Treatment of uncertainties in IPCC Assessment Reports: past approaches and considerations for the Fifth Assessment Report

The assessments of the Intergovernmental Panel on Climate Change (IPCC), since the First Assessment Report, have involved calibrated uncertainty language and other methods aimed towards clear communication of the degree of certainty in findings of the assessment process. There has been a continuing tradition of iterative improvement of the treatment of uncertainties in these assessments. Here we consider the motivations for the most recent revision of the uncertainties guidance provided to author teams of the Fifth Assessment Report (AR5). We first review the history of usage of calibrated language in IPCC Assessment Reports, along with the frameworks for treatment of uncertainties that have been provided to IPCC author teams. Our primary focus is the interpretation and application of the guidance provided to author teams in the Fourth Assessment Report, with analysis of the successes and challenges in the application of this guidance and approaches taken in usage of its calibrated uncertainty language. We discuss the ways in which the AR5 Guidance Note attempts to refine the calibrated uncertainty metrics and formalize their interrelationships to improve the consistency of treatment of uncertainties across the Working Group contributions

Medication Education of Acutely Hospitalized Older Patients

OBJECTIVES: To determine the amount of time spent providing medication education to older patients, the impact of medication education on patients’ knowledge and satisfaction, and barriers to providing medication education. DESIGN: Telephone survey of patients within 48 hours of hospital discharge and direct survey of physicians and pharmacists. SETTING: Internal medicine ward in a tertiary care teaching hospital. PARTICIPANTS: Patients 65 years of age and over regularly taking at least one medication. MEASUREMENTS: Patient demographics, medication use, time spent receiving or providing medication education, and satisfaction scores. MAIN RESULTS: Forty-seven respondents with a mean age of 77.1 years reported that physicians spent a mean of 10.5 minutes (range, 0–60 minutes) and pharmacists spent a mean of 5.3 minutes (range, 0–40 minutes) providing medication education. Fifty-one percent reported receiving no education from either physician or pharmacist, and only 30% reported receiving written medication instructions. Respondents were generally quite satisfied with their education. Physicians identified one or more barriers to providing education 51% of the time and pharmacists 80%. Lack of time was the most common barrier (18%) identified by physicians, but pharmacists cited lack of notification of discharge plans (41%) and lack of time (39%) as the main barriers. Respondents made many medication errors and knew little about their medications. CONCLUSIONS: Although older hospitalized patients received little medication education or written information and made many medication errors with and without medication education, approximately one half of physicians perceived no barriers to providing education