Explore the vast range of titles available.

Introduction Antiretroviral‐based HIV prevention, including pre‐exposure prophylaxis (PrEP), is expanding in generalized epidemic settings, but additional prevention options are needed for individuals with periodic, high‐risk sexual exposures. Non‐occupational post‐exposure prophylaxis (PEP) is recommended in global guidelines. However, in Africa, awareness of and access to PEP for sexual exposures are limited. We assessed feasibility, acceptability, uptake and adherence in a pilot study of a patient‐centred PEP programme with options for facility‐ or community‐based service delivery. Methods After population‐level HIV testing with universal access to PrEP for persons at elevated HIV risk (SEARCH Trial:NCT01864603), we conducted a pilot PEP study in five rural communities in Kenya and Uganda between December 2018 and May 2019. We assessed barriers to PEP in the population and implemented an intervention to address these barriers, building on existing in‐country PEP protocols. We used community leaders for sensitization. Test kits and medications were acquired through the Ministry of Health supply chain and healthcare providers based at the Ministry of Health clinics were trained on PEP delivery. Additional intervention components were (a)PEP availability seven days/week, (b)PEP hotline staffed by providers and (c)option for out‐of‐facility medication delivery. We assessed implementation using the Proctor framework and measured seroconversions via repeat HIV testing. Successful “PEP completion” was defined as self‐reported adherence over four weeks of therapy with post‐PEP HIV testing. Results Community leaders were able to sensitize and mobilize for PEP. The Ministry of Health supplied test kits and PEP medications; after training, healthcare providers delivered the 28‐day regimen with high completion rates. Among 124 persons who sought PEP, 66% were female, 24% were ≤25 years and 42% were fisherfolk. Of these, 20% reported exposure with a serodifferent partner, 72% with a new or existing relationship and 7% from transactional sex. 12% of all visits were conducted at out‐of‐facility community‐based sites; 35% of participants had ≥1 out‐of‐facility visit. No serious adverse events were reported. Overall, 85% met the definition of PEP completion. There were no HIV seroconversions. Conclusions Among individuals with elevated‐risk exposures in rural East African communities, patient‐centred PEP was feasible, acceptable and provides a promising addition to the current prevention toolkit.

This study proposes and tests a model that explains and predicts risk response decisions of information technology project managers (ITPMs), blending the domains of the theory of planned behavior (TPB) and behavioral decision theories, and leveraging information technology project risk management behavioral research. The model posits that a risk response decision is indirectly influenced by perceived risk exposure via overall risk response attitude. The model conceptualizes perceived risk exposure and overall risk response attitude as second-order constructs and examines the dimension-level relationships within each. The model hypothesizes that a risk response decision is also influenced by pressures ITPMs perceive for or against enacting a specific risk response, by a negative synergy effect between overall risk response attitude and perceived pressures, and by their perception of control—or lack thereof—over enacting the risk response. The model was instantiated for three specific risk responses: having user representatives as team members, appreciating team members’ work in a tangible way during the project, and dedicating much effort to planning. Each model instance was tested in a separate survey (N > 111 per survey, total N = 349). The results support the hypotheses, except for the influence of perceived control, which varied across instantiations of risk responses. Among other antecedents, overall risk response attitude is found to have the strongest effect on risk response decisions. The findings stress the effect of ITPMs’ salient beliefs about specific risk responses on their decision to enact a given response and thus pave the way for designing behavior change interventions.

Purpose This study aims to address gaps and limitations in the literature regarding firms’ exposure to climate risks. It reviews existing research, proposes new theoretical frameworks and provides directions for future studies. Design/methodology/approach A bibliometric and systematic approach is used to review the literature on firms’ climate risk exposure. The study examines current theoretical frameworks and suggests additional ones to enhance understanding. Findings This study contributes to the climate finance literature by offering a comprehensive overview of firms’ climate risk exposure and used theories. It emphasizes the urgent need to tackle climate change and the crucial role of firms in climate risk management. The study supports the advancement of sustainability policies and highlights the importance of understanding firms' climate risk exposure. Practical implications This study informs the development of climate risk management strategies within firms and supports the implementation of effective sustainability policies. Social implications Addressing climate risks can contribute to a more sustainable and resilient future for society as a whole. Originality/value This study provides a roadmap for future research by identifying gaps and limitations in the literature. It introduces new perspectives and theoretical frameworks, adding original insights to the field of study.

Preparing a city for the impact of global warming is becoming of major importance. Adopting climate-proof policies and strategies in response to climate change has become a fundamental element for city planning. To this end, this research considers a multidisciplinary approach, at the local scale, able to connect urban planning and architecture, as a vital base for considering a coastal cities’ ability to control the consequences of climate change, specifically floods. So far, there is a scarcity of research connecting sea ground and land surveys, and this study could become a foundational reference for coastline settlement management using BIM. We found in BIM (Building Information Modeling) a possible tool for managing coastal risk, since it can combine crowdsourced data for geometric and information modeling of the city. The proposed BIM model includes a topography used for 3D thematic maps, a riverbed model, and a waterway model. This model aims to facilitate coordination across separate actors and interests since the urban area model is always updatable and improvable. Focusing on a case study of Lisbon, we developed risk-based 3D maps of the area close to the shoreline of the Tagus River.

Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Bill & Melinda Gates Foundation.

Does the increasing awareness of environmental risk exposure also affect intentions to create enterprises which address these social and environmental failures? Besides economic explanations that social and environmental needs and market failure create opportunities for sustainable entrepreneurship, it is less clear how cognitive processes and motivations related to sustainable entrepreneurship are shaped by its context. This research integrates environmental risk exposure as a contextual variable into the theory of planned behavior and uses data gathered in the course of the Global Entrepreneurship Monitor. We provide empirical evidence for the impact of environmental risk exposure on the determinants of sustainable entrepreneurial intention and contribute to a deeper understanding of the formation of sustainable entrepreneurial intention.

This study aimed to identify the influence of environmental risk exposure levels on the predictive factors of COVID-19 booster dose vaccination in an urban Thai population in the post-pandemic era. Six study locations, including the three provinces with the highest environmental risk levels and the three provinces with the lowest environmental risk levels, were selected by calculating the environmental risk exposure indexes. Participants from the capital district of each province were chosen via the simple random sampling technique and interviewed using a structured questionnaire. A total of 1315 individuals were included in a sample in this study, and the best predictors of booster dose vaccination were determined using multiple regression analysis. The results showed that a high level of environmental risk exposure occurred in the provinces with a high number of total days exceeding the limits set for PM10 and high rates of mortality for lung cancer. The number of COVID-19 booster vaccinations given amount to 43.4% of the population during the post-COVID-19 pandemic period. Our multivariate analysis indicated that individuals in the working age group (≥25 years old); those with higher education (diploma degree and above); full-time employment (government and private sectors); those with high monthly incomes (≥USD144.1); and those in areas with the lowest risk level of environmental exposure significantly contributed to the number of booster dose vaccinations given during the post-pandemic period. To summarize, the rate of COVID-19 booster dose vaccination acceptance in Thailand was influenced by socio-economic factors with environmental concerns. These findings improve our understating of both the global pandemic and how environmental exposure affects behavioral change patterns and could improve the effectiveness of post-pandemic management.

This paper addresses how the environmental, social and governance (ESG) risk of a firm influences their global risk. Differentiated ESG risk measures are used to test for an excess risk effect derived from companies' effective management of ESG risk factors. With a panel quantile regression using the method of moments, we investigated a data set of 4,792 international firms over the 2018-2022 period, yielding a total of 23,960 firm-year observations. The results align with risk management theory, showing that firm risk increases with higher ESG risk. However, ESG risk exposure and unmanaged ESG risk have an asymmetrical effect on firm risk, with the latter being more positively influenced in the upper quantiles. Sensitivity analyses reveal that the findings are robust even during different market cycles, such as the recent COVID-19 pandemic. Managerial implications and insights for investors are useful regarding the riskiness of ESG issues and strategies for mitigating them.

This study investigates the impact of climate change adaptation on farm households’ downside risk exposure in the Nile Basin of Ethiopia. The analysis relies on a moment-based specification of the stochastic production function. We use an empirical strategy that accounts for the heterogeneity in the decision on whether to adapt or not, and for unobservable characteristics of farmers and their farm. We find that past adaptation to climate change (i) reduces current downside risk exposure, and so the risk of crop failure; (ii) would have been more beneficial to the non-adapters if they adapted, in terms of reduction in downside risk exposure; and (iii) is a successful risk management strategy that makes the adapters more resilient to climatic conditions.