Application of a QMRA Framework to Inform Selection of Drinking Water Interventions in the Developing Context

The aim of this study was to develop a modified quantitative microbial risk assessment (QMRA) framework that could be applied as a decision support tool to choose between alternative drinking water interventions in the developing context. The impact of different household water treatment (HWT) interventions on the overall incidence of diarrheal disease and disability adjusted life years (DALYs) was estimated, without relying on source water pathogen concentration as the starting point for the analysis. A framework was developed and a software tool constructed and then implemented for an illustrative case study for Nepal based on published scientific data. Coagulation combined with free chlorine disinfection provided the greatest estimated health gains in the short term; however, when long‐term compliance was incorporated into the calculations, the preferred intervention was porous ceramic filtration. The model demonstrates how the QMRA framework can be used to integrate evidence from different studies to inform management decisions, and in particular to prioritize the next best intervention with respect to estimated reduction in diarrheal incidence. This study only considered HWT interventions; it is recognized that a systematic consideration of sanitation, recreation, and drinking water pathways is important for effective management of waterborne transmission of pathogens, and the approach could be expanded to consider the broader water‐related context.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

Does Iconicity in Pictographs Matter? The Influence of Iconicity and Numeracy on Information Processing,Decision Making,and Liking in an Eye‐Tracking Study

Researchers recommend the use of pictographs in medical risk communication to improve people's risk comprehension and decision making. However, it is not yet clear whether the iconicity used in pictographs to convey risk information influences individuals’ information processing and comprehension. In an eye‐tracking experiment with participants from the general population (N = 188), we examined whether specific types of pictograph icons influence the processing strategy viewers use to extract numerical information. In addition, we examined the effect of iconicity and numeracy on probability estimation, recall, and icon liking. This experiment used a 2 (iconicity: blocks vs. restroom icons) × 2 (scenario: medical vs. nonmedical) between‐subject design. Numeracy had a significant effect on information processing strategy, but we found no effect of iconicity or scenario. Results indicated that both icon types enabled high and low numerates to use their default way of processing and extracting the gist of the message from the pictorial risk communication format: high numerates counted icons, whereas low numerates used large‐area processing. There was no effect of iconicity in the probability estimation. However, people who saw restroom icons had a higher probability of correctly recalling the exact risk level. Iconicity had no effect on icon liking. Although the effects are small, our findings suggest that person‐like restroom icons in pictographs seem to have some advantages for risk communication. Specifically, in nonpersonalized prevention brochures, person‐like restroom icons may maintain reader motivation for processing the risk information.     

Why Frequency is Not Well Defined for Engineering Systems with Nonexponential Failure Times

Dr. Yellman proposes to define frequency as “a time‐rate of events of a specified type over a particular time interval.” We review why no definition of frequency, including this one, can satisfy both of two conditions: (1) the definition should agree with the ordinary meaning of frequency, such as that less frequent events are less likely to occur than more frequent events, over any particular time interval for which the frequencies of both are defined; and (2) the definition should be applicable not only to exponentially distributed times between (or until) events, but also to some nonexponential (e.g., uniformly distributed) times. We make the simple point that no definition can satisfy (1) and (2) by showing that any definition that determines which of any two uniformly distributed times has the higher “frequency” (or that determines that they have the same “frequency,” if neither is higher) must assign a higher frequency number to the distribution with the lower probability of occurrence over some time intervals. Dr. Yellman's proposed phrase, “time‐rate of events … over a particular time interval” is profoundly ambiguous in such cases, as the instantaneous failure rates vary over an infinitely wide range (e.g., from one to infinity), making it unclear which value is denoted by the phrase “time‐rate of events.”     

Quantifying the Establishment Likelihood of Invasive Alien Species Introductions Through Ports with Application to Honeybees in Australia

The cost of an uncontrolled incursion of invasive alien species (IAS) arising from undetected entry through ports can be substantial, and knowledge of port‐specific risks is needed to help allocate limited surveillance resources. Quantifying the establishment likelihood of such an incursion requires quantifying the ability of a species to enter, establish, and spread. Estimation of the approach rate of IAS into ports provides a measure of likelihood of entry. Data on the approach rate of IAS are typically sparse, and the combinations of risk factors relating to country of origin and port of arrival diverse. This presents challenges to making formal statistical inference on establishment likelihood. Here we demonstrate how these challenges can be overcome with judicious use of mixed‐effects models when estimating the incursion likelihood into Australia of the European (Apis mellifera) and Asian (A. cerana) honeybees, along with the invasive parasites of biosecurity concern they host (e.g., Varroa destructor). Our results demonstrate how skewed the establishment likelihood is, with one‐tenth of the ports accounting for 80% or more of the likelihood for both species. These results have been utilized by biosecurity agencies in the allocation of resources to the surveillance of maritime ports.     

Identifying Changing Aviation Threat Environments Within an Adaptive Homeland Security Advisory System

A critical component of aviation security consists of screening passengers and baggage to protect airports and aircraft from terrorist threats. Advancements in screening device technology have increased the ability to detect these threats; however, specifying the operational configurations of these devices in response to changes in the threat environment can become difficult. This article proposes to use Fisher information as a statistical measure for detecting changes in the threat environment. The perceived risk of passengers, according to prescreening information and behavior analysis, is analyzed as the passengers sequentially enter the security checkpoint. The alarm responses from the devices used to detect threats are also analyzed to monitor significant changes in the frequency of threat items uncovered. The key results are that this information‐based measure can be used within the Homeland Security Advisory System to indicate changes in threat conditions in real time, and provide the flexibility of security screening detection devices to responsively and automatically adapt operational configurations to these changing threat conditions.     

Flood Catastrophe Model for Designing Optimal Flood Insurance Program: Estimating Location‐Specific Premiums in the Netherlands

As flood risks grow worldwide, a well‐designed insurance program engaging various stakeholders becomes a vital instrument in flood risk management. The main challenge concerns the applicability of standard approaches for calculating insurance premiums of rare catastrophic losses. This article focuses on the design of a flood‐loss‐sharing program involving private insurance based on location‐specific exposures. The analysis is guided by a developed integrated catastrophe risk management (ICRM) model consisting of a GIS‐based flood model and a stochastic optimization procedure with respect to location‐specific risk exposures. To achieve the stability and robustness of the program towards floods with various recurrences, the ICRM uses stochastic optimization procedure, which relies on quantile‐related risk functions of a systemic insolvency involving overpayments and underpayments of the stakeholders. Two alternative ways of calculating insurance premiums are compared: the robust derived with the ICRM and the traditional average annual loss approach. The applicability of the proposed model is illustrated in a case study of a Rotterdam area outside the main flood protection system in the Netherlands. Our numerical experiments demonstrate essential advantages of the robust premiums, namely, that they: (1) guarantee the program's solvency under all relevant flood scenarios rather than one average event; (2) establish a tradeoff between the security of the program and the welfare of locations; and (3) decrease the need for other risk transfer and risk reduction measures.     

The duty to care and the need to split

This paper arises out of psychoanalytically oriented consultancy to teams of staff in the helping professions where there is a statutory 'duty to care'. It takes as its premise the seemingly paradoxical hypothesis that workers may need to split off part of their emotional experience in order to preserve their own mental health and provide reliable services to their clients. I argue that while a professional 'duty to care' requires us to be emotionally 'in touch', the demands of our clients together with the demands of the institutional response to the 'duty to care' cause us to split off parts of our awareness. I also argue that provided the splitting does not become extreme we are doing no more or less than the rest of society. In other words, there is a degree of 'normal splitting' which numbs our awareness of danger and destructiveness and seeks to protect us from too much anxiety and pain. Yet if professional workers are charged with the responsibility of assessing risk and acting accordingly for the protection of all concerned they need ways of being 'in touch' (re-integrating the splits) for some or enough of the time. Finally, I will describe ways of being 'in touch', illustrating the difficulty and the pain of re-integrating the splits and some of the insights that can arise out of this work with examples from my consultancy work.     

Communicating Conservation Status: How Different Statistical Assessment Criteria Affect Perceptions of Extinction Risk

Although alternative forms of statistical and verbal information are routinely used to convey species’ extinction risk to policymakers and the public, little is known about their effects on audience information processing and risk perceptions. To address this gap in literature, we report on an experiment that was designed to explore how perceptions of extinction risk differ as a function of five different assessment benchmarks (Criteria A–E) used by scientists to classify species within IUCN Red List risk levels (e.g., Critically Endangered, Vulnerable), as well as the role of key individual differences in these effects (e.g., rational and experiential thinking styles, environmental concern). Despite their normative equivalence within the IUCN classification system, results revealed divergent effects of specific assessment criteria: on average, describing extinction risk in terms of proportional population decline over time (Criterion A) and number of remaining individuals (Criterion D) evoked the highest level of perceived risk, whereas the single‐event probability of a species becoming extinct (Criterion E) engendered the least perceived risk. Furthermore, participants scoring high in rationality (analytic thinking) were less prone to exhibit these biases compared to those low in rationality. Our findings suggest that despite their equivalence in the eyes of scientific experts, IUCN criteria are indeed capable of engendering different levels of risk perception among lay audiences, effects that carry direct and important implications for those tasked with communicating about conservation status to diverse publics.