Is 15 per cent very common? Informing people about the risks of medication side effects

Objectives - To assess the general public's interpretation of the verbal descriptors for side effect frequency recommended for use in medicine information leaflets by a European Union (EU) guideline, and to examine the extent to which differences in interpretation affect people's perception of risk and their judgments of intention to comply with the prescribed treatment. Method - Two studies used a controlled empirical methodology in which people were presented with a hypothetical, but realistic, scenario about visiting their general practitioner and being prescribed medication. They were given an explanation that focused on the side effects of the medicine, together with information about the probability of occurrence using either numerical percentages or the corresponding EU verbal descriptors. Interpretation of the descriptors was assessed. In study 2, participants were also required to make various judgments, including risk to health and intention to comply. Key findings - In both studies, use of the EU recommended descriptors led to significant overestimations of the likelihood of particular side effects occurring. Study 2 further showed that the "overestimation" resulted in significantly increased ratings of perceived severity of side effects and risk to health, as well as significantly reduced ratings of intention to comply, compared with those for people who received the probability information in numerical form. Conclusion - While it is recognised that the current findings require replication in a clinical setting, the European and national authorities should suspend the use of the EU recommended terms until further research is available to allow the use of an evidence-based approach.

Farmers' willingness to pay for agricultural extension service: evidence from Nigeria

The study was undertaken to investigate how willing would farmers be to pay for agricultural extension service in Nigeria. A multistage random sampling technique was used to select 268 respondents. Results showed that most farmers (95.1 per cent) were willing to pay for improved extension service as long as the service remained relevant to their needs. Farmers were willing to pay N1000 annually as their own share of the service cost. The most important factors that influenced farmers’ willingness to pay were states of origin, items originally paid for, major occupation, minor occupation, number of years in school and sale of farm produce.

A survey for planetary transits in the field of NGC 7789

We present results from 30 nights of observations of the open cluster NGC 7789 with the Wide Field Camera on the Isaac Newton Telescope, La Palma. From ~900 epochs, we obtained light curves and Sloan r'-i' colours for ~33000 stars, with ~2400 stars having better than 1 per cent precision. We expected to detect ~2 transiting hot Jupiter planets if 1 per cent of stars host such a companion and a typical hot Jupiter radius is ~1.2R_J. We find 24 transit candidates, 14 of which we can assign a period. We rule out the transiting planet model for 21 of these candidates using various robust arguments. For two candidates, we are unable to decide on their nature, although it seems most likely that they are eclipsing binaries as well. We have one candidate exhibiting a single eclipse, for which we derive a radius of 1.81+0.09-0.00R_J. Three candidates remain that require follow-up observations in order to determine their nature.

The importance of the diurnal and annual cycle of air traffic for contrail radiative forcing

Air traffic condensation trails, or contrails, are believed to have a net atmospheric warming effect(1), although one that is currently small compared to that induced by other sources of human emissions. However, the comparably large growth rate of air traffic requires an improved understanding of the resulting impact of aircraft radiative forcing on climate(2). Contrails have an effect on the Earth's energy balance similar to that of high thin ice clouds(3). Their trapping of outgoing longwave radiation emitted by the Earth and atmosphere (positive radiative forcing) is partly compensated by their reflection of incoming solar radiation (negative radiative forcing). On average, the longwave effect dominates and the net contrail radiative forcing is believed to be positive(1,2,4). Over daily and annual timescales, varying levels of air traffic, meteorological conditions, and solar insolation influence the net forcing effect of contrails. Here we determine the factors most important for contrail climate forcing using a sophisticated radiative transfer model(5,6) for a site in southeast England, located in the entrance to the North Atlantic flight corridor. We find that night-time flights during winter (December to February) are responsible for most of the contrail radiative forcing. Night flights account for only 25 per cent of daily air traffic, but contribute 60 to 80 per cent of the contrail forcing. Further, winter flights account for only 22 per cent of annual air traffic, but contribute half of the annual mean forcing. These results suggest that flight rescheduling could help to minimize the climate impact of aviation.

The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist’s time and activities

Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self'. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.

Does gym use impact upon nutritional knowledge?

Purpose – The purpose of this paper is to investigate gym and non-gym users' use and understanding of nutrition labels. Design/methodology/approach – A consumer survey in the form of a questionnaire conducted in the Greater London area in February/March 2005. Subject recruitment process took place in both a gym and university setting. Frequency tables and ?2-test are used to assess relationships between variables (p=0.05). Findings – The resulting sample consisted of 187 subjects, with predominance of females and gym users. Of the subjects, 88 per cent reported to at least occasionally read nutrition labels, with higher reading rates amongst women, irrespective of gym user status. Total and saturated fats are the most often information viewed on labels, however the overall knowledge of the calorie content of fat is low, with 53 per cent of subjects responding saturated fat contains more calories per gram when compared with other types of fats. This paper does not find significant differences in the use and understanding of nutrition labels between gym and non-gym users, but highlights the publics' continued lack of understanding of nutrition labels. Originality/value – This paper is unique as it investigates whether there is any difference between gym/non-gym users' use and interpretation of use of nutrition labels. It finds gender impacted more on nutritional labels knowledge than gym user's status. This points to a gender issue and questions the quality of information available to the general public. This paper is valuable as it highlights and identifies an area that requires further research and assessment, and is therefore useful to key stakeholders responsible for public health nutrition.

Costs to farmers of a tuberculosis breakdown

An on-farm survey of 151 cattle farmers who had experienced a bovine tuberculosis (Mycobacterium bovis) breakdown on their farms was undertaken in 2003 to assess the costs associated with the breakdown. In 90 per cent of cases the cost was estimated to be less than 18,513 pound for dairy herds and less than El 1,462 for beef herds, but with a range from 229 pound to 103,817 pound. The main cost was the slaughter of reactor cattle. For the majority of the farmers, the compensation payments seemed to meet most of the costs of their breakdowns, although a majority was still left with net losses.

Prevalence of subclinical mastitis and associated risk factors in smallholder dairy cows in Tanzania

A cross-sectional study was carried out on 200 randomly selected farms in each of the Iringa and Tanga regions of Tanzania to estimate the prevalence and risk factors for subclinical mastitis in dairy cows kept by smallholders. Subclinical mastitis was assessed using the California mastitis test (CMT), and by the bacteriological culture of 1500 milk samples collected from 434 clinically normal cows. The percentages of the cows (and quarters) with subclinical mastitis were 75.9 per cent (46.2 per cent) when assessed by the CMT and 43.8 per cent (24.3 per cent) when assessed by culture. Factors significantly associated with an increased risk of a CMT-positive quarter were Boran breed (odds radio [OR]=3.51), a brought-in cow (rather than homebred) (OR=2.39), peak milk yield, and age. The stripping method of hand milking was associated with a significantly lower prevalence Of CMT-positive quarters (OR=0.51). The CMT-positive cows were more likely to be culture positive (OR=4.51), as were brought-in (OR=2.10) and older cows.

Post occupancy evaluation of a building employing windcatchers for summer ventilation

A combined windcatcher and light pipe (SunCatcher) was installed in the seminar room at the University of Reading, UK. Monitoring of indoor environment in real weather conditions was conducted to evaluate the application of windcatchers for natural ventilation. In addition, a subjective occupancy survey was undertaken. External weather conditions and internal indoor air quality indicators were recorded. The “tracer-gas decay” method using SF6 was used to establish air change rate for various conditions. The results indicated that the ventilation rate achieved through the windcatcher depends on the difference between internal and external air temperatures, and on wind speed and direction, in agreement with other published work in the area. The indoor air quality parameters were found to be within acceptable levels when the windcatcher was in operation. The measured air change rate was between 1.5ac/h and 6.8ac/h. Occupants’ questionnaires showed 75 per cent satisfaction with the internal conditions and welcomed the installation of the systems in UK buildings.

Commercial reviews in the tender process of contractors

Purpose – The purpose of this paper is to show the extent to which clients amend standard form contracts in practice, the locus of the amendments, and how contractors respond to the amendments when putting together a bid. Design/methodology/approach – Four live observational case studies were carried out in two of the top 20 UK construction firms. The whole process used to review the proposed terms and conditions of the contract was shadowed using participant observation, interview and documentary analysis. Findings – All four cases showed strong evidence of amendments relating mostly to payment and contractual aspects: 83 amendments in Case Study 1 (CS1), 80 in CS2, 15 in CS3 and 29 in CS4. This comprised clauses that were modified (37 per cent), substituted (23 per cent), deleted (7 per cent) and new additions (33 per cent). Risks inherent in the amendments were mostly addressed through contractual rather than price mechanisms, to reflect commercial imperatives. “Qualifications” and “clarifications” were included in the tender submissions for post-tender negotiations. Thus, the amendments did not necessarily influence price. There was no evidence of a “standard-form contract“ being used as such, although clients may draw on published “standard-form contracts” to derive the forms of contract actually used in practice. Practical implications – Contractors should pay attention to clauses relating to contractual and financial aspects when reviewing tender documents. Clients should draft equitable payment and contractual terms and conditions to reduce risk of dispute. Indeed, it is prudent for clients not to pass on inestimable risks. Originality/value – A better understanding of the extent and locus of amendments in standard form contracts, and how contractors respond, is provided.

Responsiveness to change by standard-form contract drafters: A case study of the FIDIC White Book

Purpose – The purpose of this paper is to focus on the Fédération Internationale des Ingénieurs-Conseils (FIDIC) White Book standard form of building contract. It tracks the changes to this contract over its four editions, and seeks to identify their underlying causes. Design/methodology/approach – The changes made to the White Book are quantified using a specific type of quantitative content analysis. The amended clauses are then examined to understand the nature of the changes made. Findings – The length of the contract increased by 34 per cent between 1990 and 2006. A large proportion of the overall increase can be attributed to the clauses dealing with “conflict of interest/corruption” and “dispute resolution”. In both instances, the FIDIC drafting committees have responded to international developments to discourage corruption, and to encourage the use of alternative dispute resolution. Between 1998 and 2006, the average length of the sentences increased slightly, raising the question of whether long sentences are easily understood by users of contracts. Research limitations/implications – Quantification of text appears to be particularly useful for the analysis of documents which are regularly updated because changes can be clearly identified and the length of sentences can be determined, leading to conclusions about the readability of the text. However, caution is needed because changes of great relevance can be made to contract clauses without actually affecting their length. Practical implications – The paper will be instructive for contract drafters and informative for users of FIDIC's White Book. Originality/value – Quantifying text has been rarely used regarding standard-form contracts in the field of construction.

Does gym use impact upon nutritional knowledge?

Purpose - The purpose of this paper is to investigate gym and non-gym users' use and understanding of nutrition labels. Design/methodology/approach - A consumer survey in the form of a questionnaire conducted in the Greater London area in February/March 2005. Subject recruitment process took place in both a gym and university setting. Frequency tables and chi(2)-test are used to assess relationships between variables (p = 0.05). Findings - The resulting sample consisted of 187 subjects, with predominance of females and gym users. Of the subjects, 88 per cent reported to at least occasionally read nutrition labels, with higher reading rates amongst women, irrespective of gym user status. Total and saturated fats are the most often information viewed on labels, however the overall knowledge of the calorie content of fat is low, with 53 per cent of subjects responding saturated fat contains more calories per gram when compared with other types of fats. This paper does not find significant differences in the use and understanding of nutrition labels between gym and non-gym users, but highlights the publics' continued lack of understanding of nutrition labels. Originality/value - This paper is unique as it investigates whether there is any difference between gym/non-gym users' use and interpretation of use of nutrition labels. It finds gender impacted more on nutritional labels knowledge than gym user's status. This points to a gender issue and questions the quality of information available to the general public. This paper is valuable as it highlights and identifies an area that requires further research and assessment, and is therefore useful to key stakeholders responsible for public health nutrition.

Water reuse for irrigation in Jordan: plant beneficial nutrients, farmers’ awareness and management strategies

The reuse of treated wastewater (reclaimed water) is particularly well suited for irrigated agriculture as it often contains significant quantities of plant essential nutrients. This work has shown that reclaimed water in Jordan can have adequate concentrations of potassium, phosphate, sulphate and magnesium to meet all or part of the crop’s requirements. To fully benefit from these inputs farmers must have an awareness of the water quality and reduce the application of chemical fertilisers accordingly. Interviews with farmers have shown that 75 per cent of farmers indirectly using reclaimed water are aware of the nutrients. Farmers’ decision making as to the application of chemical fertilisers appears to be influenced by a range of factors which include the type of crops being cultivated, the provision of training on nutrient management and the availability of information on the nutrient content of the reclaimed water.

Depreciation, income distribution and the UK REIT

Purpose – The purpose of this paper is to consider prospects for UK REITs, which were introduced on 1 January 2007. It specifically focuses on the potential influence of depreciation and expenditure on income and distributions. Design/methodology/approach – First, the ways in which depreciation can affect vehicle earnings and value are discussed. This is then set in the context of the specific rules and features of REITs. An analysis using property income and expenditure data from the Investment Property Databank (IPD) then assesses what gross and net income for a UK REIT might have been like for the period 1984-2003. Findings – A UK REIT must distribute at least 90 per cent of net income from its property rental business. Expenditure therefore plays a significant part in determining what funds remain for distribution. Over 1984-2003, expenditure has absorbed 20 per cent of gross income and been a source of earnings volatility, which would have been exacerbated by gearing. Practical implications – Expenditure must take place to help UK REITs maintain and renew their real estate portfolios. In view of this, investors should moderate expectations of a high and stable income return, although it may well still be so relative to alternative investments. Originality/value – Previous literature on depreciation has not quantified amounts spent on portfolios to keep depreciation at those rates. Nor, to our knowledge, has its ideas been placed in the indirect investor context.

Negotiating access into firms: obstacles and strategies

Researchers often experience difficulties with the negotiation of access into firms for the purpose of data collection. The question we explore is: What are the main obstacles associated with access negotiation into firms; and what strategies do researchers employ to increase their chances of success? Our research work on the tendering process of contractors took place between 2006 and 2008. We successfully negotiated access into four firms (two each in Ghana and the UK) to observe live examples of tender preparation The techniques we employed in negotiating access were personal contacts, contacting firms through online details and professional institutions, etc. With all of this effort, our average success rate was less than 5 per cent. The main obstacles encountered were firms’ reluctance because of commercial sensitiveness and fear that the data could eventually be divulged to their competitors or end up in the public domain. However, some firms agreed mainly because of the written assurances of confidentiality and anonymity in reporting the study; reputation of the researchers’ academic institution; gatekeepers who spoke to their colleagues on our behalf; academic purpose of the study; and a feedback report which was promised in return for access to the case studies. Although the access through personal contacts is by far the easiest, it is not always possible. Researchers can approach firms as complete strangers, especially in a foreign country, and that could make the firms more likely to assist the research.