Risk Ranking of Antimicrobial‐Resistant Hazards Found in Meat in Switzerland

Human exposure to bacteria resistant to antimicrobials and transfer of related genes is a complex issue and occurs, among other pathways, via meat consumption. In a context of limited resources, the prioritization of risk management activities is essential. Since the antimicrobial resistance (AMR) situation differs substantially between countries, prioritization should be country specific. The objective of this study was to develop a systematic and transparent framework to rank combinations of bacteria species resistant to selected antimicrobial classes found in meat, based on the risk they represent for public health in Switzerland. A risk assessment model from slaughter to consumption was developed following the Codex Alimentarius guidelines for risk analysis of foodborne AMR. Using data from the Swiss AMR monitoring program, 208 combinations of animal species/bacteria/antimicrobial classes were identified as relevant hazards. Exposure assessment and hazard characterization scores were developed and combined using multicriteria decision analysis. The effect of changing weights of scores was explored with sensitivity analysis. Attributing equal weights to each score, poultry‐associated combinations represented the highest risk. In particular, contamination with extended‐spectrum β‐lactamase/plasmidic AmpC‐producing Escherichia coli in poultry meat ranked high for both exposure and hazard characterization. Tetracycline‐ or macrolide‐resistant Enterococcus spp., as well as fluoroquinolone‐ or macrolide‐resistant Campylobacter jejuni , ranked among combinations with the highest risk. This study provides a basis for prioritizing future activities to mitigate the risk associated with foodborne AMR in Switzerland. A user‐friendly version of the model was provided to risk managers; it can easily be adjusted to the constantly evolving knowledge on AMR.     

“Chemophobia” Today: Consumers’ Knowledge and Perceptions of Chemicals

This mixed‐methods study investigated consumers’ knowledge of chemicals in terms of basic principles of toxicology and then related this knowledge, in addition to other factors, to their fear of chemical substances (i.e., chemophobia). Both qualitative interviews and a large‐scale online survey were conducted in the German‐speaking part of Switzerland. A Mokken scale was developed to measure laypeople's toxicological knowledge. The results indicate that most laypeople are unaware of the similarities between natural and synthetic chemicals in terms of certain toxicological principles. Furthermore, their associations with the term “chemical substances” and the self‐reported affect prompted by these associations are mostly negative. The results also suggest that knowledge of basic principles of toxicology, self‐reported affect evoked by the term “chemical substances,” risk‐benefit perceptions concerning synthetic chemicals, and trust in regulation processes are all negatively associated with chemophobia, while general health concerns are positively related to chemophobia. Thus, to enhance informed consumer decisionmaking, it might be necessary to tackle the stigmatization of the term “chemical substances” as well as address and clarify prevalent misconceptions.     

Paradoxes of risk management: Social responsibility and self-exclusion in Dutch casinos

This article deals with the basic contradictions of risk management and responsibility regarding problem gambling and self-exclusions, and draws special attention to the role knowledge production and science play in the construction and evaluation of gambling risks. This remarkable case of corporate social responsibility (CSR) is analyzed from a risk-governance perspective. It is grounded on a case study of the CSR practice of the Dutch casino monopoly, in particular the problem gambling mitigation and self-exclusion program of this corporation. The intentions and operations of this ‘responsible gambling’ practice constitute new business values and working norms. At the same time empirical evaluations of the self-exclusion program reveal that despite all the efforts put in the risk-management strategies, a significant part of the problem cannot be addressed at all. This points toward a major paradox of risk management. Overall the article highlights the ambiguous nature of risk management and responsible gambling.     

Impact of Water Level Rise on Urban Infrastructures: Washington,DC, and Shanghai as Case Studies

The observed global sea level rise owing to climate change, coupled with the potential increase in extreme storms, requires a reexamination of existing infrastructural planning, construction, and management practices. Storm surge shows the effects of rising sea levels. The recent super storms that hit the United States (e.g., Hurricane Katrina in 2005, Sandy in 2012, Harvey and Maria in 2017) and China (e.g., Typhoon Haiyan in 2010) inflicted serious loss of life and property. Water level rise (WLR) of local coastal areas is a combination of sea level rise, storm surge, precipitation, and local land subsidence. Quantitative assessments of the impact of WLR include scenario identification, consequence assessment, vulnerability and flooding assessment, and risk management using inventory of assets from coastal areas, particularly population centers, to manage flooding risk and to enhance infrastructure resilience of coastal cities. This article discusses the impact of WLR on urban infrastructures with case studies of Washington, DC, and Shanghai. Based on the flooding risk analysis under possible scenarios, the property loss for Washington, DC, was evaluated, and the impact on the metro system of Shanghai was examined.     

Risk factors for severe perineal trauma during vaginal childbirth: A Western Australian retrospective cohort study

AimTo determine rates and risk factors for third and fourth degree perineal tears (severe perineal trauma) in a Western Australian context.Design and settingA retrospective hospital-based cohort study was performed using computerised data for 10,408 singleton vaginal deliveries from 28 weeks gestation.MethodsWomen with severe perineal trauma were compared to those without. Logistic regression analysis, stratified by parity, was used to assess demographic and obstetric factors associated with perineal trauma.ResultsSevere perineal trauma incidence was 3% (338/10408), 5.4% (239/4405) for primiparas and 1.7% (99/5990) for multiparas (p < 0.001). Adjusted risk factors associated with trauma and common across parity included Asian or Indian ethnicity, shoulder dystocia and assisted delivery. Epidural analgesia (OR 0.72, 95% CI 0.54–0.96), preterm birth (OR 0.40, 95% CI 0.23–0.72) and episiotomy (OR 0.54, 95% CI 0.39–0.74) were protective in primiparas, while episiotomy was associated with increased risk in multiparas (OR 2.01, 95% CI 1.18–3.45). Additional factors among primiparas were occipito posterior (OP) delivery (OR 3.35, 95% CI 1.75–6.41) and prolonged second stage (OR 1.98, 95% CI 1.46–2.68), and among multiparas included gestational diabetes (OR 1.78, 95% CI 1.04–3.03) and birth weight >4000 g (OR 1.86, 95% CI 1.10–3.15).ConclusionParity differences in risk factors such as episiotomy, infant weight, OP delivery, gestational diabetes and prolonged second stage warrant investigation into clinical management. Although rates differ internationally, and replication evidence has confirmed consistency for certain demographic and obstetric factors, the development of internationally endorsed clinical guidelines and further research around interventions to protect the perineum are recommended.     

Variability in Cross‐Domain Risk Perception among Smallholder Farmers in Mali by Gender and Other Demographic and Attitudinal Characteristics

Previous research has shown that men and women, on average, have different risk attitudes and may therefore see different value propositions in response to new opportunities. We use data from smallholder farm households in Mali to test whether risk perceptions differ by gender and across domains. We model this potential association across six risks (work injury, extreme weather, community relationships, debt, lack of buyers, and conflict) while controlling for demographic and attitudinal characteristics. Factor analysis highlights extreme weather and conflict as eliciting the most distinct patterns of participant response. Regression analysis for Mali as a whole reveals an association between gender and risk perception, with women expressing more concern except in the extreme weather domain; however, the association with gender is largely absent when models control for geographic region. We also find lower risk perception associated with an individualistic and/or fatalistic worldview, a risk‐tolerant outlook, and optimism about the future, while education, better health, a social orientation, self‐efficacy, and access to information are generally associated with more frequent worry—with some inconsistency. Income, wealth, and time poverty exhibit complex associations with perception of risk. Understanding whether and how men's and women's risk preferences differ, and identifying other dominant predictors such as geographic region and worldview, could help development organizations to shape risk mitigation interventions to increase the likelihood of adoption, and to avoid inadvertently making certain subpopulations worse off by increasing the potential for negative outcomes.     

Linking Decision Theory and Quantitative Microbial Risk Assessment: Tradeoffs Between Compliance and Efficacy for Waterborne Disease Interventions

Achieving health gains from the U.N. Sustainable Development Goals of universal coverage for water and sanitation will require interventions that can be widely adopted and maintained. Effectiveness—how an intervention performs based on actual use—as opposed to efficacy will therefore be central to evaluations of new and existing interventions. Incomplete compliance—when people do not always use the intervention and are therefore exposed to contamination—is thought to be responsible for the lower‐than‐expected risk reductions observed from water, sanitation, and hygiene interventions based on their efficacy at removing pathogens. We explicitly incorporated decision theory into a quantitative microbial risk assessment model. Specifically, we assume that the usability of household water treatment (HWT) devices (filters and chlorine) decreases as they become more efficacious due to issues such as taste or flow rates. Simulations were run to examine the tradeoff between device efficacy and usability. For most situations, HWT interventions that trade lower efficacy (i.e., remove less pathogens) for higher compliance (i.e., better usability) contribute substantial reductions in diarrheal disease risk compared to devices meeting current World Health Organization efficacy guidelines. Recommendations that take into account both the behavioral and microbiological properties of treatment devices are likely to be more effective at reducing the burden of diarrheal disease than current standards that only consider efficacy.     

A Comparison of Methods for Estimating the Benchmark Dose Based on Overdispersed Data from Developmental Toxicity Studies

Developmental anomalies resulting from prenatal toxicity can be manifested in terms of both malformations among surviving offspring and prenatal death. Although these two endpoints have traditionally been analyzed separately in the assessment of risk, multivariate methods of risk characterization have recently been proposed. We examined this and other issues in developmental toxicity risk assessment by evaluating the accuracy and precision of estimates of the effective dose ( ED ₀₅) and the benchmark dose ( BMD ₀₅) using computer simulation. Our results indicated that different variance structures (Dirichlet-trinomial and generalized linear model) used to characterize overdispersion yielded comparable results when fitting joint dose response models based on generalized estimating equations. (The choice of variance structure in separate modeling was also not critical.) However, using the Rao-Scott transformation to eliminate overdispersion tended to produce estimates of the ED ₀₅ with reduced bias and mean squared error. Because joint modeling ensures that the ED ₀₅ for overall toxicity (based on both malformations and prenatal death) is always less than the ED ₀₅ for either malformations or prenatal death, joint modeling is preferred to separate modeling for risk assessment purposes.     

An exploratory study of the influence of the IS function and organizational context on business process reengineering project initiatives

To help evaluate the risk of process reengineering failure and enhance the prospect of its success, three potential sources of influence on BPR initiatives and success are examined in this study. These include the innovative capacity of the organization, IS maturity and strategy-IS interface. It was found that while factors related to IT maturity and influence such as experience in mainframe and client/server computing may facilitate the decision to reengineer, they are not critical in the later stages of the initiative. On the other hand, factors having significant relationships beyond the initial decision include variables pertaining to innovative capacity of the organization and strategy-IS interface. These findings suggest that technical IT competence as a critical enabler is necessary but not sufficient for reengineering success. Based on study findings regarding the innovative capacity of the organization, guidelines for reengineering risk assessment are proposed. In addition, implications of the findings, limitations of the study and opportunities for further research are also discussed.     

Principles for Conduct of Pest Risk Analyses: Report of an Expert Workshop

The North American Free Trade Agreement (NAFTA) and the General Agreement on Tariffs and Trade (GATT) have focused attention on risk assessment of potential insect, weed, and animal pests and diseases of livestock. These risks have traditionally been addressed through quarantine protocols ranging from limits on the geographical areas from which a product may originate, postharvest disinfestation procedures like fumigation, and inspections at points of export and import, to outright bans. To ensure that plant and animal protection measures are not used as nontariff trade barriers, GATT and NAFTA require pest risk analysis (PRA) to support quarantine decisions. The increased emphasis on PRA has spurred multiple efforts at the national and international level to design frameworks for the conduct of these analyses. As approaches to pest risk analysis proliferate, and the importance of the analyses grows, concerns have arisen about the scientific and technical conduct of pest risk analysis. In January of 1997, the Harvard Center for Risk Analysis (HCRA) held an invitation-only workshop in Washington, D.C. to bring experts in risk analysis and pest characterization together to develop general principles for pest risk analysis. Workshop participants examined current frameworks for PRA, discussed strengths and weaknesses of the approaches, and formulated principles, based on years of experience with risk analysis in other setting and knowledge of the issues specific to analysis of pests. The principles developed highlight the both the similarities of pest risk analysis to other forms of risk analysis, and its unique attributes.