Risk Information Research Articles

Developing the Recovery Gap Index: A Comprehensive Tool for Assessing National Disaster Recovery Capacities

The increasing frequency and severity of extreme natural events, along with their escalating impacts, highlight the urgent need for robust tools to assess and strengthen national capacities for disaster preparedness and recovery. In this context, this paper introduces one of these tools, called the Recovery Gap Index (RGI), a comprehensive composite index designed to quantify and evaluate the post-extreme natural event response and recovery capabilities at the country level. The tool addresses the need for a systematic approach to quantify resilience and evaluate the impacts of consecutive events on vulnerable areas. The RGI synthesizes data from three well-established indices: the World Risk Index, INFORM, and Global Infrastructure Risk Model and Index (GIRI), covering critical dimensions related to sociodemographic factors, infrastructure, governance, technology, and economic resilience. By extracting key parameters from these diverse indices and aggregating them, the RGI provides a detailed assessment of each nation’s ability to manage the aftermath of extreme natural events. The index findings reveal significant regional disparities in recovery capacities, with European countries exhibiting stronger resilience, whereas many African and Asian nations face substantial challenges. Furthermore, this study proposes several potential future enhancements, such as the incorporation of early warning systems and insurance coverage metrics, aimed at improving its accuracy and practical application. The RGI aims to be a valuable tool for policymakers, disaster management professionals, and stakeholders, enabling them to make informed decisions and implement targeted interventions to further enhance global disaster resilience.

Enterprise Risk Management and IT Resources impact on Sustainable Competitive Advantage through mediating role of Knowledge Management Capability

Purpose – This study seeks to determine impact of enterprise risk management (ERM) and information technology resources (ITR) on sustainable competitive advantage (SCA) through mediating role of knowledge management capability (KMC). Methodology – An investigation based on empirical research was carried out on 183 software companies in Lahore, Rawalpindi, Islamabad and Karachi, Pakistan. A self-administered survey was conducted to obtain the data from software companies. The study employed stratified random sampling for participant selection and data were analyzed through partial least squares structural equation modelling (PLS-SEM). Findings – Results revealed ERM and KMC significantly contribute to SCA. However, ITR did not directly impact SCA, yet it showed an important mediated effect on SCA through KMC. Also, KMC mediates relationship between ERM and SCA. Implications – The outcomes of this study contribute to resource based view (RBV) theory by demonstrating that ERM, ITR and KMC play pivotal roles in achieving SCA within the IT industry. Policymakers and industry leaders are encouraged to support these areas to help companies anticipate risks, optimize resources and thrive in global markets. Limitations – This study focused exclusively on private software companies located in four cities (Islamabad, Rawalpindi, Lahore and Karachi) within Pakistan. Additionally, the cross-sectional, survey-based methodology captured data only at a single point in time. Originality – The novelty of this article lies in fact that it addresses the gap in existing research through exploring effect of ERM and ITR on SCA through mediating role of KMC in Pakistani private software companies.

Returning genetic risk information for hereditary cancers to participants in a population-based cohort study in Japan.

Large-scale population cohort studies that collect genomic information are tasked with returning an assessment of genetic risk for hereditary cancers to participants. While several studies have applied to return identified genetic risks to participants, comprehensive surveys of participants' understanding, feelings, and behaviors toward cancer risk remain to be conducted. Here, we report our experience and surveys of returning genetic risks to 100 carriers of pathogenic variants for hereditary cancers identified through whole genome sequencing of 50 000 individuals from the Tohoku Medical Megabank project, a population cohort study. The participants werecarriers of pathogenic variants associated with either hereditary breast and ovarian cancer (n = 79, median age=41) or Lynch syndrome (n = 21, median age=62). Of these, 28% and 38% had a history of cancer, respectively. We provided information on cancer risk, heritability, and clinical actionability to the participants in person. The comprehension assessment revealed that the information was better understood by younger (under 60 years) females than by older males. Scores on the cancer worry scale were positively related to cancer experiences and general psychological distress. Seventy-one participants were followed up at Tohoku University Hospital; six females underwent risk-reducing surgery triggered by study participation and three were newly diagnosed with cancer during surveillance. Among first-degree relatives of hereditary breast and ovarian cancer carriers, participants most commonly shared the information with daughters. This study showed the benefits of returning genetic risks to the general population and will provide insights into returning genetic risks to asymptomatic pathogenic variant carriers in both clinical and research settings.

Framing, Filtering and Fixing: The Ethics of Risk Communication

ABSTRACTThere are many puzzles about whether and how to communicate risk information, particularly in public health and medical settings. This paper does three things. First, it suggests a model for whether and how to communicate risk which balances concerns about autonomy and concerns about beneficence. Second, it argues that in the case of risk communication, there are also difficult questions, stemming from the reference class problem, about what risks to communicate. Third, it uses the Justified Misalignments framework developed in the first part of the paper to address these puzzles.

Patient Experiences of Receiving Stroke Discharge Information in Accordance With Preferences.

To examine survivors' experiences of discharge information including risk communication after hospitalisation for a stroke and the characteristics associated with receiving information in accordance with their preferences. With advances in acute stroke care and an ageing population, the number of survivors of stroke is increasing. It is important that healthcare providers ensure patients have adequate information after a stroke-related hospitalisation. Cross-sectional study. Adults recently discharged after a stroke from eight Australian hospitals were mailed a survey. Items examined risk and discharge care information, with participants asked to indicate both their preferences for and receipt of the information. Concordance with preferences was calculated, and characteristics associated with information preference concordance were assessed with binomial logistic regression. Study reported in accordance with STROBE Checklist. Of 1161 eligible patients invited, 403 (35%) completed the survey. All items were endorsed by 80% or more of respondents as being wanted. However, for all items, fewer respondents reported the care as received. Only 28% of participants received information on all five items according to their preferences. Hospital site, Body Mass Index and age were statistically significantly associated with participants receiving information in accordance with their preferences. Most participants indicated a preference to receive recommended discharge information. Findings suggest that patients may benefit from increased information provision prior to hospital discharge after stroke. Nurses have an important role in the provision of stroke care and information. The findings of this study may be used to improve the provision of post-hospital discharge care and support for survivors of stroke, and assist in identifying patients at lower odds of experiencing information aligned with their preferences and who may benefit from support. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. No patient or public contribution.

Comparison of Associations of Food Security Instruments and Mediators With Premature All-Cause and Cardiovascular Disease Death in US Adults.

Food insecurity is associated with high morbidity and mortality and is typically measured with the 10-item US Adult Food Security Survey Module. Shorter instruments may capture similar information, but this has not been validated against mortality in general populations. A nationally representative sample of individuals aged 20 to 74 years from the US National Health Interview Survey 2011 to 2018 was included, with deaths linked to the National Death Index through 2019. Cardiovascular disease deaths were ascertained by International Classification of Diseases-Tenth Revision codes for heart disease or stroke. Standard 10-, 6-, and 2-item food security instruments were compared for associations with premature all-cause and cardiovascular disease deaths occurring before age 75 years using Cox regression adjusted for demographics and social determinants of health and C statistics. Findings were replicated in the National Health and Nutrition Examination Survey 2004 to 2018, and differences were explored using mediation analysis. We included 218 136 National Health Interview Survey participants (mean age, 45.3 years; 50.8% women). Over a mean 5.0-year follow-up, 7025 premature deaths were observed (1711 from cardiovascular disease). In multivariable-adjusted models, hazard ratios (95% CIs) for all-cause death were similar among food security instruments (10-item, 1.22 [1.13, 1.32]; 6-item, 1.23 [1.13, 1.34]; and 2-item, 1.23 [1.14, 1.32]), and C statistics were identical (0.823). Hazard ratios (95% CIs) for cardiovascular disease deaths were also similar among food security instruments (10-item, 1.38 [1.17, 1.62]; 6-item, 1.27 [1.07, 1.51]; and 2-item, 1.41 [1.20, 1.66]), and C statistics ranged from 0.852 to 0.853. In the National Health and Nutrition Examination Survey replication (n=37 027, mean 7.8-year follow-up), associations were attenuated and became not statistically significant after adjustment for several cardiometabolic intermediates, particularly enrollment in food assistance programs, diabetes, low diet quality, inadequate or excessive sleep, and depression. A 2-item food security instrument captures similar mortality risk information compared with 10- and 6-item instruments. Furthermore, potential intermediate cardiometabolic factors may explain associations between food insecurity and mortality.

Exploring the Role of Communication Asset Mapping (CAM) as a Strategy to Promote Hereditary Cancer Risk Assessment Information Within African American Communities.

Objective: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, however, have inequitable access to hereditary cancer risk assessment (HCRA) tools and information, further exacerbating disparities in cancer rates. Innovative communication strategies to promote community-based HCRA information have promise as a means encouraging optimal primary cancer screening among AAs. The current pilot study followed a participatory process where researchers engaged with a Community Advisory Board (CAB) to explore how Communication Asset Mapping (CAM) could assist lay health advisors with the dissemination of evidence-based HC/RA information within AA faith communities. Methods: The research team and CAB conducted exploratory community-engaged group discussions with residents (n = 21) guided by Communication Infrastructure Theory, and used a community-engaged mapping process to inform the development of a CAM dissemination strategy. Results: Through textual analysis, the following conclusions were reached: (1) optimal locations (e.g., community centers) within specified neighborhood networks should have representatives who are trusted ambassadors to assist with HCRA information dissemination; (2) trusted community member voices should fully represent the neighborhood network in the community-engagement mapping process; (3) well-known and frequented geographic locations should provide a true representation of participants' neighborhoods to create a robust health information network concerning HCRA. Conclusions: Community residents appreciated the engagement process; however, they felt that its impact was limited due to the lack of community voices within their neighborhoods to identify important communication resources within the network for optimal HCRA information dissemination. CAM, therefore, is an important public health strategy for the identification of trusted networks and useful communication resources within these networks. The strategy was also helpful in pinpointing people who could be critical communicators of emerging health information akin to HCRA.

From Seeking to Sharing: Pathways of Environmental Risk Information on Social Media and the Roles of Outcome Expectations, Efficacy, and AI-Generated Content

This study explores the motivations driving Chinese consumers to share information about aquatic product safety risks related to radioactive wastewater discharge on social media, with a specific focus on the role of Artificial Intelligence Generated Content (AIGC) and prior information-seeking activities. The study examines key variables such as risk perception, outcome expectations, and the influence of AIGC literacy in shaping attitudes, social norms, and sharing efficacy. Data from 501 participants were analyzed using structural equation modeling. The findings indicate that risk evaluations and personal outcome expectations significantly motivate information sharing, while social expectations deter it. Additionally, AIGC literacy enhances both knowledge acquisition and sharing efficacy, while prior information seeking increases self-efficacy and risk perception, further fostering information sharing. These results provide critical insights into how environmental risk information is processed and disseminated on social media, emphasizing AIGC’s role in influencing this process.

The spillover effect of IPO technology risk information on stock price synchronization: Evidence from China

The spillover effect of IPO technology risk information on stock price synchronization: Evidence from China

Health effects of occupational exposure to jet fuels used in the military: A systematic review of the epidemiologic literature.

Jet fuels are a common chemical exposure in occupational settings involving aircraft. Jet fuels are heterogeneous mixtures of aromatic and aliphatic hydrocarbons, as well as non-hydrocarbon performance additives. Several components of jet fuels have been linked to adverse health outcomes. The "Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxins Act of 2022" required the U.S. Department of Veterans Affairs (VA) to develop a report to Congress on the health effects of jet fuels used in the military. This investigation assessed the epidemiologic evidence of the health effects associated with occupational exposure to jet fuels in military and non-military settings using robust and reproducible systematic review methods. Two scientific databases (PubMed and EBSCOhost), 17gray literature sources and five review articles were searched for relevant, primary epidemiologic studies through May, 2024. Risk of bias and strength of evidence were evaluated according to the U.S. Environmental Protection Agency's (EPA) Integrated Risk Information System (IRIS) assessment framework for systematic reviews and evidence synthesis. Twenty-eight studies met the inclusion criteria, including 18 studies in military settings and 10 studies in non-military occupational settings. It was determined that there was slight evidence of associations between jet fuel exposure and neurologic, cognitive and behavioral, respiratory, and cancer outcomes. For all other health outcome categories, the available evidence of jet fuels effect on humans was considered indeterminate. To our knowledge, this is the first systematic review of epidemiologic evidence on the health effects of occupational jet fuel exposure. Available data were sparse for multiple health outcomes, and most studies tended to be of lower quality. Future work will include expanding the scope of the review to integrate toxicological and mechanistic evidence.

Near Real-time Flood Risk Modelling in Response to Increasing Uncertainties in Flood Predictions

In the face of increasing uncertainties and the expected rise in flood events worldwide, this technical note presents an innovative approach for enhancing rapid response capabilities, exemplified during the Kakhovka Dam breach in Ukraine. Utilizing the Tygron Model, our methodology combines open-source data with high performance computing for swift hydrodynamic simulations—a departure from traditional flood risk management techniques. Central to this approach is the strategic use of social media to gather crowd-sourced feedback during the emergency, enhancing the precision and relevance of flood risk information. During the Kakhovka Dam event, our model processed extensive datasets, enabling effective predictions of flood impacts, including extents, velocities, depths, and arrival times. The near real-time modeling capability allowed for dynamic updates using social media inputs, which were of value for emergency responders to optimize response strategies for relief coordination. While the underlying technology is used for flood simulations, its application in emergency response is novel and promising for more adequate disaster response coordination. However, further research and applications are necessary to refine the approach that can ensure real-time flood risk information during a emergency situations.

Impact of polygeNic risk score for glaucoma on psycHosocial ouTcomes (INSiGHT) study protocol.

Glaucoma is the leading cause of irreversible blindness with early detection and intervention critical to slowing disease progression. However, half of those affected are undiagnosed. This is largely due to the early stages of disease being asymptomatic; current population-based screening measures being unsupported; and a lack of current efficient prediction models. Research investigating polygenic risk scores (PRS) for glaucoma have shown predictive ability to identify individuals at higher risk. Potential clinical applications include identification of high-risk individuals, resulting in earlier diagnosis and treatment to prevent glaucoma blindness, and adjusted monitoring for low-risk individuals. However, the psychological impact of receiving glaucoma PRS is unknown. There is a critical need to evaluate risk information communication and assess the impact of receiving results, to support clinical implementation of glaucoma PRS testing. In this prospective study, 300 individuals from the GRADE (Genetic Risk Assessment of Degenerative Eye disease) study will be recruited to investigate the psychosocial impact of disclosing polygenic risk results for glaucoma. GRADE aimed to apply PRS testing on 1,000 unexamined individuals aged 50 years or older from the general population and examine a subset of these individuals to assess the clinical validity of PRS to detect glaucoma. In this study, individuals each from the bottom decile (10%), top decile (10%), and middle (45-55%) of the PRS distributions will be invited to receive research glaucoma PRS results. Participants who choose to receive their results will complete up to four questionnaires (prior to receiving their results, and subsequently two-weeks, six- and 12-months after receiving their result). The questionnaires will include health belief model measures and assess glaucoma anxiety, general anxiety and depression, test-related distress, decisional regret, and recall and understanding of results. This research will provide guidance for the implementation of polygenic risk testing into clinical practice and inform delivery strategies.

Motivating conservation action in the Upper Midwest: Source attention, information seeking and sharing, and farmers' land management decisions

AbstractAdoption of on‐farm conservation strategies, such as edge‐of‐field practices, has the potential to reduce nutrient runoff, promote greater biodiversity, and improve water quality. To date, adoption rates among farmers are extremely low. Communication with farmers has been identified as a vital strategy to encourage the voluntary adoption of these practices and policies that promote on‐farm conservation. Yet little is known about which information sources shape farmers' concerns about conservation practices, perceptions of the risks and benefits of conservation practices, and ultimately, adoption behaviors. Using the Social Amplification of Risk Framework, the Risk Information Seeking and Processing Model, and a cross‐sectional survey, we examined farmers' concerns about nitrate loss and water quality, perceptions of the risks and benefits of conservation practices, attention to messages and information sources, and communication behaviors. We received N = 474 completed surveys. Attention to agricultural associations was associated with decreased concern about nitrates and diminished perceptions of the benefits of edge‐of‐field practices. Farmers paying greater attention to non‐agricultural and social media sources were more likely to share and seek information. Attention to interpersonal sources was associated with greater adoption behaviors. This work highlights the importance of farmers' social networks, exposure to multiple information sources, and the need to identify new strategies for engagement and direct communication with hard‐to‐reach audiences. We conclude with a discussion of the implications of this work for conservation communication and land management practices to promote environmental health.

Women's Experience of the Consent Process to Planned Caesarean Section and Its Surgical Risk: A Qualitative Study.

To explore how women appreciated the risks discussed within the consent process for planned caesarean section (CS). Exploratory qualitative interview study. NHS Teaching Hospital in Central London. Women over the age of 18, English speaking, scheduled for a planned CS. Semi-structured interviews were conducted before and after a woman's CS. Eighteen women were recruited and interviewed prior to undergoing CS and 12 of these were interviewed following CS. Interviews were audio-recorded, transcribed and thematically analysed. Themes generated from analysis of interviews exploring the experiences of women consenting to CS and specifically their awareness of postpartum haemorrhage (PPH), hysterectomy, organ damage and risk of placental abnormalities in future pregnancies. Two broad themes and four subthemes were identified (1) Untimely provision of risk information: (a) superficial risk discussions during the antenatal period and full risk disclosure on the day of surgery and (b) incompleteness absent or sparse risk disclosure prior to making the decision to undergo the CS, where women were unaware of specific risks and (2) Emotional overload: (a) fear of risks and (b) fear that a CS will be denied to them-women's cognitive response and notably their emotional response to their situation limited their understanding of risks disclosed. The consent process for planned CS was found to lack appropriate and full risk disclosure. Risk disclosure was ill-timed or deficient in facilitating women's understanding of risks reflecting a consent process which does not meet legal and professional standards of informed consent.

A measure of information value for risk.

Information is crucial for risk management; however, no quantified measure to evaluate risk information exists to date. The standard measure of value of factual information is information entropy-that is, the negative logarithm of probability. Despite its applications in various fields, this measure is insufficient for the evaluation of risk information; there are three reasons. First, it requires precise probabilities, which are generally absent in the context of risks. Second, it does not consider the effect of the consequences, which is essential for risks. Third, it does not account for human preferences and subjectivity. This study proposes a quantified measure for the evaluation of factual risk information-that is, observations of occurrence, particularly for binary, unambiguous, and rare phenomena. To develop such a measure, precise probabilities are replaced with updated probabilities, based on the Prospective Reference Theory. Additionally, utility is included as a proxy for the size of consequences. The third challenge-human preferences and subjectivity-is partly addressed by the application of updated perceived probabilities and utility as a measure of human preferences. Such a conventional, quantified measure facilitates the comparison of the potential impact of different messages for a new observation of occurrence for a risk, as well as of messages for different risks. Moreover, it clarifies the factors that systematically affect this impact. More particularly, it indicates the major effects of the perceived number of past occurrences.

Experiences of undergraduate students from portuguese-speaking countries during the COVID-19 pandemic

Objective: To explore experiences of Portuguese-speaking undergraduate students during the COVID-19 pandemic.Methods: This is a qualitative descriptive study carried out from August to December 2022 with 41 Portuguese-speaking undergraduate students. Virtual interviews were carried out with audio-record. The participant’s speeches were transcribed and processed in IRAMUTEQ and analyzed using the Descending Hierarchical Classification.Results: A total of 20,716 occurrences of words were observed, and six categories emerged: Media information and fear of risk of acquiring the disease; Negative effects of social isolation due to COVID-19; Reorganizing the routine during the pandemic period; Concerns about the shift from on-site teaching to online teaching; Impacts of the pandemic on future plans; Adaptation to changes and the new lifestyle to control COVID-19. The partipant’s speeches shown that COVID-19 pandemic has strongly affected the academic life of Portuguese-speaking undergraduate students with negative repercussions on mental well-being, adaptation to social isolation, difficulty in maintaining a productive routine, experiencing episodes of anxiety and concerns regarding online teaching, insecurity and anguish due to changes in future plans and a new lifestyle.Conclusions: Experiences of Portuguese-speaking undergraduate students during the COVID-19 pandemic has shown the impact of the emerging scenario in their mental health, life adaptation and academic routine. These results can subsidize the develop of strategies to promote mental health of undergraduate students, especially after COVID-19 pandemic, aiming at improving student’s quality of life and well-being, and equality in access to quality education.

Exploring the Relationship Between Ejection Fraction, Arterial Stiffness, NT-proBNP, and Hospitalization Risk in Heart Failure Patients.

Background/Objectives: Heart failure (HF) remains a leading cause of hospitalization and morbidity. Arterial stiffness, measured by pulse wave velocity (PWV) and the augmentation index (AIx), has been linked to HF severity and prognosis. This study investigates the relationship between clinical parameters, biochemical indicators, and arterial stiffness in hospitalized patients with HF, aiming to identify predictors of hospitalization and improve patient management. Methods: This cross-sectional study included 98 patients admitted with HF: 53 with acutely decompensated HF (sudden worsening of symptoms) and 45 with chronic HF (stable symptoms of HF). Clinical and biochemical parameters, including ejection fraction (EF), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, and arterial stiffness indicators (PWV and AIx), were measured at admission. During follow-up, 59 patients required re-hospitalization due to acutely decompensated HF, while 39 remained outpatients without further hospitalization. The relationship between these parameters was analyzed using Pearson correlation coefficients, and multiple Cox regression analysis was conducted to identify independent predictors of re-hospitalization. Results: A significant negative correlation between EF and PWV was found (r = -0.853, 95% CI [-0.910, -0.764]), suggesting an association between improved heart function (higher EF) and reduced arterial stiffness (lower PWV). A moderate positive correlation between EF and AIx (r = 0.626, 95% CI [0.473, 0.805]) suggests that, while higher EF is associated with increased AIx, the relationship is weaker compared to EF and PWV. This may reflect differing contributions of vascular and myocardial factors to HF severity. Hospitalized patients exhibited significantly poorer clinical and biochemical profiles, including higher NT-proBNP levels (p < 0.001) and worse blood pressure (BP) measurements (systolic and diastolic, p < 0.01). Multiple Cox regression analysis identified PWV, Aix, and NT-proBNP as independent predictors of re-hospitalization in HF patients, with significant hazard ratios: PWV (HR = 1.15, p = 0.02), AIx (HR = 1.03, p = 0.02), and NT-proBNP (HR = 1.0001, p < 0.01). Conclusions: Arterial stiffness indices (PWV and AIx), EF, and NT-proBNP were identified as significant predictors of re-hospitalization in HF patients. These findings suggest that integrating arterial stiffness measurements into routine clinical assessments may enhance the risk stratification and inform targeted interventions to reduce hospitalizations and improve outcomes.

Risk-based breast cancer screening: What are the challenges?

Population-based screening programs aim to detect the disease at an early stage, so less treatment will be needed as well as having better oncological outcomes when diagnosed earlier. In the majority of European countries, breast cancer screening programs are designed based on women age.Meta-analysis of randomized clinical trial data demonstrates a reduction in the relative risk of breast cancer mortality due to screening, which has been estimated to be approximately 20%.One of the controversies about the population breast screening programs is that age-based screening ignores women's individual breast cancer risk. Identification of high-risk women may intensify the screening measures and will optimize the population screening programs to align them to individual risks.Family history of breast cancer is one of the risk factors to consider along with the recently developed polygenic risk scores to stratify women into a risk group. Other factors to assess risk include: mammographic breast density; B3 lesions with atypia in breast biopsy specimens; hormonal and lyfestyle and, potentially, epigenetic markers. Still, there are some difficulties in validating these factors and reflecting the interaction between risk factors in the models.Ongoing screening trials (e.g., WISDOM and MyPebs) are currently evaluating the clinical acceptability and utility of risk-stratified screening programs in the general population, and should provide valuable information for the possible implementation of such programs.Communication of complex risk information to the women, as well as assessing ethical concerns need to be addressed before implementation of risk stratified programs.

Health professionals contacting patients' relatives directly about genetic risk (with patient consent): current clinical practice and perspectives.

Genetic testing can provide risk information to individuals and their blood relatives. Cascade testing uptake by at-risk relatives is <50%, with suboptimal family communication a key barrier to risk notification. The practice of health professionals (HPs) directly contacting relatives (with patient consent) to assist with risk notification has significant international support, but little is known about the practices and views of HPs in Australia. We surveyed Australian clinical genetics and laboratory services (public and private) which offer genetic testing of relevance to relatives, about current practices and views. Of 104 services invited, 78 responded to our online survey (75.0% response rate; clinical n = 59/81; laboratory n = 19/23). Most clinical services (83.3%) agreed it would be beneficial to contact at-risk relatives directly. However, the majority (80.4%) do not routinely contact relatives directly, with inadequate resources (80.0%) and privacy concerns (62.2%) cited as primary reasons. If direct contact methods were used, most clinical services (65.4%) prefer a letter which includes specific information about the genetic condition. Most clinical (86.5%) and laboratory (88.2%) services saw benefit in the development of a national clinical guideline for HPs regarding direct contact. This study confirms that most clinical genetics services would see benefits to being able to assist patients by contacting relatives directly about their potential genetic risk. Our findings highlight the need for a national clinical guideline clarifying HPs' legal and privacy obligations, and provide an opportunity for clinical services to reconsider their allocation of resources to prioritise assisting patients with risk notification.

An exploratory study evaluated the 30 most commonly reported medications in the United States food and drug administration’s adverse event reporting system that are associated with the occurrence of kidney stones

ObjectiveThis research project aimed to identify and analyze the top 30 drugs most commonly associated with kidney stone formation using data from the U.S. Food and Drug Administration’s Adverse Event Reporting System (FAERS) database. The study will focus on determining the reported Odds ratio (ROR) and Proportional Report ratio (PRR) of each identified drug to assess its potential risk of contributing to the development of kidney stones in order to effectively manage and reduce the overall burden of kidney stones worldwide.BackgroundKidney stones are a common urinary system disease, and their formation is influenced by multiple factors, including medications, metabolic syndrome, environmental factors, genetic susceptibility, urinary tract abnormalities, and obstructive pathology. Among these factors, medications are an important and clearly defined cause of kidney stone formation. Currently, drug-induced kidney stones account for 1%–2% of all cases of kidney stones. Although the proportion may appears modest, its contribution to the overall prevalence of kidney stones should not be overlooked. The high incidence and frequent recurrence of kidney stones pose significant challenges to prevention efforts. Therefore, a thorough understanding of which medications may trigger stone formation is crucial for effectively managing and reducing the burden of this global health issue.MethodThis study utilized the FDA Adverse Event Reporting System (FAERS) database maintained by the U.S. Food and Drug Administration to extract raw data from 1 January 2010, to 31 March 2024. Duplicate data was removed following the FDA-recommended method. Subsequently, data related to drug-induced kidney stones was extracted by linking the DEMO table, DRUG table, and REAC table using specific primaryid numbers, resulting in a total of 37,781 drug records and 37,027 demographic records. The data was sorted based on the frequency of drug-induced kidney stones, and the top 30 drugs associated with kidney stone formation were selected for analysis. The primary analytical methods employed were disproportionality analyses, calculating the Reporting Odds Ratio (ROR) with its 95% Confidence Interval (CI) and Proportional Reporting Ratio (PRR) to reveal the association between drugs and adverse kidney stone events.ResultsWe ranked the 30 most common drugs based on their ROR and PRR values. The three drugs most commonly associated with kidney stones were Atazanavir (ROR 46.35, 95% CI 43–50, PRR 44.9), Topamax (ROR 19.44, 95% CI 17.66–21.40, PRR 19.19), and Prevacid (ROR 12.67, 95% CI 11.62–13.82, PRR 12.57). Drug categories most commonly associated with kidney stones were antiretroviral drugs, proton pump inhibitors, and antiepileptic drugs.ConclusionOur research has summarized a list of potential drug categories associated with kidney stones. Clear understanding of the risk and frequency of drug-induced kidney stones caused by specific medications can reduce the likelihood of patients developing the condition. Clinical doctors should keep vigilant during diagnosis and treatment processes, and communicate relevant risk information to patients.