Assessing the option water-saving willingness of irrigation areas considering farmers' risk tolerance.

Water option trading could facilitate water conservation in irrigation areas to achieve optimal allocation of agricultural water resources. However, the risk associated with water-saving decisions increases due to the uncertainties of tradeable water and water-saving benefits, which makes farmers in the irrigation area with heterogeneous risk tolerances exhibit varied option water-saving willingness (OWSW) in response to the water option contract. Thus, this article provides a novel framework for prior assessing the OWSW in the irrigated area that considers farmers' heterogeneous risk tolerance and proposes the optimal contractual water demand to stimulate the OWSW. First, a multiobjective optimal allocation model for cropping water is constructed to predict tradeable water, and then risk trust, risk-return perception and reference are integrated into water-saving return analysis for proposing a willingness calculation model involving forecast information. Finally, the influence of heterogeneous risk tolerance on farmers' water-saving path choices and the irrigation area's OWSW is analyzed with three sets of comparative data from 2014 to 2021. Results indicate that the intensity and stability of OWSW in water-scarce irrigation areas increase as farmers' risk tolerance rises, but the enhancement utility exhibits a diminishing marginal trend. When both prediction accuracy and farmers' risk tolerance are low, contracts with relatively adventurous and differentiated water demands are more likely to stimulate OWSW. This study provides insights into activating water options trading and stimulating water conservation in agriculture from a risk management perspective.

The Role of Risk Tolerance in a Patient's Decision to Undergo Total Knee and Hip Arthroplasty.

BACKGROUND: A patient's decision-making process to undergo surgery is crucial for surgeons to understand for patient counseling purposes. Total knee and hip arthroplasty, like any other major surgery, is associated with serious, sometimes life-threatening, complications. Using the results of discrete choice experiments (DCE), we aimed to understand the relationship between a patient's risk tolerance and choosing to undergo surgery in real life. METHODS: This is a retrospective study of prospectively collected DCE results for 142 potential knee or hip arthroplasty clinic patients from October 2021 to March 2022. The DCE presented the patient with two scenarios, each of which was made up of different combinations of attributes and levels. A hierarchal Bayesian model was utilized to obtain a risk score that reflected the risk attributes chosen by each patient. Logistic regressions were then utilized to evaluate the association between a patient's willingness to incur risk and their decision to undergo a total joint arthroplasty (TJA). RESULTS: Out of the 142 patients enrolled in the DCE, 89 (62.3%) underwent a TJA. Risk score (OR [odds ratio] = 2.6, 95% CI [confidence interval] 1.1 to 6.6, P = 0.0400), men (OR = 2.5, 95% CI 1.1 to 5.9, P = 0.0280), and patients who have hip osteoarthritis (OR = 2.4, 95% CI 1.1 to 5.5, P = 0.0360) increased the odds of undergoing arthroplasty, whereas physical function of at least 75% at the initial visit (OR = 0.3, 95% CI 0.1 to 0.7, P = 0.0040) decreased these odds. CONCLUSIONS: We found that a patient's willingness to incur risk, lower baseline physical function, and men were all independently associated with undergoing total knee arthroplasty. We believe that these findings prompt much-needed future studies that focus solely on the relationship between patients inherent risk behavior and surgical and patient-reported outcomes.

Economic preferences and obesity: Evidence from a clinical lab-in-field study.

Many studies which describe the relationship between obesity and economic preference rely on healthy, clinically-irrelevant populations. Instead, we study economic decision-making of a clinically-relevant population of 299 people with obesity who participated in a 6-months Randomized Controlled Trial in two Sydney-based hospitals to prevent diabetes onset. To elicit preferences, we use incentive-compatible experimental tasks that participants completed during their medical screening examination. In this population, we find that participants are risk averse, show no evidence of present bias, and have impatience levels comparable to healthy samples described in the international literature. Variations in present bias and impatience are not significantly associated with variations in markers of obesity. We find however a statistically significant negative association between risk tolerance and markers of obesity for women. Importantly, impatience moderates the link between risk tolerance and obesity, a finding which we are able to replicate in nationally-representative survey data. We discuss explanations for why our findings deviate markedly from the literature for this understudied but highly policy-relevant population. One explanation is that our specific population consists of forward-looking, well-educated individuals, who are willing to participate in an intensive health intervention. Hence, other factors may be at play for why these individuals live with obesity.

L'adhérence au traitement de maladies chroniques chez les jeunes - Rôle du niveau d'actualisation et de la tolérance au risque.

Adolescents with chronic diseases must adhere to medication regimens to control their symptoms and avoid long-term complications. Despite its importance, medication adherence is low among adolescents. This commentary briefly covers the challenges described in the literature associated with measuring and addressing low medication adherence in adolescents. Next, it presents the evidence for the link between medication adherence and two prevalent psychological characteristics that have not been properly assessed so far: delay discounting (i.e., the relative value assigned to the future compared to the present), and risk tolerance. These psychological traits deserve further studies and are potentially amenable to interventions to improve medication adherence in adolescents with chronic conditions.

Les adolescents atteints d'une maladie chronique doivent adhérer à un régime médicamenteux pour contrôler leurs symptômes et éviter des complications à long terme. Malgré son importance, l'adhérence aux médicaments est faible chez les adolescents.Le présent commentaire décrit brièvement les défis associés à la mesure de l'adhérence médicamenteuse et les facteurs qui les influencent, rapportés dans la littérature scientifique. Il présente ensuite les données probantes démontrant le lien entre l'adhérence aux médicaments et deux caractéristiques psychologiques communes, mais qui ont été peu évaluées jusqu'à maintenant: le taux d'actualisation (la valeur relative que l'on attribue au futur comparativement au présent) et la tolérance au risque.Ces caractéristiques psychologiques méritent d'être approfondies, et pourraient être propices à des interventions pour améliorer l'adhérence au médicament chez les adolescents ayant une maladie chronique.

Cerebellum anatomy predicts individual risk-taking behavior and risk tolerance.

Human risk tolerance is highly idiosyncratic and individuals often show distinctive preferences when faced with similar risky situations. However, the neural underpinnings of individual differences in risk-taking remain unclear. Here we combined structural and perfusion MRI and examined the associations between brain anatomy and individual risk-taking behavior/risk tolerance in a sample of 115 healthy participants during the Balloon Analogue Risk Task, a well-established sequential risky decision paradigm. Both whole brain and region-of-interest analyses showed that the left cerebellum gray matter volume (GMV) has a strong association with individual risk-taking behavior and risk tolerance, outperforming the previously reported associations with the amygdala and right posterior parietal cortex (PPC) GMV. Left cerebellum GMV also accounted for risk tolerance and risk-taking behavior changes with aging. However, regional cerebral blood flow (CBF) provided no additional predictive power. These findings suggest a novel cerebellar anatomical contribution to individual differences in risk tolerance. Further studies are necessary to elucidate the underestimated important role of cerebellum in risk-taking.

Current Emergency Department Disposition of Patients With Acute Heart Failure: An Opportunity for Improvement.

Emergency department (ED) providers play a critical role in the stabilization and diagnostic evaluation of patients presenting with acute heart failure (AHF), and EDs are key areas for establishing current best practices and future considerations for the disposition of and decision making for patients with AHF. These elements include accurate risk assessment; response to initial treatment and shared decision making concerning optimal venue of care; reframing of physicians' risk perceptions for patients presenting with AHF; exploration of alternative venues of care beyond hospitalization; population-level changes in demographics, management and outcomes of HF patients; development and testing of data-driven pathways to assist with disposition decisions in the ED; and suggested outcomes for measuring success.

"Children are precious cargo; we don't let them take any risks!": Hearing from adults on safety and risk in children's active play in schools: a systematic review.

BACKGROUND: Understanding determinants of children's outdoor play is important for improving low physical activity levels, and schools are a key setting for both. Safety concerns shape children's opportunity to play actively outdoors, therefore, this qualitative evidence synthesis aimed to i) examine adult (e.g., parent, teacher, yard supervisor, principal) perspectives on safety and risk in children's active play during recess in elementary and/or middle schools, and ii) identify how safety and risk influence playground supervision and decision making in this setting. METHODS: Six electronic databases were systematically searched in March 2021, with an updated search in June 2022. Records were screened against eligibility criteria using Covidence software, and data extraction and synthesis were performed using predesigned coding forms in Microsoft Excel and NVivo. Framework synthesis methodology was employed, guided by a conceptual framework structured on the socio-ecological model (SEM) and affordance theory. RESULTS: From 10,370 records, 25 studies were included that represented 608 adults across 89 schools from nine countries. The synthesis identified 10 constraining and four affording factors that influenced whether school staff were risk-averse or risk tolerant during recess, and, in turn, the degree to which children's play was managed. Constraining factors stemmed from fears for children's physical safety, and fear of blame and liability in the event of playground injury, which shaped parent, school staff and institutional responses to risk. Interrelated factors across SEM levels combined to drive risk-averse decision making and constraining supervision. Emerging evidence suggests children's active play in schools can be promoted by fostering a risk tolerant and play friendly culture in schools through play facilitation training (e.g., risk-reframing, conflict resolution) and engaging stakeholders in the development of school policies and rules that balance benefits of play against potential risks. CONCLUSIONS: Findings show several socio-cultural factors limited the ability of school staff to genuinely promote active play. Future work should seek to foster risk tolerance in schools, challenge the cultural norms that shape parent attitudes and institutional responses to risk in children's play, and explore novel methods for overcoming policy barriers and fear of liability in schools. TRIAL REGISTRATION: PROSPERO registration: CRD42021238719.

"All the fun stuff, the teachers say, 'that's dangerous!'" Hearing from children on safety and risk in active play in schools: a systematic review.

BACKGROUND: Active play is vital for healthy child development, and schools are a valuable setting to promote this behaviour. Understanding the determinants of children's physical activity behaviour during recess, particularly the role of risk-taking and the influence safety concerns have on active play, is required. This systematic review aimed to 1) synthesise qualitative research with children that explored their perceptions of safety and risk in active play during recess in elementary and/or middle school, and 2) develop a model from the findings to guide efforts in schools to optimise children's active play opportunities during recess. METHODS: Six online databases were systematically searched for articles published between January 2000 and March 2021. Following PRISMA guidelines, records were screened against eligibility criteria using Covidence software, and data extraction and synthesis was conducted using customised forms in Excel and NVivo software. Framework synthesis methodology was employed, conceptually guided by Bronfenbrenner's socio-ecological model and Gibson's affordance theory. RESULTS: Of 9664 records, 31 studies met inclusion criteria, representing 1408 children across 140 schools from 11 countries. An emergent conceptual framework was developed encompassing 23 risk and safety themes and 10 risky play types that children desired in schools. Individual characteristics (age, gender, physical literacy) influenced children's engagement with risk and how they kept themselves safe. Across outer SEM levels, factors interacted to constrain or afford children's active play. Socio-cultural factors (supervision practices, rules, equipment restrictions) constrained active play, which children perceived were driven by adults' concern with physical safety. These factors contributed to a cycle of risk-averse decision making and diminished play affordances, which could inadvertently exacerbate safety issues. A model for risk tolerance in children's active play has been proposed. CONCLUSIONS: The findings show a disparity between the active play children want in schools and what they are able to do. Future work should balance the concerns of adults against the active play children want, involve children in decisions about playground policy, and foster a risk-tolerant culture in schools.

Risk Aversion, Organ Utilization and Changing Behavior.

Improving organ acceptance and utilization rates is critical to ensure we maximize usage of donated organs as a scarce resource. Many factors underlie unnecessary discard of viable organs. Declined transplantation opportunities for candidates is associated with increased wait-list mortality. Technological advancements in organ preservation may help bridge the gap between donation and utilization, but an overlooked obstacle is the practice of risk aversion by transplant professionals when decision-making under risk. Lessons from behavioral economics, where experimental work has outlined the impact of loss or risk aversion on decision-making, have not been translated to transplantation. Many external factors can influence decision-making when accepting or utilizing organs, which are potentially amendable if external conditions are improved. However, attitudes and perceptions to risk for transplant professionals can pervade decision-making and influence behaviour. If we wish to change this behavior, then the underlying nature of decision-making under risk when accepting or utilizing organs must be studied to facilitate the design of targeted behavior change interventions to convert risk aversion to risk tolerance. To ensure optimal use of donated organs, we need more research into decision-making under risk.

A study on factors affecting privacy risk tolerance to prevent the spread of COVID-19 in South Korea.

South Korea has been evaluated as a country that is responding well to COVID-19. The Government of the Republic of Korea discloses where, when, and by which means of transportation people confirmed to have the virus have visited. Although disclosure of movement has contributed to flattening the curve and providing timely medical service, concerns about privacy infringement have also been raised. This article determines what factors influence privacy risk tolerance, looking specifically at threat severity, vulnerability, response efficacy, and response cost. We also provide implications for the preparation of better countermeasures for the government to implement.

An Evaluation of the Effect of the COVID-19 Pandemic on the Risk Tolerance of Financial Decision Makers.

This paper documents the negative effect of the COVID-19 pandemic on financial risk attitudes across a broad sample of financial decision makers (N = 18,913). Findings show that the risk tolerance of financial decision makers can be altered when an extreme economic, social, or environmental shock occurs. A general shift away from be willing to take financial risk was noted after the COVID-19 pandemic emergency declaration. The COVID-19 pandemic shifted risk preference downward for the majority of financial decision makers in this study.

Patient Preferences for Endometriosis Pain Treatments in the United States.

OBJECTIVES: To quantify patient preferences for endometriosis-associated pain treatments and risk tolerance in exchange for pain reduction and to explore whether preferences vary on the basis of patient characteristics. METHODS: US women with a self-reported physician diagnosis of endometriosis and moderate to severe dysmenorrhea and nonmenstrual pelvic pain (NMPP) completed an online discrete choice experiment survey. Each choice question had a pair of hypothetical treatments characterized by attributes with varying levels: improvements in severe dysmenorrhea, severe NMPP, and severe dyspareunia; mode of administration; and treatment-related risks of pregnancy-related problems, bone fracture later in life, and moderate to severe hot flashes. A random-parameters logit model was used to quantify preferences and the attributes' conditional relative importance. RESULTS: A total of 250 women (mean age 34 years) completed the survey. The conditional relative importance of attributes was 3.66 for risk of moderate to severe hot flashes among respondents with and 3.58 among respondents without experience with moderate to severe hot flashes; 1.70, 1.49, and 1.48 for improvements in dyspareunia, NMPP, and dysmenorrhea, respectively; 0.60 for risk of pregnancy-related problems; 0.53 for mode of administration; and 0.49 for bone fracture risk. Preference weights for bone fracture risk levels were not statistically significantly different. In exchange for a greater improvement in dysmenorrhea from severe to mild (vs moderate), respondents without a history of hot flashes accepted a greater increase in the risk of moderate to severe hot flashes (38%) than did respondents with this history (16%). CONCLUSIONS: Respondents placed the greatest weight on risk of hot flashes, followed by improvements in dyspareunia, NMPP, dysmenorrhea. Bone fracture risk did not drive preferences.

The effect of peer influence on the use of CT by emergency physicians for patients with headaches.

BACKGROUND: It is challenging for emergency physicians (EPs) to distinguish between patients with life-threatening and benign headaches. We examined the effect of peer influence on computed tomography use by EPs for patients with headache and evaluated the peer influence effect in EPs with different levels of risk tolerance. METHODS: We conducted a before- and after-retrospective case review, and administered the Risk-Taking subscale of the Jackson Personality Index to attending physicians. Each EP computed tomography (CT) use rate, patient number, and CT use, were e-mailed every two months to enhance EP team norm and establish a trend in behavior. RESULTS: Of the 665 (before intervention) and 669 (after intervention) patients with headache, 206 (31%) and 171 (25.6%) underwent brain CT scans, respectively. Decreased use of CT examination was found in the post-intervention group (OR = 0.758, 95% CI: 0.593-0.967), especially for most risk-tolerant physicians (OR = 0.530, 95% CI: 0.311-0.889). There was prolonged ED length of stay (LOS) in the pre-intervention group (OR = 51.52, 95% CI: 26.998-76.050). CONCLUSIONS: We observed that peer influence is an effective way to improve CT use rate and emergency department LOS for patients with isolated headache, especially for most risk-tolerant physicians. These findings could enhance the development of appropriate guidelines to assist ED physicians' CT use.

Perceptions of risk characteristics of earthquakes compared to other hazards and their impact on risk tolerance.

People tolerate different levels of risk owing to a variety of hazards. Previous research shows that the psychometric properties of hazards predict people's tolerance of them. However, this work has not taken into account events such as earthquakes. The present study tested how earthquakes score vis-à-vis risk properties and risk tolerance as compared to five other familiar hazards. Participants from Wellington, New Zealand (N=139) rated these six hazards using measures of risk characteristics and risk tolerance. Participants demonstrated different levels of risk tolerance for the different hazards and viewed earthquakes as having similar risk features to nuclear power. They also preferred different risk mitigation strategies for earthquakes (more government funding) to the other five hazards (stronger legislation). In addition, earthquake risk tolerance was predicted by different risk characteristics than the other five hazards. These findings will help risk communicators in identifying which risk characteristics to target to influence citizens' risk tolerance.

The Unintended Consequences of an FDA Warning: The Case of Power Morcellation in Myoma Surgery.

OBJECTIVE: To study patients' perspectives regarding the risks and benefits of the use of power morcellation. DESIGN: Cross-sectional survey (Canadian Task Force classification II-3). SETTING: Academic tertiary referral hospital. PATIENTS: Women waiting in gynecology waiting rooms. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Of the 321 women invited, 310 (97%) responded to the survey; 19% of the participants had myomas requiring treatment, and the other 81% did not. Women with myomas were more likely to be aware of the risks of morcellation (32% vs 14%; p < .001); 29% obtained their information directly from their physicians, while 71% obtained it from other resources. After reading about the risks and benefits of open and MIS approaches to myoma removal, 65% would choose an MIS approach if the risk of cancer spread was up to 0.3% (1 in 350). The majority of women (75%) felt that the government should not have a role in surgical decision making, but should provide information to help patients make decisions. CONCLUSION: Women have different risk tolerances. Most women would be willing to take the 1 in 350 (0.3%) risk of undiagnosed sarcoma spread to benefit from MIS approaches. FDA warnings may have unintended consequences by limiting the acceptable medical choices available for patients.

Physician Risk Tolerance and Head Computed Tomography Use for Patients with Isolated Headaches.

BACKGROUND: Headaches are one of the most common afflictions in adults and reasons for emergency department (ED) visits. OBJECTIVE: We sought to determine the association between physician risk tolerance and head computed tomography (CT) use in patients with headaches in the ED. METHODS: We performed a retrospective study of patients with nontraumatic isolated headaches in the ED and then administered two instruments (Risk-Taking subscale [RTS] of the Jackson Personality Index and a Malpractice Fear Scale [MFS]) to attending physicians who had evaluated these patients and made decisions regarding head CT scans. Outcomes were head CT use during ED evaluation and hospital admission. A hierarchical logistic regression was used to determine the effect of risk scales on head CT use. RESULTS: Of the 1328 patients with headaches, 521 (39.2%) received brain CTs and 83 (6.9%) were admitted; 33 (2.5%) patients received a final diagnosis that the central nervous system was the origin of the disease. Among the 17 emergency physicians (EPs), the median of the MFS and RTS was 23 (interquartile range [IQR] 19-25) and 21 (IQR 20-23), respectively. EPs who were relatively risk-averse and those who possessed a higher level of malpractice fear were not more likely to order brain CTs for patients with isolated headaches. CONCLUSIONS: Individual EP risk tolerance, as measured by RTS, and malpractice concerns, measured by MFS, were not predictive of CT use in patients with isolated headaches.

Anticipating divine protection? Reminders of god can increase nonmoral risk taking.

Religiosity and participation in religious activities have been linked with decreased risky behavior. In the current research, we hypothesized that exposure to the concept of God can actually increase people's willingness to engage in certain types of risks. Across seven studies, reminders of God increased risk taking in nonmoral domains. This effect was mediated by the perceived danger of a risky option and emerged more strongly among individuals who perceive God as a reliable source of safety and protection than among those who do not. Moreover, in an eighth study, when participants were first reminded of God and then took a risk that produced negative consequences (i.e., when divine protection failed to materialize), participants reported feeling more negatively toward God than did participants in the same situation who were not first reminded of God. This research contributes to an understanding of the divergent effects that distinct components of religion can exert on behavior.

Effect of risk aversion on prioritizing conservation projects.

Conservation outcomes are uncertain. Agencies making decisions about what threat mitigation actions to take to save which species frequently face the dilemma of whether to invest in actions with high probability of success and guaranteed benefits or to choose projects with a greater risk of failure that might provide higher benefits if they succeed. The answer to this dilemma lies in the decision maker's aversion to risk--their unwillingness to accept uncertain outcomes. Little guidance exists on how risk preferences affect conservation investment priorities. Using a prioritization approach based on cost effectiveness, we compared 2 approaches: a conservative probability threshold approach that excludes investment in projects with a risk of management failure greater than a fixed level, and a variance-discounting heuristic used in economics that explicitly accounts for risk tolerance and the probabilities of management success and failure. We applied both approaches to prioritizing projects for 700 of New Zealand's threatened species across 8303 management actions. Both decision makers' risk tolerance and our choice of approach to dealing with risk preferences drove the prioritization solution (i.e., the species selected for management). Use of a probability threshold minimized uncertainty, but more expensive projects were selected than with variance discounting, which maximized expected benefits by selecting the management of species with higher extinction risk and higher conservation value. Explicitly incorporating risk preferences within the decision making process reduced the number of species expected to be safe from extinction because lower risk tolerance resulted in more species being excluded from management, but the approach allowed decision makers to choose a level of acceptable risk that fit with their ability to accommodate failure. We argue for transparency in risk tolerance and recommend that decision makers accept risk in an adaptive management framework to maximize benefits and avoid potential extinctions due to inefficient allocation of limited resources.

Workers' Risk Tolerance and Occupational Injuries.

This study explores the relationship between individuals' risk tolerance and occupational injuries. We analyze data from a national representative survey of U.S. workers that includes information about injuries, risk tolerance, cognitive and noncognitive attributes, and risky behaviors. We measure risk tolerance through questions regarding individuals' willingness to gamble on their lifetime income. We estimate zero-inflated count models to assess the role played by such measures on workers' recurrent injuries. We discuss some implications of our results for future research and occupational safety policies. Our results highlight the concurrent and changing role played by individual, work, and environmental factors in explaining recurrent incidents. They show that risk tolerance affects recurrent injuries, although not in the direction that proponents of the concept of proneness would expect. Our measure of risk aversion shows that individuals who are somewhat more risk tolerant have fewer recurrent injuries than those who are risk averse. But the estimated relationship is U-shaped, not monotonic and, therefore, not easy to predict. At the same time, we find that individuals' "revealed risk preferences"-specific risky behaviors-are related to higher injury probabilities. Demanding working conditions, measures of socioeconomic status, health, and safety problems experienced by workers during their youth remain among the most important factors explaining the phenomena of recurrent injuries. So our results contribute also to the important debate about the relationship between health and socioeconomic status.

Be meek or be bold? A colony-level behavioural syndrome in ants.

Consistent individual variation in animal behaviour is nearly ubiquitous and has important ecological and evolutionary implications. Additionally, suites of behavioural traits are often correlated, forming behavioural syndromes in both humans and other species. Such syndromes are often described by testing for variation in traits across commonly described dimensions (e.g. aggression and neophobia), independent of whether this variation is ecologically relevant to the focal species. Here, we use a variety of ecologically relevant behavioural traits to test for a colony-level behavioural syndrome in rock ants (Temnothorax rugatulus). Specifically, we combine field and laboratory assays to measure foraging effort, how colonies respond to different types of resources, activity level, response to threat and aggression level. We find evidence for a colony level syndrome that suggests colonies consistently differ in coping style--some are more risk-prone, whereas others are more risk-averse. Additionally, by collecting data across the North American range of this species, we show that environmental variation may affect how different populations maintain consistent variation in colony behaviour.