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Dom D'Silva - Reflective Journal #21

Open ddsi7192 opened 2 years ago

ddsi7192 commented 2 years ago

Hi guys! I'm in first year studying a Bachelor of Psychology and minoring in Neuroscience. I'm interested to learn about learning and am excited to see how our project can help public knowledge of science.

yaelago commented 2 years ago

Welcome @ddsi7192! Looking forward to working together :)

SerriMat commented 2 years ago

Psychology is a great course! Excited to work with everyone :)

kym834 commented 2 years ago

Welcome @ddsi7192! Psychology, neuroscience and learning - I think you'll really enjoy this project :) You might also really like this course Learning How To Learn. Pretty relevant to this project too!

polekim commented 2 years ago

Hi @ddsi7192, really excited to work with you. I love neuroscience as well :)

ddsi7192 commented 2 years ago

Task 1

Medicine 1: Dexamethasone Challenge 1: News Flash I used one of the resources provided by the survey to research dexamethasone, and also looked into some articles on Google myself. I did not know much about the drug before, so it was interesting to learn more about it what it was previously known and used for, and how it is now expanding its use to help treat COVID-19. I found that the infographic was useful in clarifying the steps required for this challenge and in highlighting my aim, so I had an idea of my objectives while reading the articles. While reading about the trial and its results, I wondered whether that was sufficient evidence for the drug to be as widely used as it had become. I thought the infographic didn't quite match what I had in mind for an infographic as it had lots of text, but the text was informative and useful in completing the challenge. This challenge expanded my awareness and understanding of the treatments for COVID-19. Challenge 2: Price Hike For this challenge, I was required to research about the potential price increases regarding dexamethasone. I found it difficult to find resources that were reputable (for example, with the .org or .edu or .gov URL endings), so instead tried to view multiple resources and look for overlapping information. It was also a little difficult to find solid prices for before and after the price hike, as well as identifying a single month that the price hiked, and of the resources where that information was listed, I was unsure if it was reliable. As I don't think about these topics often, I found it interesting to learn about the ways society and politics (as well as a world health crisis) could influence price hikes and the potential impacts of shortages of this drug. The infographic was useful in providing background, as in Challenge 1, but some of the research tips overlapped with the instructions/tips on the redcap survey, which already provided a step by step process of how to research. While it might be worth removing the overlapping information from the infographic, I think a lot of the background information on the infographic for this challenge and the news flash challenge was useful despite also overlapping with the information on the survey and E$$ENTIAL MEDICINE$ website. Challenge 3: Circle of Life For this challenge, I had to look into the history of dexamethasone and how the companies who own it have changed over the years. I found this challenge to be the most difficult as there was little information online that clearly laid out all the changes, so there was a lot of trying to connect dots on a timeline myself. The infographic did provide a couple of resources, but unfortunately, those websites did not have information about the history of dexamethasone. However, I think that makes every bit of research that this survey collects more useful, if we can collate and make sense of the different parts of the timeline found by participants.

ddsi7192 commented 2 years ago

Medicine 2: Insulin Challenge 1: News Flash I researched the price hike in insulin which has been occurring for a few decades, especially within the USA. It was quite shocking to see how much prices had risen over a 30 year period, from the '90s to now, especially in considering that individuals who require insulin would need it the rest of their lifetime. In the researching process, many different sources had varying statistics regarding specific prices (i.e. varying units, varying brands, currencies etc.), so I took the statistic from the source I regarded as most reliable. I read a report about insulin prices which stated that insulin was largely inaffordable for low income individuals. This makes me question why insulin prices are rising, and why individuals with diabetes should be required to give so much for an otherwise relatively accessible drug. I further considered this when I discovered the irony that the scientists who discovered insulin sold the patent to the University of Toronto for $1 as they wanted those who needed it to be able to afford it. Some sources also questioned the availability of the drug - this may just be speculation as a reason for why the drug is constantly increasing in price. I think I might be able to further research these points in the next challenge.
Challenge 2: Price Hike For this challenge, I researched more into the reasons for the price hike in insulin. I found that the price of insulin in the USA was dramatically higher than in other developed countries, with a variety of reasons, one of which relates to the fact that individuals would be willing to pay higher amounts to save their/their loved ones' lives. There are only a handful of companies which produce most insulin products within the US, so they have great control over the market. While there have been some proposals to lower the cost of insulin, they have been unsuccessful, meaning many individuals are and will continue to be affected financially and emotionally by the price hike. Some individuals may even travel to other countries in order to purchase insulin at a cheaper cost. This was interesting to research, and still made me question whether increasing the price was/is necessary, as it seems that perhaps companies and the supply chain may be taking advantage of people's desperation? In terms of researching this, I found a few good resources that laid out some reasons and potential solutions to this issue:

Challenge 3: Circle of Life For this challenge, I looked into the history of insulin and how the company Novo Nordisk Inc came to manufacture insulin. There was lots of information about the history of Novo Nordisk on their website which was useful in my completion of this challenge. The company founder has had ties to the first inventors of insulin and gained permission from them to produce insulin in the Nordic countries. As the inventors wanted to make insulin something that was affordable to those who needed it, it made me question what Novo Nordisk prices for insulin products are like now and whether they can be deemed affordable. For this challenge, and the previous two, I did not refer to the infographic that much as I was more familiar with how the challenges work. These challenges have enabled me to discover a lot more about insulin and accessibility issues that I didn't know existed.

ddsi7192 commented 2 years ago

Medicine 3: Diazepam Challenge 1: News Flash I investigated the shortage of diazepam in the United States that resulted from the COVID-19 pandemic. I was surprised to find that it was one of 67 acute drugs that were in a short supply as well as 18 drugs of 40 that are critical for treating COVID-19. I was not familiar with the use of diazepam and was surprised that the pandemic could impact the supply of other drugs that were not necessarily in increased demand during that time. However, I also thought there may have been an increased demand for diazepam as it provides short term relief from anxiety symptoms, which may have been useful for people dealing with harsh lockdowns and other stresses from the pandemic. The article I read went on to say that drug shortages in the US are not new and that there hasn't been much improvement in the issue since 2001. I am curious why/how a developed country such as the US can continue to have drug shortages as I would have expected that individuals in the US would have some of the best accessibility to drugs? Especially if a pandemic is not to blame... I also wonder what kinds of solutions could be implemented to prevent drug shortages, not only in the US but in other countries. For the next challenge, I am curious to see whether the drug shortage increased prices of the drug or not. Challenge 2: Price Hike I found that there was a price increase in diazepam over the pandemic period in 2020. I found this very difficult to research as only a few resources had reported an increase which was most prevalent in Lithuania, Denmark, New Zealand, Canada and the UAE. There was very little specific information about the specific prices that they rose from/to. Of the few resources that stated an increase in price, the reliability was questionable as they didn't seem to be super reputable. This lead me to believe that the price increase may not have had a great impact/been noticed by consumers. The greatest increase was of 137% in Lithuania. However, as the drug is relatively cheap to begin with, the price hike may not have had a huge impact on consumers. There was also not much information about the reasons for this price hike, so I mostly attributed it to the potential shortage / a potential increased demand for the drug during that period. In hindsight, I am unsure of whether such a small price increase would be useful? Challenge 3: Circle of Life I researched the diazepam manufacturing company Neurelis Inc. which had come out recently with a diazepam nasal spray (in 2020). I discovered a bit more about how legalities work around acquiring companies and then being able to use their technologies as Neurelis acquired a company and then was able to include one of their technologies in the final nasal spray formula. This was difficult to research, but for this challenge, I've found that the company websites tend to have a bit of information about their history, including merging, acquisitions and sometimes the products they've come out with. This has been useful for the past 2 times I did this challenge as well.

ddsi7192 commented 2 years ago

Medicine 4: Testosterone Challenge 1: News Flash I found an article linking a few studies that had shown that increased testosterone levels did not increase athletic performance in women, despite common perceptions that it does. Together, the studies showed that while increased testosterone (compared with training aimed at maximising muscle growth) may increase muscle mass in young women, it did not improve muscle strength, muscle power, explosive power (sprinting) or oxygen consumption during exercise. I found this super interesting as the treatment group (given testosterone) did build more muscle than the control group (not given testosterone), but there were no between group differences in athletic performance. For the survey, I listed this as a side effect, but it may be more accurate to say it was an absence of an effect? I then wondered how common testosterone-taking is amongst athletes and whether this information would influence how female athletes go about their training.

Challenge 2: Price Hike For this challenge, I could not find any evidence of a price increase or, just any price change at all. I then tried to research the general cost of testosterone and found injections could be as cheap as $20 USD per month or as expensive as $400 USD per month, depending on location, frequency, dosage etc. In the newsflash challenge, I had not considered other reasons for a need for testosterone, such as testosterone deficiency or transgender transitioning. This was interesting to look into. Challenge 3: Circle of Life I found researching the history of testosterone a little difficult as there was quite a bit of information about how it was discovered, and its development from a medical stance, but not as much information about companies who manufactured it. I found that three big pharmaceutical companies were interested in it, but it was ambiguous as to which was 'first'. I also realised for this challenge and for the previous Circle of Life challenges that I was unsure whether the 'first owner' referred to the scientist/s who first synthesised/discovered it, or the first company that manufactured it - I had been trying to find the first company/corporation. In terms of the infographic, I also thought perhaps it might be useful if it contained the flowchart that is in the survey, for convenience? Similarly to the challenges for previous medicines, I once again ran into some reliability issues - only a handful of resources contained information that matched what I was searching for, but those resources may not be reputable. In general, I've found that I haven't been needing to refer to the infographic since I finished the challenge for my first medicine. It mainly provided an extra layer of information to clarify everything, but after using it once, and understanding how the surveys work, it was of little use after that. I'm unsure of whether there could be any ways to sustain its use, or whether its 'one-time' (in a sense) use is okay?

ddsi7192 commented 2 years ago

Medicine 5: Carbetocin Challenge 1: News Flash I found information about carbetocin (LV-101) having passed phase 3 of a clinical trial, to treat symptoms of Prader-Willi Syndrom (PWS). I had never heard of PWS before, so it was interesting to learn about the disease and how the drug was aimed at relieving symptoms of oxytocin deficiency associated with PWS. This would include treating excessive bleeding in women after giving birth via Caesarian section. I felt glad that after decades of research into oxytocin deficiency, the drug yielded beneficial results. Challenge 2: Price Hike In this challenge, while I did not find any price hike or price changes regarding carbetocin, I found out that carbetocin is several times more expensive than oxytocin. This made me wonder what is perhaps better about carbetocin compared with oxytocin that would be worth paying so much for? One report said that oxytocin requires cold storage and transport which is difficult to maintain in low-resource settings (perhaps including low socio-economic locations). However if the carbetocin is more suitable to be transported to areas where cold storage and transport is hard to come by, then wouldn't those places also find it difficult to purchase it? However, the report (from 2019) also stated that carbetocin was being registered in 90 low/middle income countries to improve accessibility. I hope more moves like this could be made.

Challenge 3: Circle of Life This part of research was challenging for me as carbetocin has been approved in some countries but not in others. It seems that the study I found in the News Flash challenge was relating to its approval in the US, where it is undergoing clinical testing. It was also challenging to find the 'first owner'. As the excel spreadsheet listing the current owners, FDA approval date, etc. did not list that information relating to carbetocin (because it is still being approved), I assumed the information I research regarding company changes and whatnot should be in relation to availability in the US. However, I could not find any companies in the US manufacturing it, I assume, because it hasn't yet been approved. I did find a list of pharmaceutical companies, from the countries that have approved it, that do manufacture it, as listed below. Overall, this time round, this challenge was a little mind-boggling for me to research, and I felt a little empty handed going through the survey. https://www.drugs.com/international/carbetocin.html

carolineson commented 2 years ago

Hey Dom!

I really enjoyed reading through your journal and getting a look into your learning process and approach to our Task 1. I initially found myself actually opening up the Dropbox link to take a look at the infographic as I realised that I still didn't know what the resources contained (in order to leave my results unbiased!). Only after did I realise that it was basically (as you stated) a reiteration of the tips and tricks from the RedCap survey site in a more succinct and visually appealing format. While I totally agree that it would get a little tedious to re-read before every medicine (I'm not even sure if that is what is necessary), but it does seem like a very helpful tool at least in the beginning to get a better sense of what the challenges really are and how to approach them. I personally found myself very confused at first as I had no additional resource, and really only felt like I was picking up a groove after my second medication. I do also feel like it could appeal to different people with different learning styles as I appreciated how the infographic gave you an overview of the entire task before you even started. I wonder if it affected our understanding and objectives going into the project, and therefore if it affected any of my results.

I also found it really interesting to see how differently we approached medications, even when they were identical! I really appreciated how you walked us through each step of your process, even including slightly tangential queries and even links to the extra research you did! I definitely related to this as I felt myself feeling just as curious about these mostly new topics, and how it sparked curiosity about other related ideas. I think that hearing your own thoughts and opinions throughout your journal also made me more interested about the medicines, as it gave emotion and character and made me want to follow you on your journey to find out more! I'm really glad I got to read through your journal because I was able to learn so much about medicines that we didn't have in common.

Overall, I totally felt like I related to your thinking and process, including the frustration of being unable to find reliable information—or sometimes even any information at all! I'm excited to hear more about your process on Friday!

ddsi7192 commented 2 years ago

Literature Review of Learning Processes

Chandler, P & Sweller, J. (1992). The split-attention effect as a factor in the design of instruction. British Journal of Educational Psychology, 62(2), 233-246. https://doi.org/10.1111/j.2044-8279.1992.tb01017.x http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.455.1518&rep=rep1&type=pdf

This paper investigated the cognitive load theory (which generally states that extraneous cognitive activities can negatively impact learning) and the split attention effect (an aspect of cognitive load theory, whereby splitting attention between separate sources of information and having to mentally integrate the information was predicted to more negatively impact learning than if the source was physically integrated to begin with). The study consisted of two experiments. The first compared the learning transfer of two groups - one was given a resource with the diagrams and text separated, while the other group's resource had the diagrams and text integrated. The group withe the integrated resource achieved greater performance outcomes. This lead to the second experiment which investigated whether this split attention effect was still true for separate textual information (in the previous experiment, attention would have been split between textual and visual information). Similar to the first experiment, this involved one group being given a resource where text was structured in sections, while the other used physically integrated sets of mutually referring text. The learners who utilised the integrated resource once again outperformed the other group.

While not explicitly referring to infographics, I thought this study would be useful in investigating how the design of infographics or other resources would assist learning. The study showed that, in general, physically integrated information was more effective than not physically integrated information resources. However, there is no comparison of the effectiveness on resources with integrated diagrams vs text with integrated textual resources. Perhaps this could be a place we could further research to assist us.

K. T. Lyra et al., "Infographics or Graphics+Text: Which Material is Best for Robust Learning?," 2016 IEEE 16th International Conference on Advanced Learning Technologies (ICALT), 2016, pp. 366-370, doi: 10.1109/ICALT.2016.83. https://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=7756999&casa_token=SuZqP4KAJLoAAAAA:KNi2ja6MUW8q1z-CKmIYbEpoibB_XzMnJ7qAn45hkhiW0tDlHJxUXYWTIBOfA1Gel6ZwZiR5CQ&tag=1

This paper reports the randomised controlled study to compare the learning and information retention and enjoyment of using an infographic vs graphics and text resource (where all illustrations and design elements were removed and visual information was transribed). Overall, they found insignificant variation between the learning effects. When comparing post-test results to the delayed post-test results (1 week after), there was evidence to suggest infographics maybe more useful in knowledge retention than the graphics and text. The self-assessment of pleasure was not affected by learning material, but for those who used the infographic resource, higher scores were correlated with higher pleasure.

This shows that the design element of infographics provides and enjoyment factor which may positively influence learning outcomes. However, this study did have a very small sample size. The paper did reference another study which found that infographics were more beneficial to learning than pure text resources. This could be something to further investigate.

I didn't get a chance to completely read this, but this paper analysed the views of those who used infographics for educational purposes: https://files.eric.ed.gov/fulltext/EJ1106376.pdf

These papers suggest that infographics may assist in motivation or engagement. I think, these, in turn, could influence learning, although I have yet to find papers/studies to back this up.

KevinS9714 commented 2 years ago

Hi Dom, I also did the challenges with the infographic! I found it interesting that the infographic we used didn't match up to your original expectations because there was too much text - I didn't really think about it when I was using it, but now in hindsight I agree with you as well! I also researched Insulin for one of my medicines, and found your research into the price hikes in the US to be quite insightful, and how the prices for insulin in the US were significantly higher than in other developed countries. This is something that I neglected to look into, and found it particularly interesting (and also saddening) that some travel to other countries for a lower cost.