Risk Assessment Questions Research Articles

Knowledge, Attitude, and Practice of Nursing Staff Toward Patients Who Attempted Suicide at Tertiary Care Hospital of Central Gujarat, India

Background: Looking at the alarming increase in the incidence of attempted suicide worldwide, having adequate expertise in managing people with attempted suicide is imperative. Therefore, healthcare professionals, specifically nurses, must be provided training exclusively on managing patients with attempted suicide and preventing suicide in the near and distant future. Nursing staff play a major role as a point of first contact for suicide survivors, and therefore, it is of utmost importance that they are adequately trained and knowledgeable in this area. To understand their knowledge, the authors decided to do this study to measure knowledge, attitude, and practice (KAP) among nurses in suicide survivors. Aim: The aim of this article was to study the KAP of nursing staff toward patients with suicide attempts. Methods: A hospital-based cross-sectional, quantitative study was conducted among nursing staff. All nurses ( n = 300) were approached in small groups between July and November 2023 via a convenient sampling. Written informed consent from participants was taken. The semi-structured questionnaire included sociodemographic details, their professional experience, their training and experience in managing suicidal patients, and KAP questions. The KAP questions were on patients with suicide attempts and were derived from the suicide knowledge and skill questionnaire (SKSQ), suicide attitude questionnaire, and practice guidelines of the American Psychiatric Nurses Association. Data was analyzed by using MS Excel version 6.2.14. Result: In this study, a total of 200 nursing staff participated. The majority were female (80%), with a mean age of 37 years and a mean professional experience of 12 years. Out of all participants, 68% had experience managing patients with suicide attempts, but only 27% of them were trained in suicide prevention. The mean score of knowledge and attitude among study participants were 65.25/100 and 3.24/5, respectively. Nursing staff had higher scores in questions of suicide risk assessment and statements related to attitudes like “they deserve respect in society.” In practice assessment, more than 80 % of nurses were keenly observant, empathetic, and nonstigmatized for hospitalized patients of suicide attempts. The nurses took measures like restricting access to harmful objects (medicines, sharp objects) and giving medicines under supervision. Conclusion: The nursing staff had adequate knowledge, a nonstigmatized attitude, and appropriate clinical practices toward patients with suicide attempts, but they lacked formal training. So, hands-on training for suicide management at regular intervals is the need of the hour.

Inverse set estimation and inversion of simultaneous confidence intervals.

Motivated by the questions of risk assessment in climatology (temperature change in North America) and medicine (impact of statin usage and coronavirus disease 2019 on hospitalized patients), we address the problem of estimating the set in the domain of a function whose image equals a predefined subset of the real line. Existing methods require strict assumptions. We generalize the estimation of such sets to dense and nondense domains with protection against inflated Type I error in exploratory data analysis. This is achieved by proving that confidence sets of multiple upper, lower, or interval sets can be simultaneously constructed with the desired confidence nonasymptotically through inverting simultaneous confidence intervals. Nonparametric bootstrap algorithm and code are provided.

Representación del riesgo suicida y su exploración en una simulación realizada por estudiantes de Medicina

IntroductionExploring suicide risk is a fundamental skill for medical professionals. However, university medical education typically does not include enough formal training in this area. Simulation has been used as a method for learning this skill, although most studies using this pedagogic tool focus on analysing changes in self-perceived capabilities and attitudes after receiving specific training on suicide. MethodsA formative assessment task was carried out, consisting of recording a video in which groups of final-year medical students conducted a general psychiatric assessment with a simulated patient. The patient's diagnosis, suicide risk assessment, and exploratory questions were chosen by the students. Videos recorded over one term were studied. The chosen suicide risk assessment and exploratory questions regarding suicide risk were analysed independently and in relation to the chosen diagnosis. ResultsOut of 34 videos recorded, in 70% of those where suicide risk was explored, there was no suicidal ideation, and none had active suicidal ideation. Suicide risk was explored in 88% of the videos, but only 23.5% directly asked about the presence of suicidal ideation. ConclusionsThe task helped students integrate the importance of exploring suicide risk. The proportion of suicidal risk represented, and the exploratory questions, highlight the need to implement additional training interventions that focus on knowledge and stigma towards suicide.

HIV risk behavior profiles among men who have sex with men interested in donating blood: Findings from the Assessing Donor Variability and New Concepts in Eligibility study.

Individual risk assessment allows donors to be evaluated based on their own behaviors. Study objectives were to assess human immunodeficiency virus (HIV) risk behaviors in men who have sex with men (MSM) and estimate the proportion of the study population who would not be deferred for higher risk HIV sexual behaviors. Cross-sectional survey and biomarker assessment were conducted in eight U.S. cities. Participants were sexually active MSM interested in blood donation aged 18-39 years, assigned male sex at birth. Participants completed surveys during two study visits to define eligibility, and self-reported sexual and HIV prevention behaviors. Blood was drawn at study visit 1 and tested for HIV and the presence of tenofovir, one of the drugs in oral HIV pre-exposure prophylaxis (PrEP). Associations were assessed between HIV infection status or HIV PrEP use and behaviors, including sex partners, new partners, and anal sex. A total of 1566 MSM completed the visit 1 questionnaire and blood draw and 1197 completed the visit 2 questionnaire. Among 1562 persons without HIV, 789 (50.4%) were not taking PrEP. Of those not taking PrEP, 66.2% reported one sexual partner or no anal sex and 69% reported no new sexual partners or no anal sex with a new partner in the past 3 months. The study found that questions were able to identify sexually active, HIV-negative MSM who report lower risk sexual behaviors. About a quarter of enrolled study participants would be potentially eligible blood donors using individual risk assessment questions.

Exiled lives on the stage: Support networks and programs for artists at risk from Turkey in Germany.

This article analyses the support and self-care strategies of artists from Turkey who have left their country from considerable risk regarding their country's political and economic instability since 2013 and have relocated to Germany. It maps the support networks, programs and institutions as well as consider questions of sustainability and risk (self-) assessment. The study is based on interviews with Turkish and Kurdish artists in Germany and an analysis of the activities by the Maxim Gorki Theater, Apartment Projekt, bi'bak, Hafiza Merkezi Berlin, as well as support systems like artistic research fellowships, art residencies, artist networks and supportive theatres. The guiding questions of this study examine the longer-term orientation of the support of artists at risk. The findings show three deficiencies. Despite the variety of available support systems, artists who left Turkey experience difficulties integrating in the artistic labour market. The output-oriented, meritocratic basis on which programs select candidates often fail to help artists in a holistic way. The intergenerational disparity in the migrant communities create the infrastructures, solidarity discourses and networks for newly arriving artists, but also creates ideological tensions which limits inter-communitarian solidarity. Specific self-organized programs extend the solidarity to artists from other affected regions, which limits chances to support artists at risk from Turkey. There are generational disadvantages of newcomers in an overburdened, professionalized independent art scene that has struggled to break free from the social work and socio-cultural stigmas. The latter masks artists with a non-German background from positive discrimination initiatives. The study proposes improvement in support systems through a coordinated effort, encourages to relieve programs from a need for identity representation as an expectation or requirement, and advises a shift in support systems from output orientation towards enhancement of individuals through self-care, for greater autonomy and self-development in their art practices and new life.

An Artificial Intelligence-Based Smartphone App for Assessing the Risk of Opioid Misuse in Working Populations Using Synthetic Data: Pilot Development Study.

Opioid use disorder (OUD) is an addiction crisis in the United States. As recent as 2019, more than 10 million people have misused or abused prescription opioids, making OUD one of the leading causes of accidental death in the United States. Workforces that are physically demanding and laborious in the transportation, construction and extraction, and health care industries are prime targets for OUD due to high-risk occupational activities. Because of this high prevalence of OUD among working populations in the United States, elevated workers' compensation and health insurance costs, absenteeism, and declined productivity in workplaces have been reported. With the emergence of new smartphone technologies, health interventions can be widely used outside clinical settings via mobile health tools. The major objective of our pilot study was to develop a smartphone app that can track work-related risk factors leading to OUD with a specific focus on high-risk occupational groups. We used synthetic data analyzed by applying a machine learning algorithm to accomplish our objective. To make the OUD assessment process more convenient and to motivate potential patients with OUD, we developed a smartphone-based app through a step-by-step process. First, an extensive literature survey was conducted to list a set of critical risk assessment questions that can capture high-risk behaviors leading to OUD. Next, a review panel short-listed 15 questions after careful evaluation with specific emphasis on physically demanding workforces-9 questions had two, 5 questions had five, and 1 question had three response options. Instead of human participant data, synthetic data were used as user responses. Finally, an artificial intelligence algorithm, naive Bayes, was used to predict the OUD risk, trained with the synthetic data collected. The smartphone app we have developed is functional as tested with synthetic data. Using the naive Bayes algorithm on collected synthetic data, we successfully predicted the risk of OUD. This would eventually create a platform to test the functionality of the app further using human participant data. The use of mobile health techniques, such as our mobile app, is highly promising in predicting and offering mitigation plans for disease detection and prevention. Using a naive Bayes algorithm model along with a representational state transfer (REST) application programming interface and cloud-based data encryption storage, respondents can guarantee their privacy and accuracy in estimating their risk. Our app offers a tailored mitigation strategy for specific workforces (eg, transportation and health care workers) that are most impacted by OUD. Despite the limitations of the study, we have developed a robust methodology and believe that our app has the potential to help reduce the opioid crisis.

Current exposure to phthalates and DINCH in European children and adolescents - Results from the HBM4EU Aligned Studies 2014 to 2021.

Phthalates are mainly used as plasticizers for polyvinyl chloride (PVC). Exposure to several phthalates is associated with different adverse effects most prominently on the development of reproductive functions. The HBM4EU Aligned Studies (2014-2021) have investigated current European exposure to ten phthalates (DEP, BBzP, DiBP, DnBP, DCHP, DnPeP, DEHP, DiNP, DiDP, DnOP) and the substitute DINCH to answer the open policy relevant questions which were defined by HBM4EU partner countries and EU institutions as the starting point of the programme. The exposure dataset includes ∼5,600 children (6-11 years) and adolescents (12-18 years) from up to 12 countries per age group and covering the North, East, South and West European regions. Study data from participating studies were harmonised with respect to sample size and selection of participants, selection of biomarkers, and quality and comparability of analytical results to provide a comparable perspective of European exposure. Phthalate and DINCH exposure were deduced from urinary excretions of metabolites, where concentrations were expressed as their key descriptor geometric mean (GM) and 95th percentile (P95). This study aims at reporting current exposure levels and differences in these between European studies and regions, as well as comparisons to human biomonitoring guidance values (HBM-GVs). GMs for children were highest for ∑DEHP metabolites (33.6μg/L), MiBP (26.6μg/L), and MEP (24.4μg/L) and lowest for∑DiDP metabolites (1.91μg/L) and ∑DINCH metabolites (3.57μg/L). In adolescents highest GMs were found for MEP (43.3μg/L), ∑DEHP metabolites (28.8μg/L), and MiBP (25.6μg/L) and lowest for ∑DiDP metabolites (= 2.02μg/L) and ∑DINCH metabolites (2.51μg/L). In addition, GMs and P95 stratified by European region, sex, household education level, and degree of urbanization are presented. Differences in average biomarker concentrations between sampling sites (data collections) ranged from factor 2 to 9. Compared to the European average, children in the sampling sites OCC (Denmark), InAirQ (Hungary), and SPECIMEn (The Netherlands) had the lowest concentrations across all metabolites and ESTEBAN (France), NAC II (Italy), and CROME (Greece) the highest. For adolescents, comparably higher metabolite concentrations were found in NEB II (Norway), PCB cohort (Slovakia), and ESTEBAN (France), and lower concentrations in POLAES (Poland), FLEHS IV (Belgium), and GerES V-sub (Germany). Multivariate analyses (Survey Generalized Linear Models) indicate compound-specific differences in average metabolite concentrations between the four European regions. Comparison of individual levels with HBM-GVs revealed highest rates of exceedances for DnBP and DiBP, with up to 3 and 5%, respectively, in children and adolescents. No exceedances were observed for DEP and DINCH. With our results we provide current, detailed, and comparable data on exposure to phthalates in children and - for the first time - in adolescents, and - for the first time - on DINCH in children and adolescents of all four regions of Europe which are particularly suited to inform exposure and risk assessment and answer open policy relevant questions.

How do providers assess young people for risk of sex trafficking? Observed indicators, follow-up, and assessment questions from a sample of social service providers

The extent to which service providers across systems identify and assess potentially sex trafficked youth is understudied. The purpose of this study is to determine whether and how providers observe relevant indicators and assess for sex trafficking risk among minors (ages 12–17), young adults (ages 18–29), and families of minors. A cross-sectional, web-based survey was disseminated to service providers, who represented child welfare, youth justice, and social services (e.g. runaway youth, sexual violence), in a region of a Midwestern state (United States). Participants (N = 267) were asked whether they provided direct services to minors (ages 12–17, n = 245), adults (ages 18–29, n = 148), and/or families/foster families of minors (ages 12–17, n = 163), resulting in three respective client groups. Survey items assessed the extent to which providers (1) identified possible sex trafficking indicators across 5 domains; (2) took follow up actions; and (3) asked risk assessment questions. T-tests were conducted to examine differences between those who reported receiving sex trafficking trainings, compared to those who did not. Results suggest that the most commonly identified indicators included depressive symptoms, shame and guilt, lack of social support. Least common indicators included torture, false IDs, hotel involvement. A third of minor-aged providers did not ask sex trafficking risk assessment questions. Providers reported asking fewer clients about online sex trading than in-person forms. There were statistically significant differences among providers who received training. Implications, including provider strategies for assessing online sex trading and organizational protocols to enhance sex trafficking identification, are discussed.

Are Non-animal Systemic Safety Assessments Protective? A Toolbox and Workflow.

An important question in toxicological risk assessment is whether non-animal new approach methodologies (NAMs) can be used to make safety decisions that are protective of human health, without being overly conservative. In this work, we propose a core NAM toolbox and workflow for conducting systemic safety assessments for adult consumers. We also present an approach for evaluating how protective and useful the toolbox and workflow are by benchmarking against historical safety decisions. The toolbox includes physiologically based kinetic (PBK) models to estimate systemic Cmax levels in humans, and 3 bioactivity platforms, comprising high-throughput transcriptomics, a cell stress panel, and in vitro pharmacological profiling, from which points of departure are estimated. A Bayesian model was developed to quantify the uncertainty in the Cmax estimates depending on how the PBK models were parameterized. The feasibility of the evaluation approach was tested using 24 exposure scenarios from 10 chemicals, some of which would be considered high risk from a consumer goods perspective (eg, drugs that are systemically bioactive) and some low risk (eg, existing food or cosmetic ingredients). Using novel protectiveness and utility metrics, it was shown that up to 69% (9/13) of the low risk scenarios could be identified as such using the toolbox, whilst being protective against all (5/5) the high-risk ones. The results demonstrated how robust safety decisions could be made without using animal data. This work will enable a full evaluation to assess how protective and useful the toolbox and workflow are across a broader range of chemical-exposure scenarios.

PHOENIX (Picking up Hidden Osteoporosis Effectively during Normal CT Imaging without additional X-rays): protocol for a randomised, multicentre feasibility study

IntroductionTwo million out of the UK’s 5 million routine diagnostic CT scans performed each year incorporate the thoracolumbar spine or pelvic region. Up to one-third reveal undiagnosed osteoporosis or vertebral...

Proposed prospective scenarios for cumulative risk assessment of pesticide residues

To ensure a high level of consumer protection, Article 14 of Regulation (EC) No. 396/2005 stipulates that decisions on applications concerning the setting, modifying and deletion of maximum residue levels (MRLs) of pesticides shall take into account the cumulative effects, when the methods to assess such effects are available. This report investigates the feasibility of a tiered approach for prospective cumulative risk assessment (CRA). This report describes 15 case studies for the cumulative assessment group (CAG) associated with an effect on the motor division of the nervous system and 15 for the CAG associated with an effect on hypothyroidism. For each case study, Tier 0, Tier I and Tier II calculations were performed. The Tier II assessment was performed for three different scenarios representing three different risk assessment questions related to the exposure of a focal substance/focal commodity combination: 1) the MRL scenario assessing exposure at the MRL, 2) the Good Agricultural Practice (GAP) scenario assessing exposure to the focal commodity treated with the focal substance at the critical GAP and 3) the actual scenario, assessing actual exposure of pesticides, and taking into account use frequency of the focal substance. Additionally, three sensitivity analyses were performed addressing the impact of changing parameters or assumptions made in the comparison. The results revealed that prospective CRA could be performed more efficiently if a trigger value (e.g. a certain percentage of the Health Based Guidance Value (HBGV)) is implemented at Tier 0. For the tiered approach, however, although Tier II calculations should in principle result in a higher total Margin of Exposure compared to Tier I, this was not the case for all scenarios and case studies. Final criteria will need to be discussed and agreed by the Standing Committee of Plants, Animal, Food and Feed.

Clinical impact of plasma haemostasis disorders and their correction in chronic glomerulonephritis with nephrotic syndrome

Introduction. Thrombosis and thromboembolism are frequent complications in chronic glomerulonephritis (CGN) with nephrotic syndrome (NS), despite the use of anticoagulant therapy. Therefore, the questions of thrombosis risk assessment and thrombotic complication prevention in NS are still relevant.Aim. Description of the frequency and localisation of thromboembolic complications in CGN-NS patients and a review of approaches to their risk assessment and prevention.Main findings. The main risk predictors of venous thrombosis in NS are considered, including low serum albumin, high plasma D-dimer, age over 60 and hypovolemic conditions. The risk of arterial thrombosis is determined by general population factors: age, gender, smoking, diabetes mellitus and arterial hypertension. Venous thrombosis may be asymptomatic and mainly occurs in deep lower limb veins, renal veins and branches of pulmonary artery. Among the NS-associated CGN morphotypes of high risk are membranous nephropathy and membranoproliferative CGN. Issues in the thrombotic complication risk assessment, prevention and treatment are highlighted.

ExpoKids: An R-based tool for characterizing aggregate chemical exposure during childhood

BackgroundAggregate exposure, the combined exposures to a single chemical from all pathways, is a critical children’s health issue.ObjectiveThe primary objective is to develop a tool to illustrate potential differences in aggregate exposure at various childhood lifestages and the adult lifestage.MethodsWe developed ExpoKids (an R-based tool) using oral exposure estimates across lifestages generated by US EPA’s Exposure Factors Interactive Resource for Scenarios Tool (ExpoFIRST).ResultsExpoKids is applied to illustrate aggregate oral exposure, for ten media, as average daily doses (ADD) and lifetime average daily doses (LADD) in five graphs organized across seven postnatal childhood lifestages and the adult lifestage. This data visualization tool conveys ExpoFIRST findings, from available exposure data, to highlight the relative contributions of media and lifestages to chemical exposure. To evaluate the effectiveness of ExpoKids, three chemical case examples (di[2-ethylhexyl] phthalate [DEHP], manganese, and endosulfan) were explored. Data available from the published literature and databases for each case example were used to explore research questions regarding media and lifestage contributions to aggregate exposure.SignificanceThese illustrative case examples demonstrate ExpoKids’ versatile application to explore a diverse set of children’s health risk assessment and management questions by visually depicting specific media and lifestage contributions to aggregate exposure.

Screening for fetal alcohol spectrum disorder in forensic mental health settings

ABSTRACT There is limited evidence to inform effective screening practices for identifying fetal alcohol spectrum disorder (FASD) in forensic mental health settings. This study sought to explore the potential use of four FASD screening tools in a Canadian forensic mental health program. In total, 151 patient charts were screened using the FASD Screening and Referral Tool for Youth Probation Officers and the FASD Risk Assessment Questions Asubset of current patients (n = 41) also completed screening interviews using the FASD Brief Screen Checklist and Life History Screen. Based on passive ascertainment via chart review, we found six cases of confirmed/suspected FASD (4%), evidence of PAE in 7% of the sample, and signs of maternal alcohol use during childhood in 17% of cases. Across the entire sample and four screening tools, the proportion of potentially ‘positive’ FASD screens based on exploratory evaluation ranged from 10% to 33%. Exploratory screening outcomes varied considerably between tools. Findings highlight the need for additional research to identify rates of FASD in forensic mental health settings, and to develop evidence-based screening and assessment approaches, and practice guidelines, for this setting.

Communication inside Risk Assessment and Risk Management (COMRISK): Final report

A key feature of risk analysis is that risk assessment and risk management should be functionally separated. However, the usefulness of a risk assessment may be limited if the output is not designed to help with risk management decisions. The COMRISK project investigated the communication between risk assessors and risk managers. The overall goal of the project was to identify current practices and challenges in communication between risk assessors and risk managers during the risk analysis process, and thus increase and improve the understanding and the quality of the communication between them. Specific actions to achieve this aim included reviewing of historical food safety cases, analysing risk assessment requests, identifying communication guiding documents, including legislation and agreements, conducting semi‐structured interviews with risk assessors and risk managers, and identifying tools for facilitating the communication between risk assessors and risk managers. It was concluded that the usefulness of a risk assessment is strongly dependent on well‐defined and mutually recognised risk questions and that scarce or poor communication between risk assessors and risk managers is one of the major reasons when an output from risk assessment fails to support risk management. The communication between risk assessors and risk managers preceding the onset of the risk assessment, when the risk assessment requests with its risk questions are defined, is especially identified as one of the critical points to ensure a risk assessment that is fit for purpose. However, difficulties in understanding were also reported for the communication between risk assessors and risk managers during and after the risk assessment. Lack of communication is seldom a result of formal constraints or agreements nor can it be explained by a wish of the risk assessors or risk managers. Instead, perceived constraints or traditions appear to be possible underlying factors leading to scarce or poor communication between risk assessors and risk managers. It is essential that both risk assessors and risk managers acknowledge the crucial importance of communication between them while at the same time respect their different roles in a risk analysis.According to respondents, the best solution to facilitate the framing of the risk assessment questions isan open dialogue between risk assessors and risk managers to agree on the goal of the assessment and to build trust. Further, the interviewresults indicate that a formal systematic process may facilitate communication during the risk analysis. Where there is uncertainty, e.g due to data gaps or issues related to the methodology and models, it should be acknowledged and described properly by risk assessors to risk managers. Training of risk assessors and risk managers may improve the possibility of a timely and fit‐for‐purpose output.Such a training should give a deeper insight in the risk management process, give a better understanding of the risk managers role, and especially raise the awareness of the importance of the communication between risk assessors and risk managers.To improve the risk analysis process, it is also important that the risk assessor gets feedback regarding how risk assessments have met the needs of the risk managers.The present study also found that aspects of risk communication studied in this project are not extensively discussed in the guidance documents for risk analysis. More research is needed to identify the barriers for a fit for purpose communication.

A Risk Analysis Framework for Cyber Security and Critical Infrastructure Protection of the U.S. Electric Power Grid.

The purpose of this article is to introduce a risk analysis framework to enhance the cyber security of and to protect the critical infrastructure of the electric power grid of the United States. Building on the fundamental questions of risk assessment and management, this framework aims to advance the current risk analysis discussions pertaining to the electric power grid. Most of the previous risk-related studies on the electric power grid focus mainly on the recovery of the network from hurricanes and other natural disasters. In contrast, a disproportionately small number of studies explicitly investigate the vulnerability of the electric power grid to cyber-attack scenarios, and how they could be prevented or mitigated. Such a limited approach leaves the United States vulnerable to foreign and domestic threats (both state-sponsored and "lone wolf") to infiltrate a network that lacks a comprehensive security environment or coordinated government response. By conducting a review of the literature and presenting a risk-based framework, this article underscores the need for a coordinated U.S. cyber security effort toward formulating strategies and responses conducive to protecting the nation against attacks on the electric power grid.

Climate change, ‘slow violence’ and the indefinite deferral of responsibility for ‘loss and damage’

ABSTRACT This article traces debates within international climate regime on loss and damage from climate impacts. Impacts from climate change should be understood as incremental violence structurally over-determined by international relations of power and control that affect most acutely those who contributed least to dangerous levels of anthropocentric greenhouse gas emissions. Calls for compensation or reparation for ‘loss and damage’ are therefore a demand for climate justice. This article shows how questions of loss and damage were initially avoided within the climate regime. At the nineteenth Conference of the Parties in December 2013 the United Nations Framework Convention on Climate Change (UNFCCC) adopted the Warsaw International Mechanisms for Loss and Damage (WIM) associated with climate change. However, even then questions of compensative or reparative justice were persistently evaded. The institutionalisation of the WIM focused on questions of comprehensive risk assessment and disaster risk reduction and the promotion of privatised, insurance-based and financialised approaches to financing loss and damage. These operate in different ways to displace responsibility away from historical polluters, by nationalising responsibility to anticipate and prepare for disasters and seeking to responsibilise the vulnerable and risk-exposed subject.

Prognosis evaluation of environmental risks in case of accident on main and technological oil pipelines

The article is devoted to questions of environmental risk assessment. The subject relevance consists in normative introduction of risk assessment requirements for many activity fields connected with danger or result uncertainty. The purpose of the article is ecological damages assessment and environmental risks in case of accident on main and technological oil pipelines. A task of the study is an application possibility consideration of regulatory ecological requirements together with the environmental risks valuation methods accepted now by the oil and gas companies. During a solution of an objective the environmental risks assessment technique was developed for the ecological management systems of the oil and gas companies.

Confidence and Intentions to Help a Person at Risk of Suicide.

We aimed to identify Australian adults' current level of confidence and intentions to help a person close to them in distress or at risk of suicide to inform the content and targeting of suicide prevention messages aimed at family and friends of those at risk. We conducted a nationally representative computer-assisted telephone survey of confidence and intentions to help someone in distress or at risk of suicide (n=3,002). We used logistic regression to determine whether sociodemographic and exposure variables predicted confidence and intentions to help. Confidence to help was high. About half of the respondents had intentions inconsistent with best practice. Listening and talking, and encouraging the person to seek professional help were the most common types of intended helping actions. Intentions to ask suicide risk assessment questions were least common. Men were more likely than women to have intentions to carry out nonrecommended actions, and less likely to have intentions to carry out recommended actions. Suicide prevention messaging aimed at family and friends could encourage them to ask direct questions about suicide risk and could include messages about "what not to do." Suicide prevention messages aimed specifically at men are indicated.

Amate: A Mobile Application To Improve Access To Early Breast And Cervical Cancer Detection

Purpose For Colombian women, breast and cervical cancer are the leading causes of mortality, despite being potentially curable through early detection and timely treatment. Tedious administrative processes and a lack of cancer screening education and awareness hinders early detection. Mobile applications (mApps) have permeated all levels of society and are potential tools by which to deliver personalized information and identify high-risk patients in need of screening tests thereby improving early cancer detection. The aim of this work is to create a free mApp that educates and guides patients to the national screening programs for breast and cervical cancer. Methods An mApp Amate was advertised to women (age ≥ 14 years) in the waiting rooms of a health care facility of a community hospital during a period of 9 months. Amate used educational, evaluative, and risk factor questions to measure the population’s knowledge of breast and cervical cancer. Each question was followed by an explanation. Correct answers yielded points that were redeemable for cellular data. Risk assessment questions identified women who required screening who were subsequently contacted by a health care provider and enrolled in the national cancer care program. Results A total of 4,553 women were contacted from August 2017 to May 2018. Of this group, 830 downloaded Amate and answered all of the questions. On the basis of the risk factor questions, 16% of patients (n = 131) were identified as being at risk for breast and/or cervical cancer and needed to be enrolled in the national screening program. Thus far, 24% of patients (n = 32) have successfully completed their recommended screening tests—mammogram, Papanicolau smear, or both. We also identified specific barriers to enrolling patients in these programs, including an unwillingness to be enrolled, limited available appointments at health care centers, and denied access as a result of health care coverage. Conclusion Amate is a low-cost, accessible tool that identifies women who are at risk for breast and cervical cancer and detects access barriers to early cancer detection. Administrative obstacles still exist and must be addressed to improve early cancer detection and screening. Amate has the potential to reach people from rural areas of Colombia and other underserved countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Armando Sardi Stock or Other Ownership: Celgene, Johnson & Johnson Mavalynne Orozco-Urdaneta Employment: Partners For Cancer Care And Prevention Foundation, Stamina-in-Action Stock or Other Ownership: Celgene, Johnson & Johnson Luis Gabriel Parra-Lara Research Funding: Merk & Co