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Students at all levels of education experience difficulties with the concepts of measurement uncertainties. One task that includes concepts of measurement uncertainties is a data comparison problem where students decide whether two datasets are in agreement or not--an authentic scientific practice. To aid students with these concepts and tasks, sensitive instruments are needed that probe students' understanding and track their progress. We present a tool in the form of a coding manual that analyzes students' written justifications for such a data comparison problem. With this coding manual, justifications are coded based on the quantity that is compared and the deciding criterion in this comparison. Our coding manual was used in the evaluation of a digital learning environment (DLE). In this evaluation, 154 participants (aged 14-17 years) wrote a justification for a data comparison problem before and after going through the DLE. These participants were randomly assigned to one of three groups where each group was taught an increased amount of concepts regarding measurement uncertainties. By analyzing the participants' justifications with our coding manual, we could probe their ability to compare datasets on a fine-grained level. The sensitivity of our tool was illustrated by the increase in higher quality codes with the increased conceptual teaching between the three groups. We argue that our tool for coding justifications can be applied to any data comparison problem giving detailed information about what data analysis methods students use and how they reach their conclusion and thus contributes to the research on students' understanding of measurement uncertainties.

There is a growing recognition that needs more to be done to ensure that research contributes to better health services and patient outcomes. Stakeholder engagement in research, including co-production, has been identified as a promising mechanism for improving the value, relevance and utilization of research. This article presents findings from a prospective study which explored the impact of stakeholder engagement in a 3-year European tobacco control research project. That research project aimed to engage stakeholders in the development, testing and dissemination of a return-on-investment tool across five EU countries (the Netherlands, Spain, Hungary, Germany and the UK). The prospective study comprised interviews, observations and document review. The analysis focused on the extent to which the project team recognized, conceptualized and operationalized stakeholder engagement over the course of the research project. Stakeholder engagement in the European research project was conceptualized as a key feature of pre-designated spaces within their work programme. Over the course of the project, however, the tool development work and stakeholder engagement activities decoupled. While the modelling and tool development became more secluded, stakeholder engagement activities subtly transformed from co-production, to consultation, to something more recognizable as research participation. The contribution of this article is not to argue against the potential contribution of stakeholder engagement and co-production, but to show how even well-planned engagement activities can be diverted within the existing research funding and research production systems where non-research stakeholders remain at the margins and can even be seen as a threat to academic identify and autonomy.

In this study with 153 middle school students, we investigate the influence of the number of decimal places from the reading of a measurement device on students' decisions to change or keep an initial hypothesis about falling objects. Participants were divided into three groups, introduced to two experiments--the time it takes a free falling object with a zero, and a nonzero initial horizontal velocity to fall a certain distance--and asked to state a hypothesis that compares the falling times of the two experiments. We asked the participants whether they wanted to change or keep their initial hypothesis after they were provided with data sets. Members of each group were given the same number of measurements but with a different number of decimal places. Results show that for an increase in the number of decimal places, the number of participants switching from a false to a correct hypothesis decreases, and at the same time the number of students switching from a correct to a false hypothesis increases. These results indicate that showing more exact data to students--given through different resolutions of the measurement device--may hinder students' ability to compare data sets and may lead them to incorrect conclusions. We argue that this is due to students' lack of knowledge about measurement uncertainties and the concept of variance.

• We compared multilevel coastal flood risk reduction governance and public finance in the UK, Germany, the Netherlands and Australia. • We evaluated alignment of multilevel governance arrangements to spillovers from coastal risk reduction based on fiscal federalism. • We find diverse coastal flood risk governance arrangements ranging from highly centralised to full decentralisation. • We find that multilevel coastal flood risk governance arrangements are reflective of the distribution of the benefits across different levels of government. • We find that major fiscal redistributions may be put under pressure by rising costs under SLR and coastal development. Coastal flood risk reduction (CFRR) presents a significant public funding challenge, due to its high upfront costs and long-term benefits, and this challenge will increase with future sea-level rise. The funding challenge necessarily involves multiple levels of government, due to the regional nature of CFRR public goods involved. Yet there has been little research comparing such multilevel arrangements across countries, and in particular exploring the performance of public funding arrangements for providing coastal flood risk reduction. We address this gap, applying fiscal federalism to develop a multilevel governance analysis of public decision-making and fiscal authorities for CFRR in the Netherlands, Germany, the UK and Australia. For each country, we locate key decision-making and fiscal authorities in multilevel governance arrangements, and analyse their alignment with the benefits of CFRR measures (spillovers). We find diverse coastal flood risk governance arrangements ranging from highly centralised (NL), mixed arrangements, involving regional centralisation (Germany) or partial devolvement (UK), to full decentralisation (AUS). Further, we find that in accordance with fiscal federalism, multilevel coastal flood risk governance arrangements are generally reflective of the distribution of the benefits across different levels of government, with some exceptions (Germany and UK). Finally, exploring the outlook of current arrangements under sea-level rise, we find that major fiscal redistributions may be put under pressure by rising costs likely under SLR and future coastal development. This is particularly the case for those systems which operate under hazard-based, as opposed to risk-based, coastal protection policies. Further, we find that both fully and moderately decentralised arrangements may require greater central support for alternative measures, such as retreat, in light of growing financial burdens on local governments. [ABSTRACT FROM AUTHOR]

Importance: Loneliness is a risk factor for depression and other illnesses and may be caused and reinforced by maladaptive social cognition. Secularized classical meditation training programs address social cognition, but practice typically occurs alone. Little is known about the effectiveness of contemplative practice performed in dyads.Objective: To introduce and assess the effectiveness of contemplative dyadic practices relative to classical-solitary meditation with regard to engagement and perceived social connectedness.Design, Setting, and Participants: The ReSource Project was a 9-month open-label efficacy trial of three, 3-month secularized mental training modules. Replacement randomization was used to assign 362 healthy participants in Leipzig and Berlin, Germany. Eligible participants were recruited between November 11, 2012, and February 13, 2013, and between November 13, 2013, and April 30, 2014. Intention-to-treat analyses were conducted.Interventions: Breathing meditation and body scan (the presence module), loving-kindness meditation and affect dyad (the affect module), and observing-thoughts meditation and perspective dyad (the perspective module).Main Outcomes and Measures: Primary outcomes were self-disclosure and social closeness. Engagement measures included compliance (ie, the mean [95% margin of error] number of meditation sessions that a participant engaged in per week), liking, and motivation to practice.Results: Thirty participants dropped out after assignment to 3 experimental groups; 90 participants were assigned to a retest control that did not complete the main outcome measures; 16 participants provided no state-change data for the affect and perspective modules (226 remaining participants; mean age of 41.15 years; 59.3% female). Results are aggregated across training cohorts. Compliance was similar across the modules: loving-kindness meditation (3.78 [0.18] sessions), affect dyad (3.59 [0.14] sessions), observing-thoughts meditation (3.63 [0.20] sessions), and perspective dyad (3.24 [0.18] sessions). Motivation was higher for meditation (11.20 [0.40] sessions) than the dyads (9.26 [0.43] sessions) and was higher for the affect dyad (10.11 [0.46] sessions) than the perspective dyad (8.41 [0.46] sessions). Social closeness increased during a session for the affect dyad (1.49 [0.12] sessions) and the perspective dyad (1.06 [0.12] sessions) and increased over time for the affect dyad (slope of 0.016 [0.003]) and the perspective dyad (slope of 0.012 [0.003]). Self-disclosure increased over time for the affect dyad (slope of 0.023 [0.004]) and the perspective dyad (slope of 0.006 [0.005]), increasing more steeply for the affect dyad (P < .001).Conclusions and Relevance: Contemplative dyads elicited engagement similar to classical contemplative practices and increased perceived social connectedness. Contemplative dyads represent a new type of intervention targeting social connectedness and intersubjective capacities deficient in participants who experience loneliness and in many psychopathologies.Trial Registration: clinicaltrials.gov Identifier: NCT01833104. [ABSTRACT FROM AUTHOR]

The article describes a hand-colored woodcut of the Crucified Christ in the Staatliche Graphische Sammlung in Munich, Germany. The style is close to Lucas van Leyden's "The Crucifixion" in the Missale Traictensis. It has a devotional text in letterpress. The text is comparable with the inscriptions in letterpress on the woodcuts by van Leyden and Jacob Cornelisz van Oostsanen published by Doen Pietersz in Amsterdam, Netherlands between 1520 and 1530. There is a letter G indicating that the engraving must be sheet seven of a set of at least seven woodcuts.

Background: Human papillomavirus is responsible for a variety of diseases including grade 2 and 3 vulvar and vaginal intraepithelial neoplasia. The aim of this study was to assess parts of the burden of the last diseases including treatment costs. The direct medical resource use and cost of surgery associated with neoplasia and related diagnostic procedures (statutory health insurance perspective) were estimated, as were the indirect costs (productivity losses) associated with surgical treatment and related gynaecology visits for diagnostic purposes., Methods: Data from 1991-2008 were retrospectively collected from patient records of the outpatient unit of the Gynaecological Dysplasia Clinic, Heinrich Heine University, Dusseldorf, Germany. Two subgroups of patients were analysed descriptively: women undergoing one surgical procedure related to a diagnosis of vulvar and/or vaginal intraepithelial neoplasia, and women undergoing two or more surgical procedures. Target measures were per-capita medical resource consumption, direct medical cost and indirect cost., Results: Of the 94 women analysed, 52 underwent one surgical intervention and 42 two or more interventions (mean of 3.0 interventions during the total period of analysis). Patients undergoing one surgical intervention accrued €881 in direct costs and €682 in indirect costs; patients undergoing more than one intervention accrued €2,605 in direct costs and €2,432 in indirect costs., Conclusions: The economic burden on German statutory health insurance funds and society induced by surgical interventions and related diagnostic procedures for grade 2/3 vulvar and vaginal neoplasia should not be underrated. The cost burden is one part of the overall burden attributable to human papillomavirus infections.