Risk Communication Tools Research Articles

Codesigning a Digital Type 2 Diabetes Risk Communication Tool in Singapore: Qualitative Participatory Action Research Approach.

Diabetes is a serious public health concern worldwide. Despite public health efforts encouraging early screening and improving knowledge of effective interventions for those at increased risk of type 2 diabetes (T2D), the incorporation of preventative behaviors into an individual's daily life remains suboptimal. Successfully and accurately increasing risk perception has been demonstrated to increase behavioral intention. The study aims to codesign a T2D risk communication tool by engaging public participants to (1) identify key characteristics that contribute to an effective risk communication tool and (2) test and iterate to develop a culturally sensitive and meaningful risk communication tool that can motivate T2D preventative behaviors. We adopted a novel methodology, "Patient and Public Involvement (PPI) Hawkers," where we approached patrons at hawker centers and public eateries frequented by all local residents to evaluate and test 3 prototypes for the tool. The three prototypes were (1) "Diabetes Onset"-estimated age of diabetes onset of T2D based on one's risk factors, (2) "Relative Risk"-the relative risk of T2D is presented in a 1-10 scale indicating where one's risk score lie in relation to others, and (3) "Metabolic Age"-the median age of the risk category based on one's risk factors, presented to be compared against their chronological age. We gathered reactions and feedback through rapid testing and iteration to understand which risk result presentation would be received the best. All the collected data were revisited and analyzed using an inductive thematic analysis to identify the key characteristics contributing to an effective risk communication tool. We engaged with 112 participants (female: n=59, 56%) across 6 hawker centers. The key characteristics that were important to participants emerged in four main themes: (1) appeal and user experience, in terms of format and readability; (2) trust and validity of the institution providing the tool and the accuracy of the risk result; (3) threat appraisal: salience of risk information, which influenced their risk perception; and (4) coping appraisal: facilitators for behavior change, which impacted their intention for implementing T2D preventative behaviors. The predictive nature of the prototype entitled "Diabetes Onset" was poorly received and removed after the first iteration. The Relative Risk prototype was valued for being straightforward but feared to be boring. The Metabolic Age prototype was anticipated to be more motivating for behavior change, but there were some concerns that the terminology may not be understood by everyone. Participants were divided on which of the 2 prototypes, "Metabolic Age" or "Relative Risk," they would favor adopting. Further testing is now required to determine which prototype will be more effective in motivating behavior change. This study's insights on the design process and valued characteristics of a risk communication tool will inform future development of such interventions.

Assessment of Lifetime Risk for Cardiovascular Disease: Time to Move Forward.

Over the past decades, there has been a notable increase in the risk of Cardiovascular Disease (CVD), even among younger individuals. Policymakers and the health community have revised CVD prevention programs to include younger people in order to take these new circumstances into account. A variety of CVD risk assessment tools have been developed in the past years with the aim of identifying potential CVD candidates at the population level; however, they can hardly discriminate against younger individuals at high risk of CVD.Therefore, in addition to the traditional 10-year CVD risk assessment, lifetime CVD risk assessment has recently been recommended by the American Heart Association/American College of Cardiology and the European Society of Cardiology prevention guidelines, particularly for young individuals. Methodologically, the benefits of these lifetime prediction models are the incorporation of left truncation observed in survival curves and the risk of competing events which are not considered equivalent in the common survival analysis. Thus, lifetime risk data are easily understandable and can be utilized as a risk communication tool for Public Health surveillance. However, given the peculiarities behind these estimates, structural harmonization should be conducted in order to create a sex-, race-specific tool that is sensitive to accurately identifying individuals who are at high risk of CVD. In this review manuscript, we present the most commonly used lifetime CVD risk tools, elucidate several methodological and critical points, their limitations, and the rationale behind their integration into everyday clinical practice.

The construction and validity assessment of the respiratory air quality health index (AQHI) based on the analytic hierarchy process in Tianjin, China

BackgroundAir quality health index (AQHI), as a developed air quality risk communication tool, has been proved to be more accurate in predicting air quality related health risks than air quality index (AQI) by previous studies. However, the standard method to construct AQHI is summing the excess risks of single-pollutant models directly, which may ignore the joint effect of air pollutant mixtures.MethodsIn this study, a new method which could solve the aforementioned problem, Analytic hierarchy process (AHP), was introduced. Based on this method, we constructed the respiratory health related AQHI using years of life lost (YLL) as indicator of health outcome and compared its validity with AQI.ResultsThere was a correlation between daily AQI and AQHI in 2019 (R2 = 0.830, P < 0.01), and the chi-square test between the two excellent rates showed a statistically significant difference (χ2 = 4.156, P < 0.05). Both AQI and AQHI were correlated with the daily respiratory YLL (P < 0.01), however, the coefficient of AQHI was larger than those of AQI.ConclusionsThis study indicated that compared with AQI, the constructed AQHI based on AHP may predict the health risk of air pollution more effectively. AHP may become a new method to construct AQHI which needs to be proved by taking into consideration by more studies.

Integrating Intelligent Hydro-informatics into an effective Early Warning System for risk-informed urban flood management

The urban drainage system constantly facing flooding issues in coastal and urban areas. Robust and accurate urban flood management, particularly considering fast-moving compound floods, is crucial to minimize the impact of flood disasters in coastal cities. Till now, Ho Chi Minh City (HCMC) lacks an effective means of urban flood management because of flood risk communication among residents. Existing flood risk communication tools rely on post-disaster flood model outcomes and data. Therefore, this research proposes a real-time Early Urban Flooding Warning System (EUFWS) integrated with a user-friendly web and app interface. The backbone of this system consists of flood models developed using machine learning (ML) algorithms, combined with big data and Web-GIS visualization, with ML serving as the core for constructing the EUFWS. EUFWS offer several key advantages: they are available at all times, accessible from anywhere, and provide a real-time, multi-user working platform. Additionally, the system is flexible, allowing for the easy addition of components and services and scalable, adjusting to workload demands. EUFWS have been successfully deployed in Thu Duc City, Vietnam, as a case study and are operating effectively. EUFWS have been successfully deployed in Thu Duc City, Vietnam, as a case study and are operating effectively. Research results indicate that EUFWS supported decision-makers to be effectively risk informed and make intelligent decisions during urban flood emergencies. This underscores the significant potential of integrating ML and information technology to enhance the management of smart urban drainage systems in flood-prone cities worldwide.

Conoce Tus Opciones: The Challenges of Communicating Rip Current Information in Spanish

Abstract Rip currents are poorly understood by the public and thus a leading cause of weather-related fatalities in the United States. Individuals who speak languages other than English, such as Spanish-speaking communities, have been historically underserved by communication efforts for natural hazards and thus are at additional risk from rip currents. In response, the National Weather Service (NWS) has developed rip current outreach tools translated into Spanish in recent years, though their efficacy has not been systematically tested. We therefore surveyed members of the Spanish-speaking community in the New York City area to gain insights into how the NWS two-page rip current informational brochure is working and possible improvements to be made. The English version of the brochure was also tested, and the results from the two languages were compared. Quantitative survey results indicate that while both brochures are generally effective, several changes could be made to improve clarity, especially for Spanish speakers, who found more issues with the Spanish version. For example, the translation of the term rip current itself used by the NWS, “corrientes de resaca,” was determined to be confusing by some Spanish speakers, as were other pieces of text with complex scientific terms. Moreover, certain graphics contained in the brochure were difficult to understand for users in both languages. The results of this work can be used by the NWS and other agencies to improve their Spanish risk communication tools and can also be used as a guide when translating scientific information into other languages. Significance Statement Rip currents, narrow channels of fast-moving water that can pull swimmers away from the shore, are among the leading weather-related killers in the United States yet are poorly understood by the public. Recent efforts to reduce society’s vulnerability to rip currents include the translation of outreach materials from English to Spanish. This study evaluated a new National Weather Service Spanish rip current informational brochure and compared it to the English version. The results show that while both the English and Spanish brochures were generally effective at communicating risk, the Spanish version had more issues, primarily surrounding the translation of scientific terms and phrases. Findings from this research can help guide scientists in designing improved non-English severe weather outreach products.

Feasibility Assessment of a Novel Isolation Care Tent in Uganda During the 2022 Sudan ebolavirus Outbreak.

This case study describes a feasibility assessment of a novel isolation care tent used in health facilities in Uganda during the 2022 Sudan ebolavirus outbreak. The Isolation System for Treatment and Agile Response to High-Risk Infections Model 1B (ISTARI 1B) is a single-occupancy, portable, negative-pressure isolation tent designed for the safe delivery of standard care to patients with a communicable disease, including Ebola disease (Sudan). At the request of the Uganda Ministry of Health, the Makerere University Infectious Diseases Institute and University of Nebraska Medical Center partnered to evaluate 7 health facilities across 4 districts in Uganda for infrastructure, case management, and infection prevention and control (IPC) capacity relevant to isolation care and ISTARI 1B use. A 3-day workshop was held with IPC leaders to provide familiarization and hands-on experience with the ISTARI 1B, delineate appropriate use scenarios in Ugandan healthcare settings, contextualize ISTARI 1B use in case management and IPC workflows, develop a framework for site assessment and implementation readiness, and consider ongoing monitoring, assessment, and intervention tools. Workshop participants performed a comprehensive site assessment and mock deployment of the ISTARI 1B. In this case study, we describe lessons learned from health facility assessments and workshop outcomes and offer recommendations to support successful ISTARI 1B implementation. Use scenarios and implementation strategies were identified across facility levels, including tools for site assessment, training, risk communication, and ongoing quality and safety monitoring.

Improving cyber risk governance through storytelling

This paper addresses the critical challenge of cyber risk governance faced by executives, security committees and boards of directors in the rapidly changing digital landscape. Cyber security complexity, characterised by data deluges and the translational gap between technical jargon and business risk, significantly hinders effective cyber risk messaging and governance. Drawing on five years of research and interviews with chief information security officers (CISOs), the paper highlights the struggle in establishing trust and confidence in governance bodies due to these complexities. It introduces three constructs that aim to simplify cyber security messaging to enhance cyber risk governance: the intelligence to risk (I2R) pyramid, five risk impacts, and resilience and proximity graph. Each construct, illustrated with practical examples, is designed to provide clarity and foster understanding between cyber security professionals and governance bodies, ensuring a cohesive approach to cyber risk management. Readers can expect to gain valuable insights into overcoming the limitations of traditional risk communication tools such as risk registers. By adopting the presented storytelling approach, the paper promises strategies for building trust through transparency and accountability, bridging the communication gap between technical and executive levels, and facilitating informed decision making for improved governance outcomes in the face of cyber security threats.

Constructing an AQHI as a health risk communication tool for Bangkok, Thailand

In this study, we established an air quality health index (AQHI) based on the associations between multiple air pollutants and respiratory and cardiovascular outpatient department (OPD) visits to communicate the health risks from air pollution in Bangkok, Thailand. The associations between various air pollutants, namely, suspended particulate matter (PM) with an aerodynamic diameter smaller than 2.5 µm and 10 µm (PM2.5 and PM10, respectively), sulphur dioxide (SO2), and ozone (O3) and the number of OPD visits for respiratory and cardiovascular diseases in Bangkok from 2016 to 2019 were assessed using generalised additive models with a Poisson link function. Significant associations were established between most cases of cardiovascular and respiratory diseases and these pollutants with a lag time of 0–7 days. The total excess risk was calculated to construct the AQHI, which was then adjusted to an arbitrary scale and banded into four groups based on the calculated score, where 1–3, 4–6, 7–10, and 10+ represented low risk, moderate risk, high risk, and very high risk, respectively. We found that the AQHI captured both high and very high risk levels during the day for most stations. The constructed AQHI also recorded a greater number of high and very high risk days than the currently used AQI but fewer than the WHO-based AQI. Our findings suggest that the AQHI can capture the combined effects of multiple air pollutants, which makes it an effective tool for communicating air pollution-related health risks.

Towards a risk-based food safety management system in the fresh produce supply chain in Da Nang, Viet Nam

Food safety has emerged as a paramount concern for both Vietnamese consumers and the government. However, limited data are available on food safety management systems in Viet Nam. This study identified significant gaps in good agricultural and hygienic practices along the fresh produce chain (farmers and traditional wholesalers/market sellers) in the region of Da Nang, Viet Nam. This was achieved through a survey on good agricultural and hygienic practices for farmers (n = 100) and sellers (n = 100), which researchers further supplemented by microbiological analysis for E. coli, Salmonella spp., and Listeria monocytogenes on leafy greens, water in contact with produce and contact surfaces (hands). The results indicated that 86.0 % of farmers and 54.0 % of sellers received food safety training in the last 3 years; and women dominated both vegetable cultivation but also trading. Farm-level deficiencies included inadequate handwashing practices, lack of documentation for manure application schedules, improper washing and drying of harvest tools, failure to keep containers elevated off the ground, improper storage of vegetables, and inadequate covering of containers, with respectively 34.0 %, 30.3 %, 12.1 %, 41.7 % and 7.9 % of farmers executing the practice as prescribed by the WHO/FAO ‘5 keys of growing safer fruits and vegetables’. As for sellers, the most dominant gaps (<50.0 % compliance) were the way of handwashing and the practice of keeping containers elevated off the ground before, during, and after harvesting. The microbiological analysis confirmed that, in a total of 36 fresh produce samples including mustard greens, cucumber, lettuce, and crown daisy, the number of samples positive for E. coli, Salmonella spp., and L. monocytogenes were 12, 2, and 10 respectively. Samples of hands and the irrigation water showed high contamination with E. coli. Based on identified gaps, risk communication tools were developed and distributed amongst farmers, sellers, and Da Nang food safety management authority (governmental organisation performing inspections in the traditional food markets). As intervention, two farmers and two sellers were trained in safe agricultural practices for the cultivation of fresh vegetables (managerial intervention) and instructed to use tap water as irrigation water instead of uncontrolled surface water (technological intervention). A post-assessment was conducted, including redoing the survey on good practices and microbiological analysis. The outcome of these interventions showed positive results in terms of good agricultural and hygienic practices resulting in improved hygiene levels and safety of the fresh produce. The findings from this research have the potential to provide a model for the development of a science-based risk management strategy in alternative food chains or geographic areas in emerging countries.

The Impact of Vaping on the Ocular Surface: A Systematic Review of the Literature.

Background: The use of electronic cigarettes has become increasingly popular in recent years. However, the impact that electronic cigarettes have on the ocular surface is not well known. Therefore, the aim of this review is to explore the current literature on the acute and chronic sequelae of electronic cigarettes on the ocular surface. Methods: A systematic review of the literature was undertaken by keyword searching on the Embase, Medline, and Web of Science databases. Articles identified through the search underwent title/abstract screening, full-text screening, and data extraction. Results: A total of 18 studies were included in this review. Non-intended ocular surface exposures and intended exposures on the ocular surface were found to be associated with the use of electronic cigarettes. Conclusions: The impact of vaping on the ocular surface is not benign. There are significant risks that vaping can pose to the ocular surface. Hence, it is necessary to develop appropriate risk communication tools given the increasing popularity of this activity. Additionally, future long-term studies are needed to better understand the long-term impacts of vaping on the ocular surface given the lack of current data.

Beliefs and behaviors associated with the first named heat wave in Seville Spain 2022

Heat waves pose a substantial and increasing risk to public health. Heat health early warning systems (HHEWSs) and response plans are increasingly being adopted to alert people to the health risks posed by days of extreme heat and recommend protective behaviors. However, evidence regarding the effectiveness of HHEWSs remains limited. We examined the impact of heat wave naming on heat-related beliefs and behaviors to ascertain the potential effectiveness of heat wave naming as a heat health risk communication and management tool. Specifically, we surveyed members of the public exposed to the proMETEO Sevilla HHEWS messaging campaign which in the summer of 2022 applied a name to heat waves considered to pose the greatest risk to public health. During the heat season we evaluated, the proMETEO Sevilla HHEWS campaign applied a name to one heat wave, heat wave “Zoe”. Our analysis of the post-survey of 2022 adults indicated that the 6% of participants who recalled the name Zoe unaided reported greater engagement in heat wave safety behaviors and more positive beliefs about naming heat waves and their local governments’ heat wave response. These results provide initial evidence for potential utility in naming heat waves as part of HHEWSs and HAPs.

Development of a virtual flood experience system and its suitability as a flood risk communication tool

Development of a virtual flood experience system and its suitability as a flood risk communication tool

Do numerical probabilities promote informed stated preference responses under inherent outcome uncertainty? Insight from a coastal adaptation choice experiment

Stated preference (SP) valuation provides insight into individuals’ preferences for environmental goods and assigns a monetary value to these preferences. It employs survey questions that elicit information on choices or behaviors in response to hypothetical future scenarios involving changes to these goods. Outcome uncertainty (OU) within SP studies refers to uncertainty concerning whether the effects communicated in these hypothetical scenarios would actually occur, were the scenario to be implemented as indicated in the questionnaire. Inherent OU may be further defined as OU that is invariant across scenarios. For example, the effect of installing coastal flood defenses may depend on a probability of severe storms that is fixed in the study area over the relevant time horizon. Inherent OU has received little attention in the environmental SP literature. For example, it is unknown whether numerical, percentage probabilities—a ubiquitous means of communicating uncertainty in SP questionnaires—are an effective risk communication tool for inherent OU in environmental valuation scenarios. This article evaluates two treatments in a discrete choice experiment survey related to coastal climate change adaptation in Connecticut, USA: one provides only raw frequencies as a risk communication tool, while the other provides implied percentage probabilities in addition to the same raw frequencies. Results show that the use of percentage probabilities to communicate inherent OU has no additional effect on average welfare estimates or the choice behavior of respondents. These findings suggest that percentage probabilities may not provide useful information to SP respondents, beyond that conveyed by past event frequencies.

Derivation and validation of a mortality risk prediction model in older adults needing home care: Updating the RESPECT (Risk Evaluation for Support: Predictions for Elder-Life in their Communities Tool) algorithm for use with data from the interRAI Home Care Assessment System

Background Despite an increasing number of risk prediction models being developed within the healthcare space, few have been widely adopted and evaluated in clinical practice. RESPECT, a mortality risk communication tool powered by a prediction algorithm, has been implemented in the home care setting in Ontario, Canada, to support the identification of palliative care needs among older adults. We sought to re-estimate and validate the RESPECT algorithm in contemporary data. Methods The study and derivation cohort comprised adults living in Ontario aged 50 years and older with at least 1 interRAI Home Care (interRAI HC) record between April 1, 2018 and September 30, 2019. Algorithm validation used 500 bootstrapped samples, each containing a 5% random selection from the total cohort. The primary outcome was mortality within 6 months following an interRAI HC assessment. We used proportional hazards regression with robust standard errors to account for clustering by the individual. Kaplan–Meier survival curves were estimated to derive the observed risk of death at 6 months for assessment of calibration and median survival. Finally, 61 risk groups were constructed based on incremental increases in the observed median survival. Results The study cohort included 247,377 adults and 35,497 deaths (14.3%). The mean predicted 6-month mortality risk was 18.0% and ranged from 1.5% (95% CI 1.0%–1.542%) in the lowest to 96.0 % (95% CI 95.8%–96.2%) in the highest risk group. Estimated median survival spanned from 36 days in the highest risk group to over 3.5 years in the lowest risk group. The algorithm had a c-statistic of 0.76 (95% CI 0.75-0.77) in our validation cohort. Conclusions RESPECT demonstrates good discrimination and calibration. The algorithm, which leverages routinely-collected information, may be useful in home care settings for earlier identification of individuals who might be nearing the end of life.

Disaster risk reduction on stage: An empirical evaluation of community-based theatre as risk communication tool for coastal risk mitigation and ecosystem-based adaptation

The Sendai Framework highlights the need for an all-of-society effort to reduce the societal burden of flooding, with a focus on those being disproportionately affected. In this context, community-based organizations shall contribute to and support public awareness, a culture of prevention and education on disaster risk. Participatory theatre could be a promising means to that end, but quantitative evaluations are currently lacking. We provide a systematic literature review on participatory theatre in the context of natural hazards and disaster risk reduction. Moreover, we quantitatively evaluate to what extent community-based theatre implemented by the Women's Union in Central Vietnam could contribute to public awareness and foster societal engagement. 10 theatre performances in five coastal communes were evaluated using pre- and post-performance surveys among 635 visitors, mainly women. We find that community-based theatre enhanced risk perceptions, perceived flood knowledge, self-efficacy, and the importance of social participation. No significant effect was found on intentions to engage in (collective) risk reducing behavior. We conclude that participatory theatre is an effective risk-communication tool for community-based organizations, which should be embedded in broader activities addressing societal resilience against flooding. Future research should explore the sustainability of the observed increases and the long-term dynamics of behavioral changes.

Update of Air Quality Health Index (AQHI) and harmonization of health protection and climate mitigation

Hong Kong has used a risk-based Air Quality Health Index (AQHI) system for nearly a decade, which aggregates hospitalization risks associated with short-term exposure to pollutants. Serving as an air pollution risk communication tool, it keeps the public informed about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update to the AQGs in 2021, it is pertinent to examine how Hong Kong's air quality risk communication might be enhanced using these updated guidelines.The AQHI currently focuses only on short-term health risks, potentially leading to an underestimation of cumulative impacts. To address this, we propose enhancing the AQHI to include both long-term and short-term health risks. Short-term risks are estimated based on excess hospitalization risks from various pollutants using local data, while long-term risks are estimated using beta coefficients from the WHO due to limited local data. We further suggest using the WHO's Interim Targets (ITs) as thresholds for health risk categories, eliminating arbitrary cut-points.Promoting both public health protection and climate mitigation is important but challenging, particularly with the surge in ozone levels due to enhanced NOx controls in VOC-limited regions like Hong Kong and Guangdong. Nevertheless, despite the rise in ozone, combined health risks in these areas have decreased due to reductions in NO2 and PM concentrations. Shifting to an AQHI-like total health risk assessment emphasizes the harmonization of health protection and climate mitigation goals. This health-focused framework posits that rigorous NOx controls can effectively serve both policy objectives in tandem.

Patients’ views on usefulness and effects of a risk communication tool for cardiovascular disease: a qualitative analysis

BackgroundFailing to comprehend risk communication might contribute to poor treatment adherence. Using hypertension as a case, we investigated how a risk communication tool for patients with an elevated risk of cardiovascular disease was perceived.MethodsAs part of a large project featuring a randomised controlled trial in a general practice setting in the Region of Southern Denmark, we conducted a semi-structured individual interview study. The study included patients with hypertension who had used an intervention comprising a visual and dynamic cardiovascular risk communication tool, along with receiving recurring emails providing advice on a healthy lifestyle. The analyses were based on Malterud’s Systematic Text Condensation.ResultsThis article focuses solely on the results of the interview study, which comprised a total of 9 conducted and analysed interviews. The IT setup had a major impact on adherence to the intervention. A positive impact was found when the IT setup was perceived as easy to use and accessible, while a negative impact was noted when it malfunctioned. The intervention increased patients’ self-reported insight into risk of cardiovascular disease. Patients reported the intervention and their risk of cardiovascular disease to become less important to them when they had more severe comorbidities. The involved health professional was very important for treatment adherence when communicating risk visually. Patients expressed trust in their general practitioners, and the general practitioners’ attitudes toward the intervention affected patients’ perceptions of its usefulness. While the informants reported an increased awareness of their risk of cardiovascular disease, none of them felt more concerned.ConclusionsPatients reported an increase in their perceived insight into the risk of cardiovascular disease but not an increased concern. Our findings align with previous studies emphasizing the importance of patients’ motivation as well as risk perception for adherence. General practitioners have an important role when implementing new tools for patients.

Maritime decision-makers and cyber security: deck officers’ perception of cyber risks towards IT and OT systems

Through a quantitative study of deck officers’ cyber risk perceptions towards information (IT) and operational (OT) systems, this paper contributes to substantiate the importance of considering human behaviour within maritime cyber security. Using survey data from 293 deck officers working on offshore vessels, statistical analyses were conducted to measure and predict the participants cyber risk perceptions towards IT and OT systems. Performing a Wilcoxon signed-rank test revealed a significant discrepancy in the levels of cyber risk perception between the system categories. Hierarchical regression analyses were conducted to develop statistical models, considering multiple independent variables, including perceived benefit, cyber security training, experience with cyber-attacks, and trust towards various stakeholders. Key findings revealed distinct results for IT and OT systems, and the regression models varied in both predictive power and significance of the independent variables. Perceived benefit positively predicts deck officers cyber risk perception for both IT and OT systems, while trust, which included measures of social trust and confidence, was not found to be significant. Cyber security training and experience with cyber-attacks only influence deck officers’ perception of cyber risks related to operational technology. Practical implications of this work provide actionable recommendations for the maritime industry, including tailored risk communication tools, training programs, reporting systems, and holistic policies.

Teaching Medical Students to Communicate Risks Like Military Intelligence Analysts.

Communication about health often involves descriptions of risk: the probability or likelihood of an unfavorable outcome. Communicating risk helps individuals make choices about their own health by building understanding of potential outcomes and providing context for the importance of procedures, health interventions, and lifestyle choices. However, medical education in the United States does not provide future physicians with adequate statistical literacy to communicate risk effectively and rarely encourages them to practice communicating risk in pre-clinical years. Risk communication in military intelligence, a field with formalized risk language and training, offers a unique perspective into potential improvements for medical risk communication. With backgrounds in the military, public health, communication, surgery, and medical education, the authors offer the following recommendations to improve risk communication for medical students. (1) Encourage the use of numerical absolute risk when communicating among health practitioners to avoid varied interpretations of what different risk descriptors ("uncommon," "likely," or "low") might mean; (2) build efficient, teachable skills in use of patient-facing risk communication tools like comparative probabilities and visual aids; and (3) practice estimating risk through role-play of risk communication between medical students and standardized patients. By improving risk communication in medical education, future doctors will be better equipped to build trust through open communication and improve the health of the patients and the communities for whom they care.

Pathogens associated with seafood exports from Southeast Asia to the European Union: Analysis of the Rapid Alert System for Food and Feed (1997–2020)

Over the years, the need for healthy food has increased the demand for seafood in the international market. However, despite the high global demand, seafood is highly perishable and may harbour pathogenic microorganisms that could be transferred to humans during handling, processing, and consumption. Therefore, establishing strict food safety standards and risk communication tools is critical to prevent the infiltration of unsafe seafood into global markets. In the global food supply chain, the European Union (EU) is the largest importer of seafood, while more than 80% of global seafood production is from Asia. Additionally, Southeast Asian countries account for 32% of global seafood production. Therefore, this study aimed to evaluate the microbiological safety of seafood imported from Southeast Asia to the EU by analysing alert notifications in the Rapid Alert System for Food and Feed (RASFF) database. The RASFF is a tool used for reporting and communicating food safety-related risks among the EU Member States and other members of the RASFF network. A total of 301 notifications of pathogens in seafood originating from four Southeast Asian countries (Malaysia, Thailand, Vietnam, and Indonesia) were reported by 19 EU countries, including the United Kingdom (1997-2020). More than 56% of the pathogen notifications involved crustaceans and related products. Fifty-two percent of the notifications involved seafood from Vietnam, while 30% of the notifications from EU member countries were from Italy. Vibrio spp. was the most predominant bacterial pathogen responsible for 50% of the notifications, followed by Salmonella spp. and Clostridium accounting for 38% and 2% of the notifications, respectively. Norovirus was implicated in 10% of the notifications, and this was only in clams from Vietnam. These pathogens pose a risk to consumers’ health, indicating the need to enforce stringent food safety standards in producing countries to ensure the safety of seafood exported to other parts of the world. These actions will ultimately prevent economic loss associated with the rejection, destruction or import restrictions of contaminated seafood originating from Southeast Asia to the EU.