The Need for Public Education: “Surveillance and Risk Reduction Strategies” for Women at Risk for Carrying BRCA Gene Mutations

2007 ◽  
Vol 29 (6) ◽  
pp. 510-511 ◽  
Author(s):  
Jeff A. Nisker
Keyword(s):  
At Risk ◽  
Public Education ◽  
Risk Reduction ◽  
Gene Mutations ◽  
Brca Gene ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

scholarly journals Feasibility of a Pilot Randomized Controlled Trial Examining a Multidimensional Intervention in Women with Gynecological Cancer at Risk of Lymphedema

2021 ◽  
Vol 28 (1) ◽  
pp. 455-470
Author(s):  
Shirin M. Shallwani ◽  
Anna Towers ◽  
Anne Newman ◽  
Shannon Salvador ◽  
Angela Yung ◽  
...  
Keyword(s):  
At Risk ◽  
Risk Reduction ◽  
Controlled Trial ◽  
Gynecological Cancer ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Randomized Controlled ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

There is limited knowledge on non-invasive lymphedema risk-reduction strategies for women with gynecological cancer. Understanding factors influencing the feasibility of randomized controlled trials (RCTs) can guide future research. Our objectives are to report on the design and feasibility of a pilot RCT examining a tailored multidimensional intervention in women treated for gynecological cancer at risk of lymphedema and to explore the preliminary effectiveness of the intervention on lymphedema incidence at 12 months. In this pilot single-blinded, parallel-group, multi-centre RCT, women with newly diagnosed gynecological cancer were randomized to receive post-operative compression stockings and individualized exercise education (intervention group: IG) or education on lymphedema risk-reduction alone (control group: CG). Rates of recruitment, retention and assessment completion were recorded. Intervention safety and feasibility were tracked by monitoring adverse events and adherence. Clinical outcomes were evaluated over 12 months: presence of lymphedema, circumferential and volume measures, body composition and quality of life. Fifty-one women were recruited and 36 received the assigned intervention. Rates of recruitment and 12-month retention were 47% and 78%, respectively. Two participants experienced post-operative cellulitis, prior to intervention delivery. At three and six months post-operatively, 67% and 63% of the IG used compression ≥42 h/week, while 56% engaged in ≥150 weekly minutes of moderate-vigorous exercise. The cumulative incidence of lymphedema at 12 months was 31% in the CG and 31.9% in the IG (p = 0.88). In affected participants, lymphedema developed after a median time of 3.2 months (range, 2.7–5.9) in the CG vs. 8.8 months (range, 2.9–11.8) in the IG. Conducting research trials exploring lymphedema risk-reduction strategies in gynecological cancer is feasible but challenging. A tailored intervention of compression and exercise is safe and feasible in this population and may delay the onset of lymphedema. Further research is warranted to establish the role of these strategies in reducing the risk of lymphedema for the gynecological cancer population.

Innovative tools for improving flood risk reduction strategies: the FLORIS project

2020 ◽  
Author(s):  
Giuseppe Tito Aronica ◽  
Giusina Brigandi ◽  
Negin Binesh ◽  
Simon McCarthy ◽  
Christophe Viavattene ◽  
...  
Keyword(s):  
At Risk ◽  
Risk Management ◽  
Risk Reduction ◽  
Flood Risk ◽  
High Frequency ◽  
Flood Risk Management ◽  
Civil Protection ◽  
Reduction Strategies ◽  
Flood Risk Reduction ◽  
Risk Reduction Strategies

<p>The FLORIS project aims to study innovative approaches for the development of integrated flood risk scenarios taking into consideration critical specific issues of areas at risk and the consequences of high frequency/low damage events that affect them. High frequency floods still involve and require mitigation actions on the part of civil protection and citizens before floodwaters inundate the land and directly impact assets. These emergency actions can benefit from enhanced protocol development based on realistic scenarios.</p><p>In particular, the main idea is to develop a supporting decision tool for the comparative analysis of disaster reduction strategies in flood risk management. This will have a specific focus on studying the functional vulnerability of critical infrastructure in order to preserve their efficiency during and after hazardous events. This include, hydraulic modelling at a finer scale, vulnerability and damage analysis at single element scale.</p><p>To address the project aims, identification of critical infrastructures that influences both the actions and outcomes of civil protection in flood prone areas and the disruption to the at-risk public, will be undertaken. To achieve the goal, initial steps consist of presenting to, and discussing with, civil protection teams the established approaches already available to them together with those identified by the project team from past research and within the literature. This will identify opportunities to further develop the civil protection protocols via innovative modelling of cascade effects incorporating existing algorithms. The developed procedures for flood risk reduction, taking into account resource management requirements will then be applied in a pilot case study, in the city of Berat, Albania and in Sarajevo, Bosnia and Herzegovina.</p><p>Working with the relevant professionals who are the principal beneficiaries of the project enables protocols to be co-developed to include associated physical, social and resource characteristics particular to the selected location. The main achievements will include enhanced management for flood protection in the beneficiary organisation with increased awareness of the interrelationships both spatially and temporally enhancing management protocols, protocols more closely aligned with existing beneficiaries’ procedures and resources for sustainability and establishing tools that are transferable to other regional and country contexts.</p><p>The main expected output is a suite of tools, embedded in a cascade procedure, able to support various actors (Civil Protection, municipalities, administrations, professionals, etc.) in planning and design measures to improve flood risk management actions under different and variable risk scenarios including climate and global change.</p><p>Acknowledgements</p><p>FLORIS (Innovative tools for improving FLood risk reductiOn stRategIeS) project has received funding from the EUROPEAN COMMISSION - under the 2018 Call Prevention and Preparedness in Civil Protection  (Project number: UCPM-2018-PP-AG  - 826561)</p>

scholarly journals Hazards of Risk: Identifying Plausible Community Wildfire Disasters in Low-Frequency Fire Regimes

Forests ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 934
Author(s):  
Andy McEvoy ◽  
Becky K. Kerns ◽  
John B. Kim
Keyword(s):  
Risk Reduction ◽  
Low Frequency ◽  
Fire Regimes ◽  
Cascade Range ◽  
Private Land ◽  
Wildfire Risk ◽  
Location Data ◽  
Reduction Strategies ◽  
Community Exposure ◽  
Risk Reduction Strategies

Optimized wildfire risk reduction strategies are generally not resilient in the event of unanticipated, or very rare events, presenting a hazard in risk assessments which otherwise rely on actuarial, mean-based statistics to characterize risk. This hazard of actuarial approaches to wildfire risk is perhaps particularly evident for infrequent fire regimes such as those in the temperate forests west of the Cascade Range crest in Oregon and Washington, USA (“Westside”), where fire return intervals often exceed 200 years but where fires can be extremely intense and devastating. In this study, we used wildfire simulations and building location data to evaluate community wildfire exposure and identify plausible disasters that are not based on typical mean-based statistical approaches. We compared the location and magnitude of simulated disasters to historical disasters (1984–2020) in order to characterize plausible surprises which could inform future wildfire risk reduction planning. Results indicate that nearly half of communities are vulnerable to a future disaster, that the magnitude of plausible disasters exceeds any recent historical events, and that ignitions on private land are most likely to result in very high community exposure. Our methods, in combination with more typical actuarial characterizations, provide a way to support investment in and communication with communities exposed to low-probability, high-consequence wildfires.

Prevention of Breast Cancer (Part II): Risk Reduction Strategies

2010 ◽  
Vol 28 (10) ◽  
pp. 1070-1077 ◽  
Author(s):  
Maria Tria Tirona ◽  
Rajesh Sehgal ◽  
Oscar Ballester
Keyword(s):  
Breast Cancer ◽  
Risk Reduction ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Prevention Of Breast Cancer

Impact of the New York State Prescription Drug Monitoring Program (IStop) on chronic pain management by primary care providers

2021 ◽  
Vol 17 (1) ◽  
pp. 39-54
Author(s):  
Josiah D. Strawser, MD ◽  
Lauren Block, MD, MPH
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Risk Reduction ◽  
New York State ◽  
Monitoring Program ◽  
Primary Care Providers ◽  
Care Providers ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

Objective: To explore the impact of the New York State Prescription Drug Monitoring Program (IStop) on the self-reported management of patients with chronic pain by primary care providers.Design: Mixed-methods study with survey collection and semistructured interviews.Setting: Multiple academic hospitals in New York.Participants: One hundred and thirty-six primary care providers (residents, fellows, attendings, and nurse practitioners) for survey collection, and eight primary care clinicians (residents, attending, and pharmacist) for interviews. Interventions: Introduction of IStop.Main outcome measure(s): Change in usage of four risk reduction strategies (pain contracts, urine tests, monthly visits, and co-management) as reported by primary care providers for patients with chronic pain.Results: After the introduction of IStop, 25 percent (32/128) of providers increased usage of monthly visits, 28 percent (36/128) of providers increased usage of pain management co-management with other healthcare providers, and 46 percent (60/129) of providers increased usage of at least one of four risk reduction strategies. Residents indicated much higher rates of change in risk reduction strategies due to IStop usage; increasing in the use of monthly visits (32 vs. 13 percent, p = 0.02) and co-management (36 vs. 13 percent, p = 0.01) occurred at a much higher rate in residents than attending physicians. Interview themes revealed an emphasis on finding opioid alternatives when possible, the need for frequent patient visits in effective pain management, and the importance of communication between the patient and provider to protect the relationship in chronic pain management.Conclusions: After the introduction of IStop, primary care providers have increased usage of risk reduction strategies in the care of chronic pain patients.

scholarly journals Evaluation of flood risk reduction strategies through combinations of interventions

2018 ◽  
Vol 12 (S2) ◽  
Author(s):  
Erik C. Berchum ◽  
William Mobley ◽  
Sebastiaan N. Jonkman ◽  
Jos S. Timmermans ◽  
Jan H. Kwakkel ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Flood Risk ◽  
Reduction Strategies ◽  
Flood Risk Reduction ◽  
Risk Reduction Strategies

scholarly journals Inadequate stakeholder management and its effect on a coherent sinkhole risk management strategy: The case of the Merafong Local Municipality, South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Tshepo Moshodi ◽  
Christo Coetzee ◽  
Kristel Fourie
Keyword(s):  
Risk Management ◽  
Risk Reduction ◽  
Community Involvement ◽  
Stakeholder Management ◽  
Current Status ◽  
Community Stakeholders ◽  
Management Processes ◽  
Reduction Strategies ◽  
Local Municipality ◽  
Risk Reduction Strategies

The Merafong Local Municipality (MLM) has historically suffered financial and human losses because of the presence of dolomite and the consequent formation of sinkholes. There is a great need for the MLM to address the risk posed by sinkholes to ensure the continued safety of communities. However, as the risk is so pervasive, the MLM needs to coordinate their risk reduction strategies with a wide array of stakeholders in the municipality. Efficient stakeholder management is thus crucial if the sinkhole risk is to be addressed appropriately. This article reviews the current status of stakeholder management in the MLM as it pertains to the formulation of a holistic sinkhole risk reduction strategy. Findings indicate that there are serious deficiencies in the MLM’s stakeholder management relating to key risk management processes such as community involvement in risk management structures, disaster risk assessment, training and awareness, and early warning and response. Improved stakeholder management could be characterised by the following factors: improved two-way communication between the municipality and community stakeholders, fostering a relationship based upon trust and equality amongst stakeholders, participation by a wide array of stakeholder groups affected by the sinkhole risk and a mutual commitment by all stakeholders to address the risk. These factors could contribute to enhancing current and future sinkhole risk reduction strategies.

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