Detailed Risk Information Research Articles

A multi-dimensional framework for improving flood risk assessment: Application in the Han River Basin, China

Study regionThe Han River Basin, China Study focusAs the water source of the Middle Route Project of the South to North Water Transfer Project, water security in the Han River Basin deeply impacts national water resource allocation. This study constructed a Multi-Dimensional Flood Risk Assessment (MDFRA) framework combining a comprehensive index system, an integrated weight method, and a clustering algorithm to assess flood risk in the Han River Basin. We first constructed a comprehensive index system including eight hazard indexes, four exposure indexes, and eight vulnerability indexes in demographic, economic, ecological, and infrastructural categories to assess flood risk. The index weights were determined by the integrated weight method, which integrated the Shapley value and the Analytic Hierarchy Process method (SAHP). Finally, the possibilistic fuzzy C-means algorithm was employed to identify flood risk levels. New hydrological insights for the regionThe MDFRA framework presents flood risk in the Han River Basin realistically and comprehensively, revealing flood risk composition and providing more detailed risk information. Results show that high-risk regions accounted for 34.51% of the basin area and were mainly concentrated in the mid-lower reaches, while middle-risk (19.13%) and middle-high-risk (23.35%) regions were mainly distributed in the upstream. 4.52%, 5.12%, and 13.37% of the basin area were assigned as very-low, low, and middle-low risk regions respectively, and were mainly adjacent to the Danjiangkou reservoir. Flood-prone natural conditions and dense population and assets were the causes of high flood risk, while reservoir regulation and storage capacity had significantly alleviated flood risk.

Situated Food Safety Risk and the Influence of Social Norms.

Previous studies of risk behavior observed weak or inconsistent relationships between risk perception and risk-taking. One aspect that has often been neglected in such studies is the situational context in which risk behavior is embedded: Even though a person may perceive a behavior as risky, the social norms governing the situation may work as a counteracting force, overriding the influence of risk perception. Three food context studies are reported. In Study 1 (N = 200), we assess how norm strength varies across different social situations, relate the variation in norm strength to the social characteristics of the situation, and identify situations with consistently low and high levels of pressure to comply with the social norm. In Study 2 (N = 502), we investigate how willingness to accept 15 different foods that vary in terms of objective risk relates to perceived risk in situations with low and high pressure to comply with a social norm. In Study 3 (N = 1,200), we test how risk-taking is jointly influenced by the perceived risk associated with the products and the social norms governing the situations in which the products are served. The results indicate that the effects of risk perception and social norm are additive, influencing risk-taking simultaneously but as counteracting forces. Social norm had a slightly stronger absolute effect, leading to a net effect of increased risk-taking. The relationships were stable over different social situations and food safety risks and did not disappear when detailed risk information was presented.

Decision aids for second-line palliative chemotherapy: a randomised phase II multicentre trial

BackgroundThere is increasing recognition of the delicate balance between the modest benefits of palliative chemotherapy and the burden of treatment. Decision aids (DAs) can potentially help patients with advanced cancer with these difficult treatment decisions, but providing detailed information could have an adverse impact on patients' well-being. The objective of this randomised phase II study was to evaluate the safety and efficacy of DAs for patients with advanced cancer considering second-line chemotherapy.MethodsPatients with advanced breast or colorectal cancer considering second-line treatment were randomly assigned to usual care (control group) or usual care plus a DA (intervention group) in a 1:2 ratio. A nurse offered a DA with information on adverse events, tumour response and survival. Outcome measures included patient-reported well-being (primary outcome: anxiety) and quality of the decision-making process and the resulting choice.ResultsOf 128 patients randomised, 45 were assigned to the control group and 83 to the intervention group. Median age was 62 years (range 32-81), 63% were female, and 73% had colorectal cancer. The large majority of patients preferred treatment with chemotherapy (87%) and subsequently commenced treatment with chemotherapy (86%). No adverse impact on patients' well-being was found and nurses reported that consultations in which the DAs were offered went well. Being offered the DA was associated with stronger treatment preferences (3.0 vs. 2.5; p=0.030) and increased subjective knowledge (6.7 vs. 6.3; p=0.022). Objective knowledge, risk perception and perceived involvement were comparable between the groups.ConclusionsDAs containing detailed risk information on second-line palliative treatment could be delivered to patients with advanced cancer without having an adverse impact on patient well-being. Surprisingly, the DAs only marginally improved the quality of the decision-making process. The effectiveness of DAs for palliative treatment decisions needs further exploration.Trial registrationNetherlands Trial Registry (NTR): NTR1113 (registered on 2 November 2007)

Complications of epilepsy surgery in Sweden 1996-2010: a prospective, population-based study.

Detailed risk information is essential for presurgical patient counseling and surgical quality assessments in epilepsy surgery. This study was conducted to investigate major and minor complications related to epilepsy surgery in a large, prospective series. The Swedish National Epilepsy Surgery Register provides extensive population-based data on all patients who were surgically treated in Sweden since 1990. The authors have analyzed complication data for therapeutic epilepsy surgery procedures performed between 1996 and 2010. Complications are classified as major (affecting daily life and lasting longer than 3 months) or minor (resolving within 3 months). A total of 865 therapeutic epilepsy surgery procedures were performed between 1996 and 2010, of which 158 were reoperations. There were no postoperative deaths. Major complications occurred in 26 procedures (3%), and minor complications in 65 (7.5%). In temporal lobe resections (n = 523), there were 15 major (2.9%) and 41 minor complications (7.8%); in extratemporal resections (n = 275) there were 9 major (3.3%) and 22 minor complications (8%); and in nonresective procedures (n = 67) there were 2 major (3%) and 2 minor complications (3%). The risk for any complication increased significantly with age (OR 1.26 per 10-year interval, 95% CI 1.09-1.45). Compared with previously published results from the same register, there is a trend toward lower complication rates, especially in patients older than 50 years. This is the largest reported prospective series of complication data in epilepsy surgery. The complication rates comply well with published results from larger single centers, confirming that epilepsy surgery performed in the 6 Swedish centers is safe. Patient age should be taken into account when counseling patients before surgery.

Randomised controlled trial of the effect of standard and detailed risk disclosure prior to bronchoscopy on peri-procedure anxiety and satisfaction

Background:Deciding what risks to disclose before a procedure is often challenging for clinicians. Consecutive patients undergoing elective fibreoptic bronchoscopy were randomised to receive simple or more detailed written information about...

Impact of risk information in a patient education leaflet

Informed consent requires the communication of information about possible adverse effects of treatment. Health professionals have expressed concern that increased provision of risk information may make patients unduly anxious and change their decisions about treatment. This study compared two patient leaflets about laparoscopy, one containing detailed information about potential side effects. Forty one consenting participants attending an outpatient gynaecology clinic and scheduled for an elective laparoscopic procedure were studied. They were randomly assigned to receive one of two leaflets after their consultation. Knowledge about laparoscopy, satisfaction with information provided, and anxiety were tested 2 days later, between the original consultation and their operation. Results showed that the leaflet containing detailed risk information was associated with greater knowledge about laparoscopy, higher satisfaction with information provision and no increase in anxiety. Provision of detailed information about possible adverse consequences of treatment can improve patients’ understanding and satisfaction without inducing increased anxiety.

Risk Information for Public Consumption: Print Media Coverage of Two Risky Situations

This study examines (1) the extent to which newspaper and magazine coverage of two risky situations included the kinds of cognitive information about risks that would help readers make risk judgments and (2) the extent to which the scientific sophistication of the audience would influence such inclusion. The two situations were a nuclear power plant accident that released a small amount of radioactive steam into the atmosphere and a report in the New England Journal of Medicine about a potential relationship between coffee consumption and pancreatic cancer. Stories about each topic in trade magazines, popular science magazines, general magazines, and both prestige and more typical daily newspapers were examined to determine the nature and extent of risk information included. The analysis found more detailed risk information in these stories than has been found in past studies, but it also suggested that sophistication of audience was not a good predictor of the presence/absence of such information. The most pronounced differences in communication strategies were found instead between topics, not across types of media. Closer examination of individual stories suggests that the variance may be attributable to differences in the way stories about the two incidents were framed by journalists.