This article analyzes the conditions under which any change in a multiplicative background risk induces a more cautious behavior. We give necessary and sufficient conditions under which any change in the multiplicative background risk with respect to the Nth-degree stochastic dominance raises local risk aversion. Surprisingly, decreasing relative risk aversion of any order up to N in the sense of Pratt coupled with decreasing relative risk aversion in the sense of Ross are sufficient (...) to guarantee an increase in local risk aversion after any deterioration of the multiplicative background risk thanks to the Nth-degree stochastic dominance. We link our results concerning second-order stochastic dominance with the concept of multiplicative risk vulnerability. (shrink)

This note examines the theory of optimal insurance purchasing in the presence of a nonpecuniary background risk. The occurrence of the qualitative uninsurable background loss can increase, decrease or can leave the marginal utility of wealth unchanged, whereas a financial background loss (as in Doherty and Schlesinger, 1883a) always increases it. Existing theorems on the optimal level of insurance and the optimal form of insurance contracts are shown to hold only under restrictive assumptions on the correlation (...) level between risks. The paper shows that sufficient conditions for the validity of the theorems depend not only on the correlation between the insurable and noninsurable losses, but also on the variation of the marginal utility of wealth with respect to the nonpecuniary variable. (shrink)

Scientific risk evaluations are constructed by specific evidence, value judgements and biological background assumptions. The latter are the framework-setting suppositions we apply in order to understand some new phenomenon. That background assumptions co-determine choice of methodology, data interpretation, and choice of relevant evidence is an uncontroversial claim in modern basic science. Furthermore, it is commonly accepted that, unless explicated, disagreements in background assumptions can lead to misunderstanding as well as miscommunication. Here, we extend the discussion on (...) background assumptions from basic science to the debate over genetically modified (GM) plants risk assessment. In this realm, while the different political, social and economic values are often mentioned, the identity and role of background assumptions at play are rarely examined. We use an example from the debate over risk assessment of stacked genetically modified plants (GM stacks), obtained by applying conventional breeding techniques to GM plants. There are two main regulatory practices of GM stacks: (i) regulate as conventional hybrids and (ii) regulate as new GM plants. We analyzed eight papers representative of these positions and found that, in all cases, additional premises are needed to reach the stated conclusions. We suggest that these premises play the role of biological background assumptions and argue that the most effective way toward a unified framework for risk analysis and regulation of GM stacks is by explicating and examining the biological background assumptions of each position. Once explicated, it is possible to either evaluate which background assumptions best reflect contemporary biological knowledge, or to apply Douglas' 'inductive risk' argument. (shrink)

There were more than 36,000 firearm-related deaths in the U.S. in 2015. Under federal law, a background check is required only for gun purchases from licensed dealers. Research suggests that some persons prohibited from owning a gun turn to private sellers, including those identified online, to attempt to obtain a firearm. State-level approaches to make it more difficult for high-risk persons to purchase or possess firearms include universal background check and gun violence restraining order laws. UBC laws, (...) on the books in 18 states as of the end of 2016, can reduce both homicide and suicide rates. After Colorado adopted a UBC law in 2013, the number of background checks conducted by private sellers for sales occurring at places other than gun shows steadily increased. GVRO laws give law enforcement and families the authority to petition a court to temporarily remove firearms from an individual who presents a danger to himself or others during times of crisis, regardless of whether that person has been diagnosed with a mental illness. California enacted a GVRO law in 2014. Data are emerging to suggest the effectiveness of GVRO-type laws at averting suicides and providing an entryway to services. (shrink)

International regulation of autonomous weapon systems (AWS) is increasingly conceived as an exercise in risk management. This requires a shared approach for assessing the risks of AWS. This paper presents a structured approach to risk assessment and regulation for AWS, adapting a qualitative framework inspired by the Intergovernmental Panel on Climate Change (IPCC). It examines the interactions among key risk factors—determinants, drivers, and types—to evaluate the risk magnitude of AWS and establish risk tolerance thresholds through (...) a risk matrix informed by background knowledge of event likelihood and severity. Further, it proposes a methodology to assess community risk appetite, emphasizing that such assessments and resulting tolerance levels should be determined through deliberation in a multistakeholder forum. The paper highlights the complexities of applying risk-based regulations to AWS internationally, particularly the challenge of defining a global community for risk assessment and regulatory legitimization. (shrink)

Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal.Method: Around 162 patients were assessed at the beginning of their therapy, with regard to risk (...) factors, such as sociodemographic, physical, hereditary, and adverse childhood experiences. Depressive symptoms and personality functioning were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis.Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology.Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression. (shrink)

Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health-related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks.Aim: (...) to explore the ways in which clinicians distinguish important from unimportant health risks.Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in-depth interviews on their interpretation of what makes a health risk important.Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance.Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction. (shrink)

Systemic risks are risks produced through interconnected non-wrongful actions of individuals, in the sense that an individual's action is a negligible cause of the risk. Due to scale effects of interaction, their consequences can be serious but they are also difficult to predict and assess via a risk assessment. Since we can have good reason to engage in the interconnected activities giving rise to systemic risk, we incur a concurrent collective responsibility to ensure that the risks are (...) fairly distributed and well regulated. James argues that fairness in this context requires taking reasonably available precautions ensuring for each risk-bearer a favourable ratio of expected benefits over expected losses. In sections 2 and 3 we argue that such a conception of fairness applies but only on the condition that the systemic risks created are irreversible risks and that the general background conditions of justice are imperfectly fair. When risks are reversible, compensatory justice can correct for unfairness in risk imposition. Where risks are irreversible, compensatory justice necessarily fails, giving rise to a collective responsibility to regulate fairly ex ante. Additionally, where background conditions of justice are fully fair and the systemic risk is well understood, risk bearers can be said to have consented to the systemic risk. If they are not fair, we argue that the primary political obligation should lie in fixing the fairness of the backgrounds of justice. A related reason for addressing the general background conditions of fairness is that James’ account of fairness in systemic risk imposition encounters a baseline problem. If expected risks and benefits are calculated again an unfair historic background condition, systemic risk imposition would not be fully fair. Section 4 shows why differences in evidentiary uncertainty as to probability and levels of harm and effective responses require a normatively appropriate response in the form of additional precautions. We show that the evidentiary standards set for risk-based cost-benefit analysis have a connection with deontology because they express a postulate of equal treatment in formal terms. Systemic risks can have different possible degrees of epistemological certainty due to factors of social and natural origin, such as more available research funding or higher degrees of complexity for some systemic risks but not others. These differences have to be mitigated by taking even greater precautions in difficult-to-research systemic risks. (shrink)

Panel data from the German SOEP is used to test for risk vulnerability in the wider population. Two different survey responses are analysed: the response to the question about willingness-to-take risk in general and the chosen investment in a hypothetical lottery. A convenient indicator of background risk is the VDAX index, an established measure of volatility in the German stock market. This is used as an explanatory variable in conjunction with HDAX, the stock market index, which (...) proxies wealth. The impacts of these measures on risk attitude are identifiable by exploiting the time dimension of the panel and matching survey months with corresponding observations from these time-varying factors. Both of the survey responses allow us to test for decreasing absolute risk aversion ; in one case, we find strong evidence of DARA, while in the other, we do not. Both survey responses also allow us to test for RV, and in both cases we find strong evidence. In the case of the hypothetical lottery response, we are also able to estimate a “coefficient of risk vulnerability”. This is defined as the absolute amount by which absolute risk aversion rises in response to a doubling of background risk. We estimate CRV to be between 1.03 and 1.27. (shrink)

Luigi Giussani, a high school religion teacher throughout the 1950s and 1960s, grounded his teachings in the vast body of experience to be found in Christianity's two-thousand-year history. He told his students, “I'm not here to make you adopt the ideas I will give you as your own, but to teach you a method for judging the things I will say.” Throughout his life, education was one of Giussani's primary intellectual interests. He believed that effective education required an adequate (...) class='Hi'>background in the Christian tradition, presented within a lived experience that underscored the capacity of the faith to answer universal questions. What he proposed was a process that allowed one to sift through tradition, critically examining it and comparing it against the ultimate criteria for judgment: the desires of the heart. In Giussani's view, the primary concern was to “educate the human heart as God made it.” In The Risk of Education he states that fear leads students to associate this process of criticism with negativity or doubt. Yet, without an education in criticism, students cannot develop conviction. At a time when young people are abandoning the church and questioning the value of faith, Giussani's method of judging and verifying Christianity as an experience seems a necessary intervention. In The Risk of Education he argues that, ultimately, education and the Christian message reveal themselves through human freedom. (shrink)

Purpose This paper aims to expose the challenges facing the attempt by Jamaica to introduce a new digital ID system without adequate regard to public consultation and the rights of citizens. Design/methodology/approach The method used is critical text analysis and policy analysis, providing background and relevant factors leading up to the legislative changes under review. Extensive literature sources were consulted and the relevant sections of the Jamaican constitution referenced and analysed. Findings The case study may have national peculiarities not (...) applicable in other jurisdictions. Its introduction acknowledges that the Jamaican Government may amend and re-submit the legislation, absent the flawed clauses. The paper however will remain valid given its detailed analysis and exposure of risks associated with biometric data collection, face recognition technology and data storage flaws. Practical implications It will be a practical example of the risks associated with flawed biometric data collection and the role of Courts in reviewing such legislation. Referrals to the Courts can be used as a remedy, as occurred not only in Jamaica but also in many other jurisdictions, including India and Kenya. Social implications The paper foregrounds the rights of citizens to be consulted on the collection and storage of their sensitive biometric data. The social implications and risks of violating the constitutional rights of citizens were made evident, and can be an example to other jurisdictions. Originality/value The paper is the first of its kind to provide detailed data and analysis on an outright rejection by the Courts of a country's ID legislation on grounds that it violated the constitution and rights of citizens. It shows the ethical and social challenges in proposing and implementing legislation without adequate public consultation on such sensitive matters as biometric data. It also exposes some of the challenges of artificial intelligence and face recognition technologies in ID data collection, including flaws related to race, gender and coding. (shrink)

ABSTRACT Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health‐related 10 principles for screening, it seems crucial to distinguish important from unimportant health (...) risks. Aim: to explore the ways in which clinicians distinguish important from unimportant health risks. Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in‐depth interviews on their interpretation of what makes a health risk important. Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance. Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Background Theory of Delusion and Existential PhenomenologyRichard G. T. Gipps (bio) and John Rhodes (bio)KeywordsPhenomenology, psychological explanation, epistemology, schizophreniaSituating and Clarifying the PaperThe commentaries of Nassir Ghaemi and Giovanni Stanghellini help to sketch out the intellectual landscape of philosophical perspectives in psychiatry, and situate our paper within it. A happy convergence between the analytical philosophy perspective from which we were writing, and the existential–phenomenological paradigm described by (...) both authors, is the result. Stanghellini in particular carefully describes three main theories of existential deformations, tracing delusion formation back to either (i) a disturbance of meaning synthesis conceived as a dysfunction of a Husserlian consciousness, (ii) a disturbance of pre-reflective self-consciousness resulting in a kind of paralyzing hyperreflexivity, and (iii) (Stanghellini’s preferred model) a disturbance of embodiment. This final account views delusion as springing from a failure in the subject’s corporeal and praxical being-in-the-world. As the subject’s practical, pre-reflective grip on the world is loosened, so their minds become unconstrained by that understanding and practical rationality immanent within that grip, and thought, now unconstrained, starts to travel through delusional worlds. Stanghellini accordingly views our model as an example of a disembodiment theory, which allows it to overcome the disadvantages of the first two models, which may both, in their own ways, overvalue the rôle of (disturbances of) reflective consciousness in the formation (and delusional deformation) of everyday understanding.Being situated within a preexisting landscape has both its benefits and its disbenefits, the principle example of the latter being the potential assimilation of anything new to what has already been said. Thus, although we are grateful to our commentators for placing us on the larger historical and conceptual map, it may be helpful to briefly rehearse our motivations for drawing on the philosophical ideas of the Bedrock and Background in our theory of delusion. Our paper was primarily motivated by a concern that current, psychologically mainstream, cognitive models of delusion, although helpfully drawing our attention to common reasoning and perceptual deficits in the person with psychosis, fail to adequately account for what is delusional about delusions. It was, in [End Page 321] particular, to account for the certainty with which the deluded person clings to often quite extraordinary beliefs that we drew on the epistemological notion of the background. And although this epistemological notion fits quite neatly with ontological concerns regarding the embodied and praxical character of human existence, it is the particular epistemic rôle that it played in our theory—to do with the extraratiocinative constraint on judgement provided by the Background—that we wish to stress here.We return to this shortly, but first wish to comment briefly on two specific considerations raised by the commentaries. The first concerns Stanghellini’s claim that, for us, “when studying delusions, the focus should be on providing an adequate framework for understanding, rather than providing empirical hypotheses to be tested” (2008, 311–314). It seems to us, however, that both are equally important. What we wished to stress, however, was that empirical hypothesis testing may be led astray if it is not informed by an adequate framework for understanding. For example, most cognitive psychological experiments on delusions concern themselves with the individual’s ability to make appropriate guesses (e.g., regarding the color of beads in a bag), and their tendency to jump to conclusions; they do not concern themselves with the kinds of extraordinary conviction and certainty met with in delusion. The risk run by empirical researchers of cognitive factors in delusion is that a lack of a prior adequate theorization of delusion makes for accounts that are ultimately only of the formation, not of delusion in particular but rather of false or unusual beliefs more generally. An analytical approach, however, can help to explicate the ways in which the psychiatric concept of delusion fails to be adequately characterized by the quite general ‘external criteria’ of delusion (as Jaspers [1963] called them: falsity, stubbornness, uncommon), and aids in the construction of empirical hypotheses this time constrained by an understanding of the true ‘internal criteria’ of psychotic belief. Such an approach helps to spell out the... (shrink)

Consider a sequence of outcomes of descending value, A > B > C >... > Z. According to Larry Temkin, there are reasons to deny the continuity axiom in certain ‘extreme’ cases, i.e. cases of triplets of outcomes A, B and Z, where A and B differ little in value, but B and Z differ greatly. But, Temkin argues, if we assume continuity for ‘easy’ cases, i.e. cases where the loss is small, we can derive continuity for the ‘extreme’ case (...) by applying the axiom of substitution and the axiom of transitivity. The rejection of continuity for ‘extreme’ cases therefore renders the triad of continuity in ‘easy’ cases, the axiom of substitution and the axiom of transitivity inconsistent.As shown by Arrhenius and Rabinowitz, Temkin's argument is flawed. I present a result which is stronger than their alternative proof of an inconsistency. However, this result is not quite what Temkin intends, because it only refers to an ordinal ranking of the outcomes in the sequence, whereas Temkin appeals to intuitions about the size of gains and losses. Against this background, it is argued that Temkin's trilemma never gets off the ground. This is because Temkin appeals to two mutually inconsistent conceptions of aggregation of value. Once these are clearly separated, it will transpire, in connection with each of them, that one of the principles to be rejected does not appear plausible. Hence, there is nothing surprising or challenging about the result; it is merely a corollary to Expected Utility Theory. View HTML Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.UNACCEPTABLE RISKS AND THE CONTINUITY AXIOMVolume 28, Issue 1Karsten Klint Jensen DOI: https://doi.org/10.1017/S0266267112000107Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. UNACCEPTABLE RISKS AND THE CONTINUITY AXIOMVolume 28, Issue 1Karsten Klint Jensen DOI: https://doi.org/10.1017/S0266267112000107Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. UNACCEPTABLE RISKS AND THE CONTINUITY AXIOMVolume 28, Issue 1Karsten Klint Jensen DOI: https://doi.org/10.1017/S0266267112000107Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

Historically the concept of risk is rooted in Renaissance lifestyles, in which autonomous agents such as sailors, warriors, and tradesmen ventured upon dangerous enterprises. Thus, the concept of risk inseparably combines objective reality (nature) and social construction (culture): Risk = Danger + Venture. Mathematical probability theory was constructed in this social climate in order to provide a quantitative risk assessment in the face of indeterminate futures. Thus we have the famous formula: Risk = Probability (of (...) events) × the Size (of future harms). Because the concept of harm is always observer relative, however, risk assessment cannot be purely quantitative. This leads to the question, What are the general conditions under which risks can be accepted? There is, after all, a difference between incurring a risk and bearing the costs of risks selected for by other agencies. Against this background, contours of a theology of risk emerge. If God creates a self-organizing world of relatively autonomous agents, and if self-organization is favored by cooperative networks of autopoietic processes, then the theological hypothesis of a risk-taking God is at least initially plausible. Moreover, according to the Christian idea of incarnation, God is not only taking a risk but is also bearing the risks implied by the openness of creation. I thus argue for a twofold divine kenosis---in creation as well as in redemption. I discuss some objections to this view, including the serious counterargument that risk taking on behalf of others remains, even for God, a morally dubious task. What are the conditions under which the notion of a risk-taking God can be affirmed without leaving us with the picture of God as an arbitrary, cosmic tyrant? And what are the practical implications for the ways in which human agents of faith, hope, and love can learn to cope with the risks of everyday life and of political decisions? (shrink)

Background: Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of (...) undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods: An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results: Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally, brokers' roles in follow up care, their prices, and the speed of surgery were the most commonly included business dimensions on the reviewed websites. Conclusion: Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implications for the informed consent and consequent safety of Canadian medical tourists. (shrink)

The global public health threat posed by infectious disease is well recognised. The obligation to treat whilst exposed to risk, and its limits, is debated with each novel serious and communicable pathogen. Within national jurisdictions, different responses are forthcoming. Some, like France in 2009, give government the power to require healthcare staff to work, and even to requisition staff, including retired professionals. Others rely on notions of solidarity and professional duty, with scope for individual discretion. Our research with staff (...) in the West Midlands in 2008/2009– including non-professionals – suggested a strong correlation between feeling a duty to work and willingness to work during a pandemic. This was more influential than removing other barriers to working. Medical military personnel can already be ordered into risky situations. Our research in 2015/16 with those who worked in the Ebola treatment unit in Sierra Leone suggested that their concerns about risk were complex: the perceived magnitude of the risk was only one factor, even though tolerance was high. The type of risk and circumstances requiring that risk to be taken were also influential.Against this background, it will be argued, with caveats, that:military medical personnel should be willing to accept greater risk than civilian medical staff;and that to maintain national health services during a communicable disease emergency:civilian medical staff ought to accept greater risks than they currently appear willing to tolerate;conscription – from civilian or military populations – is permissible, even though it may elevate personal risk. (shrink)

Background In a previous paper in Philos Ethics Humanit Med, the 1937 Swedish novel Sömnlös (Swedish for sleepless) by Vilhelm Moberg was used as background for a thought experiment, in which last century’s progresses concerning the safety of sleeping pills were projected into the future. This gave rise to a theoretical discussion about broad medico-philosophical questions such as (among other things) the concept of pharmaceuticalisation. Methods In this follow-up paper, the theme of insomnia in Sömnlös is complemented by (...) a discussion of the concept of nostalgia. The core of the paper is a theoretical discussion about the benefits and risks of nostalgia, bringing together some aspects of recent psychological research about the construct of nostalgia with the main story line of the novel. Results and Conclusion Nostalgia is portrayed as being, in some sense at least, ultimately beneficial for the protagonist of Sömnlös. This is congruent with recent psychological research. However, the story also shows that nostalgia may lead to problematic behaviours, at least when viewed from a virtue ethics perspective. Hence, nostalgia is both what leads the protagonist into ethically problematic behaviour and that which (paradoxically) ultimately saves him from his initial lack of courage, justice, temperance and practical wisdom. Moreover, the protagonist does not only “grow” ethically but also existentially. Hence, the novel opens up the possibility that insomnia and nostalgia might be viewed as bearers of important existential information (cf. sociologist of religion Peter L. Berger and his concept of “signals of transcendence”). (shrink)

College student entrepreneurship is a complex and dynamic process, in which the potential risks faced by entrepreneurial enterprises are interactive and diverse. The changes in risk assessment for college student entrepreneurship are also dynamic and nonlinear and are affected by many factors, which make the risk assessment process for college student entrepreneurship quite complicated. Big data analysis technology is a new product formed under the background of cloud computing and Internet technology, which has the characteristics of large (...) data scale, multiple data types, and strong data value and provides more technical support for the researches on the risk assessment algorithm for college student entrepreneurship. On the basis of summarizing and analyzing previous research results, this article expounded the research status and significance of the risk assessment algorithm for college student entrepreneurship, elaborated the development background, current status, and future challenges of big data analysis technology, introduced the basic principles of support vector machine and hierarchical analytic process, constructed a risk assessment model for college student entrepreneurship based on big data analysis, analyzed the risk factors and assessment indicators of the entrepreneurial model, proposed a risk assessment algorithm for college student entrepreneurship based on big data analysis, performed the discrimination coefficient calculation and comprehensive correlation optimization, and finally conducted a case experiment and its result analysis. The study results show that the risk assessment algorithm for college student entrepreneurship based on big data analysis can effectively realize the comprehensive management of risk factors, make full use of the value of assessment parameter data, and significantly improve the accuracy and efficiency of the risk assessment for college student entrepreneurship, providing more technical support for the researches on the risk assessment algorithm for college student entrepreneurship. The study results of this article provide a reference for further researches on the risk assessment algorithm of college student entrepreneurship based on big data analysis. (shrink)

Virtual enterprise is a dynamic alliance of businesses, in which multiple members undertake joint research, development, manufacturing, operation, etc. The complexity of the relationship between business members, coupled with many new technologies or methods applied in the alliance operation, leads to more uncertain factors and difficulties in the operation and risk management of the virtual enterprise. The distributed decision-making model is a fast and effective decision-making model, in which dispersed intellectual resources and information resources are dynamically integrated through virtual (...) organization forms and operating mechanisms, and the dynamic reorganization, result evaluation, and synthesis of the decision-making system are realized by certain control rules. On the basis of summarizing and analyzing previous research works, this paper expounded the research status and significance of the risk control of virtual enterprise; elaborated the development background, current status, and future challenges of distributed decision-making model; introduced the related works of decision-making variable calculation and constraint determination; constructed a risk control model for virtual enterprise based on distributed decision-making model; analyzed the multiobjective model and interval programming model of risk control; established a risk control approach for virtual enterprise based on distributed decision-making model; performed the optimal allocation of risk control funds and the selective optimization of backup allies; and finally conducted a case analysis. The study results show that, in view of the diversity of relationships between alliance businesses and the complexity of the distribution of cooperative areas, the distributed decision-making model can more reasonably describe the relationship between alliance members and accurately control the risks of virtual enterprise from multiple angles, which can effectively manage the risks of virtual enterprise. The study results of this paper provide a reference for further research on the risk control of virtual enterprise based on distributed decision-making model. (shrink)

The lack of engagement of philosophy with decisions made under conditions of risk and uncertainty has lately received increasing attention. But philosophers have devoted little thought to the development of a conceptual framework for distinguishing different types of risks. This article begins by illustrating the need for a more nuanced conceptual framework. As the normative considerations risks give rise to are highly varied, ethicists need to distinguish between different types of risks. It then offers two ideas. First, it proposes (...) that we understand ‘risk’ as a multi-dimensional concept, i.e. a concept that can always be evaluated in different dimensions, e.g. a qualitative, a quantitative and an epistemic dimension. While this understanding of risk underlies the current practice of risk analysis, making it explicit is of value, in particular for the philosophical debate. It draws attention to the diversity of risks, helps to group them sensibly and sharpens existing arguments. Second, the article introduces a novel account of the notion ‘systemic risk’. Criticising existing accounts, it proposes we understand ‘systemic risk’ as referring to a risk that endangers the functioning of a system and originates in the system or its background noise, where a system is conceived of as a set of interdependent, interacting components that form a complex, functionally defined whole. The article identifies a number of structural features shared by systemic risks and evaluates the distinctive normative considerations they give rise to. It then argues that the notion ‘systemic risk’ is particularly suited to characterise some of the most pressing risks faced in an increasingly interconnected world. While the notion ‘systemic risk’ rests on the understanding of ‘risk’ as a multi-dimensional concept, it also complements it. Its necessity shows that in addressing risks, it is sometimes helpful to move beyond a characterisation based solely on their dimensions. (shrink)

Hypothesis-driven approaches identified important characteristics that differentiate violent from non-violent radicals. However, they produced a mosaic of explanations as they investigated a restricted number of preselected variables. Here we analyzed without a priory assumption all the variables of the “Profiles of Individual Radicalization in the United States” database by a machine learning approach. Out of the 79 variables considered, 19 proved critical, and predicted the emergence of violence with an accuracy of 86.3%. Typically, violent extremists came from criminal but not (...) radical backgrounds and were radicalized in late stages of their life. They were followers in terrorist groups, sought training, and were radicalized by social media. They belonged to low social strata and had problematic social relations. By contrast, non-violent but still criminal extremists were characterized by a family tradition of radicalism without having criminal backgrounds, belonged to higher social strata, were leaders in terrorist organizations, and backed terrorism by supporting activities. Violence was also promoted by anti-gay, Sunni Islam and Far Right, and hindered by Far Left, Anti-abortion, Animal Rights and Environment ideologies. Critical characteristics were used to elaborate a risk-matrix, which may be used to predict violence risk at individual level. (shrink)

Tendencies and efforts have shifted from genome description, DNA mapping, and DNA sequencing to active and profound re-programming, repairing life on genetic and molecular levels in some parts of contemporary life science research. Mirroring and materializing this atmosphere, various life engineering technologies have been used and established in many areas of life sciences in the last decades. A contemporary progressive example of one such technology is DNA editing. Novel developments related to reproductive technologies, particularly embryo editing, prenatal human life engineering, (...) and germline engineering need to be analyzed against the broader social and structural background. The crucial analytical scope for this paper is a specific field: the life-editing technologies used in reproductive medicine and performed experimentally on viable human embryos, particularly CRISPR/cas9 technology. This text argues that germline editing technologies, as a representative part of contemporary biomedicine, are merging ideas of treatment and enhancement to avoid future risks. Using this specific life manipulation of embryos and gametes, the text analyzes these processes within the concept of power over life—biopower and the specific governing rationality that imagines, classifies, and governs contemporary societies. The text specifically focuses on the potential to create, define, and manage future risks and uncertainties related to prenatal life. (shrink)

Background Past studies emphasized the possible cultural influence on attitudes regarding reprogenetics and reproductive risks among medical students who are taken to be “future physicians.” These studies were crafted in order to enhance the knowledge and expand the boundaries of cultural competence. Yet such studies were focused on MS from relatively marginalized cultures, namely either from non-Western developing countries or minority groups in developed countries. The current study sheds light on possible cultural influences of the dominant culture on medical (...) students in two developed countries, potentially with different dominant cultures regarding reprogenetics and reproductive risks: Israel and Croatia. Methods Quantitative-statistical analyses were employed, based on anonymous questionnaires completed by 150 first year medical students in Israel and Croatia. The questionnaires pertained to the knowledge and attitudes regarding genetics, reproduction and reproductive risks. These questionnaires were completed before the students were engaged in learning about these topics as part of the curriculum in their medical school. Results Substantial differences were revealed between the two groups of medical students. Israeli medical students were less tolerant regarding reproductive risks and more knowledgeable about genetics and reproductive risks than Croatian medical students. For example, while nearly all Israeli medical students disagreed with the idea that “Screening for reproductive risks in prospective parents is wrong,” less than 40% of their Croatian counterparts shared a similar stance. Similarly, all Israeli medical students correctly observed that “A carrier of a recessive genetic disease actually has the disease” was wrong, as opposed to only 82% of Croatian students. Conclusions By linking applicable theoretical literature to these findings, we suggest that they may reflect the hidden influence of the dominant culture in each country, disguised as part of the “culture of medicine.” Acknowledging and learning about such influence of the dominant culture, may be an important addition to the training of medical students in cultural competence, and specifically their cultural awareness. Such an acknowledgement may also pave the road to drawing the attention of existing physicians regarding a less known yet an important aspect of their cultural competence, insofar as the cultural awareness component is concerned. (shrink)

Background: Adolescence is a period with physical, psychological, biological, intellectual, and social changes in which there is usually little perception of risk. COVID-19 has generated constant situations of change and uncertainty worldwide. During the pandemic, the acquisition of preventive behaviors has been relevant. Various studies carried out with adults associate risk perception and the implementation of preventive behaviors with knowledge about the COVID-19 and with age, but there are not many studies with adolescents. Therefore, the objective is (...) to validate, in Spanish, the questionnaire of the knowledge, attitudes, risk perceptions, and practices of adolescents toward the pandemic, and analyze it according to sociodemographic characteristics.Method: This study was a descriptive cross-sectional study, which included adolescents between the ages of 12–18. First, a translation and a back-translation of the questionnaire were performed. The questionnaire was presented in several high schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Reliability and validity analyses were then carried out and the relationships between the different sociodemographic variables were analyzed.Results: The reliability of the questionnaire is acceptable. Knowledge was higher in women, and in those with a higher level of education; and were lower in those who lived in smaller towns, as well as in those who had a member of their family receiving financial aid. In terms of attitudes and risk perceptions, younger adolescents had higher scores, and those who had a member of their family receiving financial aid, lower.Conclusion: The questionnaire is a reliable tool in the Spanish adolescent population. Knowledge was influenced by gender, place of residence, level of education, and financial aid. Attitudes and risk perceptions were influenced by age and financial aid. For practices, no predictors were found. In general, adolescents scored lower on knowledge about COVID-19, but they scored higher on COVID-19 safety practices. (shrink)

What is risk? How do we assess risk? What are the ethical implications of risk? The concept of risk is important – sometimes even crucial – for many philosophical domains, from philosophy of science and technology to ethics and sustainability. Philosophy and Science of Risk is a clear, wide-ranging introduction to this urgent and fast-growing subject. It covers the following key topics: -/- • The philosophical and historical background to understanding and interpreting risk (...) -/- • The meaning of risk and how it differs from closely related concepts, such as uncertainty or dangers -/- • The social construction of risk -/- • Risk perception and risk as an object of scientific study -/- • The measurement of risk, its probability and severity -/- • Risk and scientific modeling -/- • Risk, value judgments, and expertise -/- • Risk management, including cost-benefit analysis and the precautionary approach -/- • Risk communication, including deliberative models -/- • Ethics of risk, including duties toward nonhuman animals and future generations -/- • Risk and sustainability -/- • Decision-making under risk -/- Including helpful additional features such as text boxes, chapter summaries, review, and discussion questions, Philosophy and Science of Risk: An Introduction is an ideal textbook for students of the philosophy of risk. It is also suitable for students studying the conceptual questions surrounding risk in related subjects, such as sociology, psychology, economics, politics, geography, sustainability, and environmental studies. (shrink)

Background:An ethical, informed consent process requires that potential participants understand the study, their rights, and the risks and benefits. Yet, despite strategies to improve communication, many participants still lack understanding of potential risks and benefits. Investigating attitudes and practices of research nurses can identify ways to improve the informed consent process.Research question:What are the attitudes, practices, and preparedness of nurses involved in the informed consent process regarding communication of risks and benefits?Research design:A survey was developed and administered online to (...) a national purposive sample of 107 research nurses with experience obtaining informed consent for clinical trials. Survey responses stratified by selected work-related characteristics were analyzed.Ethical considerations:Participants were instructed they need not answer each question and could stop at any time. They consented by clicking “accept” on the email which linked to the survey. The study was approved by the Northeastern University Institutional Review Board, Boston, Massachusetts.Findings:Most research nurses used a teach-back method to assess participant comprehension, while 72% relied on their intuition. About one-third did not feel prepared to communicate related statistics. About 20% did not feel prepared to tailor information, and half did not feel competent using supplemental materials to enhance risks and benefits comprehension. Only 70% had received training in the informed consent process which included in-person training, case studies, online courses, feedback during practice sessions, and simulation, such as role playing and viewing videos. Perceived preparedness was significantly associated with greater informed consent experience and training.Conclusion:Research nurses may have inadequate training to encourage, support, and reinforce communication of risks and benefits during the informed consent process. Relevant purposeful education and training should help to improve and standardize the ethical informed consent process. (shrink)

The oil crisis, risk and evidence‐based practice Evidence‐based practice has risen to prominence over the last 20 years. Different professions have taken it up in different ways and for different purposes. It has been seen as holding both threats and advantages to professionalising endeavours and professional identity. It has engendered controversy but some criticisms of it have been unconvincing. It is possible to account for its rise as a response to tightening financial constraints on state spending in the west, (...) as a sign of a culture increasingly concerned with risk, distrust of professionals and experts, as well as a way for professionals themselves to maintain control over their activity in the face of growing managerialism. This paper reviews the literature of some of the movement's proponents as well as criticism from various professional groups. It concludes that more useful than either arguing for or against it, is to understand the policy background and sociological reasons for its emergence and spread. (shrink)

Most discussions about the risks associated with synthetic biology tend to begin and end with the same message. That is, in these revolutionary times, when the capabilities for designing and reengineer­ing biological agents are advancing at previously unimag­inable rates but have still not realized their full potential, when risks therefore remain uncertain, and where the actors are generally well‐meaning people who seek im­portant benefits for society and environment, the most reasonable approach is to exercise “prudent vigilance,” to minimize proscriptive oversight, (...) and to avoid judgments about and limitations on research until some elusive date when greater clarity might be achieved. This approach may be useful in allowing scientific research to move forward, but it strikes me as a politi­cal expedient that minimizes conflict between would‐be opposing factions with different values and backgrounds and as an excuse to avoid some difficult problems. Uncertainties about key features of the landscape seem to justify a reluctance to formulate judgments and promote action. I believe there are reasonable kinds of conclusions that can be made right now about when and how to con­duct and publish potentially dangerous research in the life sciences. These conclusions are enabled by a more rigorous examination of the nature of uncertainty in the conduct of experiments in synthetic biology and genetic engineering. (shrink)

Background and ObjectivesSchool bullying threatens the health of children and adolescents, such as mental health disorders, social deviant behaviors, suicidal behaviors, and coping difficulties. The present study aims to address prevalence rates of both traditional and cyber school bullying perpetration, and the associations between self-control, parental involvement, experiencing conflicts with parents, experiencing interparental conflict, and risk behaviors, and school bullying perpetration among Chinese children and adolescents.MethodThis study used data from a national representative school bullying survey among children and (...) adolescents from all grades in seven cities in China. Negative binomial regression was used to estimate the effects of these predictive factors on traditional and cyber school bullying perpetration, respectively. Seven control variables were included, such as gender, boarding school, family socioeconomic status, and parents’ education levels.ResultsThe sample comprised 52% female, 18% at boarding school, 70% of the participants’ academic performance was average or above. Approximately 17.3% of the participants reported participating in traditional school bullying against their peers, and 7.8% perpetrated cyberbullying behaviors. Also, after controlling sociodemographic characteristics and high self-control, parental involvement reduced the likelihood of traditional and cyberbullying perpetrating. Experiencing interparental conflict and risk behavior was significantly associated with increased perpetration of traditional and cyber school bullying. We found that having a conflict with parents was significantly associated with cyberbullying perpetration.ImplicationsFindings have implications for practice. Anti-bullying intervention programs targeting this population should consider these factors. For example, school administrators may develop school programs involving parents in the efforts and interventions workshops improving children and adolescents’ levels of self-control. Limitations are also discussed. (shrink)

In risk management, de minimis risk is the idea that risks that are sufficiently small, in terms of probabilities, ought to be disregarded. In the context of the distinction between disregarding a risk and accepting it, this paper examines one suggested way of determining how small risks ought to be disregarded, specifically, the natural-occurrence view of de minimis, which has been proposed by Alvin M. Weinberg, among others. It is based on the idea that “natural” background (...) levels of risk should be used as benchmarks and de minimis levels should be derived from those levels. This approach fails even if the doubtful distinction between what is natural and what is not can be upheld. (shrink)

The early warning of financial risk is to identify and analyze existing financial risk factors, determine the possibility and severity of occurring risks, and provide scientific basis for risk prevention and management. The fragility of financial system and the destructiveness of financial crisis make it extremely important to build a good financial risk early-warning mechanism. The main idea of the K-means clustering algorithm is to gradually optimize clustering results and constantly redistribute target dataset to each clustering (...) center to obtain optimal solution; its biggest advantage lies in its simplicity, speed, and objectivity, being widely used in many research fields such as data processing, image recognition, market analysis, and risk evaluation. On the basis of summarizing and analyzing previous research works, this paper expounded the current research status and significance of financial risk early-warning, elaborated the development background, current status and future challenges of the K-means clustering algorithm, introduced the related works of similarity measure and item clustering, proposed a financial risk indicator system based on the K-means clustering algorithm, performed indicator selection and data processing, constructed a financial risk early-warning model based on the K-means clustering algorithm, conducted the classification of financial risk types and optimization of financial risk control, and finally carried out an empirical experiments and its result analysis. The study results show that the K-means clustering method can effectively avoid the subjective negative impact caused by artificial division thresholds, continuously optimize the prediction process of financial risk and redistribute target dataset to each cluster center for obtaining optimized solution, so the algorithm can more accurately and objectively distinguish the state interval of different financial risks, determine risk occurrence possibility and its severity, and provide a scientific basis for risk prevention and management. The study results of this paper provide a reference for further researches on financial risk early-warning based on K-means clustering algorithm. (shrink)

Background:The understanding of factors that shape risk perception is crucial to modulate the perceived threat and, in turn, to promote optimal engagement in preventive actions.Methods:An on-line, cross-sectional, survey was conducted in Italy between May and July 2020 to investigate risk perception for COVID-19 and the adoption of preventive measures. A total of 964 volunteers participated in the study. Possible predictors of risk perception were identified through a hierarchical multiple linear regression analysis, including sociodemographic, epidemiological and, most (...) of all, psychological factors. A path analysis was adopted to probe the possible mediating role of risk perception on the relationship between the independent variables considered and the adoption of preventive measures.Results:Focusing on the psychological predictors of risk perception, high levels of anxiety, an anxious attachment, and an external locus of control predicted higher perceived risk. Conversely, high levels of openness personality and of avoidant attachment predicted a lower perception of risk. In turn, the higher was the perceived risk the higher was the adoption of precautionary measures. Furthermore, psychological factors influenced the adoption of preventive behaviors both directly and indirectly through their effect on risk perception.Conclusions:Our findings might be taken into high consideration by stakeholders, who are responsible for promoting a truthful perception of risk and proper compliance with precautionary measures. (shrink)

Background: The development of the COVID-19 pandemic has prompted the implementation of many procedures to safeguard against further increases in illness. Unfortunately, this has drastically reduced residents’ contact with their families, which has increased feelings of loneliness and isolation. This is particularly difficult in long-term care facilities, where the risk of developing depression is higher than in the general population.Objectives: The aim of the study was to assess the risk of depression among the residents of long-term care (...) institutions in Poland during the COVID-19 pandemic and to determine the relationship between the risk of depression and the occurrence of cognitive impairment in the study group.Methods: The study included 273 residents from long-term care institutions in Poland. The risk of depression was determined based on an originally designed questionnaire. The cognitive state of the subjects was assessed using the screening test Mini-Mental State Examination. Both the depression risk assessment and the MMSE test were conducted twice: in March and December 2020.Results: In March, severe dementia was present in 28.2% of the residents and normal MMSE scores were observed in 16.1% of the subjects; in December, the prevalence of severe dementia increased to 31.1% and that of normal scores decreased to 10.3%. In March, no participant was found to be at high risk of depression and moderate risk was observed in 14.3% of the subjects; in December, 2.6% of the residents had a high risk score and 45.4% had a moderate risk score. Statistical analysis revealed that higher MMSE scores correspond with a higher risk of depression.Conclusion: A higher risk of depression was observed with the development of the pandemic. Residents with cognitive impairment were characterised by a lower risk of depression compared to individuals with normal MMSE scores. During the study, progression of cognitive impairment was observed in the residents. (shrink)

There is a growing literature on how scientific experts understand risk of technology related to their disciplinary field. Previous research shows that experts have different understandings and perspectives depending on disciplinary culture, organizational affiliation, and how they more broadly look upon their role in society. From a practice-based perspective on risk management as a bottom-up activity embedded in work place routines and everyday interactions, we look, through an ethnographic lens, at the laboratory life of nanoscientists. In the USA (...) and Sweden, two categories of nanoscientists have been studied: upstream scientists who are mainly electrical and physical engineers and downstream scientists who are toxicologists, often with a more multidisciplinary background, including physics, chemistry, biology, and engineering. The results show that although the two groups of scientists share the same norms of appropriate laboratory conduct to promote safety and good science practice, they have very different perspectives on risk with nanomaterials. Upstream scientists downplay risk; they emphasize the innovative potential of the new materials to which they express an affectionate and personalized stance. The downstream scientists, instead, focus on the uncertainties and unpredictability of nanomaterials and they see some materials as potentially highly dangerous. The results highlight the ambiguous and complex role of scientific experts in policy processes about the risk and regulation of nanotechnology. (shrink)

In the last decade, a number of studies in the behavioural sciences, particularly in psychology and economics, have explored the complexity of individual risk behaviour and its underlying factors. Most previous studies have examined the influences of various socio-economic, cognitive, biological and psychological factors on human decision-making however, the relationship between the decision-makers’ risk preferences and occupational background has not received much empirical attention. Accordingly, in the current study, we investigated how occupational background, together with decision-making (...) framing (e.g., variations in decision domain, context, presentation of risk and utility ratios), influence participants’ risk preferences for decision options with equivalent expected utility. Our novel findings indicate that risk preferences may vary among individuals from different occupational backgrounds. As such, when the task was framed in gain terms, participants who mostly deal with health/safety-related risks on a day-to-day basis (high-risk occupations) were predominantly risk-averse (avoiding risky options), while participants who mostly deal with financial/social risks (white-collar occupations) were prone to risk-seeking behaviour (avoiding certain options). Specifically, in “high-risk” occupations, participants’ pattern of choices changed from risk-averse in gain scenarios to risk-seeking in loss scenarios. However, the opposite pattern of risk preferences was found in participants with “white-collar” occupations. Our findings indicate that decision-makers’ occupational backgrounds influence risk preferences under some circumstances. (shrink)

Background: With the outbreak of the coronavirus disease 2019 epidemic in China, the general public but also medical staff were confronted with psychological challenges, suffering from the highly infectious and unknown characteristics of COVID-19. In this study, we surveyed psychological symptoms including anxiety, depression, and sleep disorders in medical staff.Method: A questionnaire star/WeChat link-based survey assessing the Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9 depression, the Insomnia Severity Index, Social Support scales in addition to lifestyle, and income level (...) was conducted and included 8,288 medical staff from 24 provinces in China. Pearson Chi-square and Mann-Whitney U-tests were used to evaluate single risk factors and significant differences in psychological symptoms before and during the outbreak of COVID-19. Binary logistic regression analyses were conducted for the risk factors of anxiety, depression, and sleep disorder symptoms.Results: Medical staff had a high incidence of psychological symptoms, which was more prominent during the COVID-19 epidemic. Comparatively, females, nurses, first-line department, never exercised, and low income were risk factors for psychological symptoms. Social support including objective support, subjective support, support utility, and regular sports over 3 times per week were protective and manageable elements that could protect from and manage the psychological symptoms of medical staff.Conclusion: The susceptibility of psychological symptoms among medical staff should be of concern to policymakers and the public in the long-term, and the aggravation of mental health problems of medical staff could be eased by providing adequate social support during and after the COVID-19 outbreak. (shrink)

In order to explore, from the perspective of the social ecological model, the relationship and its mechanism linking public risk familiarity and mental health during the new coronary pneumonia epidemic, the new coronary pneumonia epidemic risk perception scale, psychological resilience scale, Chinese mental health scale, and SARS familiarity scale were used 741 members of the public were surveyed as research objects. The results show that: When gender, age, and educational background are controlled, risk familiarity has a (...) significant positive predictive effect on public mental health; Risk familiarity predicts mental health through the mediating effect of mental toughness; The mediating effect of mental toughness is moderated by the public’s familiarity with SARS. Specifically, for members of the public with low SARS familiarity, the indirect effect of risk familiarity on mental health through mental toughness is smaller than that for those with high SARS familiarity. The results of this study integrate psychological resilience into the theory of risk cognition, which has implications for the improvement of public mental health. (shrink)

BackgroundOperation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their (...) elective surgery rescheduled for non-medical reasons.MethodsIn this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test.ResultsSignificantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer.ConclusionsElderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery.Trial registration DRKS00015836. Retrospectively registered. (shrink)

Background: The transition to child care is a challenging time in a child’s life and leads to elevated levels of cortisol. These elevations may be influenced by the quality of the mother-child-relationship. However, remarkably little is known about cortisol production in response to the beginning of child care among children-at-risk such as children with an immigrant background. However, attending kindergarten or any other child day-care institution can for example have a compensating effect on potential language deficits thus (...) improving the educational opportunities of these children. Method: Data of a subsample of N = 24 “hard-to-reach” mother-child dyads was collected in the context of the psychoanalytic early prevention project “First Steps”. The project focuses on the earliest integration of children with an immigrant background by supporting parenting capacities in the critical phase of migration and early parenthood. Children’s hair cortisol concentration (HCC) was assessed one week before (mean age = 38.77 months) and three months after kindergarten entry (mean age = 42.26 months). Hair analysis was conducted for both times of measurement, reflecting the first 3 months after kindergarten entry and 3 months prior. Furthermore, the emotional quality of the mother-child-relationship was assessed with the help of the Emotional Availability Scales (EAS) shortly before kindergarten entry when the children were about three years old (mean age = 37.2). Results and Conclusion: Children’s mean cumulated HCC was higher after kindergarten entry than before. The increase correlated negatively with several dimensions of the EAS. Repeated measures ANCOVA revealed that particularly responsive children and children who had experienced less intrusive mother-child-relationships demonstrated lower elevations in HCC after kindergarten entry. Furthermore, a decreased EA score was found in all EA dimensions, besides the dimension “mother’s non-hostility”, indicating problematic EA within the mother-child-relationships of the sample. The results suggest that children with an immigrant background who experience more emotional available mother-child-relationships seem to regulate stress induced by kindergarten entry more effectively, indicated by lower cortisol elevations after entry. This implicates that supporting early mother-child-relationships by intervention may have a positive effect on the children’s ability to regulate stress induced by kindergarten entry thus promoting child development. (shrink)

Background Changes in policies and practices related to repeat cesareans and home birth in the U.S. have been influenced by different interpretations of the risk of poor outcomes. Methods This article examines two cases—vaginal birth after cesarean (VBAC) and home birth to illustrate how an emphasis on relative over absolute risk has been used to characterize outcomes associated with these practices. The case studies will rely on reviews of the research literature and examination of data on birth (...) trends and outcomes. Results Childbirth involves some unique challenges in assessing health risks, specifically the issues of: (1) timing of risks (lowering health risk in a current birth can increase it in subsequent births); (2) the potential weighing of risks to the mother’s versus the infant’s health; (3) the fact that birth is a condition of health and many of the feared outcomes (for example, symptomatic uterine rupture) involve very low absolute risk of occurrence; and (4) a malpractice environment that seizes upon those rare poor outcomes in highly publicized lawsuits that receive widespread attention in the clinical community. In the cases of VBAC and home birth, the result has been considerable emphasis on relative risks, typically an adjusted odds ratio, with little consideration of absolute risks. Conclusion Assessments of the safety of interventions in childbirth should involve careful consideration and communication of the multiple dimensions of risk, particularly a balancing of relative and absolute risks of poor health outcomes. (shrink)

Based on a unique data set on US direct microloans, we study the funding determinants of interest-free peer-to-peer crowdlending aimed at borrowers in the US. By performing logistic regressions on funding success and Tobit regressions on the reversed funding time, the existence of a social underwriting by a third-party trustee and information in the description texts fostering the investors’ trust are shown to be the main predictors of successful funding. Regarding social impact, the possibility to empower women and groups of (...) borrowers appeals to the investors, whereas empowerment of the family or community beyond the borrowers themselves appears to remain unappreciated. When examining the vulnerability of the borrowers as a predictor, the results manifest differences amongst the attitudes of the investors towards social impact. In the subsample of non-endorsed loans, the investors appear to prefer to support borrowers with an immigration background. In contrast, this is not the case with endorsed loans. (shrink)

Given the importance of data safety for psychology, the present study investigated the influence of data leaking scandal on campus customers’ financial consumption behaviors at intelligent tourism platforms in China, and explored the roles that individual characteristics play in this process by focusing on a set of participants from colleges. Data were collected through sending out an online questionnaire, where respondents were asked to finish a series of questions about their background information, their trust, future consuming intention, and defensive (...) behaviors toward intelligent platforms. After they finished these questions, a short description about an online tourism platform leaking customers’ personal information was presented to the respondents, following which they were asked to report about their future consuming intentions and defensive behaviors again. In total, 236 participants of college students and teachers were recruited. Paired samples mean comparison showed that after the stimulus was presented, the respondents had a significant decrease in future financial consumption intention, and a significant increase in defensive behaviors toward online tourism platforms due to risks perceived. Multiple regression analysis was conducted subsequently to investigate individual characteristics that may account for part of the decrease in consuming intention. Results showed that, customers with higher level of trust and monthly income, as well as older customers, tend to experience higher level of decrease in consuming intention, and increase in defensive behaviors. These findings highlighted the importance of online tourism platforms guaranteeing data security of their customers. (shrink)

Background Clinical papers so flawed that they are eventually retracted may put patients at risk. Patient risk could arise in a retracted primary study or in any secondary study that draws ideas or inspiration from a primary study. Methods To determine how many patients were put at risk, we evaluated 788 retracted English-language papers published from 2000 to 2010, describing new research with humans or freshly derived human material. These primary papers—together with all secondary studies citing (...) them—were evaluated using ISI Web of Knowledge. Excluded from study were 468 basic science papers not studying fresh human material; 88 reviews presenting older data; 22 case reports; 7 papers retracted for journal error and 23 papers unavailable on Web of Knowledge. Overall, 180 retracted primary papers (22.8%) met the inclusion criteria. Subjects enrolled and patients treated in 180 primary studies and 851 secondary studies were combined. Results Retracted papers were cited over 5000 times, with 93% of citations being research related, suggesting that ideas promulgated in retracted papers can influence subsequent research. Over 28 000 subjects were enrolled—and 9189 patients were treated—in 180 retracted primary studies. Over 400 000 subjects were enrolled—and 70 501 patients were treated—in 851 secondary studies which cited a retracted paper. Papers retracted for fraud (n=70) treated more patients per study (p<0.01) than papers retracted for error (n=110). Conclusions Many patients are put at risk by retracted studies. These are conservative estimates, as only patients enrolled in published clinical studies were tallied. (shrink)

This article presents a structured and systematic approach for identifying and modelling compliance risks. The sophistication with which modern business is carried out and the unprecedented access to a global market means that businesses are exposed to increasing and diverse regulatory requirements in and across jurisdictions. Compliance with such requirements is practically challenging, partly due to the complexity of regulatory environments. One possibility in this regard is a risk-based approach to compliance, where resources are allocated to those compliance issues (...) that are most risky. Despite the need for risk-based compliance, few specific methods and techniques for identifying and modelling compliance risks have been developed. Due to the lack of methodological and tool support, compliance risk identification often involves unstructured brainstorming, with uncertain outcomes. The proposed approach consists of a five-step process for the structured identification and assessment of compliance risks. This process aims at facilitating the identification of compliance risks and their documentation in a consistent and reusable fashion. As part of the process, the article provides a systematic approach for a graphical modelling of compliance risks, which aims at facilitating communication among experts from different backgrounds. The creation of graphical models can be partly automated based on natural language patterns for regulatory requirements. Furthermore, the structuring of the compliance requirement in a template aims at simplifying the modelling of compliance risks and facilitating a potential future automated model. (shrink)

In this paper we analyse how the risks associated with research on transgenic plants are regulated in Sweden. The paper outlines the way in which pilot projects in the plant sciences are overseen in Sweden, and discusses the international and national background to the current regulatory system. The historical, and hitherto unexplored, reasons for the evolution of current administrative and legislative procedures in plant science are of particular interest. Specifically, we discuss similarities and differences in the regulation of medicine (...) and plant science, and we examine the tendency towards dichotomizing risk — focusing on social/ethical risks in medicine and biological risks in plant science. The context of this article is the Synpraxia research project, an inter-disciplinary program combining expertise in sciences and the humanities. (shrink)

Background: It is not known how neonatologists address the affective and cognitive loads on parents deciding whether to resuscitate infants born extremely preterm. This study explores expert neonatologists' views on these decision-making processes and their own roles in counseling parents. Methods: Semistructured interviews asked internationally recognized experts to share their perspectives on perinatal consultations. Their responses were subjected to thematic analysis. Results: Eighteen of 22 invited experts participated. Approximately equal numbers reported employing a physician-driven approach, a parent-driven approach, and (...) a combined approach during these consultations. Those who followed a physician-driven approach typically focused on conveying standard information about adverse outcomes. Those who followed a parent-driven approach typically focused on addressing parents' information requests, guiding their decision making, and providing affective support. Nearly all experts, in each group, endorsed addressing the child's quality of life, in terms of functionality, when discussing long-term outcomes. Although many believed that families adjusted to life with a disabled child, few discussed the topic during prenatal consultations. Most, in each group, reported trying to alleviate future “decisional regret” for parents whose premature infants subsequently became disabled. None spoke to parents about possible decisional regret after deciding to forgo resuscitation. Conclusions: Expert neonatologists are deeply concerned that parents understand the decision facing them. However, they differ on what information they offer and how they balance parents' need for cognitive and affective support. They expressed more concern about parents' decisional regret should their child survive resuscitation, but have severe disability, than about decisional regret after foregoing resuscitation. (shrink)

Background Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units . A quantitative, multicentre, correlational study was conducted among 300 professionals.Results The most crucial ethical decisions made by professionals working in ICU were related (...) to communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments , to withhold treatments and to proceed to terminal sedation . This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses , it was the physicians who more keenly felt the need to proceed to ethical decisions in ICU.Conclusions Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout. (shrink)

Background Medical research so flawed as to be retracted may put patients at risk by influencing treatments. Objective To explore hypotheses that more patients are put at risk if a retracted paper appears in a journal with a high impact factor (IF) so that the paper is widely read; is written by a ‘repeat offender’ author who has produced other retracted research; or is a clinical trial. Methods English language papers (n=788) retracted from the PubMed database between (...) 2000 and 2010 were evaluated. Only those papers retracting research with humans or freshly derived human material were included; 180 retracted primary papers (22.8%) met inclusion criteria. Subjects enrolled and patients treated were tallied, both in the retracted primary studies and in 851 secondary studies that cited a retracted primary paper. Results Retracted papers published in high-IF journals were cited more often (p=0.0004) than those in low-IF journals, but there was no difference between high- and low-IF papers in subjects enrolled or patients treated. Retracted papers published by ‘repeat offender’ authors did not enrol more subjects or treat more patients than papers by one-time offenders, nor was there a difference in number of citations. However, retracted clinical trials treated more patients (p=0.0002) and inspired secondary studies that put more patients at risk (p=0.0019) than did other kinds of medical research. Conclusions If the goal is to minimise risk to patients, the appropriate focus is on clinical trials. Clinical trials form the foundation of evidence-based medicine; hence, the integrity of clinical trials must be protected. (shrink)

Children dependent on life-prolonging medical technology are often subject to a constant background risk of sudden death or catastrophic complications. Such children can be cared for in hospital, in an intensive care environment with highly trained nurses and doctors able to deliver specialised, life-saving care immediately. However, remaining in hospital, when life expectancy is limited, can considered to be a harm in of itself. Discharge home offers the possibility for an improved quality of life for the child and (...) their family but comes with significant medical risks.When making decisions for children, two ethical models predominate, the promotion of the child’s best interests or the avoidance of harm. However, in some circumstances, particularly for children with life-limiting and/or life-threatening illness, all options may be associated with risk. There are no good options, only potentially harmful choices.In this paper, we explore decisions made by one family in such circumstances. We describe a model adopted from risk management programmes beyond medicine, which offers a potential framework for identifying risks to the child that are morally permissible. Some risks and harms to a child, not ordinarily permitted, may be acceptable when undertaken in the pursuit of a specified desired good, so long as they are as low as reasonably practicable. (shrink)