Comparison of two methods of presenting risk information to patients about the side effects of medicines

Objective: To determine whether the use of verbal descriptors suggested by the European Union (EU) such as "common" (1-10% frequency) and "rare" (0.01-0.1%) effectively conveys the level of risk of side effects to people taking a medicine. Design: Randomised controlled study with unconcealed allocation. Participants: 120 adults taking simvastatin or atorvastatin after cardiac surgery or myocardial infarction. Setting: Cardiac rehabilitation clinics at two hospitals in Leeds, UK. Intervention: A written statement about one of the side effects of the medicine (either constipation or pancreatitis). Within each side effect condition half the patients were given the information in verbal form and half in numerical form (for constipation, "common" or 2.5%; for pancreatitis, "rare" or 0.04%). Main outcome measure: The estimated likelihood of the side effect occurring. Other outcome measures related to the perceived severity of the side effect, its risk to health, and its effect on decisions about whether to take the medicine. Results: The mean likelihood estimate given for the constipation side effect was 34.2% in the verbal group and 8.1% in the numerical group; for pancreatitis it was 18% in the verbal group and 2.1% in the numerical group. The verbal descriptors were associated with more negative perceptions of the medicine than their equivalent numerical descriptors. Conclusions: Patients want and need understandable information about medicines and their risks and benefits. This is essential if they are to become partners in medicine taking. The use of verbal descriptors to improve the level of information about side effect risk leads to overestimation of the level of harm and may lead patients to make inappropriate decisions about whether or not they take the medicine.

Interpreting information about medication side effects: differences in risk perception and intention to comply when medicines are prescribed for adults or young children

This study investigates whether, and how, people's perception of risk and intended health behaviours are affected by whether a medicine is prescribed for themselves or for a young child. The question is relevant to the issue of whether it is beneficial to produce medicines information that is tailored to particular subgroups of the population, such as parents of young children. In the experiment, participants read scenarios which referred either to themselves or their (imagined) 1-year-old child, and were required to make a number of risk judgements. The results showed that both parents and non-parents were less satisfied, perceived side effects to be more severe and more likely to occur, risk to health to be higher, and said that they would be less likely to take (or give) the medicine when the recipient was the child. On the basis of the findings, it is suggested that it may well be beneficial to tailor materials to broader classes of patient type.

Psychological response to later life widowhood: coping and the effects of gender

The study examined the effects of psychological response and gender on coping with late life widowhood. Forty-six men and 46 women (55 years +) were interviewed about their experiences of widowhood. Participants were classified as to whether they were coping well or less well. Data were analyzed using grounded theory, content. analysis, and three-way loglinear analyses. Loglinear analyses revealed three-way interactions for Gender, Coping, and Response. Men who report feeling upset or selfish are more likely to be coping, as are women who report being comfortable alone. There were two-way interactions between Coping and Response and Gender and Response. Participants who talk to their dead spouse are more Rely to be coping than those who do not. Those who "keep themselves to themselves" are more likely not to be coping than those who do not. Gender differences, were found in psychological response. Differences were also found between those who coped and those who coped less well. The study has enabled the synthesis of quantitative and qualitative data to present a more complete view of late life widowhood than has previously been possible. In addition, the article draws attention to the importance of distinguishing between the effects of bereavement and those of widowhood.

Taking time to understand: articulating relationships between technologies and organizations

Dynamic relationships between technologies and organizations are investigated through research on digital visualization technologies and their use in the construction sector. Theoretical work highlights mutual adaptation between technologies and organizations but does not explain instances of sustained, sudden, or increasing maladaptation. By focusing on the technological field, I draw attention to hierarchical structuring around inter-dependent levels of technology; technological priorities of diverse groups; power asymmetries and disjunctures between contexts of development and use. For complex technologies, such as digital technologies, I argue these field-level features explain why organizations peripheral to the field may experience difficulty using emerging technology.

Theory of mind and attentional bias to facial emotional expressions: A preliminary study

Theory of mind ability has been associated with performance in interpersonal interactions and has been found to influence aspects such as emotion recognition, social competence, and social anxiety. Being able to attribute mental states to others requires attention to subtle communication cues such as facial emotional expressions. Decoding and interpreting emotions expressed by the face, especially those with negative valence, are essential skills to successful social interaction. The current study explored the association between theory of mind skills and attentional bias to facial emotional expressions. According to the study hypothesis, individuals with poor theory of mind skills showed preferential attention to negative faces over both non-negative faces and neutral objects. Tentative explanations for the findings are offered emphasizing the potential adaptive role of vigilance for threat as a way of allocating a limited capacity to interpret others’ mental states to obtain as much information as possible about potential danger in the social environment.

A moving-mesh finite element method and its application to the numerical solution of phase-change problems

A distributed Lagrangian moving-mesh finite element method is applied to problems involving changes of phase. The algorithm uses a distributed conservation principle to determine nodal mesh velocities, which are then used to move the nodes. The nodal values are obtained from an ALE (Arbitrary Lagrangian-Eulerian) equation, which represents a generalization of the original algorithm presented in Applied Numerical Mathematics, 54:450--469 (2005). Having described the details of the generalized algorithm it is validated on two test cases from the original paper and is then applied to one-phase and, for the first time, two-phase Stefan problems in one and two space dimensions, paying particular attention to the implementation of the interface boundary conditions. Results are presented to demonstrate the accuracy and the effectiveness of the method, including comparisons against analytical solutions where available.

ERP correlates of shared control mechanisms involved in saccade preparation and in covert attention

We investigated whether attention shifts and eye movement preparation are mediated by shared control mechanisms, as claimed by the premotor theory of attention. ERPs were recorded in three tasks where directional cues presented at the beginning of each trial instructed participants to direct their attention to the cued side without eye movements (Covert task), to prepare an eye movement in the cued direction without attention shifts (Saccade task) or both (Combined task). A peripheral visual Go/Nogo stimulus that was presented 800 ms after cue onset signalled whether responses had to be executed or withheld. Lateralised ERP components triggered during the cue–target interval, which are assumed to reflect preparatory control mechanisms that mediate attentional orienting, were very similar across tasks. They were also present in the Saccade task, which was designed to discourage any concomitant covert attention shifts. These results support the hypothesis that saccade preparation and attentional orienting are implemented by common control structures. There were however systematic differences in the impact of eye movement programming and covert attention on ERPs triggered in response to visual stimuli at cued versus uncued locations. It is concluded that, although the preparatory processes underlying saccade programming and covert attentional orienting may be based on common mechanisms, they nevertheless differ in their spatially specific effects on visual information processing.

To what extent do pupils perceive science to be inconsistent with religious faith? An exploratory survey of 13-14 year-old English pupils

Scientists hold a wide range of beliefs on matters of religion, although popular media coverage in the UK commonly suggests that atheism is a core commitment for scientists. Considering the relationship between religion and science is a recommended topic in the English National Curriculum for lower secondary pupils (11-14 year-olds), and it is expected that different perspectives will be considered. However it is well established that many pupils may have difficulty accessing sophisticated ideas about the nature of science, and previous research suggests some may identify science with scientism. To explore pupil impressions of the relationship between science and religion, 13-14 year old pupils were surveyed in one class from each of four English secondary schools, by asking them to rate a set of statements about the relationship between science and religion, and scientific and religious perspectives on the origins of the world, and of life on earth, on the value of prayer and on the status of miracles. The survey revealed diverse views on these issues, reflecting the wider society. However it was found that a considerable proportion of the pupils in the sample considered religious beliefs and scientific perspectives to be opposed. The basis and potential consequences of such views are considered, and the need for more attention to this area of student thinking is highlighted.

Who owned Earls Colne in 1798....or how to squeeze more from the Land Tax

In this important article Richard Hoyle, one of the country’s leading historians of the early modern period, introduces new perspectives on the Land Tax and its use in the analysis of local communities in the late eighteenth and early nineteenth centuries. He uses as his case study the parish of Earls Colne in Essex, on which he has already written extensively with Professor Henry French. The article begins with an overview of the tax itself, explaining its history and the procedures for the collection of revenues – including the numerous changes which took place. The sizeable problems confronting any would-be analyst of the data are clearly identified, and Hoyle observes that because of these apparently insoluble difficulties the potential of the tax returns has never been fully realised. He then considers the surviving documentation in The National Archives, providing an accessible introduction to the sources and their arrangement, and describing the particularly important question o f the redemption of the tax by payment of a lump sum. The extent of redemption (in the years around 1800-1804) is discussed. Hoyle draws attention to the potential for linking the tax returns themselves with the redemption certificates (which have never been subjected to historical analysis and thereby proposes new ways of exploiting the evidence of the taxation as a whole. The article then discusses in detail the specific case of Earls Colne, with tabulated data showing the research potential. Topics analysed include the ownership of property ranked by size of payment, and calculations whereby the amount paid may be used to determine the worth of land and the structure of individual estates. The important question of absentee owners is investigated, and there is a very valuable consideration of the potential for looking at portfolio estate ownership, whereby owners held land in varying proportions in a number of parishes. It is suggested that such studies will allow us to be more aware of the entirety of property ownership, which a focus on a single community does not permit. In the concluding paragraph it is argued that using these sources we may see the rise and fall of estates, gain new information on landownership, landholding and farm size, and even approach the challenging topic of the distribution of wealth.

Steering across scales: applying Strategic-Relational Approach to a study of land mobilisation for road widening in Kochi

This paper argues for the relevance of paying attention to structuring participation processes across scales as one of the ways in which participation of multi-organisational partnerships that involve conflicting interests might be managed. Issue wise the paper deals with problems in connection with land mobilisation for road widening in complex and concentrated high value urban settings. It discusses a case study of plan implementation involving individual landowners, the land development market, the local government, other governmental and non-governmental organisations and the state government, which together achieved objectives that seemed impossible at first sight. In theoretical terms, the paper engages with Jessop's (2001) Strategic-Relational Approach (SRA), arguing for its potential for informing action in a way that is capable of achieving steering outputs. The claim for SRA is demonstrated by re-examining the case study. The factors that come through as SRA is applied are drawn out and it is suggested that the theory though non-deterministic, helps guide action by highlighting certain dynamics of systems that can be used for institutional intervention. These dynamics point to the importance of paying attention to scale and the way in which participation and negotiation processes are structured so as to favour certain outcomes rather than others

Attention through self-synchronisation in the spiking neuron stochastic diffusion network

The paper discusses ensemble behaviour in the Spiking Neuron Stochastic Diffusion Network, SNSDN, a novel network exploring biologically plausible information processing based on higher order temporal coding. SNSDN was proposed as an alternative solution to the binding problem [1]. SNSDN operation resembles Stochastic Diffusin on Search, SDS, a non-deterministic search algorithm able to rapidly locate the best instantiation of a target pattern within a noisy search space ([3], [5]). In SNSDN, relevant information is encoded in the length of interspike intervals. Although every neuron operates in its own time, ‘attention’ to a pattern in the search space results in self-synchronised activity of a large population of neurons. When multiple patterns are present in the search space, ‘switching of at- tention’ results in a change of the synchronous activity. The qualitative effect of attention on the synchronicity of spiking behaviour in both time and frequency domain will be discussed.

Attention, visual consciousness and indeterminacy

I propose a new argument showing that conscious vision sometimes depends constitutively on conscious attention. I criticise traditional arguments for this constitutive connection, on the basis that they fail adequately to dissociate evidence about visual consciousness from evidence about attention. On the same basis, I criticise Ned Block's recent counterargument that conscious vision is independent of one sort of attention (‘cognitive access'). Block appears to achieve the dissociation only because he underestimates the indeterminacy of visual consciousness. I then appeal to empirical work on the interaction between visual indeterminacy and attention, to argue for the constitutive connection.

Microencapsulation of probiotics for gastrointestinal delivery

The administration of probiotic bacteria as nutraceuticals is an area that has rapidly expanded in recent years, with a global market worth $32.6 billion predicted by 2014. Many of the health promoting claims attributed to these bacteria are dependent on the cells being both viable and sufficiently numerous in the intestinal tract. The oral administration of most bacteria results in a large loss of viability associated with passage through the stomach, which is attributed to the high acid and bile salt concentrations present. This loss of viability effectively lowers the efficacy of the administered supplement. The formulation of these probiotics into microcapsules is an emerging method to reduce cell death during GI passage, as well as an opportunity to control release of these cells across the intestinal tract. The majority of this technology is based on the immobilization of bacteria into a polymer matrix, which retains its structure in the stomach before degrading and dissolving in the intestine, unlike the diffusion based unloading of most controlled release devices for small molecules. This review shall provide an overview of progress in this field as well as draw attention to areas where studies have fallen short. This will be followed by a discussion of emerging trends in the field, highlighting key areas in which further research is necessary.

Listening behind the Curtain: BBC broadcasting to East Germany and its Cold War echo

This article considers the BBC External Service's East German wing, which broadcast from 1949 on, focusing on the continuities in broadcast techniques between wartime anti-Nazi programming and slots such as 'Two Comrades' and 'The Bewildered Newspaper Reader', both of which replicated pre-1945 formats. The role of the Foreign Office, both as cold warrior in the 1940s and force for detente in the 1970s is included. The article also investigates the response from German listeners to the BBC's external service broadcasting in the 1950s and 1960s. The BBC paid special attention to its German listeners, and has preserved a large number of original letters at the Written Archive at Caversham, as well as conducting regular listener surveys. These considered whether Britain's democratic agenda was getting across in the late 1940s and 50s, but the author also considers to what extent German listeners were pressing for a harder stance in the Cold War or were urging caution on the great powers deciding their fate.

The Life of Galileo and Brechtian television drama

Bertolt Brecht's dramaturgy was as influential upon the development of British drama on television between the 1950s and the 1970s as it was in the theatre. His influence was made manifest through the work of writers, directors and producers such as Tony Garnett, Ken Loach, John McGrath and Dennis Potter, whose attempts to create original Brechtian forms of television drama were reflected in the frequent reference to Brecht in contemporary debate concerning the political and aesthetic direction and value of television drama. While this discussion has been framed thus far around how Brechtian techniques and theory were applied to the newer media of television, this article examines these arguments from another perspective. Through detailed analysis of a 1964 BBC production of The Life of Galileo, I assess how the primary, canonical sources of Brecht's stage plays were realised on television during this period, locating Brecht's drama in the wider context of British television drama in general during the 1960s and 1970s. I pay particular attention to the use of the television studio as a site that could replicate or reinvent the theatrical space of the stage, and the responsiveness of the television audience towards Brechtian dramaturgy.