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Besides intensive surveillance, prophylactic mastectomy is an alternative risk reducing strategy, especially for BRCA 1/2 mutation carriers (Meijers-Heijboer et al, 2001).
The decision aid further increased the proportion of CHD prevention discussions with providers, patients' perceptions that at least some features of patient-provider interactions were more favorable, and patients' intentions for any effective risk reducing strategy.
The team also performed sensitivity analyses to determine whether modeling the effects of each CHD risk reducing strategy (aspirin, blood pressure medicine, cholesterol medicine, and smoking cessation) on baseline CHD risk produced different results than recalculating risk as described above.
As large herd size maximizes long term viability for pastoral households, the results from this study may be taken to indicate that predation compensation may represent an additional risk reducing strategy in the reindeer husbandry.
The research team measured intent to start any effective risk reducing strategy after the primary study visit by asking participants whether or not they planned to initiate aspirin or smoking cessation or initiate or increase blood pressure or cholesterol medication.
While a previous study found support for the general assumption that large herds may be an efficient risk reducing strategy for nomadic pastoralists (cf. Næss and Bårdsen 2010), the same study also hypothesized that that governmental initiatives such as predation compensation may positively interact with the risk beneficial aspects of having a large herd.
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She stresses comprehensive risk reducing strategies and prevention in high-risk populations, as well as earlier detection through advanced imaging technologies.
While there is no definite way to prevent breast cancer, some risk reducing strategies for high-risk women have been trialled.
Consequently, present governmental management initiatives aimed at reducing herd size have to change so as to incorporate factors associated with risk reducing strategies in their management plans.
The intervention increased self-reported adherence to chosen risk reducing strategies by 25 percentage points (95% CI 8%to4242%), with the biggest effect for aspirin.
Challenges related to improving decision making include overcoming patients' lack of knowledge about CHD risk factors [ 2, 3], their CHD risk [ 4], and the potential benefits of risk reducing strategies [ 5- 8].
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