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The analysis of risk awareness should be the initial stage in integrated natural hazard risk management to promote appropriate and effective measures for mitigating risks and strengthening social resilience inside the multi-risk framework. Nevertheless, earlier studies focused on cross-sectional data and overlooked the changes in risk awareness levels and associated independent variables with time. This study analyzes for the first time a balanced nationwide panel dataset of 1612 respondent-year observations from Switzerland (period 2015-2021, including the epidemic of COVID-19) to examine and compare the effects of potential independent variables on the four dimensions of natural hazard risk awareness (NHRA), ranging from the broadest dimension of Relevance to higher dimensions of Perceived Probability of an event, Perceived Threat to life and valuables, and Perceived Situational Threat. The analysis in this study incorporates multiple methods of Random-Effect Model (RE), Generalized Linear Model (GLM), and mediation analysis. Results show that NHRA increased in Switzerland to different extents (up to 23.24%) depending on the dimension. Event memory, perceived information impact and reported individual informed level appeared to be the most consistent independent variables positively influencing panel NHRA. Among these, perceived information impact as an important indicator of risk communication, was also found to serve as a mediator from risk preparedness to risk awareness. By encouraging residents to engage in "Begin Doing Before Thinking" (BDBT) programs to leverage subliminal effects and self-reflection, this study proposes that behavior-cognition feedback loops may facilitate a virtuous cycle. Our promising observations provide recommendations for an effective awareness-rising strategy design and suggest extensive insights from potential short-interval panel analysis in the future.
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This study assessed the manual handling of materials in a local market environment and evaluated workers' awareness of ergonomics and health risks. Of 315 workers surveyed, 308 responded. The findings revealed a high prevalence rate of 96.4% for injuries and musculoskeletal discomfort, attributed to a low ergonomics and health risk awareness rate of only 6.8%. Consequently, 75% of workers resorted to self-medication or drug abuse for relief. The study also explored barriers to using engineering equipment, finding that 26.3% of respondents cited cost as a barrier, while 51% believed that the introduction of engineering equipment would lead to job loss. This research is valuable for practitioners and researchers as it highlights the current state of ergonomics and health risk awareness among workers who handle heavy loads. The study also highlights the need for improved ergonomic practices and health risk awareness to reduce injury rates and promote safer work environments.
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Background: Persons living with HIV (PLWH) have a higher risk of persistent infection with human papillomavirus (HPV) and anal cancer. We evaluated knowledge and awareness of HPV infection and risk factors for anal cancer among PLWH in Puerto Rico (PR). Methods: Data from a cross-sectional study (2020-2021) were analyzed (n=212). Inclusion criteria included PLWH, aged ≥ 26 years, and living in PR. Telephone interviews collected information on sociodemographic, lifestyle and clinical characteristics. Two 13-item scales were used to assess knowledge of HPV and anal cancer risk factors; adequate knowledge for both scales were defined as scoring >70%. Logistic regression models using generalized linear models were used to determine the association between 1) HPV infection awareness, 2) HPV infection knowledge, and 3) Anal cancer risk factors knowledge. Results: The median age was 54 years (IQR: 46,58), 67.5% were male, 71.7% reported having an income <$20,000, and 54.3% had an education level of more than high school. HPV awareness was high (82.1%), but only 40.2% and 3.8% had adequate knowledge of HPV and anal cancer risk factors, respectively. In adjusted logistic regression models, men who have sex with men (OR: 1.26, 95%CI: 1.07-1.47) and women (OR: 1.35, 95%CI: 1.15-1.59) aged ≥50 years had higher odds of HPV awareness than heterosexual men in that age group. Moreover, those with history of anal Pap test aged <50 years had more HPV awareness (OR 1.34, 95%CI: 1.08-1.66) than their counterparts. Adequate HPV knowledge was higher among participants with an education level of more than high-school (OR:1.28, 95%CI: 1.10-1.50) and with a history of HPV diagnosis (OR:1.33, 95%CI: 1.08-1.65) than their counterparts. In addition, people with good/very good/excellent health perception had higher odds of HPV knowledge (OR:1.23, 95%CI: 1.03-1.47) than those who reported poor/regular health perception. For anal cancer risk factors, PLWH for ≥15 years had increased odds of having adequate knowledge (OR:1.07, 95%CI: 1.02-1.14) than their counterparts. Conclusions: Despite high awareness of HPV, limited knowledge about HPV and anal cancer risk factors was observed among PLWH. Results from our study highlight the need for educational efforts within this population as an anal cancer prevention strategy.
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We demonstrate that heterogeneity in the perceived risks associated with infection within host populations amplifies chances of superspreading during the crucial early stages of epidemics. Under this behavioural model, individuals less concerned about dangers from infection are more likely to be infected and attend larger sized (riskier) events, where we assume event sizes remain unchanged. For directly transmitted diseases such as COVID-19, this leads to infections being introduced at rates above the population prevalence to those events most conducive to superspreading. We develop an interpretable, computational framework for evaluating within-event risks and derive a small-scale reproduction number measuring how the infections generated at an event depend on transmission heterogeneities and numbers of introductions. This generalizes previous frameworks and quantifies how event-scale patterns and population-level characteristics relate. As event duration and size grow, our reproduction number converges to the basic reproduction number. We illustrate that even moderate levels of heterogeneity in the perceived risks of infection substantially increase the likelihood of disproportionately large clusters of infections occurring at larger events, despite fixed overall disease prevalence. We show why collecting data linking host behaviour and event attendance is essential for accurately assessing the risks posed by invading pathogens in emerging stages of outbreaks.
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COVID-19 , SARS-CoV-2 , Humanos , COVID-19/transmissão , COVID-19/epidemiologia , Número Básico de Reprodução , Modelos BiológicosRESUMO
Exotic animals traded and kept as pets can transmit a variety of diseases to humans and other animals, and vice versa. Therefore, it is essential for pet owners, particularly vulnerable groups, to be informed about associated risks. Veterinarians play a crucial role in informing pet owners about health risks associated with zoonotic pathogens and antimicrobial resistance (AMR) and should, therefore, have good communication skills to effectively transfer information to pet owners. Thus, exotic pet owners in Germany were surveyed on animal husbandry, veterinary consultation and risk communication. To evaluate the perception of communication, a self-developed questionnaire was used to derive a communication score. The perception of veterinarian communication received a high average score showing a high level of satisfaction. The duration of the veterinarian-client relationship was associated with better communication perception, and the frequency of communication on zoonoses and AMR was associated with the presence of a permanent veterinarian. However, the results indicated that the frequency of disseminated information on zoonoses and/or AMR from veterinarians was lower than desired by the pet owners. Therefore, more educational material on zoonoses and AMR should be made available, and the awareness concerning risk communication should be increased by further education and training at universities.
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OBJECTIVE: In 2021, thrombosis with thrombocytopenia syndrome (TTS) was confirmed by the European Medicines Agency (EMA) as a rare side effect of the COVID-19 adenovirus vector vaccines Vaxzevria® and Jcovden®. This study aimed to describe the public's knowledge of TTS and how it affected the willingness to be vaccinated with COVID-19 vaccines and other vaccines in six European countries. METHODS: From June to October of 2022, a multi-country cross-sectional online survey was conducted in Denmark, Greece, Latvia, Netherlands, Portugal, and Slovenia. The minimum target of participants to be recruited was based on the size of the country's population. The results were analysed descriptively. RESULTS: In total, 3794 respondents were included in the analysis; across the six countries, 33.3 %-68.3 % reported being familiar with signs and symptoms of TTS, although 3.1-61.4 % of those were able to identify the symptoms correctly. The reported changes in willingness to be vaccinated against COVID-19 and with other vaccines varied per country. The largest reported change in the willingness to be vaccinated with Vaxzevria® and Jcovden® was observed in Denmark (61.2 %), while the willingness to be vaccinated with other COVID-19 vaccines changed most in Slovenia (30.4 %). The smallest decrease in willingness towards future vaccination against COVID-19 was reported in the Netherlands (20.9 %) contrasting with the largest decrease observed in Latvia (69.1 %). CONCLUSION: Knowledge about TTS seemed to have influenced the public's opinion in Europe resulting in less willingness to be vaccinated with Vaxzevria® and Jcovden®. Willingness for vaccination against COVID-19 with other vaccines and widespread use of vaccines to prevent other diseases also differed and seemed to be determined by the approaches taken by national health authorities when reacting to and communicating about COVID-19 vaccination risks. Further investigation of optimal risk communication strategies is warranted.
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COVID-19 , Trombocitopenia , Trombose , Humanos , Vacinas contra COVID-19 , Estudos Transversais , COVID-19/prevenção & controle , ChAdOx1 nCoV-19 , Vacinação , Adenoviridae/genéticaRESUMO
Risk perception is considered the primary motivator for taking preparedness actions. But people with prior experience and a high-risk perception are not necessarily more prepared. This relationship is even more complex when assessing preparedness levels for hazards with different characteristics. These inconsistent findings can be explained by how preparedness has been measured and the influence of other factors, such as trust and risk awareness. Thus, the main goal of this study was to analyze the role of risk awareness and trust in authorities on risk perception and intention to prepare for natural hazards in a coastal city in Chile. A representative sample of the city of Concepción, located in the center-south zone of Chile (n = 585), completed a survey. We measured risk awareness, risk perception, trust in authorities, and intention to prepare for two hazards: earthquakes/tsunamis and floods. Through structural equation models, we tested five hypotheses. We found that the perception of risk maintained a direct and positive influence on the intention to prepare for both hazards. The results showed that awareness and risk perception influence the intention to prepare and should be considered different concepts. Finally, trust did not significantly influence risk perception when faced with known hazards for the population. Implications for understanding the relationship between risk perception and direct experience are discussed.
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Terremotos , Confiança , Humanos , Inundações , Motivação , PercepçãoRESUMO
PURPOSE: To describe the process of becoming aware of and acting on personal cardiovascular (CVD) risk in type 2 diabetes (T2D). METHOD: A purposive sample of 14 persons living with T2D participated in semi-structured, open-ended, in-dept interviews. The interviews were analysed with grounded theory. RESULT: The analysis identified the core category "Balancing emotions, integrating knowledge and understanding to achieve risk awareness and act on it." Five categories describe the movement from not being aware of the risk of cardiovascular disease (CVD) to becoming aware of this risk and taking action to reduce it. Persons with T2D need to transform their knowledge and experience of CVD risk and incorporate it in their individual situations. Emotional and existential experiences of CVD risk can lead to awareness about the severity of the condition and contribute to increased motivation for self-management. However, an overly high emotional response can be overwhelming and may result in insufficient self-management. CONCLUSION: Persons with T2D seemed not to fully grasp their increased risk of CVD or recognize that self-management activities were aimed at reducing this risk. However, their awareness of CVD risk gradually increased as they came to understand the severity of T2D and became more emotionally and existentially engaged.
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Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Autogestão , Humanos , Diabetes Mellitus Tipo 2/psicologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/psicologia , Fatores de Risco , Fatores de Risco de Doenças CardíacasRESUMO
BACKGROUND: we aim to investigate attitudes toward vaccination by analyzing empirical factors associated with vaccine acceptance in the Lazio region mpox vaccination (MpoxVax) campaign in Italy. METHODS: all subjects who accessed MpoxVax and signed the informed consent were prospectively enrolled in the MPOX-VAC Study and were asked to fill out an anonymous survey. Two endpoints were selected: 'delayed acceptance' and 'early acceptance', defined as access for vaccination >60 and ≤30 days from the vaccination campaign starting (VCS), respectively. RESULTS: over the study period, 1717 individuals underwent vaccination: 129 (7%) > 60 [1588 (92.5%) ≤ 60] and 676 (60%) ≤ 30 days from VCS. A bisexual orientation, a lower education level and a worse perceived physical and mental health were associated with delayed access to vaccination. Being pre-exposure prophylaxis (PrEP) users and, marginally, HIV positive; having a high perceived risk for mpox infection; and reporting high-risk behaviors like the use of recreational drugs/chems, sex under the influence of drugs and/or alcohol and having a higher number of principal sexual partners, were associated with early access to vaccination. CONCLUSIONS: according to our data, risk awareness was a major determinant of early MpoxVax acceptance. Conversely, worse perceived health status and a low educational level were critical factors associated with delayed vaccination.
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Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon and severe condition in patients who are receiving treatment with antiresorptive and/or antiangiogenic drugs, which are frequently used to treat or prevent cancer metastases. The treatment of MRONJ is challenging because the choice of a specific dental treatment depends on several factors, including the systemic condition of the patient, type and dosage of medications, and clinical and radiographic characteristics of the dental lesions. This case report describes the conservative endodontic treatment of an odontogenic infection in a patient at risk of developing MRONJ owing to bisphosphonate treatment. Endodontic retreatment was performed to control the odontogenic infection and avoid tooth extraction. Certain factors favor the use of a conservative approach, such as a localized and small infection, the absence of systemic factors (such as metabolic disorders or medications) that can impair bone healing, and good oral hygiene.
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Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Humanos , Conservadores da Densidade Óssea/efeitos adversos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/prevenção & controle , Difosfonatos/efeitos adversos , Assistência Odontológica/efeitos adversos , Extração Dentária/efeitos adversosRESUMO
Computation offloading has effectively solved the problem of terminal devices computing resources limitation in hospitals by shifting the medical image diagnosis task to the edge servers for execution. Appropriate offloading strategies for diagnostic tasks are essential. However, the risk awareness of each user and the multiple expenses associated with processing tasks have been ignored in prior works. In this article, a multi-user multi-objective computation offloading for medical image diagnosis is proposed. First, the prospect theoretic utility function of each user is designed considering the delay, energy consumption, payment, and risk awareness. Second, the computation offloading problem including the above factors is defined as a distributed optimization problem, which with the goal of maximizing the utility of each user. The distributed optimization problem is then transformed into a non-cooperative game among the users. The exact potential game proves that the non-cooperative game has Nash equilibrium points. A low-complexity computation offloading algorithm based on best response dynamics finally is proposed. Detailed numerical experiments demonstrate the impact of different parameters and convergence in the algorithm on the utility function. The result shows that, compare with four benchmarks and four heuristic algorithms, the proposed algorithm in this article ensures a faster convergence speed and achieves only a 1.14% decrease in the utility value as the number of users increases.
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Since the ban of effective feed additives and therapeutics, histomonosis has become an important disease and, subsequently, a welfare issue for turkey production. We conducted an interview-based case series study to generate hypotheses about possible disease-favouring conditions in 31 H. meleagridis-infected flocks. The determined parameters were related to the general farm (flock management, biosecurity measures, etc.) as well as the histomonosis-specific disease management. Some inadequate biosecurity measures were observed. An inappropriate usage of the hygiene lock and cleaning as well as the disinfection frequency of equipment, clothes, and the hygiene lock could possibly be histomonosis-favouring conditions. These factors could increase the risk for the introduction of H. meleagridis and the risk of a pathogen spread on an affected farm. Insects, wild birds, litter materials, and contaminated dung could be potential vectors of H. meleagridis. Predisposing gastrointestinal diseases were observed in 71% of the affected flocks. Additionally, stress events related to higher temperature, movement of birds, and vaccination were documented in association with clinical histomonosis. The results emphasise the need for both good disease control and health management to ensure sustainable animal health and welfare.
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Sexual enhancement supplements (SESs) that have illegal additions of pharmaceuticals or analogues pose a significant health risk, particularly with long-term usage. When supplements are adulterated with phosphodiesterase type 5 (PDE-5) inhibitors, dosages can vary widely and there may be an increase in adverse effects and drug-drug interactions which cannot be avoided. Consequently, there is a need to evaluate the public risk awareness toward SES and the associated adverse events as well as explore significant factors associated with knowledge and risk awareness. A cross-sectional community-based study was conducted among University male students and staff at Ajman University, United Arab Emirates (UAE), using a self-administered survey via a web-based electronic link to explore key issues. A total of 1,101 male subjects participated in the study and completed the questionnaire. Four hundred and thirty-three(39.3%) (95% confidence interval [CI]: 33.2-44.5) participants reported using SES products. Of these, 137 (31.6%) [95% CI: 28.6-37.2] experienced adverse effects from SES product use. SES use was more prevalent among participants aged 60 to 69 years (odds ratio [OR]: 2.94; 95% CI: 1.63-5.28), diabetic patients (OR: 2.61; 95% CI: 1.75-3.90), hypertension patients (OR: 2.12; 95% CI: 1.45-3.1), and those overweight or obese (OR: 1.84; 95% CI: 1.44-2.35). This study indicates that SES is a popular practice among the UAE university staff and students. However, there is a need to implement risk awareness programs to raise public awareness regarding SES use and safety. Regulatory bodies are encouraged to provide additional advice on the proper use and possible risks of consuming SES.
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Estudantes , Humanos , Masculino , Estudos Transversais , Emirados Árabes Unidos , Universidades , Inquéritos e Questionários , DemografiaRESUMO
OBJECTIVES: Agriculture in the United Kingdom (UK) continues to be one of the most dangerous occupations, accounting for around a fifth of fatal workplace injuries and many other injuries, both major and minor. This study examines young farmers' awareness of, attitude to and behaviors around safety practices on-farm. METHOD: A survey was undertaken amongst a group of young farmers aged 16-years and over who were actively engaged in farming in Northern Ireland, focusing on attitudes and behaviors towards safety on-farm. Drawing on previous literature, this study examined whether younger farmers demonstrate a higher degree of risk tolerance and are more likely to engage in risk taking behavior when undertaking routine farming practices leading to potential injuries and lost working days. The young farmers surveyed were classified into three groups and differences in risk perception were examined. RESULTS: The results indicate that, statistically, farmer age, intensity of farming alongside the level of farming experience contribute to incident occurrence. Our results indicate a need for attitudinal and behavioral change, particularly around risk-taking behaviors that ultimately result in farm incidents, impacting on both the performance of the farm business and individual farmer well-being. CONCLUSION: Policies aimed at addressing perception and acceptance of risks among farmers are recommended.
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Agricultura , Fazendeiros , Humanos , Fazendas , Atitude , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Certain maternal complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, birth of a growth restricted infant, idiopathic preterm labour, and placental abruption, are associated with a significantly increased risk of future maternal cardiovascular disease. In Australia, it is relatively unknown how many women with a history of complicated pregnancies are aware of their future cardiovascular disease risk. AIM: The aim of this study was to determine what percentage of women attending a cardiovascular disease prevention clinic in South Australia soon after a complicated pregnancy were aware of their increased risk of cardiovascular disease. METHODS: This prospective observational study included 188 women attending a postpartum prevention clinic between 7th August 2018 and 10th February 2021. These women had experienced a serious maternal complication of pregnancy approximately seven months earlier. Women completed a self-administered health awareness survey immediately prior to their first clinic appointment to assess their awareness of their increased cardiovascular risk. FINDINGS: Over two-thirds (69.1 %) of the women were unaware of the association between pregnancy complications and cardiovascular disease, and 6.4 % of the cohort did not realise they had experienced a complicated pregnancy. Almost 10 % of the cohort did not correctly identify the complication/s they had been diagnosed with during pregnancy. CONCLUSION: Awareness of the association between complications of pregnancy and future cardiovascular disease was low in our cohort of women who had experienced a complication of pregnancy only seven months earlier. This emphasises the need for improved education for and communication with women to assist in implementing preventative care strategies.
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Doenças Cardiovasculares , Hipertensão , Complicações na Gravidez , Recém-Nascido , Gravidez , Feminino , Humanos , Doenças Cardiovasculares/complicações , Placenta , Complicações na Gravidez/diagnóstico , Hipertensão/complicações , Período Pós-PartoRESUMO
As the threat of global warming to human beings has gradually received attention, this article introduces the terror management theory to explain whether health risk awareness will affect their willingness to accept smart green buildings and that relationship is positively regulated by death anxiety. In addition, this article introduces the concept of materialism to propose that consumers will also accept smart green buildings due to the influence of materialism. This article interviewed two consumers and two professors in Taiwan, and verified the three hypotheses of this article through qualitative coding analysis. This article also used quantitative research methods to verify the theoretical model. This article not only introduces the cross-cutting contributions between terror management theory, materialism and smart green buildings, but also helps the construction industry develop strategies to attract consumers.
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What countermeasures should the public take as they become aware of the dangers of haze pollution? Insurance has the function of risk diversification, and little existing literature has focused on the relationship between haze pollution and commercial health insurance. This paper analyzes the impact of haze pollution on residents' demand for commercial health insurance and the heterogeneous impact of institutional environment using the 2017 China Household Finance Survey cross-sectional data (CHFS). The study finds that haze pollution raises residents' demand for commercial health insurance as their health risk perception level rises. The legal environment, market environment, and traditional culture affect the relationship between haze pollution and the demand for commercial health insurance. Further analysis reveals that the relationship between haze pollution and residents' demand for commercial health insurance can show significant regional heterogeneity, with a significant positive correlation in the eastern region and a significant negative correlation in the central and western regions. In addition, the preventive behaviors adopted by residents in the face of haze pollution can vary significantly depending on individual risk preferences. The findings of this paper are important for the public to take measures to cope with the haze pollution hazards. At the same time, insurance companies should improve their services to meet the needs of the public regarding haze pollution, which will contribute to the healthy development of the insurance industry.
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The awareness of healthcare practitioners concerning heated tobacco product (HTP) use risks has been evaluated; however, few studies have investigated general dental practitioners' awareness regarding HTP-use risks. In this cross-sectional study, we investigated dentists' awareness of the risks of smoking, particularly HTP use. A self-administered questionnaire, including eight questions on conventional cigarette and HTP smoking/using status and both knowledge and awareness of HTP-use risks, was posted to 3883 dentists belonging to the Aichi Dental Association, Japan, in August 2019. Statistical analysis was performed using the Statistical Package for Social Sciences; statistical significance was set at p < 0.05. We analyzed the data of 1317 dentists (participation rate, 41.6%). The study group included cigarette smokers (11.5%) and HTP users (8.5%), among whom 41.1% were dual users. HTP users were more likely than never smokers/users to correctly perceive HTP-use risks (p < 0.05). This study indicates that in Japan, the proportion of HTP users is higher than that of the general population. It is important to educate not only smokers/users but also never smokers/users on the risks of smoking and using HTPs. Smoking cessation, including ceasing HTP use, and aiming to quit smoking and HTP use among dentists would contribute to appropriate smoking cessation among patients.
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Although mobility restrictions during the COVID-19 pandemic were intended to change behaviours by influencing risk awareness, they might have prompted a rise in risk anxiety ('worry for one's health') both among individuals exposed to such restrictions and those living in border countries. This paper studies this question by examining survey data from 22 European countries in the first wave of the COVID-19 pandemic (March 20th and April 6th 2020). Drawing on an event study analysis we show that COVID-19 mobility restrictions raised individuals COVID-19 risk awareness both in the exposed and border countries for almost a week after the announcement. The spillover effect on border countries accounts for about 67% of the effect in the exposed country. However, mobility restrictions gave rise to an increase in risk anxiety in low-risk countries (which is between 4 and 7 times higher than moderate and high-risk countries). These effects are heterogeneous across age, education and socioeconomic status.
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COVID-19 , Pandemias , Ansiedade , Europa (Continente) , Humanos , SARS-CoV-2RESUMO
Under the influence of social changes, latent factors in campus safety are increasing, and dealing with them is becoming more difficult. Facing the challenges in the pluralistic society, students need to cope with the changes of external and internal environments in the dynamic society. Additionally, there are new events on campus at any time, which may lead to campus risk. The frequent events that have occurred on campus in recent years have created difficulties for school administrative units. Implementing campus risk management strategies and conducting risk awareness education campaigns are, therefore, necessary. The fact that we are in a technologically dynamic age is another factor that makes risk awareness and proper risk management essential for individual survival and sustainable development of organizations. The participants of the study were university students in Nanchang, Jiangxi Province. Three hundred copies of the questionnaire were distributed, and 238 valid copies were retrieved, representing a retrieval rate of 79%. The results of the survey show that "life education" is the most emphasized dimension, followed by "curriculum and instruction," and "environmental planning." The five most emphasized indicators among the 14 indicators are opportunity education, physical activity, role-play, team competition, and learning area planning. The results suggest that school administrative units can take control in an emergency and reduce the likelihood of school members being threatened or harmed by the risk factor, and educators can make a quick decision to turn risk into opportunity.