Risk Reduction Strategies Research Articles

Risk-based portfolio planning of dike reinforcements

A system of dikes in flood-prone areas continuously requires measures to mitigate changes such as ageing and climate change. Planning costly measures requires proper insight into system risk effects. Especially in a riverine dike system, the risk contributions of individual assets to the system flood risks are not independent, because reinforcement of a dike upstream increases the risks downstream. Tactical plans define the planning of consecutive measures to implement a flood risk reduction strategy, which may take decades. They may differ due to choices such as a prioritization metric, planning conditions and budget. In this study, a method is developed to compare different tactics to prioritize and plan measures in interdependent systems of dikes to reduce risks most effectively and efficiently. A case study meant as a proof of concept was carried out for the reinforcement of about 500 km of dikes along the Rhine River branches in the Netherlands. We studied the effects of 12 different tactical plans on the aggregated risks over time. The economic risks differ by up to about 40%, and the risks on victims differ by up to 70 %. We conclude that tactical planning and corresponding decisions are important for reduction of time-aggregated flood risks.

Evaluation of seagrass as a nature-based solution for coastal protection in the German Wadden Sea

Global climate change increases the overall risks for coastal flooding and erosion. Meanwhile, nature-based solutions (NbS) are increasingly becoming a focus of coastal protection measures to improve the climate adaptability. In this study, the present and potential future role of seagrass in coastal risk reduction strategies were explored for the highly energetic Wadden Sea area of the German Bight. The methodology in this study combined seagrass coverage data (Zostera marina and Zostera noltei) obtained by field surveys and what-if scenario simulations using the SCHISM unstructured grid model framework, coupling hydrodynamics, waves, sediments, and a seagrass module. The results suggest that the introduction of seagrass meadows locally can reduce both current velocities and significant wave heights in the order of up to 30% in the deeper areas and above 90% in the shallow areas. Reduction in bottom shear stress of a similar relative magnitude significantly reduced sediment mobilisation on the order of 2 g/L in the 95th quantile of bottom layer sediment concentrations. Effectively altering hydromorphodynamic conditions favouring sediment accumulation, seagrass expansion could help tidal flats height growths to keep up with SLR, thus further maintaining the bathymetry-induced tidal dampening and lowering flooding and erosion risks as well the amount of energy at dike infrastructure. The accumulated effect of seagrass under calm weather conditions is considered more important than the increased attenuation in absolute values it provides during extreme conditions. The overall conclusion is that seagrass expansion could be a useful addition to engineered coastal protection measures.

Impulse control during the online shopping frenzy in China: the role of consumer inertia

This study examined impulse control during an online shopping festival in China. The research model integrated the flow theory into a Stimulus-Organism-Response (S-O-R) framework to explore the direct and indirect impacts of positive eWOM on impulse buying; the mediating role of consumer inertia was assessed as a risk-reduction strategy in impulse-control intervention. The proposed model reasonably well fits the data; all hypotheses are supported. The structural equation modeling results (n = 497) show that positive eWOM contributes to impulse buying because of the online shopping frenzy. Simultaneously, the rise of these stimuli also leads to reflective impulse control, and the three types of consumer inertia can explain the transition from positive eWOM to impulse buying. Furthermore, the affective and cognitive inertia enhance the dependence on the behavioral type after continuous stimulation with positive reinforcement. The findings imply consumer inertia helps secure decision quality and alleviates impulse behavior. In addition, the behavioral inertia generated by sustained affective and cognitive stimulation is essential to subsequent impulse purchases associated with evolving brand loyalty. The study consequently offers some suggestions for marketers to promote repeat purchases as well as potential lines of inquiry for further research.

The Perceptions and Risk Reduction Strategies of Small-Scale Salt Farmers on Madura Island

Salt farming is considered a risky venture due to the influence of both internal and external factors. Therefore, this study aimed to describe farmers' perceptions regarding the causes, opportunities, and impacts of risks to develop a risk reduction strategy for salt farming in Madura Island. The study used a multistage sampling method to obtain 120 respondents and was conducted in three regencies: Sampang, Pamekasan, and Sumenep. The first objective was analyzed using the descriptive method, while the second was designed using the Kountur method. Farmers' perceptions showed that seawater quality, wind and temperature, rainfall, soil porosity, price volatility, marketing channels, government policies, capital constraints, and human resource quality could cause risks in salt farming. Several risks were perceived to significantly impact salt farming, such as government policies, partnerships, marketing channels, prices, and capital availability. Therefore, some recommendations to improve the risk reduction strategies included the use of horizontal axis windmills, revitalization of groups and partnerships, and capital strengthening through the effectiveness of the PUGAR (Empowerment of Smallholder Salt Businesses) policy by the development of standard procedures for the timely and targeted distribution of the aides.
 
 Keywords: perception, risk, salt, strategy

BRCA1/2 mutation carriers & risk reducing mastectomy: Who undergoes surgery and potential benefits

BackgroundRisk-reducing mastectomy (RRM) is the most effective breast cancer risk-reduction strategy in BRCA1/2 mutation carriers. We examined factors associated with RRM and its relationship with overall survival (OS). MethodsPatients aged 18-80y at diagnosis of their BRCA1/2 mutation were selected from our institutional database and stratified by RRM receipt. Differences were tested; unadjusted OS was estimated. ResultsOf the 306 patients, median age was 43y; median follow-up was 41.6mo. Patients undergoing RRM were more often married with a history of pregnancy (both p ​≤ ​0.05). Of female patients, 23.1% underwent RRM. Two patients had malignancy detected at RRM, and one developed breast cancer after RRM. Higher unadjusted OS was observed with RRM (p ​= ​0.02). ConclusionsOur analyses suggest that family-structure may play a role in a patient's decision to undergo RRM. We also demonstrated RRM is likely associated with improved survival, potentially underscoring the importance of this option for BRCA1/2 mutation carriers.

Exploring English policymakers' attitudes towards dementia risk reduction: A qualitative study.

A growing evidence-base indicates that dementia occurrence can be changed. This has been linked to potentially modifiable risk factors. Risk reduction and primary prevention strategies are increasingly recognized as needing to include population-level policies to tackle the social and commercial determinants of health. How this knowledge can influence policymaking on dementia prevention is unknown. Understanding attitudes of policymakers is an important step in translating evidence into practice, helping to gauge system readiness for implementation, and potential barriers and enablers for influencing policy. The aim of this qualitative study is to explore the understanding of, and attitudes to, dementia risk reduction and population-level prevention strategies amongst English policymakers at national, regional, and local level. Semi-structured interviews were undertaken with a range of dementia and prevention policymakers, with purposive sampling of national and local policymakers, including politicians, government officials, health system leaders, academics, and dementia charity directors. Analysis of interview transcripts was undertaken by thematic analysis. 14 policymakers were interviewed between November 2021 and February 2022. Three main themes were identified (1) Preventability of dementia, (2) Prevention approach, (3) Barriers and facilitators to improving the approach. Policymakers generally held dementia to be partially preventable. Policymakers recognised that both individual- and population-level approaches to primary prevention of dementia are required - with some policymakers perceiving that population-level approaches are under-utilised. Key barriers to implementing more population-level approaches were identified as the complexity and co-ordination required to effectively tackle upstream determinants of health.

Refined urban disaster vulnerability assessment based on elements at risk: A case study of Dalian, China

With the rapid development of global urbanization, cities tend to suffer higher frequencies and risks of various hazards and are becoming more vulnerable, especially under the circumstance of global warming. Hence, people have begun to attach importance to the study of urban disaster vulnerability gradually. However, existing studies focus more on the multi-dimensional expression and comprehensive measurement of disaster vulnerability at the macro scale, which cannot reflect the changes of disaster vulnerability within the small scale. It is difficult for the research results to provide practical information for accurate disaster prevention and reduction. For this purpose, this study proposed a framework for refined urban disaster vulnerability assessment from the perspective of elements at risk, which includes three quantitative models: exposure assessment model, sensibility assessment model, and coping capability assessment model. Then, the framework and its quantitative models were applied to assess the disaster vulnerability of Dalian at the scale of 30 × 30 m grid. Furthermore, the main factors contributing to vulnerability were highlighted based on of exposure, sensibility, and coping capability indexs. Results showed that the disaster vulnerability of Dalian was autocorrelative and heterogeneous spatially. This research could provides some implications for disaster mitigation and risk reduction strategies at the urban scale.

Special Issue on ICoE Taipei Integrated Research on Disaster Risk

Established in 2010 as an integrated research program for disaster risk reduction, the IRDR ICoE Taipei is co-sponsored by the International Science Council (ISC) and the United Nations Office for Disaster Risk Reduction (UNDRR). In the past decade, the IRDR ICoE Taipei has received hundreds of participants around the world to the more than a dozen international training workshops (AI, Advanced Institute) it has organized. These workshops focused mostly on the capacity building program for disaster risk reduction. Bearing this in mind, one important motivation for this Special Issue was to encourage the participants of each Advanced Institute, in particular those who were awarded Seed Grants to conduct one-year projects following each workshop, to publish the results of their studies on the topics related to disaster risk reduction. In this Special Issue, the first paper provides a brief review of the capacity building program of the IRDR ICoE Taipei, followed by three research articles. Viola van Onselen and her co-workers in Taiwan present a methodology of strategies of ecosystem-based disaster risk reduction, with several case studies in coastal environments of Taiwan. Shyamli Singh of India proposes an integrated system for sustainable rice economics linking from farm to market, a case study on one of the largest rice production fields on the Indo-Gangetic plain. From the engineering perspective, Wen-Yi Huang and his colleagues in Taiwan and Australia present a paper dealing with the reinforcement of soil walls to prevent geohazards on the roads. This is the first special issue produced as a collaboration between the IRDR ICoE Taipei and the JDR, with great support from the National Science and Technology Center for Disaster Reduction (NCDR) and Academia Sinica of Taiwan. We hope there will be more Special Issues to come in the next few years.

Prevalence of dementia among older age people and variation across different sociodemographic characteristics: a cross-sectional study in Bangladesh.

Dementia is a significant global health issue, particularly for low-income and middle-income countries which majorly contribute to the dementia cases reported globally (67%). We estimated the prevalence of dementia among older people in Bangladesh and compared the estimate across different sociodemographic characteristics and divisions. A cross-sectional study was conducted in 2019 among individuals aged 60 years or older in seven administrative divisions in Bangladesh. Equal numbers of male and female participants were recruited from each division through a multi-stage random sampling technique. Recruitment was proportionally distributed in urban and rural areas in each division. Following consent, the Mini Mental State Examination (MMSE) was performed on all participants. Dementia was defined as an MMSE score of <24 out of 30. Data on age, sex, education, marital status, occupation, socioeconomic status, and type of community (urban or rural) were obtained using a structured questionnaire to compare the prevalence of dementia across different sociodemographic characteristics. Between January and December 2019, 2795 individuals were recruited including ∼400 from each of the seven administrative divisions. The mean age was 67 years (SD: 7), 68% were from rural areas and 51% were female. The prevalence of dementia was 8.0% (95% CI: 7.0-8.9%) with variations across age, sex, education, marital status, occupation, and division. No variations in prevalence were observed across urban/rural locations or socioeconomic status. After adjusting for age, sex, education, occupation and marital status, the odds of dementia was two times higher in females than males (OR: 2.15, 95% CI: 1.43-3.28); nine times higher in people aged ≥90 years than people aged 60-69 years (OR: 9.62, 95% CI: 4.79-19.13), and three times higher in people with no education compared to those who had completed primary school (OR: 3.10, 95% CI: 1.95-5.17). The prevalence of dementia is high in Bangladesh and varies across sociodemographic characteristics with a higher prevalence among females, older people, and people with no education. There is an urgent need to identify the key risk factors for dementia in developing countries, such as Bangladesh, to inform the development of context-relevant risk reduction and prevention strategies. None.

Overview of the Genetic Aspects of Lynch Syndrome

"Lynch syndrome (LS) is one of the most common inherited cancer predisposition syndromes and the most important cause of hereditary colorectal and endometrial cancers. It is inherited in an autosomal dominant pattern, caused by a pathogenic germline variant in one of the mismatch repair (MMR) genes (MLH1, MSH2, MSH6, or PMS2), which encode proteins responsible for maintaining genome stability. A defective MMR system confers an elevated risk of developing certain types of cancer, at a younger age than in the general population and at a high rate of multiple primary neoplasia. Lynch syndrome is not just one disease, but a collection of different subtypes of underlying molecular aspects with specific clinical implications. A better understanding of these subgroup profiles could offer better care for each patient, leading to more personalized risk-reduction and surveillance strategies. Lynch syndrome is a frequent but yet underdiagnosed condition that needs multidisciplinary increased awareness for correct diagnosis and management. The aim of this review is to provide a summary of available literature data on the genetic aspects of Lynch syndrome together with geno-type-phenotype correlations and its clinical implications in the detection, genetic counseling, genetic testing, risk stratification, and management of this condition."

NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024.

The NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic focus primarily on assessment of pathogenic/likely pathogenic (P/LP) variants associated with increased risk of breast, ovarian, pancreatic, and prostate cancer, including BRCA1, BRCA2, CDH1, PALB2, PTEN, and TP53, and recommended approaches to genetic counseling/testing and care strategies in individuals with these P/LP variants. These NCCN Guidelines Insights summarize important updates regarding: (1) a new section for transgender, nonbinary and gender diverse people who have a hereditary predisposition to cancer focused on risk reduction strategies for ovarian cancer, uterine cancer, prostate cancer, and breast cancer; and (2) testing criteria and management associated with TP53 P/LP variants and Li-Fraumeni syndrome.

Assessment of Ecosystem-Based Disaster Risk Reduction Strategies in Coastal Environments of Taiwan

Taiwan’s rapid economic and industrial growth has put enormous pressure on its natural environment. This is especially visible in the coastal zone, where risks such as sea-level rise, coastal erosion, land subsidence, and flooding threaten the already vulnerable ecosystems. Ecosystem-based disaster risk reduction (Eco-DRR) is a management strategy that uses ecosystems to reduce disaster risks. While this type of strategy is promoted in the ‘Taiwan Coastal Zone Management Act’ (TCZMA), there is still a lack of data on the implementation of Eco-DRR methods in Taiwan. This study examines papers on policy analyses of the TCZMA, and five main barriers for implementation of Eco-DRR in Taiwan are identified. Subsequently, in order to assess Eco-DRR strategies in the coastal zone of Taiwan, case studies and evaluation data on ecosystem-based management strategies were assembled and evaluated. The results of this study show that initial strategies to plant mangroves for reduction of wave energy have not always been successful; in certain areas they were removed again due to invasiveness in endemic wetland ecosystems. Moreover, artificially building sand dunes can have negative side effects, like oversteepening of the dune profile or deteriorating the natural dune dynamics. To address and tackle aforementioned challenges, a novel framework is introduced for improved uptake of Eco-DRR in Taiwan and beyond, and suggestions for future strategies are proposed.

Epidemiology of injuries in elite Women’s Artistic Gymnastics: a retrospective analysis of six seasons

BackgroundWomen’s Artistic Gymnastics (WAG) is a sport well known for requiring a heavy and difficult training load from a younger age to reach a high level of performance. This also...

The Role of Friction in the LISA-Pathfinder Release Mechanism Anomaly

Release mechanisms are crucial devices for the success of space missions. In LISA, the first gravitational waves observatory in space, the grabbing positioning and release mechanism (GPRM) is responsible for setting all the test masses (TMs) in the free-fall condition necessary for starting science observations. This mechanism is considered a key equipment for the success of the entire space mission. The GPRM was initially tested in LISA Pathfinder (LPF), a space mission flown between 2015 and 2017, and an anomaly was encountered in the TM velocity after the release, which also resulted in some failures. One of the suspected reasons of this behavior is that the trajectory of the release mechanism deviates from the nominally rectilinear one. We find that this anomaly is due to the presence of high and asymmetric friction between moving parts. In this paper, we characterize experimentally the deviation from the linear trajectory, using LPF qualification models of the mechanism available on ground, and we identify the mechanical features that determine the friction-driven spurious lateral motion via a numerical finite element model. The results are one of the basis to improve the design of the GPRM for LISA. Some risk-reduction strategies and design guidelines are also presented and discussed.

Environmental risk scores of persistent organic pollutants associate with higher ALS risk and shorter survival in a new Michigan case/control cohort

BackgroundAmyotrophic lateral sclerosis (ALS) is a fatal, progressive neurogenerative disease caused by combined genetic susceptibilities and environmental exposures. Identifying and validating these exposures are of paramount importance to modify disease...

The menopausal transition period and cardiovascular risk.

The menopausal transition period spans, on average, 2-8 years before the final menstrual period and is associated with an increase in clinical and subclinical cardiovascular risk. In this Review, we discuss the metabolic and cardiovascular changes that occur during the menopausal transition period and the role of ovarian ageing, chronological ageing and other ageing-related risk factors in mediating these changes. Disentangling the relative contributions of chronological and reproductive ageing to cardiovascular risk is challenging, but data from longitudinal studies in women transitioning from premenopause to post-menopause have provided valuable insights. We also discuss evidence on how cardiovascular risk is altered by premature or early menopause, surgical menopause, and vasomotor and other menopausal symptoms. Whether targeted interventions can slow the progression of atherosclerosis and subclinical disease during the menopausal transition, thus delaying or preventing the onset of cardiovascular events, remains to be determined. Furthermore, we consider the recommended strategies for cardiovascular risk reduction in women undergoing menopausal transition using the framework of the American Heart Association's Life's Essential 8 key measures for improving and maintaining cardiovascular health, and discuss the cardiovascular risks and benefits of menopausal hormone therapy. Finally, we also discuss novel therapies that might benefit this population in reducing cardiovascular risk.

Cascade testing for hereditary cancer: comprehensive multigene panels identify unexpected actionable findings in relatives.

Current guidelines recommend single variant testing in relatives of patients with known pathogenic or likely pathogenic germline variants in cancer predisposition genes. This approach may preclude the use of risk-reducing strategies in family members who have pathogenic or likely pathogenic germline variants in other cancer predisposition genes. Cascade testing using multigene panels was performed in 3696 relatives of 7433 probands. Unexpected pathogenic or likely pathogenic germline variants were identified in 230 (6.2%) relatives, including 144 who were negative for the familial pathogenic or likely pathogenic variant but positive for a pathogenic or likely pathogenic variant in a different gene than the proband and 74 who tested positive for the familial pathogenic or likely pathogenic variant and had an additional pathogenic or likely pathogenic variant in a different gene than the proband. Of the relatives with unexpected pathogenic or likely pathogenic germline variants, 36.3% would have qualified for different or additional cancer screening recommendations. Limiting cascade testing to only the familial pathogenic or likely pathogenic variant would have resulted in missed, actionable findings for a subset of relatives.

Alcohol, Sexual Arousal, and Partner Familiarity as Predictors of Condom Negotiation: An Experience Sampling Study.

Numerous contextual factors contribute to risky sexual decision-making among men who have sex with men (MSM), with experimental laboratory-based studies suggesting that alcohol consumption, sexual arousal, and partner familiarity have the potential to impact condom negotiations during sexual encounters. The purpose of the current study was to extend this line of inquiry outside of the laboratory and into the everyday lives of MSM. We collected six weeks of daily data on alcohol consumption and sexual behaviors from 257 moderate- and heavy-drinking MSM to examine the within- and between-subjects effects of alcohol consumption, average daily sexual arousal, and partner familiarity on condom negotiation processes during sexual encounters. We hypothesized that alcohol consumption, higher levels of average daily sexual arousal, and greater partner familiarity would all contribute to a reduced likelihood of condom negotiation prior to sexual activity, and that they would also affect the difficulty of negotiations. Contrary to hypotheses, none of these three predictors had significant within-subjects effects on condom negotiation outcomes. However, partner familiarity and average daily sexual arousal did exert significant between-subjects effects on the incidence of negotiation and negotiation difficulty. These findings have important implications for risk-reduction strategies in this population. They also highlight the challenges of reconciling results from experimental laboratory research and experience sampling conducted outside of the laboratory on sexual risk behavior.

Flood Disaster Risk Reduction Strategies in Urban Area, Bulukumba Regency

Flood is a disaster that often occurs in big cities in Indonesia, caused by the high density of buildings and the unpreparedness of infrastructure to adapt. Urban Areas of Bulukumba Regency (UABR) is one of the centers of urban areas that has experienced flooding in recent years. The urban area ofBulukumba Regency is a downstream area of the Bialo Watershed whose upstream area is also in the Bantaeng Regency area. Rapid urban development has resulted in a change in land cover to become built-up land so that catchment areas are narrower in the middle and downstream zones, as well as changes in vegetation in the upstream zone which has received land conversion from forest areas to plantation areas. In addition to the potential for flooding due to river flow, the urban area of Bulukumba also has the potential for flooding due to sea tides or tidal floods. The high level of hazard flood potential has not been followed up with sustainable flood management based on disaster risk reduction in the UABR. Based on this, it is necessary to study the level of risk of flooding in the Urban Area of Bulukumba Regency and an appropriate strategy to reduce the risk of flooding in the Urban Area ofBulukumba. The aim of this research is; (1) identify the level of risk of flooding in the UABR; and (2) formulate an appropriate strategy as an effort to reduce the risk of flood disaster in the UABR. The research approach used is the mixed method, with the analytical method used for data processing in the form of risk analysis, spatial analysis namely overlay analysis using GIS software and qualitative descriptive in formulating strategies. The results of this study are a map of the level of flood disaster risk and recommendations for flood risk reduction strategies in the UABR.

Exposure to Treponema pallidum Infection among Adolescent and Young Adult Women in Roraima, Amazon Region of Brazil.

Syphilis is a chronic infectious disease, and its prevalence has been described since the 15th century. Because of the high prevalence of this infection in Brazil, this study aimed to evaluate the prevalence of syphilis and its associated factors among adolescent and young women living in the city of Boa Vista, Roraima, Brazil. The present study was cross-sectional, descriptive, analytical and quantitative. It involved 200 young and adolescent women. Laboratory tests were performed to diagnose syphilis, and a sociodemographic and epidemiological questionnaire was employed. In the studied sample, 10 women had a positive result for syphilis, characterizing a prevalence of 5% for infection with Treponema pallidum. There was a statistically significant association between a monthly family income of less than 1 minimum wage and syphilis (p = 0.0449) and between illicit drug use and syphilis (p = 0.0234). These results indicate the need for public health interventions, action plans, and the implementation of risk reduction strategies focused on this population.