Objectives: Placebo effects can relieve acute and chronic pain in both research and clinical treatments by learning mechanisms. However, the application of placebo-based treatment strategies in routine medical care is questioned. The current study investigated the opinions of patients with fibromyalgia and healthy controls regarding learning of placebo effects and their practical applications. Method: An online survey asked 158 age- and sex-matched adult patients and controls (79 per group) to rate the perceived influence of various placebo learning mechanisms on pain relief, and the acceptability and perceived effectiveness of placebo-based strategies (open-label, closed-label, dose-extending, and treatment-enhancing strategies). Respondents' knowledge about placebo effects was obtained through a 7-item quiz. Results: The groups did not differ in the perceived influence of placebo learning mechanisms on pain relief (p = 0.217). Controls considered closed-label and treatment-enhancing strategies more acceptable than patients (p = 0.003 and p < 0.001), whereas controls perceived all strategies more effective. In both groups, closed-label strategies were significantly less acceptable than any other strategy (p-values < 0.001), and treatment-enhancing or dose-extending strategies were most acceptable. Higher acceptability was predicted by higher perceived effectiveness ratings (p < 0.001). Also, increased placebo knowledge was related to higher acceptability (p = 0.03) and perceived effectiveness (p < 0.001). Discussion: This survey suggests that both the medical history of patients and knowledge about placebo effects affect the acceptability and perceived effectiveness of placebo-based strategies. Furthermore, strategies that are transparent, assumed effective, or combined with existing medical treatments are deemed most acceptable. Keeping these factors in mind is essential for the clinical implementation of placebo-based strategies in routine medical care.

Rapidly attending towards potentially harmful stimuli to prevent possible damage to the body is a critical component of adaptive behavior. Research suggests that individuals display an attentional bias, i.e., preferential allocation of attention, for consciously perceived bodily sensations that signal potential threat, like itch or pain. Evidence is not yet clear whether an attentional bias also exists for stimuli that have been presented for such a short duration that they do not enter the stream of consciousness. This study investigated whether a preconscious attentional bias towards itch-related pictures exists in 127 healthy participants and whether this can be influenced by priming with mild itch-related stimuli compared to control stimuli. Mild itch was induced with von Frey monofilaments and scratching sounds, while control stimuli where of matched modalities but neutral. Attentional bias was measured with a subliminal pictorial dot-probe task. Moreover, we investigated how attentional inhibition of irrelevant information and the ability to switch between different tasks, i.e., cognitive flexibility, contribute to the emergence of an attentional bias. Attentional inhibition was measured with a Flanker paradigm and cognitive flexibility was measured with a cued-switching paradigm. Contrary to our expectations, results showed that participants attention was not biased towards the itch-related pictures, in facts, attention was significantly drawn towards the neutral pictures. In addition, no effect of the itch-related priming was observed. Finally, this effect was not influenced by participants' attentional inhibition and cognitive flexibility. Therefore, we have no evidence for a preconscious attentional bias towards itch stimuli. The role of preconscious attentional bias in patients with chronic itch should be investigated in future studies.

Research and design activities are important focus points in international policies for secondary Science, Technology, Engineering and Mathematics (STEM) education. It is up to school teachers to implement and supervise these activities in the STEM classroom. However, not much is known about the attitudes teachers hold towards supervising research projects or design projects. In this study, a questionnaire to measure teacher attitudes towards supervising research activities and design activities in secondary school was completed by 130 Dutch teachers who taught the relatively new Dutch STEM subjects O&O (research and design) and NLT (nature, life, and technology). These integrated STEM subjects are project and context based and are taught in a limited number of schools. Important differences between these integrated STEM subjects are their student and teacher populations: NLT is taught in grades 10–12 by teachers with a qualification in a science subject, while O&O is taught in grades 7–12 and can be given by any teacher in secondary school. The results showed that on average, both O&O and NLT teachers had high self-efficacy scores on supervising research and design projects even when they had received no special education in doing so. Furthermore, the teachers in general viewed supervising research projects as a more relevant activity than supervising design. Since research and design activities are becoming more important in (inter)national curriculum standards, STEM teacher education and subsequent professional development should not only familiarize teachers with supervising research projects, but with design projects as well.

Research and design activities are often employed in STEM (Science, Technology, Engineering & Mathematics) education. This study aims to examine students’ attitudes towards doing research and design activities in secondary school, among two groups of students: (1) students that take the quite recently introduced Dutch subject O&O (research & design), in which students perform authentic research and design projects related to STEM disciplines; and (2) students that do not take O&O. The subject O&O is only taught at a limited number of certified, so called ‘Technasium’, schools. A questionnaire, developed by the authors, was completed by 1625 students from Grades 8 and 11. Unlike previous studies on student attitudes, which usually use abstract concepts like ‘science’ or ‘technology’, the questionnaire used in this study contains active verbs to characterise research and design activities. The results showed that, in general, students who took the subject O&O had more positive attitudes towards doing research and design activities than regular students. Both student groups appeared to find doing design activities more enjoyable than doing research activities. The results of this study provide useful information for teachers as well as teacher educators about the existing attitudes of students, for example their preference for design projects over research projects.