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.

Results of an aqueous source term model for a radiological risk assessment of the Drigg LLW Site, U.K.

A radionuclide source term model has been developed which simulates the biogeochemical evolution of the Drigg low level waste (LLW) disposal site. The DRINK (DRIgg Near field Kinetic) model provides data regarding radionuclide concentrations in groundwater over a period of 100,000 years, which are used as input to assessment calculations for a groundwater pathway. The DRINK model also provides input to human intrusion and gaseous assessment calculations through simulation of the solid radionuclide inventory. These calculations are being used to support the Drigg post closure safety case. The DRINK model considers the coupled interaction of the effects of fluid flow, microbiology, corrosion, chemical reaction, sorption and radioactive decay. It represents the first direct use of a mechanistic reaction-transport model in risk assessment calculations.

Do in vivo terahertz imaging systems comply with safety guidelines?

Techniques for the coherent generation and detection of electromagnetic radiation in the far infrared, or terahertz, region of the electromagnetic spectrum have recently developed rapidly and may soon be applied for in vivo medical imaging. Both continuous wave and pulsed imaging systems are under development, with terahertz pulsed imaging being the more common method. Typically a pump and probe technique is used, with picosecond pulses of terahertz radiation generated from femtosecond infrared laser pulses, using an antenna or nonlinear crystal. After interaction with the subject either by transmission or reflection, coherent detection is achieved when the terahertz beam is combined with the probe laser beam. Raster scanning of the subject leads to an image data set comprising a time series representing the pulse at each pixel. A set of parametric images may be calculated, mapping the values of various parameters calculated from the shape of the pulses. A safety analysis has been performed, based on current guidelines for skin exposure to radiation of wavelengths 2.6 µm–20 mm (15 GHz–115 THz), to determine the maximum permissible exposure (MPE) for such a terahertz imaging system. The international guidelines for this range of wavelengths are drawn from two U.S. standards documents. The method for this analysis was taken from the American National Standard for the Safe Use of Lasers (ANSI Z136.1), and to ensure a conservative analysis, parameters were drawn from both this standard and from the IEEE Standard for Safety Levels with Respect to Human Exposure to Radio Frequency Electromagnetic Fields (C95.1). The calculated maximum permissible average beam power was 3 mW, indicating that typical terahertz imaging systems are safe according to the current guidelines. Further developments may however result in systems that will exceed the calculated limit. Furthermore, the published MPEs for pulsed exposures are based on measurements at shorter wavelengths and with pulses of longer duration than those used in terahertz pulsed imaging systems, so the results should be treated with caution.

Children playing branded video games: The impact of interactivity on product placement effectiveness

This study extends product placement research by testing the impact of interactivity on product placement effectiveness. The results suggest that when children cannot interact with the placements in video games, perceptual fluency is the underlying mechanism leading to positive affect. Therefore, the effects are only evident in a stimulus-based choice where the same stimulus is provided as a cue. However, when children have the opportunity to interact with the placements in video games, they may be influenced by conceptual fluency. Thus, placements are still effective in a memory-based choice where no stimulus is provided as a cue. Keywords: Perceptual fluency; Conceptual fluency; Video games; Interactivity; Children; Product placement

A study of the ethene-ozone reaction with photoelectron spectroscopy: measurement of product branching ratios and atmospheric implications

The ozone-ethene reaction has been investigated at low pressure in a flow-tube interfaced to a u.v. photoelectron spectrometer. Photoelectron spectra recorded as a function of reaction time have been used to estimate partial pressures of the reagents and products, using photoionization cross-sections for selected photoelectron bands of the reagents and products, which have been measured separately. Product yields compare favourably with results of other studies, and the production of oxygen and acetaldehyde have been measured as a function of time for the first time. A reaction scheme developed for the ozone-ethene reaction has been used to simulate the reagents and products as a function of time. The results obtained are in good agreement with the experimental measurements. For each of the observed products, the simulations allow the main reaction (or reactions) for production of that product to be established. The product yields have been used in a global model to estimate their global annual emissions in the atmosphere. Of particular interest are the calculated global annual emissions of formaldehyde (0.96 ± 0.10 Tg) and formic acid, (0.05 ± 0.01 Tg) which are estimated as 0.04% and 0.7% of the total annual emission respectively.

Consumer perceptions of poultry meat: a qualitative analysis

Consumer studies of meat have tended to use quantitative methodologies providing a wealth of statistically malleable information, but little in-depth insight into consumer perceptions of meat. The aim of the present study was therefore, to understand factors perceived important in the selection of chicken meat, using qualitative methodology. Focus group discussions were tape recorded, transcribed verbatim and content analysed for major themes. Themes arising implied that “appearance” and “convenience” were the most important determinants of choice of chicken meat and these factors appeared to be associated with perceptions of freshness, healthiness, product versatility and concepts of value. A descriptive model has been developed to illustrate the interrelationship between factors affecting chicken meat choice. This study indicates that those involved in the production and retailing of chicken products should concentrate upon product appearance and convenience as market drivers for their products.

The influence of context upon consumer sensory evaluation of chicken-meat quality

There is an apparent lack of research investigating how different test conditions influence or bias consumer sensory evaluation of food. The aim of the present pilot study was to determine if testing conditions had any effect on responses of an untrained panel to a novel chicken product. Assessments of flavour, texture and overall liking of corn-fed chicken were made across three different testing conditions (laboratory-based under normal lighting; laboratory-based under controlled lighting; and, home testing). Least favourable evaluations occurred under laboratory-based conditions irrespective of what lighting was used. Consumers perceived the product more favourably in terms of flavour (p < 0.001), texture (p < 0.001) and overall preference (p < 0.001) when evaluated in the familiar setting of the home. Home testing produced more consistent assessments than under either of the two laboratory-based test conditions. The results imply that home evaluation should be undertaken routinely in new food product development.

Eliciting consumer preferences for certified animal-friendly foods: can elements of the theory of planned behavior improve choice experiment analysis?

Models used in neoclassical economics assume human behaviour to be purely rational. On the other hand, models adopted in social and behavioural psychology are founded on the ‘black box’ of human cognition. In view of these observations, this paper aims at bridging this gap by introducing psychological constructs in the well established microeconomic framework of choice behaviour based on random utility theory. In particular, it combines constructs developed employing Ajzen’s theory of planned behaviour with Lancaster’s theory of consumer demand for product characteristics to explain stated preferences over certified animal-friendly foods. To reach this objective a web survey was administered in the largest five EU-25 countries: France, Germany, Italy, Spain and the UK. Findings identify some salient cross-cultural differences between northern and southern Europe and suggest that psychological constructs developed using the Ajzen model are useful in explaining heterogeneity of preferences. Implications for policy makers and marketers involved with certified animal-friendly foods are discussed.

Consumer robotic products: studying the factors that influence market adoption

The aim of this article is to identify the key factors that are associated with the adoption of a commercial robot in the home. This article is based on the development of the robot product Cybot by the University of Reading in conjunction with a publisher (Eaglemoss International Ltd.). The robots were distributed through a new part-work magazine series (Ultimate Real Robots) that had long-term customer usage and retention. A part-work is a serial publication that is issued periodically (e.g., every two weeks), usually in magazine format, and builds into a complete collection. This magazine focused on robotics and was accompanied by cover-mounted component parts that could be assembled, with instructions, by the user to build a working robot over the series. In total, the product contributed over half a million operational domestic robots to the world market, selling over 20 million robot part-work magazines across 18 countries, thereby providing a unique breadth of insight. Gaining a better understanding of the overall attitudes that customers of this product had toward robots in the home, their perception of what such devices could deliver and how they would wish to interact with them should provide results applicable to the domestic appliance, assistance/care, entertainment, and educational markets.

The impact of price promotions on producer strategies in markets with large product heterogeneity

Although current research indicates that increasing the number of options has negative effects on the cognitive ability of consumers, little understanding has been given to the consequences on producers and their strategic behavior. This article tests whether a large portfolio of products is beneficial to producers by observing UK consumer response to price promotions. The article shows that discounts induce mainly segment switching (74% of the total impact), with a limited effect on stockpiling (26%) and no impact on purchase incidence. Consequently, consumers prefer to “follow the discount” rather than purchase multiple units of the same wine. This result seems to explain the current structure of the market, and suggests that discounts may conflict with segment loyalty, a situation that disfavors producers, particularly in very populated segments. Results also casts doubts on the economic sustainability of competition based on an intense product differentiation in the wine sector.

Entrepreneurial opportunities, implicit contracts and market making for complex consumer goods

This article extends the theory of entrepreneurial opportunity exploitation, outlining how under certain conditions, opportunity exploitation is dependent on market making innovations. Where adverse selection and moral hazard characterize markets, consumers are likely to withdraw regardless of product quality. In order to overcome consumer resistance, entrepreneurs must signal credible commitments. But because consumers purchase without fully specifying requirements, entrepreneurs' commitments take the partial form of implicit contracts, creating strong mutual commitments to repeated transactions. These commitments enable novel markets to function, but introduce additional costs. This article illustrates the theory with the historic case of Singer in sewing machines

The consumer acceptance of novel vegetable-enriched bread products as a potential vehicle to increase vegetable consumption

Currently UK fruit and vegetable intakes are below recommendations. Bread is a staple food consumed by ~95% of adults in western countries. In addition, bread provides an ideal matrix by which functionality can be delivered to the consumer in an accepted food. Therefore, enriching bread with vegetables may be an effective strategy to increase vegetable consumption. This study evaluated consumer acceptance, purchase intent and intention of product replacement of bread enriched with red beetroot, carrot with coriander, red pepper with tomato or white beetroot (80g vegetable per serving of 200g) compared to white control bread (0g vegetable). Consumers (n=120) rated their liking of the breads overall, as well as their liking of appearance, flavour and texture using nine-point hedonic scales. Product replacement and purchase intent of the breads was rated using five-point scales. The effect of providing consumers with health information about the breads was also evaluated. There were significant differences in overall liking (P<0.0001), as well as liking of appearance (P<0.0001), flavour (P=0.0002) and texture (P=0.04), between the breads. However, the significant differences resulted from the red beetroot bread which was significantly (P<0.05) less liked compared to control bread. There were no significant differences in overall liking between any of the other vegetable-enriched breads compared with the control bread (no vegetable inclusion), apart from the red beetroot bread which was significantly less liked. The provision of health information about the breads did not increase consumer liking of the vegetable-enriched breads. In conclusion, this study demonstrated that vegetable-enriched bread appeared to be an acceptable strategy to increase vegetable intake, however, liking depended on vegetable type.

Negative online consumer reviews: effects of different responses

Purpose When consumers buy online, they are often confronted with consumer reviews. A negative consumer review on an online shopping website may keep consumers from buying the product. Therefore, negative online consumer reviews are a serious problem for brands. This paper aims to investigate the effects of different response options to a negative consumer review. Design/methodology/approach In an online experiment of 446 participants different response options towards a negative consumer review on an online shopping website are examined. The experimental data is analysed with simple linear regression models using product purchase intentions as the outcome variable. Findings The results indicate that a positive customer review counteracts a negative consumer review more effectively than a positive brand response, whereas brand strength moderates this relationship. Including a reference to an independent, trusted source in a brand or a customer response is only a limited strategy for increasing the effectiveness of a response. Research limitations/implications Additional research in other product categories and with other subjects than students is suggested to validate the findings. In future research, multiple degrees of the phrasing’s strength of the reference could be used. Practical implications Assuming high quality products, brands should encourage their customers to write reviews. Strong brands can also reassure consumers by responding whereas weak brands cannot. Originality/value This research contributes to the online consumer reviews literature with new insights about the role of brand strength and referencing to an independent, trusted source.

Avoiding the dark side of positive online consumer reviews: enhancing reviews' usefulness for high risk-averse travelers

The influence of positive online consumer reviews on a traveler's decision making remains unclear. To better understand the perceived usefulness of online reviews, this study conducts two experiments using positive and negative online consumer reviews. Study results suggest that high risk-averse travelers find negative online reviews more useful than positive reviews. For positive online reviews, high-risk averse travelers feel expert reviewers' postings, travel product pictures, and well-known brand names enhance usefulness of the positive online reviews. These findings offer interesting implications for both marketing theory and practice.

Sensory profiles and consumer acceptability of a range of sugar-reduced products on the UK market

Current UK intake of non-milk extrinsic sugars (NMES) is above recommendations. Reducing the sugar content of processed high sugar foods through reformulation is one option for reducing consumption of NMES at a population level. However, reformulation can alter the sensory attributes of food products and influence consumer liking. This study evaluated consumer acceptance of a selection of products that are commercially-available in the UK; these included regular and sugar-reduced baked beans, strawberry jam, milk chocolate, cola and cranberry & raspberry juice. Sweeteners were present in the reformulated chocolate (maltitol), cola (aspartame and acesulfame-K) and juice (sucralose) samples. Healthy, non-smoking consumers (n = 116; 55 men, 61 women, age: 33 ± 9 years; BMI: 25.7 ± 4.6 kg/m2) rated the products for overall liking and on liking of appearance, flavor and texture using a nine-point hedonic scale. There were significant differences between standard and reduced sugar products in consumers’ overall liking and on liking of each modality (appearance, flavor and texture; all P < 0.0001). For overall liking, only the regular beans and cola were significantly more liked than their reformulated counterparts (P < 0.0001). Cluster analysis identified three consumer clusters that were representative of different patterns of consumer liking. For the largest cluster (cluster 3: 45%), there was a significant difference in mean liking scores across all products, except jam. Differences in liking were predominantly driven by sweet taste in 2 out of 3 clusters. The current research has demonstrated that a high proportion of consumers prefer conventional products over sugar-reduced products across a wide range of product types (45%) or across selected products (27%), when tasted unbranded, and so there is room for further optimization of commercial reduced sugar products that were evaluated in the current study. Future work should evaluate strategies to facilitate compliance to dietary recommendations on NMES and free sugars, such as the impact of sugar-reduced food exposure on their acceptance.