Managing the possible health risks of mobile telecommunications: Public understandings of precautionary action and advice

It has been suggested that precautionary approaches to managing possible health risks mobile telecommunications (MT) technology may cause or exacerbate public concerns. In contrast, precautionary approaches to managing such risks in the UK have been framed as a way of reducing public concerns. This article presents evidence from a series of focus groups about publics’ understandings of the actions taken and advice given about potential MT health risks by the UK government. Eight focus groups were conducted with members of the public that varied in their age, their awareness and concern about mast siting, and the self-reported level of mobile phone use. From the analyses a complex picture emerged in which publics’ understandings were not primarily framed in terms of precautionary action and advice either provoking concern or providing reassurance. People made sense of precaution by drawing upon a range of evidence from their understandings of costs and benefits of the technology, as well as the institutional context in which MT health risks were managed. For some of those involved in protesting against mast siting, precaution was seen as confirming existing concern. Further systematic exploration of the contexts within which different responses to precaution emerge is thus likely to be instructive.Mobile Telecommunications Health Research Programme

Choosing treatment for localised prostate cancer: A patient-conducted-interview study

Objectives: Treatment choice can be particularly difficult in localised prostate cancer because of the uncertainty involved. Indeed, some men prefer maintaining their masculine identity and quality of life to potentially securing longer-term survival through surgery or radiotherapy. UK health services are now obliged to leave the choice of treatment to the patient and the aim of this study is to improve understanding of patients’ experiences of choosing treatment. Methods: A one-day participative workshop where men of six months post-diagnosis design and conduct audio and video interviews on each other about their experiences of choosing treatment. Results: The findings show that treatment choice is a complex process combining emotional and rational elements. Information gathering and delegation to professional expertise were two key themes that emerged. Conclusions: The findings emphasise that treatment choice for localised prostate cancer is little like the traditional notions of consumerism from which it is derived. Importantly, the results illustrate, from a patient perspective, how health professionals can engage in their roles as information providers and as experts

Public engagement with research: Citizens’ views on motivations, barriers and support

Responsible research and innovation (RRI) approaches that have emerged in the past ten years point to the importance of engaging the public in dialogues about research. The different variants of RRI share the notion that societal actors, including citizens, need to work together – that is, engage in two-way communication during the research and innovation process – in order to better align both the process and its outcomes with the values, needs and expectations of society. Yet, sponsors and organizers of dialogues about research often face difficulties in recruiting sufficient numbers of participants or ensuring a sufficient level of diversity of participants. This paper asks what motivates or hinders individual citizens as members of the broader public to participate in such dialogues. It presents empirical findings of the European Union-funded project Promoting Societal Engagement Under the Terms of RRI (PROSO), which aimed to foster public engagement with research for RRI. PROSO used a quasi-experimental, qualitative approach directly involving citizens to address this question. The core of the innovative methodology were focus group discussions with European citizens about hypothetical opportunities to take part in dialogues about research. Three hypothetical scenarios of different dialogue formats (varied by whether they seek to inform the participants, consult or enable deeper collaboration on a scientific issue) were used as stimuli to explore the participants’ willingness (motivations and perceived barriers) to engage with scientific research. Our findings show a preference towards dialogue formats that give citizens a more active role and a greater say in research policy or research funding. They further suggest that those who seek to broaden citizen participation in dialogues about research should consider the role of relevance, impact, trust, legitimacy, knowledge, and time and resources as factors that can motivate or discourage citizens to take part. Based on our findings, we discuss possibilities to promote citizen participation in dialogues about research as part of putting RRI into practice

Public health nutrition and sustainability

In public health nutrition, sustainability refers to the ability to maintain food system capacity to support the nutritional health needs of current and future populations while protecting the ecological systems that produce food. The FAO defines sustainable diets as those that are ‘protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources’

European micronutrient recommendations aligned: a general framework developed by EURRECA

Background: In Europe, micronutrient recommendations have been established by (inter)national committees of experts and are used by public health-policy decision makers to monitor and assess the adequacy of the diets of population groups. Current micronutrient recommendations are, however, heterogeneous, whereas the scientific basis for this is not obvious. Alignment of setting micronutrient recommendations is necessary to improve the transparency of the process, the objectivity and reliability of recommendations that are derived by diverse regional and (inter)national bodies. Objective: This call for alignment of micronutrient recommendations is a direct result of the current sociopolitical climate in Europe and uncovers the need for an institutional architecture. There is a need for evidence-based policy making, transparent decision making, stakeholder involvement and alignment of policies across Europe. Results: In this paper, we propose a General Framework that describes the process leading from assessing nutritional requirements to policy applications, based on evidence from science, stakeholder interests and the sociopolitical context. The framework envisions the derivation of nutrient recommendations as scientific methodology, embedded in a policy-making process that also includes consumer issues, and acknowledges the influences of the wider sociopolitical context by distinguishing the principal components of the framework: (a) defining the nutrient requirements for health, (b) setting nutrient recommendations, (c) policy options and (d) policy applications. Conclusion: The General Framework can serve as a basis for a systematic and transparent approach to the development and review of micronutrient requirements in Europe, as well as the decision making of scientific advisory bodies, policy makers and stakeholders involved in this process of assessing, developing and translating these recommendations into public health nutrition policy. European Journal of Clinical Nutrition (201 0) 64, S2-510; doi:10.1038/ejcn.2010.5

Consumer involvement in dietary guideline development: opinions from European stakeholders.

OBJECTIVE: The involvement of consumers in the development of dietary guidelines has been promoted by national and international bodies. Yet, few best practice guidelines have been established to assist with such involvement. DESIGN: Qualitative semi-structured interviews explored stakeholders' beliefs about consumer involvement in dietary guideline development. SETTING: Interviews were conducted in six European countries: the Czech Republic, Germany, Norway, Serbia, Spain and the UK. SUBJECTS: Seventy-seven stakeholders were interviewed. Stakeholders were grouped as government, scientific advisory body, professional and academic, industry or non-government organisations. Response rate ranged from 45 % to 95 %. RESULTS: Thematic analysis was conducted with the assistance of NVivo qualitative software. Analysis identified two main themes: (i) type of consumer involvement and (ii) pros and cons of consumer involvement. Direct consumer involvement (e.g. consumer organisations) in the decision-making process was discussed as a facilitator to guideline communication towards the end of the process. Indirect consumer involvement (e.g. consumer research data) was considered at both the beginning and the end of the process. Cons to consumer involvement included the effect of vested interests on objectivity; consumer disinterest; and complications in terms of time, finance and technical understanding. Pros related to increased credibility and trust in the process. CONCLUSIONS: Stakeholders acknowledged benefits to consumer involvement during the development of dietary guidelines, but remained unclear on the advantage of direct contributions to the scientific content of guidelines. In the absence of established best practice, clarity on the type and reasons for consumer involvement would benefit all actors

Designing a mHealth clinical decision support system for Parkinson's disease: a theoretically grounded user needs approach.

BACKGROUND: Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson's disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty. METHODS: A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson's disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians' (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians' (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. RESULTS: Study 1 indicated that system development should move away from the traditional silos of 'motor' and 'non-motor' symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients' overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient's condition from the patient's self-report and the wearable devices. CONCLUSIONS: Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment

Selection and Validation of Reference Genes for Quantitative Real-Time PCR in Buckwheat (Fagopyrum esculentum) Based on Transcriptome Sequence Data

Quantitative reverse transcription PCR (qRT-PCR) is one of the most precise and widely used methods of gene expression analysis. A necessary prerequisite of exact and reliable data is the accurate choice of reference genes. We studied the expression stability of potential reference genes in common buckwheat (Fagopyrum esculentum) in order to find the optimal reference for gene expression analysis in this economically important crop. Recently sequenced buckwheat floral transcriptome was used as source of sequence information. Expression stability of eight candidate reference genes was assessed in different plant structures (leaves and inflorescences at two stages of development and fruits). These genes are the orthologs of Arabidopsis genes identified as stable in a genome-wide survey gene of expression stability and a traditionally used housekeeping gene GAPDH. Three software applications – geNorm, NormFinder and BestKeeper - were used to estimate expression stability and provided congruent results. The orthologs of AT4G33380 (expressed protein of unknown function, Expressed1), AT2G28390 (SAND family protein, SAND) and AT5G46630 (clathrin adapter complex subunit family protein, CACS) are revealed as the most stable. We recommend using the combination of Expressed1, SAND and CACS for the normalization of gene expression data in studies on buckwheat using qRT-PCR. These genes are listed among five the most stably expressed in Arabidopsis that emphasizes utility of the studies on model plants as a framework for other species