TALplanner in IPC-2002: Extensions and Control Rules

TALplanner is a forward-chaining planner that relies on domain knowledge in the shape of temporal logic formulas in order to prune irrelevant parts of the search space. TALplanner recently participated in the third International Planning Competition, which had a clear emphasis on increasing the complexity of the problem domains being used as benchmark tests and the expressivity required to represent these domains in a planning system. Like many other planners, TALplanner had support for some but not all aspects of this increase in expressivity, and a number of changes to the planner were required. After a short introduction to TALplanner, this article describes some of the changes that were made before and during the competition. We also describe the process of introducing suitable domain knowledge for several of the competition domains

Älgexplosionen på 70- och 80-talet, ett hot mot sågverket?

The background of this study is an article in the hunting magazine “Svensk Jakt” where Karl Hedin claims that his sawmills has not noticed any significant moose damages in the timber. The purpose with the study is to find out the causes to the moose explosion and what it has led to in today’s forests. A questionnaire has been sent out to sawmills in the region Dalarna with the purpose of finding out if sawmills receive moose-damaged timber and what they think about how they foresee future development. There were two causes of the moose explosion, that had effects on the moose population. The first cause was that the moose hunters wanted to raise the moose population, and by raising the calf shooting and by saving the cows they succeeded. The second cause was changing methods in Swedish forestry. Extensive clear-cuttings led to much more food for the moose and the population grew. The moose ravages in the forests have a large negative effect on the forest. The growth in the stands decline and the number of stems per hectar drop significantly. The moose grazing on pines leads to different types of damages, trunk break, treetop grazing and bark eating. These damages on the pine leads to technical damages which leads to that the price on the log drops. The questionnaire shows that four of five sawmills has not noticed the moose explosion. The fifth sawmill writes that they don’t know. Three out of seven sawmills doesn’t see the moose as a threat. On the question of what they think about the future seven people answered. Four people believed that we can handle the problem in a good way and that business will continue in the same way as it has been. There were other interesting things that appeared in answers to the questionnaire, several sawmills will handle the problem with moose-damaged timber by installing an x-ray equipment. The majority of the people that answered believes that we can prevent a new moose explosion by a proper management of the moose population

Why patients do not take medication as prescribed: The complexity of medication adherence as a phenomenon

Poor medication adherence is a significant barrier to achieving the expected outcomes of a treatment. The prevalence of chronic diseases is increasing globally, and within ageing populations, both morbidity and use of medicines increase. Only about 50% of patients are estimated to treat their chronic diseases according to instructions in developed countries. Patients with multiple conditions and multiple medications are particularly challenging to healthcare professionals. A common feature of poor adherence is a tendency to stop taking the medication within a few months after the provider has prescribed it. In addition, the patients may not take the medicine as regularly as prescribed and skip doses or take lower or higher doses than prescribed. This study aimed to enhance understanding of the complexity of medication adherence as a phenomenon by studying why patients do not take their medication as prescribed. The goal was to collect information on the factors influencing medication adherence by summarizing research evidence obtained using qualitative methods (Study I) and investigating primary care physicians’ and patients’ perspectives (Studies II and III). Study I was a scoping review of qualitative studies (n=89). The literature search for eligible qualitative studies was conducted on September 23, 2019, and updated on June 9, 2021, using MEDLINE (Ovid), Scopus, and the Cochrane Library. The focus was on patients' experiences and attitudes towards medication adherence. The use of qualitative methods both for data collection and data analysis was mandatory. We used the PRISMA-ScR checklist to ensure the quality of the scoping review. Study II applied the focus group discussions (n=4) for primary care physicians (GPs, n=16). The study was conducted in the Kirkkonummi Health Centre, Southern Finland. The qualitative design was chosen to understand GPs' perceptions of medication adherence and the problems GPs thought patients might have experienced following instructions for their medicine taking. An interview guide of semi-structured questions was used to allow the GPs to discuss the topic from a personal point of view. Study III presents a study protocol of a new patient-oriented method to investigate reasons for non-adherence using pharmacist-conducted medication reconciliation in the primary care clinics as a data collection point. The study is based on pharmacist-patient communication during medication reconciliation. It will be carried out in the public primary care clinics in Vantaa, located in the capital region of Finland. By interviewing, the pharmacist will learn how the patient has been taking the prescribed medicines and whether any non-prescription medicines and food supplements have been used for self-medication. Patients aged 55 years or older will be included, as they most commonly have multiple medications and illnesses. Medication reconciliation will occur upon admission to the public outpatient clinic, usually before a physician's appointment. The search (Study I) revealed 4404 studies, of which 89 qualitative studies were included in the scoping review. The studies more often dealt with barriers than facilitators. The factors were classified as patient-specific, illness-specific, medication-related, healthcare and system-related, sociocultural, logistical, and financial. Information and knowledge of diseases and their treatment, communication, trust in patient-provider relationships, support, and adequate resources appeared to be the critical facilitators in medication adherence from the patient perspective. Patients were willing to discuss their concerns about medications. Better communication and better information on medicines appeared to be critical factors for patients. The two main themes that emerged in the focus group discussions with the GPs (Study II) were non-adherence in chronic disease care and increased need for information about medicines. The GPs (n=16) were increasingly confronted with non-adherence in the care of chronic diseases. The medication management challenges identified were related to patient-specific factors, the healthcare system, characteristics of drug therapies and the function and role of healthcare professionals as a team. The GPs offered several solutions such as improved coordination of care, better patient education and IT systems, and enhanced interprofessional involvement in the follow-up of patients. To support medication adherence and self-management, the GPs appreciated pharmacists' assistance, especially with patients with polypharmacy and chronic diseases. Study III will provide quantitative data for descriptive analysis to identify: 1) the number of discrepancies between the physician's prescription orders and the patient's self-reported use of the medicines, 2) what kind of discrepancies there are, 3) which are high-risk medicines in terms of non-adherence, and 4) why medicines were taken differently than prescribed. Based on the results, 5) a preliminary conceptual model of patient-reported reasons for non-adherence will be constructed. There is a wide range of barriers and facilitators to medication adherence, but barriers seem to be better known than facilitators. Better communication and information appear to be the most crucial factors in enhancing medication adherence. Patients wish to discuss their worries about medications. Medication reconciliation could be used more effectively to monitor medication adherence and prevent the inappropriate use of medicines in routine clinical practice. Based on the findings of this doctoral thesis, it is possible to continue developing a theoretical model related to adherence. The model could consider previous theories related to medication adherence, patient perspective and the research evidence constructed by qualitative methods. Developing new interventions should be based on an enhanced understanding of the patient's perspectives on medication adherence.Huono lääkehoitoihin sitoutuminen on maailmanlaajuinen ongelma. Väestön ikääntyessä sairastavuus ja lääkkeiden käyttö lisääntyvät. On arvioitu, että vain noin 50 % potilaista hoitaa pitkäaikaista sairauttaan ohjeiden mukaisesti. Erityisen haastavassa asemassa ovat potilaat, joilla on useita sairauksia ja useita lääkehoitoja. Tämän tutkimuksen tavoitteena oli lisätä ymmärrystä lääkehoitoihin sitoutumisesta ilmiönä järjestelmällisen kartoittavan katsauksen avulla (osatyö I) sekä tutkimalla lääkkeiden ohjeidenmukaista käyttöä perusterveydenhuollon lääkäreiden ja potilaiden näkökulmasta (osatyöt II ja III). Osatyössä I kartoitettiin potilaiden lääkehoitoon sitoutumiseen vaikuttavia tekijöitä laadullisten tutkimusten perusteella (n=89). Tutkimuksista tunnistettiin potilaisiin, sairauteen, lääkkeisiin, terveydenhuoltoon ja järjestelmään liittyviä tekijöitä sekä sosiokulttuurisia ja logistisia ja taloudellisia tekijöitä. Tutkimuksista tunnistettiin enemmän hoitoon sitoutumista estäviä kuin edistäviä tekijöitä. Osa tutkimuksista (n=17) oli käyttäytymisteorioihin perustuvia. Sairauteen ja sen hoitoon liittyvät tiedot ja taidot, kommunikaatio, potilaan ja terveydenhuollon ammattilaisen välinen luottamus, tuki ja riittävät resurssit näyttäisivät olevan potilaan näkökulmasta avaintekijöitä. Tärkeiksi tekijöiksi tiivistyivät potilaan ja ammattilaisen välinen kommunikaatio sekä lääkeneuvonta. Huono lääkehoitoihin sitoutuminen ja lääkeneuvonnan tarve nousivat pääteemoiksi terveyskeskuslääkäreiden ryhmäkeskusteluissa (n=4) (osatyö II). Lääkärit (n=16) havaitsivat hoitoon sitoutumiseen liittyviä haasteita hoitaessaan pitkäaikaissairauksia. Haasteet liittyivät potilaaseen, terveydenhuoltojärjestelmään, lääkehoitoihin, terveydenhuollon ammattilaisten yhteistyöhön ja rooliin. Lääkärit ehdottivat ratkaisuiksi parempaa hoidon koordinointia, potilaiden kouluttamista, parempia tietojärjestelmiä sekä moniammatillisuutta potilaiden lääkehoitojen seurannassa. Lääkärit toivoivat farmasian ammattilaisten osallistumista erityisesti monilääkittyjen ja monisairaiden potilaiden lääkehoitoon sitoutumisen ja omahoidon tukemiseen. Osatyö III on tutkimussuunnitelma lääkärin määräämien ja potilaan todellisuudessa käyttämien lääkkeiden välisten erojen tutkimiseksi. Kotilääkitysten selvittämisen yhteydessä käydyn keskustelun perusteella halutaan tutkia, minkälaisia eroavaisuudet ovat, mitkä ovat hoitoon sitoutumisen kannalta suuren riskin lääkkeitä ja miksi potilaat käyttävät lääkkeitä toisin kuin lääkäri on määrännyt. Tutkimuksen tarkoituksena on luoda toimintamalli, jonka avulla voidaan edistää parempaa lääkehoitoon sitoutumista kroonisten sairauksien hoidossa. Lääkehoitoon sitoutuminen on monimutkainen ilmiö, johon liittyy monia estäviä ja edistäviä tekijöitä. Tämä väitöskirjatutkimus auttaa ymmärtämään hoitoon sitoutumisen monimutkaisuutta laadullista ja potilaslähtöistä tutkimusnäkökulmaa hyödyntäen. Potilaat haluavat keskustella lääkkeisiin liittyvistä huolistaan. Tilanteen korjaamiseksi tarvitsemme parempaa potilaan ja terveydenhuollon ammattilaisten välistä kommunikaatiota ja informaatiota. Tämän väitöskirjatutkimuksen tulosten perusteella on mahdollista jatkaa hoitoon sitoutumiseen liittyvän teoreettisen mallin kehittämistä. Mallissa voitaisiin ottaa huomioon aikaisemmat lääkehoitoon sitoutumiseen liittyvät teoriat, potilasnäkökulma ja laadullisin menetelmin koottu tutkimusnäyttö. Potilaan näkemysten ja tilanteen huomioiminen on avainasemassa, kun lääkehoitoon sitoutumiseen tähtääviä toimintamalleja kehitetään

Bridging sanitation engineering and planning: theory and practice in Burkina Faso

The global challenge of providing sanitation services to the un-served underlines a need to change the way in which sanitation planning and service provision is approached. This paper offers a framework for categorizing sanitation projects planning processes based on planning steps and procedural planning theory to help engineers and sanitation planners gain a deeper understanding of the dynamics of these processes. The analysis identifies and discusses trends in both guidelines and actual sanitation programs. The results show that contemporary sanitation planning guidelines and field projects utilize patchwork processes of different planning modes, although the step of designing options is dominated by an expert-driven, rational-comprehensive approach. The use of planning theory can help engineers to ask critical questions about the objectives of the planning process and to develop context-appropriate planning processes that will make a difference for improving sanitation service provision

The moose explosion in the 1970:s and the 1980:s, a threat against sawmills?

The background of this study is an article in the hunting magazine “Svensk Jakt” where Karl Hedin claims that his sawmills has not noticed any significant moose damages in the timber. The purpose with the study is to find out the causes to the moose explosion and what it has led to in today’s forests. A questionnaire has been sent out to sawmills in the region Dalarna with the purpose of finding out if sawmills receive moose-damaged timber and what they think about how they foresee future development. There were two causes of the moose explosion, that had effects on the moose population. The first cause was that the moose hunters wanted to raise the moose population, and by raising the calf shooting and by saving the cows they succeeded. The second cause was changing methods in Swedish forestry. Extensive clear-cuttings led to much more food for the moose and the population grew. The moose ravages in the forests have a large negative effect on the forest. The growth in the stands decline and the number of stems per hectar drop significantly. The moose grazing on pines leads to different types of damages, trunk break, treetop grazing and bark eating. These damages on the pine leads to technical damages which leads to that the price on the log drops. The questionnaire shows that four of five sawmills has not noticed the moose explosion. The fifth sawmill writes that they don’t know. Three out of seven sawmills doesn’t see the moose as a threat. On the question of what they think about the future seven people answered. Four people believed that we can handle the problem in a good way and that business will continue in the same way as it has been. There were other interesting things that appeared in answers to the questionnaire, several sawmills will handle the problem with moose-damaged timber by installing an x-ray equipment. The majority of the people that answered believes that we can prevent a new moose explosion by a proper management of the moose population