Special Issue on Virtual Reality Technologies for Disability and Rehabilitation

The papers presented in this issue provide a glimpse of the International Conference on Disability, Virtual Reality and Associated Technologies (ICDVRAT) research community, illustrating advances in virtual reality and associated technologies facilitating interaction in physical and digital environments for individuals and practitioners in disability and rehabilitation. We hope that you will find this issue of interest and recommend this journal and use it to communicate this research to a broader public.

Isotype: representing social facts pictorially

In developing Isotype, Otto Neurath and his colleagues were the first to systematically explore a consistent visual language as part of an encyclopedic approach to representing all aspects of the physical world. The pictograms used in Isotype have a secure legacy in today's public information symbols, but Isotype was more than this: it was designed to communicate social facts memorably to less educated groups, including schoolchildren and workers, reflecting its initial testing ground in the socialist municipality of Vienna during the 1920s. The social engagement and methodology of Isotype are examined here in order to draw some lessons for information design today.

Lewis Fry Richardson's forecast factory - for real

The idea that supercomputers are an important part of making forecasts of the weather and climate is well known amongst the general population. However, the details of their use are somewhat mysterious. A concept used to illustrate many undergraduate numerical weather prediction courses is the idea of a giant 'forecast factory,' conceived by Lewis Fry Richardson in 1922. In this article, a way of using the same idea to communicate key ideas in numerical weather prediction to the general public is outlined and tested amongst children from local schools.

Increasing food familiarity without the tears. A role for visual exposure?

Research has established the success of taste exposure paradigms as a means of increasing children’s acceptance, and liking, of previously unfamiliar or disliked foods. Yet, parents report that they tend to avoid the stress associated with repeatedly offering their children foods that are likely to be rejected. Given that successful taste exposure programmes often enhance children’s familiarity with a food’s appearance, as well as its taste, this article reviews the potential for exposure interventions that do not require repeated tastings to bring about positive attitude changes towards healthy foods. Recent evidence from studies that expose toddlers to picture books about fruit and vegetables suggest that familiarity with the origins and appearance of unfamiliar foods might increase children’s willingness to accept these into their diets.

PINCER trial: a cluster randomised trial comparing the effectiveness and cost-effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices

Background: Medication errors in general practice are an important source of potentially preventable morbidity and mortality. Building on previous descriptive, qualitative and pilot work, we sought to investigate the effectiveness, cost-effectiveness and likely generalisability of a complex pharm acist-led IT-based intervention aiming to improve prescribing safety in general practice. Objectives: We sought to: • Test the hypothesis that a pharmacist-led IT-based complex intervention using educational outreach and practical support is more effective than simple feedback in reducing the proportion of patients at risk from errors in prescribing and medicines management in general practice. • Conduct an economic evaluation of the cost per error avoided, from the perspective of the National Health Service (NHS). • Analyse data recorded by pharmacists, summarising the proportions of patients judged to be at clinical risk, the actions recommended by pharmacists, and actions completed in the practices. • Explore the views and experiences of healthcare professionals and NHS managers concerning the intervention; investigate potential explanations for the observed effects, and inform decisions on the future roll-out of the pharmacist-led intervention • Examine secular trends in the outcome measures of interest allowing for informal comparison between trial practices and practices that did not participate in the trial contributing to the QRESEARCH database. Methods Two-arm cluster randomised controlled trial of 72 English general practices with embedded economic analysis and longitudinal descriptive and qualitative analysis. Informal comparison of the trial findings with a national descriptive study investigating secular trends undertaken using data from practices contributing to the QRESEARCH database. The main outcomes of interest were prescribing errors and medication monitoring errors at six- and 12-months following the intervention. Results: Participants in the pharmacist intervention arm practices were significantly less likely to have been prescribed a non-selective NSAID without a proton pump inhibitor (PPI) if they had a history of peptic ulcer (OR 0.58, 95%CI 0.38, 0.89), to have been prescribed a beta-blocker if they had asthma (OR 0.73, 95% CI 0.58, 0.91) or (in those aged 75 years and older) to have been prescribed an ACE inhibitor or diuretic without a measurement of urea and electrolytes in the last 15 months (OR 0.51, 95% CI 0.34, 0.78). The economic analysis suggests that the PINCER pharmacist intervention has 95% probability of being cost effective if the decision-maker’s ceiling willingness to pay reaches £75 (6 months) or £85 (12 months) per error avoided. The intervention addressed an issue that was important to professionals and their teams and was delivered in a way that was acceptable to practices with minimum disruption of normal work processes. Comparison of the trial findings with changes seen in QRESEARCH practices indicated that any reductions achieved in the simple feedback arm were likely, in the main, to have been related to secular trends rather than the intervention. Conclusions Compared with simple feedback, the pharmacist-led intervention resulted in reductions in proportions of patients at risk of prescribing and monitoring errors for the primary outcome measures and the composite secondary outcome measures at six-months and (with the exception of the NSAID/peptic ulcer outcome measure) 12-months post-intervention. The intervention is acceptable to pharmacists and practices, and is likely to be seen as costeffective by decision makers.

Quantifying the value of ecosystem services: a case study of honeybee pollination in the UK

There is concern that insect pollinators, such as honey bees, are currently declining in abundance, and are under serious threat from environmental changes such as habitat loss and climate change; the use of pesticides in intensive agriculture, and emerging diseases. This paper aims to evaluate how much public support there would be in preventing further decline to maintain the current number of bee colonies in the UK. The contingent valuation method (CVM) was used to obtain the willingness to pay (WTP) for a theoretical pollinator protection policy. Respondents were asked whether they would be WTP to support such a policy and how much would they pay? Results show that the mean WTP to support the bee protection policy was £1.37/week/household. Based on there being 24.9 million households in the UK, this is equivalent to £1.77 billion per year. This total value can show the importance of maintaining the overall pollination service to policy makers. We compare this total with estimates obtained using a simple market valuation of pollination for the UK.

Consequences of a coexistence policy on the adoption of GMHT crops in the European Union

This article examines the adoption of genetically modified herbicide tolerant (GMHT) crops in the European Union (EU) prior to its commercial release. A set of potential drivers including the implementation of coexistence measures by farmers, farmers’ own motivational factors (e.g. economic, environmental and technical factors) and perceived social pressure to accept or reject adoption may influence European Union farmers’ willingness to adopt GMHT oilseed rape and GMHT maize. The analysis includes economic and sociological factors. Results show that coexistence measures may hamper GMHT adoption in the EU.

A method for the economic valuation of animal welfare benefits using a single welfare score

Unless the benefits to society of measures to protect and improve the welfare of animals are made transparent by means of their valuation they are likely to go unrecognised and cannot easily be weighed against the costs of such measures as required, for example, by policy-makers. A simple single measure scoring system, based on the Welfare Quality® index, is used, together with a choice experiment economic valuation method, to estimate the value that people place on improvements to the welfare of different farm animal species measured on a continuous (0-100) scale. Results from using the method on a survey sample of some 300 people show that it is able to elicit apparently credible values. The survey found that 96% of respondents thought that we have a moral obligation to safeguard the welfare of animals and that over 72% were concerned about the way farm animals are treated. Estimated mean annual willingness to pay for meat from animals with improved welfare of just one point on the scale was £5.24 for beef cattle, £4.57 for pigs and £5.10 for meat chickens. Further development of the method is required to capture the total economic value of animal welfare benefits. Despite this, the method is considered a practical means for obtaining economic values that can be used in the cost-benefit appraisal of policy measures intended to improve the welfare of animals.

Office sustainability: occupier perceptions and implementation of policy

Purpose – The purpose of this research was twofold. First, to investigate the views of occupiers in a typical UK city on the importance of various sustainability issues, their perceived impact of different sustainability drivers and willingness to pay. Second, the environmental and social performance of existing buildings in that city was examined. Design/methodology/approach – The research focuses on buildings of 10,000 feet2 or more that have been constructed in the Bristol city-region in the UK over the past 50 years. The buildings in the sample are located in the city centre and in out-of-town business parks. A questionnaire survey investigated the views of occupiers and follow-up interviews looked more closely at the sustainability performance of the existing stock. Findings – The findings indicate that, as far as occupiers are concerned, the strongest drivers are consumer demand and staff demand. Green features of a building appear to rank low in the overall building selection preference structure and a willingness to pay a premium for green features was indicated. The interviews uncovered barriers to progress as well as initiatives to reduce both energy consumption and the environmental impact of office space. Practical implications – The paper identifies progress and issues which could form obstacles to improving the environmental performance of office buildings. It is argued that there is a need to focus on energy efficiency. Originality/value – This paper explores the linkage between the perception and use of office space by occupants and how this affects the environmental performance of this space.

Technological change and the challenges for regional development: building social capital in less-favoured regions

The relevance of regional policy for less favoured regions (LFRs) reveals itself when policy-makers must reconcile competitiveness with social cohesion through the adaptation of competition or innovation policies. The vast literature in this area generally builds on an overarching concept of ‘social capital’ as the necessary relational infrastructure for collective action diversification and policy integration, in a context much influenced by a dynamic of industrial change and a necessary balance between the creation and diffusion of ‘knowledge’ through learning. This relational infrastructure or ‘social capital’ is centred on people’s willingness to cooperate and ‘envision’ futures as a result of “social organization, such as networks, norms and trust that facilitate action and cooperation for mutual benefit” (Putnam, 1993: 35). Advocates of this interpretation of ‘social capital’ have adopted the ‘new growth’ thinking behind ‘systems of innovation’ and ‘competence building’, arguing that networks have the potential to make both public administration and markets more effective as well as ‘learning’ trajectories more inclusive of the development of society as a whole. This essay aims to better understand the role of ‘social capital’ in the production and reproduction of uneven regional development patterns, and to critically assess the limits of a ‘systems concept’ and an institution-centred approach to comparative studies of regional innovation. These aims are discussed in light of the following two assertions: i) learning behaviour, from an economic point of view, has its determinants, and ii) the positive economic outcomes of ‘social capital’ cannot be taken as a given. It is suggested that an agent-centred approach to comparative research best addresses the ‘learning’ determinants and the consequences of social networks on regional development patterns. A brief discussion of the current debate on innovation surveys has been provided to illustrate this point.

A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis

Background: Medication errors are common in primary care and are associated with considerable risk of patient harm. We tested whether a pharmacist-led, information technology-based intervention was more effective than simple feedback in reducing the number of patients at risk of measures related to hazardous prescribing and inadequate blood-test monitoring of medicines 6 months after the intervention. Methods: In this pragmatic, cluster randomised trial general practices in the UK were stratified by research site and list size, and randomly assigned by a web-based randomisation service in block sizes of two or four to one of two groups. The practices were allocated to either computer-generated simple feedback for at-risk patients (control) or a pharmacist-led information technology intervention (PINCER), composed of feedback, educational outreach, and dedicated support. The allocation was masked to general practices, patients, pharmacists, researchers, and statisticians. Primary outcomes were the proportions of patients at 6 months after the intervention who had had any of three clinically important errors: non-selective non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to those with a history of peptic ulcer without co-prescription of a proton-pump inhibitor; β blockers prescribed to those with a history of asthma; long-term prescription of angiotensin converting enzyme (ACE) inhibitor or loop diuretics to those 75 years or older without assessment of urea and electrolytes in the preceding 15 months. The cost per error avoided was estimated by incremental cost-eff ectiveness analysis. This study is registered with Controlled-Trials.com, number ISRCTN21785299. Findings: 72 general practices with a combined list size of 480 942 patients were randomised. At 6 months’ follow-up, patients in the PINCER group were significantly less likely to have been prescribed a non-selective NSAID if they had a history of peptic ulcer without gastroprotection (OR 0∙58, 95% CI 0∙38–0∙89); a β blocker if they had asthma (0∙73, 0∙58–0∙91); or an ACE inhibitor or loop diuretic without appropriate monitoring (0∙51, 0∙34–0∙78). PINCER has a 95% probability of being cost eff ective if the decision-maker’s ceiling willingness to pay reaches £75 per error avoided at 6 months. Interpretation: The PINCER intervention is an effective method for reducing a range of medication errors in general practices with computerised clinical records. Funding: Patient Safety Research Portfolio, Department of Health, England.

Everything and nothing project

An EPRSC ‘Partnerships for Public Engagement’ scheme 2010. FEC 122,545.56/UoR 10K everything and nothing is a performance and workshop which engages the public creatively with mathematical concepts: the Poincare conjecture, the shape of the universe, topology, and the nature of infinity are explored through an original, thought provoking piece of music theatre. Jorge Luis Borges' short story 'The Library of Babel' and the aviator Amelia Earhart’s attempt to circumnavigate the globe combine to communicate to audience key mathematical concepts of Poincare’s conjecture. The project builds on a 2008 EPSRC early development project (EP/G001650/1) and is led by an interdisciplinary team the19thstep consisting of composer Dorothy Ker, sculptor Kate Allen and mathematician Marcus du Sautoy. everything and nothing has been devised by Dorothy Ker and Kate Allen, is performed by percussionist Chris Brannick, mezzo soprano Lucy Stevens and sound designer Kelcey Swain. The UK tour targets arts-going audiences, from the Green Man Festival to the British Science Festival. Each performance is accompanied with a workshop led by Topologist Katie Steckles. Alongside the performances and workshops is a website, http://www.everythingandnothingproject.com/ The Public engagement evaluation and monitoring for the project are carried out by evaluator Bea Jefferson. The project is significant in its timely relation to contemporary mathematics and arts-science themes delivering an extensive programme of public engagement.

The emergence and use of diagramming in system dynamics: a critical account

The paper reviews the leading diagramming methods employed in system dynamics to communicate the contents of models. The main ideas and historical development of the field are first outlined. Two diagramming methods—causal loop diagrams (CLDs) and stock/flow diagrams (SFDs)—are then described and their advantages and limitations discussed. A set of broad research directions is then outlined. These concern: the abilities of different diagrams to communicate different ideas, the role that diagrams have in group model building, and the question of whether diagrams can be an adequate substitute for simulation modelling. The paper closes by suggesting that although diagrams alone are insufficient, they have many benefits. However, since these benefits have emerged only as ‘craft wisdom’, a more rigorous programme of research into the diagrams' respective attributes is called for.

Creative participation in construction firms: bridging creativity and innovation

An intricate evolution of mainstream theories follows the growing need to explain employees’ commitment and engagement. Our understanding of these work-related phenomena and behaviour has improved but creativity and innovation as desired indicators are still often treated as coexisting constructs with very little attention given to a state of willingness of an individual to even consider contributing ideas. In this research we investigate the influence of knowledge and understanding, perceived radicality, personality dimensions, and favouring of ideas on employee willingness to creatively participate in order to trace its existence in propagation of ideas. A total of 76 construction and non-construction professionals participated in between-subject quasi-experiments. We also proposed IPO-based radicality of ideas construct from the viewpoint of employees involved in the processes of transformation. The research findings show that experts with deep understanding of the work are more likely to contribute highly radical ideas to decision-makers than less knowledgeable employees. Furthermore, personal factors that impact employee willingness to creatively participate have been valued higher than organisational factors. Personality dimensions by The BigFive Inventory have shown no effect on willingness to contribute ideas, while favouring of ideas showed a significant effect. In general, the findings show similarities with some studies of consumer willingness to participate in co-creation processes and thus indicate that firms may be studied as dynamic internal markets of ideas.

The MaPS project: mapping teacher conceptions of musical development

The chapter starts from the premise that an historically- and institutionally-formed orientation to music education at primary level in European countries privileges a nineteenth century Western European music aesthetic, with its focus on formal characteristics such as melody and rhythm. While there is a move towards a multi-faceted understanding of musical ability, a discrete intelligence and willingness to accept musical styles or 'open-earedness', there remains a paucity of documented evidence of this in research at primary school level. To date there has been no study undertaken which has the potential to provide policy makers and practitioners with insights into the degree of homogeneity or universality in conceptions of musical ability within this educational sector. Against this background, a study was set up to explore the following research questions: 1. What conceptions of musical ability do primary teachers hold a) of themselves and; b) of their pupils? 2. To what extent are these conceptions informed by Western classical practices? A mixed methods approach was used which included survey questionnaire and semi-structured interview. Questionnaires have been sent to all classroom teachers in a random sample of primary schools in the South East of England. This was followed up with a series of semi-structured interviews with a sub-sample of respondents. The main ideas are concerned with the attitudes, beliefs and working theories held by teachers in contemporary primary school settings. By mapping the extent to which a knowledge base for teaching can be resistant to change in schools, we can problematise primary schools as sites for diversity and migration of cultural ideas. Alongside this, we can use the findings from the study undertaken in an English context as a starting point for further investigation into conceptions of music, musical ability and assessment held by practitioners in a variety of primary school contexts elsewhere in Europe; our emphasis here will be on the development of shared understanding in terms of policies and practices in music education. Within this broader framework, our study can have a significant impact internationally, with potential to inform future policy making, curriculum planning and practice.