31 research outputs found
Impact of a risk based breast screening decision aid on understanding, acceptance and decision making
Abstract Internationally, population breast cancer screening is moving towards a risk-stratified approach and requires engagement and acceptance from current and future screening clients. A decision aid ( www.defineau.org ) was developed based on women’s views, values, and knowledge regarding risk-stratified breast cancer screening. This study aims to evaluate the impact of the decision aid on women’s knowledge, risk perception, acceptance of risk assessment and change of screening frequency, and decision-making. Here we report the results of a pre and post-survey in which women who are clients of BreastScreen Victoria were invited to complete an online questionnaire before and after viewing the decision aid. 3200 potential participants were invited, 242 responded with 127 participants completing both surveys. After reviewing the decision aid there was a significant change in knowledge, acceptance of risk-stratified breast cancer screening and of decreased frequency screening for lower risk. High levels of acceptance of risk stratification, genetic testing and broad support for tailored screening persisted pre and post review. The DEFINE decision aid has a positive impact on acceptance of lower frequency screening, a major barrier to the success of a risk-stratified program and may contribute to facilitating change to the population breast screening program in Australia
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The complexity of global change and its effects on insects.
Global change includes multiple overlapping and interacting drivers: 1) climate change, 2) land use change, 3) novel chemicals, and 4) the increased global transport of organisms. Recent studies have documented the complex and counterintuitive effects of these drivers on the behavior, life histories, distributions, and abundances of insects. This complexity arises from the indeterminacy of indirect, non-additive and combined effects. While there is wide consensus that global change is reorganizing communities, the available data are limited. As the pace of anthropogenic changes outstrips our ability to document its impacts, ongoing change may lead to increasingly unpredictable outcomes. This complexity and uncertainty argue for renewed efforts to address the fundamental drivers of global change