A Reference Interpreter for the Graph Programming Language GP 2

GP 2 is an experimental programming language for computing by graph transformation. An initial interpreter for GP 2, written in the functional language Haskell, provides a concise and simply structured reference implementation. Despite its simplicity, the performance of the interpreter is sufficient for the comparative investigation of a range of test programs. It also provides a platform for the development of more sophisticated implementations.Comment: In Proceedings GaM 2015, arXiv:1504.0244

The adoption space of early-emerging technologies: evaluation, innovation, gatekeeping (PATH). Final report. NIHR Service Delivery and Organisation programme

Aims: the research aims to provide an empirical, robust foundation for the broader task of identifying the factors involved in appropriate technology adoptive practice. It focuses on understanding and explaining adoptive behaviour in key early-emerging technologies. It provides a major set of documented case studies as resources for the NHS/Service Delivery & Organisation R&D community, and informs the development of a context-sensitive conceptual model for understanding and potentially planning adoption-evaluation pathways. It identifies alignments of factors in the early adoptive process that enable or control adoption in a variety of settings. This involves innovatory forces outside the NHS such as commercial device producers and the private healthcare sector. Methodology: in a 30-month multi-method project, we undertake a set of four detailed in-depth multi-method qualitative case studies (in wound care, chronic back pain, anticoagulation monitoring, and prostate cancer surgery), augmented by a further four less detailed case studies to extend generalisability. We will develop a typology of technologies, and in consultation with research-users and stakeholders, we will develop a new conceptual model of what we term the adoption space', validating it against the case study data. The model will identify the key parameters, and the salient drivers within them, through which early-emerging technologies take distinct pathways into healthcare. The initial conceptualisation of the model is based on actor-network theory/Science and Technology Studies and methodological health services research, and our own recent case studies of device innovation/governance. The model's core working parameters are: Technology, Network, Promotion, Gatekeeping, and Evidence. The research is distinct in giving artefactual technology itself due recognition as a factor shaping adoption pathways. Data collection: a baseline state of evidence and adoption' will be compiled for each case. It will document retrospectively key events that have shaped the early pathway, then developments will be tracked prospectively in real-time through the project's duration. A variety of ethnographic data-collection methods are used including observation, documents and semi-structured interviewing with key informants. There are two levels of data-collection: the technology-specific network', including extra-NHS actors, and the intra-NHS level, where fieldwork is undertaken in two separate organisational sites for each of the four technologies. For the additional four rapid appraisal' cases, key informant and documentary methods are used. Analysis: The key principle of the analysis is to provide for cycles of iteration between case study analysis and development of the adoption space model. The two levels of data-collection (wider network and adoptive NHS site) are an organising principle of the analysis. Mid-way through the project we will present interim analysis and model development to select research users, to debate the evolving model. Both descriptive and explanatory analytic techniques will be applied. We deploy standard qualitative case study data analysis techniques, and discourse analysis. The study design enables within-case and cross-case comparative analyses, including between organisational settings for the same technology; and inter-technology comparisons. Cross-case syntheses and comparisons will develop the conceptual model of the adoption space and strengthen its explanatory power for understanding the determinants of early adoption-evaluation pathways

Technology identities explain under- and non-adoption of community-based point-of-care tests in the UK NHS

Objectives This study applies the concept of ‘technology identities’ to explain non-adoption and alleged under-adoption of a number of technologies in the NHS. Methods As part of a qualitative comparative case study of (non)adoption of eight device technologies using in-depth stakeholder interviews and documentary analysis, we compared two point-of-care test (POCT) technologies: C-reactive protein (CRP) to rule out bacterial infection in acute cough in primary care, and near-patient (NPT) or self-testing of blood coagulation (INR) for patients taking warfarin. We draw on an explanatory model we have developed, the ‘adoption space’, encompassing multiple influences (political, social, technical, evidential and structural) and actors, within and outside the NHS and the construct of ‘technology identity’. Results Both technologies were supported by formal evidence but were either not used at all (CRP) or not as widely as might be expected (coagulometer). CRP testing was not attractive due to a weak utility identity coupled with high financial and pragmatic requirements. NPT for anticoagulation had been adopted primarily because its requirement for widespread organisational change enabled the redesign of dysfunctional services. Self-testing for INR had not been encouraged by healthcare professionals or commissioners due to its perceived high clinical risk and doubt about patients׳ capability, but this was changing somewhat as its clinical effectiveness identity became more prominent. Conclusions Technology identities (attributes that healthcare technologies acquire in the course of often contested deliberations about adoption) shape the pathway that (non)adoption takes; the concept can be used to explain and manage adoption and non-adoption

Patients' views of physical activity as treatment for depression: a qualitative study

BACKGROUND: Clinical guidance recommends physical activity to manage patients with persistent subthreshold depressive symptoms or mild-to-moderate depression. However, little is known regarding the acceptability of physical activity as a treatment for depression from patients' perspective. AIM: To explore patients' views of physical activity for the treatment of depression in the context of primary care. DESIGN OF STUDY: In-depth interviews were held with 33 participants taking part in a randomised controlled trial assessing the effectiveness of physical activity for the management of depression. SETTING: Primary care. RESULTS: Most participants perceived physical activity to be an acceptable treatment for depression. The mechanisms by which physical activity could enhance mood were attributed to a number of subjective benefits including biochemical pathways, providing a source of distraction from negative thoughts, and a sense of purpose. Participants who expressed a belief that their depression was caused by biochemical mechanisms reported activity that 'raised the heartbeat' as most beneficial, while those who believed depression was situational in origin tended to state the benefits of less-aerobic activities, such as walking. Many participants reported low motivation and a lack of confidence as barriers to undertaking physical activity. These patients suggested that medication could be helpful for initiating and maintaining activity. CONCLUSION: Patients view physical activity as an effective treatment for depression. However, they vary in their views about how physical activity might impact on depression, what intensity and form of activity is necessary to enhance mood, and the barriers to undertaking activity. This variation suggests the need for GPs to elicit patients' views on physical activity as a treatment, and offer interventions that are tailored to the needs and expectations of individual patients