Risk Information Research Articles

Public support for flood adaptation policy in Tokyo lowland areas

ABSTRACT Sea level rise induced flooding is projected to cause significant damage to the low-lying coastal areas of many countries around the planet. Many households located in vulnerable areas have already started to adapt to flooding, although some empirical studies indicate that informal adaptation is reaching its limit and that more formal countermeasures by governments will be necessary to cope with the increased flood risks. In such cases, public support for flood adaptation policy is crucial to ensure a successful and timely adaptation, as these strategies can directly affect coastal residents. However, there is limited understanding on the mechanisms and factors that determine public support for flood adaptation policy. Thus, this study proposes a new model – the Foundation of Adaptation Policy Support (FAPS) – which integrates the Protection Motivation Theory and the Risk Information Seeking and Processing models. FAPS was tested using structural equation modelling with latent variables and data that was collected from a household questionnaire survey conducted in the Tokyo lowland areas (n = 388), with the super levee representing a policy that could be applied to sea level rise adaptation. The proposed FAPS model showed a good fit with the collected data, indicating that the strongest predictors of policy support include the perceived effectiveness of the policy and the importance of the issue of flooding to individuals. Other important predictors of policy support include knowledge about flooding, the opinions of surrounding people (i.e. family and friends), and the systematic processing by respondents of information related to floods. The FAPS model sets the foundation for understanding the mechanisms of public support for adaptation policy and provides new insights into designing and planning such policies in practice. Key policy insights Perceived policy effectiveness and the importance of addressing floods are the strongest predictors of public support for adaptation policy. Increasing people’s knowledge about flooding is essential to communicate the importance of adaptation policy. Investigating people’s knowledge and the perceived importance of the issue of flooding prior to designing policies can predict public preferences for certain countermeasures.

P-554 Artificial intelligence (AI) for embryo genetic risk assessment: a novel form of preimplantation genetic screening

Abstract Study question Can an AI-based embryo ploidy screening tool effectively provide a genetic risk assessment on Day 5 embryos? Summary answer AI screening results showed strong predictive value for early detection of at-risk embryos warranting confirmatory diagnostic testing, based only on time lapse video assessment. What is known already Euploid embryo transfer is the dogma of IVF success. Embryo evaluation relies extensively on diagnostic preimplantation genetic testing for aneuploidy (PGT-A) by means of trophectoderm biopsy. Though pivotal, this presents substantial practical and financial limitations. There is demand for an alternative genetic screening method that provides a quantitative embryo genetic risk assessment for patients who opt out of invasive diagnostic testing, or who intend to undergo fresh transfer. These results can provide information for understanding your aneuploidy risk for more precise prognosis counseling and testing. This is important since diagnostic tests may incur excess financial burden, inconclusive outcomes, and time-to-results. Study design, size, duration Time lapse videos (N = 5,000) were used for AI training. The AI core architecture was a video transformer model for spatio-temporal video sampling. Known ploidy and live-birth results were used as ground truth, with maternal age and embryo quality scores incorporated as input parameters during calibrated logistic regression. A blind test dataset (N = 708 embryos; euploid=352; aneuploid=356; mean ± SD patient age: 35.9 ± 5.4 years) was used to evaluate predictive accuracy. Participants/materials, setting, methods The AI outputs a scalar (1-99) that associates with euploidy likelihood. The AI’s screening value was determined by its specificity (correct prediction of aneuploid), sensitivity (correct prediction of euploid), false positive, and false negative rate. We determined optimal AI score thresholds that identified high aneuploidy and euploidy risk categories (AI score <33; AI score >66, respectively). Main results and the role of chance Specificity of the AI screening test was 83.0%, with a sensitivity of 56.0%. The false positive rate was 26.7% and the false negative rate was 29.3%. The AI’s high specificity relative to its sensitivity shows its clinical value to deselect embryos with the strongest risk of genetic abnormality, and for the prioritization of embryos for confirmatory PGT. Boxplot visualization of the full AI score distribution showed successful discrimination between aneuploid and euploid embryos (mean AI score for aneuploid and euploid were 51.3 and 43.5, respectively) with appropriately minimized overlapping of the interquartile range. The optimal AI score thresholds for detecting embryos with the highest and lowest likelihoods of euploidy were >66 /<33, respectively, representing 71% likelihood of euploidy for the >66 group and 72% aneuploidy for the <33 group. Limitations, reasons for caution The screening does not provide diagnostic genetic testing on the chromosome level. The influence of mosaicism on the false positive/negative rates was not assessed. Wider implications of the findings Results support the use of an AI ploidy screening test for effective decision-making and triage of at-risk embryos for transfer or confirmatory diagnostic testing via PGT-A. Trial registration number Not applicable

Mortality risk information and health-seeking behavior during an epidemic

In a context where pessimistic survival perceptions have been widespread as a result of the HIV/AIDS epidemic (Fig. 1 A), we study vaccine uptake and other health behaviors during the recent COVID-19 pandemic. Leveraging a longitudinal cohort study in rural Malawi that has been followed for up to 25 y, we document that a 2017 mortality risk information intervention designed to reduce pessimistic mortality perceptions (Fig. 1 B) resulted in improved health behavior, including COVID-19 vaccine uptake (Fig. 1 C). We also report indirect effects for siblings and household members. This was likely the result of a reinforcing process where the intervention triggered engagement with the healthcare system and stronger beliefs in the efficacy of modern biomedical treatments, which led to the adoption of health risk reduction behavior, including vaccine uptake. Our findings suggest that health information interventions focused on survival perceptions can be useful in promoting health behavior and participation in the formal healthcare system, even during health crises-such as the COVID-19 pandemic-that are unanticipated at the time of the intervention. We also note the importance of the intervention design, where establishing rapport, tailoring the content to the local context, and spending time with respondents to convey the information contributed to the salience of the message.

Quantifying and reducing flood forecast uncertainty by the CHUP-BMA method

Abstract. The Bayesian model averaging (BMA), hydrological uncertainty processor (HUP), and HUP-BMA methods have been widely used to quantify flood forecast uncertainty. This study proposes the copula-based hydrological uncertainty processor BMA (CHUP-BMA) method by introducing a copula-based HUP in the framework of BMA to bypass the need for a normal quantile transformation of the HUP-BMA method. The proposed ensemble forecast scheme consists of eight members (two forecast precipitation inputs; two advanced long short-term memory, LSTM, models; and two objective functions used to calibrate parameters) and is applied to the interval basin between the Xiangjiaba and Three Gorges Reservoir (TGR) dam sites. The ensemble forecast performance of the HUP-BMA and CHUP-BMA methods is explored in the 6–168 h forecast horizons. The TGR inflow forecasting results show that the two methods can improve the forecast accuracy over the selected member with the best forecast accuracy and that the CHUP-BMA performs much better than the HUP-BMA. Compared with the HUP-BMA method, the forecast interval width and continuous ranked probability score metrics of the CHUP-BMA method are reduced by a maximum of 28.42 % and 17.86 % within all forecast horizons, respectively. The probability forecast of the CHUP-BMA method has better reliability and sharpness and is more suitable for flood ensemble forecasts, providing reliable risk information for flood control decision-making.

O-230 The ethics of disclosing reported conditions in donor-conceived offspring to recipients of the same donor

Abstract Study question To what extent should new genetic risk information, identified after donation, be disclosed to recipients? Summary answer Withholding new genetic risk information from donor sperm recipients may sometimes be ethically justified or even preferred. What is known already In some cases, donor-conceived persons are born with (suspected) harmful genetic mutations. These occurrences may flag increased genetic risks for others if the donor is used for multiple recipients. Genetic conditions can also emerge in donors or their families after donation. Current guidelines, such as those established by the European Directorate for the Quality of Medicines & HealthCare, recommend contacting recipients “in the case of a diagnosis that may seriously affect a child’s health”. However, the specific timing of such disclosures and the circumstances under which (or even whether) information may be withheld are unclear. Study design, size, duration This normative analysis draws initial insights from empirical data obtained from a quantitative study into current practices of fertility clinics and extends to a comprehensive review of academic literature and international guidelines. It evaluates current practices and explores the justifications for (not) informing recipients about (possible) genetic risks linked to their donor, guided by bioethical principles. Participants/materials, setting, methods In June 2023, an electronic questionnaire was sent to all fertility clinics in Belgium to obtain information on current practices regarding the management of genetic mutations in donor treatment. The responses from 15 clinics provided empirical insights that served as an impetus for the subsequent normative analysis. This analysis integrated the findings with normative considerations using the ‘wide reflective equilibrium’ method. Main results and the role of chance Our findings revealed considerable diversity in current practices. Some clinics always informed recipients of newly identified genetic risks (possibly) related to their donor, while others based their decision on various factors. The main arguments for disclosing this information are clinical utility (beneficence) and respect for the recipient’s autonomy. Withholding health-related information can be harmful, especially if it impedes diagnosis and treatment. Moreover, when sperm samples are reserved for additional children from the same donor, disclosure facilitates better-informed reproductive decisions. Conversely, non-disclosure is sometimes justified on the same grounds. If the recurrence risk is absent or equivalent to the general population risk level, disclosure could cause undue alarm and overtreatment. These harms may outweigh the marginal benefits of (immediate) disclosure, particularly for unconfirmed, late-onset, non-severe, and untreatable conditions. Respecting autonomy also implies recognizing the right not to know, by allowing recipients to prespecify the type of information they wish to receive (e.g., untreatable conditions). However, other factors can complicate this assessment. When early diagnosis is crucial, confirming the donor’s link to the reported condition or determining the recurrence risk may take too long. Additionally, a thorough risk analysis becomes more intricate if insemination is planned, embryos are created, or during pregnancy. Limitations, reasons for caution This analysis focuses on cases with anonymous donors and excludes situations involving identifiable and known donors. If the recipient and donor know each other, a distinct set of ethical considerations and duties may emerge. Wider implications of the findings The need for a nuanced, context-sensitive ethical framework for the disclosure of (potential) harmful genetic mutations in a donor to recipients of donor sperm is highlighted. Such a framework could inspire policy development and support ethical decision-making in fertility treatments. Trial registration number Not applicable

Managing risks for genetic conditions in donor sperm treatment: current practices in Belgian fertility clinics

Research questionHow do fertility clinics in Belgium manage risks for genetic conditions in donor sperm treatment? DesignAn electronic questionnaire was distributed to all fertility clinics in Belgium in June 2023, focusing on treatments with anonymous sperm donors from 2018 to 2022. Responses from 15 clinics were analysed anonymously using IBM SPSS statistics. ResultsAll clinics assessed donor risks, including a personal and family history, conventional karyotyping and (for 83.3% of the clinics) carrier screening for common autosomal recessive conditions. For recipients, 58.3% of the clinics relied only on a personal and family history. Despite efforts, the suspicion or detection of genetic conditions in donor sperm treatment was prevalent, with 9.4 adverse events reported per 100 children born. When adverse events occurred, most clinics (58.3%) would not inform the donor if no additional genetic testing was needed. Around 1 in 4 (26.7%) clinics always informed recipients about an adverse event possibly related to their donor. An equal number (26.7%) categorically ruled out the use of spermatozoa from a donor after an adverse event was traced back to his DNA, and 53.3% would not consider using the donor when the adverse event was not genetically confirmed. For the other clinics, deciding when to disclose new genetic risk information or when to allow the use of a donor linked to an adverse event was a complex matter involving different considerations. ConclusionAlthough suspected or detected genetic conditions linked to donor treatments were common, there was wide variation in how Belgian clinics prevented and managed these situations.

Allocating Inventory Risk in Retail Supply Chains: Risk Aversion, Information Asymmetry, and Outside Opportunity

Problem definition: Recent global crises have caused unprecedented economic uncertainty and intensified retailers’ concerns over inventory risks. Mitigating inventory risks and incentivizing retailer orders is critical to managing retail supply chains and restoring their norms after severe impacts. We study the allocation of inventory risk using contracts in a retail supply chain with a risk-neutral manufacturer and a risk-averse retailer. We consider two factors that affect the effectiveness of contracting: (1) asymmetric risk aversion information—retailers’ attitudes are typically diverse and unknown to the manufacturer, and (2) uncertain outside opportunity—retailers typically face a volatile external business environment. Methodology/results: With a game-theoretic model that captures the interaction among risk aversion, information asymmetry, and outside opportunity, we derive the contracting equilibrium under two widely adopted risk allocation schemes—push (i.e., the retailer bears the inventory risk) and pull (i.e., the manufacturer bears the inventory risk) contracts. Contrary to the conventional wisdom that pull contracts are more effective in risk mitigation, we show that push contracts may induce larger expected order quantities and achieve the highest supply chain efficiency due to the interaction of asymmetric risk aversion information and risky outside opportunities. We also find that the manufacturer may obtain higher profits with push contracts when both the heterogeneity in the retailer’s risk attitude and the risk of the outside opportunity are sufficiently high. In addition, when the risk of the outside opportunity is in a medium range, the push contract allows the manufacturer to fully eliminate the information rent and achieve the supply chain’s first-best outcomes. We further evaluate the effects of product profitability and demand uncertainty and generalize the retailer’s risk measure to any coherent risk measure. Managerial implications: Our analysis highlights the importance of modeling asymmetric risk aversion information and risky outside opportunities in analyzing supply chain contracting. When considering these practical factors, allocating more inventory risks to a risk-averse retailer may be better than a risk-neutral manufacturer. Our results provide novel insights into the selection of proper contract types for managing inventory risks in retail supply chains. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0624 .

A Framework Analyzing Climate Change, Air Quality and Greenery to Unveil Environmental Stress Risk Hotspots

Rapid urbanization has resulted in increased environmental challenges, compounding worries about deteriorating air quality and rising temperatures. As cities become hubs of human activity, understanding the complex interplay of numerous environmental elements is critical for developing effective mitigation solutions. Recognizing this urgency, a framework to highlight the hotspots with critical environmental issues emerges as a comprehensive approach that incorporates key criteria such as the surface urban heat island intensity (SUHII), heat index (HI) and air quality index (AQI) to assess and address the complex web of environmental stressors that grip urban landscapes. Employing the multicriteria decision analysis approach, the proposed framework, named the environmental risk hotspot mapping framework (ERHMF), innovatively applies the analytic hierarchy process at a sub-criteria level, considering long-term heat island trends with recent fluctuations in the HI and AQI. Climate change impact has been symbolized through rising temperatures, as reflected by surface urban heat island intensity trends over two decades. The robustness and correctness of the weights have been assessed by computing the consistency ratio, which came out as 0.046, 0.065 and 0.044 for the sub-criteria of the SUHII, AQI and HI, respectively. Furthermore, the framework delves into the nexus between environmental stressors and vegetation cover, elucidating the role of green spaces in mitigating urban environmental risks. Augmented by spatial and demographic data, the ERHMF adeptly discerns high-risk areas where environmental stress converges with urban development, vulnerable population concentrations and critical vegetation status, thereby facilitating targeted risk management interventions. The framework’s effectiveness has been demonstrated in a regional case study in Italy, underscoring its ability to pinpoint risk hotspots and inform specific policy interventions. The quantitative study undertaken at the sub-administrative level revealed that approximately 6,000,000 m2 of land in Bologna are classified as being under high to extremely high environmental stress, with over 4,000,000 m2 lying only within the extremely high stress group (90–100). Similarly, 1,000,000 m2 of land in Piacenza and Modena have high levels of environmental stress (80–90). In conclusion, the ERHMF presents a holistic methodology for delineating high-risk urban hotspots, providing essential insights for policymakers, urban planners and stakeholders, with the potential to enhance overall urban resilience and foster sustainable development efforts.

How Government Actions Influence People’s Intentions to Share on Social Media During Shanghai’s Lockdown for COVID-19: A Third-Person Effect Perspective

During the COVID-19 pandemic, China’s “Zero-COVID” policy and strong government actions led to significant disruptions in daily life. Using Shanghai’s 2022 lockdown as an example, this study investigated how the government’s actions influenced people’s intentions to share information about risks and content with positive emotions. By employing the Third-Person Effect theory, this study further explores the underlying socio-psychological mechanism. A survey was conducted with 7,962 participants, and multiple linear regressions and structural equation models were applied to analyze the data. We found that (1) the policies that led to inconvenience whetted the dissemination of risk information and restricted the sharing of positive-emotion content; (2) “status-led” motivation was the critical reason why people shared both types of messages; and (3) Third-Person Perception mediated both of these influences. These findings expand our understanding of social communication during public health crises, particularly how the Third-Person Effect works.

Developing a transdisciplinary tool for water risk management and decision-support in Ontario, Canada

Extant literature reveals limited examination of risk management strategies and tools to support decision-making for sustainable water management in the private sector in Ontario, Canada. Moreover, a gap persists in understanding how water risks are prioritized and managed in the private sector. Addressing these gaps, this transdisciplinary study applied a novel normative-analytical risk governance theoretical framework to water security risks, which combines analytical risk estimation with normative priorities and insights of practitioners, to examine contextually-attuned water risk management strategies and develop a decision-support tool. Using mixed methods, the study first employed a survey to elicit practitioner priorities for seven water risk indicators and investigated water risk management approaches. Then, interviews were conducted to obtain in-depth understanding about the priorities, strategies, opportunities, and role of trust in water risk management. The study found that a combination of regulatory, voluntary, and multi-stakeholder participatory approaches is needed, contingent on the severity of water risks, sector, location, and context. Moreover, the criteria of flexibility, efficiency, strategic incentives, and economic and regulatory signals, are essential. Finally, using secondary data analysis, the study integrated interdisciplinary risk data with practitioner priorities to develop a first-of-a-kind decision-support tool for water risk management in Ontario, ‘WATR-DST’. WATR-DST is an automated tool that applies the study’s findings and assists multi-sector water-related decisions, practices, and investments by providing contextually-attuned risk information in a user-friendly format. Based on the user inputs (location, sector, and source type), it displays the severity of seven water risks, qualitative themes under public and media attention, and recommends water risk management strategies. Thus, the study contributes to knowledge in sustainability management, risk analysis, and environmental management by demonstrating the novel application of the normative-analytical framework for water risk management in the private sector. WATR-DST is a key contribution envisioned to improve multi-sector water-related decisions in Ontario.

Motivation for Risk Information Seeking among Hospital Employees in the Context of COVID-19 Pandemic: An Organisational Perspective

The outbreak of novel infectious diseases like COVID-19 elicits widespread uncertainty and fear, prompting individuals to seek information from various media channels to protect themselves and their loved ones. However, the factors that motivate hospital employees, who serve as the frontliners in combating the COVID-19 pandemic, to seek COVID-19-related information are still far from understood. Guided by the Risk Information Seeking and Processing (RISP) model, this study aimed to examine the motivational factors that drive hospital employees' risk information-seeking behaviour within the Malaysian context. Through analysis of a proportionate stratified sample size of hospital employees (N=407), this study revealed that information needs, current knowledge, and organisational norms significantly influence hospital employees' intention to seek risk information. These findings contribute to the theoretical development of the RISP model by highlighting the importance of information needs as a prominent factor and underscoring the valuable role of organisational norms in shaping hospital employees' risk information-seeking behaviour within hospital settings. From a practical standpoint, our findings offer valuable insights that can inform communication strategies and enhance organisational support in healthcare environments, particularly in risk management. By considering our results, healthcare institutions can improve their preparedness for future pandemics and strengthen risk communication within Malaysia's healthcare system. Furthermore, this study extends the application of the RISP model and related work within the COVID-19 pandemic, providing pertinent knowledge on risk communication within the healthcare sector. Keywords: COVID-19, hospital employees, Risk Information Seeking and Processing Model, risk information seeking, pandemic preparedness.

The Uptake of Partner Participation in Sequential Preconception Carrier Screening

Introduction: Carrier screening that is performed in the preconception period allows for couples at risk for having children affected with certain single gene (Mendelian) conditions to be identified. This is the most optimal timeframe to perform such screening. Most obstetric providers utilize a sequential process in which the patient first undergoes screening and their partner is only offered testing if the initial results reveal that the first is a carrier for one or more autosomal recessive (AR) deleterious variants. If the partner fails to undergo screening, the couple cannot obtain meaningful and actionable risk information for future or current pregnancies. In this study, we sought to assess the frequency of completed carrier screening risk assessment among individuals and couples who were undergoing preconception screening at two prenatal screening programs staffed by genetic counselors and geneticists. Materials and Methods: We reviewed the screening outcomes for individuals and couples who presented for preconception carrier screening from January 1, 2020 through December 30, 2021 at Insight Medical Genetics and the clinical genetics program at Northwestern Medicine. All individuals received pretest genetic counseling prior to screening and posttest counseling after results were available. We evaluated individuals who were found to be a carrier of at least one deleterious variant and whether the partner of that person underwent carrier screening, and, if so, which type of screening. Results: 548 patients who identified as women underwent preconception carrier screening during the study period, along with 3 men presenting for initial screening. These screens consisted of a panel containing primarily autosomal recessive conditions with a few X-linked conditions. 247 individuals (45.1%) were positive for at least one pathogenic variant; of these, 244 (98.8%) were variants in genes associated with autosomal recessive conditions. A total of 219 partners (88.7%) underwent carrier screening, including the 3 female partners of the men who initiated carrier screening. Of note, 4 of the patients who underwent carrier screening reported not having a partner at the time of screening; accordingly, the partners who underwent screening represent 89.8% of individuals eligible for partner screening following an initial positive result. Of the 219 partners who underwent carrier screening, 201 (91.8%) chose a carrier screening panel of 150+ conditions, while 18 chose a more limited panel that included the gene(s) of relevance based on their partner’s results, with or without additional genes relevant to their learned/self-identified ethnicity or race. Conclusions: Approximately 10% of couples presenting for preconception genetic counseling and carrier screening found to be at potential risk for a child with an autosomal recessive condition did not obtain the requisite information to fully assess their risk of having an affected child. It is possible that the frequency of couples who do not obtain complete and actionable screening information is even higher when carrier screening is provided without the assistance of certified genetic counselors or geneticists. Recently, cell free DNA-based maternal screening has been introduced that assesses the risk for a limited number of genetic conditions in the fetus that may not require assessment of the partner. Nonetheless, providers must communicate to their patients that meaningful risk information can only be obtained when the partner undergoes screening in cases where the initial member of the couple is found to be a carrier of at least one autosomal recessive condition. Laboratories and professional societies need to develop effective educational outreach to patients and providers alike to improve the screening process for couples who want to determine if they are at risk to have a child with an inherited condition.

FRAUD PREVENTION STRATEGIES IN INDONESIAN MSMEs: THE SIGNIFICANCE OF HONESTY AND INTERNAL CONTROL FACTORS

This study highlights the role of honesty and internal control in preventing fraud in Micro, Small, and Medium Enterprises (MSMEs) in Indonesia. MSMEs are an important pillar in the national economy, but face challenges such as poor management, limited human resources, and fraud. This study examines the impact of a culture of honesty and the implementation of effective internal controls to reduce fraud risk. The sample consisted of 150 MSMEs. Testing was performed using SmartPLS. The results show that honesty and good internal control can increase the reliability of financial information, operational efficiency, and consumer trust. In addition, the implementation of internal control, which includes risk assessment, control activities, and information and communication, has proven to be effective in mitigating the risk of fraud. To support MSMEs in moving up in class and achieving sustainable success, the government and other stakeholders must provide management guidance, training, and support programs that focus on increasing honesty and internal control. Thus, MSMEs can be better prepared to face business challenges, reduce the risk of fraud, and contribute more to national economic growth. Keywords: Fraud, Honesty, Internal Control, Micro Small and Medium Enterprises, MSMEs

Inter-disciplinary Approaches to Risk Management and Information Sharing for Resilience to the Changing Climate

Inter-disciplinary Approaches to Risk Management and Information Sharing for Resilience to the Changing Climate

Coral Safe or Skin Safe?: Risk Information Behaviors and Green Purchase Decisions

Coral bleaching threatens coral safety and the marine environment. Coral-safe sunscreens are encouraged as a green product to protect coral reefs by many U.S. states and other nations. This study cited key variables from the planned risk information seeking and processing (PRISM) model to explore the connection between risk information behaviors and pro-environmental purchase decisions. We surveyed a sample of 409 U.S. respondents, and employed structural equation modeling for analysis. Results showed that both information seeking and processing were precursors to consumers’ product information seeking during purchasing, thereby impacting the purchase intent of coral-safe sunscreens. Systematic processing is also directly related to the purchase intent. Implications are further discussed.

Factors influencing U.S. women’s interest and preferences for breast cancer risk communication: a cross-sectional study from a large tertiary care breast imaging center

BackgroundBreast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women’s interest in and preferences for breast cancer risk communication.MethodsThis is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women’s interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women’s interest in knowing their personal risk and preferences for details around exact risk estimates.ResultsAmong 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as “more than one race or other” were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p < 0.01), while women with greater than a high school education were significantly more likely to prefer exact risk estimates (OR 2.5, 95% CI 1.5, 4.2, p < 0.001).ConclusionU.S. women in this study expressed strong interest in knowing their risk and preferred to receive exact risk estimates verbally if found to be at high risk. Sociodemographic and family history influenced women’s interest and preferences for risk communication. Breast imaging centers implementing risk assessment should consider strategies tailored to women’s preferences to increase interest in risk estimates and improve risk communication.

Adopting the risk information seeking and processing model to examine the impact of personality on vaccination intentions in Taiwan

Using the risk information seeking and processing model, this study examined how five personality traits—extraversion, neuroticism, conscientiousness, openness to experience, and agreeableness—influenced individuals’ information-seeking behaviors and vaccination intentions. An online survey was administered by a reputable polling company commissioned by this study. The survey employed age, education, gender, and income as distinct strata for sampling, which resulted in 1100 valid questionnaires.The following five conclusions were drawn from the data analysis: (1) Of the five personality traits, two—extraversion and conscientiousness—exhibited a notable impact on individuals' information-seeking behaviors and vaccination intentions. Individuals with the remaining three personality traits—neuroticism, agreeableness, and openness to experience—demonstrate either passive or no information-seeking behaviors on COVID-19. (2) Conscientiousness was the only personality trait linked to increased awareness of COVID-19 characteristics. Moreover, conscientious individuals were inclined to avoid depending on ISNs to seek COVID-19 information and developed vaccination intentions. In contrast, individuals high in agreeableness heavily depended on ISNs for COVID-19 information to initiate information-seeking behaviors. Meanwhile, individuals high in extraversion relied on two variables—affective responses and ISNs—to begin their information-seeking behaviors. (3) Respondents' perceptions of COVID-19 characteristics and their affective responses did not positively influence their perceived information insufficiency directly; instead, both needed to be mediated by ISNs to initiate their information-seeking behaviors. (4) In contrast to the two variables—perceived COVID-19 characteristics and affective responses—this study found that ISNs regarding COVID-19 played a more substantial role in shaping respondents' information-seeking behaviors and vaccination intentions. (5) Unexpectedly, openness to experience was found to have no impact on information-seeking behaviors during the COVID-19 pandemic.

Data-driven ergonomic assessment of construction workers

Automating ergonomic assessment improves both objectivity and cost-effectiveness. However, existing ergonomic scales remain susceptible to inaccuracy and insensitivity when assessing diversified construction activities. This susceptibility stems from the unreliable ranges, sharp boundaries, and oversimplified binary rules within conventional joint-level assessment rules, coupled with the restricted transformation rules to integer input/output. This paper presents a data-driven ergonomic assessment method grounded in statistical data from Construction Motion Data Library (CML) dataset, comprising: 1) Developing joint-level scoring models to primarily improve accuracy through leveraging Heuristics Gaussian Cloud Transformation (H-GCT), and 2) Designing fuzzy inference mechanism to enhance sensitivity through retaining risk information during transformation across levels. Subsequently, a three-step validation confirms accurate risk identification, sensitive risk feedback, and positive correlation with previous methods, contributing to occupational health and safety management. Future research could enhance the method by expanding the pose dataset, recruiting more participants, and refining the 3D pose estimation.

A Pilot Study of BRAIN BOOTCAMP, a Low-Intensity Intervention on Diet, Exercise, Cognitive Activity, and Social Interaction to Improve Older Adults’ Dementia Risk Scores

BackgroundLittle is known about the impact of short, low-intensity multidomain dementia risk reduction interventions in older adults.ObjectivesTo examine the effectiveness and feasibility of a low-intensity multidomain lifestyle intervention on dementia risk and dementia literacy in Australian older adults.DesignSingle-group pre-post design.SettingCommunity-dwelling.ParticipantsA total of 853 older Australians (Mean age=73.3 years, SD=6.1) recruited from the community.InterventionA 3-month dementia risk reduction program, BRAIN BOOTCAMP, including education, personalised risk information, physical cues for healthier choices and goal setting and planning to target four modifiable risk factors of diet, exercise, cognitive activity and social interaction in older adults.MeasurementsThe ‘LIfestyle for BRAin health’ (LIBRA) index was used to assess participants’ modifiable dementia risk based on 12 factors, with higher scores indicating greater risk. Dementia literacy was measured using a modified questionnaire derived from Dutch and British surveys, encompassing knowledge, risk reduction, and awareness aspects. Paired t-tests were used to compare dementia risk scores and dementia literacy before and after the program. Multivariate regressions were performed to identify sociodemographic and psychological factors associated with change in the LIBRA index.ResultsProgram attrition was high (58.3%). Participants who completed the program had decreased dementia risk scores (Cohen’s d=0.59, p<0.001), increased dementia literacy and awareness (Cohen’s d=0.64, p<0.001) and increased motivation to change lifestyle behaviors (Cohen’s d=0.25–0.52, p<0.016). Participants with higher motivational beliefs had greater dementia risk reduction.ConclusionsImproving older adults’ motivation and knowledge may help modify lifestyle behaviors to reduce dementia risk. However, program attrition remains a challenge, suggesting the need for strategies to enhance participant engagement and retention in such interventions.

Private Loan Issuance and Risk Factor Disclosure

ABSTRACT This study provides evidence that private loan issuance offers opportunities for borrowers to learn new information about their own risks and subsequently disclose such information in their risk factor disclosures (RFDs) to satisfy lenders’ demand for transparency about borrowers’ risks. This loan issuance effect on risk disclosures is more pronounced when greater learning opportunities are present and when lenders have a stronger demand for borrowers’ risk information transparency. Further analyses suggest that the enhanced risk disclosures following loan issuance not only benefit lenders by reducing the costs of accessing the secondary credit markets, but also create spillover benefits for equity investors by increasing risk information about the borrower and reducing uncertainty about the borrower’s risk. Taken together, these findings suggest that borrowers’ private interactions with lenders provide new opportunities for managers to generate and reflect fresh information in corporate risk disclosures, ultimately benefiting a wide range of capital market participants. Data Availability: Data are available from the sources identified in the paper. JEL Classifications: G21; G32; M41.