Patients' understanding of risk associated with medication use: impact of European Commission guidelines and other risk scales

Patients want and need comprehensive and accurate information about their medicines so that they can participate in decisions about their healthcare: In particular, they require information about the likely risks and benefits that are associated with the different treatment options. However, to provide this information in a form that people can readily understand and use is a considerable challenge to healthcare professionals. One recent attempt to standardise the Language of risk has been to produce sets of verbal descriptors that correspond to specific probability ranges, such as those outlined in the European Commission (EC) Pharmaceutical Committee guidelines in 1998 for describing the incidence of adverse effects. This paper provides an overview of a number of studies involving members of the general public, patients, and hospital doctors, that evaluated the utility of the EC guideline descriptors (very common, common, uncommon, rare, very rare). In all studies it was found that people significantly over-estimated the likelihood of adverse effects occurring, given specific verbal descriptors. This in turn resulted in significantly higher ratings of their perceived risks to health and significantly lower ratings of their likelihood of taking the medicine. Such problems of interpretation are not restricted to the EC guideline descriptors. Similar levels of misinterpretation have also been demonstrated with two other recently advocated risk scales (Caiman's verbal descriptor scale and Barclay, Costigan and Davies' lottery scale). In conclusion, the challenge for risk communicators and for future research will be to produce a language of risk that is sufficiently flexible to take into account different perspectives, as well as changing circumstances and contexts of illness and its treatments. In the meantime, we urge the EC and other legislative bodies to stop recommending the use of specific verbal labels or phrases until there is a stronger evidence base to support their use.

Uncanny Valley revisited

The 'Uncanny Valley' was conceived in 1970 by Prof Masahiro Mori and details a possible relationship between an object's appearance or motion and how people perceive the object. Initially this research was used without validation. Modern technology has enabled initial investigations, summarised here, that conclude further work is required. A good design guideline for humanoid robots is desired if humanoid robots are to assist with an increasingly elderly population, but not yet possible due to technological constraints. Prosthetics is considered a good resource as the user interaction is comparable to the anticipated level of human-robot interaction and there is a wide range of existing devices.

The impact of urban wind environments on natural ventilation

The aim of this paper is to illustrate the impact of urban wind environments when assessing the availability of natural ventilation. A numerical study of urban airflow for a complex of five building blocks located at the University of Reading, UK is presented. The computational fluid dynamics software package ANSYS was used to simulate six typical cases of urban wind environments and the potential for natural ventilation assessed. The study highlights the impact of three typical architectural forms (street canyons, semi-enclosures and courtyards) on the local wind environment. Simulation results have also been compared with experimental data collected from six locations on the building complex. The study demonstrates that ventilation strategies formed using regional weather data, may have a propensity to over-estimate the potential for natural ventilation and cooling, due to the impact of urban form which creates a unique microclimate. Characteristics of urban wind flow patterns are presented as a guideline and can be used to assess the design and performance of natural or hybrid ventilation and the opportunity for passive cooling.

A study on effect of built forms on urban wind environment by using CFD simulations

This paper presents a numerical study of urban air-flow for a group of five buildings that is located at the University of Reading in the United Kingdom. The airflow around these buildings has been simulated by using ANSYS CFD software package. In this study, the association between certain architectural forms: a street canyon, a semi-closure, and a courtyard-like space in a low-rise building complex, and the wind environment were investigated. The analysis of CFD results has provided detailed information on the wind patterns of these urban built forms. The numerical results have been compared with the experimental measurements within the building complex. The observed characteristics of urban wind pattern with respect to the built structures are presented as a guideline. This information is needed for the design and/or performance assessments of systems such as passive and low energy design approach, a natural or hybrid ventilation, and passive cooling. Also, the knowledge of urban wind patterns allows us to develop better design options for the application of renewable energy technologies within urban environment.

Nutritional value of edible seaweeds

This article presents information on the nutritional aspects of seaweeds in terms of fiber, mineral content, fats and lipids, vitamin contents, and components that have a confirmed and investigated nutritional effect. The nutrient levels of seaweeds are also shown in comparison to currently applicable reference nutrient intakes or guideline daily amounts of nutrients and are contrasted with terrestrial foodstuffs with respect to selected nutrients. For the purpose of comparison, a sample serving size of 8 g dry weight of seaweed is used to illustrate the potential contribution of seaweeds to the diet.

Effect of acceptable use policy on employee computer use : case of Sri Lankan software development organizations

It is a known fact that some employees misuse the organizational computers to do their personal work such as sending emails, surfing the Internet, chatting, playing games. These activities not only waste productive time of employees but also bring a risk factor to the organization. This affects organizations in the software industry very much as almost all of their employees are connected to the Internet throughout them day./ By introducing an Acceptable Use Policy (AUP) for an organization, it is believed that the computer misuse by its employees could be reduced. In many countries Acceptable Use Policies are used and they have been studied with various perspectives. In Sri Lankan context research on these areas are scarce. This research explored the situation in Sri Lanka with respect to AUPs and their effectiveness./ A descriptive study was carried out to identify the large and medium scale software development organizations that had implemented computer usage guidelines for employees. A questionnaire was used to gather information regarding employee’s usual computer usage behavior. Stratified random sampling was employed to draw a representative sample from the population./ Majority of the organizations have not employed a written guideline on acceptable use of work computers. The study results did not provide evidence to conclude that the presence or non presence of an AUP has a significant difference in computer use behaviors of employees. A significant negative correlation was observed between level of awareness about AUP and misuse. Access to the Internet and organizational settings were identified as significant factors that influence employee computer misuse behavior.

Context relevant persuasive interaction and design: consideration of human factors influencing B2C persuasive interaction

The revolutions of electronic and mobile commerce have opened up unique opportunities for global marketing and business to consumer (B2C) persuasive interaction; with the aim of influencing user behavior. The success or failure of such persuasive interaction is impacted by cultural, social, and personal dimensions. Accordingly, failure to consider such dimensions risks the user forming a negative attitude towards retailer’s websites or mobile applications, which subsequently threatens customer behavior. A better understanding of human factors influencing the way people perceive B2C persuasive interaction is needed. This paper is introduces the concept of a context relevant persuasive interaction and proposes a guideline for designing relevant B2C persuasive interaction.

Meat quality and health implications of organic and conventional beef production

Recommendation to reduce fat consumption from ruminant meat does not consider the contribution of nutritionally beneficial fatty acids in lean beef. Here we report effects of production system (organic vs conventional) and finishing season on meat and fat quality of sirloin steaks from retail outlets and simulated fatty acid intakes by consumers. There was little difference in meat quality (pH, shear force and colour), but the fat profiles varied considerably between production systems and season. Meat fat from organic and summer finished cattle contained higher concentrations of conjugated linoleic acid, its precursor vaccenic acid and individual omega-3 fatty acids and had a lower ratio of omega-6 to omega-3 fatty acids compared with non-organic and winter finished cattle respectively. The fat profile from summer finished organic beef aligns better to recommended dietary guideline including those for long chain omega-3 fatty acids compared with that from winter finished, non-organic steak.

Monitoring scan asymmetry of microwave humidity sounding channels using simultaneous all angle collocations (SAACs)

Simultaneous all angle collocations (SAACs) of microwave humidity sounders (AMSU-B and MHS) on-board polar orbiting satellites are used to estimate scan-dependent biases. This method has distinct advantages over previous methods, such as that the estimated scan-dependent biases are not influenced by diurnal differences between the edges of the scan and the biases can be estimated for both sides of the scan. We find the results are robust in the sense that biases estimated for one satellite pair can be reproduced by double differencing biases of these satellites with a third satellite. Channel 1 of these instruments shows the least bias for all satellites. Channel 2 has biases greater than 5 K, thus needs to be corrected. Channel 3 has biases of about 2 K and more and they are time varying for some of the satellites. Channel 4 has the largest bias which is about 15 K when the data are averaged for 5 years, but biases of individual months can be as large as 30 K. Channel 5 also has large and time varying biases for two of the AMSU-Bs. NOAA-15 (N15) channels are found to be affected the most, mainly due to radio frequency interference (RFI) from onboard data transmitters. Channel 4 of N15 shows the largest and time varying biases, so data of this channel should only be used with caution for climate applications. The two MHS instruments show the best agreement for all channels. Our estimates may be used to correct for scan-dependent biases of these instruments, or at least used as a guideline for excluding channels with large scan asymmetries from scientific analyses.

Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison

The Global Initiative Against Asthma (GINA) was developed to meet the global challenge of asthma. GINA has been adopted in most countries and comparison of asthma management in different parts of the world may be of help when assessing the global dissemination of the guideline. The overall goals in GINA include that asthma patients should be free of symptoms, acute asthma attacks and activity limitations. The aim of the present study was to compare asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden. Information was collected from asthmatics in Sao Paulo and Uppsala with a questionnaire. The questionnaire dealt with the following issues: symptoms, smoking, self-management, hospital visits, effect on school/work and medication. The Sao Paulo patients were more likely to have uncontrolled asthma (36% vs 13%, P < 0.001), having made emergency room visits (57% vs 29%, P < 0.001) and having lost days at school or work because of their asthma (46% vs 28%, P = 0.03) than the asthmatics from Uppsala. There were no difference in the use of inhaled corticosteroids, but the Brazilian patients were more likely to be using theophylline (18% vs 1%, P = 0.001) and less likely to be using long-acting beta-2 agonists (18% vs 37%, P < 0.001). We conclude that the level of asthma control was lower among the patients from Sao Paulo than Uppsala. Few of the patients in either city reached the goals set up by GINA. Improved asthma management may therefore lead to health-economic benefits in both locations. Please cite this paper as: Skorup P, Rizzo LV, Machado-Boman L and Janson C. Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison. The Clinical Respiratory Journal 2009; 3: 22-28.

Grafisk profil till ett företag som tillverkar handgjorda textilprodukter av naturmaterial : Hur kan en hemsida kommunicera ett varumärke?

Målet med detta examensarbete var att skapa en grafisk profil till företaget Lyst Form AB som bedriver större delen av sin affärsverksamhet via en hemsida. Företaget säljer handgjorda kläder och accessoarer i lintyg. En teoretisk del i arbetet tar upp hur varumärket kan kommuniceras genom hemsidan. Den grafiska profilen utformades utifrån företagets identitet. Det är viktigt att företaget speglas på ett korrekt sätt. Ett företags identitet kan beskrivas som organisationens själ och den visas utåt i form av bland annat den grafiska profilen. Denna ses därför som en viktig identitetsbärare och den kan kallas för den visuella identiteten. En grafisk profil innehåller bland annat logotyp, profilfärger samt typografi. Företagets målgrupp ansågs vara en viktig del i hela processen eftersom de i slutändan ska tilltalas av den grafiska profilen. Först gjordes en grundlig undersökning och research av företaget för att få en god uppfattning av dess identitet. Även konkurrenterna granskades. En enkätundersökning gjordes för att kunna samla information utifrån målgruppens perspektiv. Denna informationsinsamling gav ett bra underlag och en riktlinje i framtagningen av den grafiska profilen.   Under designprocessens gång diskuterades de logotypförslag som togs fram med hjälp av en sammansatt fokusgrupp. Diskussionen var givande och var till stor nytta i designprocessen. Baserat på den grafiska profilen skapades en layout för hemsidan samt exempel på trycksaker för att visa hur den kan användas. En enklare grafisk manual skapades för att företaget ska kunna synas utåt på ett enhetligt sätt. En sista enkätundersökning gjordes för att se om målet uppnåtts. Resultatet visade att den nya framtagna grafiska profilen var en klar förbättring jämfört mot den nuvarande sett utifrån företagets identitet. I slutändan valde dock företaget en annan logotyp. Detta påvisar svårigheterna i processen att ta fram en grafisk profil. Alla delar i processen är viktiga och undersökningarna är bland annat en av de väsentliga delarna vilka bidrar med en större chans till ett bra slutresultat som tar hänsyn till både företagets och målgruppens åsikter.  

Granskning av riktlinjer vid Sveriges förlossningskliniker gällande sfinkterskada i samband med förlossning : Innehållsanalys med en kombination av en deduktiv och induktiv ansats

Background: Sphincter injury is serious complication in connection to vaginal childbirth. Desire to avoid vaginal birth again is seen in women who previously suffered from a sphincter injury. Objective: To identify and evaluate obstetric guidelines in Sweden regarding sphincter injury in relation to childbirth Method: Content analysis with a combination of a deductive and inductive approach. Results: The most frequently occurring risk factors and prevention with help of perineal protection were described in the guidelines. The physician made diagnosis and repaired the sphincter injury at the theatre.  Complications such as coital pain and anal incontinence were described in the guidelines. Paracetamol and diclofenac was most common analgesic regimen given for pain. Prophylaxis such as antibiotic treatment and laxative were common. Information given to women was described. Follow-up by physician, midwife and physiotherapist was recommended after four weeks to six months. For future birth a cesarean section was recommended. Conclusion: The guidelines were constructed in the same way and had to a large extent similar content. The authors of the present work recommend a national guideline.

A user guide to simple monitoring and sustainable operation of PV-diesel hybrid systems : Handbook for system users and operators

This report contains a suggestion for a simple monitoring and evaluation guideline for PV-diesel hybrid systems. It offers system users a way to better understand if their system is operated in a way that will make it last for a long time. It also gives suggestions on how to act if there are signs of unfavourable use or failure. The application of the guide requires little technical equipment, but daily manual measurements. For the most part, it can be managed by pen and paper, by people with no earlier experience of power systems.The guide is structured and expressed in a way that targets PV-diesel hybrid system users with no, or limited, earlier experience of power engineering. It is less detailed in terms of motivations for certain choices and limitations, but rich in details concerning calculations, evaluation procedures and maintenance routines. A more scientific description of the guide can be found in a related journal article.

Modelos de simulações de fusões: aplicação a casos brasileiros

Este trabalho tem como objetivo explicar o funcionamento do Sistema Brasileiro de Defesa da Concorrência e apresentar novas ferramentas de auxílio à política antitruste. Para isso, discutiremos o Sistema Norte-Americano de Defesa da Concorrência e, principalmente, o guideline americano, que é a base das técnicas de análise de fusões e aquisições em grande parte dos países, inclusive o Brasil. Uma vez apresentado o ambiente institucional, explicare- mos alguns modelos de simulação de fusões, uma técnica relativamente recente utilizada por alguns órgãos antitruste do mundo que permite fazer previsões do novo nível de preços da indústria após a fusão. Para ilustrar as virtudes do método, aplicaremos o modelo a alguns casos de aquisições conhecidos no Brasil e analisaremos seus resultados.

Roteiro para análise de atos de concentração: uma proposta para o quadro institucional brasileiro

O objetivo deste projeto é elaborar uma proposta de roteiro para a análise de concentrações econômicas horizontais aplicável à jurisdição brasileira. O estudo será dividido em três partes: i. avaliação do atual estágio de orientação para o agente econômico no tocante ao roteiro de análise de atos de concentração ao amparo da Lei 8884/94 (Lei antitruste); ii. resenha da experiência internacional em roteiros de análise de atos de concentração; iii. proposta de roteiro aplicável ao caso brasileiro com duas variantes: a) supondo o atual marco legal que faculta o controle estrutural ex post; b) admitindo alteração legal que introduz o controle estrutural ex ante.