Though the individual item sequence in our study did not exactly follow the original US scale, in general the progressing difficulty of the items is reflected in the mean scores.
The design of the instrument reflects the four stages of activation in a progressing difficulty of the items: level 1 (patients believe that their role is important; items 1 and 2), level 2 (patients have confidence and knowledge to take action; items 3-8), level 3 (taking action; items 9-11) and level 4 (staying on course under stress; items 12 and 13) [ 2].
The instrument design reflects the four stages of activation in a progressing difficulty of the items: level 1 (patients believe that their role is important: item 1 and 2), level 2 (patients have confidence and knowledge to take action: items 3 8), level 3 (taking action: items 9 11) and level 4 (staying on course under stress: items 12 and 13).
The architects and the writer talk with the two contractors, Mike Miller and Paul Nelson, about construction progress, difficulties, and stories about the work.
Students were interviewed at different stages of their studies in order to understanding their progress, difficulties and achievements.
Similarly, the project managers held planning meetings with the NGO managers and staff on a regular basis, during which field progress, difficulties and adaptive strategies were also discussed.
Participants were informed that a new, sometimes deadly, disease had developed in India that caused symptoms including bloody diarrhea, severe headaches, muscle and joint pain, and as the disease progresses, difficulty in breathing, and that the disease was spreading from person to person but had not yet spread outside of India.
Putin said the peace process was progressing despite difficulties.
The programme included some progressions whereby the intensity and difficulty of the programme varied, beginning with less strenuous tasks and progressing in difficulty.
Despite substantial progress, fundamental difficulties in catchment scale applications have been widely reported.
But participants in the drafting of the report have described its progress and difficulties over a period of seven months to The New York Times, which obtained the most recent version of the report.
