What do patients want to know about their medicines, and what do doctors want to tell them?: a comparative study

A two phase study is reported. In the first phase, we asked a number of doctors to rate a list of information categories (identified by Berry, Gillie and Banbury 1995) in terms of how important they felt it was for the items to be included in an explanation to a patient about a drug prescription. In the second phase, we presented a large sample of people with a scenario about visiting their doctor and being prescribed medication, together with an explanation about the prescription which was said to be provided by the doctor. Four different explanations were compared, which were either based on what people in our earlier study wanted to know about drug prescriptions or on what the doctors thought it was important lo tell them. We also manipulated whether or not the explanations conveyed negative information (e.g. about the possible side effects of the medication). The results showed that people 'preferred' the explanations based on what the participants in the earlier study wanted to know about their medicines, rather than those based on what the doctors thought they should be told. They also 'preferred' the explanations that did not convey negative information, rather than those that did convey some negative information. In addition, the inclusion of negative information affected ratings of likely compliance with the prescribed medication.

What do patients want to know? An empirical approach to explanation generation and validation

This article describes an empirical, user-centred approach to explanation design. It reports three studies that investigate what patients want to know when they have been prescribed medication. The question is asked in the context of the development of a drug prescription system called OPADE. The system is aimed primarily at improving the prescribing behaviour of physicians, but will also produce written explanations for indirect users such as patients. In the first study, a large number of people were presented with a scenario about a visit to the doctor, and were asked to list the questions that they would like to ask the doctor about the prescription. On the basis of the results of the study, a categorization of question types was developed in terms of how frequently particular questions were asked. In the second and third studies a number of different explanations were generated in accordance with this categorization, and a new sample of people were presented with another scenario and were asked to rate the explanations on a number of dimensions. The results showed significant differences between the different explanations. People preferred explanations that included items corresponding to frequently asked questions in study 1. For an explanation to be considered useful, it had to include information about side effects, what the medication does, and any lifestyle changes involved. The implications of the results of the three studies are discussed in terms of the development of OPADE's explanation facility.

Dichotomous-choice contingent valuation with 'don't know' responses and misreporting

A new approach is presented that simultaneously deals with Misreporting and Don't Know (DK) responses within a dichotomous-choice contingent valuation framework. Utilising a modification of the standard Bayesian Probit framework, a Gibbs with Metropolis-Hastings algorithm is used to estimate the posterior densities for the parameters of interest. Several model specifications are applied to two contingent valuation datasets: one on wolf management plans, and one on the US Fee Demonstration Program. We find that DKs are more likely to be from people who would be predicted to have positive utility for the bid. Therefore, a DK is more likely to be a YES than a NO. We also find evidence of misreporting, primarily in favour of the NO option. The inclusion of DK responses has an unpredictable impact on willingness-to-pay estimates, since it impacts differently on the results for the two datasets we examine. Copyright (C) 2009 John Wiley & Sons, Ltd.

"I don't know what you are trying to establish": The socio-environmental 'problems' of visual impaired children

This paper uses the social model of disability to examine visually impaired children's experiences of their housing and neighbourhoods and finds that they did not experience any significant problems with the design of them. The source of their problems was within these environments, and was caused by factors such as the intensity of movement, for example, from flows of traffic. We conclude by discussing the social policy implications of these findings.

Judgments of path, not heading, guide locomotion

To steer a course through the world, people are almost entirely dependent on visual information, of which a key component is optic flow. In many models of locomotion, heading is described as the fundamental control variable; however, it has also been shown that fixating points along or near one's future path could be the basis of an efficient control solution. Here, the authors aim to establish how well observers can pinpoint instantaneous heading and path, by measuring their accuracy when looking at these features while traveling along straight and curved paths. The results showed that observers could identify both heading and path accurately (similar to 3 degrees) when traveling along straight paths, but on curved paths they were more accurate at identifying a point on their future path (similar to 5 degrees) than indicating their instantaneous heading (similar to 13 degrees). Furthermore, whereas participants could track changes in the tightness of their path, they were unable to accurately track the rate of change of heading. In light of these results, the authors suggest it is unlikely that heading is primarily used by the visual system to support active steering.

Using what we know: consequences of intentionally retrieving gist versus item-specific information

The effect of a prior gist-based versus item-specific retrieval orientation on recognition of objects and words was examined. Prior item-specific retrieval increased item-specific recognition of episodically related but not previously tested objects relative to both conceptual- and perceptual-gist retrieval. An item-specific retrieval advantage also was found when the stimuli were words (synonyms) rather than objects but not when participants overtly named objects during gist-based recognition testing, which suggests that they did not always label objects under general gist-retrieval instructions. Unlike verbal overshadowing, labeling objects during recognition attenuated (but did not eliminate) test- and interference-related forgetting. A full understanding of how retrieval affects subsequent memory, even for events or facts that are not themselves retrieved, must take into account the specificity with which that retrieval occurs.

Older adults encode-but do not always use-perceptual details: intentional versus unintentional effects of detail on memory judgments

Investigations of memory deficits in older individuals have concentrated on their increased likelihood of forgetting events or details of events that were actually encountered (errors of omission). However mounting evidence demonstrates that normal cognitive aging also is associated with an increased propensity for errors of commission-shown in false alarms or false recognition. The present study examined the origins of this age difference. Older and younger adults each performed three types of memory tasks in which details of encountered items might influence performance. Although older adults showed greater false recognition of related lures on a standard (identical) old/new episodic recognition task, older and younger adults showed parallel effects of detail on repetition priming and meaning-based episodic recognition (decreased priming and decreased meaning-based recognition for different relative to same exemplars). The results suggest that the older adults encoded details but used them less effectively than the younger adults in the recognition context requiring their deliberate, controlled use.

Judgments, forecasts and decisions: an analysis of fund managers over time

Decision theory is the study of models of judgement involved in, and leading to, deliberate and (usually) rational choice. In real estate investment there are normative models for the allocation of assets. These asset allocation models suggest an optimum allocation between the respective asset classes based on the investors’ judgements of performance and risk. Real estate is selected, as other assets, on the basis of some criteria, e.g. commonly its marginal contribution to the production of a mean variance efficient multi asset portfolio, subject to the investor’s objectives and capital rationing constraints. However, decisions are made relative to current expectations and current business constraints. Whilst a decision maker may believe in the required optimum exposure levels as dictated by an asset allocation model, the final decision may/will be influenced by factors outside the parameters of the mathematical model. This paper discusses investors' perceptions and attitudes toward real estate and highlights the important difference between theoretical exposure levels and pragmatic business considerations. It develops a model to identify “soft” parameters in decision making which will influence the optimal allocation for that asset class. This “soft” information may relate to behavioural issues such as the tendency to mirror competitors; a desire to meet weight of money objectives; a desire to retain the status quo and many other non-financial considerations. The paper aims to establish the place of property in multi asset portfolios in the UK and examine the asset allocation process in practice, with a view to understanding the decision making process and to look at investors’ perceptions based on an historic analysis of market expectation; a comparison with historic data and an analysis of actual performance.