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.

Towards an improved understanding of farmers' behaviour: the integrative agent-centred (IAC) framework

An effective approach to research on farmers' behaviour is based on: i) an explicit and well-motivated behavioural theory; ii) an integrative approach; and iii) understanding feedback processes and dynamics. While current approaches may effectively tackle some of them, they often fail to combine them together. The paper presents the integrative agent-centred (IAC) framework, which aims at filling this gap. It functions in accordance with these three pillars and provides a conceptual structure to understand farmers' behaviour in agricultural systems. The IAC framework is agent-centred and supports the understanding of farmers' behavior consistently with the perspective of agricultural systems as complex social-ecological systems. It combines different behavioural drivers, bridges between micro and macro levels, and depicts a potentially varied model of human agency. The use of the framework in practice is illustrated through two studies on pesticide use among smallholders in Colombia. The examples show how the framework can be implemented to derive policy implications to foster a transition towards more sustainable agricultural practices. The paper finally suggests that the framework can support different research designs for the study of agents' behaviour in agricultural and social-ecological systems.

The role of agronomic research in climate change and food security policy

Societal concern is growing about the consequences of climate change for food systems and, in a number of regions, for food security. There is also concern that meeting the rising demand for food is leading to environmental degradation thereby exacerbating factors in part responsible for climate change, and further undermining the food systems upon which food security is based. A major emphasis of climate change/food security research over recent years has addressed the agronomic aspects of climate change, and particularly crop yield. This has provided an excellent foundation for assessments of how climate change may affect crop productivity, but the connectivity between these results and the broader issues of food security at large are relatively poorly explored; too often discussions of food security policy appear to be based on a relatively narrow agronomic perspective. To overcome the limitation of current agronomic research outputs there are several scientific challenges where further agronomic effort is necessary, and where agronomic research results can effectively contribute to the broader issues underlying food security. First is the need to better understand how climate change will affect cropping systems including both direct effects on the crops themselves and indirect effects as a result of changed pest and weed dynamics and altered soil and water conditions. Second is the need to assess technical and policy options for either reducing the deleterious impacts or enhancing the benefits of climate change on cropping systems while minimising further environmental degradation. Third is the need to understand how best to address the information needs of policy makers and report and communicate agronomic research results in a manner that will assist the development of food systems adapted to climate change. There are, however, two important considerations regarding these agronomic research contributions to the food security/climate change debate. The first concerns scale. Agronomic research has traditionally been conducted at plot scale over a growing season or perhaps a few years, but many of the issues related to food security operate at larger spatial and temporal scales. Over the last decade, agronomists have begun to establish trials at landscape scale, but there are a number of methodological challenges to be overcome at such scales. The second concerns the position of crop production (which is a primary focus of agronomic research) in the broader context of food security. Production is clearly important, but food distribution and exchange also determine food availability while access to food and food utilisation are other important components of food security. Therefore, while agronomic research alone cannot address all food security/climate change issues (and hence the balance of investment in research and development for crop production vis à vis other aspects of food security needs to be assessed), it will nevertheless continue to have an important role to play: it both improves understanding of the impacts of climate change on crop production and helps to develop adaptation options; and also – and crucially – it improves understanding of the consequences of different adaptation options on further climate forcing. This role can further be strengthened if agronomists work alongside other scientists to develop adaptation options that are not only effective in terms of crop production, but are also environmentally and economically robust, at landscape and regional scales. Furthermore, such integrated approaches to adaptation research are much more likely to address the information need of policy makers. The potential for stronger linkages between the results of agronomic research in the context of climate change and the policy environment will thus be enhanced.

Exploring the Influence of Vocabulary Instruction on Students’ Understanding of Mathematical Concepts

In this action research study of my classroom of 8th grade mathematics, I investigated the influence of vocabulary instruction on students’ understanding of the mathematics concepts. I discovered that knowing the meaning of the vocabulary did play a major role in the students’ understanding of the daily lessons and the ability to take tests. Understanding the vocabulary and the concepts allowed the students to be successful on their daily assignments, chapter tests, and standardized achievement tests. I also discovered that using different vocabulary teaching strategies enhanced equity in my classroom among diverse learners. The knowledge of the math vocabulary increased my students’ confidence levels, which in turn increased their daily and test scores. As a result of this research, I plan to find ways to incorporate the vocabulary teaching strategies I have used into current math curriculum. I will start this process at the beginning of the next school year, and will continue looking for new strategies that will promote math vocabulary retention.

The role of empirical research in the study of complex forms of governance in agroindustrial systems

The growing complexity of supply chains poses new challenges for Agricultural Research Centers and statistical agencies. The aim of this perspective paper is to discuss the role of empirical research in understanding the complex forms of governance in agribusiness. The authors argue that there are three fundamental levels of analysis: (i) the basic structure of the market, (ii) the formal contractual arrangements that govern relations within the agroindustrial system and (iii) the transactional dimensions governed by non-contractual means. The case of the agrochemical industry in Brazil illustrates how traditional analyses that only address market structure are insufficient to fully explain the agricultural sector and its supply chain. The article concludes by suggesting some indicators which could be collected by statistical agencies to improve understanding of the complex relationships among agribusiness segments. In doing so, the paper seeks to minimize costs and to enable a better formulation of public and private policies.

Effect of Participant Gender, Professor Gender, and Activity Interventions on the Understanding of Concepts in Thermodynamics

Misconceptions about heat and temperature have been seen across all educational levels, even in undergraduate engineering courses. One way these misconceptions can be remediated is through instructional methods, such as inquiry-based activities. Performance on assessments in sciences and engineering has been found to vary when gender is taken into consideration. The purpose of the current study was to investigate the effects of participant gender, professor gender, and level of inquiry-based activities on the conceptual understanding of 247 undergraduate engineering students in thermodynamics. A pre-test post-test design was used. Conceptual understanding of thermodynamics was measured by students’ scores on the Concept Inventory for Engineering Thermodynamics (CIET; Vigeant, Prince & Nottis, 2011). Inquiry-based activities were developed by the researchers and given to professors who determined if they would do all, some, or none of them as they taught. Significant differences were found among participants of different gender, different gender of the professor instructing the course, and level of inquiry-based activity. The participants who were exposed to all of the activities provided didsignificantly better on the post-test than those who were only exposed to some or none of the activities. The results from this current study indicated that differences in gender, professorgender, and level of inquiry-based activity has an effect on undergraduate engineering students’ conceptual understanding of thermodynamics. Future research should investigate more factorsthat contribute to lower representation of women in the engineering field.

The Effect of Grade Point Average on Undergraduates' Understanding of Heat Transfer

Engineering students continue to develop and show misconceptions due to prior knowledge and experiences (Miller, Streveler, Olds, Chi, Nelson, & Geist, 2007). Misconceptions have been documented in students’ understanding of heat transfer(Krause, Decker, Niska, Alford, & Griffin, 2003) by concept inventories (e.g., Jacobi,Martin, Mitchell, & Newell, 2003; Nottis, Prince, Vigeant, Nelson, & Hartsock, 2009). Students’ conceptual understanding has also been shown to vary by grade point average (Nottis et al., 2009). Inquiry-based activities (Nottis, Prince, & Vigeant, 2010) haveshown some success over traditional instructional methods (Tasoglu & Bakac, 2010) in altering misconceptions. The purpose of the current study was to determine whether undergraduate engineering students’ understanding of heat transfer concepts significantly changed after instruction with eight inquiry-based activities (Prince & Felder, 2007) supplementing instruction and whether students’ self reported GPA and prior knowledge, as measured by completion of specific engineering courses, affected these changes. The Heat and Energy Concept Inventory (Prince, Vigeant, & Nottis, 2010) was used to assess conceptual understanding. It was found that conceptual understanding significantly increased from pre- to post-test. It was also found that GPA had an effect on conceptual understanding of heat transfer; significant differences were found in post-test scores onthe concept inventory between GPA groups. However, there were mixed results when courses previously taken were analyzed. Future research should strive to analyze how prior knowledge effects conceptual understanding and aim to reduce the limitations of the current study such as, sampling method and methods of measuring GPA and priorknowledge.

Looking at the effectiveness of an earth science unit designed using the Understanding by Design process

This report shares my efforts in developing a solid unit of instruction that has a clear focus on student outcomes. I have been a teacher for 20 years and have been writing and revising curricula for much of that time. However, most has been developed without the benefit of current research on how students learn and did not focus on what and how students are learning. My journey as a teacher has involved a lot of trial and error. My traditional method of teaching is to look at the benchmarks (now content expectations) to see what needs to be covered. My unit consists of having students read the appropriate sections in the textbook, complete work sheets, watch a video, and take some notes. I try to include at least one hands-on activity, one or more quizzes, and the traditional end-of-unit test consisting mostly of multiple choice questions I find in the textbook. I try to be engaging, make the lessons fun, and hope that at the end of the unit my students get whatever concepts I‘ve presented so that we can move on to the next topic. I want to increase students‘ understanding of science concepts and their ability to connect understanding to the real-world. However, sometimes I feel that my lessons are missing something. For a long time I have wanted to develop a unit of instruction that I know is an effective tool for the teaching and learning of science. In this report, I describe my efforts to reform my curricula using the “Understanding by Design” process. I want to see if this style of curriculum design will help me be a more effective teacher and if it will lead to an increase in student learning. My hypothesis is that this new (for me) approach to teaching will lead to increased understanding of science concepts among students because it is based on purposefully thinking about learning targets based on “big ideas” in science. For my reformed curricula I incorporate lessons from several outstanding programs I‘ve been involved with including EpiCenter (Purdue University), Incorporated Research Institutions for Seismology (IRIS), the Master of Science Program in Applied Science Education at Michigan Technological University, and the Michigan Association for Computer Users in Learning (MACUL). In this report, I present the methodology on how I developed a new unit of instruction based on the Understanding by Design process. I present several lessons and learning plans I‘ve developed for the unit that follow the 5E Learning Cycle as appendices at the end of this report. I also include the results of pilot testing of one of lessons. Although the lesson I pilot-tested was not as successful in increasing student learning outcomes as I had anticipated, the development process I followed was helpful in that it required me to focus on important concepts. Conducting the pilot test was also helpful to me because it led me to identify ways in which I could improve upon the lesson in the future.