Conservation and development interventions as networks: The case of the India ecodevelopment project, Karnataka

Experience with community-based biodiversity conservation programs in the 1980s and 1990s contributed to the conviction among donor agencies and researchers that such programs must be based on the active support of local resource users, appropriate incentives, and institutional support. Yet the continuing struggles of practitioners to implement conservation interventions that are socially and ecologically sustainable point to difficulty in realizing these principles on the ground. Actor-oriented research in rural development and actor network theory emphasize that the capacity of facilitators to engage effectively in negotiation processes and establish strong networks with key actors is critical in mediating intervention outcomes. Drawing on the case of the India Ecodevelopment Project at Rajiv Gandhi (Nagarahole) National Park in Karnataka, India, this paper explores the role of relationships and networks between actors in a conservation and development intervention, finding that practitioners need to focus on negotiation and network building as a central rather than subsidiary part of the intervention process. Associated with this is the need for change in the way donor and implementing agencies conduct themselves, to promote communication and greater flexibility in intervention processes.

Focus group study of endometriosis: struggle, loss and the medical merry-go-round

Women with endometriosis experience a range of problems for which they may or may not be adequately supported. This paper reports on one aspect of a study conducted at the Epworth Hospital, Melbourne, to identify the information needs of women facing laparoscopy for endometriosis. A number of focus groups were conducted that provided women with a forum for communicating their experiences of endometriosis and laparoscopy. The findings include the experiences of 61 women who described the lack of support, the struggles and the losses involved in living with endometriosis. By far the worst experience that these women described was the encounter with health professionals and the ways in which their symptoms were trivialised and dismissed. There is a great deal for nurses to learn about the experience of living with endometriosis if they are to support women with this chronic illness in their search for well-being.

The test-retest reliability of the child-initiated pretend play assessment

OBJECTIVE: The purpose of this study is to establish the test–retest reliability of the Child-Initiated Pretend Play Assessment (ChIPPA) (Stagnitti, 2002a; Stagnitti, Unsworth, & Rodger, 2000).

METHOD: The first author rated 38 preschool children ages 4 and 5 years (4 with developmental delay and 34 typically developing) on the ChIPPA. The ChIPPA employs conventional play materials and unstructured play materials to assess three qualities of a child's play ability: elaborateness of play action, ability to substitute objects during play, and the child's need to imitate the modelled actions of the examiner. The ChIPPA was administered twice, at a 2-week interval, to each participant.

RESULTS: Test–retest intraclass correlation coefficients (ICCs) (Type 2,1) calculated for each of the three elaborate play measures ranged from .73 to .84. A test–retest ICC of .56 was obtained for object substitution with unstructured play materials. The test–retest ICC obtained for the combined score for unstructured and conventional play materials was .57. Percentage agreement figures ranging from 63.2% to 84.2% were obtained on test–retest of the object substitution with conventional toys and imitated actions measures. There was no significant difference between test and retest scores for these measures based on a Wilcoxon Matched Pairs Signed-Ranks Test (Wilcoxon Sign Test).

CONCLUSION: Elaborate play scores, object substitution with conventional toys score, and imitation scores on the ChIPPA showed stability over time. Object substitution scores using unstructured materials were the least stable play measures and appeared to be related to the child's play themes. Since play is the primary occupation of children, it is essential that therapists have a reliable measure of play behavior. The test–retest reliability results from the ChIPPA provide evidence that this assessment produces a stable measure of play behavior that can then guide therapists when planning intervention strategies for children.

Development and reliability of a self-report questionnaire to examine children's perceptions of the physical activity environment at home and in the neighbourhood

Background: Environmental factors are increasingly being implicated as key influences on children's physical activity. Few studies have comprehensively examined children's perceptions of their environment, and there is a paucity of literature on acceptable and reliable scales for measuring these. This study aimed to develop and test the acceptability and reliability of a scale which examined a broad range of environmental perceptions among children.
Methods: Based on constructs from ecological models, a survey incorporating items on children's perceptions of the physical and social environment at home and in the neighbourhood was developed. This was administered on two occasions, nine days apart, to a sample of 39 children aged 11 years (54% boys), attending a metropolitan Australian elementary school. The acceptability of the survey was determined by the proportion of missing responses to each item. The test-retest reliability of individual items, scores and scales were determined using Kappa statistics and percent agreement for categorical variables, and intraclass correlation coefficients (ICC) for continuous variables.
Results: There were few missing responses to each question, with only 4% of all responses missing. Although some Kappa values were low, all categorical variables showed acceptable reliability when examined for percent agreement between test and retest (range 68%–100% agreement). Continuous variables all showed moderate to good ICC values (range 0.72–0.92).
Conclusion: Findings suggest this questionnaire is reliable and acceptable to children for assessing environmental perceptions relevant to physical activity among 11-year-old children.

Agreement between adolescent self-report and parent reports of health and well-being: results of an epidemiological study.

Objective To examine parent and adolescent agreement on physical, emotional, mental and social health and well-being in a representative population.
Methodology An epidemiological design was used to obtain parent–child/adolescent dyad data on comparable items and scales of a generic measure of health and well-being, the Child Health Questionnaire (parent/proxy report 50 item, self-report 80 item). Scale analysis included intraclass correlations (ICCs) to examine strength of parent–child associations and independent t-tests for differences between adolescents (with or without an illness). Where there were significant differences in scale scores, analysis of variance and two sample t-tests were used to examine the influence of social, demographic, health concern and school variables. Single items were examined for trends in response categories.
Results 2096 parent–adolescent dyads (adolescent mean age of 15.1 years, males 50%, maternal parent 83.2%, biological parent 93.5%). ICCs were strong. Overall, adolescents reported poorer emotional and social health, and clinically significant differences were observed for perceptions of general health (mean difference 8.1/100), frequency and amount of body pain (5.94/100), experience of mental health (5.14/100), and impact of health on family activities (12.43/100), which widen significantly for adolescents with illness. Social, health and school enjoyment and performance significantly widened parent–child differences.
Conclusions All adolescents were much less optimistic about their health and well-being than their parents, and were only in close agreement on aspects of health and well-being they rated highly. Adolescent reports are more likely to be sensitive to pain, mental health problems, health in general and the impact of their health on family activities.

Positivism: one ring to rule them all? A tale of information systems research methodology

The tale of research methodology in information systems is told through the fantasy of Tolkien’s Lord of the Rings. The tale is intended to be at once a piece of light hearted fun in its placement of the struggles of research methodology as an epic story but, in the tradition of the court jester, attempts to provide a new perspective on Information Systems (IS) research methodology and our struggles with positivism in particular. Our tale is one of developing a greater maturity and confidence in IS methodology and introduces postmodern methodologies to Information Systems. Our tale, our pastiche, is itself postmodern.

Deconstructing power within a strategic information system

Strategy is a political act, and yet that has received very little attention in IS strategy research. The purpose of this paper is to explore the mixes between politics, power and strategy using a case study of implementation of a Student Administration System. This takes Strategic Information Systems out of the realm of the purely socia-technical view of information systems and moves it into a dimension which deals with the real social interactions that occur within organisations as a result of the implementation of a strategy in the form of a Student Administration System. This case study shows the power struggles, primarily by two Senior Executives and the users of the information system. The discourse behind this project was initially to create uniformity across a system therefore enabling more than 30 universities around Australia to move from a diversified system to a centralized system. It was through this resistance and through their positions that the two Senior Executives were able to create the discourse that framed many of the decisions and implementation of the system. There eventually became an acceptance that it was for the social good of the University that the Student Administration System was adopted across the University of Australia.

Hybridity, globalisation and literacy education in the context of New York City

Although multiliteracies have been well theorised in recent years, few studies have researched the practical aspects of developing a curriculum of multiliteracies. This article examines multiliteracies as a crossdisciplinary curriculum practice, drawing on data from a 3-year study in an urban middle school. The data show possibilities for students to engage in critique and to move toward designing multimodal texts. Using Bourdieusian concepts of social capital and academic field, we explore the struggles around learning to inhabit certain school discourses.

The impact of the financial costs of multiple sclerosis on quality of life

This study examined the financial costs of multiple sclerosis (MS) and the impact of financial strain on the subjective quality of life of people with MS and their families. Due to the lack of research in this area, a qualitative research design was employed. Interviews were conducted with 16 health professionals, 26 people with MS, and 11 family members of people who had MS. Adjusting to actual or threatened loss of income caused financial stress. These financial struggles led to a lower quality of life among respondents. Problem solving, coping, and positive reappraisal helped people to adjust to financial changes. Professionals focused on increased funding for services, whereas people with MS focused on improved income support. These findings highlight the need for professionals to consider the financial strain associated with this disease and the impact of this strain on the quality of life of individuals with MS and their families.

Automated attention flags in chronic disease care planning

Objectives: To assess the value of computerised decision support in the management of chronic respiratory disease by comparing agreement between three respiratory specialists, general practitioners (care coordinators), and decision support software.
Methods: Care guidelines for two chronic obstructive pulmonary disease projects of the SA HealthPlus Coordinated Care Trial were formulated. Decision support software, Care Plan On-Line (CPOL), was created to represent the intent of these guidelines via automated attention flags to appear in patients' electronic medical records. For a random sample of 20 patients with care plans, decisions about the use of nine additional services (eg,.smoking cessation, pneumococcal vaccination) were compared between the respiratory specialists, the patients' GPs and the CPOL attention flags.
Results: Agreement among the specialists was at the lower end of moderate (intraclass correlation coefficient [ICC], 0.48; 95% CI, 0.39-0.56), with a 20% rate of contradictory decisions. Agreement with recommendations of specialists was moderate to poor for GPs (le, 0.49; 95% CI, 0.33-0.66) and moderate to good for CPOL (K, 0.72; 95% CI, 0.55-0.90). CPOL agreement with GPs was moderate to poor (le, 0.41; 95% CI, 0.24-0.58). GPs were less likely than specialists or CPOL to decide in favour of an additional service (P< 0.001). CPOL was 87% accurate as an indicator of specialist decisions. It gave a 16% false-positive rate according to specialist decisions, and flagged 61% of decisions where GPs said No and specialists said Yes.
Conclusions: Automated decision support may provide GPs with improved access to the intent of guidelines; however, further investigation is required.

Stranger in a Strange Land: The struggle for cultural and personal identity in Haruki Murakami's Hard-Boiled Wonderland and the End of the World

In order to explicate Murakami's version of the official culture, I have analyzed the novel with the works of several different theorists. Primarily, I drew my own understanding of the official culture from Raymond Williams's examination of culture in Marxism and Literature. His terminology became helpful in writing about the operation of the System and the Town, though it did not define that operation precisely. Williams's work also introduced me to the theory behind the official culture's manipulation and exclusion of historical aspects in order to create their "official" version of history, from which the official culture draws its identity. For further analysis of the treatment of history, I turned to Friedrich Nietzsche's On the Advantage and Disadvantage of History for Life. Though it examines the official culture's manipulation of history in a much more in-depth manner, it seems to have influenced Murakami's treatment of individual memories and cultural histories. For instance, the herd ofunicoms in the End of the World resembles Nietzsche's description of the ''unhistorical herd," or has the potential to resemble it. With these theories I was able to access the mechanisms of cultural control that Murakami depicts in the form of the System and the Town, and from there I was able to develop a model for how the narrator struggles to subvert that control. Both sides of that struggle are depicted and re-imagined many times throughout Hard-Boiled Wonderland and the End of the World.

A simplified stroke rehabilitation assessment of movement instrument

Background and Purpose. An efficient, reliable, and valid instrument for assessing motor function in patients with stroke is needed by both clinicians and researchers. To improve administration efficiency, we applied the multidimensional Rasch model to the 30-item, 3-subscale Stroke Rehabilitation Assessment of Movement (STREAM) instrument to produce a concise, reliable, and valid instrument (simplified STREAM [S-STREAM]) for measuring motor function in patients with stroke. Subjects and Methods. The STREAM (consisting of 3 subscales: upper-limb movements, lower-limb movements, and mobility) was administered to 351 subjects with first stroke occurrence and a median time after stroke of 19.5 months. The unidimensionality of each subscale of the STREAM first was verified with unidimensional Rasch analysis. Each subscale of the STREAM then was simplified by deleting redundant items on the basis of expert opinion and the results of the Rasch analysis. The Rasch reliability of the S-STREAM and the concurrent validity of the S-STREAM with the STREAM were examined with multidimensional Rasch analysis and the intraclass correlation coefficient (ICC), respectively. Results. After deleting the items that did not fit the Rasch model, we found that the 8-item upper-limb movement subscale, the 9-item lower-limb movement subscale, and the 10-item mobility subscale assessed single, unidimensional upper-limb movements, lower-limb movements, and mobility, respectively. We selected 5 items from each subscale to construct the S-STREAM and found that the reliability of each subscale of the resulting simplified instrument was high (Rasch reliability coefficients of [greater than or equal to] .91). The agreement between the subscale scores (Rasch estimates) of the S-STREAM and those of the STREAM was excellent (ICC of [greater than or equal to] .99, with a lower limit for the 95% confidence interval of [greater than or equal to] .985), indicating good concurrent validity of the S-STREAM with the STREAM. Discussion and Conclusion. The S-STREAM demonstrates high Rasch reliability, unidimensionality, and concurrent validity with the STREAM in patients with stroke. Furthermore, the S-STREAM is efficient to administer, as it consists of only half the number of items in the original STREAM. Additional studies to examine other psychometric properties (eg, predictive validity and responsiveness) of the S-STREAM or its psychometric properties in various recovery stages after stroke are needed to further establish its utility in both clinical and research settings.

Psychometric properties of the modified Emory functional ambulation profile in stroke patients

Objective: To examine the test – retest reliability, convergent and predictive validity and responsiveness of the modified Emory Functional Ambulation Profile (mEFAP) in assessing gait function in stroke patients undergoing rehabilitation. Subjects: Forty subacute stroke inpatients were enrolled in the validity and responsiveness study. Twenty chronic patients participated in the reliability study. Setting: Rehabilitation department of a medical centre. Design: In the validity and responsiveness study, patients were tested using the mEFAP, 10-m walking speed test, Barthel Index and Rivermead Mobility Index at admission and at discharge. For the reliability study, the patients completed the mEFAP twice one week apart. Results: The patients' performances on the mEFAP were moderately to highly correlated with results of the 10-m walking speed test and Rivermead Mobility Index (absolute correlation coefficients ≥ 0.67), indicating good convergent validity. Patients' performance on the mEFAP at admission was moderately correlated with the Barthel Index and Rivermead Mobility Index scores at discharge (Spearman's rank correlation coefficients = -0.52 and -0.78, respectively), indicating good predictive validity. The standardized response mean of the mEFAP was 1.1 (P < 0.0001), suggesting good responsiveness. The intraclass correlation coefficient ICC(3,1) for the mEFAP was 0.997, indicating excellent test – retest reliability. Conclusions: Our results provide strong evidence that the mEFAP has good reliability, validity and responsiveness for assessing stroke patients undergoing rehabilitation. The mEFAP is a useful scale for measuring walking function and recovery in stroke patients.

Wolves in sheeps' clothing: Creationist manipulation of Kansas science standards

So the question that animates this paper is this: what happens when a state's education policy seeks to make popular social and religious values a central part of its education standards in direct confrontation with the Establishment Clause of the First Amendment of the U.S. Constitution? I will try to answer that question in three ways. First, I will examine the tactics used in the manipulation of curricula to reflect social and religious values, with special focus on the Kansas case. Second, I will try to ascertain the determinants of success in these efforts; under what conditions are movements to impose creation science on public school curricula likely to succeed, and when to fail? Third, I will try to place these struggles over educational curricula, and between religion and science, in broader context, focusing on what they tell us about the nature of public policy making in the contemporary United States.

The performance of solarscan : an automated dermoscopy image analysis instrument for the diagnosis of primary melanoma

Objective To describe the diagnostic performance of SolarScan (Polartechnics Ltd, Sydney, Australia), an automated instrument for the diagnosis of primary melanoma.

Design Images from a data set of 2430 lesions (382 were melanomas; median Breslow thickness, 0.36 mm) were divided into a training set and an independent test set at a ratio of approximately 2:1. A diagnostic algorithm (absolute diagnosis of melanoma vs benign lesion and estimated probability of melanoma) was developed and its performance described on the test set. High-quality clinical and dermoscopy images with a detailed patient history for 78 lesions (13 of which were melanomas) from the test set were given to various clinicians to compare their diagnostic accuracy with that of SolarScan.

Setting Seven specialist referral centers and 2 general practice skin cancer clinics from 3 continents. Comparison between clinician diagnosis and SolarScan diagnosis was by 3 dermoscopy experts, 4 dermatologists, 3 trainee dermatologists, and 3 general practitioners.

Patients Images of the melanocytic lesions were obtained from patients who required either excision or digital monitoring to exclude malignancy.

Main Outcome Measures Sensitivity, specificity, the area under the receiver operator characteristic curve, median probability for the diagnosis of melanoma, a direct comparison of SolarScan with diagnoses performed by humans, and interinstrument and intrainstrument reproducibility.

Results The melanocytic-only diagnostic model was highly reproducible in the test set and gave a sensitivity of 91% (95% confidence interval [CI], 86%-96%) and specificity of 68% (95% CI, 64%-72%) for melanoma. SolarScan had comparable or superior sensitivity and specificity (85% vs 65%) compared with those of experts (90% vs 59%), dermatologists (81% vs 60%), trainees (85% vs 36%; P =.06), and general practitioners (62% vs 63%). The intraclass correlation coefficient of intrainstrument repeatability was 0.86 (95% CI, 0.83-0.88), indicating an excellent repeatability. There was no significant interinstrument variation (P = .80).

Conclusions SolarScan is a robust diagnostic instrument for pigmented or partially pigmented melanocytic lesions of the skin. Preliminary data suggest that its performance is comparable or superior to that of a range of clinician groups. However, these findings should be confirmed in a formal clinical trial.