the organization, especially at the Board and National chapter levels. Future training should emphasize practical application with exercises relevant to ATPS leadership structure from the Board to the National Chapter levels. Training on Transformational Leadership - Leading a Change Though a subject of intense debate amongst economists and social scientists, it is generally agreed that cultural mindsets and attitudes could enhance and/or hinder organizational progress. ATPS’s vision demands transformational leadership skills amongst its leaders from the Board members to the National Chapter Coordinators. To lead such a change, ATPS leaders must understand and avoid personal and cultural mindsets and value systems that hinder change, while embracing those that enhance it. It requires deliberate assessment of cultural, behavioural patterns that could hinder progress and the willingness to be recast into cultural and personal habits that make for progress. Improvement of relationship amongst the Board, Secretariat, and National Chapters A large number of ATPS members and stakeholders feel they do not have effective communications and/or access to Board, National Chapter Coordinators and Regional Secretariat activities. Effort should be made to improve the implementation of ATPS communication strategy to improve on information flows amongst the ATPS management and the members. The results of the survey and the FGDs suggest that progress has been made during the past two years in this direction, but more could be done to ensure effective flow of pertinent information to members following ATPS communications channels. Strategies for Increased Funding for National Chapters There is a big gap between the fundraising skills of the Regional Secretariat and those of the National Coordinators. In some cases, funds successfully raised by the Secretariat and disbursed to national chapters were not followed up with timely progress and financial reports by some national chapters. Adequate training in relevant skills required for effective interactions with STI key policy players should be conducted regularly for National Chapter coordinators and ATPS members. The ongoing training in grant writing should continue and be made continent-wide if funding permits. Funding of National Chapters should be strategic such that capacity in a specific area of research is built which, with time, will not only lead to a strong research capacity in that area, but also strengthen academic programmes. For example, a strong climate change programme is emerging at University of Nigeria Nsukka (UNN), with strong collaborations with Universities from neighbouring States. Strategies to Increase National Government buy-in and support for STI Translating STI research outcomes into policies requires a great deal of emotional intelligence, skills which are often lacking in the first and second generation universities. In the epoch of the science-based or 2GUs, governments were content with universities carrying out scientific research and providing scientific education. Now they desire to see universities as incubators of new science- or technology-based commercial activities, whether by existing firms or start-ups. Hence, governments demand that universities take an active and leading role in the exploitation of their knowledge and they are willing to make funds available to support such activities. Thus, for universities to gain the attention of national leadership they must become centres of excellence and explicit instruments of economic development in the knowledge-based economy. The universities must do this while working collaboratively with government departments, parastatals, and institutions and dedicated research establishments. ATPS should anticipate these shifting changes and devise programmes to assist both government and universities to relate effectively. New administrative structures in member organizations to sustain and manage the emerging STI multidisciplinary teams Second Generation universities (2GUs) tend to focus on pure science and often do not regard the application of their know-how as their task. In contrast, Third Generation Universities (3GUs) objectively stimulate techno-starters – students or academics – to pursue the exploitation or commercialisation of the knowledge they generate. They view this as being equal in importance to the objectives of scientific research and education. Administratively, research in the 2GU era was mainly monodisciplinary and departments were structured along disciplines. The emerging interdisciplinary scientific teams with focus on specific research areas functionally work against the current mono-disciplinary faculty-based, administrative structure of 2GUs. For interdisciplinary teams, the current faculty system is an obstacle. There is a need for new organisational forms for university management that can create responsibilities for the task of know-how exploitation. ATPS must anticipate this and begin to strategize solutions for their member institutions to transition to 3Gus administrative structure, otherwise ATPS growth will plateau, and progress achieved so far may be stunted.

Where Does All the Knowledge Go in Small Knowledge-intensive Professional Service Firms?

Small knowledge-intensive professional service firms are becoming increasingly important agents of innovation in construction. There is thus an urgent need to better understand the nature and process of innovation in such firms. First, this paper presents a review of the relevant literature. It is concluded that this literature is often not appropriate for SKIPSFs, as it neglects the critical role of knowledge and knowledge workers in innovation within SKIPSFs. Second, a knowledge-based innovation model is presented as a holistic, system-oriented framework to better investigate how the SKIPSFs create, manage and exploit innovation. This model is to be tested with case study research.

Generating recipient-centred explanations about drug prescription

In this paper we describe how we generated written explanations to ‘indirect users’ of a knowledge-based system in the domain of drug prescription. We call ‘indirect users’ the intended recipients of explanations, to distinguish them from the prescriber (the ‘direct’ user) who interacts with the system. The Explanation Generator was designed after several studies about indirect users' information needs and physicians' explanatory attitudes in this domain. It integrates text planning techniques with ATN-based surface generation. A double modeling component enables adapting the information content, order and style to the indirect user to whom explanation is addressed. Several examples of computer-generated texts are provided, and they are contrasted with the physicians' explanations to discuss advantages and limits of the approach adopted.