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PubMed2006

Risk-reducing surgery in women with familial susceptibility for breast and/or ovarian cancer.

This multicentre study examined uptake of bilateral risk-reducing mastectomy (BRRM) and bilateral risk-reducing oophorectomy (BRRO) in women at increased risk for breast and/or ovarian cancer who had attended a familial cancer clinic (FCC) between January 1999 and June 2000. Eligible women (N=396), were mailed a questionnaire assessing: BRRM and BRRO details; risk perception; and anxiety. Family history, genetic testing and risk assessment were abstracted from medical records. Surgery was cross-tabulated with demographics, risk perception and anxiety with either Fisher's exact test or the exact form of the Mantel-Haenszel test (for ordinal factors) used to investigate for associations. Ordinal logistic regression was used with continuous-scale covariates. In total, 130 women were lost to follow-up leaving 266; of these 182 (68.4%) responded. Mean follow-up time was 3.73 years. The BRRM rate was 4.4%; with no difference found between moderate and high-risk groups. BRRM was associated with increasing numbers of affected relatives (P=0.025). BRRO was undertaken by 17.3%, more commonly in women older than 40 years of age (P=0.023) and with a BRCA1/2 mutation (P=0.017). Women who underwent BRRM (P=0.052) or BRRO (P<0.001) had a lower post-procedure risk perception than those who did not. During the timeframe of this study, risk-reducing surgery was undertaken by a small percentage of Australian women at increased risk for breast and/or ovarian cancer who attended FCCs. Family cancer history and mutation status were associated with uptake.

Adult↗

PubMed1998

Perception of risk, sexual behaviour and STD/HIV prevalence in western Kenya.

OBJECTIVE: To determine the feasibility and acceptability of collecting data on sexual practices, knowledge, attitudes and perception of risk with regard to HIV and STD infection in two clinic populations. DESIGN: A cross sectional survey carried out between June and July 1992. SETTING: An urban and a rural health centre in western Kenya. SUBJECTS: One hundred and sixty women attending Maternal Child Health (MCH) and Family Planning Clinics (FP). INTERVENTIONS: Screening STDs including N. gonorrhoea, C. trachomatis, T. vaginalis and syphilis. In addition subjects were interviewed about sexual practices, knowledge, attitudes and perception of risk with regard to HIV and STD infection. RESULTS: The presence of any STD including HIV was detected in 36.2% of women at the urban clinic and 21.2% of women at the rural clinic. The demographics of the two populations were similar with respect to age but were significantly different for several variables including marital status, ethnicity and education. Knowledge of STDs and HIV was nearly universal in both clinic populations with > 96% of patients being aware of the existence of such diseases. 76.3% of women at the urban clinic felt they could get an STD as compared to 48.8% at the rural clinic (p < 0.02). This awareness of vulnerability among the urban population was also seen for HIV. CONCLUSION: It appears to be feasible to conduct studies of sexual practices and perceptions of risk for STD/HIV acquisition in women attending health centres in Kenya.

Adult↗

PubMed1996

Urban ozone plumes and population distribution by income and race: a case study of New York and Philadelphia.

Who lives in the downwind areas of urban ozone plumes? Location theory suggests that the poor should disaproportionately populate the downwind area, while the rich are most likely to live outside urban ozone plumes. Dynamically, we would expect that the downwind area would become poorer over time because the rich would "vote with their feet" under the serious impacts of urban ozone plumes. However, the importance of urban ozone pollution could be discounted due to the public's risk perception. According to risk and air quality perception literature, one would expect that the public would likely perceive ozone air pollution as a relatively low risk, compared with other environmental risks and social concerns. Therefore, actual population distribution might not follow what location theory suggests. Who actually does live in the downwind areas of urban ozone plumes? The results from a case study of New York and Philadelphia show that the ozone downwind areas are currently populated by a considerably larger proportion of upper income households and whites than the source areas. Furthermore, the population dynamics data do not provide any evidence for the "vote with their feet" hypothesis. While these findings deviate from the hypotheses prescribed by location theory, they are consistent with what we could expect from theories of risk perception.

Air Pollutants↗

PubMed1994

Perception of risks and benefits of in vitro fertilization, genetic engineering and biotechnology.

The use of new biotechnology in medicine has become an everyday experience, but many people still express concern about biotechnology. Concerns are evoked particularly by the phrases genetic engineering and in vitro fertilization (IVF), and these concerns persist despite more than a decade of their use in medicine. Mailed nationwide opinion surveys on attitudes to biotechnology were conducted in Japan, among samples of the public (N = 551), high school biology teachers (N = 228), scientists (N = 555) and nurses (N = 301). People do see more benefits coming from science than harm when balanced against the risks. There were especially mixed perceptions of benefit and risk about IVF and genetic engineering, and a relatively high degree of worry compared to other developments of science and technology. A discussion of assisted reproductive technologies and surrogacy in Japan is also made. The opinions of people in Japan were compared to the results of previous surveys conducted in Japan, and international surveys conducted in Australia, China, Europe, New Zealand, U.K. and U.S.A. Japanese have a very high awareness of biotechnology, 97% saying that they had heard of the word. They also have a high level of awareness of IVF and genetic engineering. Genetic engineering was said to be a worthwhile research area for Japan by 76%, while 58% perceived research on IVF as being worthwhile, however 61% were worried about research on IVF or genetic engineering. Japanese expressed more concern about IVF and genetic engineering than New Zealanders. The major reason cited for rejection of genetic manipulation research in Japan and New Zealand was that it was seen as interfering with nature, playing God or as unethical. The emotions concerning these technologies are complex, and we should avoid using simplistic public opinion data as measures of public perceptions. The level of concern expressed by scientists and teachers in Japan suggest that public education "technology promotion campaigns" will not reduce concern about science and technology. Such concern should be valued as discretion that is basic to increasing the bioethical maturity of a society, rather than being feared.

Adult↗

PubMed2006

Breast cancer-specific intrusions are associated with increased cortisol responses to daily life stressors in healthy women without personal or family histories of breast cancer.

Studies indicate that women fear breast cancer more than any other disease and that women's levels of breast cancer-specific intrusions are related to their perceived risk of breast cancer. Here, we explore possible biological consequences of higher breast cancer risk perceptions and intrusions in healthy women without personal or family histories of the disease. We hypothesized that women with higher perceived risk would have more intrusions about breast cancer, which would constitute a background stressor sufficient to increase hypothalamus-pituitary-adrenal axis (HPA) responsivity to daily stress. HPA responses to an ordinary life stressor (work) were assessed in 141 employed women (age = 37.2+/-9.2) without personal or family histories of breast cancer. Urinary cortisol excretion rates were assessed with timed sample collections at work, home, and during sleep. Repeated measures ANOVA revealed a significant Group by Time interaction with higher work cortisol levels in women with breast cancer-specific intrusions compared to women without intrusions (p < 0.02). Regression analyses revealed a significant association between risk perceptions and intrusions (p < 0.001). Regression analysis with intrusions and risk perceptions predicting work cortisol indicated a significant contribution of intrusions (p < 0.04), but not risk perceptions (p = 0.53). Overestimation of breast cancer risk is associated with higher levels of breast cancer-specific intrusions that can result in increased cortisol responsivity to daily stressors. This heightened responsivity could have long-term negative health implications.

Adult↗

PubMed1998

Judgments of personal and environmental risks of consumer products--do they differ?

Many psychometric studies have investigated judgments concerning personal risks from technologies, activities or consumer products, but only a few studies have included judgments of risk to the environment. Thus, little is known about this aspect of environmental risk perception, and whether it differs from personal risk perception. This study investigates risk judgments for 30 consumer products of various types such as herbal remedies, mobile telephones, genetically engineered drugs, or garden pesticides. A survey was conducted in two German cities: Leipzig and West Berlin. In total, 408 subjects evaluated the consumer products with regard to personal and environmental risk (and other risk-related aspects) and whether they would recommend the product to others. The findings show statistically significant differences between the mean values of perceived personal risk and environmental risk for most products. Despite these differences, the rank order of mean personal risk and environmental risk judgments for the products is quite similar. However, separate analyses for each product reveal that correlations between perceived personal and environmental risk vary strongly across products. Multiple regression analyses with personal and environmental risk judgments as predictors and product recommendation as criterion, run separately for each consumer product, show that it is mainly the judgment of perceived personal risk that explains product recommendation. Perceived risk to the environment adds little explanatory power. The study also explores differences in judgments of personal and environmental risk with regard to two sociodemographic variables: location (former East Germany vs. West Germany) and gender. Differences in both types of risk judgments are found with regard to location but not for gender.

Adolescent↗

PubMed2004

Perception of risk: a study of A&E nurses and NHS managers.

This exploratory study investigates perceptions of two groups of NHS staff, of a range of risks, topical and relevant to accident and emergency (A&E). Literature suggests that the effectiveness of a risk management strategy is lessened if staff exposed to risk, and managers, have different perceptions of the nature and severity of the risk. A self-administered questionnaire was distributed to registered A&E nurses and to Trust managers at directorate level and above, working in five large inner-city NHS Trusts. Managers and nurses were asked to quantify their perceptions of nine defined adverse events. They were also asked to identify the jobholder with day-to-day responsibility for managing four specific risks. Completed forms were obtained from 38 per cent of managers and nurses. Results showed broadly that managers tended to quantify risks of violence and stress to A&E nurses less highly than did nurses. By contrast, they tended to quantify risks to patients more highly than did nurses. Overall, a coherent pattern of difference in risk perception between the two groups was identified. It is argued that identification of differences of perception is an essential part of the risk management process. Illustrations are given of ways in which these differences can undermine the effectiveness of a risk management strategy.

Administrative Personnel↗

PubMed2003

Self-efficacy in sleep apnea: instrument development and patient perceptions of obstructive sleep apnea risk, treatment benefit, and volition to use continuous positive airway pressure.

STUDY OBJECTIVES: The purpose of this study was to evaluate the Self-Efficacy Measure for Sleep Apnea (SEMSA) designed to assess adherence-related cognitions. DESIGN: Subjects completed the questionnaire prior to the initiation of continuous positive airway pressure (CPAP) treatment. Test-retest reliability of the instrument was evaluated by having a subset of subjects complete the SEMSA a second time at home, 1 week later, returning the questionnaire by mail. PATIENTS: 213 subjects with newly diagnosed obstructive sleep apnea were recruited from the clinic populations of 2 sleep disorders centers. MEASUREMENTS AND RESULTS: Content validity was confirmed by a panel of expert judges. Confirmatory factor analysis validated the 3 a priori sub-scales: risk perception, outcome expectancies, and treatment self-efficacy. The internal consistency of the total instrument was 0.92. Test-retest reliability coefficients (N = 20) were estimated to be 0.68, P = 0.001, for Perceived Risk; 0.77, P more more than 0.0001, for Outcome Expectancies; and 0.71, P = 0.0005, for the Treatment Self-Efficacy subscale. Subject responses indicated that approximately half of the subjects did not perceive problems with concentration, sexual performance, sleepy driving, or an accident as related to sleep apnea. More than 60% of the subjects acknowledged most of the benefits of CPAP presented to them, but only 53% associated CPAP use with enhanced sexual performance. Frequently identified barriers to treatment use were nasal stuffiness, claustrophobia, and disturbing bed partner sleep. CONCLUSION: These findings indicate that the SEMSA has strong psychometric properties and has the potential for identifying patient perceptions that may indicate those most likely to not adhere to treatment.

Adult↗

PubMed2004

Relationships between older men and younger women: implications for STIs/HIV in Kenya.

The aim of this study is to contribute to the understanding of motivations for cross-generational relationships and how the perception of risk of acquiring sexually transmitted infections (STIs) including HIV affects condom use in Kenya. Eight focus-group discussions were conducted with women and 28 interviews were held with men in four Kenyan towns. Ethnograph 5.0 computer software was used for the analysis of data. Women's primary incentive for engaging in such relationships is financial; men seek sexual gratification. Pressure from peers compels women to find older partners. Although some peers encourage such relationships, other groups, especially wives, same-aged boyfriends, and parents, disapprove of them. Couples are preoccupied by the threat of discovery. STI/HIV risk perception is low, and couples rarely use condoms. Material gain, sexual gratification, emotional factors, and recognition from peers override concern for STI/ HIV risk. Women's ability to negotiate condom use is compromised by age and economic disparities. Programmatic strategies include communicating information about such relationships' STI/HIV risk, promoting consistent condom use, decreasing peer pressure to pursue such relationships, and improving women's access to alternative sources of income.

Adolescent↗

PubMed2005

Condom use and perceived risk of HIV transmission among sexually active HIV-positive men who have sex with men.

This study examined the association between HIV transmission risk perception and the sexual risk behaviors of HIV-positive men who have sex with men. Respondents rated the degree of risk of transmitting HIV through insertive anal intercourse and insertive oral sex. We examined (a) the perceived level of HIV transmission risk assigned to each sexual behavior and (b) the association between perceived risk for HIV transmission and condom use during insertive anal intercourse and insertive oral sex. We found for behaviors that have achieved less risk consensus that as transmission risk perception increases, so too does the likelihood of condom use. This study highlights the need for more research in understanding how perceived health risk to others influences protective behaviors.

Adult↗

PubMed1997

Genital human papillomavirus infections: knowledge, perception of risk, and actual risk in a nonclinic population of young women.

The purpose of this study was to assess knowledge, beliefs, and attitudes about genital human papillomavirus (HPV) infections in a group of young women in a nonclinic setting and to examine the association between perception of risk and actual risk. One hundred ten women attending a state university participated in the study and were asked to complete a self-administered questionnaire about knowledge and perceptions of risk. They were then offered testing for the virus using a self-administered vaginal method. The mean age was 20 +/- 1.2 years. Ninety (82%) were sexually experienced (SE), with a mean number of lifetime partners of 5.1 +/- 4.3. The mean knowledge score was less than the 68th percentile, reflecting low levels of knowledge about genital HPV infections. The SE group had a higher knowledge score than the sexually inexperienced (p < .02), but there were no differences in knowledge between those who chose to be tested and those who refused testing. The majority of women attributed negative emotion to being hypothetically tested positive for HPV. Emotions selected by > 50% of the group included feeling scared, angry, guilty, anxious, confused, dirty, regretful, and panicky. A greater negative emotion score was associated with refusing HPV testing (p < .002). Of the SE women, 58% (51) perceived themselves at risk, and, of this group, 71% (36) agreed to be tested. Of the women who agreed to HPV testing, 36% who perceived themselves at risk and 35% who did not perceive themselves at risk were, in fact, positive for HPV (p = ns). The majority of women have little knowledge of HPV infections and have attributed many negative emotions associated with infectivity. These negative attributes appear to influence women's decision making concerning HPV testing. The risk of HPV infection in this nonclinic group was substantial, suggesting that even in a nonclinic group, the prevalence of HPV is quite high. Perception of risk was unrelated to actual risk (HPV positive test), reflecting the lack of self-identified risk.

Adolescent↗

PubMed1991

Adolescent smoking and perceived vulnerability to smoking-related causes of death.

Tested adolescent smokers' perceptions of risk for smoking-related causes of death in comparison to nonsmoking peers. 408 high school Ss (11% regular smokers, 15% occasional smokers) estimated the likelihood of personal death from cancer, emphysema, and stroke. Smokers did not differ from nonsmokers on perceived risks for smoking-related deaths. Smokers and nonsmokers perceived the odds of dying from cancer as high but, unrealistically, smokers did not view it as higher than nonsmokers. Regular smokers who report high exposure to news appear to minimize the risks for cancer and stroke deaths. High sensation-seeking tendencies led to lower perceived risks for males but not for females. The "invulnerability syndrome" is discussed in relationship to adolescents' risk perceptions.

Adolescent↗

PubMed1992

Psychological morale and job satisfaction among homecare workers who care for persons with AIDS.

This paper reports the findings of a study of 103 home care workers who have cared for PWAs. It investigated degree of "exposure" to AIDS cases, perception of risk of occupational contagion, client/worker relationships, attitudes toward homosexuality and drug abuse and other work related factors for their relationship with psychological morale and job satisfaction. Multivariate analyses found sociodemographic characteristics and physical health to be the strongest predictors of morale. The quality of client/worker relationships and risk perception were the strongest predictors of job satisfaction. These findings, and that of the relative lack of importance of exposure to AIDS cases and attitudes toward the risk groups in accounting for job satisfaction, are discussed in terms of qualitative data collected from respondents during informal small group discussions.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

[Health and social aspects in the investigation of cancer clusters].

This paper analyzes the main problems in the research on cancer clusters, with a specific emphasis on the population perception and risk communication. Population information needs and the approach to give information to the population regarding environmental risks are reviewed, as well as the relationship with mass media. Finally, the implications of risk perception for epidemiologic research on clusters and for public health are discussed.

Group Processes↗

PubMed2003

Risk assessment and perception.

Injury prevention efforts often focus on reducing the risk of potentially dangerous activities, facilities or equipment, such as diving, swimming pools or flotation devices. This paper aims to clarify the concepts of risk assessment and risk perception. Statistically, risk denotes the probability of an untoward event, often expressed in terms of potential financial loss. Subjectively, though, risk denotes an individual's perception of the likelihood and the seriousness of an undesirable event. Individual perception appears to be strongly influenced by personal traits and socio-cultural parameters. Risk assessment helps to form the basis for public health interventions. The implementation and effectiveness of these are influenced by individual risk perception. Therefore, preventive efforts need to incorporate and hopefully influence the determinants of risk perception among the target populations. Considering drowning, both hazard and incidence of submersion injuries are underestimated, whereas treatment options are usually overestimated. Consequently, individual risk alertness needs to be improved--drowning remains a ubiquitous risk.

Adolescent↗

PubMed2003

Perceived and objective risk in children of patients with peripheral arterial disease.

This study examined perceived and objective health risks, health promotive behavior, risk perception, and knowledge of risk factors for peripheral arterial disease (PAD) in children of patients with PAD. Children of patients who had lower extremity distal arterial reconstructive surgery or amputation for complications of PAD completed an investigator-developed questionnaire. Risk factor and behavioral measures were self-reported. Data were collected by telephone interview. The sample consisted of 15 children of 6 patients. Subjects displayed optimistic bias regarding their risk for developing PAD, with 67% reporting their parent's illness had no impact on their health behaviors. Fifty-three percent felt their comparative risk was "about the same" as same-age, same-sex peers. Risk factor knowledge varied and none mentioned hypertension, age, obesity, or gender; the most commonly cited risk factor was diabetes mellitus. Forty-seven percent of the offspring never smoked, less than half exercised regularly, most were overweight or had class I or class II obesity, and most were unaware of their blood pressure or cholesterol levels. Despite frequent interactions with their affected parent, these children exhibited poor understanding of risk factors and personal risk of developing PAD and most did not participate in health promotive behaviors. Educational efforts by national societies promoting an understanding of modifiable risk factors must be improved. Future studies need to explore interventions designed to improve risk perception and health promotive behaviors.

Adult↗

PubMed1999

Perception of dioxin and other risks in Japan: replication and extension.

Previous research has shown that the common understanding of risk may be expressed by factor-analytic models that represent how fatal are risks and how voluntarily one assumes such threats. We investigated whether a similar representation would model Japanese participants' risk perception. Moreover, because Japanese newscasts concentrated their coverage exclusively on dioxin during the period of this research, we expected that those who were exposed to such newscasts would more frequently develop greater environmental awareness. We also examined whether this "news-exposed group's" knowledge about dioxin was consistent with the known facts regarding dioxin. Analysis showed that the two factors adequately modeled the Japanese sample's risk representation (N = 473) and that the news-exposed group (n = 188) did exhibit higher environmental awareness. Implications for risk research are discussed.

Attitude to Health↗

PubMed2002

Adolescent condom use and perceptions of risk for sexually transmitted diseases: a prospective study.

BACKGROUND: The authors' previous research has shown that in cross-sectional analysis, partner-specific perceptions of risk for gonorrhea and chlamydial and HIV infection correlated with partner-specific intentions to use condoms. GOAL: The goal was to determine whether partner-specific measures of perception of risk for STDs (PRSTD) predict partner-specific condom use 6 months later among high-risk and low-risk youth. STUDY DESIGN: Youths aged 14 to 19 years were recruited from an STD clinic (n = 236) and an HMO teen clinic (n = 306) and were interviewed at baseline and at 6 months about PRSTD, attitudes about condoms, self-efficacy, normative expectations, and condom use. RESULTS: PRSTD with a main sex partner was an independent predictor of condom use with a main sex partner in the STD clinic cohort (odds ratio = 2.5; 95% CI = 1.1-6.2). There was no association between PRSTD with a casual sex partner and condom use in this cohort or between PRSTD for main or casual sex partners and condom use in the HMO teen clinic cohort. CONCLUSION: Interventions that target high-risk adolescents should focus on PRSTD with a main sex partner.

Adolescent↗