The social amplification of risk and the hazard sequence: The October 1995 oral contraceptive pill scare

Hazard notifications routinely occur as part of the identification or management of a hazard. It is argued that a series of such notifications - a hazard sequence - may affect public responses to future notifications about that hazard and also that hazard sequences can help explain patterns of risk amplification, particularly how a risk becomes normalised. Exploration of the hazard sequence also means exploring hazard templates: frameworks through which people make sense of risk information across the lifetime of the hazard. Events surrounding the 1995 oral contraceptive 'pill scare' are used to illustrate the way in which a hazard sequence might operate

Perceived efficacy and attitudes towards genetic science and science governance

This is the postprint version of the Article. The official published version can be obtained from the link below - © 2010 SAGE Publications.Arguments for public involvement in science and technology are often based on ideas of developing a more capable public and the assumed effects this may have for science. However, such a relationship is yet to be sufficiently explored and recent work indicates that a more involved public may have counterintuitive effects. Using nationally representative survey data for the UK and Northern Ireland, the effects of the public's own beliefs about involvement are explored. Developing the concept of "belief in public efficacy," findings suggest those who believe that the public might be able to affect the course of decision making have less approving attitudes towards future applications of genetic science; however, an individual's political efficacy does not significantly influence these attitudes. Furthermore, political efficacy and belief in public efficacy have some distinct and opposing relationships with the principles of governance people prefer. Overall, findings provide support for suggestions that it is simplistic to consider increasing public involvement as a way of increasing the approval of risky new technologies

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

When is choice a good thing?: An experimental study of the impact of choice on patient outcomes

The official published version can be obtained from the link below - Copyright @ Taylor & FrancisAlthough policy emphasises the benefits of choice, an increasing body of work points to times when choice may not always have positive consequences. The present experimental study aimed to explore the impact of choice on a number of patient outcomes in the health care setting. The study also explored the extent to which the influence of choice was affected by patient uncertainty and anticipated regret. Choice was conceptualized as consisting of two dimensions: ‘having choice’ which reflects the availability of a number of options and ‘making choice’ reflecting resolution and a desire for a choice to be made. Consecutive patients (n=427) from 4 General Practices in Surrey were asked to read one of 16 vignettes which varied in terms of 4 independent variables (having choice, making choice, uncertainty, anticipated regret) and to rate items relating to 4 outcome variables (patient satisfaction, perceived control, negative emotions, information seeking). The results showed that having more choice was consistently associated with more positive patient outcomes than having no choice. Having no choice was particularly detrimental for those experiencing anticipated regret and uncertainty. In contrast, whether or not a choice was made had no impact upon any of the outcome measures. In line with current policy having choice in the health care setting is related to improved patient outcomes. The results provide some insights into the factors which influence the direction of the impact of choice. They also indicate the importance of differentiating between ‘having choice’ and ‘making choice’.Funding received from ESRC award: RES-000-22-165

THE FEDERAL CROP INSURANCE PROGRAM: OPPORTUNITIES AND CHALLENGES

Risk and Uncertainty,

Patient perceptions of epinephrine auto-injectors: Exploring barriers to use

Background: In recent years, government initiatives have proposed that patient self-care should serve as a key resource in response to the anticipated increase in global demand for health care. However, if patients are to be empowered as self-carers, barriers to engagement must be identified and overcome. Anaphylaxis is an increasingly common life threatening allergic reaction. Patients at risk of anaphylaxis are prescribed epinephrine auto-injectors and play a crucial role in delivering their own care and management of this condition. One key recommendation is that patients routinely carry an epinephrine auto-injector with them, and deploy the device when needed. However, only a small proportion of patients that require epinephrine actually receive it. Objective: To explore the reasons why patients who have been prescribed epinephrine auto-injectors fail to adhere to self-care and management recommendations. Methods: In-depth interviews with 15 adults who have been prescribed epinephrine auto-injectors were carried out to explore the barriers that exist in the provision of effective self-care and management of anaphylaxis. Results: Inconsistent health professional advice, perceived stigma of carrying a ‘weapon-like’ device, poor device design and limited patient training were identified as barriers to carriage or use. Patients were reluctant to carry devices in public because of perceived and observed stigma and suspicion. They were happy to ignore expiry dates and some participants were confident that the emergency services would provide them with the appropriate care they needed, and therefore did not carry the device in urban areas. Conclusions and clinical implications: Improved training of patients, the public and health professionals around both the carriage and use of auto-injectors are areas for urgent attention if improved levels of self-care are to be attained. The design of epinephrine auto-injectors should also receive attention as patients often fail to carry them due to size and aesthetics. Key words: Adherence, allergy, anaphylaxis, empowerment, epinephrine, self-care, self-management, patient perspectivesThis study was funded by grant number Ref: GR/S29874/01 from the Engineering and Physical Sciences Research Council

Clinical users' perspective on telemonitoring of patients with long term conditions: Understood through concepts of Giddens's structuration theory & consequence of modernity

This is the post-print version of the article - Copyright @ 2010 IOS.This study involves conducting focus group discussions with clinical users (nurses and technicians) prior to the launch of telehealth service in Nottingham, UK, to elicit their initial perceptions about the service. It describes the findings from preliminary phase of otherwise a larger longitudinal study. Using Giddens’s concepts from structuration theory and con-sequence of modernity, we were able to acknowledge trust and sense of security as two very salient aspects that govern adop-tion of new technological innovation. Unattended, these as-pects contribute to arousal of conflict and contradiction within a system. In order for successful telehealth implementa-tions in health care setting, providers of the service, need to focus on ways in which clinical users’ trust can be gained and sense of security can be promoted while using the telehealth service and technology.Funding was obained from MATCH (Multidisciplinary Assessment of Technologies Centre for Healthcare)

Bayes' theorem and quantum retrodiction

We derive on the basis of Bayes' theorem a simple but general expression for the retrodicted premeasurement state associated with the result of any measurement. The retrodictive density operator is the normalized probability operator measure element associated with the result. We examine applications to quantum optical cryptography and to the optical beam splitter