Diminished concern

One-fourth to one-half of all completed suicides were by psychiatric patients who had a history of a prior attempt. Thus, the majority of those who attempted suicide did not ultimately go on to complete the act, with estimates placing the ratio of attempters to completers at approximately 8 1. The absence of past suicide attempts does not guarantee or substantially reduce the risk of suicide if other risk factors are present. This risk factor is counterintuitive and, therefore, deserves special mention. Most individuals who die of suicide do so on their first or second attempt. Thus, the absence of a prior attempt should not minimize concern about its risk. In fact, the absence of previous attempts in a first-time, profoundly depressed middle-or late-life patient who has other risk factors (as discussed) should increase rather than diminish concern. Because suicide completions usually occur on the first or second attempt, multiple attempters (i.e., greater than five) are at greater risk for future attempts rather than completion. 

The term deactivation will be used to designate a continuum of phenomena variously described as disinterest, indifference, diminished concern, blunting, lack of spontaneity, reduced emotional reactivity, reduced motivation or will, apathy, and, in the extreme, a reusable stupor. 

Where there is a risk of about 10 year that individuals may become casualties, steps are usually taken to reduce the risk if possible—thus, the present day concern of society to reduce the death toll from traffic accidents. As the risk diminishes, concern and countermeasures become less in evidence. For risks less than 10 year , the individual does not appear to worry much, and so elaborate precautions against the risk are seldom taken—we do not pass our lives in constant fear of being struck by lightning. Some consider that in these thoughts lies a possible clue to the level of risk from nuclear power that may be acceptable to the individual. This may well be true, and we discuss the matter further below however, experience of debate about reactor siting, and common experience of life and of the daily news which most affect people s actions and reactions may persuade us that it is the collective risk of numbers of people or a group that should provide the basis of a criterion of overriding importance in relation to risk from nuclear power. This also is discussed further in this section. 

The non-use of chemical and biological weapons during the Gulf War will doubtless prompt further debate. Non-use by the Iraqis has neither diminished concern about these weapons, nor indicated that nations possessing chemical and biological weapons would abandon their capabilities and refrain from their use in future. Had either of these assumptions... 

These areas are interrelated, and decisions about one affect the others. Also, decisions concerning these areas are not simply made once, never to be considered again. You should review each area periodically as intermediate results are developed to ensure that the QRA remains on track. Ignoring any of these areas diminishes the likelihood that your QRA objectives will be satisfied. 

A problem exists in the perception of risk because the experts and lay people s views differ. The experts usually base their assessment on mortality rates, while the lay people s fears are based on "outrage" factors. In order to help solve tliis problem, in tlie future, risk nimuigcrs must work to make truly serious hazards more outrageous. One example is tlie ongoing concern for tlie risk involved in cigarette smoke. Another effort must be made to decrease tlie public s concern with low to modest hazards, i.e., risk managers must diminish "outrage" in these areas. In addition, people must be treated fairly and honestly. 

Some patients may experience anxiety about die appearance of certain skin lesions or the symptoms of a specific dermatologic disorder. This may cause a negative body imaga The nurse must allow time for die patient to verbalize concerns or ask questions concerning dierapy. The nurse reassures die patient tiiat die lesions are temporary and will diminish or disappear with treatment (if diat is true). 

However, the American consumer now seems ready to accept some reduction in cosmetic standards, provided pesticide use is diminished (47). Their concern about pesticide use is confirmed by the growing popularity of organic food stores and supermarkets that guarantee pesticide-free produce (48). Also, the "Big Green" initiative in California, although it didn t pass, signals that consumers are alarmed about pesticide use and are willing to take political action to make their views known. 

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