Support and information needs of older and disabled older people in the UK

The aim of this study was to determine the support and information needs of older and disabled older people in the UK. Following an initial literature survey, an examination of data on enquiries made by older people to information providers, and a series of focus groups, a questionnaire was developed for a nationwide survey. Over 1630 questionnaires were completed by disabled older clients of Day Care Centres and less frail older members of social clubs. Findings showed that there is a serious shortfall in the number of older people getting the practical support that they need, and the information that enables access to this support, compared to the number that actually need help. Substantial percentages of the survey respondents experienced difficulty with everyday tasks and with accessing the information they needed. Implications for formal sources of support and information are discussed.

Patients' attitudes towards, and information needs in relation to, nurse prescribing in rheumatology

Aims and objectives: To assess the level of confidence that rheumatology patients would have in nurse prescribing, the effects on likely adherence and particular concerns that these patients have. In addition, given that information provision has been cited as a potential benefit of nurse prescribing, the present study assessed the extent to which these patients would want an explanation for the selected medicine, as well as which types of information should be included in such an explanation. Background: Nurse prescribing has been successfully implemented in the UK in several healthcare settings. Existing research has not addressed the effects on patients' confidence and likely adherence, nor have patients' information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction. Methods: Fifty-four patients taking disease-modifying drugs for inflammatory joint disease attending a specialist rheumatology clinic self-completed a written questionnaire. Results: Patients indicated a relatively high level of confidence in nurse prescribing and stated that they would be very likely to take the selected medication. The level of concern was relatively low and the majority of concerns raised did not relate to the nurse's status. Strong support was expressed for the nurse providing an explanation for medicine choice. Conclusion: This research provides support for the prescription of medicines by nurses working in the area of rheumatology, the importance of nurses providing a full explanation about the selected medicines they prescribe for these patients and some indication as to which categories of information should be included. Relevance to clinical practice: Rheumatology patients who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood.

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.

Modelling for planning building design - a critique of available approaches

This paper reviews four approaches used to create rational tools to aid the planning and the management of the building design process and then proposes a fifth approach. The new approach that has been developed is based on the mechanical aspects of technology rather than subjective design issues. The knowledge base contains, for each construction technology, a generic model of the detailed design process. Each activity in the process is specified by its input and output information needs. By connecting the input demands of one technology with the output supply from another technology a map or network of design activity is formed. Thus, it is possible to structure a specific model from the generic knowledge base within a KBE system.

Fit for planning? An evaluation of the application of development viability appraisal models in the UK planning system

The aim of this paper is to critically examine the application of development appraisal to viability assessment in the planning system. This evaluation is of development appraisal models in general and also their use in particular applications associated with estimating planning obligation capacity. The paper is organised into four themes: · The context and conceptual basis for development viability appraisal · A review of development viability appraisal methods · A discussion of selected key inputs into a development viability appraisal · A discussion of the applications of development viability appraisals in the planning system It is assumed that readers are familiar with the basic models and information needs of development viability appraisal rather than at the cutting edge of practice and/or academe

The role of agronomic research in climate change and food security policy

Societal concern is growing about the consequences of climate change for food systems and, in a number of regions, for food security. There is also concern that meeting the rising demand for food is leading to environmental degradation thereby exacerbating factors in part responsible for climate change, and further undermining the food systems upon which food security is based. A major emphasis of climate change/food security research over recent years has addressed the agronomic aspects of climate change, and particularly crop yield. This has provided an excellent foundation for assessments of how climate change may affect crop productivity, but the connectivity between these results and the broader issues of food security at large are relatively poorly explored; too often discussions of food security policy appear to be based on a relatively narrow agronomic perspective. To overcome the limitation of current agronomic research outputs there are several scientific challenges where further agronomic effort is necessary, and where agronomic research results can effectively contribute to the broader issues underlying food security. First is the need to better understand how climate change will affect cropping systems including both direct effects on the crops themselves and indirect effects as a result of changed pest and weed dynamics and altered soil and water conditions. Second is the need to assess technical and policy options for either reducing the deleterious impacts or enhancing the benefits of climate change on cropping systems while minimising further environmental degradation. Third is the need to understand how best to address the information needs of policy makers and report and communicate agronomic research results in a manner that will assist the development of food systems adapted to climate change. There are, however, two important considerations regarding these agronomic research contributions to the food security/climate change debate. The first concerns scale. Agronomic research has traditionally been conducted at plot scale over a growing season or perhaps a few years, but many of the issues related to food security operate at larger spatial and temporal scales. Over the last decade, agronomists have begun to establish trials at landscape scale, but there are a number of methodological challenges to be overcome at such scales. The second concerns the position of crop production (which is a primary focus of agronomic research) in the broader context of food security. Production is clearly important, but food distribution and exchange also determine food availability while access to food and food utilisation are other important components of food security. Therefore, while agronomic research alone cannot address all food security/climate change issues (and hence the balance of investment in research and development for crop production vis à vis other aspects of food security needs to be assessed), it will nevertheless continue to have an important role to play: it both improves understanding of the impacts of climate change on crop production and helps to develop adaptation options; and also – and crucially – it improves understanding of the consequences of different adaptation options on further climate forcing. This role can further be strengthened if agronomists work alongside other scientists to develop adaptation options that are not only effective in terms of crop production, but are also environmentally and economically robust, at landscape and regional scales. Furthermore, such integrated approaches to adaptation research are much more likely to address the information need of policy makers. The potential for stronger linkages between the results of agronomic research in the context of climate change and the policy environment will thus be enhanced.

Memory as discrimination: what distraction reveals

Recalling information involves the process of discriminating between relevant and irrelevant information stored in memory. Not infrequently, the relevant information needs to be selected from amongst a series of related possibilities. This is likely to be particularly problematic when the irrelevant possibilities are not only temporally or contextually appropriate but also overlap semantically with the target or targets. Here, we investigate the extent to which purely perceptual features which discriminate between irrelevant and target material can be used to overcome the negative impact of contextual and semantic relatedness. Adopting a distraction paradigm, it is demonstrated that when distracters are interleaved with targets presented either visually (Experiment 1) or auditorily (Experiment 2), a within-modality semantic distraction effect occurs; semantically-related distracters impact upon recall more than unrelated distracters. In the semantically-related condition, the number of intrusions in recall is reduced whilst the number of correctly recalled targets is simultaneously increased by the presence of perceptual cues to relevance (color features in Experiment 1 or speaker’s gender in Experiment 2). However, as demonstrated in Experiment 3, even presenting semantically-related distracters in a language and a sensory modality (spoken Welsh) distinct from that of the targets (visual English) is insufficient to eliminate false recalls completely, or to restore correct recall to levels seen with unrelated distracters . Together, the study shows how semantic and non-semantic discriminability shape patterns of both erroneous and correct recall.

A semiotic framework for information representation of energy consumption in office buildings

Taking a perspective from a whole building lifecycle, occupier's actions could account for about 50% of energy. However occupants' activities influence building energy performance is still a blind area. Building energy performance is thought to be the result of a combination of building fabrics, building services and occupants' activities, along with their interactions. In this sense, energy consumption in built environment is regarded as a socio-technical system. In order to understand how such a system works, a range of physical, technical and social information is involved that needs to be integrated and aligned. This paper has proposed a semiotic framework to add value for Building Information Modelling, incorporating energy-related occupancy factors in a context of office buildings. Further, building information has been addressed semantically to describe a building space from the facility management perspective. Finally, the framework guides to set up building information representation system, which can help facility managers to manage buildings efficiently by improving their understanding on how office buildings are operated and used.

An ontological modelling of user requirements for personalised information provision

The knowledge economy offers opportunity to a broad and diverse community of information systems users to efficiently gain information and know-how for improving qualifications and enhancing productivity in the work place. Such demand will continue and users will frequently require optimised and personalised information content. The advancement of information technology and the wide dissemination of information endorse individual users when constructing new knowledge from their experience in the real-world context. However, a design of personalised information provision is challenging because users’ requirements and information provision specifications are complex in their representation. The existing methods are not able to effectively support this analysis process. This paper presents a mechanism which can holistically facilitate customisation of information provision based on individual users’ goals, level of knowledge and cognitive styles preferences. An ontology model with embedded norms represents the domain knowledge of information provision in a specific context where users’ needs can be articulated and represented in a user profile. These formal requirements can then be transformed onto information provision specifications which are used to discover suitable information content from repositories and pedagogically organise the selected content to meet the users’ needs. The method is provided with adaptability which enables an appropriate response to changes in users’ requirements during the process of acquiring knowledge and skills.

Digitisation, representation, and formalisation - Digital libraries of mathematics

One of the main tasks of the mathematical knowledge management community must surely be to enhance access to mathematics on digital systems. In this paper we present a spectrum of approaches to solving the various problems inherent in this task, arguing that a variety of approaches is both necessary and useful. The main ideas presented are about the differences between digitised mathematics, digitally represented mathematics and formalised mathematics. Each has its part to play in managing mathematical information in a connected world. Digitised material is that which is embodied in a computer file, accessible and displayable locally or globally. Represented material is digital material in which there is some structure (usually syntactic in nature) which maps to the mathematics contained in the digitised information. Formalised material is that in which both the syntax and semantics of the represented material, is automatically accessible. Given the range of mathematical information to which access is desired, and the limited resources available for managing that information, we must ensure that these resources are applied to digitise, form representations of or formalise, existing and new mathematical information in such a way as to extract the most benefit from the least expenditure of resources. We also analyse some of the various social and legal issues which surround the practical tasks.

View-based approaches to spatial representation in human vision

In an immersive virtual environment, observers fail to notice the expansion of a room around them and consequently make gross errors when comparing the size of objects. This result is difficult to explain if the visual system continuously generates a 3-D model of the scene based on known baseline information from interocular separation or proprioception as the observer walks. An alternative is that observers use view-based methods to guide their actions and to represent the spatial layout of the scene. In this case, they may have an expectation of the images they will receive but be insensitive to the rate at which images arrive as they walk. We describe the way in which the eye movement strategy of animals simplifies motion processing if their goal is to move towards a desired image and discuss dorsal and ventral stream processing of moving images in that context. Although many questions about view-based approaches to scene representation remain unanswered, the solutions are likely to be highly relevant to understanding biological 3-D vision.

The social relations of business representation and devolved governance in the United Kingdom

The reform of regional governance in the United Kingdom has been, in part, premised on the notion that regions provide new territories of action in which cooperative networks between business communities and state-agencies can be established. Promoting business interests is seen as one mechanism for enhancing the economic competitiveness and performance of 'laggard' regions. Yet, within this context of change, business agendas and capacities are often assumed to exist 'out there, as a resource waiting to be tapped by state institutions. There is little recognition that business organisations' involvement in networks of governance owes much to historical patterns and practices of business representation, to the types of activities that exist within the business sector, and to interpretations of their own role and position within wider policymaking and implementation networks. This paper, drawing on a study of business agendas in post-devolution Scotland, demonstrates that in practice business agendas are highly complex. Their formation in any particular place depends on the actions of reflexive agents, whose perspectives and capacities are shaped by the social, economic, and political contexts within which they are operating. As such, any understanding of business agendas needs to identify the social relations of business as a whole, rather than assuming away such complexities.

Evaluating explanations about drug prescriptions: effects of varying the nature of information about side effects and its relative position in explanations

This study evaluates computer-generated written explanations about drug prescriptions that are based on an analysis of both patient and doctor informational needs. Three experiments examine the effects of varying the type of information given about the possible side effects of the medication, and the order of information within the explanation. Experiment 1 investigated the effects of these two factors on people's ratings of how good they consider the explanations to be and of their perceived likelihood of taking the medication, as well as on their memory for the information in the explanation. Experiment 2 further examined the effects of varying information about side effects by separating out the contribution of number and severity of side effects. It was found that participants in this study did not “like” explanations that described severe side effects, and also judged that they would be less likely to take the medication if given such explanations. Experiment 3 therefore investigated whether information about severe side effects could be presented in such a way as to increase judgements of how good explanations are thought to be, as well as the perceived likelihood of adherence. The results showed some benefits of providing additional explanatory information.

Modeling the user knowledge by belief networks

This paper describes the user modeling component of EPIAIM, a consultation system for data analysis in epidemiology. The component is aimed at representing knowledge of concepts in the domain, so that their explanations can be adapted to user needs. The first part of the paper describes two studies aimed at analysing user requirements. The first one is a questionnaire study which examines the respondents' familiarity with concepts. The second one is an analysis of concept descriptions in textbooks and from expert epidemiologists, which examines how discourse strategies are tailored to the level of experience of the expected audience. The second part of the paper describes how the results of these studies have been used to design the user modeling component of EPIAIM. This module works in a two-step approach. In the first step, a few trigger questions allow the activation of a stereotype that includes a "body" and an "inference component". The body is the representation of the body of knowledge that a class of users is expected to know, along with the probability that the knowledge is known. In the inference component, the learning process of concepts is represented as a belief network. Hence, in the second step the belief network is used to refine the initial default information in the stereotype's body. This is done by asking a few questions on those concepts where it is uncertain whether or not they are known to the user, and propagating this new evidence to revise the whole situation. The system has been implemented on a workstation under UNIX. An example of functioning is presented, and advantages and limitations of the approach are discussed.

How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?

Objective The Medicines Use Review (MUR) community pharmacy service was introduced in 2005 to enhance patient empowerment but the service has not been taken up as widely as expected. We investigated the depiction of the patient–pharmacist power relationship within MUR patient information leaflets. Methods We identified 11 MUR leaflets including the official Department of Health MUR booklet and through discourse analysis examined the way language and imagery had been used to symbolise and give meaning to the MUR service, especially the portrayal of the patient–pharmacist interactions and the implied power relations. Results A variety of terminology was used to describe the MUR, a service that aimed ultimately to produce more informed patients through the information imparted by knowledgeable, skilled pharmacists. Conclusion The educational role of the MUR overshadowed the intended patient empowerment that would take place with a true concordance-centred approach. Although patient empowerment was implied, this was within the boundaries of the biomedical model with the pharmacist as the expert provider of medicines information. Practice implications If patient empowerment is to be conveyed this needs to be communicated to patients through consistent use of language and imagery that portrays the inclusivity intended.