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51.
Recently, the concept of black swans has gained increased attention in the fields of risk assessment and risk management. Different types of black swans have been suggested, distinguishing between unknown unknowns (nothing in the past can convincingly point to its occurrence), unknown knowns (known to some, but not to relevant analysts), or known knowns where the probability of occurrence is judged as negligible. Traditional risk assessments have been questioned, as their standard probabilistic methods may not be capable of predicting or even identifying these rare and extreme events, thus creating a source of possible black swans. In this article, we show how a simulation model can be used to identify previously unknown potentially extreme events that if not identified and treated could occur as black swans. We show that by manipulating a verified and validated model used to predict the impacts of hazards on a system of interest, we can identify hazard conditions not previously experienced that could lead to impacts much larger than any previous level of impact. This makes these potential black swan events known and allows risk managers to more fully consider them. We demonstrate this method using a model developed to evaluate the effect of hurricanes on energy systems in the United States; we identify hurricanes with potentially extreme impacts, storms well beyond what the historic record suggests is possible in terms of impacts.  相似文献   
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Many theoretical models examining health risk behaviors, such as sexual risk taking, assume intentions directly predict behavior, and intentions are sometimes measured as a proxy for behavior. Given that there is often a discrepancy between intentions and behaviors (e.g., Sheeran, 2002 ), this study addressed factors that predict intention-behavior congruence. Specifically, utilizing a prospective design, the goal of the study was to determine if characteristics of university students' last sexual encounter predicted whether those students who intended to use condoms, contraception, or dual methods did so in their last sexual encounter with both relationship and casual partners. The seven tested variables were condom planning and preparatory behaviors, mood, sexual arousal, substance use, perceived partner attractiveness, intention certainty, and intention stability. Data were collected from 520 American undergraduate students at a medium-sized university. The six discriminant function analyses examining the intention-behavior relationship were able to correctly classify between 74% and 92% of the participants concerning whether intenders engaged in safe sex behaviors. The variables that best discriminated between behavior engagement over the six analyses were intention stability, intention certainty, and engagement in condom preparatory behaviors. The implications of these results for sexual risk prevention and intervention research are discussed.  相似文献   
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Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings.  相似文献   
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Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.  相似文献   
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Older adults are a vulnerable group in a disaster and are more at risk of adverse effects as a result. This paper draws on the use of narrative theory in health and gerontology studies to examine how a disruptive disaster was storied. Narrative interviews were conducted with nine older adults aged over 65 years who had recently experienced a flood disaster. The participants' narratives about the disruptive event were integrated with past personal events that spanned more than seven decades. The disaster became a reference point for previous challenging experiences, which created biographical continuity, coherence and order over time. Furthermore, the disaster stories were about biography and identity, and showed how older adults made sense of the flood from a life-course perspective. The use of narrative approaches provides an insight into how the flood disaster was experienced, and reveals how four older adults storied their experiences of a significant life challenge.  相似文献   
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This work was undertaken in France at the request of a local fire and rescue school in order to conduct an analysis of driving two types of heavy rescue vehicle with a view to improving training. This study took place in a context of specialisation: the drivers of these vehicles will henceforth only perform this type of task. Consequently, specific training has been designed in advance. Our study concerns the improvement of this training, taking account of the particularities of driving these vehicles in emergency situations typical to the profession of fire-fighters. The results stress first that driving of rescue vehicles in emergency situations is a multidimensional collective activity. Driving strategies identified share certain common objectives: "optimising trajectories", warn other road users, anticipate their behaviour and leave room for manoeuvre to counter and react to any unexpected behaviour. They include risks management for the potential victims of the incident and the risk of accidents during the journey. These initial results help identify certain recommendations for the training courses dealing with driving vehicles in emergency situations. They also provide a warning concerning the possible consequences of driver specialisation.  相似文献   
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The New Deal for Engagement in Fragile States marks an important ideological shift in development co‐operation. Despite this progress, no practical response has been found to the problem of aid co‐ordination. This article traces the issue of aid allocation and highlights lessons from the ‘aid orphan’ and ‘aid darling’ debate. It examines the significant, yet under‐reported, policy process of the New Deal. It argues that deeper engagement with the concept of trust, and renewed focus on the political elements of the agreement, should be key priorities for the International Dialogue on Peacebuilding and Statebuilding.  相似文献   
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