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Background: Colorectal cancer is major public health concern in China. This study seeks to explore the role of online cancer information seeking in influencing colorectal cancer screening, by taking into account one’s coping appraisals (i.e., self-efficacy, response efficacy), threat appraisals (i.e., perceived severity, cancer worry) and cancer fatalism. Methods: A cross-sectional survey was conducted with 730 participants in China recruited from a Chinese survey company’s online panels. Path analysis was performed to investigate the relationships between the key constructs. Results: First, online cancer information seeking increased both coping appraisals and threat appraisals. Second, threat appraisal did not significantly influence cancer fatalism, but coping appraisal reduced cancer fatalism. Third, cancer fatalism had no effects on colorectal cancer screening. Lastly, online cancer information also had a direct and positive relationship with cancer screening. Conclusions: This research emphasises the need for health organisations to offer timely cancer information to people, and educate them about the importance of cancer screening. Health authorities may also regulate online cancer information to ensure that the information is accurate and appropriate in improving people’s cancer prevention and cancer screening knowledge.

Vaccination is a global health development success story that saves millions of lives every year and reduces the risk of getting various infectious diseases, including COVID-19. At the end of 2021, a rapid increase in the size of the population infected with COVID-19 and a low vaccination coverage were observed in Latvia (Centre for Disease Prevention and Control, 2021). Also, despite the available vaccines, by the beginning of May 2022, only 60.6% of the population of Latvia had completed the full course of vaccination against COVID-19. According to the Ministry of Health, the vaccination process is characterised by variability and flexibility, and in general, vacci-nation rates have declined in recent years. Therefore, the aim of the study was to investigate the vaccination predicting factors of unvaccinated adults in Latvia using the Health Belief Model (HBM) during the COVID-19 pandemic. The study sample consisted of 539 respondents aged 18 to 75 years (M = 45.35, SD = 15.70), who were not vaccinated against COVID-19 and who had to make a decision to vaccinate or not, and who were part of a representative sample of Latvian residents (n = 1017). The data was collected in September and were analysed using Spearman's rank correlation coefficient and multivariate linear regression analysis. A statistically significant moderate strong positive correlation was shown between vaccination intention and all six vaccination motives as perceived benefits (r = 0.40–0.44, p < 0.01); statistically significant but weak positive correlation between vaccination intention and risk appraisal as perceived threat (r = 0.20, p < 0.01) and COVID-19 experience as cues to action (r = 0.20, p < 0.01); and statistically significant negative but weak correlation for vaccination intention and fear of vaccination as perceived barriers (r = –0.21, p < 0.01). The results revealed a statistically significant positive association of vaccination intention and the components of HBM: perceived threats, perceived benefits and cues to action, as well as a statistically significant negative association with perceived barriers. The results revealed several factors that predict vaccination intention, explaining 32% of the variation in vaccination intention: education level, perceived threats, perceived benefits, perceived barriers, and cues to action. Higher levels of education, higher perceived threat of contracting COVID-19, many different social motives for vaccination (e.g., to be able travel), confidence that the vaccine will not cause significant side effects and long-term consequences, and experience with COVID-19 are factors that predicts an individual's intention to vaccinate against COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament‐Return to Sport after Injury (ACL‐RSI) scale among patients following ACL reconstruction. Methods: Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL‐RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL‐RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single‐leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate <0.05 in simple linear regression analyses as independent variables and the ACL‐RSI in each subcategory score as the dependent variable. Results: Multiple regression analysis showed that subjective running ability affected all subcategories (p ≤ 0.001), and that the limb symmetry index of medial SLH distance affected both the Emotions (p = 0.047) and Confidence (p = 0.009) subcategories. Higher subjective running ability and greater limb symmetry in the medial SLH were thus positively associated with each dimension of psychological readiness. Conclusions: This study highlights the differential impact of physical function factors on specific subcategories of the ACL‐RSI scale, providing clinicians with insights for designing targeted rehabilitation strategies. This original paper suggests the importance of analysing factors related to subcategory scores in addition to total ACL‐RSI score, and could contribute to the understanding of determinants for a successful return to sport following ACL reconstruction. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Abstract Purpose This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament‐Return to Sport after Injury (ACL‐RSI) scale among patients following ACL reconstruction. Methods Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL‐RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL‐RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single‐leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate

Objective: Lung cancer in never‐smokers represents a growing proportion of patients. The relationship between smoking status, symptom appraisal and help‐seeking behaviour is complex. Little is known about cancer symptom‐related health behaviours according to smoking status. The aim of the study was to explore lung cancer patients' experiences of a lung cancer diagnosis, identifying differences by smoking history. Method: This was a qualitative study involving telephone interviews with 40 lung cancer patients (20 never smokers, 11 former smokers and 9 current smokers). We used framework analysis to analyse the data using the Common Sense Model of Illness Self‐Regulation as a theoretical framework, developed after initial analysis. Results: All patients were likely to delay seeking help for symptoms in primary care regardless of smoking history, but for different reasons. Smoking history was instrumental to how individuals perceived and responded to early symptoms of lung cancer. Differences in interpretation and coping responses to new symptoms seemed to be caused by the higher presence of comorbidities due to smoking, and perceptions of the current state of health. Individuals with a smoking history reported acting with urgency in seeking help and follow up, whereas patients who experienced low levels of concern were more easily reassured by clinicians, resulting in delays. Conclusions: Never and former smokers perceive, interpret, and respond to symptoms of lung cancer differently to smokers. However, few people attribute their lung symptoms to cancer initially, even with a smoking history. Interventions that drive increased urgency and vigilance in never smokers may be effective. [ABSTRACT FROM AUTHOR]

University students report experiencing regrettable health and social outcomes following excessive alcohol consumption. Students also report experiencing regret when they are unable to attend drinking events. This study explored how such experiences influence risk appraisals and decisions about future alcohol consumption. Thirteen university students (69% female, 18–20 years old) discussed the interplay of regret with alcohol consumption, and nonattendance at drinking events, in one of three focus groups. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). IPA produced three super-ordinate themes: 'It's not something I would have done sober', 'Attitudes towards action regret' and 'Fear of Missing Out (FoMO)'. Participants reported regrettable experiences (e.g. alcohol poisoning, tattoos), and a gender difference in risk appraisals was apparent. Attitudes towards action regret affected risk appraisals and informed future drinking decisions. Participants reported experiencing FoMO when they were unable to attend drinking events. Regrettable incidents following excessive consumption were seen as common but did not affect risk appraisals or future drinking decisions. Students' reported they preferred the regrettable experiences that follow excessive consumption than the FoMO experienced when they were unable to attend drinking events, suggesting FoMO may drive attendance at future drinking events. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is major public health concern in China. This study seeks to explore the role of online cancer information seeking in influencing colorectal cancer screening, by taking into account one's coping appraisals (i.e., self-efficacy, response efficacy), threat appraisals (i.e., perceived severity, cancer worry) and cancer fatalism., Methods: A cross-sectional survey was conducted with 730 participants in China recruited from a Chinese survey company's online panels. Path analysis was performed to investigate the relationships between the key constructs., Results: First, online cancer information seeking increased both coping appraisals and threat appraisals. Second, threat appraisal did not significantly influence cancer fatalism, but coping appraisal reduced cancer fatalism. Third, cancer fatalism had no effects on colorectal cancer screening. Lastly, online cancer information also had a direct and positive relationship with cancer screening., Conclusions: This research emphasises the need for health organisations to offer timely cancer information to people, and educate them about the importance of cancer screening. Health authorities may also regulate online cancer information to ensure that the information is accurate and appropriate in improving people's cancer prevention and cancer screening knowledge., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Inc.)

Observational studies and landmark randomized control trials support early and sustained allergenic food introduction in infancy as an effective preventive strategy against food allergy development. Despite a consensus regarding the intended goals of early and sustained allergenic food introduction, there have been myriad policy recommendations among health authorities in how to achieve both individual and population-level health outcomes for food allergy prevention. This clinical management review provides an overview on the data that informs early and sustained allergenic food introduction strategies, suggestions on how to advise allergenic food introduction, principles of prevention programs as they relate to food allergy prevention, and health promotion and systems-level challenges that impede achievement of food allergy prevention goals., (Copyright © 2024. Published by Elsevier Inc.)

This study sheds light on the effects of community resilience and risk appraisal on climate change adaptation behaviour within the context of the resettlement site of Kannagi Nagar in Chennai, India. The residents of Kannagi Nagar, built on flood-prone marshlands, are exposed to the risks of flooding and water scarcity. Data were collected at the household level through a questionnaire and interviews to investigate activities contributing to community resilience, their interrelatedness, and the influence of community resilience and risk appraisal on household adaptation behaviour. Findings show that community resilience – assessed using the five core dimensions of trust, place attachment, collective efficacy, social networks and social support – significantly and positively influences adaptation actions. This implies that only when the inhabitants of Kannagi Nagar are supported by their social networks and have confidence in their community's capabilities, can greater risk awareness increase the number of adaptation measures taken. [ABSTRACT FROM AUTHOR]

BackgroundIn crisis communication, warning messages are key to informing and galvanizing the public to prevent or mitigate damage. Therefore, this study examines how risk appraisal and individual characteristics influence the intention to comply with behavioral recommendations of a warning message regarding three hazard types: the COVID-19 pandemic, violent acts, and severe weather.MethodsA cross-sectional survey examined 403 German participants from 18 to 89 years (M = 29.24; 72% female). Participants were allocated to one of three hazard types (COVID-19 pandemic, violent acts, severe weather) and presented with warning messages that were previously issued via an official warning app. Four components of risk appraisal—perceived severity (PS), anticipated negative emotions (AE), anticipatory worry (AW), and risk perception (RP)—were assessed before and after presenting the warning message. Path models were calculated to predict the intention to comply with the warning message, controlling for age, gender, and previous hazard experience.ResultsFor the COVID-19 pandemic, higher age (β = 0.18) predicted warning compliance (R2 = 0.05). AE (β = 0.20) predicted compliance in the case of violent acts (R2 = 0.09). For severe weather, PS (β = 0.28), age (β = 0.29), and female gender (β = 0.34) lead to higher compliance (R2 = 0.27). Changes across risk appraisal components were not consistent, as some facets decreased after the receipt of a warning message.DiscussionRisk appraisal has shown a marginal yet differential influence on warning message compliance in different types of hazards. Regarding the COVID-19 pandemic, the impact of sociodemographic factors on compliance should be studied more intensively. Moreover, integrating intermediary variables, such as self-efficacy, is necessary.

The aim of the study is to investigate the motivational effects of tourist traits and risk appraisal on tourist destination risk perception. Risk appraisal involves subjective estimates of vulnerability to a threat and the threat's consequential severity. Fear levels influence both of these elements of risk appraisal. Individual differences in reactance proneness and risk aversion are introduced into the study model to more fully account for differences in travel destination risk perceptions. The study design involves US adults, who have used their passports for international travel in the past 5 years. Travel risk assessments were studied for four destination sites: London, Tokyo, Kuala Lumpur and Istanbul. A general structural model is developed to test hypotheses about antecedents and consequents of risk appraisal and destination risk perception. [ABSTRACT FROM AUTHOR]

Background: In crisis communication, warning messages are key to informing and galvanizing the public to prevent or mitigate damage. Therefore, this study examines how risk appraisal and individual characteristics influence the intention to comply with behavioral recommendations of a warning message regarding three hazard types: the COVID-19 pandemic, violent acts, and severe weather. Methods: A cross-sectional survey examined 403 German participants from 18 to 89 years (M = 29.24; 72% female). Participants were allocated to one of three hazard types (COVID-19 pandemic, violent acts, severe weather) and presented with warning messages that were previously issued via an official warning app. Four components of risk appraisal—perceived severity (PS), anticipated negative emotions (AE), anticipatory worry (AW), and risk perception (RP)—were assessed before and after presenting the warning message. Path models were calculated to predict the intention to comply with the warning message, controlling for age, gender, and previous hazard experience. Results: For the COVID-19 pandemic, higher age (β = 0.18) predicted warning compliance (R 2 = 0.05). AE (β = 0.20) predicted compliance in the case of violent acts (R 2 = 0.09). For severe weather, PS (β = 0.28), age (β = 0.29), and female gender (β = 0.34) lead to higher compliance (R 2 = 0.27). Changes across risk appraisal components were not consistent, as some facets decreased after the receipt of a warning message. Discussion: Risk appraisal has shown a marginal yet differential influence on warning message compliance in different types of hazards. Regarding the COVID-19 pandemic, the impact of sociodemographic factors on compliance should be studied more intensively. Moreover, integrating intermediary variables, such as self-efficacy, is necessary. [ABSTRACT FROM AUTHOR]

Amid ongoing threats from COVID-19, developing an effective vaccine against COVID-19 is deemed to be, hopefully, the only means of dealing with those threats. To accelerate Coronavirus vaccine licensure, Human Challenge trial, in which researchers would deliberately expose Coronavirus to research participants with the purpose of assessing the effectiveness of vaccine candidates, has been proposed by Nir Eyal, Marc Lipsitch, and Peter Smith, as an alternative research design to conventional 3rd phase efficacy trial which usually takes a long period of time and needs to recruit, by and large, over thousands of participants. Despite common worries around Human Challenge trial for Coronavirus mostly grounded on traditional research ethics, such as those pointing out excessive harm to participants, no significantly effective treatment option, and exploitation, Nir Eyal et al. have claimed this research design is ethically justifiable. The main supporting points are the following: (1) vast social benefits, i.e. preventing millions of deaths by expediting vaccine development, should be taken into consideration properly; (2) secondary gains provided to each participant, e.g. access to health services of best quality and being prioritized in getting scarce medical resources, such as ventilators, should fall into the category of relevant "benefits" to participants, as primary gains, i.e. protective effects of vaccine candidates, obviously do, in order to prudentially and reasonably balance risks and benefits given to each research participant; (3) the risk of dying or acquiring severe adverse outcomes from Coronavirus infection, if research participants are recruited among those in 20s, seems not significant, about 0.2%, which is lower than 1% which major research ethicists have agreed to be one crude threshold of permissible risk; (4) compared to the level of risks which, if participants opt out from participating Human Challenge trials, status quo, research participants would be exposed to and the risks which, if research participants are recruited in conventional 3rd phase efficacy trials, research participants would be exposed to, the level of incremental risks imposed to participants in Human Challenge trials is not seriously higher, in some cases, may be even lower; (5) if research participants grant their consent of fairly good quality, it seems wrong for a state to forbid them, particularly those with purely altruistic goals, from participating in Human Challenge trials. Even though there can be several counterarguments finding Human Challenge trials as problematic, grounded on potential exploitation and the required level of informed consent, there are many practical ways to minimize their worries, such as, setting age limits of participants as 20s, excluding volunteers under extreme deprivation, and selecting geographical regions under severe pandemical threats of COVID-19 but without deeply entrenched injustice. Lastly, addressing distributive concerns and more population-wide approach in research ethics will be vastly needed to ensure fairness in later rollout of vaccines and articulate ethical research protocols of Human Challenge trials. [ABSTRACT FROM AUTHOR]

Risk-taking has been a major field of interest for scientists and for applied purposes since decades. However, many researchers have noted that the current measurement instruments fail to show adequate validity and predictive power. Given the recent calls to develop new measures, this paper aims to highlight six key points that should be kept in mind when constructing or using measures of risk-taking concepts. Specifically, we encourage risk-taking scholars (a) to pay close attention to the terminology used in studies, (b) to distinguish measures of general and specific risk-taking, (c) to distinguish risk-taking from the appeal of risky activities, (d) to keep in mind the subjectivity of risk-taking, (e) to consider the measurement of passive risk-taking, and (f) to favour more realistic risk-taking tasks. Overall, these recommendations should help researchers to design and use more relevant risk-taking measures. [ABSTRACT FROM AUTHOR]

Objectives: The primary aim was to explore adolescents' cardiovascular disease risk appraisals and establish whether they understood the preventative role of physical activity (PA). The secondary aim was to examine whether adolescents' cardiovascular disease risk appraisal fitted with the Illness Risk Representations (IRR) framework.Design: Qualitative.Methods: Thirty-one adolescents aged between 13 and 15 years participated in semi-structured interviews. Data were analysed using Framework Analysis.Results: Knowledge of lifestyle behaviours contributing to cardiovascular disease was good. Participants reflected on their current (or expected future) patterns of these behaviours when making judgements about lifetime risk. They struggled however to explain how different health behaviours, including PA, affected the development of the disease. Cardiovascular disease was viewed as potentially fatal, but participants had only a superficial understanding of the consequences of, or treatments for, the disease. The IRR framework, as proposed by Cameron (2003, https://cancercontrol.cancer.gov/brp/research/theories_project/cameron.pdf), largely captured the way in which adolescents' made judgements about their risk of cardiovascular disease.Conclusions: The findings suggest that adolescents are underestimating their risk of cardiovascular disease due to unhelpful beliefs. Interventions should: provide clear and simple explanations of how different health behaviours contribute to cardiovascular risk, highlight discrepancies that exist between current levels of preventative behaviour and that required to confer a protective effect, expose the false belief that a lack of PA in early life can be compensated for in later adulthood, and aid understanding of the true impact that the disease and its treatment could have of health and quality of life outcomes. Statement of contribution What is already known on this subject? Physical activity (PA) throughout one's lifetime can reduce the risk of developing cardiovascular disease. The majority of adolescents' do not meet the recommended levels of PA. Changing beliefs about the risk of cardiovascular disease might be a useful strategy to motivate engagement in PA. What does this study add? An increased understanding of adolescents' knowledge of cardiovascular disease and the link with PA. Identification of strategies to change adolescents' risk perceptions of cardiovascular disease in ways that could motivate PA. Evidence to support the Illness Risk Representation framework. [ABSTRACT FROM AUTHOR]

For some chemical substances in food, scientific uncertainty prevents definitive statements about the presence of risk for human health. In this qualitative study, we explored the public's understanding and risk appraisal of these substances. During semi-structured interviews, participants from the public were presented with inconclusive risk information about either a food additive or one of two food contaminants. Findings show that interviewees had no prior knowledge and constructed their risk appraisal on the spot. Results suggest that generic and case specific beliefs and inferences affect understanding and appraisal. Respondents' interpretations of the risk messages used in this study were often not in line with what the message intended to convey. In addition, specific use of scientific jargon was associated with increased risk. In general, respondents were more apprehensive about the presence of the chemical in food than that they were worried about the chance of experiencing health effects. [ABSTRACT FROM AUTHOR]

The successful implementation of Vessel Traffic Services (VTS) relies heavily on human decisions. With the increasing development of maritime traffic, there is an urgent need to provide a sound support for dynamic risk appraisals and decision support. This research introduces a cellular automata (CA) simulation-based modelling approach the objective of which is to analyze and evaluate real-time maritime traffic risks in port environments. The first component is the design of a CA model to monitor ships’ behavior and maritime fairway traffic. The second component is the refinement of the modelling approach by combining a cloud model with expert knowledge. The third component establishes a risk assessment model based on a fuzzy comprehensive evaluation. A typical scenario was experimentally implemented to validate the model’s efficiency and operationality.

While studies have shown a robust association between sensation seeking (SS) and adolescent marijuana use, comparatively little is known about the mechanisms that potentially account for this association. The current study tests a theoretical model linking SS to marijuana use through risk appraisal and normative influences (i.e., perceived behavior and attitudes of others). Utilizing a nationally representative, cross-sectional sample of high school seniors (N = 2117), the current study finds risk appraisal and normative influences mediate the relationship between SS and marijuana use. Furthermore, perceptions of risk appear to be strongly influenced by proximal peer norms. These results indicate risk appraisal and normative processes may be key explanatory mechanisms in the association between SS and adolescent marijuana use. Theoretical and policy implications for this model are discussed. [ABSTRACT FROM AUTHOR]

Theories of risk aversion, epistemic defense, and ingroup enhancement converge in predicting greater impact of negative (vs. positive) experiences with outgroup members on generalized evaluations of stigmatized outgroups. However, they diverge in predictions for admired outgroups. Past tests have focused on negative outgroups using correlational designs without a control group. Consequently, they have not distinguished between alternative explanations or ascertained the direction of causality/generalization, and they have suffered from self-selection biases. These limitations were redressed by a meta-analysis of experimental research on individual-to-group generalization with positive and negative outgroups (59 tests; 3,012 participants). Controlling for modest confounds, the meta-analysis found a generalization advantage of negative experiences for stigmatized outgroups and a generalization advantage of positive experiences for admired outgroups. These results highlight the centrality of valenced expectations about outgroups, consistent with epistemic defense and ingroup enhancement and inconsistent with risk aversion. Implications for positive changes in intergroup dynamics are discussed. [ABSTRACT FROM AUTHOR]

We assessed the psychological well-being and workplace functioning of hospital workers in South Korea after an infectious disease outbreak by focusing on the effects of risk appraisal, emotional experience, and coping ability. Participants were 280 hospital workers who experienced the 2015 Middle East respiratory syndrome outbreak. We found that high risk appraisal decreased psychological resilience, whereas coping ability increased psychological resilience. Additionally, emotional disruption was associated with low resilience and also mediated the effect of perceived risk on psychological resilience. Results varied across occupational type (health-care workers vs. non-health-care workers), which implies that different considerations are needed for resilience-building among hospital workers responding to an outbreak. In particular, lowering perceived risk was most beneficial to health-care workers, whereas strengthening coping ability and relieving the intensity of negative emotions experienced were the most effective strategies for non-health-care workers. Implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

Purpose: There is good evidence that for many behaviours, increasing risk appraisal can lead to a change in behaviour, heightened when efficacy appraisals are also increased. The present systematic review addressed whether interventions presenting a risk message increase risk appraisal and an increase in vaccination intentions and uptake.Method: A systematic search identified randomized controlled trials of interventions presenting a risk message and measuring risk appraisal and intentions and uptake post-intervention. Random-effects meta-analyses investigated the size of the effect that interventions had on vaccination risk appraisal and on vaccination behaviour or intention to vaccinate, and the size of the relationship between vaccination risk appraisal and vaccination intentions and uptake.Results: Eighteen studies were included and 16 meta-analysed. Interventions overall had small significant effects on risk appraisal (d = 0.161, p = .047) and perceptions of susceptibility (d = 0.195, p = .025), but no effect on perceptions of severity (d = -0.036, p = .828). Interventions showed no effect on intention to vaccinate (d = 0.138, p = .195) and no effect on vaccination behaviour (d = 0.043, p = .826). Interventions typically did not include many behaviour change techniques (BCTs), with the most common BCT unique to intervention conditions being 'Information about Health Consequences'. Few of the included studies attempted to, or successfully increased, efficacy appraisals.Conclusions: Overall, there is a lack of good-quality primary studies, and existing interventions are suboptimal. The inclusion of additional BCTs, including those to target efficacy appraisals, could increase intervention effectiveness. The protocol (CRD42015029365) is available from http://www.crd.york.ac.uk/PROSPERO/. Statement of contribution What is already known on this subject? Previous research indicates that an increase in risk appraisal is associated with increased uptake in health-related behaviours. Research suggests that interventions increasing risk appraisal have a greater effect on intention when elements of efficacy appraisals are simultaneously increased. What does this study add? This is the first systematic review to examine the effect of interventions on risk appraisal and vaccination uptake using only experimental studies. Limitations of the interventions themselves, and those caused by study methods and reporting, mean that the potential value of this type of review is lost. Instead, its value is in shining a light on the paucity of experimental studies in this area, and the quality of methods and reporting used. Future experimental studies should examine interventions that focus exclusively on increasing risk and efficacy appraisal compared to controls, use conditional measures of risk, and improve reporting to enable both more accurate coding of intervention content and more accurate assessments of study bias. [ABSTRACT FROM AUTHOR]

Introduction: Studies found that higher risk appraisal of radiofrequency electromagnetic fields is associated with reporting more non-specific symptoms such as headache and back pain. There is limited data available on the longitudinal nature of such associations and what aspects of risk appraisal and characteristics of subjects are relevant.Objective: To examine cross-sectional and longitudinal associations between risk appraisal measures and non-specific symptoms, and assess the role of subject characteristics (sex, age, education, trait negative affect) in a general population cohort.Methods: This study was nested in the Dutch general population AMIGO cohort that was established in 2011/2012, when participants were 31-65 years old. We studied a sample of participants (n = 1720) who filled in two follow-up questionnaires in 2013 and 2014, including questions about perceived exposure, perceived risk, and health concerns as indicators of risk appraisal of base stations, and non-specific symptoms.Results: Perceived exposure, perceived risk, and health concerns, respectively, were associated with higher symptom scores in cross-sectional and longitudinal analyses. Only health concerns (not perceived exposure and perceived risk) temporally preceded high symptom scores and vice versa. Female sex, younger age, higher education, and higher trait negative affect were associated with higher risk appraisal of mobile phone base stations.Discussion: The findings in this study strengthen the evidence base for cross-sectional and longitudinal associations between higher risk appraisal and non-specific symptoms in the general population. However, the directionality of potential causal relations in non-sensitive general population samples should be examined further in future studies, providing information to the benefit of risk communication strategies. [ABSTRACT FROM AUTHOR]

Objectives: The primary objective was to explore young people's risk appraisals of bowel cancer, including whether they had a coherent understanding of the protective effects of physical activity (PA). A secondary objective was to examine whether the illness risk representations (IRRs) framework could be used to understand beliefs underlying bowel cancer risk appraisals.Design: Qualitative.Methods: Framework analysis of semi-structured interviews with 19 people aged 14-17 years.Results: Participants judged their risk of getting bowel cancer as low. This was based on a lack of family history of cancer and their current lifestyle behaviours, which were viewed as having a protective effect, or because they planned on making change to their lifestyle in the future when disease risk became more relevant. Participants were not aware of, and struggled to understand, the link between PA and bowel cancer. They also lacked knowledge of the effects of, or treatments for, bowel cancer. Beliefs underlying judgements about the risk of bowel cancer fitted the IRR framework reasonably well.Conclusions: The present research suggests that interventions designed to increase PA with a view to reducing the risk of bowel cancer should aim to make the future risk of bowel cancer feel more tangible, help young people to understand the full range of consequences, explain how and why preventative behaviours such as PA are effective in reducing risk, and emphasize that the typical late presentation of symptoms, and therefore investigation by health care services, reduces treatability. Statement of contribution What is already known on this subject? Physical activity (PA) performed throughout the lifespan can have a protective effect on bowel cancer, but levels of PA are low among young people. Changing beliefs about the risk of getting bowel cancer may be a useful strategy in motivating PA. What does this study add? Increased understanding of how young people think about bowel cancer and the relationship between PA and cancer. Identification of strategies for increasing young adults' appraisals of the likelihood and severity of bowel cancer. Evidence to support the validity of illness risk representations framework. [ABSTRACT FROM AUTHOR]

Heterosexuals' use of the Internet for meeting romantic or sexual partners is rapidly increasing, raising concerns about the Internet's potential to facilitate encounters that place individuals at risk for acquiring HIV or other sexually transmitted infections (STIs). For example, online sharing of personal information and self-revelations can foster virtual intimacy, promoting a false sense of familiarity that might accelerate progression to unprotected sex. Therefore, it is critical to understand how those who meet sexual partners online attempt to assess the possible risk of acquiring HIV or STIs posed by having unprotected sex with a new partner and decide whether to use a condom. To investigate this issue, in-depth interviews were conducted with a diverse sample of heterosexual male and female participants from large metropolitan cities who had had unprotected vaginal or anal sex with at least two partners met online in the past 3 months. With few exceptions, participants relied on faulty strategies and heuristics to estimate these risks; yet, most engaged in unprotected sex at their first meeting or very soon afterward. While some seemed to try to make a genuine effort to arrive at a reliable assessment of the HIV risk posed, most appeared to be looking for a way to justify their desire and intention to have unprotected sex. The findings suggest the need for more HIV and sexual health education targeted at heterosexuals, especially for those who go online to meet partners. [ABSTRACT FROM AUTHOR]

Purpose: To present evidence from the literature on the rates, underlying causes and consequences of the misdiagnosis of epilepsy and place these meaningfully within a practical framework of risk appraisal and managed diagnostic uncertainty towards informing a clinical practice that might make misdiagnosis less likely.Method: Narrative review.Results: Misdiagnosis of epilepsy remains common and the consequences for the individual significant. Evidence and critical appraisal are presented as regards the absolute level of risk associated with the false positive diagnosis epilepsy, and reasons as to why those risks need to be appraised against the risks associated to false negative diagnosis.Conclusions: Diagnostic error is not entirely avoidable and a degree of uncertainty, and perforce risk, is intrinsic to the diagnostic process of epilepsy. The risks of a false negative diagnosis of epilepsy must be appraised against the also significant risks of a false positive diagnosis. [ABSTRACT FROM AUTHOR]