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Low processing fluency fosters the impression that a stimulus is unfamiliar, which in turn results in perceptions of higher risk, independent of whether the risk is desirable or undesirable. In Studies 1 and 2, ostensible food additives were rated as more harmful when their names were difficult to pronounce than when their names were easy to pronounce; mediation analyses indicated that this effect was mediated by the perceived novelty of the substance. In Study 3, amusement-park rides were rated as more likely to make one sick (an undesirable risk) and also as more exciting and adventurous (a desirable risk) when their names were difficult to pronounce than when their names were easy to pronounce.

The term governance describes the multitude of actors and processes that lead to collectively binding decisions. The term risk governance translates the core principles of governance to the context of risk-related policy making. We aim to delineate some basic lessons from the insights of the other articles in this special issue for our understanding of risk governance. Risk governance provides a conceptual as well as normative basis for how to cope with uncertain, complex and/or ambiguous risks. We propose to synthesize the breadth of the articles in this special issue by suggesting some changes to the risk governance framework proposed by the International Risk Governance Council (IRGC) and adding some insights to its analytical and normative implications.

Background. Influenza vaccination of healthcare personnel (HCP) is recommended in >40 countries. However, there is controversy surrounding the evidence that HCP vaccination reduces morbidity and mortality among patients. Key factors for developing evidence-based recommendations include quality of evidence, balance of benefits and harms, and values and preferences. Methods. We conducted a systematic review of randomized trials, cohort studies, and case-control studies published through June 2012 to evaluate the effect of HCP influenza vaccination on mortality, hospitalization, and influenza cases in patients of healthcare facilities. We pooled trial results using meta-analysis and assessed evidence quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results. We identified 4 cluster randomized trials and 4 observational studies conducted in long-term care or hospital settings. Pooled risk ratios across trials for all-cause mortality and influenza-like illness were 0.71 (95% confidence interval [CI], .59–.85) and 0.58 (95% CI, .46–.73), respectively; pooled estimates for all-cause hospitalization and laboratory-confirmed influenza were not statistically significant. The cohort and case-control studies indicated significant protective associations for influenza-like illness and laboratory-confirmed influenza. No studies reported harms to patients. Using GRADE, the quality of the evidence for the effect of HCP vaccination on mortality and influenza cases in patients was moderate and low, respectively. The evidence quality for the effect of HCP vaccination on patient hospitalization was low. The overall evidence quality was moderate. Conclusions. The quality of evidence is higher for mortality than for other outcomes. HCP influenza vaccination can enhance patient safety.

Alan Strudler’s “Lying about Reservation Prices in Business Negotiation: A Qualified Defense” challenges a number of claims I make in a prior essay, “A Lie Is a Lie: The Ethics of Lying in Business Negotiations.” Here, I examine Strudler’s critique and seek to refute his various arguments—in particular, those based on assumption of risk and the signalling value of reservation price lies.

How can policy makers decide which of five treatments is the best? Standard meta-analysis provides little help but evidence based decisions are possible

Experimental economic techniques have been widely used to evaluate human risk attitudes, but how these measured attitudes relate to overall individual wealth levels is unclear. Previous noneconomic work has addressed this uncertainty in animals by asking the following: (i) Do our close evolutionary relatives share both our risk attitudes and our degree of economic rationality? And (ii) how does the amount of food or water one holds (a nonpecuniary form of \"wealth\") alter risk attitudes in these choosers? Unfortunately, existing noneconomic studies have provided conflicting insights from an economic point of view. We therefore used standard techniques from human experimental economics to measure monkey risk attitudes for water rewards as a function of blood osmolality (an objective measure of how much water the subjects possess). Early in training, monkeys behaved randomly, consistently violating first-order stochastic dominance and monotonicity. After training, they behaved like human choosers—technically consistent in their choices and weakly risk averse (i.e., risk averse or risk neutral on average)—suggesting that well-trained monkeys can serve as a model for human choice behavior. As with attitudes about money in humans, these risk attitudes were strongly wealth dependent; as the animals became \"poorer,\" risk aversion increased, a finding incompatible with some models of wealth and risk in human decision making.

Marine spatial planning provides a comprehensive framework for managing multiple uses of the marine environment and has the potential to minimize environmental impacts and reduce conflicts among users. Spatially explicit assessments of the risks to key marine species from human activities are a requirement of marine spatial planning. We assessed the risk of ships striking humpback (Megaptera novaeangliae), blue (Balaenoptera musculus), and fin (Balaenoptera physalus) whales in alternative shipping routes derived from patterns of shipping traffic off Southern California (U.S.A.). Specifically, we developed whale-habitat models and assumed ship-strike risk for the alternative shipping routes was proportional to the number of whales predicted by the models to occur within each route. This definition of risk assumes all ships travel within a single route. We also calculated risk assuming ships travel via multiple routes. We estimated the potential for conflict between shipping and other uses (military training and fishing) due to overlap with the routes. We also estimated the overlap between shipping routes and protected areas. The route with the lowest risk for humpback whales had the highest risk for fin whales and vice versa. Risk to both species may be ameliorated by creating a new route south of the northern Channel Islands and spreading traffic between this new route and the existing route in the Santa Barbara Channel. Creating a longer route may reduce the overlap between shipping and other uses by concentrating shipping traffic. Blue whales are distributed more evenly across our study area than humpback and fin whales; thus, risk could not be ameliorated by concentrating shipping traffic in any of the routes we considered. Reducing ship-strike risk for blue whales may be necessary because our estimate of the potential number of strikes suggests that they are likely to exceed allowable levels of anthropogenic impacts established under U.S. laws. La planificación marina espacial proporciona un marco de referencia integral para el manejo de usos múltiples del ambiente marino, y tiene el potencial para minimizar los efectos ambientales y reducir conflictos entre los usuarios. Las evaluaciones espacialmente explícitas de los riesgos para especies marinas clave derivados de las actividades humanas son un requerimiento de la planificación marina espacial. Evaluamos el riesgo de colisión de barcos con ballenas Megaptera novaeangliae, Balaenoptera musculus y B. physalus en rutas de navegación alternas derivadas de patrones del tráfico marino en el sur de California (U.S.A.). Específicamente, desarrollamos modelos del hábitat de ballenas y asumimos que el riesgo de colisión con barcos en las rutas alternativas fue proporcional al número de ballenas que los modelos pronosticaron que iban a ocurrir en cada ruta. Esta definición de riesgo asume que todos los barcos viajan en una sola ruta. También calculamos el riesgo asumiendo que los barcos viajan en rutas múltiples. Estimamos el potencial de conflictos entre la navegación y otros usos (entrenamiento militar y pesca) debido al traslape con las rutas. También estimamos el traslape entre rutas de navegación y áreas protegidas. La ruta con el menor riesgo para M. novaeangliae tenía el mayor riesgo para B. physalus y viceversa. El riesgo para ambas especies puede ser disminuido mediante la creación de una nueva ruta al sur de las Channel Islands y distribuyendo el tráfico entre esta ruta nueva y la existente en el Canal de Santa Bárbara. La creación de una ruta más larga puede reducir el traslape entre la navegación y otros usos al concentrar el tráfico de navegación. Las ballenas B. musculus se distribuyen más homogéneamente que M. novaeangliae y B. physalus en nuestra zona de estudio; por lo tanto, el riesgo no podría disminuir con la concentración del tráfico de navegación en ninguna de las rutas que consideramos. La reducción del riesgo de colisión de las ballenas puede ser necesario porque nuestra evaluación del número potencial de choques sugiere que es probable que excedan los niveles permisibles de impactos antropogénicos establecidos por las leyes de E.U.A.

Objectives National quantifications of the health burden related to traffic noise are still rare. In this study, we use disability-adjusted life-years (DALY) measure to assess the burden of disease from road traffic and railway noise in Sweden. Methods The number of DALY was assessed for annoyance, sleep disturbance, hypertension, myocardial infarction (MI) and stroke using a method previously implemented by the World Health Organization (WHO). Population exposure to noise was obtained from the Swedish Environmental Protection Agency and the Swedish Transport Administration. Data on disease occurrence were gathered from registers held by the National Board of Health and Welfare and Statistics Sweden. Disability weights (DW) and duration were based on WHO definitions. Finally, we used research-based exposure–response functions or relative risks to estimate disease attributable to noise in each exposure category. Results The number of DALY attributed to traffic noise in Sweden was estimated to be 41 033 years; 36 711 (90%) related to road traffic and 4322 (10%) related to railway traffic. The most important contributor to the disease burden was sleep disturbances, accounting for 22 218 DALY (54%), followed by annoyance, 12 090 DALY (30%), and cardiovascular diseases, 6725 DALY (16%). Conclusions Road traffic and railway noise contribute significantly to the burden of disease in Sweden each year. The total number of DALY should, however, be interpreted with caution due to limitations in data quality.

Objectives To assess quality of reporting of sample size calculation, ascertain accuracy of calculations, and determine the relevance of assumptions made when calculating sample size in randomised controlled trials.Design Review. Data sources We searched MEDLINE for all primary reports of two arm parallel group randomised controlled trials of superiority with a single primary outcome published in six high impact factor general medical journals between 1 January 2005 and 31 December 2006. All extra material related to design of trials (other articles, online material, online trial registration) was systematically assessed. Data extracted by use of a standardised form included parameters required for sample size calculation and corresponding data reported in results sections of articles. We checked completeness of reporting of the sample size calculation, systematically replicated the sample size calculation to assess its accuracy, then quantified discrepancies between a priori hypothesised parameters necessary for calculation and a posteriori estimates.Results Of the 215 selected articles, 10 (5%) did not report any sample size calculation and 92 (43%) did not report all the required parameters. The difference between the sample size reported in the article and the replicated sample size calculation was greater than 10% in 47 (30%) of the 157 reports that gave enough data to recalculate the sample size. The difference between the assumptions for the control group and the observed data was greater than 30% in 31% (n=45) of articles and greater than 50% in 17% (n=24). Only 73 trials (34%) reported all data required to calculate the sample size, had an accurate calculation, and used accurate assumptions for the control group. Conclusions Sample size calculation is still inadequately reported, often erroneous, and based on assumptions that are frequently inaccurate. Such a situation raises questions about how sample size is calculated in randomised controlled trials.