'I'd like to know what causes it, you know, anything I've done?' Are we meeting the information and support needs of patients with macular degeneration? A qualitative study

Objective: To examine patients' experiences of information and support provision for age-related macular degeneration (AMD) in the UK. Study design: Exploratory qualitative study investigating patient experiences of healthcare consultations and living with AMD over 18 months. Setting: Specialist eye clinics at a Birmingham hospital. Participants: 13 patients diagnosed with AMD. Main outcome measures: Analysis of patients' narratives to identify key themes and issues relating to information and support needs. Results: Information was accessed from a variety of sources. There was evidence of clear information deficits prior to diagnosis, following diagnosis and ongoing across the course of the condition. Patients were often ill informed and therefore unable to self-advocate and recognise when support was needed, what support was available and how to access support. Conclusions: AMD patients have a variety of information needs that are variable across the course of the condition. Further research is needed to determine whether these experiences are typical and identify ways of translating the guidelines into practice. Methods of providing information need to be investigated and improved for this patient group.

Putting children forward for epilepsy surgery:a qualitative study of UK parents' and health professionals' decision-making experiences

Background Against a backdrop of recommendations for increasing access to and uptake of early surgical intervention for children with medically intractable epilepsy, it is important to understand how parents and professionals decide to put children forward for epilepsy surgery and what their decisional support needs are. Aim The aim of this study was to explore how parents and health professionals make decisions regarding putting children forward for pediatric epilepsy surgery. Methods Individual interviews were conducted with nine parents of children who had undergone pediatric epilepsy surgery at a specialist children's hospital and ten healthcare professionals who made up the children's epilepsy surgery service multidisciplinary healthcare team (MDT). Three MDT meetings were also observed. Data were analyzed thematically. Findings Four themes were generated from analysis of interviews with parents: presentation of surgery as a treatment option, decision-making, looking back, and interventions. Three themes were generated from analysis of interviews/observations with health professionals: triangulating information, team working, and patient and family perspectives. Discussion Parents wanted more information and support in deciding to put their child forward for epilepsy surgery. They attempted to balance the potential benefits of surgery against any risks of harm. For health professionals, a multidisciplinary approach was seen as crucial to the decision-making process. Advocating for the family was perceived to be the responsibility of nonmedical professionals. Conclusion Decision-making can be supported by incorporating families into discussions regarding epilepsy surgery as a potential treatment option earlier in the process and by providing families with additional information and access to other parents with similar experiences.

Toward understanding inter-organizational knowledge transfer needs in SMEs:insight from a UK investigation

Purpose - External knowledge is generally believed to be of prime importance to small to medium-sized enterprises (SMEs). However, a review of the literature shows that no empirical research has looked at knowledge management issues at the inter-organizational level in SMEs. This paper seeks to report on an empirical investigation with UK SMEs in the service sector to identify their needs and practices regarding inter-organizational knowledge transfer, and thus provide empirical evidence to support the above belief. Design/methodology/approach - A two-tier methodology (i.e. using both questionnaire survey and interview approaches) is deployed to address the main research objectives. A questionnaire survey of SMEs is carried out to investigate their current inter-organizational knowledge transfer situation and managers' perception on various relevant issues. Then 12 face-to-face interviews with SME managers are conducted to further validate key findings drawn from the questionnaire survey. Findings - The empirical evidence collected from the survey and interviews confirms the general belief that external knowledge is of prime importance for SMEs, and demonstrates that SMEs have very strong needs for external knowledge and inter-organizational knowledge transfer. Research limitations/implications - The findings provide very strong underpinning for further theoretical research on inter-organizational knowledge transfer in SMEs. However, this study has certain limitations: its results may not be applicable to other industrial sectors or the same sector in other countries; or to micro or large companies; nor does it involve cross-cultural issues. Originality/value - By adopting a two-tier research methodology, this study provides more reliable understanding and knowledge on SMEs' inter-organizational knowledge transfer needs and practices, and fills the gap that exists in the empirical investigations on the subject. © Emerald Group Publishing Limited.

Determining inventory service support levels in multi-national companies

Multi-national manufacturing companies are often faced with very difficult decisions regarding where and how to cost effectively manufacture products in a global setting. Clearly, they must utilize efficient and responsive manufacturing strategies to reach low cost solutions, but they must also consider the impact of manufacturing and transportation solutions upon their ability to support sales. One important sales consideration is determining how much work in process, in-transit stock, and finished goods to have on hand to support sales at a desired service level. This paper addresses this important consideration through a comprehensive scenario-based simulation approach, including sensitivity analysis on key study parameters. Results indicate that the inventory needs vary considerably for different manufacturing and delivery methods in ways that may not be obvious when using common evaluative tools.

Adapting an apprenticeship model to the needs of English-medium education at the tertiary level in Turkey

Despite the difficulties that we have regarding the use of English in tertiary education in Turkey, we argue that it is necessary for those involved to study in the medium of English. Furthermore, significant advances have been made on this front. These efforts have been for the most part language-oriented, but also include research into needs analysis and the pedagogy of team-teaching. Considering the current situation at this level of education, however, there still seems to be more to do. And the question is, what more can we do? What further contribution can we make? Or, how can we take this process further? The purpose of the study reported here is to respond to this last question. We test the proposition that it is possible to take this process further by investigating the efficient management of transition from Turkish-medium to English-medium at the tertiary level of education in Turkey. Beyond what is achieved by only the language orientation of the EAP approach, and moving conceptually deeper than what has been achieved by the team-teaching approach, the research undertaken for the purpose of this study focuses on the idea of the discourse community that people want to belong to. It then pursues an adaptation of the essentially psycho-social approach of apprenticeship, as people become aspirants and apprentices to that discourse community. In this thesis, the researcher recognises that she cannot follow all the way through to the full implementation of her ideas in a fully-taught course. She is not in a position to change the education system. What she does here is to introduce a concept and sample its effects in terms of motivation, and thereby of integration and of success, for individuals and groups of learners. Evaluation is provided by acquiring both qualitative and quantitative data concerning mature members' perceptions of apprenticed-neophytes functioning as members in the new community, apprenticed-neophytes' perceptions of their own membership and of the preparation process undertaken, and the comparison of these neophytes' performance with that of other neophytes in the community. The data obtained provide strong evidence in support of the potential usefulness of this apprenticeship model towards the declared purpose of improving the English-medium tertiary education of Turkish students in their chosen fields of study.

A methodology for implementing a decision support system:a small company case study

The importance of non-technical factors in the design and implementation of information systems has been increasingly recognised by both researchers and practitioners, and recent literature highlights the need for new tools and techniques with an organisational, rather than technical, focus. The gap between what is technically possible and what is generally practised, is particularly wide in the sales and marketing field. This research describes the design and implementation of a decision support system (DSS) for marketing planning and control in a small, but complex company and examines the nature of the difficulties encountered. An intermediary with functional, rather than technical, expertise is used as a strategy for overcoming these by taking control of the whole of the systems design and implementation cycle. Given the practical nature of the research, an action research approach is adopted with the researcher undertaking this role. This approach provides a detailed case study of what actually happens during the DSS development cycle, allowing the influence of organisational factors to be captured. The findings of the research show how the main focus of the intermediary's role needs to be adapted over the systems development cycle; from coordination and liaison in the pre-design and design stages, to systems champion during the first part of the implementation stage, and finally to catalyst to ensure that the DSS is integrated into the decision-making process. Two practical marketing exercises are undertaken which illustrate the nature of the gap between the provision of information and its use. The lack of a formal approach to planning and control is shown to have a significant effect on the way the DSS is used and the role of the intermediary is extended successfully to accommodate this factor. This leads to the conclusion that for the DSS to play a fully effective role, small firms may need to introduce more structure into their marketing planning, and that the role of the intermediary, or Information Coordinator, should include the responsibility for introducing new techniques and ideas to aid with this.

Understanding the IT-related attitudes and needs of persons with age-related macular degeneration : a case study

In the UK, 20 per cent of people aged 75 years and over are living with sight loss; this percentage is expected to increase as the population ages (RNIB, 2011). Age-Related Macular Degeneration (AMD) is the UK’s leading cause of severe visual impairment amongst the elderly. It accounts for 16,000 blind/partial sight registrations per year and is the leading cause of blindness among people aged 55 years and older in western countries (Bressler, 2004). Our ultimate goal is to develop an assistive mobile application to support accurate and convenient diet data collection on which basis to then provide customised dietary advice and recommendations in order to help support individuals with AMD to mitigate their ongoing risk and retard the progression of the disease. In this paper, we focus on our knowledge elicitation activities conducted to help us achieve a deep and relevant understanding of our target user group. We report on qualitative findings from focus groups and observational studies with persons with AMD and interviews with domain experts which enable us to fully appreciate the impact that technology may have on our intended users as well as to inform the design and structure of our proposed mobile assistive application.

Decision support system for spare parts warehousing

Spare parts warehousing decision-making plays an important role in today's manufacturing industry as it derives an optimum inventory policy for the organizations. Previous research on spare parts warehousing decision-making did not deal with the problem holistically considering all the subjective and objective criteria of operational and strategic needs of the manufacturing companies in the process industry. This study reviews current relevant literature and develops a conceptual framework (an integrated group decision support system) for selecting the most effective warehousing option for the process industry using the analytic hierarchy process (AHP). The framework has been applied to a multinational cement manufacturing company in the UK. Three site visits, eight formal interviews, and several discussions have been undertaken with personnel of the organization, many of which have more than 20 years of experience, in order to apply the proposed decision support system (DSS). Subsequently, the DSS has been validated through a questionnaire survey in order to establish its usefulness, effectiveness for warehousing decision-making, and the possibility of adoption. The proposed DSS is an integrated framework for selecting the best warehousing option for business excellence in any manufacturing organization.

Knowledge management in support of enterprise risk management

Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs related to knowledge sharing, and two risk management concepts: perceived quality of risk control and perceived value of enterprise risk management. From a literature review, relationships with eight knowledge management variables covering people, process and technology aspects were hypothesised. A survey was administered to risk management employees in financial institutions. The results showed that the perceived quality of risk control is significantly associated with four knowledge management variables: perceived quality of risk knowledge sharing, perceived quality of communication among people, web channel functionality, and risk management information system functionality. However, the relationships of the knowledge management variables to the perceived value of enterprise risk management are not significant. We conclude that better knowledge management is associated with better risk control, but that more effort needs to be made to break down organizational silos in order to support true Enterprise Risk Management.

Accommodating special needs users in the evaluation of an m-Learning application:a case study

Adult illiteracy rates are alarmingly high worldwide. The portability, affordability, and ease of use of mobile (or handheld) devices offer a realistic opportunity to provide novel, context-sensitive literacy resources to adults with limited literacy skills. To this end, we developed the concept of ALEX – a mobile Adult Literacy support application for EXperiential learning (Lumsden et al., 2005). On the basis of a medium-fidelity prototype of this application, we conducted an evaluation of ALEX using participants from our in tended user group. This evaluation had two goals: (a) to assess the usefulness of the ALEX concept and the usability of its current design; and (b) to reflect on the appropriateness of our evaluation process given the literacy-related needs of our participants. This paper outlines our approach to this evaluation as well as the results we obtained and our reflections on the process.

The attitudes of students and academic staff towards electronic course support:are we convergent?

The present study investigates the views and attitudes of both the students and staff with regard to the usefulness of electronic course support throughout all four years of the MPharm programme at Aston University. Students were sampled between January and March 2001 using a self-completion questionnaire administered during the start of a practical or tutorial class. All internal academic staff were interviewed using a semi-structured interview format. Response rates were 100 and 89.5%, respectively. The study found that students rapidly embraced the use of electronic course support within the undergraduate programme, although they view its role as augmenting traditional course delivery. This view was mirrored by the academic staff, although only around a half currently place their material on the University's virtual learning environment (VLE), WebCT. The failure of staff to completely embrace the VLE is grounded in a lack of confidence and ability in its use. A majority of the academic staff indicated that they wish to be trained further in the use of information technology. Academic institutions need to understand and meet these needs in parallel with the introduction of any electronic course support.

Understanding the IT-related attitudes and needs of persons with age-related macular degeneration:a case study

In the UK, 20 per cent of people aged 75 years and over are living with sight loss; this percentage is expected to increase as the population ages (RNIB, 2011). Age-Related Macular Degeneration (AMD) is the UK’s leading cause of severe visual impairment amongst the elderly. It accounts for 16,000 blind/partial sight registrations per year and is the leading cause of blindness among people aged 55 years and older in western countries (Bressler, 2004). Our ultimate goal is to develop an assistive mobile application to support accurate and convenient diet data collection on which basis to then provide customised dietary advice and recommendations in order to help support individuals with AMD to mitigate their ongoing risk and retard the progression of the disease. In this paper, we focus on our knowledge elicitation activities conducted to help us achieve a deep and relevant understanding of our target user group. We report on qualitative findings from focus groups and observational studies with persons with AMD and interviews with domain experts which enable us to fully appreciate the impact that technology may have on our intended users as well as to inform the design and structure of our proposed mobile assistive application.

Representing human expertise by the OWL web ontology language to support knowledge engineering in decision support systems

Clinical decision support systems (CDSSs) often base their knowledge and advice on human expertise. Knowledge representation needs to be in a format that can be easily understood by human users as well as supporting ongoing knowledge engineering, including evolution and consistency of knowledge. This paper reports on the development of an ontology specification for managing knowledge engineering in a CDSS for assessing and managing risks associated with mental-health problems. The Galatean Risk and Safety Tool, GRiST, represents mental-health expertise in the form of a psychological model of classification. The hierarchical structure was directly represented in the machine using an XML document. Functionality of the model and knowledge management were controlled using attributes in the XML nodes, with an accompanying paper manual for specifying how end-user tools should behave when interfacing with the XML. This paper explains the advantages of using the web-ontology language, OWL, as the specification, details some of the issues and problems encountered in translating the psychological model to OWL, and shows how OWL benefits knowledge engineering. The conclusions are that OWL can have an important role in managing complex knowledge domains for systems based on human expertise without impeding the end-users' understanding of the knowledge base. The generic classification model underpinning GRiST makes it applicable to many decision domains and the accompanying OWL specification facilitates its implementation.

Knowledge management in support of enterprise risk management

Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs related to knowledge sharing, and two risk management concepts: perceived quality of risk control and perceived value of enterprise risk management. From a literature review, relationships with eight knowledge management variables covering people, process and technology aspects were hypothesised. A survey was administered to risk management employees in financial institutions. The results showed that the perceived quality of risk control is significantly associated with four knowledge management variables: perceived quality of risk knowledge sharing, perceived quality of communication among people, web channel functionality, and risk management information system functionality. However, the relationships of the knowledge management variables to the perceived value of enterprise risk management are not significant. We conclude that better knowledge management is associated with better risk control, but that more effort needs to be made to break down organizational silos in order to support true Enterprise Risk Management.

Liquid desiccant dehumidification and regeneration process to meet cooling and freshwater needs of desert greenhouses

Agriculture accounts for ~70% of freshwater usage worldwide. Seawater desalination alone cannot meet the growing needs for irrigation and food production, particularly in hot, desert environments. Greenhouse cultivation of high-value crops uses just a fraction of freshwater per unit of food produced when compared with open field cultivation. However, desert greenhouse producers face three main challenges: freshwater supply, plant nutrient supply, and cooling of the greenhouse. The common practice of evaporative cooling for greenhouses consumes large amounts of fresh water. In Saudi Arabia, the most common greenhouse cooling schemes are fresh water-based evaporative cooling, often using fossil groundwater or energy-intensive desalinated water, and traditional refrigeration-based direct expansion cooling, largely powered by the burning of fossil fuels. The coastal deserts have ambient conditions that are seasonally too humid to support adequate evaporative cooling, necessitating additional energy consumption in the dehumidification process of refrigeration-based cooling. This project evaluates the use of a combined-system liquid desiccant dehumidifier and membrane distillation unit that can meet the dual needs of cooling and freshwater supply for a greenhouse in a hot and humid environment.