Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study

Background Patients' health related quality of life (HRQoL) has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i) the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii) the perceived practical utility of HRQoL results and iii) to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30) were electronically presented on portable tablet computers. Wireless network (WLAN) integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs) and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments). On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%), most practice assistants (19/27 = 70%; 95% CI = 50–86%) and the majority of patients (240/280 = 86%; 95% CI = 82–91%) indicated that they would welcome the use of electronic HRQoL questionnaires in the future. GPs mentioned availability of local health services (e.g. supportive, physiotherapy) (mean: 9.4 ± 1.0 SD; scale: 1 – 10), sufficient extra time (8.9 ± 1.5) and easy interpretation of HRQoL results (8.6 ± 1.6) as the most important prerequisites for their use. They believed HRQoL assessment facilitated both communication and follow up of patients' conditions. Practice assistants emphasised that this process demonstrated an extra commitment to patient centred care; patients viewed it as a tool, which contributed to the physicians' understanding of their personal condition and circumstances. Conclusion This pilot study indicates that electronic HRQoL assessment is technically feasible in general practices. It can provide clinically significant information, which can either be used in the consultation for routine care, or for research purposes. While GPs, practice assistants and patients were generally positive about the electronic procedure, several barriers (e.g. practices' lack of time and routine in HRQoL assessment) need to be overcome to enable broader application of electronic questionnaires in every day medical practice.

Digital multitext editions from scratch to electronic performance. Transcription and collation routines transformed in a flexible database system

The poster demonstrates the preparatory steps of a digital multi-text edition that are abstracted from the experiences made in the Parzival Project, based at the University of Bern, the Berlin-Brandenburg Academy of Sciences and the University of Erlangen. This edition of Wolfram von Eschenbach’s German Grail novel, written shortly after 1200 and transmitted during several centuries in ca. hundred witnesses, has now been completed by more than a half of the textual corpus. As the text is transmitted in medieval manuscripts the witnesses have to be transcribed according to specific encoding rules. The transcriptions then are collated following certain ideas and concepts of how the transmission process could have developed. The transcriptions and collations finally have to be transferred to a digital edition that allows the users to explore the characteristics of single witnesses as well as the history of a text, which is delivered in variants and in different versions. A dynamically organized database offering various components and adapted to the needs of diverse user-profiles is nowadays the right tool for this purpose.

Digital multi-text editions from scratch to electronic performance. Transcription and collation routines transformed in a flexible database system

The poster demonstrates the preparatory steps of a digital multi-text edition that are abstracted from the experiences made in the Parzival Project, based at the University of Bern, the Berlin-Brandenburg Academy of Sciences and the University of Erlangen. This edition of Wolfram von Eschenbach’s German Grail novel, written shortly after 1200 and transmitted during several centuries in ca. hundred witnesses, has now been completed by more than a half of the textual corpus.

Mining the Ecosystem to Improve Type Inference For Dynamically Typed Languages

Dynamically typed languages lack information about the types of variables in the source code. Developers care about this information as it supports program comprehension. Ba- sic type inference techniques are helpful, but may yield many false positives or negatives. We propose to mine information from the software ecosys- tem on how frequently given types are inferred unambigu- ously to improve the quality of type inference for a single system. This paper presents an approach to augment existing type inference techniques by supplementing the informa- tion available in the source code of a project with data from other projects written in the same language. For all available projects, we track how often messages are sent to instance variables throughout the source code. Predictions for the type of a variable are made based on the messages sent to it. The evaluation of a proof-of-concept prototype shows that this approach works well for types that are sufficiently popular, like those from the standard librarie, and tends to create false positives for unpopular or domain specific types. The false positives are, in most cases, fairly easily identifiable. Also, the evaluation data shows a substantial increase in the number of correctly inferred types when compared to the non-augmented type inference.

Relational and Allegorical Semantics for Constraint Logic Programming

El cálculo de relaciones binarias fue creado por De Morgan en 1860 para ser posteriormente desarrollado en gran medida por Peirce y Schröder. Tarski, Givant, Freyd y Scedrov demostraron que las álgebras relacionales son capaces de formalizar la lógica de primer orden, la lógica de orden superior así como la teoría de conjuntos. A partir de los resultados matemáticos de Tarski y Freyd, esta tesis desarrolla semánticas denotacionales y operacionales para la programación lógica con restricciones usando el álgebra relacional como base. La idea principal es la utilización del concepto de semántica ejecutable, semánticas cuya característica principal es el que la ejecución es posible utilizando el razonamiento estándar del universo semántico, este caso, razonamiento ecuacional. En el caso de este trabajo, se muestra que las álgebras relacionales distributivas con un operador de punto fijo capturan toda la teoría y metateoría estándar de la programación lógica con restricciones incluyendo los árboles utilizados en la búsqueda de demostraciones. La mayor parte de técnicas de optimización de programas, evaluación parcial e interpretación abstracta pueden ser llevadas a cabo utilizando las semánticas aquí presentadas. La demostración de la corrección de la implementación resulta extremadamente sencilla. En la primera parte de la tesis, un programa lógico con restricciones es traducido a un conjunto de términos relacionales. La interpretación estándar en la teoría de conjuntos de dichas relaciones coincide con la semántica estándar para CLP. Las consultas contra el programa traducido son llevadas a cabo mediante la reescritura de relaciones. Para concluir la primera parte, se demuestra la corrección y equivalencia operacional de esta nueva semántica, así como se define un algoritmo de unificación mediante la reescritura de relaciones. La segunda parte de la tesis desarrolla una semántica para la programación lógica con restricciones usando la teoría de alegorías—versión categórica del álgebra de relaciones—de Freyd. Para ello, se definen dos nuevos conceptos de Categoría Regular de Lawvere y _-Alegoría, en las cuales es posible interpretar un programa lógico. La ventaja fundamental que el enfoque categórico aporta es la definición de una máquina categórica que mejora e sistema de reescritura presentado en la primera parte. Gracias al uso de relaciones tabulares, la máquina modela la ejecución eficiente sin salir de un marco estrictamente formal. Utilizando la reescritura de diagramas, se define un algoritmo para el cálculo de pullbacks en Categorías Regulares de Lawvere. Los dominios de las tabulaciones aportan información sobre la utilización de memoria y variable libres, mientras que el estado compartido queda capturado por los diagramas. La especificación de la máquina induce la derivación formal de un juego de instrucciones eficiente. El marco categórico aporta otras importantes ventajas, como la posibilidad de incorporar tipos de datos algebraicos, funciones y otras extensiones a Prolog, a la vez que se conserva el carácter 100% declarativo de nuestra semántica. ABSTRACT The calculus of binary relations was introduced by De Morgan in 1860, to be greatly developed by Peirce and Schröder, as well as many others in the twentieth century. Using different formulations of relational structures, Tarski, Givant, Freyd, and Scedrov have shown how relation algebras can provide a variable-free way of formalizing first order logic, higher order logic and set theory, among other formal systems. Building on those mathematical results, we develop denotational and operational semantics for Constraint Logic Programming using relation algebra. The idea of executable semantics plays a fundamental role in this work, both as a philosophical and technical foundation. We call a semantics executable when program execution can be carried out using the regular theory and tools that define the semantic universe. Throughout this work, the use of pure algebraic reasoning is the basis of denotational and operational results, eliminating all the classical non-equational meta-theory associated to traditional semantics for Logic Programming. All algebraic reasoning, including execution, is performed in an algebraic way, to the point we could state that the denotational semantics of a CLP program is directly executable. Techniques like optimization, partial evaluation and abstract interpretation find a natural place in our algebraic models. Other properties, like correctness of the implementation or program transformation are easy to check, as they are carried out using instances of the general equational theory. In the first part of the work, we translate Constraint Logic Programs to binary relations in a modified version of the distributive relation algebras used by Tarski. Execution is carried out by a rewriting system. We prove adequacy and operational equivalence of the semantics. In the second part of the work, the relation algebraic approach is improved by using allegory theory, a categorical version of the algebra of relations developed by Freyd and Scedrov. The use of allegories lifts the semantics to typed relations, which capture the number of logical variables used by a predicate or program state in a declarative way. A logic program is interpreted in a _-allegory, which is in turn generated from a new notion of Regular Lawvere Category. As in the untyped case, program translation coincides with program interpretation. Thus, we develop a categorical machine directly from the semantics. The machine is based on relation composition, with a pullback calculation algorithm at its core. The algorithm is defined with the help of a notion of diagram rewriting. In this operational interpretation, types represent information about memory allocation and the execution mechanism is more efficient, thanks to the faithful representation of shared state by categorical projections. We finish the work by illustrating how the categorical semantics allows the incorporation into Prolog of constructs typical of Functional Programming, like abstract data types, and strict and lazy functions.

Designing a high performance parallel logic programming system

Compilation techniques such as those portrayed by the Warren Abstract Machine(WAM) have greatly improved the speed of execution of logic programs. The research presented herein is geared towards providing additional performance to logic programs through the use of parallelism, while preserving the conventional semantics of logic languages. Two áreas to which special attention is given are the preservation of sequential performance and storage efficiency, and the use of low overhead mechanisms for controlling parallel execution. Accordingly, the techniques used for supporting parallelism are efficient extensions of those which have brought high inferencing speeds to sequential implementations. At a lower level, special attention is also given to design and simulation detail and to the architectural implications of the execution model behavior. This paper offers an overview of the basic concepts and techniques used in the parallel design, simulation tools used, and some of the results obtained to date.

Partial order and contextual net semantics for atomic and locally atomic CC programs

We present two concurrent semantics (i.e. semantics where concurrency is explicitely represented) for CC programs with atomic tells. One is based on simple partial orders of computation steps, while the other one is based on contextual nets and it is an extensión of a previous one for eventual CC programs. Both such semantics allow us to derive concurrency, dependency, and nondeterminism information for the considered languages. We prove some properties about the relation between the two semantics, and also about the relation between them and the operational semantics. Moreover, we discuss how to use the contextual net semantics in the context of CLP programs. More precisely, by interpreting concurrency as possible parallelism, our semantics can be useful for a safe parallelization of some CLP computation steps. Dually, the dependency information may also be interpreted as necessary sequentialization, thus possibly exploiting it for the task of scheduling CC programs. Moreover, our semantics is also suitable for CC programs with a new kind of atomic tell (called locally atomic tell), which checks for consistency only the constraints it depends on. Such a tell achieves a reasonable trade-off between efficiency and atomicity, since the checked constraints can be stored in a local memory and are thus easily accessible even in a distributed implementation.

Towards execution time estimation in abstract machine-based languages

Abstract machines provide a certain separation between platformdependent and platform-independent concerns in compilation. Many of the differences between architectures are encapsulated in the speciflc abstract machine implementation and the bytecode is left largely architecture independent. Taking advantage of this fact, we present a framework for estimating upper and lower bounds on the execution times of logic programs running on a bytecode-based abstract machine. Our approach includes a one-time, programindependent proflling stage which calculates constants or functions bounding the execution time of each abstract machine instruction. Then, a compile-time cost estimation phase, using the instruction timing information, infers expressions giving platform-dependent upper and lower bounds on actual execution time as functions of input data sizes for each program. Working at the abstract machine level makes it possible to take into account low-level issues in new architectures and platforms by just reexecuting the calibration stage instead of having to tailor the analysis for each architecture and platform. Applications of such predicted execution times include debugging/veriflcation of time properties, certiflcation of time properties in mobile code, granularity control in parallel/distributed computing, and resource-oriented specialization.

High-level languages for small devices: A case study

In this paper we study, through a concrete case, the feasibility of using a high-level, general-purpose logic language in the design and implementation of applications targeting wearable computers. The case study is a "sound spatializer" which, given real-time signáis for monaural audio and heading, generates stereo sound which appears to come from a position in space. The use of advanced compile-time transformations and optimizations made it possible to execute code written in a clear style without efñciency or architectural concerns on the target device, while meeting strict existing time and memory constraints. The final executable compares favorably with a similar implementation written in C. We believe that this case is representative of a wider class of common pervasive computing applications, and that the techniques we show here can be put to good use in a range of scenarios. This points to the possibility of applying high-level languages, with their associated flexibility, conciseness, ability to be automatically parallelized, sophisticated compile-time tools for analysis and verification, etc., to the embedded systems field without paying an unnecessary performance penalty.

Using attributed variables in the implementation of concurrent and parallel logic programming systems

Incorporating the possibility of attaching attributes to variables in a logic programming system has been shown to allow the addition of general constraint solving capabilities to it. This approach is very attractive in that by adding a few primitives any logic programming system can be turned into a generic constraint logic programming system in which constraint solving can be user deñned, and at source level - an extreme example of the "glass box" approach. In this paper we propose a different and novel use for the concept of attributed variables: developing a generic parallel/concurrent (constraint) logic programming system, using the same "glass box" flavor. We argüe that a system which implements attributed variables and a few additional primitives can be easily customized at source level to implement many of the languages and execution models of parallelism and concurrency currently proposed, in both shared memory and distributed systems. We illustrate this through examples and report on an implementation of our ideas.

From eventual to atomic and locally atomic CC programs: A concurrent semantics

We present a concurrent semantics (i.e. a semantics where concurrency is explicitely represented) for CC programs with atomic tells. This allows to derive concurrency, dependency, and nondeterminism information for such languages. The ability to treat failure information puts CLP programs also in the range of applicability of our semantics: although such programs are not concurrent, the concurrency information derived in the semantics may be interpreted as possible parallelism, thus allowing to safely parallelize those computation steps which appear to be concurrent in the net. Dually, the dependency information may also be interpreted as necessary sequentialization, thus possibly exploiting it to schedule CC programs. The fact that the semantical structure contains dependency information suggests a new tell operation, which checks for consistency only the constraints it depends on, achieving a reasonable trade-off between efficiency and atomicity.

Programming with global analysis

Global data-flow analysis of (constraint) logic programs, which is generally based on abstract interpretation [7], is reaching a comparatively high level of maturity. A natural question is whether it is time for its routine incorporation in standard compilers, something which, beyond a few experimental systems, has not happened to date. Such incorporation arguably makes good sense only if: • the range of applications of global analysis is large enough to justify the additional complication in the compiler, and • global analysis technology can deal with all the features of "practical" languages (e.g., the ISO-Prolog built-ins) and "scales up" for large programs. We present a tutorial overview of a number of concepts and techniques directly related to the issues above, with special emphasis on the first one. In particular, we concéntrate on novel uses of global analysis during program development and debugging, rather than on the more traditional application área of program optimization. The idea of using abstract interpretation for validation and diagnosis has been studied in the context of imperative programming [2] and also of logic programming. The latter work includes issues such as using approximations to reduce the burden posed on programmers by declarative debuggers [6, 3] and automatically generating and checking assertions [4, 5] (which includes the more traditional type checking of strongly typed languages, such as Gódel or Mercury [1, 8, 9]) We also review some solutions for scalability including modular analysis, incremental analysis, and widening. Finally, we discuss solutions for dealing with meta-predicates, side-effects, delay declarations, constraints, dynamic predicates, and other such features which may appear in practical languages. In the discussion we will draw both from the literature and from our experience and that of others in the development and use of the CIAO system analyzer. In order to emphasize the practical aspects of the solutions discussed, the presentation of several concepts will be illustrated by examples run on the CIAO system, which makes extensive use of global analysis and assertions.

A system for automatically generating documentation for (C)LP programs

We describe lpdoc, a tool which generates documentation manuals automatically from one or more logic program source files, written in ISO-Prolog, Ciao, and other (C)LP languages. It is particularly useful for documenting library modules, for which it automatically generates a rich description of the module interface. However, it can also be used quite successfully to document full applications. A fundamental advantage of using lpdoc is that it helps maintaining a true correspondence between the program and its documentation, and also identifying precisely to what version of the program a given printed manual corresponds. The quality of the documentation generated can be greatly enhanced by including within the program text assertions (declarations with types, modes, etc.) for the predicates in the program, and machine-readable comments. One of the main novelties of lpdoc is that these assertions and comments are written using the Ciao system assertion language, which is also the language of communication between the compiler and the user and between the components of the compiler. This allows a significant synergy among specification, documentation, optimization, etc. A simple compatibility library allows conventional (C)LP systems to ignore these assertions and comments and treat normally programs documented in this way. The documentation can be generated in many formats including texinfo, dvi, ps, pdf, info, html/css, Unix nroff/man, Windows help, etc., and can include bibliographic citations and images. lpdoc can also generate “man” pages (Unix man page format), nicely formatted plain ascii “readme” files, installation scripts useful when the manuals are included in software distributions, brief descriptions in html/css or info formats suitable for inclusion in on-line indices of manuals, and even complete WWW and info sites containing on-line catalogs of documents and software distributions. The lpdoc manual, all other Ciao system manuals, and parts of this paper are generated by lpdoc.

A documentation generator for logic programming systems

We describe lpdoc, a tool which generates documentation manuals automatically from one or more logic program source files, written in ISO-Prolog, Ciao, and other (C)LP languages. It is particularly useful for documenting library modules, for which it automatically generates a rich description of the module interface. However, it can also be used quite successfully to document full applications. The documentation can be generated in many formats including t e x i n f o, dvi, ps, pdf, inf o, html/css, Unix nrof f/man, Windows help, etc., and can include bibliographic citations and images, lpdoc can also genérate "man" pages (Unix man page format), nicely formatted plain ascii "readme" files, installation scripts useful when the manuals are included in software distributions, brief descriptions in html/css or inf o formats suitable for inclusión in on-line Índices of manuals, and even complete WWW and inf o sites containing on-line catalogs of documents and software distributions. A fundamental advantage of using lpdoc is that it helps maintaining a true correspondence between the program and its documentation, and also identifying precisely to what versión of the program a given printed manual corresponds. The quality of the documentation generated can be greatly enhanced by including within the program text assertions (declarations with types, modes, etc. ...) for the predicates in the program, and machine-readable comments. These assertions and comments are written using the Ciao system assertion language. A simple compatibility library allows conventional (C)LP systems to ignore these assertions and comments and treat normally programs documented in this way. The lpdoc manual, all other Ciao system manuals, and most of this paper, are generated by lpdoc.