WorldWideScience

Sample records for risk management patient

  1. Improving ICU risk management and patient safety.

    Science.gov (United States)

    Kielty, Lucy Ann

    2017-06-12

    Purpose The purpose of this paper is to describe a study which aimed to develop and validate an assessment method for the International Electrotechnical Commission (IEC) 80001-1 (IEC, 2010) standard (the Standard); raise awareness; improve medical IT-network project risk management processes; and improve intensive care unit patient safety. Design/methodology/approach An assessment method was developed and piloted. A healthcare IT-network project assessment was undertaken using a semi-structured group interview with risk management stakeholders. Participants provided feedback via a questionnaire. Descriptive statistics and thematic analysis was undertaken. Findings The assessment method was validated as fit for purpose. Participants agreed (63 per cent, n=7) that assessment questions were clear and easy to understand, and participants agreed (82 per cent, n=9) that the assessment method was appropriate. Participant's knowledge of the Standard increased and non-compliance was identified. Medical IT-network project strengths, weaknesses, opportunities and threats in the risk management processes were identified. Practical implications The study raised awareness of the Standard and enhanced risk management processes that led to improved patient safety. Study participants confirmed they would use the assessment method in future projects. Originality/value Findings add to knowledge relating to IEC 80001-1 implementation.

  2. Managing Risk to the Patient: Recoding Quality Risk Management for the Pharmaceutical and Biopharmaceutical Industries

    OpenAIRE

    Waldron, Kelly

    2017-01-01

    This thesis explores the application of quality risk management (QRM) in pharmaceutical and biopharmaceutical companies and its effectiveness at managing risk to the patient. The objective of the research described in this thesis was to characterize a maturity state of QRM implementation in which the patient is adequately protected from the risks associated with medicinal products of inadequate quality. The research was conducted over three phases: first, to determine whether patients are bet...

  3. Therapeutic risk management of the suicidal patient: safety planning.

    Science.gov (United States)

    Matarazzo, Bridget B; Homaifar, Beeta Y; Wortzel, Hal S

    2014-05-01

    This column is the fourth in a series describing a model for therapeutic risk management of the suicidal patient. Previous columns presented an overview of the therapeutic risk management model, provided recommendations for how to augment risk assessment using structured assessments, and discussed the importance of risk stratification in terms of both severity and temporality. This final column in the series discusses the safety planning intervention as a critical component of therapeutic risk management of suicide risk. We first present concerns related to the relatively common practice of using no-suicide contracts to manage risk. We then present the safety planning intervention as an alternative approach and provide recommendations for how to use this innovative strategy to therapeutically mitigate risk in the suicidal patient.

  4. Gun Safety Management with Patients at Risk for Suicide

    Science.gov (United States)

    Simon, Robert I.

    2007-01-01

    Guns in the home are associated with a five-fold increase in suicide. All patients at risk for suicide must be asked if guns are available at home or easily accessible elsewhere, or if they have intent to buy or purchase a gun. Gun safety management requires a collaborative team approach including the clinician, patient, and designated person…

  5. Risk management.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided.

  6. Risk management

    OpenAIRE

    Mcmanus, John

    2009-01-01

    Few projects are completed on time, on budget, and to their original requirement or specifications. Focusing on what project managers need to know about risk in the pursuit of delivering projects, Risk Management covers key components of the risk management process and the software development process, as well as best practices for risk identification, risk planning, and risk analysis. The book examines risk planning, risk analysis responses to risk, the tracking and modelling of risks, intel...

  7. Safe patient care - safety culture and risk management in otorhinolaryngology.

    Science.gov (United States)

    St Pierre, Michael

    2013-12-13

    Safety culture is positioned at the heart of an organization's vulnerability to error because of its role in framing organizational awareness to risk and in providing and sustaining effective strategies of risk management. Safety related attitudes of leadership and management play a crucial role in the development of a mature safety culture ("top-down process"). A type marker for organizational culture and thus a predictor for an organization's maturity in respect to safety is information flow and in particular an organization's general way of coping with information that suggests anomaly. As all values and beliefs, relationships, learning, and other aspects of organizational safety culture are about sharing and processing information, safety culture has been termed "informed culture". An informed culture is free of blame and open for information provided by incidents. "Incident reporting systems" are the backbone of a reporting culture, where good information flow is likely to support and encourage other kinds of cooperative behavior, such as problem solving, innovation, and inter-departmental bridging. Another facet of an informed culture is the free flow of information during perioperative patient care. The World Health Organization's safe surgery checklist" is the most prevalent example of a standardized information exchange aimed at preventing patient harm due to information deficit. In routine tasks mandatory standard operating procedures have gained widespread acceptance in guaranteeing the highest possible process quality. Technical and non-technical skills of healthcare professionals are the decisive human resource for an efficient and safe delivery of patient care and the avoidance of errors. The systematic enhancement of staff qualification by providing training opportunities can be a major investment in patient safety. In recent years several otorhinolaryngology departments have started to incorporate stimulation based team trainings into their

  8. [Safe patient care: safety culture and risk management in otorhinolaryngology].

    Science.gov (United States)

    St Pierre, M

    2013-04-01

    Safety culture is positioned at the heart of an organisation's vulnerability to error because of its role in framing organizational awareness to risk and in providing and sustaining effective strategies of risk management. Safety related attitudes of leadership and management play a crucial role in the development of a mature safety culture ("top-down process"). A type marker for organizational culture and thus a predictor for an organizations maturity in respect to safety is information flow and in particular an organization's general way of coping with information that suggests anomaly. As all values and beliefs, relationships, learning, and other aspects of organizational safety culture are about sharing and processing information, safety culture has been termed "informed culture". An informed culture is free of blame and open for information provided by incidents. "Incident reporting systems" are the backbone of a reporting culture, where good information flow is likely to support and encourage other kinds of cooperative behavior, such as problem solving, innovation, and inter-departmental bridging. Another facet of an informed culture is the free flow of information during perioperative patient care. The World Health Organisation's "safe surgery checklist" is the most prevalent example of a standardized information exchange aimed at preventing patient harm due to information deficit. In routine tasks mandatory standard operating procedures have gained widespread acceptance in guaranteeing the highest possible process quality.Technical and non-technical skills of healthcare professionals are the decisive human resource for an efficient and safe delivery of patient care and the avoidance of errors. The systematic enhancement of staff qualification by providing training opportunities can be a major investment in patient safety. In recent years several otorhinolaryngology departments have started to incorporate simulation based team trainings into their curriculum

  9. Cardiovascular risk management in rheumatoid arthritis patients still suboptimal: the Implementation of Cardiovascular Risk Management in Rheumatoid Arthritis project.

    Science.gov (United States)

    van den Oever, Inge A M; Heslinga, Maaike; Griep, Ed N; Griep-Wentink, Hanneke R M; Schotsman, Rob; Cambach, Walter; Dijkmans, Ben A C; Smulders, Yvo M; Lems, Willem F; Boers, Maarten; Voskuyl, Alexandre E; Peters, Mike J L; van Schaardenburg, Dirkjan; Nurmohamed, Micheal T

    2017-09-01

    To assess the 10-year cardiovascular (CV) risk score and to identify treatment and undertreatment of CV risk factors in patients with established RA. Demographics, CV risk factors and prevalence of cardiovascular disease (CVD) were assessed by questionnaire. To calculate the 10-year CV risk score according to the Dutch CV risk management guideline, systolic blood pressure was measured and cholesterol levels were determined from fasting blood samples. Patients were categorized into four groups: indication for treatment but not treated; inadequately treated, so not meeting goals (systolic blood pressure ⩽140 mmHg and/or low-density lipoprotein ⩽2.5 mmol/l); adequately treated; or no treatment necessary. A total of 720 consecutive RA patients were included, 375 from Reade and 345 from the Antonius Hospital. The mean age of patients was 59 years (s.d. 12) and 73% were female. Seventeen per cent of the patients had a low 10-year CV risk (management remains a major challenge and better awareness and management are urgently needed to reduce the high risk of CVD in the RA population. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  10. Sepsis: at-risk patients, clinical manifestations and management

    African Journals Online (AJOL)

    management of sepsis has resulted in a remarkable increase of new knowledge on the ... As sepsis progresses to septic shock, the risk of dying increases substantially. Where .... altered mental state, thrombocytopenia, raised serum lactate ...

  11. Management of Cardiovascular Risk in Patients with Chronic Inflammatory Diseases

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Kristensen, Søren Lund; Ahlehoff, Ole

    2016-01-01

    An increased risk of cardiovascular disease (CVD) has been observed in a range of chronic inflammatory diseases (CID), including rheumatoid arthritis (RA), psoriasis, inflammatory bowel diseases (IBD), and systemic lupus erythematosus (SLE). The increased risk of CVDs and reduced life expectancy...... considerable interest in recent years. We briefly summarize the current level of evidence of the association between CIDs and CVD and cardiovascular risk management recommendations. Perspectives of ongoing and planned trials are discussed in consideration of potential ways to improve primary and secondary CVD...

  12. Management of Skin Cancer in the High-Risk Patient.

    Science.gov (United States)

    Behan, James W; Sutton, Adam; Wysong, Ashley

    2016-12-01

    Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression. We have recently proposed classifying NMSC as a chronic disease in a certain subset of patients. Although no consensus definition exists for a chronic disease in medicine, there are three components that are present in most definitions: duration of at least 1 year, need for ongoing medical care, and functional impairment and/or alteration of activities of daily living (ADLs) and quality of life (QOL). Immunosuppression can refer to exogenous (organ or stem cell transplant patients,) or endogenous (HIV, leukemia, lymphoma, genodermatoses with DNA mismatch repair problems or other immunosuppression) causes. These patients are at risk for high-risk tumors and/or the development of multiple tumors.

  13. A cooperative building up of care security: patient participation to risk management in radiotherapy

    International Nuclear Information System (INIS)

    Pernet, A.; Mollo, V.; Giraud, P.

    2010-01-01

    Based on observations of radiotherapy consultations, interviews of professionals (physicians and operators), of ex-patients and patients under treatment, and on analysis of questionnaires sent to patients, this study aimed at understanding how, and to which levels, participation of patients can optimize risk management. It outlines the major role of therapeutic information and education of patients, but also of health professionals, in order to reach a shared cooperative management of cares. Short communication

  14. Cardiovascular risk management in rheumatoid arthritis patients still suboptimal: the Implementation of Cardiovascular Risk Management in Rheumatoid Arthritis project

    NARCIS (Netherlands)

    van den Oever, Inge A. M.; Heslinga, Maaike; Griep, Ed N.; Griep-Wentink, Hanneke R. M.; Schotsman, Rob; Cambach, Walter; Dijkmans, Ben A. C.; Smulders, Yvo M.; Lems, Willem F.; Boers, Maarten; Voskuyl, Alexandre E.; Peters, Mike J. L.; van Schaardenburg, Dirkjan; Nurmohamed, Micheal T.

    2017-01-01

    To assess the 10-year cardiovascular (CV) risk score and to identify treatment and undertreatment of CV risk factors in patients with established RA. Demographics, CV risk factors and prevalence of cardiovascular disease (CVD) were assessed by questionnaire. To calculate the 10-year CV risk score

  15. Mortality in perforated peptic ulcer patients after selective management of stratified poor risk cases.

    Science.gov (United States)

    Rahman, M Mizanur; Islam, M Saiful; Flora, Sabrina; Akhter, S Fariduddin; Hossain, Shahid; Karim, Fazlul

    2007-12-01

    Perforated peptic ulcer disease continues to inflict high morbidity and mortality. Although patients can be stratified according to their surgical risk, optimal management has yet to be described. In this study we demonstrate a treatment option that improves the mortality among critically ill, poor risk patients with perforated peptic ulcer disease. In our study, two series were retrospectively reviewed: group A patients (n = 522) were treated in a single surgical unit at the Dhaka Medical College Hospital, Dhaka, Bangladesh during the 1980s. Among them, 124 patients were stratified as poor risk based on age, delayed presentation, peritoneal contamination, and coexisting medical problems. These criteria were the basis for selecting a group of poor risk patients (n = 84) for minimal surgical intervention (percutaneous peritoneal drainage) out of a larger group of patients, group B (n = 785) treated at Khulna Medical College Hospital during the 1990s. In group A, 479 patients underwent conventional operative management with an operative mortality of 8.97%. Among the 43 deaths, 24 patients were >60 years of age (55.8%), 12 patients had delayed presentation (27.9%), and 7 patients were in shock or had multiple coexisting medical problems (16.2%). In group B, 626 underwent conventional operative management, with 26 deaths at a mortality rate of 4.15%. Altogether, 84 patients were stratified as poor risk and were managed with minimal surgical intervention (percutaneous peritoneal drainage) followed by conservative treatment. Three of these patients died with an operative mortality of 3.5%. Minimal surgical intervention (percutaneous peritoneal drainage) can significantly lower the mortality rate among a selected group of critically ill, poor risk patients with perforated peptic ulcer disease.

  16. [Endorsement of risk management and patient safety by certification of conformity in health care quality assessment].

    Science.gov (United States)

    Waßmuth, Ralf

    2015-01-01

    Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. While these effects have strong face validity, they are currently not sufficiently supported by evidence from health care research. Whether this relates to a lack of evidence or a lack of investigation remains open. Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.

  17. Sepsis: at-risk patients, clinical manifestations and management

    African Journals Online (AJOL)

    As sepsis progresses to septic shock, the risk of dying increases ... Jantjie Taljaard's current fields of interests are general internal medicine, antibiotic stewardship, HIV/HBV co-infection, drug-related .... infections (infection control) and stress.

  18. Characterizing the High-Risk Homebound Patients in Need of Nurse Practitioner Co-Management

    Science.gov (United States)

    Jones, Masha G.; Ornstein, Katherine A.; Skovran, David M.; Soriano, Theresa A.; DeCherrie, Linda V.

    2016-01-01

    By providing more frequent provider visits, prompt responses to acute issues, and care coordination, nurse practitioner (NP) co-management has been beneficial for the care of chronically ill older adults. This paper describes the homebound patients with high symptom burden and healthcare utilization who were referred to an NP co-management intervention and outlines key features of the intervention. We compared demographic, clinical, and healthcare utilization data of patients referred for NP co-management within a large home-based primary care (HBPC) program (n=87) to patients in the HBPC program not referred for co-management (n=1027). A physician survey found recurrent hospitalizations to be the top reason for co-management referral and a focus group with nurses and social workers noted that co-management patients are typically those with active medical issues more so than psychosocial needs. Co-management patients are younger than non-co-management patients (72.31 vs. 80.30 years old, P<0.001), with a higher mean Charlson comorbidity score (3.53 vs. 2.47, P=0.0001). They have higher baseline annual hospitalization rates (2.27 vs. 0.61, P=0.0005) and total annual home visit rates (13.1 vs. 6.60, P=0.0001). NP co-management can be utilized in HBPC to provide intensive medical management to high-risk homebound patients. PMID:27876403

  19. APPROACHES TO THE CONSTRUCTION OF THE VITRECTOMY RISK MANAGEMENT SYSTEM IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    A. M. Ruban

    2016-08-01

    Full Text Available The article presents the some approaches to create a system support of making decision during vitrectomy in patients with diabetic proliferative retinopathy, promotes objective assessment of individual risk-management for patient and allows optimize ophthalmological care for them.

  20. Medical Assistant-based care management for high risk patients in small primary care practices

    DEFF Research Database (Denmark)

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

  1. Differences in cardiovascular disease risk factor management in primary care by sex of physician and patient.

    Science.gov (United States)

    Tabenkin, Hava; Eaton, Charles B; Roberts, Mary B; Parker, Donna R; McMurray, Jerome H; Borkan, Jeffrey

    2010-01-01

    The purpose of this study was to evaluate differences in the management of cardiovascular disease (CVD) risk factors based upon the sex of the patient and physician and their interaction in primary care practice. We evaluated CVD risk factor management in 4,195 patients cared for by 39 male and 16 female primary care physicians in 30 practices in southeastern New England. Many of the sex-based differences in CVD risk factor management on crude analysis are lost once adjusted for confounding factors found at the level of the patient, physician, and practice. In multilevel adjusted analyses, styles of CVD risk factor management differed by the sex of the physician, with more female physicians documenting diet and weight loss counseling for hypertension (odds ratio [OR] = 2.22; 95% confidence interval [CI], 1.12-4.40) and obesity (OR = 2.14; 95% CI, 1.30-3.51) and more physical activity counseling for obesity (OR = 2.03; 95% CI, 1.30-3.18) and diabetes (OR = 6.55; 95% CI, 2.01-21.33). Diabetes management differed by the sex of the patient, with fewer women receiving glucose-lowering medications (OR = 0.49; 95% CI, 0.25-0.94), angiotensin-converting enzyme inhibitor therapy (OR = 0.39; 95% CI, 0.22-0.72), and aspirin prophylaxis (OR = 0.30; 95% CI, 0.15-0.58). Quality of care as measured by patients meeting CVD risk factors treatment goals was similar regardless of the sex of the patient or physician. Selected differences were found in the style of CVD risk factor management by sex of physician and patient.

  2. Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

    Directory of Open Access Journals (Sweden)

    Jun D Tai

    2012-01-01

    Full Text Available Background: Presently it is difficult to differentiate malignancy for thyroid nodules by palpation, ultrasonography and fine-needle aspiration cytology (FNAC at the outpatient department, especially for solitary thyroid nodule (STN. So a great emphasis should be placed on the STN. AIms: The objective of this study was to investigate the predictive clinicopathological risk factors for malignancy in patients with STN and further to provide an appropriate clinical management. Materials and Methods: The records were reviewed from 265 patients with STN who had undergone thyroidectomy in our hospital. All cases were classified as two independent groups in terms of the final pathological results to assess the independent risk factors using a multinomial logistic regression analysis. Results: A multinomial logistic analysis revealed that the male gender, microcalcification and cervical lymphadenopathy were independent risk factors related to malignancy in patients with STN. The incidence of malignancy in patients with 0,1,2,3 risks was 10.71%, 26.6%, 61.43%, and 100%, respectively. Conclusions: Male gender, microcalcification and lymphadenopathy were independent risk factors for predicting the malignancy in patients with STN. Patients with more than two of those risk factors should be subjected to further examination or thyroidectomy. The findings may provide a simple and reasonable management for the STN.

  3. Can or must the patient participate to risk management in radiotherapy?

    International Nuclear Information System (INIS)

    Mollo, V.; Pernet, A.; Moutel, G.; Duchange, N.; Giraud, P.

    2011-01-01

    Purpose. - The present study aimed at analyzing if patient participation constitutes a promising way of improvement of patient safety, or not. The hypothesis is that patient participation is a means to develop a safety culture based on the cooperation between patients and health care providers, to improve patients' satisfaction and to reduce the costs associated to adverse events. Patients and methods. - A half-day session was organized on this theme during a training of radiotherapy professionals on risk management. Professionals were first distributed in three subgroups according to their specialty (radiation oncologists, radiation physicists and medical technicians), and had to work on four main questions relating to participation, among which the collection of real situations in which patients effectively contributed (positively or negatively) to patient safety. Results were then collectively discussed. Results. - Patient participation allows not only to detect and recover some mistakes or errors made by the professionals (error of identity), but also to decrease patients' risk behaviors (purposely taking the place of another patient in order to be treated faster). However, it must be seen as a possibility offered to patients, and not as an obligation. Conclusion. - Patient participation to patient safety is a field of study, which requires to be developed in order to define the conditions enhancing such participation and to implement a set of actions to improve health care safety by a cooperative management of this one. (authors)

  4. A multidisciplinary approach to therapeutic risk management of the suicidal patient

    Directory of Open Access Journals (Sweden)

    Grant CL

    2015-06-01

    Full Text Available Cynthia L Grant,1,2 Jaimie L Lusk3 1Arapahoe/Douglas Mental Health Network, Englewood, CO, 2School of Education and Human Development, University of Colorado Denver, Denver, CO, 3Mental Health Service, VA Portland Health Care System, Portland, OR, USA Abstract: As health care trends toward a system of care approach, providers from various disciplines strive to collaborate to provide optimal care for their patients. While a multidisciplinary approach to suicide risk assessment and management has been identified as important for reducing suicidality, standardized clinical guidelines for such an approach do not yet exist. In this article, the authors propose the adoption of the therapeutic risk management of the suicidal patient (TRMSP to improve suicide risk assessment and management within multidisciplinary systems of care. The TRMSP, which has been fully articulated in previous articles, involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. Augmenting clinical risk assessments with reliable and valid structured instruments serves several functions, including ensuring important aspects of suicide are addressed, establishing a baseline for suicidal thoughts and behaviors, facilitating interprofessional communication, and mitigating risk. Similarly, a two-dimensional risk stratification qualifying suicide risk in terms of both severity and temporality can enhance communication across providers and settings and improve understanding of acute crises in the context of chronic risk. Finally, safety planning interventions allow providers and patients to collaboratively create a personally meaningful plan for managing a suicidal crisis that can be continually modified across time with multiple providers in different care settings. In a busy care environment, the TRMSP can provide concrete guidance on conducting clinically and

  5. Reconsideration of Secondary Risk Management Strategies in Patients with Ischemic Heart Disease.

    Science.gov (United States)

    Kashiyama, Kuninobu; Sonoda, Shinjo; Otsuji, Yutaka

    2017-01-01

    The main risk factors in ischemic heart diseases, including myocardial infarction, are hypertension, dyslipidemia, diabetes, obesity and smoking. The incidence of ischemic heart disease in Japan has been lower than that in Western countries because of differences in lifestyle and the anatomy of the coronary arteries, but the situation has been changing recently because of the westernization of lifestyle. Cardiovascular diseases have become the second most common cause of death in Japan, and 40% of those deaths are attributed to ischemic heart disease. Patients with a history of myocardial infarction, especially, have an increased risk of re-infarction, so strict management of coronary risk factors is important for the prevention of secondary ischemic heart disease. Although there are many guidelines about how to manage the risk factors, there are still many problems. Although lipid management has been demonstrated to have a protective effect against coronary artery disease and arteriosclerotic guidelines have been developed, it is reported that only about one third of patients achieved the low-density lipoprotein (LDL) target value under secondary prevention. Moreover, it is unclear whether the lower target value is required for high-risk patients. Recent research on diabetes has reported increased mortality in patients with intensive glycemic control. We should discuss when to start treatment, which medicine to use, and to what extent we should manage glycemic control. Strict management based on current therapeutic guidelines is effective for secondary prevention of ischemic heart disease, with target values of less than 135/85 mmHg for home blood pressure, less than 100 mg/dl for LDL-C, more than 40 mg/dl for HDL-C, less than 150 mg/dl for TG, and, for diabetic patients, less than 7.0% for HbA1c (NGSP).

  6. Nonoperative options for management of residual stones after cholecystostomy in high-risk patients

    Science.gov (United States)

    Reed, David M.; Daye, S. S.; Lincer, R. M.

    1993-05-01

    Cholecystostomy is frequently performed to obtain control of sepsis in high risk patients with acute cholecystitis. Retained stones in the gallbladder may cause future clinical problems. We present two patients with cholecystostomy tubes managed non-operatively. A review of other reported methods for stone extraction or destruction is also presented. Knowledge of safe and effective techniques for removal of these stones, using minimally invasive techniques is useful to the general surgeon.

  7. Managing high-risk patients: the Mass General care management programme

    Directory of Open Access Journals (Sweden)

    Dennis L Kodner

    2015-09-01

    Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program

  8. Managing risks

    International Nuclear Information System (INIS)

    Nathwani, J.S.

    1993-01-01

    The three principles to guide regulating authorities are: Risks shall be managed to maximize the total expected net benefit to society; The safety benefit to be promoted is quality-adjusted life expectancy; Decisions for the public in regard to health and safety must be open and apply across the entire range of hazards to life and health. Based on the principle that excessive spending on health and safety, or lack of necessary development, may cause poverty and thereby actually decrease (adjusted) life expectancy, the author has developed a Life Product Index which gives comparable results to the Human Development Index promoted by the United Nations Development Program. These two social indicators can be used for purposes such as project evaluation, choosing between alternative technologies, or evaluation of health and safety programs

  9. Mammary radiotherapy and patients-risks management with continue evaluation of clinical indicators

    International Nuclear Information System (INIS)

    Untereiner, M.; Frederick, B.; Burie, D.; Cavuto, C.; Rob, L.; Coiffier, N.; Colet, M.

    2009-01-01

    Purpose: The breast irradiation represents 25% of radiotherapy indication in the radiotherapy centers. The modeling of the management of complications risks and recurrences in relation with mammary irradiation constitutes a methodological base allowing to develop a general concept for any other indication of radiotherapy. The objective of the study was a continuous evaluation of clinical risks to get indicators of the therapy results: for the institution, to get an auto-evaluation tool of the functioning (continuous evaluation of clinical results, identification of sentinel events); for the patients to get precise and detailed information on the risks linked to their treatment (communication of clinical results, comparison with the literature, benchmarking). (N.C.)

  10. Patient safety risk assessment and risk management: A review on Indian hospitals

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2011-01-01

    Full Text Available This paper is intended to discuss a critical need expressed by present healthcare system of India, and how to provide a better health facility and diluting the medication errors caused by inappropriate management of the hospitals. Adverse events related to medication occur due to pathetic infrastructures, corporal punishment by the patient if unsatisfied, doctors on strike and working only for riches, trivial financial aid, and lack of basic amenities in the government-run hospitals of India. Government should reduce the barriers of awareness, accountability, ability, and action into accelerators of patient safety in the government organizations. Physicians, nurses, and pharmacists are truly the critical ingredient to rapid safety practice adoption. Various approaches like Technological Iatrogenesis, Computerized Provider Order Entry, and Electronic Health Record should be used. Although patient safety is recognized as a serious issue in health system, there is an urgent need for development and implementation of strategies for prevention and early detection of errors.

  11. Risk Management for Gastrointestinal Endoscopy in Elderly Patients: Questionnaire for Patients Undergoing Gastrointestinal Endoscopy

    OpenAIRE

    Umegaki, Eiji; Abe, Shinya; Tokioka, Satoshi; Takeuchi, Nozomi; Takeuchi, Toshihisa; Yoda, Yukiko; Murano, Mitsuyuki; Higuchi, Kazuhide

    2009-01-01

    More elderly patients now undergo gastrointestinal endoscopy following recent advances in endoscopic techniques. In this study, we conducted a high-risk survey of endoscopies in Japan, using a questionnaire administered prior to upper gastrointestinal tract endoscopy (UGITE), and identified anticholinergic agents and glucagon preparations as high-risk premedication. We also evaluated the cardiovascular effects of anticholinergic agents and glucagon through measurements of plasma levels of hum...

  12. Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

    Science.gov (United States)

    Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

    2017-06-01

    This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

  13. Peri-procedural risk stratification and management of patients with Williams syndrome.

    Science.gov (United States)

    Collins Ii, R Thomas; Collins, Margaret G; Schmitz, Michael L; Hamrick, Justin T

    2017-03-01

    Williams syndrome (WS) is a congenital, multisystem disorder affecting the cardiovascular, connective tissue, and central nervous systems in 1 in 10 000 live births. Cardiovascular involvement is the most common cause of morbidity and mortality in patients with WS, and noninvasive and invasive procedures are common. Sudden cardiovascular collapse in patients with WS is a well-known phenomenon, especially in the peri-procedural period. Detailed guidelines for peri-procedural management of patients with WS are limited. The goal of this review is to provide thoughtful, safe and effective management strategies for the peri-procedural care of patients with WS with careful consideration of hemodynamic impacts of anesthetic strategies. In addition, an expanded risk stratification system for anesthetic administration is provided. © 2017 Wiley Periodicals, Inc.

  14. [Clinical guideline for management of patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan José; Oleaga, Amelia; Álvarez-Escolá, Cristina; Martín, Tomás; Galofré, Juan Carlos

    2015-01-01

    Incidence of thyroid cancer is increasing in Spain and worldwide. Overall thyroid cancer survival is very high, and stratification systems to reliably identify patients with worse prognosis have been developed. However, marked differences exist between the different specialists in clinical management of low-risk patients with thyroid carcinoma. Almost half of all papillary thyroid carcinomas are microcarcinomas, and 90% are tumors < 2 cm that have a particularly good prognosis. However, they are usually treated more aggressively than needed, despite the lack of adequate scientific support. Surgery remains the gold standard treatment for these tumors. However, lobectomy may be adequate in most patients, without the need for total thyroidectomy. Similarly, prophylactic lymph node dissection of the central compartment is not required in most cases. This more conservative approach prevents postoperative complications such as hypoparathyroidism or recurrent laryngeal nerve injury. Postoperative radioiodine remnant ablation and strict suppression of serum thyrotropin, although effective for the more aggressive forms of thyroid cancer, have not been shown to be beneficial for the treatment of low risk patients, and may impair their quality of life. This guideline provides recommendations from the task force on thyroid cancer of the Spanish Society of Endocrinology and Nutrition for adequate management of patients with low-risk thyroid cancer. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  15. What Do High-Risk Patients Value? Perspectives on a Care Management Program.

    Science.gov (United States)

    Ganguli, Ishani; Orav, E John; Weil, Eric; Ferris, Timothy G; Vogeli, Christine

    2018-01-01

    There is growing interest in coordinating care for high-risk patients through care management programs despite inconsistent results on cost reduction. Early evidence suggests patient-centered benefits, but we know little about how participants engage with the programs and what aspects they value. To explore care management program participants' awareness and perceived utility of program offerings. Cross-sectional telephone survey administered December 2015-January 2016. Patients enrolled in a Boston-area primary care-based care management program. Our main outcome was the number of topics in which patients reported having "very helpful" interactions with their care team in the past year. We analyzed awareness of one's care manager as an intermediate outcome, and then as a primary predictor of the main outcome, along with patient demographics, years in the program, attitudes, and worries as secondary predictors. The survey response rate was 45.8% (n = 1220); non-respondents were similar to respondents. More respondents reported worrying about family (72.8%) or financial issues (52.5%) than about their own health (41.6%). Seventy-four percent reported care manager awareness, particularly women (OR 1.33, 95% CI 1.01-1.77) and those with more years in the program (OR 1.16, 95% CI 1.03-1.30). While interaction rates ranged from 19.8% to 72.4% across topics, 81.3% rated at least one interaction as very helpful. Those who were aware of their care manager reported very helpful interactions on more topics (OR 2.77, 95% CI 2.15-3.56), as did women (OR 1.25, 95% CI 1.00-1.55), younger respondents (OR 0.98 for older age, 95% CI 0.97-0.99), and those with higher risk scores (OR 1.04, 95% CI 1.02-1.06), preference for deferring treatment decisions to doctors (OR 2.00, 95% CI 1.60-2.50), and reported control over their health (OR 1.67, 95% CI 1.33-2.10). High-risk patients reported helpful interactions with their care team around medical and social determinants of health

  16. Risk management

    International Nuclear Information System (INIS)

    Magne, L.

    1999-01-01

    There is always a risk of an accident occurring at a nuclear power plant, however small. The problem lies in estimating the probability of it occurring. The method of probabilistic safety assessment provides this estimate, and by identifying the sources of potential risk, makes it possible to prevent them from occurring. It is not, however, a substitute for other decision-making processes. (author)

  17. NASA's Risk Management System

    Science.gov (United States)

    Perera, Jeevan S.

    2011-01-01

    Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  18. Nursing involvement in risk and patient safety management in Primary Care.

    Science.gov (United States)

    Coronado-Vázquez, Valle; García-López, Ana; López-Sauras, Susana; Turón Alcaine, José María

    Patient safety and quality of care in a highly complex healthcare system depends not only on the actions of professionals at an individual level, but also on interaction with the environment. Proactive risk management in the system to prevent incidents and activities targeting healthcare teams is crucial in establishing a culture of safety in centres. Nurses commonly lead these safety strategies. Even though safety incidents are relatively infrequent in primary care, since the majority are preventable, actions at this level of care are highly effective. Certification of services according to ISO standard 9001:2008 focuses on risk management in the system and its use in certifying healthcare centres is helping to build a safety culture amongst professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  19. NASA's Risk Management System

    Science.gov (United States)

    Perera, Jeevan S.

    2013-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  20. Clinical risk management and patient safety education for nurses: a critique.

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2007-04-01

    Nurses have a pivotal role to play in clinical risk management (CRM) and promoting patient safety in health care domains. Accordingly, nurses need to be prepared educationally to manage clinical risk effectively when delivering patient care. Just what form the CRM and safety education of nurses should take, however, remains an open question. A recent search of the literature has revealed a surprising lack of evidence substantiating models of effective CRM and safety education for nurses. In this paper, a critical discussion is advanced on the question of CRM and safety education for nurses and the need for nurse education in this area to be reviewed and systematically researched as a strategic priority, nationally and internationally. It is a key contention of this paper that without 'good' safety education research it will not be possible to ensure that the educational programs that are being offered to nurses in this area are evidence-based and designed in a manner that will enable nurses to develop the capabilities they need to respond effectively to the multifaceted and complex demands that are inherent in their ethical and professional responsibilities to promote and protect patient safety and quality care in health care domains.

  1. Primary care physician management, referral, and relations with specialists concerning patients at risk for cancer due to family history.

    Science.gov (United States)

    Wood, M E; Flynn, B S; Stockdale, A

    2013-01-01

    Risk stratification based on family history is a feature of screening guidelines for a number of cancers and referral guidelines for genetic counseling/testing for cancer risk. Our aim was to describe primary care physician perceptions of their role in managing cancer risk based on family history. Structured interviews were conducted by a medical anthropologist with primary care physicians in 3 settings in 2 north-eastern states. Transcripts were systematically analyzed by a research team to identify major themes expressed by participants. Forty interviews were conducted from May 2003 through May 2006. Physicians provided a diversity of views on roles in management of cancer risk based on family history, management practices and patient responses to risk information. They also provided a wide range of perspectives on criteria used for referral to specialists, types of specialists referred to and expected management roles for referred patients. Some primary care physicians appeared to make effective use of family history information for cancer risk management, but many in this sample did not. Increased focus on efficient assessment tools based on recognized guidelines, accessible guides to management options, and patient education and decision aids may be useful directions to facilitate broader use of family history information for cancer risk management. Copyright © 2013 S. Karger AG, Basel.

  2. Lead Toxicity in the Pediatric Patient with Sickle Cell Disease: Unique Risks and Management.

    Science.gov (United States)

    Jung, Josephine Misun; Peddinti, Radhika

    2018-01-01

    Lead toxicity is the result of lead ingestion, one of the most common ingestions in the pediatric population. Nationwide and statewide efforts to recognize and curtail this epidemic have led to declining rates of toxicity. In patients with sickle cell disease (SCD), lead toxicity can be an elusive diagnosis due to overlapping symptom profiles, and inconsistent follow-up with a primary care physician can make the diagnosis even more difficult. In this article, two illustrative cases of lead toxicity in patients with SCD are described. The discussion reviews the current risk factors, screening, and inpatient management of lead toxicity, as well as describing the unique and sometimes confounding presentations of lead toxicity versus sickle cell crisis. [Pediatr Ann. 2018;47(1):e36-e40.]. Copyright 2018, SLACK Incorporated.

  3. Enterprise risk management

    Energy Technology Data Exchange (ETDEWEB)

    Eaton, C. [Enbridge, Calgary, AB (Canada)

    2015-07-01

    Enterprise risk management (ERM) is a relative new, holistic and strategic approach for managing risks in modern organizations. ERM builds on and extends traditional risk management (RM). Risk is the effect of uncertainty on objectives - positive and/or negative. Risk management is a set of practices used to understand and address risk. ERM is a form of RM that emphasizes risk aggregation and integration. Risk aggregation is combining individual risks into categories ({sup r}olled up{sup )}. risk integration is embedding RM into organizational contexts ({sup b}uilt in{sup )}.

  4. Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system.

    Science.gov (United States)

    Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J

    2015-12-15

    Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.

  5. Project Risk Management

    Science.gov (United States)

    Jr., R. F. Miles

    1995-01-01

    Project risk management is primarily concerned with performance, reliability, cost, and schedule. Environmental risk management is primarily concerned with human health and ecological hazards and likelihoods. This paper discusses project risk management and compares it to environmental risk management, both with respect to goals and implementation. The approach of the Jet Propulsion Laboratory to risk management is presented as an example of a project risk management approach that is an extension to NASA NHB 7120.5: Management of Major System Programs and Projects.

  6. Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events

    Directory of Open Access Journals (Sweden)

    Turakhia Mintu P

    2008-07-01

    Full Text Available Abstract Background Adherence to clinical practice guidelines for management of cardiovascular disease (CVD is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine the association between physician characteristics and cardiovascular risk management. Methods A case vignette survey focused on cardiovascular disease risk management was distributed to a random sample of 12,000 U.S. family physicians and general internists between November and December 2006. Results Responses from a total of 888 practicing primary care physicians who see 60 patients per week were used for analysis. In an asymptomatic patient at low risk for cardiovascular event, 28% of family physicians and 37% of general internists made guideline-based preventive choices for no antiplatelet therapy (p Conclusion Despite the benefits demonstrated for managing cardiovascular risks, gaps remain in primary care practitioners' management of risks according to guideline recommendations. Innovative educational approaches that address barriers may facilitate the implementation of guideline-based recommendations in CVD risk management.

  7. Clinical pharmacy cardiac risk service for managing patients with coronary artery disease in a health maintenance organization.

    Science.gov (United States)

    Sandhoff, Brian G; Nies, Leslie K; Olson, Kari L; Nash, James D; Rasmussen, Jon R; Merenich, John A

    2007-01-01

    A clinical pharmacy service for managing the treatment of coronary artery disease in a health maintenance organization is described. Despite the proven benefits of aggressive risk factor modification for patients with coronary artery disease (CAD), there remains a treatment gap between consensus- and evidence-based recommendations and their application in patient care. In 1998, Kaiser Permanente of Colorado developed the Clinical Pharmacy Cardiac Risk Service (CPCRS) to focus on the long-term management of patients with CAD to improve clinical outcomes. The primary goals of the CPCRS are to increase the number of CAD patients on lipid-lowering therapy, manage medications shown to decrease the risk of future CAD-related events, assist in the monitoring and control of other diseases that increase cardiovascular risk, provide patient education and recommendations for nonpharmacologic therapy, and act as a CAD information resource for physicians and other health care providers. Using an electronic medical record and tracking database, the service works in close collaboration with primary care physicians, cardiologists, cardiac rehabilitation nurses, and other health care providers to reduce cardiac risk in the CAD population. Particular attention is given to dyslipidemia, blood pressure, diabetes mellitus, and tobacco cessation. Treatment with evidence-based regimens is initiated and adjusted as necessary. Over 11,000 patients are currently being followed by the CPCRS. A clinical pharmacy service in a large health maintenance organization provides cardiac risk reduction for patients with CAD and helps close treatment gaps that may exist for these patients.

  8. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders

    DEFF Research Database (Denmark)

    Agca, R; Heslinga, S C; Rollefstad, S

    2017-01-01

    and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing...... was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist...... is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which...

  9. Risk management and safety

    International Nuclear Information System (INIS)

    Niehaus, F.; Novegno, A.

    1985-01-01

    Risk assessment, including probabilistic analyses, has made great progress over the past decade. In spite of the inherent uncertainties it has now become possible to utilize methods and results for decision making at various levels. This paper will, therefore, review risk management in industrial installations, risk management for energy safety policy and prospects of risk management in highly industrialized areas. (orig.) [de

  10. NSAID-induced gastro-duodenal bleeding: risk of development and patient management

    Directory of Open Access Journals (Sweden)

    A P Rebrov

    2008-01-01

    Full Text Available A.P. Rebrov, E.l. Koshkina, A.A. Antonyan, R.V. Lyakisheva NSAID-induced gastro-duodenal bleeding: risk of development and patient management. Retrospective analysis of gastro-duodenal bleeding (GDB report forms was performed. Pts admitted to the department of internal diseases of Saratov regional clinical hospital from 1999 to 2004 were included. 354 cases of GDB were recorded ( 282 from 1999 to 2001 and 72 from 2002 to 2004. Cause ofbleeding, influence of NSAID administration on appearance and relapse ofbleeding, source ofbleeding and pt management were assessed. NSAJD administration was considered trigger factor of GDB in 24% in 1999-2001 and in 18% in 2002-2004. The results of the study show some tendency to decrease of NSAID- induced gastropathy frequency among causes of GDB. The main risk factors ofbleeding during NSAID treatment were age of more than 30 years, ulcer history, the first month of NSAID administration. GDB frequency did not depend on regularity of treatment and NSAID dosage.

  11. Risk management at university

    OpenAIRE

    Ivanova, H.; Abramovich, S.

    2013-01-01

    This article observes the basic recommendations for the risk management system in higher education as an example Yanka Kupala State University of Grodno. Consider the risk-management standard that based in a process approach

  12. Management of business risks

    OpenAIRE

    BAZARBAY A.

    2015-01-01

    The article presents methodological ideas concerning the problem of risk management. Special attention is paid to increasing of enterprises' operating efficiency by means of risk-management system development in business organizations.

  13. Rethinking risk management

    International Nuclear Information System (INIS)

    Kloman, H.F.

    1992-01-01

    The purpose of this paper is to bring together the ideas of those who currently practice the many different forms of risk management on a global basis. These forms include guidance of public policy on macro risks, risk financing and insurance for many larger commercial organizations, managing credit, currency and interest rate risks for financial institutions, plus other extensions of risk management including security, quality control, and quality assurance in a health-care environment

  14. Commodity risk management

    Directory of Open Access Journals (Sweden)

    Hilary Till

    2016-09-01

    Full Text Available This article discusses the practical issues involved in applying a disciplined risk management methodology to commodity futures trading. Accordingly, the paper shows how to apply methodologies derived from both conventional asset management and hedge fund management to futures trading. The article also discusses some of the risk management issues that are unique to leveraged futures trading.

  15. Are gastroenterologists less tolerant of treatment risks than patients? Benefit-risk preferences in Crohn's disease management.

    Science.gov (United States)

    Johnson, F Reed; Hauber, Brett; Özdemir, Semra; Siegel, Corey A; Hass, Steven; Sands, Bruce E

    2010-10-01

    Crohn's disease is a serious and debilitating gastrointestinal disorder with a high, unmet need for new treatments. Biologic agents have the potential to alter the natural course of Crohn's disease but present known risks of potential serious adverse events (SAEs). Previous studies have shown that patients are willing to accept elevated SAE risks in exchange for clinical efficacy. Gastroenterologists and patients may have similar goals of maximizing treatment benefit while minimizing risk; however, gastroenterologists may assess the relative importance of risk differently than patients. To (a) understand how gastroenterologists caring for patients with Crohn's disease balance benefits and risks in their treatment decisions and (b) compare their treatment preferences with those of adult patients with Crohn's disease. Both patient and gastroenterologist treatment preferences were elicited using a web-based, choice-format conjoint survey instrument. The conjoint questions required subjects to choose between 2 hypothetical treatment options with differing levels of treatment attributes. Patients evaluated the treatment options for themselves, and gastroenterologists evaluated the treatment options for each of 3 hypothetical patient types: (a) female aged 25 years with no history of Crohn's disease surgery (young), (b) male aged 45 years with 1 Crohn's disease surgery (middleaged), and (c) female older than 70 years with 4 Crohn's disease surgeries (older). Treatment attributes represented the expected outcomes of treatment: severity of daily symptoms, frequency of flare-ups, serious disease complications, oral steroid use, and the risks of 3 potentially fatal SAEs - lymphoma, serious or opportunistic infections, and progressive multifocal leukoencephalopathy (PML) - during 10 years of treatment. Maximum acceptable risk (MAR), defined as the highest level of SAE risk that subjects would accept in return for a given improvement in efficacy (i.e., the increase in

  16. Risk management of QTc-prolongation in patients receiving haloperidol: an epidemiological study in a University hospital in Belgium.

    Science.gov (United States)

    Vandael, Eline; Vandenberk, Bert; Vandenberghe, Joris; Spriet, Isabel; Willems, Rik; Foulon, Veerle

    2016-04-01

    Many drugs, including haloperidol, are linked with a risk of QTc-prolongation, which can lead to Torsade de Pointes and sudden cardiac death. To investigate the prevalence of concomitant risk factors for QTc-prolongation in patients treated with haloperidol, and the use of safety measures to minimize this risk. University Hospitals of Leuven, Belgium. Methods A retrospective epidemiological study was performed. On 15 consecutive Mondays, all patients with a prescription for haloperidol were included. A risk score for QTc-prolongation, inspired by the pro-QTc score of Haugaa et al., was calculated based on gender, comorbidities, lab results and concomitant QTc-prolonging drugs (each factor counting for one point). Available electrocardiograms before and during the treatment of haloperidol were registered. Management of the risk of QTc-prolongation. Two hundred twenty-two patients were included (59.0 % men, median age 77 years) of whom 26.6 % had a risk score of ≥4 (known to significantly increase the mortality). Overall, 24.3 % received haloperidol in combination with other drugs with a known risk of Torsade de Pointes. Half of the patients had an electrocardiogram in the week before the start of haloperidol; only in one-third a follow-up electrocardiogram during haloperidol treatment was performed. Of the patients with a moderately (n = 41) or severely (n = 14) prolonged QTc-interval before haloperidol, 48.8 % and 42.9 % respectively had a follow-up electrocardiogram. In patients with a risk score ≥4, significantly more electrocardiograms were taken before starting haloperidol (p = 0.020). Although many patients had risk factors for QTc-prolongation (including the use of other QTc-prolonging drugs) or had a prolonged QTc on a baseline electrocardiogram, follow-up safety measures were limited. Persistent efforts should be taken to develop decision support systems to manage this risk.

  17. Certification and risk management

    International Nuclear Information System (INIS)

    Villanueva Fernandez, M.

    2015-01-01

    Nowadays more organizations are increasingly aware of the importance of properly managing the uncertainty of its activities and build competitive advantages through the identification, assessment and management of risks that they face. Risk management is also an aspect of great importance within the new version of ISO fact it is one of the most innovative and also the most laborious, because an appropriate risk management achieves expected results and customer satisfaction. In conclusion, risk management is a new field of business and can be considered a cross-cutting component for other relevant factors of organizational change management. (Author)

  18. Associations between patients' adherence and GPs' attitudes towards risk, statin therapy and management of non-adherence

    DEFF Research Database (Denmark)

    Barfoed, Benedicte L; Paulsen, Maja S; Christensen, Palle M

    2016-01-01

    BACKGROUND: Previous studies suggest that doctors' personal lifestyle, risk taking personality and beliefs about risk reducing therapies may affect their clinical decision-making. Whether such factors are further associated with patients' adherence with medication is largely unknown. OBJECTIVE...... statin treatment as important, how they managed non-adherence and whether non-adherence annoyed them. The Jackson Personality Inventory-revised was used to measure risk attitude. The GPs' responses were linked to register data on their patients' redeemed statin prescriptions. Mixed effect logistic...

  19. [Global risk management].

    Science.gov (United States)

    Sghaier, W; Hergon, E; Desroches, A

    2015-08-01

    Risk management is a fundamental component of any successful company, whether it is in economic, societal or environmental aspect. Risk management is an especially important activity for companies that optimal security challenge of products and services is great. This is the case especially for the health sector institutions. Risk management is therefore a decision support tool and a means to ensure the sustainability of an organization. In this context, what methods and approaches implemented to manage the risks? Through this state of the art, we are interested in the concept of risk and risk management processes. Then we focus on the different methods of risk management and the criteria for choosing among these methods. Finally we highlight the need to supplement these methods by a systemic and global approach including through risk assessment by the audits. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. [A systemic risk analysis of hospital management processes by medical employees--an effective basis for improving patient safety].

    Science.gov (United States)

    Sobottka, Stephan B; Eberlein-Gonska, Maria; Schackert, Gabriele; Töpfer, Armin

    2009-01-01

    Due to the knowledge gap that exists between patients and health care staff the quality of medical treatment usually cannot be assessed securely by patients. For an optimization of safety in treatment-related processes of medical care, the medical staff needs to be actively involved in preventive and proactive quality management. Using voluntary, confidential and non-punitive systematic employee surveys, vulnerable topics and areas in patient care revealing preventable risks can be identified at an early stage. Preventive measures to continuously optimize treatment quality can be defined by creating a risk portfolio and a priority list of vulnerable topics. Whereas critical incident reporting systems are suitable for continuous risk assessment by detecting safety-relevant single events, employee surveys permit to conduct a systematic risk analysis of all treatment-related processes of patient care at any given point in time.

  1. Multi-Centre Study on Cardiovascular Risk Management on Patients Undergoing AAA Surveillance.

    Science.gov (United States)

    Saratzis, A; Dattani, N; Brown, A; Shalhoub, J; Bosanquet, D; Sidloff, D; Stather, P

    2017-07-01

    The risk of cardiovascular events and death in patients with abdominal aortic aneurysms (AAA) is high. Screening has been introduced to reduce AAA related mortality; however, after AAA diagnosis, cardiovascular modification may be as important to patient outcomes as surveillance. The aim of this study was to assess cardiovascular risk reduction in patients with small AAA. Institutional approval was granted for The Vascular and Endovascular Research Network (VERN) to retrospectively collect data pertaining to cardiovascular risk reduction from four tertiary vascular units in England. Patients with small AAA (January 2013-December 2015) were included. Demographic details, postcode, current medications, and smoking status were recorded using a bespoke electronic database and analysed. In a secondary analysis VERN contacted all AAA screening units in England and Wales to assess their current protocols relating to CV protection. In total, 1053 patients were included (mean age 74 ± 9 years, all men). Of these, 745 patients (70.8%) had been prescribed an antiplatelet agent and 787 (74.7%) a statin. Overall, only 666 patients (63.2%) were prescribed both a statin and antiplatelet. Two hundred and sixty eight patients (32.1%) were current smokers and the proportion of patients who continued to smoke decreased with age. Overall, only 401 patients (48.1%) were prescribed a statin, antiplatelet, and had stopped smoking. In the secondary analysis 38 AAA screening units (84% national coverage) replied. Thirty-one units (82%) suggest changes to the patient's prescription; however, none monitor compliance with these recommendations or assess whether the general practitioner has been made aware of the AAA diagnosis or prescription advice. Many patients with small AAA are not prescribed an antiplatelet/statin, and still smoke cigarettes, and therefore remain at high risk of cardiovascular morbidity and mortality. National guidance to ensure this high risk group of patients is

  2. Management of Hypercholesterolemia, Appropriateness of Therapeutic Approaches and New Drugs in Patients with High Cardiovascular Risk.

    Science.gov (United States)

    Agabiti Rosei, Enrico; Salvetti, Massimo

    2016-09-01

    Control of lipid levels is one of the most effective strategies for cardiovascular (CV) event prevention. In fact, many clinical trials have clearly demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, primarily with statins, reduces major CV events and mortality. The evidence from these trials has been useful in designing the cholesterol treatment guidelines, which are mainly aimed at preventing and managing cardiovascular disease (CVD). However, available data indicate that a large proportion of patients fail to achieve lipid goals, and this is particularly frequent in patients at high or very high CV risk. Furthermore, owing to side effects, a significant percentage of patients cannot tolerate statin treatment. Hence, researchers have focused their attention on novel LDL-C-lowering agents that act via mechanisms distinct from that of statins. Among the new compounds under investigation, the monoclonal antibodies to proprotein convertase subtilisin/kexin type 9 (PCSK9) seem particularly promising, having recently been shown to be well tolerated and highly effective at lowering LDL-C, with a possible effect on the occurrence of CV events. Currently, alirocumab is approved by the US Food and Drug Administration (FDA) as an adjunct to diet and maximally tolerated statin therapy for use in adults with heterozygous familial hypercholesterolemia (FH) or those with atherosclerotic CV disease who require additional LDL-C lowering; it has also been recently approved by the European Medicines Agency (EMA) for use in patients with heterozygous FH, non-familial hypercholesterolemia or mixed dyslipidemia in whom statins are ineffective or not tolerated. Evolocumab is approved by the FDA as an adjunct to diet and maximally tolerated statins for adults with hetero- and homozygous FH and those with atherosclerotic CV disease who require additional lowering of LDL-C, and by the EMA in adults with primary hypercholesterolemia or mixed dyslipidemia, as an adjunct

  3. Agile risk management

    CERN Document Server

    Moran, Alan

    2014-01-01

    This work is the definitive guide for IT managers and agile practitioners. It elucidates the principles of agile risk management and how these relate to individual projects. Explained in clear and concise terms, this synthesis of project risk management and agile techniques is illustrated using the major methodologies such as XP, Scrum and DSDM.Although the agile community frequently cites risk management, research suggests that risk is often narrowly defined and, at best, implicitly treated, which in turn leads to an inability to make informed decisions concerning risk and reward and a poor u

  4. Risk management in Takaful

    OpenAIRE

    Akhter, Waheed

    2010-01-01

    Risk management is of vital importance in Islam and Takāful provides a way to manage risks in business according to Sharī’ah principles. This research paper attempts to identify various types of risks involved in Takāful business that affect operational and investment functions of Takāful operators across the globe. It lays down criteria for Takāful operator to manage those risks effectively. However, Takāful operators often face difficulty in managing market and credit risks as Sharī’ah comp...

  5. Financial Risk Management

    OpenAIRE

    Catalin-Florinel Stanescu; Laurentiu Mircea Simion

    2011-01-01

    Concerns about the financial risk is increasing. In this climate, companies of all types and sizes want a robust framework for financial risk management to meet compliance requirements, contribute to better decision making and increase performance. Financial risk management professionals working with financial institutions and other corporate clients to achieve these objectives.

  6. Intensive case management for high-risk patients with first-episode psychosis: service model and outcomes.

    Science.gov (United States)

    Brewer, Warrick J; Lambert, Timothy J; Witt, Katrina; Dileo, John; Duff, Cameron; Crlenjak, Carol; McGorry, Patrick D; Murphy, Brendan P

    2015-01-01

    The first episode of psychosis is a crucial period when early intervention can alter the trajectory of the young person's ongoing mental health and general functioning. After an investigation into completed suicides in the Early Psychosis Prevention and Intervention Centre (EPPIC) programme, the intensive case management subprogramme was developed in 2003 to provide assertive outreach to young people having a first episode of psychosis who are at high risk owing to risk to self or others, disengagement, or suboptimal recovery. We report intensive case management model development, characterise the target cohort, and report on outcomes compared with EPPIC treatment as usual. Inclusion criteria, staff support, referral pathways, clinical review processes, models of engagement and care, and risk management protocols are described. We compared 120 consecutive referrals with 50 EPPIC treatment as usual patients (age 15-24 years) in a naturalistic stratified quasi-experimental real-world design. Key performance indicators of service use plus engagement and suicide attempts were compared between EPPIC treatment as usual and intensive case management, and psychosocial and clinical measures were compared between intensive case management referral and discharge. Referrals were predominately unemployed males with low levels of functioning and educational attainment. They were characterised by a family history of mental illness, migration and early separation, with substantial trauma, history of violence, and forensic attention. Intensive case management improved psychopathology and psychosocial outcomes in high-risk patients and reduced risk ratings, admissions, bed days, and crisis contacts. Characterisation of intensive case management patients validated the clinical research focus and identified a first episode of psychosis high-risk subgroup. In a real-world study, implementation of an intensive case management stream within a well-established first episode of psychosis

  7. Advanced echocardiography and clinical surrogates to risk stratify and manage patients with structural heart disease

    NARCIS (Netherlands)

    Debonnaire, Philippe Jean Marc Rita

    2016-01-01

    Part I focuses on the potential role of 3-dimensional echocardiography. At first a clinical risk score model for prediction of outcome in patients undergoing TAVI is presented (Chapter 2). Second the role of 3D-echocardiography is explored in depth in patients with mitral valve disease. Different

  8. Identification and management of patients at increased risk of osteoporotic fracture

    DEFF Research Database (Denmark)

    Kanis, J A; Cooper, C; Rizzoli, R

    2017-01-01

    where the risk of a subsequent fracture following a first fracture is high. Consequently, there is a significant treatment gap between those who would benefit from treatment and those who receive it, which urgently needs to be addressed so that the burden of disease can be reduced. Conclusions......Summary: Osteoporosis represents a significant and increasing healthcare burden in Europe, but most patients at increased risk of fracture do not receive medication, resulting in a large treatment gap. Identification of patients who are at particularly high risk will help clinicians target...... appropriate treatment more precisely and cost-effectively, and should be the focus of future research. Introduction: The purpose of the study was to review data on the identification and treatment of patients with osteoporosis at increased risk of fracture. Methods: A working group convened by the European...

  9. Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

    Science.gov (United States)

    Swanson, Jeffrey; Weissert, William G

    2017-08-01

    Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

  10. Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes.

    Science.gov (United States)

    Cho, Sukyung; Kim, Minkyeong; Park, Kyong

    2018-02-01

    Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ≥ 30 years, were categorized according to the duration of their illness (accounting for the complex survey design of the KNHANES. In the multivariable adjusted models, patients with a longer duration (≥ 10 years) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

  11. Value of risk management

    OpenAIRE

    Vik, Marie Amdal

    2012-01-01

    Master's thesis in Risk management The overall aim of this study was to discuss the validity of the hypothesis that risk management contributes with added value to projects and the enterprise holding the projects, and consequently to the enterprise’s stakeholders. To examine this hypothesis, a case study of three projects taken from the same portfolio at Statoil was selected. The projects were said to have an active risk management. Data was collected from the project’s documentation as...

  12. Supply Cain Risk Management

    OpenAIRE

    Goodwin, Les

    2011-01-01

    “The management of supply chain risk is crucial to any business, more so to Rolls Royce who face an almost doubling of load within the next 10 years. So what is supply chain risk management and how well is it deployed within an operational business of Rolls Royce? What are the tools and techniques available and what are the key issues around implementing world class supply chain risk management with a Supply Chain Unit within Rolls Royce?”

  13. Supply chain risk management

    OpenAIRE

    Christian Hollstein; Frank Himpel

    2013-01-01

    Background: Supply chain risk management increasingly gains prominence in many international industries. In order to strengthen supply chain structures, processes, and networks, adequate potentials for risk management need to be built (focus on effective logistics) and to be utilized (focus on efficient logistics). Natural-based disasters, such as the case of Fukushima, illustrate how crucial risk management is. Method: By aligning a theoretical-conceptual framework with empirical-induct...

  14. Exchange Risk Management Policy

    CERN Document Server

    2005-01-01

    At the Finance Committee of March 2005, following a comment by the CERN Audit Committee, the Chairman invited the Management to prepare a document on exchange risk management policy. The Finance Committee is invited to take note of this document.

  15. Identifying and Managing Risk.

    Science.gov (United States)

    Abraham, Janice M.

    1999-01-01

    The role of the college or university chief financial officer in institutional risk management is (1) to identify risk (physical, casualty, fiscal, business, reputational, workplace safety, legal liability, employment practices, general liability), (2) to develop a campus plan to reduce and control risk, (3) to transfer risk, and (4) to track and…

  16. Risk management overview

    International Nuclear Information System (INIS)

    McGovern, S.

    1995-01-01

    Launching of the first natural gas contract by the New York Mercantile Exchange (NYMEX) in April 1990 was a huge success which allowed natural gas to surpass crude oil as the most successful launch of any commodity contract. Despite this unprecedented initial success it must be kept in mind that in a competitive marketplace there are risks of many kinds (market risks, price risks, basis risks, currency risks and timing risks), that parties must deal with in everyday operations. The concept of risk management was defined, techniques and issues in risk management were explained, a glossary of fully explained industry terms, and basic financial tools most often used in risk management, were provided. 11 figs

  17. Managing risk in healthcare: understanding your safety culture using the Manchester Patient Safety Framework (MaPSaF).

    Science.gov (United States)

    Parker, Dianne

    2009-03-01

    To provide sufficient information about the Manchester Patient Safety Framework (MaPSaF) to allow healthcare professionals to assess its potential usefulness. The assessment of safety culture is an important aspect of risk management, and one in which there is increasing interest among healthcare organizations. Manchester Patient Safety Framework offers a theory-based framework for assessing safety culture, designed specifically for use in the NHS. The framework covers multiple dimensions of safety culture, and five levels of safety culture development. This allows the generation of a profile of an organization's safety culture in terms of areas of relative strength and challenge, which can be used to identify focus issues for change and improvement. Manchester Patient Safety Framework provides a useful method for engaging healthcare professionals in assessing and improving the safety culture in their organization, as part of a programme of risk management.

  18. Endovascular Management of Infected Femoral Artery Pseudoaneurysms in High-Risk Patients: A Case Series

    Energy Technology Data Exchange (ETDEWEB)

    D’Oria, Mario, E-mail: mario.doria88@outlook.com; Sgorlon, Giada; Calvagna, Cristiano; Zamolo, Francesca; Chiarandini, Stefano; Adovasio, Roberto; Griselli, Filippo [University Hospital of Cattinara, Vascular and Endovascular Surgery Unit (Italy)

    2017-04-15

    We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period. Endovascular therapy represents a feasible treatment option for IFAPs in those patients for whom the risk of open surgical repair would be prohibitive, especially under urgent circumstances.

  19. Redefining diabetes and the concept of self-management from a patient's perspective: implications for disease risk factor management.

    Science.gov (United States)

    Masupe, T K; Ndayi, K; Tsolekile, L; Delobelle, P; Puoane, T

    2018-02-01

    The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers. Data collection employed in-depth interviews, focus group discussions (FGDs) using structured interviews and FGD topic guides. Thematic data analysis was done to identify recurrent themes. Themes identified: knowledge and awareness about T2DM; health-seeking behaviour; weight perceptions; healthy lifestyles; self-management; health education needs and health care provider experiences. Patients defined T2DM as a physically and emotionally dangerous disease caused by socio-cultural factors, influenced by the sufferers' food and socio-cultural environment with significance placed on physical, social and emotional effects of T2DM diagnosis. Patient-centred definition of T2DM is key to enhancing T2DM self-management. Patients suggested that personally rewarding benefits of physical activity and healthy diet such as anti-ageing, brain boosting, energy boosting which are commonly harnessed by food, tobacco and beauty industry should be considered in T2DM self-management strategies.

  20. Perspectives: Intellectual Risk Management

    Science.gov (United States)

    Hall, James C.

    2013-01-01

    Ask a college administrator about students and risk management, and you're likely to get a quick and agitated speech about alcohol consumption and bad behavior or a meditation on mental health and campus safety. But in colleges and universities, we manage intellectual risk-taking too. Bring that up, and you'll probably get little out of that same…

  1. Risk Management and Simulation

    DEFF Research Database (Denmark)

    Skovmand, David

    2014-01-01

    Review of: Risk Management and Simulation / Aparna Gupta. Boca Raton, FL: CRC Press, 2013, xxix + 491 pp., $99.95(H), ISBN: 978-1-4398-3594-4.......Review of: Risk Management and Simulation / Aparna Gupta. Boca Raton, FL: CRC Press, 2013, xxix + 491 pp., $99.95(H), ISBN: 978-1-4398-3594-4....

  2. Agricultural risk management

    DEFF Research Database (Denmark)

    Lund, Mogens; Oksen, Arne; Larsen, Torben U.

    2005-01-01

    A new model for risk management in agriculture is described in the paper. The risk model is constructed as a context dependent process, which includes four main phases. The model is aimed at agricultural advisors, who wish to facilitate and disseminate risk management to farmers. It is developed...... and tested by an action research approach in an attempt to make risk management more applicable on family farms. Our obtained experiences indicate that farmers don’t apply probabilistic thinking and other concepts according to formal decision theory....

  3. Management of stroke prevention in canadian patients with atrial fibrillation at moderate to high risk of stroke.

    Science.gov (United States)

    Semchuk, William M; Levac, Brandon; Lara, Muria; Shakespeare, Annabelle; Evers, Thomas; Bolt, Jennifer

    2013-09-01

    Many patients with atrial fibrillation who are at moderate to high risk of stroke do not receive anticoagulation with vitamin K antagonists (VKAs) in accordance with recommendations. To determine (1) why Canadian patients with atrial fibrillation who are potentially eligible for VKA do not receive this therapy, (2) why Canadian primary care physicians discontinue VKA therapy, and (3) why VKA therapy is perceived as difficult to manage. The study involved a chart review of 3 cohorts of patients with nonvalvular atrial fibrillation at moderate to high risk of stroke: patients who had never received VKA treatment (VKA-naive), those whose treatment had been discontinued, and those whose VKA treatment was considered difficult to manage. Charts for 187 patients (mean age 78.4 years, standard deviation 8.9 years) treated at 39 primary care sites were reviewed (62 treatment-naive, 42 with therapy discontinued, and 83 whose therapy was considered difficult to manage). Atrial fibrillation was paroxysmal in 82 (44%) of the patients, persistent in 47 patients (25%), and permanent in 58 (31%). One patient in each of the 3 cohorts had experienced a stroke during the 6 months before study participation. Bleeding events were more frequent among patients who had discontinued VKA therapy than in the other 2 groups. Among those whose therapy was discontinued and those whose therapy was difficult to manage, the mean time in the therapeutic range was 46.3% and 56.4%, respectively. The most common reason for not initiating VKA therapy in treatment-naive patients was the transient nature of atrial fibrillation (25/62 [40%]). The most common reason for discontinuation of VKA therapy was a bleeding event (10/42 [24%]). The presence of a concomitant chronic disease was the most common reason that a patient's therapy was considered difficult to manage (46/83 [55%]). VKA therapy was not initiated or was discontinued for various reasons. Multiple comorbid conditions made management of VKA

  4. Can or must the patient participate to risk management in radiotherapy?; Le patient peut-il et doit-il participer a la gestion des risques en radiotherapie?

    Energy Technology Data Exchange (ETDEWEB)

    Mollo, V.; Pernet, A. [Laboratoire d' ergonomie, centre de recherche sur le travail et le developpement - CRTD-EA 4132, Conservatoire national des arts et metiers - Cnam, 41, rue Gay-Lussac, 75005 Paris, France (France); Moutel, G. [Universite Paris Descartes, 12, rue de l' ecole-de-Medecine, 75270 Paris cedex 06 (France); Unite de medecine sociale et d' ethique medicale, hopital Corentin-Celton, 4, parvis Corentin-Celton, 92133 Issy-les-Moulineaux cedex, France (France); Duchange, N. [Laboratoire d' ethique medicale et de medecine legale, universite Paris Descartes, 45, rue des Saints-Peres, 75006 Paris (France); Giraud, P. [Universite Paris Descartes, 12, rue de l' ecole-de-Medecine, 75270 Paris cedex 06 (France); Service d' oncologie radiotherapie, hopital europeen Georges-Pompidou (HEGP), 20, rue Leblanc, 75015 Paris (France)

    2011-06-15

    Purpose. - The present study aimed at analyzing if patient participation constitutes a promising way of improvement of patient safety, or not. The hypothesis is that patient participation is a means to develop a safety culture based on the cooperation between patients and health care providers, to improve patients' satisfaction and to reduce the costs associated to adverse events. Patients and methods. - A half-day session was organized on this theme during a training of radiotherapy professionals on risk management. Professionals were first distributed in three subgroups according to their specialty (radiation oncologists, radiation physicists and medical technicians), and had to work on four main questions relating to participation, among which the collection of real situations in which patients effectively contributed (positively or negatively) to patient safety. Results were then collectively discussed. Results. - Patient participation allows not only to detect and recover some mistakes or errors made by the professionals (error of identity), but also to decrease patients' risk behaviors (purposely taking the place of another patient in order to be treated faster). However, it must be seen as a possibility offered to patients, and not as an obligation. Conclusion. - Patient participation to patient safety is a field of study, which requires to be developed in order to define the conditions enhancing such participation and to implement a set of actions to improve health care safety by a cooperative management of this one. (authors)

  5. The management object in risk management approaches

    OpenAIRE

    Christiansen, Ulrik

    2013-01-01

    Using a systematic review of the last 55 years of research within risk management this paper explores how risk management as a management technology (methodologies, tools and frameworks to mitigate or manage risks) singles out risks as an object for management in order to make action possible. The paper synthesise by developing a framework of how different views on risk management enable and constrain the knowledge about risk and thus frame the possibilities to measure, analyse an...

  6. The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management.

    Science.gov (United States)

    Reuben, David B; Gazarian, Priscilla; Alexander, Neil; Araujo, Katy; Baker, Dorothy; Bean, Jonathan F; Boult, Chad; Charpentier, Peter; Duncan, Pamela; Latham, Nancy; Leipzig, Rosanne M; Quintiliani, Lisa M; Storer, Thomas; McMahon, Siobhan

    2017-12-01

    In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients' PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  7. Individual Property Risk Management

    Directory of Open Access Journals (Sweden)

    Michael S. Finke

    2010-01-01

    Full Text Available This paper reviews household property risk management and estimates normatively optimal choice under theoretical assumptions. Although risk retention limits are common in the financial planning industry, estimates of optimal risk retention that include both financial and human wealth far exceed limits commonly recommended. Households appear to frame property losses differently from other wealth losses leading to wealth-reducing, excess risk transfer. Possible theoretical explanations for excess sensitivity to loss are reviewed. Differences between observed and optimal risk management imply a large potential gain from improved choice.

  8. Risk factors in surgical management of thoracic empyema in elderly patients.

    Science.gov (United States)

    Hsieh, Ming-Ju; Liu, Yun-Hen; Chao, Yin-Kai; Lu, Ming-Shian; Liu, Hui-Ping; Wu, Yi-Cheng; Lu, Hung-I; Chu, Yen

    2008-06-01

    Although elderly patients with thoracic disease were considered to be poor candidates for thoracotomy before, recent advances in preoperative and postoperative care as well as surgical techniques have improved outcomes of thoracotomies in this patient group. The aim of this study was to investigate surgical risk factors and results in elderly patients (aged > or =70 years) with thoracic empyema. Seventy-one elderly patients with empyema thoracis were enrolled and evaluated from July 2000 to April 2003. The following characteristics and clinical data were analysed: age, sex, aetiology of empyema, comorbid diseases, preoperative conditions, postoperative days of intubation, length of hospital stay after surgery, complications and mortality. Surgical intervention, including total pneumonolysis and evacuation of the pleura empyema cavity, was carried out in all patients. Possible influent risk factors on the outcome were analysed. The sample group included 54 men and 17 women with an average age of 76.8 years. The causes of empyema included parapneumonic effusion (n = 43), lung abscess (n = 8), necrotizing pneumonitis (n = 8), malignancy (n = 5), cirrhosis (n = 2), oesophageal perforation (n = 2), post-traumatic empyema (n = 2) and post-thoracotomy complication (n = 1). The 30-day mortality rate was 11.3% and the in-hospital mortality rate was 18.3% (13 of 71). Mean follow up was 9.4 months and mean duration of postoperative hospitalization was 35.8 days. Analysis of risk factors showed that patients with necrotizing pneumonitis or abscess had the highest mortality rate (10 of 18, 62.6%). The second highest risk factor was preoperative intubation or ventilator-dependency (8 of 18, 44.4%). This study presents the clinical features and outcomes of 71 elderly patients with empyema thoracis who underwent surgical treatment. The 30-day surgical mortality rate was 11.3%. Significant risk factors in elderly patients with empyema thoracis were necrotizing pneumonitis, abscess

  9. Management of Stroke Prevention in Canadian Patients with Atrial Fibrillation at Moderate to High Risk of Stroke

    Science.gov (United States)

    Semchuk, William M; Levac, Brandon; Lara, Muria; Shakespeare, Annabelle; Evers, Thomas; Bolt, Jennifer

    2013-01-01

    Background Many patients with atrial fibrillation who are at moderate to high risk of stroke do not receive anticoagulation with vitamin K antagonists (VKAs) in accordance with recommendations. Objective: To determine (1) why Canadian patients with atrial fibrillation who are potentially eligible for VKA do not receive this therapy, (2) why Canadian primary care physicians discontinue VKA therapy, and (3) why VKA therapy is perceived as difficult to manage. Methods: The study involved a chart review of 3 cohorts of patients with nonvalvular atrial fibrillation at moderate to high risk of stroke: patients who had never received VKA treatment (VKA-naive), those whose treatment had been discontinued, and those whose VKA treatment was considered difficult to manage. Results: Charts for 187 patients (mean age 78.4 years, standard deviation 8.9 years) treated at 39 primary care sites were reviewed (62 treatment-naive, 42 with therapy discontinued, and 83 whose therapy was considered difficult to manage). Atrial fibrillation was paroxysmal in 82 (44%) of the patients, persistent in 47 patients (25%), and permanent in 58 (31%). One patient in each of the 3 cohorts had experienced a stroke during the 6 months before study participation. Bleeding events were more frequent among patients who had discontinued VKA therapy than in the other 2 groups. Among those whose therapy was discontinued and those whose therapy was difficult to manage, the mean time in the therapeutic range was 46.3% and 56.4%, respectively. The most common reason for not initiating VKA therapy in treatment-naive patients was the transient nature of atrial fibrillation (25/62 [40%]). The most common reason for discontinuation of VKA therapy was a bleeding event (10/42 [24%]). The presence of a concomitant chronic disease was the most common reason that a patient’s therapy was considered difficult to manage (46/83 [55%]). Conclusions: VKA therapy was not initiated or was discontinued for various reasons

  10. A modified portfolio diet complements medical management to reduce cardiovascular risk factors in diabetic patients with coronary artery disease.

    Science.gov (United States)

    Keith, Mary; Kuliszewski, Michael A; Liao, Christine; Peeva, Valentina; Ahmed, Mavra; Tran, Susan; Sorokin, Kevin; Jenkins, David J; Errett, Lee; Leong-Poi, Howard

    2015-06-01

    Secondary prevention can improve outcomes in high risk patients. This study investigated the magnitude of cardiovascular risk reduction associated with consumption of a modified portfolio diet in parallel with medical management. 30 patients with type II diabetes, 6 weeks post bypass surgery received dietary counseling on a Modified Portfolio Diet (MPD) (low fat, 8 g/1000 kcal viscous fibres, 17 g/1000 kcal soy protein and 22 g/1000 kcal almonds). Lipid profiles, endothelial function and markers of glycemic control, oxidative stress and inflammation were measured at baseline and following two and four weeks of intervention. Seven patients with no diet therapy served as time controls. Consumption of the MPD resulted in a 19% relative reduction in LDL (1.9 ± 0.8 vs 1.6 ± 0.6 mmol/L, p managed, high risk patients resulted in important reductions in risk factors. Clinical Trials registry number NCT00462436. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  11. Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice

    Science.gov (United States)

    Stam, Hanneke; Harting, Thomas; van der Sluijs, Marjolijn; van Marum, Rob; van der Horst, Henriëtte; van der Wouden, Johannes C.; Maarsingh, Otto R.

    2016-01-01

    Objective For general practitioners (GPs) dizziness is a challenging condition to deal with. Data on the management of dizziness in older patients are mostly lacking. Furthermore, it is unknown whether GPs attempt to decrease Fall Risk Increasing Drugs (FRIDs) use in the management of dizziness in older patients. The aim of this study is to gain more insight into GP’s management of dizziness in older patients, including FRID evaluation and adjustment. Design Data were derived from electronic medical records, obtained over a 12-month period in 2013. Setting Forty-six Dutch general practices. Patients The study sample comprised of 2812 older dizzy patients of 65 years and over. Patients were identified using International Classification of Primary Care codes and free text. Main outcome measures Usual care was categorized into wait-and-see strategy (no treatment initiated); education and advice; additional testing; medication adjustment; and referral. Results Frequently applied treatments included a wait-and-see strategy (28.4%) and education and advice (28.0%). Additional testing was performed in 26.8%; 19.0% of the patients were referred. Of the patients 87.2% had at least one FRID prescription. During the observation period, GPs adjusted the use of one or more FRIDs for 11.7% of the patients. Conclusion This study revealed a wide variety in management strategies for dizziness in older adults. The referral rate for dizziness was high compared to prior research. Although many older dizzy patients use at least one FRID, FRID evaluation and adjustment is scarce. We expect that more FRID adjustments may reduce dizziness and dizziness-related impairment. Key PointsIt is important to know how general practitioners manage dizziness in older patients in order to assess potential cues for improvement.This study revealed a wide variety in management strategies for dizziness in older patients.There was a scarcity in Fall Risk Increasing Drug (FRID) evaluation and adjustment

  12. Coronary computed tomography and triple rule out CT in patients with acute chest pain and an intermediate cardiac risk profile. Part 1: Impact on patient management

    International Nuclear Information System (INIS)

    Gruettner, Joachim; Fink, Christian; Walter, Thomas; Meyer, Mathias; Apfaltrer, Paul; Schoepf, U. Joseph; Saur, Joachim; Sueselbeck, Tim; Traunwieser, Dominik; Takx, Richard

    2013-01-01

    Objective: To evaluate the impact of coronary CT angiography (coronary CTA) or “triple-rule-out” CT angiography (TRO-CTA) on patient management in the work-up of patients with acute chest pain and an intermediate cardiac risk profile. Materials and methods: 100 patients with acute chest pain and an intermediate cardiac risk for acute coronary syndrome (ACS) underwent coronary CTA or TRO-CTA for the evaluation of chest pain. Patients with a high and low cardiac risk profile were not included in this study. All patients with significant coronary stenosis >50% on coronary CTA underwent invasive coronary catheterization (ICC). Important other pathological findings were recorded. All patients had a 90-day follow-up period for major adverse cardiac events (MACE). Results: Based on a negative coronary CTA 60 of 100 patients were discharged on the same day. None of the discharged patients showed MACE during the 90-day follow-up. Coronary CTA revealed a coronary stenosis >50% in 19 of 100 patients. ICC confirmed significant coronary stenosis in 17/19 patients. Among the 17 true positive patients, 9 underwent percutaneous coronary intervention with stent implantation, 7 were received intensified medical therapy, and 1 patient underwent coronary artery bypass surgery. A TRO-CTA protocol was performed in 36/100 patients due to elevated D-dimer levels. Pulmonary embolism was present in 5 patients, pleural effusion of unknown etiology in 3 patients, severe right ventricular dysfunction with pericardial effusion in 1 patient, and an incidental bronchial carcinoma was diagnosed in 1 patient. Conclusion: Coronary CTA and TRO-CTA allow a rapid and safe discharge in the majority of patients presenting with acute chest pain and an intermediate risk for ACS while at the same time identifies those with significant coronary artery stenosis

  13. Coronary computed tomography and triple rule out CT in patients with acute chest pain and an intermediate cardiac risk profile. Part 1: Impact on patient management

    Energy Technology Data Exchange (ETDEWEB)

    Gruettner, Joachim, E-mail: joachim.gruettner@umm.de [Emergency Department, University Medical Center, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Fink, Christian, E-mail: Christian.Fink@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Walter, Thomas, E-mail: thomas.walter@umm.de [Emergency Department, University Medical Center, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Meyer, Mathias, E-mail: mr.meyer.mathias@gmail.com [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Apfaltrer, Paul, E-mail: Paul.Apfaltrer@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, Ashley River Tower, 25 Courtenay Drive, Charleston, SC 29425-2260 (United States); Saur, Joachim, E-mail: joachim.saur@umm.de [1st Department of Medicine (Cardiology), University Medical Center, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Sueselbeck, Tim, E-mail: tim.sueselbeck@umm.de [1st Department of Medicine (Cardiology), University Medical Center, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Traunwieser, Dominik, E-mail: dominik.traunwieser@umm.de [1st Department of Medicine (Cardiology), University Medical Center, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Takx, Richard, E-mail: richard.takx@gmail.com [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, Ashley River Tower, 25 Courtenay Drive, Charleston, SC 29425-2260 (United States); and others

    2013-01-15

    Objective: To evaluate the impact of coronary CT angiography (coronary CTA) or “triple-rule-out” CT angiography (TRO-CTA) on patient management in the work-up of patients with acute chest pain and an intermediate cardiac risk profile. Materials and methods: 100 patients with acute chest pain and an intermediate cardiac risk for acute coronary syndrome (ACS) underwent coronary CTA or TRO-CTA for the evaluation of chest pain. Patients with a high and low cardiac risk profile were not included in this study. All patients with significant coronary stenosis >50% on coronary CTA underwent invasive coronary catheterization (ICC). Important other pathological findings were recorded. All patients had a 90-day follow-up period for major adverse cardiac events (MACE). Results: Based on a negative coronary CTA 60 of 100 patients were discharged on the same day. None of the discharged patients showed MACE during the 90-day follow-up. Coronary CTA revealed a coronary stenosis >50% in 19 of 100 patients. ICC confirmed significant coronary stenosis in 17/19 patients. Among the 17 true positive patients, 9 underwent percutaneous coronary intervention with stent implantation, 7 were received intensified medical therapy, and 1 patient underwent coronary artery bypass surgery. A TRO-CTA protocol was performed in 36/100 patients due to elevated D-dimer levels. Pulmonary embolism was present in 5 patients, pleural effusion of unknown etiology in 3 patients, severe right ventricular dysfunction with pericardial effusion in 1 patient, and an incidental bronchial carcinoma was diagnosed in 1 patient. Conclusion: Coronary CTA and TRO-CTA allow a rapid and safe discharge in the majority of patients presenting with acute chest pain and an intermediate risk for ACS while at the same time identifies those with significant coronary artery stenosis.

  14. Management of the geriatric trauma patient at risk of death: therapy withdrawal decision making.

    Science.gov (United States)

    Trunkey, D D; Cahn, R M; Lenfesty, B; Mullins, R

    2000-01-01

    The management of geriatric injured patients admitted to a trauma center includes the selective decision to provide comfort care only, including withdrawal of therapy, and a choice to not use full application of standard therapies. The decision makers in this process include multiple individuals in addition to the patient. Retrospective review of documentation by 2 blinded reviewers of the cohort of patients over a recent 5-year period (1993-1997). Trauma service of a level I trauma center. A convenience sample of patients aged 65 years and older who died, and whose medical record was available for review. Patients were categorized as having withdrawal of therapy, and documentation in the medical record of who made the assessment decisions and recommendations, and to what extent the processes of care were documented. Among 87 geriatric trauma patients who died, 47 had documentation interpreted as indicating a decision was made to withdraw therapy. In only a few circumstances was the patient capable of actively participating in these decisions. The other individuals involved in recommendations for withdrawal of therapy were, in order of prevalence, the treating trauma surgeon, family members (as proxy reporting the patient's preferences), or a second physician. Documentation regarding the end-of-life decisions was often fragmentary, and in some cases ambiguous. Copies of legal advance directives were rarely available in the medical record, and ethics committee participation was used only once. Withdrawal of therapy is a common event in the terminal care of geriatric injured patients. The process for reaching a decision regarding withdrawal of therapy is complex because in most circumstances patients' injuries preclude their full participation. Standards for documentation of essential information, including patients' preferences and decision-making ability, should be developed to improve the process and assist with recording these complicated decisions that often

  15. Optimizing risk management

    International Nuclear Information System (INIS)

    Kindred, G.W.

    2000-01-01

    Commercial nuclear power plant management is focussed on the safe, efficient, economical production of electricity. To accomplish the safe aspect of the equation, risk must be determined for the operation and maintenance of the facility. To accomplish the efficient aspect of the equation, management must understand those risks and factor risk insights into their decision process. The final piece of the equation is economical which is accomplished by minimizing, plant outage durations and proper utilization of resources. Probabilistic Risk Assessment can provide the risk insights to accomplish all three; safety, efficiency, and economically. How? Safe production of electricity can be quantified by use of PRA modeling and other risk insights that can determine the core damage frequency. Efficient production of electricity can be influenced by providing management with quantified risk insights for use in decision making. And, one example of economical production of electricity is by not having over conservative deterministic based defense in depth approaches to system maintenance and availability. By using risk-informed insights nuclear safety can be quantified and risk can be managed. Confidence in this approach can be achieved by ensuring the content and quality of the PRA is standardized throughout the industry. The time has arrived for Probabilistic Risk Assessment to take an active position as a major role player in the safe, efficient, and economical operation of commercial nuclear power plants. (author)

  16. Internal Audit and Risk Management

    OpenAIRE

    Constantin Nicolae Vasile; Alexandru Georgiana

    2011-01-01

    Internal audit and risk management have the same goal: the control of risk. There are various roles for the internal audit in respect of risk management. The main limitations of internal audit in respect of risk management regards assuming risk management tasks. One of the main issues regarding risk management is to make sure that the key risks are taken into consideration and that the management and the board of the organization take action as needed. Internal audit could give advice to mana...

  17. Risk Management Plan Rule

    Science.gov (United States)

    RMP implements Section 112(r) of the 1990 Clean Air Act amendments, and requires facilities that use extremely hazardous substances to develop a Risk Management Plan and revise/resubmit every five years. Find guidance, factsheets, training, and assistance.

  18. Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jonathan Stokes

    Full Text Available An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis.We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group. Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately, and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14. A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36 and long-term (0.35, 0.04 to 0.66. Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care.This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and

  19. Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Stokes, Jonathan; Panagioti, Maria; Alam, Rahul; Checkland, Kath; Cheraghi-Sohi, Sudeh; Bower, Peter

    2015-01-01

    An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group). Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately), and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14). A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36) and long-term (0.35, 0.04 to 0.66). Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care. This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and considered also the

  20. Making Risk Management Strategic

    DEFF Research Database (Denmark)

    Sax, Johanna; Andersen, Torben Juul

    2018-01-01

    Enterprise risk management (ERM) is an established management practice and is increasing in prominence as more firms spend substantial resources implementing ERM frameworks, partially induced by regulatory requirements. Yet, there is a lack of knowledge as to whether such frameworks add value and...... outcomes. The study develops a new multidimensional measure of adherence to ERM practices where earlier studies typically have relied on dichotomous proxies. We discuss the implications of these findings for ERM practice and strategic management in general....

  1. Governmental management of chemical risk

    International Nuclear Information System (INIS)

    Zimmerman, R.

    1990-01-01

    This book is organized under the following headings: risk management in the government context; legal and regulatory decrees and directives for managing chemical risk; incentive-based approaches for regulating risk; risk management in the federal system; and traditional approaches and new initiatives for managing chemical risk

  2. Risk management versus incentives

    International Nuclear Information System (INIS)

    Aven, E.; Lovas, K.; Osmundsen, P.

    2006-01-01

    Portfolio theory indicates that risk management should take place at the group level. Hedging at the project level or in the individual business areas may lead to suboptimal results. However, the efficiency of a profit centre depends on its management's being able to influence factors that are crucial to the unit's financial results. Price hedging could be one such factor. In the wider perspective, this constitutes part of the balancing between centralisation and decentralisation. This article covers important elements of risk management and incentive design. It goes on to discuss the balancing of overall risk management at the group level and incentive design in profit centres and corporate units. Throughout the article, the oil industry serves as a case. (author)

  3. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model.Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation.Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes.Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  4. Trial of a "credit card" asthma self-management plan in a high-risk group of patients with asthma.

    Science.gov (United States)

    D'Souza, W; Burgess, C; Ayson, M; Crane, J; Pearce, N; Beasley, R

    1996-05-01

    The "credit card" asthma self-management plan provides the adult asthmatic patient with simple guidelines for the self-management of asthma, which are based on the self-assessment of peak expiratory flow rate recordings and symptoms. The study was a trial of the clinical efficacy of the credit card plan in a high-risk group of asthmatic patients. In this "before-and-after" trial, patients discharged from the emergency department of Wellington Hospital, after treatment for severe asthma were invited to attend a series of hospital outpatient clinics at which the credit card plan was introduced. Questionnaires were used to compare markers of asthma morbidity, requirement for emergency medical care, and medication use during the 6-month period before and after intervention with the credit card plan. Of the 30 patients with asthma who attended the first outpatient clinic, 26 (17 women and 9 men) completed the program. In these 26 participants, there was a reduction in both morbidity and requirement for acute medical services: specifically, the proportion waking with asthma more than once a week decreased from 65% to 23% (p = 0.005) and the proportion visiting the emergency department for treatment of severe asthma decreased from 58% to 15% (p = 0.004). The patients attending the clinics commented favorably on the plan, in particular on its usefulness as an educational tool for monitoring and treating their asthma. Although the interpretation of this study is limited by the lack of a randomized control group, the findings are consistent with other evidence that the credit card asthma self-management plan can be an effective and acceptable system for improving asthma care in a high-risk group of adult patients with asthma.

  5. Risk management guide

    International Nuclear Information System (INIS)

    Briscoe, G.J.

    1977-06-01

    Risk management requires an assessment or a knowledge of risk. This, in turn, requires identification of hazards (sources of risk) and a determination of risk (evaluation of the hazard degree). The hazard identification and risk analysis techniques presented in this Guide are, in general, based on the MORT concept that accidents result from unwanted energy flow in the absence of adequate controls and/or barriers. This Guide presents an analytical tree designed to prevent oversight of specific energy sources in risk identification. Hazard identification by field personnel is also discussed. Quantitative risk analysis is discussed in the following section. A method for summary of the risks for each energy classification is given. This method uses a graphical log-normal projection so that low probability events, which are not adequately represented in the experience data, are included in the risk assessment. This permits a more acceptable risk assessment since catastrophes are not ignored, even though the actual risk is only approximated. In addition, a few examples of risk analysis of specific hazards are given. Rudimentary probability and fault tree theory are used in these examples. Total risk assessment and resource allocation and safety performance trend analysis are discussed

  6. Managing Risk and Opportunity

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Garvey, Maxine; Roggi, Oliviero

    outcomes. This topic is timely and of interest both to the academic community as well as to practicing managers, executives, and directors. The volume focuses on contemporary risk leadership issues based on recent research insights but avoids excessive technical language and mathematical formulas. The book...... is framed around the challenges imposed on executives and directors in dealing with an increasingly complex and unpredictable world. This requires a new risk leadership focus that not only avoids the downside risks but also considers ways to exploit the upside potential offered by a dynamic environment....... The underlying logic is built on the principles of financial economics where benefits derive from reducing bankruptcy costs and increasing future cash inflows. This provides a stringent framework for analyzing the effect of different risk management actions and behaviors in effective risk-taking organizations...

  7. Air quality risk management.

    Science.gov (United States)

    Williams, Martin L

    2008-01-01

    Rather than attempt to provide a comprehensive account of air quality risk assessment, as might be found in a textbook or manual, this article discusses some issues that are of current importance in the United Kingdom and the rest of Europe, with special emphasis on risk assessment in the context of policy formulation, and emerging scientific knowledge. There are two pollutants of particular concern and that both pose challenges for risk assessment and policy, and they are particulate matter (PM) and ozone. The article describes some issues for health risk assessment and finally some forward-looking suggestions for future approaches to air quality management.

  8. Managing power risk

    International Nuclear Information System (INIS)

    Rudd, D.C.

    1999-01-01

    Issues regarding the management of financial risks in the electric power market were discussed. The nature of the risk was defined for electricity producers, local utilities, traders/dealers, and brokers, each of which are exposed to different types of risks with the exception of credit risk, which is common to all. The main features of options, swaps, CFDs, bilateral financial contracts, futures contracts and the terms of the NYMEX electricity contract were outlined. Basic derivative strategies, the role of the broker, the elements of emissions trading, and trading strategies for consumers were also explained. 3 fig

  9. Posterior reversible encephalopathy syndrome in liver transplant patients: clinical presentation, risk factors and initial management.

    Science.gov (United States)

    Cruz, R J; DiMartini, A; Akhavanheidari, M; Iacovoni, N; Boardman, J F; Donaldson, J; Humar, A; Bartynski, W S

    2012-08-01

    Posterior reversible encephalopathy syndrome (PRES) is an uncommon but well-known complication after transplantation diagnosed by characteristic radiological features. As limited data on this complex syndrome exist we sought to better define the incidence, clinical presentation and risk factors for PRES in liver transplant (LTx) patients. We conducted a retrospective analysis of 1923 adult LTx recipients transplanted between 2000 and 2010. PRES was diagnosed radiologically in 19 patients (1%), with 84% of cases occurring within 3 months post-LTX. We compared this cohort of PRES patients to 316 other LTx recipients also requiring radiographic imaging within 3 months after LTx for neurological symptoms. Seizure was the most common clinical manifestation in the PRES group (88% vs. 16%, pliver disease and infection/sepsis. These factors may be related to a common pathway of vascular dysregulation/damage that appears to characterize this complex syndrome. Intracranial bleeding and seizures may be the end result of these phenomena. The relationship of these associated factors to the hypothesized pathophysiology of PRES is discussed. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. Current state of cardiac rehabilitation in Germany: patient characteristics, risk factor management and control status, by education level.

    Science.gov (United States)

    Bestehorn, Kurt; Jannowitz, Christina; Horack, Martin; Karmann, Barbara; Halle, Martin; Völler, Heinz

    2011-01-01

    After the acute hospital stay, most cardiac patients in Germany are transferred for a 3-4-week period of inpatient cardiac rehabilitation. We aim to describe patient characteristics and risk factor management of cardiac rehabilitation patients with a focus on drug treatment and control status, differentiated by education level (low level, elementary school; intermediate level, secondary modern school; high level, grammar school/university). Data covering a time period between 2003 and 2008 from 68,191 hospitalized patients in cardiac rehabilitation from a large-scale registry (Transparency Registry to Objectify Guideline- Oriented Risk Factor Management) were analyzed descriptively. Further, a multivariate model was applied to assess factors associated with good control of risk factors. In the total cohort, patients with a manifestation of coronary artery disease (mean age 63.7 years, males 71.7%) were referred to cardiac rehabilitation after having received percutaneous coronary intervention (51.6%) or coronary bypass surgery (39.5%). Statin therapy increased from 76.3% at entry to 88.9% at discharge, and low density lipoprotein cholesterol education. In contrast with patients having high education, those with low education had more diabetes, hypertension, and peripheral arterial disease, had lower exercise capacity, and received less treatment with statins and guideline-orientated therapy in general. In the multivariate model, good control was significantly more likely in men (odds ratio 1.38; 95% confidence interval 1.30-1.46), less likely in patients of higher age (0.99; 0.99-0.99), with diabetes (0.90; 0.85-0.95), or peripheral arterial disease (0.88; 0.82-0.95). Compared with a low level education, a mid level education was associated with poor control (0.94; 0.89-0.99), while high education did not have a significant effect (1.08; 0.99-1.17). Patients with different levels of education treated in cardiac rehabilitation did not differ relevantly in terms of

  11. Management of radiation risk

    International Nuclear Information System (INIS)

    Hubert, P.

    1996-01-01

    The need to control the risk from ionizing radiation can be tracked back to the eve of the twentieth century. However, as knowledge improved and practices expanded, the approaches to this control have evolved. No longer is the mere respect of some forms of exposure limits or safety related standards sufficient. Rather, it is widely admitted that there is a need for managing radiation risk, both by balancing the advantages and disadvantages of enhancing protection and by setting up a proper organization that allows handling of the risk. This paper describes the multiple aspects of radiation risk management and points out the main related issues. It critically analyzes ALARA and ICRP recommendations. 74 refs, 8 figs, 5 tabs

  12. MANAGEMENT OF ENDOCRINE DISEASE: Risk of overtreatment in patients with adrenal insufficiency: current and emerging aspects.

    Science.gov (United States)

    Mazziotti, G; Formenti, A M; Frara, S; Roca, E; Mortini, P; Berruti, A; Giustina, A

    2017-11-01

    The effects of long-term replacement therapy of adrenal insufficiency (AI) are still a matter of controversy. In fact, the established glucocorticoid replacement regimens do not completely reproduce the endogenous hormonal production and the monitoring of AI treatment may be a challenge for the lack of reliable clinical and biochemical markers. Consequently, several AI patients are frequently exposed to relative glucocorticoid excess potentially leading to develop chronic complications, such as diabetes mellitus, dyslipidemia, hypertension and fragility fractures with consequent impaired QoL and increased mortality risk. This review deals with the pathophysiological and clinical aspects concerning the over-replacement therapy of primary and secondary AI. © 2017 European Society of Endocrinology.

  13. Audit of co-management and critical care outreach for high risk postoperative patients (The POST audit).

    Science.gov (United States)

    Story, D A; Shelton, A; Jones, D; Heland, M; Belomo, R

    2013-11-01

    Co-management and critical care outreach for high risk surgical patients have been proposed to decrease postoperative complications and mortality. We proposed that a clinical project with postoperative comanagement and critical care outreach, the Post Operative Surveillance Team: (POST), would be associated with decreased hospital length of stay. We conducted a retrospective before (control group) and after (POST group) audit of this hospital program. POST was staffed for four months in 2010 by two intensive care nurses and two senior registrars who conducted daily ward rounds for the first five postoperative days on high risk patients undergoing inpatient general or urological surgery. The primary endpoint was length of hospital stay and secondary endpoints were Medical Emergency Team (MET) calls, cardiac arrests and in-hospital mortality. There were 194 patients in the POST group and 1,185 in the control group. The length of stay in the POST group, median nine days (Inter-quartile range [IQR]: 5 to 17 days), was longer than the control group, median seven days (IQR: 4 to 13 days): difference two days longer (95.0% confidence interval [95.0% CI]: 1 to 3 days longer, P audit found that the POST service was not associated with reduced length of stay. Models of co-management, different to POST, or with different performance metrics, could be tested.

  14. Managing Chemical & Material Risks

    Science.gov (United States)

    2011-12-01

    Certification Program Acquisition, Technology and Logistics 9 DoD Hexavalent Chromium Risk Reduction Non- Chrome Primer II EXAVAJ ENT CHROM lrUMI...Royal Demolition eXplosive (RDX) • Cyclotrimethylenetrinitramine  Hexavalent Chromium (Cr6+) Naphthalene …pending downgrade to watch list Beryllium...T1me (secondo) 700 Acquisition, Technology and Logistics 10 Hexavalent Chromium Risk Management Actions • DoD minimization policy signed April

  15. Managing risk at Hanford

    International Nuclear Information System (INIS)

    Hesser, W.A.; Stillwell, W.G.; Rutherford, W.A.

    1994-01-01

    Clearly, there is sufficient motivation from Washington for the Hanford community to pay particular attention to the risks associated with the substantial volumes of radiological, hazardous, and mixed waste at Hanford. But there is also another reason for emphasizing risk: Hanford leaders have come to realize that their decisions must consider risk and risk reduction if those decisions are to be technically sound, financially affordable, and publicly acceptable. The 560-square miles of desert land is worth only a few thousand dollars an acre (if that) -- hardly enough to justify the almost two billion dollars that will be spent at Hanford this year. The benefit of cleaning up the Hanford Site is not the land but the reduction of potential risk to the public and the environment for future generations. If risk reduction is our ultimate goal, decisions about priority of effort and resource allocation must consider those risks, now and in the future. The purpose of this paper is to describe how Hanford is addressing the issues of risk assessment, risk management, and risk-based decision making and to share some of our experiences in these areas

  16. Investigation of risk management auditing

    International Nuclear Information System (INIS)

    Cao Lu

    2012-01-01

    2004, COSO published 'Enterprise Risk Management Framework', 2009, SASAC issued the 'central enterprise-wide risk management guidelines' to promote risk management within the formal state-owned enterprises in medium and large. Nuclear Group, which risk management in all branches to carry out the project homeopathic, and A Ⅱ will carry out risk management program as the first unit has accumulated more experience. This article from the perspective of internal control, based on the company's risk management practices carried out to try for the nuclear power enterprise risk management audit to describe and propose new ideas. Which expounds the significance of risk management, audit, risk management audit of the ways and means, for practical application of risk management audit of a representative summary of the issues and the ways and means to solve the problem of forward-looking recommendations. (authors)

  17. Managing Risk and Opportunity

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Garvey, Maxine; Roggi, Oliviero

    outcomes. This topic is timely and of interest both to the academic community as well as to practicing managers, executives, and directors. The volume focuses on contemporary risk leadership issues based on recent research insights but avoids excessive technical language and mathematical formulas. The book...... is framed around the challenges imposed on executives and directors in dealing with an increasingly complex and unpredictable world. This requires a new risk leadership focus that not only avoids the downside risks but also considers ways to exploit the upside potential offered by a dynamic environment...

  18. Risk management in customs control

    OpenAIRE

    Drobot, Elena; Klevleeva, Aziza

    2016-01-01

    The particularities of risk-management system implementation within customs control are discussed in the article. The authors single out the elements of risk-management system, evaluate effectiveness of risk-management in customs control. The main reasons for non-implementation of risk-management system in customs control are described, as well. Particular attention is paid to the benefits of customs risk management.

  19. Risk management in nuclear projects

    International Nuclear Information System (INIS)

    Salles, Claudio J.R.

    2002-01-01

    The risk management will be defined by different aspects: danger or loss possibility, or responsibility for damage. The risk management is one stage of project management. The risk management is a continuous process of planning, identification, quantification, answer and risk control to maximize the success potential of activity. The reduction of risk is part of priority establishment. This work will indicate how introduce this important instrument in the management of nuclear projects. (author)

  20. Risk factors, management and outcomes of patients admitted with near fatal asthma to a tertiary care hospital in Riyadh

    Directory of Open Access Journals (Sweden)

    Hasan M Al-Dorzi

    2014-01-01

    Conclusions: In our study, NFA risk factors were younger age and higher number of ED visits. NFA had significant morbidity. Reducing neuromuscular blockade duration during ventilator management may decrease neuromyopathy risk.

  1. The Management Object in Risk Management Approaches

    DEFF Research Database (Denmark)

    Christiansen, Ulrik

    Using a systematic review of the last 55 years of research within risk management this paper explores how risk management as a management technology (methodologies, tools and frameworks to mitigate or manage risks) singles out risks as an object for management in order to make action possible....... The paper synthesise by developing a framework of how different views on risk management enable and constrain the knowledge about risk and thus frame the possibilities to measure, analyse and calculate uncertainty and risk. Inspired by social studies of finance and accounting, the paper finally develops...... three propositions that illustrate how the framing of risk establishes a boundary for how managers might understand value creation and the possible future and how this impacts the possible responses to risk....

  2. Managing cardiovascular disease risk in patients treated with antipsychotics: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Shulman M

    2014-10-01

    Full Text Available Matisyahu Shulman,1 Avraham Miller,2 Jason Misher,3 Aleksey Tentler4 1Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA; 2The Ruth and Bruce Rappaport Faculty of Medicine, The Technion Israel Institute of Technology, Haifa, Israel; 3Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA; 4Department of Internal Medicine, Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA Background: The use of antipsychotic medication in the United States and throughout the world has greatly increased over the last fifteen years. These drugs have significant side effect burdens, many of them relating to cardiovascular health. Objective: To review the available evidence on the major cardiovascular issues that arise in patients taking antipsychotic medication. Method: A PubMed literature review was performed to identify recent meta-analyses, review articles, and large studies. Further articles were identified through cited papers and based on expert consultation when necessary. Results: Clinical guidance on the following adverse effects and antipsychotics was reviewed: electrocardiogram (ECG changes, (specifically, prolonged QT and risk of torsades de pointes, weight gain, dyslipidemia, metabolic syndrome, and myocarditis. Specific attention was paid to monitoring guidelines and treatment options in the event of adverse events, including dose change, medication switch, or adjuvant therapy. Keywords: schizophrenia, prolonged QT, increased mortality, weight gain, myocarditis

  3. Continuous Risk Management: An Overview

    Science.gov (United States)

    Rosenberg, Linda; Hammer, Theodore F.

    1999-01-01

    Software risk management is important because it helps avoid disasters, rework, and overkill, but more importantly because it stimulates win-win situations. The objectives of software risk management are to identify, address, and eliminate software risk items before they become threats to success or major sources of rework. In general, good project managers are also good managers of risk. It makes good business sense for all software development projects to incorporate risk management as part of project management. The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to implement risk management. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This is an introductory tutorial to continuous risk management based on this course. The rational for continuous risk management and how it is incorporated into project management are discussed. The risk management structure of six functions is discussed in sufficient depth for managers to understand what is involved in risk management and how it is implemented. These functions include: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

  4. Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

    Science.gov (United States)

    Pfeiffer, Yvonne; Schwappach, David

    2016-01-01

    National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

  5. Study of differences in presentation, risk factors and management in diabetic and nondiabetic patients with acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Krishna Kumar Sharma

    2016-01-01

    Full Text Available Objectives: To compare clinical characteristics, treatment, and utilization of evidence-based medicines at discharge from hospital in acute coronary syndrome (ACS patients with or without diabetes at a tertiary care cardiac center in India. Methods: We performed an observational study in consecutive patients discharged following management of ACS. We obtained demographic details, comorbid conditions, and cardiovascular risk factors, physical and biochemical parameters, and management. Descriptive statistics are reported. Results: We enrolled 100 patients (diabetics = 28 with mean age of 59.0 ± 10.8 years (diabetics 59.3 ± 11.6, nondiabetics 58.9 ± 8.5. Forty-nine patients had ST-elevation myocardial infarction (STEMI (diabetics = 14, 28.7% while 51 had nonSTEMI/unstable angina (diabetics = 14, 27.4% (P = nonsignificant. Among diabetics versus nondiabetics there was greater prevalence (% of hypertension (78.6% vs. 44.4%, obesity (25.0% vs. 8.3%, abdominal obesity (85.7% vs. 69.4% and sedentary activity (89.2% vs. 77.8%, and lower prevalence of smoking/tobacco use (10.7% vs. 25.0% (P < 0.05. In STEMI patients 28 (57.1% were thrombolysed (diabetes 17.8% vs. 31.9%, percutaneous coronary interventions (PCI was in 67.8% diabetics versus 84.7% nondiabetics and coronary bypass surgery in 21.4% versus 8.3%. At discharge, in diabetics versus nondiabetics, there was similar use of angiotensin converting enzyme inhibitors (67.9% vs. 69.4% and statins (100.0% vs. 98.6% while use of dual antiplatelet therapy (85.7% vs. 95.8% and beta-blockers (64.3% vs. 73.6% was lower (P < 0.05. Conclusions: Diabetic patients with ACS have greater prevalence of cardiometabolic risk factors (obesity, abdominal obesity, and hypertension as compared to nondiabetic patients. Less diabetic patients undergo PCIs and receive lesser dual anti-platelet therapy and beta-blockers.

  6. Contemporary management of patients with high-risk non-muscle-invasive bladder cancer who fail intravesical BCG therapy.

    Science.gov (United States)

    Yates, D R; Rouprêt, M

    2011-08-01

    It is advocated that patients with high-risk non-muscle-invasive bladder cancer (NMIBC) receive an adjuvant course of intravesical Bacille Calmette-Guerin (BCG) as first-line treatment. However, a substantial proportion of patients will 'fail' BCG, either early with persistent (refractory) disease or recur late after a long disease-free interval (relapsing). Guideline recommendation in the 'refractory' setting is radical cystectomy, but there are situations when extirpative surgery is not feasible due to competing co-morbidity, a patient's desire for bladder preservation or reluctance to undergo surgery. In this review, we discuss the contemporary management of NMIBC in patients who have failed prior BCG and are not suitable for radical surgery and highlight the potential options available. These options can be categorised as immunotherapy, chemotherapy, device-assisted therapy and combination therapy. However, the current data are still inadequate to formulate definitive recommendations, and data from ongoing trials and maturing studies will give us an insight into whether there is a realistic efficacious second-line treatment for patients who fail intravesical BCG but are not candidates for definitive surgery.

  7. Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists.

    Science.gov (United States)

    Cannesson, Maxime; Pestel, Gunther; Ricks, Cameron; Hoeft, Andreas; Perel, Azriel

    2011-08-15

    Several studies have demonstrated that perioperative hemodynamic optimization has the ability to improve postoperative outcome in high-risk surgical patients. All of these studies aimed at optimizing cardiac output and/or oxygen delivery in the perioperative period. We conducted a survey with the American Society of Anesthesiologists (ASA) and the European Society of Anaesthesiology (ESA) to assess current hemodynamic management practices in patients undergoing high-risk surgery in Europe and in the United States. A survey including 33 specific questions was emailed to 2,500 randomly selected active members of the ASA and to active ESA members. Overall, 368 questionnaires were completed, 57.1% from ASA and 42.9% from ESA members. Cardiac output is monitored by only 34% of ASA and ESA respondents (P = 0.49) while central venous pressure is monitored by 73% of ASA respondents and 84% of ESA respondents (P < 0.01). Specifically, the pulmonary artery catheter is being used much more frequently in the US than in Europe in the setup of high-risk surgery (85.1% vs. 55.3% respectively, P < 0.001). Clinical experience, blood pressure, central venous pressure, and urine output are the most widely indicators of volume expansion. Finally, 86.5% of ASA respondents and 98.1% of ESA respondents believe that their current hemodynamic management could be improved. In conclusion, these results point to a considerable gap between the accumulating evidence about the benefits of perioperative hemodynamic optimization and the available technologies that may facilitate its clinical implementation, and clinical practices in both Europe and the United States.

  8. Information Risk Management and Resilience

    Science.gov (United States)

    Dynes, Scott

    Are the levels of information risk management efforts within and between firms correlated with the resilience of the firms to information disruptions? This paper examines the question by considering the results of field studies of information risk management practices at organizations and in supply chains. The organizations investigated differ greatly in the degree of coupling from a general and information risk management standpoint, as well as in the levels of internal awareness and activity regarding information risk management. The comparison of the levels of information risk management in the firms and their actual or inferred resilience indicates that a formal information risk management approach is not necessary for resilience in certain sectors.

  9. Nuclear risk management

    International Nuclear Information System (INIS)

    2001-01-01

    This paper gives the list of contributions to Eurosafe 2001 which was organised around two round tables on the first day and five seminars on the second day. The first round table dealt with the technical, organisational and societal aspects of risk management aimed at the prevention of accidents in nuclear power plants. The second round table focused on radiological risks from the normal operation of nuclear installations. Special consideration has been given to the involvement of stakeholders. The five seminars were held in order to provide opportunities for comparing experiences and learning about recent activities of IRSN, GRS and their partners in the European Union and Eastern Europe: - Safety assessment and analysis of nuclear installations; -Nuclear safety research; -Environment and radiation protection; - Waste management; - Nuclear material security. (author)

  10. Nuclear risk management

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This paper gives the list of contributions to Eurosafe 2001 which was organised around two round tables on the first day and five seminars on the second day. The first round table dealt with the technical, organisational and societal aspects of risk management aimed at the prevention of accidents in nuclear power plants. The second round table focused on radiological risks from the normal operation of nuclear installations. Special consideration has been given to the involvement of stakeholders. The five seminars were held in order to provide opportunities for comparing experiences and learning about recent activities of IRSN, GRS and their partners in the European Union and Eastern Europe: - Safety assessment and analysis of nuclear installations; -Nuclear safety research; -Environment and radiation protection; - Waste management; - Nuclear material security. (author)

  11. Credit risk management in banks

    OpenAIRE

    Pětníková, Tereza

    2014-01-01

    The subject of this diploma thesis is managing credit risk in banks, as the most significant risk faced by banks. The aim of this work is to define the basic techniques, tools and methods that are used by banks to manage credit risk. The first part of this work focuses on defining these procedures and describes the entire process of credit risk management, from the definition of credit risk, describing credit strategy and policy, organizational structure, defining the most used credit risk mi...

  12. Current state of cardiac rehabilitation in Germany: patient characteristics, risk factor management and control status, by education level

    Directory of Open Access Journals (Sweden)

    Bestehorn K

    2011-10-01

    Full Text Available Kurt Bestehorn1, Christina Jannowitz2, Martin Horack3, Barbara Karmann2, Martin Halle4, Heinz Völler5 1Institute for Clinical Pharmacology, Technical University, Dresden; 2Medical Department, MSD Sharp and Dohme GmbH, Haar; 3Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen; 4Center for Prevention and Sports Medicine, Technical University, Munich; 5Klinik am See, Rehabilitation Center for Cardiovascular Diseases, Rüdersdorf, Germany Background: After the acute hospital stay, most cardiac patients in Germany are transferred for a 3–4-week period of inpatient cardiac rehabilitation. We aim to describe patient characteristics and risk factor management of cardiac rehabilitation patients with a focus on drug treatment and control status, differentiated by education level (low level, elementary school; intermediate level, secondary modern school; high level, grammar school/university. Methods: Data covering a time period between 2003 and 2008 from 68,191 hospitalized patients in cardiac rehabilitation from a large-scale registry (Transparency Registry to Objectify Guideline-Oriented Risk Factor Management were analyzed descriptively. Further, a multivariate model was applied to assess factors associated with good control of risk factors. Results: In the total cohort, patients with a manifestation of coronary artery disease (mean age 63.7 years, males 71.7% were referred to cardiac rehabilitation after having received percutaneous coronary intervention (51.6% or coronary bypass surgery (39.5%. Statin therapy increased from 76.3% at entry to 88.9% at discharge, and low density lipoprotein cholesterol <100 mg/dL rates increased from 31.1% to 69.6%. Mean fasting blood glucose decreased from 108 mg/dL to 104 mg/dL, and mean exercise capacity increased from 78 W to 95 W. Age and gender did not differ by education. In contrast with patients having high education, those with low education had more diabetes

  13. Current Chemical Risk Management Activities

    Science.gov (United States)

    EPA's existing chemicals programs address pollution prevention, risk assessment, hazard and exposure assessment and/or characterization, and risk management for chemicals substances in commercial use.

  14. The Use of Exenatide in Managing Markers of Cardiovascular Risk in Patients with Type 2 Diabetes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2016-09-01

    Full Text Available Objective: This review examines the use of exenatide twice daily in managing changes in markers of cardiovascular risk in patients with type 2 diabetes. Background: Type 2 diabetes is a progressive metabolic disorder, which results from defects in insulin secretion and/or insulin action leading to chronic hyperglycaemia and associated cardiovascular complications. Despite the use of diet, exercise, oral antihyperglycaemic agents and insulin, the progressive nature of the condition means that the levels of the preventive and treatment measures would have to be increased and/or new therapies have to be developed in order to address the long term impact of type 2 diabetes. The advent of exenatide, a glucagon-like peptide-1 receptor agonist provides a useful basis for managing type 2 diabetes and related cardiovascular complications without the side effects of regular diabetes therapies. However, exenatide twice daily is often used in combination with other therapies, although the mechanism of exenatide in managing diabetes and and associated cardiovascular risks and complications remain complex and still evolving. Method: A range of databases including EBSCOhost online research database were used to access articles based on PICO (Population, Interventions, Comparative Interventions, Outcomes framework and Boolean operators. Results: Eleven randomised controlled studies which met the inclusion criteria were selected for this review. Nine of the eleven studies showed significant decrease in body weight among participants in the exenatide group compared with placebo or control group while the other two studies did not report statistically significant differences in body weight. In adition, all the studies showed statistically significant decrease in glycated haemoglobin (HbA1c in the exenatide group compared to controls except in one study. In the present review, the seven studies, which looked at the effect of exenatide twice daily on lipid profile

  15. Managing Complex Environmental Risks

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Mikael [Karlstad Univ. (Sweden). Dept. of Environmental Sciences

    2006-09-15

    Environmental and public health risks are often handled in a process in which experts, and sometimes policy makers, try their best to quantitatively assess, evaluate and manage risks. This approach harmonises with mainstream interpretations of sustainable development, which aim at defining a desirable relationship between human and natural systems, for instance by policies that define limit values of different forms of disturbances. However, under conditions of high scientific incertitude, diverging values and distrust, this approach is far from satisfactory. The use of cell phones, hazardous chemicals, nuclear or fossil energy systems, and modern biotechnology are examples of activities causing such risks with high complexity. Against this background, a complementary interpretation of the concept of sustainable development is suggested. This interpretation is operationalised through new formulations of three common principles for public risk management; the precautionary principle, the polluter pays principle and the principle of public participation. Implementation of these reformulated principles would challenge some foundations of present mainstream views on environmental decision-making, but would on the other hand contribute to improved practices for long-term human welfare and planetary survival (full text of contribution)

  16. Managing Complex Environmental Risks

    International Nuclear Information System (INIS)

    Karlsson, Mikael

    2006-01-01

    Environmental and public health risks are often handled in a process in which experts, and sometimes policy makers, try their best to quantitatively assess, evaluate and manage risks. This approach harmonises with mainstream interpretations of sustainable development, which aim at defining a desirable relationship between human and natural systems, for instance by policies that define limit values of different forms of disturbances. However, under conditions of high scientific incertitude, diverging values and distrust, this approach is far from satisfactory. The use of cell phones, hazardous chemicals, nuclear or fossil energy systems, and modern biotechnology are examples of activities causing such risks with high complexity. Against this background, a complementary interpretation of the concept of sustainable development is suggested. This interpretation is operationalised through new formulations of three common principles for public risk management; the precautionary principle, the polluter pays principle and the principle of public participation. Implementation of these reformulated principles would challenge some foundations of present mainstream views on environmental decision-making, but would on the other hand contribute to improved practices for long-term human welfare and planetary survival (full text of contribution)

  17. [The relevance of clinical risk management].

    Science.gov (United States)

    Gulino, Matteo; Vergallo, Gianluca Montanari; Frati, Paola

    2011-01-01

    Medical activity includes a risk of possible injury or complications for the patients, that should drive the Health Care Institutions to introduce and/ or improve clinical Risk management instruments. Although Italy is still lacking a National project of Clinical Risk Management, a number of efforts have been made by different Italian Regions to introduce instruments of risk management. In addition, most of National Health Care Institutions include actually a Department specifically in charge to manage the clinical risk. Despite the practical difficulties, the results obtained until now suggest that the risk management may represent a useful instrument to contribute to the reduction of errors in clinical conduct. Indeed, the introduction of adequate instruments of prevention and management of clinical risk may help to ameliorate the quality of health care Institution services.

  18. Improving patient adherence to lifestyle advice (IMPALA): a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol).

    NARCIS (Netherlands)

    Koelewijn-van Loon, M.S.; Steenkiste, B.C. van; Ronda, G.; Wensing, M.J.P.; Stoffers, H.E.; Elwyn, G.; Grol, R.P.T.M.; Weijden, G.D.E.M. van der

    2008-01-01

    BACKGROUND: Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on

  19. Management of patients with chronic kidney disease

    African Journals Online (AJOL)

    management of the complications of CKD, e.g. renal anaemia, ... ARTICLE. Management of patients with chronic kidney disease. T Gerntholtz,1 FCP (SA); G Paget,2 ..... Telmisartan, ramipril, or both in patients at high risk for vascular events.

  20. CEA - 2014 risk management assessment

    International Nuclear Information System (INIS)

    Bonnevie, Edwige; Verwaerde, Daniel; Maillot, Bernard

    2015-06-01

    After introducing presentations of CEA managers in charge of risk management and controls, this document presents and comments the actions undertaken by the CEA and the obtained results in terms of risk management in different fields: protection and control of the environment, installation safety, health, safety and radiation protection, transport of hazardous materials, waste management, protection of sites, installations and heritage, management of emergency situations, management of legal risks, internal audits and controls. Other topics are addressed like the presentation of the risk management department, and the role of the CEA in the relationship between research and industry

  1. CEA: risk management assessment 2011

    International Nuclear Information System (INIS)

    Bigot, Bernard; Bonnevie, Edwige; Maillot, Bernard

    2012-01-01

    This report proposes a qualitative and quantitative overview of CEA activities in the field of risk management during 2011. These activities concerned the impact on the environment, the safety of installations, the management of professional risks (safety and health at work), the radiological protection of workers, the transports of hazardous materials, waste management, protection of sites, installations and heritage, the management of emergency situations, the management of law risks, controls and audits

  2. Bleeding in patients using new anticoagulants or antiplatelet agents: Risk factors and management

    NARCIS (Netherlands)

    Levi, M.M.; Eerenberg, E.; Löwenberg, E.; Kamphuisen, P.W.

    2010-01-01

    The most important adverse effect of antithrombotic treatment is the occurrence of bleeding. in case of serious or even life-threatening bleeding in a patient who uses anticoagulant agents or when patient on anticoagulants needs to undergo an urgent invasive procedure, anticoagulant treatment can be

  3. Analysis of emergency helpline support for home ventilator dependent patients: risk management and workload

    Directory of Open Access Journals (Sweden)

    M. Chatwin

    2008-04-01

    Full Text Available From a total of 1211 adult & paediatric patients receiving home ventilation (HV supervised by Royal Brompton Hospital between 1/1/06 and 30/6/06 the respiratory support team received an average of 528 daytime calls/month and 14/month out of hours calls to a telephone helpline. Diagnoses included: neuromuscular disease, chest wall disease, COPD, obesity hypoventilation and non-COPD lung disease. 99% received non-invasive ventilation, 1% tracheostomy ventilation. 149 required 2 ventilators for near 24 hour ventilator dependency, the remainder were classified as 1 (17% 2 (33% & 3 (50% night dependency as were able to breathe spontaneously for this period. 50% used bilevel positive pressure ventilators, 48% inspiratory pressure ventilators and 2% volume ventilators. In 188 calls a home visit was carried out because of ventilator or associated equipment-related problems. Despite regular equipment servicing programme, in 188 patients there was a technical problem with the equipment which was solved in the patient's home in 64% or required replacement / parts in 22%. Of the 25 calls in which no fault was found, 13 patients were unwell at home or required hospital admission, 2 patients died within 1 month of identification of no fault. No patient was admitted as a result of technical failure of equipment. Conclusion: There is a significant workload associated with supporting HV patients. Patients / carers all received standard competency training before discharge but other calls may be reduced by a more flexible problem-solving approach. Importantly, reports in which no technical fault is found may indicate deteriorating health in the patient and require close follow-up.

  4. Probability concepts in quality risk management.

    Science.gov (United States)

    Claycamp, H Gregg

    2012-01-01

    Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as

  5. The effect of electronic reminders on risk management among diabetic patients in low resourced settings

    NARCIS (Netherlands)

    Adjei, D. N.; Agyemang, C.; Dasah, J. B.; Kuranchie, P.; Amoah, A. G. B.

    2015-01-01

    Information technology has potential to improve health care delivery particularly among individuals with chronic diseases such as diabetes in low and middle-income countries (LMIC). Research on the usefulness of information technology to manage persons living with chronic diseases is scarce in LMIC.

  6. Risk Management in Cocurricular Activities.

    Science.gov (United States)

    Webb, Edward M.

    1988-01-01

    Discusses risk management for colleges' cocurricular activities. Discusses tort liability, contributory negligence, and assumption of risk. Provides six concrete steps for managing risks responsibly and professionally: adopting an educational mission statement, assigning risk to others, establishing safety standards, training club advisors,…

  7. Managing Corruption Risks

    DEFF Research Database (Denmark)

    Krause Hansen, Hans

    2011-01-01

    This article investigates the emerging engagement of private actors and specifically Western corporations in international anti-corruption, drawing on Foucauldian studies of governmentality. It explores this engagement as governing practices that have emanated quite independently from the inter......-state system commonly understood to be at the core of the anti-corruption regime. It demonstrates how corporate anti-corruption ties in with a relatively new way of perceiving corruption. In this framing, anti-corruption comes out as risk management, which is latched on to notions of corporate social...... responsibility and business ethics. Moreover, the constitution of corruption risk relates to the rise of new actors and networks engaged in a wider business of anti-corruption, including commercial and hybrid actors that supply corporations with managerial instruments, benchmarks for best practice, rankings...

  8. Case Study: Nutritional management of a patient at high risk of ...

    African Journals Online (AJOL)

    2015-08-14

    Aug 14, 2015 ... refeeding (either enteral or parenteral).3 Critically ill patients, such as oncology .... calculated basal energy expenditure.4 Universally, it is recommended ... It was decided to calculate the protein requirement at 20% of total.

  9. INTERNAL AUDIT AND RISK MANAGEMENT

    OpenAIRE

    Elena RUSE; Georgiana SUSMANSCHI (BADEA); Daniel DĂNECI-PĂTRĂU

    2014-01-01

    The existence of risk in economic activity can not be denied. In fact, the risk is a concept which exists in every activity, the term of risk being identified with uncertainty, respectively the (un)chance to produce an undesirable event. Internal audit and risk management aim at the same goal, namely the control of risks. Internal Audit performs several roles in risk management plan. The objectives of the internal audit function varies from company to company, but in all economic entities int...

  10. Burden of upper gastrointestinal symptoms in patients receiving low-dose acetylsalicylic acid for cardiovascular risk management

    DEFF Research Database (Denmark)

    Bytzer, Peter; Pratt, Stephen; Elkin, Eric

    2013-01-01

    Continuous low-dose acetylsalicylic acid (aspirin; ASA) is a mainstay of cardiovascular (CV) risk management. It is well established, however, that troublesome upper gastrointestinal (GI) symptoms are commonly experienced among low-dose ASA users.......Continuous low-dose acetylsalicylic acid (aspirin; ASA) is a mainstay of cardiovascular (CV) risk management. It is well established, however, that troublesome upper gastrointestinal (GI) symptoms are commonly experienced among low-dose ASA users....

  11. Role of post-therapy 131Iodine SPECT-CT in risk stratification and management of patients with differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Agarwal, K.; Bhattacharya, A.; Harishankar, C.N.B.; Manohar, K.; Mittal, B.R.

    2010-01-01

    Full text: To determine whether post therapy 131 I SPECT/CT changed the American Thyroid Association risk of recurrence classification and further management of the patients with differentiated thyroid carcinoma. Materials and Methods: In this prospective study, 33 consecutive patients with thyroid carcinoma (28 papillary, 4 follicular, 1 Hurthle cell) were included. Planar imaging and SPECT/CT were performed 4-7 days after the therapeutic administration of 1,221-5,180 MBq (33-140 mCi) of 131 I. SPECT/CT of the neck and upper chest were obtained for all subjects. Additional SPECT/CT scans of the abdomen or pelvis were acquired if planar imaging showed any abnormal focus of uptake. Planar and SPECT/CT images were interpreted independently, and sites of uptake were categorized as residual thyroid uptake, level VI cervical lymph node uptake, level II-V cervical lymph nodal uptake or distant metastasis. An experienced nuclear medicine physician determined if the imaging findings changed the patient's risk category and further management. Results: In 4 of 33 post surgical patients, SPECT/CT findings changed the initial ATA risk of recurrence classification. In 3 of these 4 patients, WB planar imaging showed distant metastases (1 in lung, 1 in spleen, 1 in left humerus), SPECT/CT confirming these to physiological uptake in breast and intestine and skin contamination respectively. This altered the risk of recurrence from high to intermediate category. In 1 of these 4 patients, WB planar imaging was suggestive of cervical lymph nodal metastasis, but SPECT/CT localized the abnormal focus of uptake to residual thyroid tissue, altering the risk of recurrence from intermediate to low. SPECT/CT changed the further post ablation management in 13 out of 33 patients. In 4/13 patients SPECT/CT detected cervical lymph nodes metastases, in 1/13 patient supraclavicular lymph node metastasis was detected, in 7/13 patients distant metastases was confirmed as physiological uptake or

  12. Managing Climate Change Risks

    Energy Technology Data Exchange (ETDEWEB)

    Jones, R. [CSIRO Atmospheric Research, PMB1 Aspendale, Victoria 3195 (Australia)

    2003-07-01

    Issues of uncertainty, scale and delay between action and response mean that 'dangerous' climate change is best managed within a risk assessment framework that evolves as new information is gathered. Risk can be broadly defined as the combination of likelihood and consequence; the latter measured as vulnerability to greenhouse-induced climate change. The most robust way to assess climate change damages in a probabilistic framework is as the likelihood of critical threshold exceedance. Because vulnerability is dominated by local factors, global vulnerability is the aggregation of many local impacts being forced beyond their coping ranges. Several case studies, generic sea level rise and temperature, coral bleaching on the Great Barrier Reef and water supply in an Australian catchment, are used to show how local risk assessments can be assessed then expressed as a function of global warming. Impacts treated thus can be aggregated to assess global risks consistent with Article 2 of the UNFCCC. A 'proof of concept' example is then used to show how the stabilisation of greenhouse gases can constrain the likelihood of exceeding critical thresholds at both the both local and global scale. This analysis suggests that even if the costs of reducing greenhouse gas emissions and the benefits of avoiding climate damages can be estimated, the likelihood of being able to meet a cost-benefit target is limited by both physical and socio-economic uncertainties. In terms of managing climate change risks, adaptation will be most effective at reducing vulnerability likely to occur at low levels of warming. Successive efforts to mitigate greenhouse gases will reduce the likelihood of reaching levels of global warming from the top down, with the highest potential temperatures being avoided first, irrespective of contributing scientific uncertainties. This implies that the first cuts in emissions will always produce the largest economic benefits in terms of avoided

  13. Communicating Risk to Program Managers

    Science.gov (United States)

    Shivers, C. Herbert

    2005-01-01

    Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

  14. Diabetic ketoacidosis: risk factors, mechanisms and management ...

    African Journals Online (AJOL)

    Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Africa: a review. ... ketoacidosis is the most common hyperglycaemic emergency in patients with diabetes mellitus, especially type 1 diabetes.

  15. Managing information technology security risk

    Science.gov (United States)

    Gilliam, David

    2003-01-01

    Information Technology (IT) Security Risk Management is a critical task for the organization to protect against the loss of confidentiality, integrity and availability of IT resources. As systems bgecome more complex and diverse and and attacks from intrusions and malicious content increase, it is becoming increasingly difficult to manage IT security risk. This paper describes a two-pronged approach in addressing IT security risk and risk management in the organization: 1) an institutional enterprise appraoch, and 2) a project life cycle approach.

  16. Credit derivatives and risk management

    OpenAIRE

    Michael S. Gibson

    2007-01-01

    The striking growth of credit derivatives suggests that market participants find them to be useful tools for risk management. I illustrate the value of credit derivatives with three examples. A commercial bank can use credit derivatives to manage the risk of its loan portfolio. An investment bank can use credit derivatives to manage the risks it incurs when underwriting securities. An investor, such as an insurance company, asset manager, or hedge fund, can use credit derivatives to align its...

  17. Audit of the management of patients at high risk of carbapenemase-producing enterobacteriaceae (CPE): Are we ready?

    Science.gov (United States)

    Ratnayake, Lasantha; Harris, Amy; Ko, Doreen; Hawtin, Linda

    2017-11-01

    Incidence of carbapenemase-producing enterobacteriaceae (CPE) in the UK is increasing. In 2013, Public Health England (PHE) published a toolkit to control spread of CPE within healthcare settings. To assess compliance to hospital CPE policy (adapted from PHE) in the identification, isolation and screening of suspected CPE patients. Admission booklets of 150 patients were evaluated to see whether the relevant section had been completed to identify high-risk CPE patients. Where necessary, patients were interviewed or their GPs were contacted to assess their CPE risk. Additionally, 28 patients screened for CPE were audited to assess compliance to screening and isolation. Only 23 patients out of 147 (15.6%) were risk assessed on admission. Risk status of 27 (18.4%) patients could not be assessed due to lack of data. Fifteen patients out of 28 (54%) screened for CPE were identified and isolated on admission. Ten out of 19 patients (53%) had three screens 48 h apart. This audit highlights difficulties in screening based on individual risk factors as the majority of patients were not screened on admission and documentation on isolation and screening was poor. More needs to be done to raise awareness of the requirements for routine assessment, isolation and screening.

  18. [Patient blood management].

    Science.gov (United States)

    Folléa, G

    2016-11-01

    In a context of regular review of transfusion practice, the aim of this review is to present an update of the scientific basis of the so-called "patient blood management" (PBM), the state of its development in Europe, and possible ways to progress its development further in France. Analysis and synthesis of the data from scientific literature on the scientific basis of PBM (methods, indications, efficacy, risks, efficiency). PBM appears as an evidence-based, patient centred, multidisciplinary approach, aiming to optimise the care of patients who might need transfusion and, consequently, the use of blood products. PBM is based on three pillars: optimise the patient's own blood supplies, minimise blood loss, optimise patient's tolerance of anaemia. Available scientific evidence can be considered as sufficient to consider PBM guidelines and practices as an indispensable complement to the transfusion medicine guidelines and practices. Several countries have launched PBM programmes (alternatives to allogeneic transfusion and optimisation of the use of blood components). Although current French national transfusion guidelines contain some PBM measures, PBM programmes should be further developed in France, primarily for medical reasons. Possible ways, using the existing basis having proved to be effective, are proposed to further develop PBM in France, as a complement to transfusion medicine, with the participation of involved stakeholders, including experts from relevant medical specialties, both at local and national levels. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Patient profiling can identify patients with adult spinal deformity (ASD) at risk for conversion from nonoperative to surgical treatment: initial steps to reduce ineffective ASD management.

    Science.gov (United States)

    Passias, Peter G; Jalai, Cyrus M; Line, Breton G; Poorman, Gregory W; Scheer, Justin K; Smith, Justin S; Shaffrey, Christopher I; Burton, Douglas C; Fu, Kai-Ming G; Klineberg, Eric O; Hart, Robert A; Schwab, Frank; Lafage, Virginie; Bess, Shay

    2018-02-01

    Non-operative management is a common initial treatment for patients with adult spinal deformity (ASD) despite reported superiority of surgery with regard to outcomes. Ineffective medical care is a large source of resource drain on the health system. Characterization of patients with ASD likely to elect for operative treatment from non-operative management may allow for more efficient patient counseling and cost savings. This study aimed to identify deformity and disability characteristics of patients with ASD who ultimately convert to operative treatment compared with those who remain non-operative and those who initially choose surgery. A retrospective review was carried out. A total of 510 patients with ASD (189 non-operative, 321 operative) with minimum 2-year follow-up comprised the patient sample. Oswestry Disability Index (ODI), Short-Form 36 Health Assessment (SF-36), Scoliosis Research Society questionnaire (SRS-22r), and spinopelvic radiographic alignment were the outcome measures. Demographic, radiographic, and patient-reported outcome measures (PROMs) from a cohort of patients with ASD prospectively enrolled into a multicenter database were evaluated. Patients were divided into three treatment cohorts: Non-operative (NON=initial non-operative treatment and remained non-operative), Operative (OP=initial operative treatment), and Crossover (CROSS=initial non-operative treatment with subsequent conversion to operative treatment). NON and OP groups were propensity score-matched (PSM) to CROSS for baseline demographics (age, body mass index, Charlson Comorbidity Index). Time to crossover was divided into early (1 year). Outcome measures were compared across and within treatment groups at four time points (baseline, 6 weeks, 1 year, and 2 years). Following PSM, 118 patients were included (NON=39, OP=38, CROSS=41). Crossover rate was 21.7% (41/189). Mean time to crossover was 394 days. All groups had similar baseline sagittal alignment, but CROSS had larger

  20. Care Management to Promote Treatment Adherence in Patients with Cognitive Impairment and Vascular Risk Factors: A Demonstration Project.

    Science.gov (United States)

    Bonner, L M; Hanson, A; Robinson, G; Lowy, E; Craft, S

    2018-01-01

    Dementia prevention is highly important. Improved control of vascular risk factors has the potential to decrease dementia risk, but may be difficult. Therefore, we developed and piloted a care management protocol for Veterans at risk for dementia. We enrolled 32 Veterans with diabetes and hypertension, at least one of which was poorly controlled, and cognitive impairment. Participants were randomly assigned to a 6-month care management intervention or to usual care. At enrollment, 6-months and 12-months, we assessed cognitive performance, mood, and diabetes and hypertension control. At follow-up, diastolic blood pressure was lower in intervention participants at 6 months (p=.041) and 12 months (p=.022); hemoglobin A1c, global mental status and mood did not differ between groups. Recall of a distractor list (p=.006) and logical memory long-delay recall (p=.036) were better at 6 months in the intervention group (p=.006). Care management may contribute to improved control of dementia risk factors.

  1. The Key to Risk Management: Management

    OpenAIRE

    Adrian E. Tschoegl

    2000-01-01

    The Barings, Daiwa Bank and Sumitomo Corp. financial debacles in the mid-1990s suggest that management failures rather than misfortune, errors, or complexity are a major source of the risk of financial debacles. These errors are systematic and are a concommittant of the structure of trading and of human nature. Risk management systems must take these facts into account.

  2. Risk Management in Insurance Companies

    OpenAIRE

    Yang, Xufeng

    2006-01-01

    Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...

  3. Information systems for risk management

    OpenAIRE

    Michael S. Gibson

    1997-01-01

    Risk management information systems are designed to overcome the problem of aggregating data across diverse trading units. The design of an information system depends on the risk measurement methodology that a firm chooses. Inherent in the design of both a risk management information system and a risk measurement methodology is a tradeoff between the accuracy of the resulting measures of risk and the burden of computing them. Technical progress will make this tradeoff more favorable over time...

  4. Framework for systematic risk management

    International Nuclear Information System (INIS)

    Knief, R.A.; Mahn, J.A.; Briant, V.S.; Lee, R.B.; Long, R.L.

    1991-01-01

    The first paper of the Symposium described GPU Nuclear's Risk Management Group (RMG) and the use of literature search and interviews in a extensive study of risk management. One of the most important goals of the study was to identify comprehensive approaches to managing risk in the nuclear and major high-technology industries. This paper discusses RMG's multi-step generic risk-management process consisting of the following steps to: identify hazards; screen hazards and identify preventive actions, including costs; evaluate hazards for severity, probable frequency, and cost of preventive actions; prioritize preventive actions (preference to high risk and low cost); implement preventive actions; monitor and provide feedback

  5. Patient caries risk assessment

    DEFF Research Database (Denmark)

    Twetman, Svante; Fontana, Margherita

    2009-01-01

    Risk assessment is an essential component in the decision-making process for the correct prevention and management of dental caries. Multiple risk factors and indicators have been proposed as targets in the assessment of risk of future disease, varying sometimes based on the age group at which...... they are targeted. Multiple reviews and systematic reviews are available in the literature on this topic. This chapter focusses primarily on results of reviews based on longitudinal studies required to establish the accuracy of caries risk assessment. These findings demonstrate that there is a strong body...... of evidence to support that caries experience is still, unfortunately, the single best predictor for future caries development. In young children, prediction models which include a variety of risk factors seem to increase the accuracy of the prediction, while the usefulness of additional risk factors...

  6. Trends in risk management in nuclear industry

    International Nuclear Information System (INIS)

    Kim, Inn Seock

    1996-01-01

    Safety management may be classified into three dimensions: risk management, accident management, and emergency management. This paper addresses the recent trends of safety management in nuclear industry, focussing on risk management and accident management

  7. Risks in hospitals. Assessment and Management

    Directory of Open Access Journals (Sweden)

    Bradea Ioana-Alexandra

    2014-12-01

    Full Text Available In a complex world, characterized by a multitude of risks, managers need to manage the risks they encounter, in an efficient way and in the shortest time possible. In the current economic crisis, the concept of hospital risk management, as the process in which is identified, analyzed, reduced, or avoided a risk that may affect the hospital, gained great importance. The Romanian health system, distinguished by: lack of transparency, poor funding, the loss of the valuable medical staff, lack of hospitals in villages and small towns, inability to engage patients due to the old and poor equipment, lack of research and problems in information privacy and cyber-security, requires an appropriate management, enabling risk managers to take decisions in order to avoid the occurrence of risks. Important for the functioning of every hospital is the perception of patients and their degree of satisfaction, regarding the quality of services, which depend largely on the quality of human resources. But what are the human resources weaknesses and risks from the patient point of view? What are the risk indicators which must be monitored to avoid risks? And also, which is the most useful method for measurement and assessment of risk?

  8. Risk assessment and risk management in managed aquifer recharge

    CSIR Research Space (South Africa)

    Page, D

    2012-06-01

    Full Text Available This chapter presents the methodologies used for risk assessment and risk management in MAR in Australia and the European Union, qualitative and quantitative approaches adopted within the RECLAIM Water project and case studies where the outcomes...

  9. Understanding and managing risk attitude

    National Research Council Canada - National Science Library

    Hillson, David; Murray-Webster, Ruth

    2007-01-01

    ... This book highlights how risk attitude factors influence the human psyche, and carefully explains the impacts. Organisations seeking to dramatically improve the effectiveness of their risk management process will want to use this book's insights. Craig Peterson, President, PMI Risk Management SIG This book has prompted me to think more deeply as a change d...

  10. Methods of Financial Risk Management

    Directory of Open Access Journals (Sweden)

    Korzh Natalia

    2016-10-01

    Full Text Available The essence and nature of financial risks are investigated. Their classification is conducted. The features of financial risk management and the main methods of management are considered. The ways of risk compensation are identified. It is proved that the objective external risk basis is such market imperfections as externalities of enterprises and incomplete information about the operation of the business environment and internal objective basis risk – the objective function to maximise profits in a competitive environment. It is revealed that to compensate market imperfections business entities should develop a strategy that combines fill in missing information and neutralise or minimise externalities that tactically implemented in financial risk management programs.

  11. [Does clinical risk management require a structured conflict management?].

    Science.gov (United States)

    Neumann, Stefan

    2015-01-01

    A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management.

  12. IMPLEMENTING A RISK MANAGEMENT STANDARD

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2013-01-01

    Full Text Available After risk management “conquered” more and more project managers’ minds and showed its benefits for business and programs, the need to have a global risk management standard has become a crucial issue in the world of risk management. But having a global risk management standard has been a big challenge, starting from the decision of developing the standard (March-June 2005, to the moment of publishing it, November 2009. So, developing the ISO 31000:2009 standard has been more or less like a bumpy ride. Apparently, the people involved in developing the global risk management standard understood from the very beginning that no challenges are too big, nor any tasks too small and that the task of having a new, comprehensive global risk management standard should be completed with excellence: defining the principles and the framework guiding the risk management process applicable for all type of organizations and for a wide range of activities. Coming up with a global standard should always be based on the real organizations’ needs and should fulfill real risk management requirements. The article is trying to present the pros and cons of risk management standard implementation, challenging the implementation process itself and the added value of implementing the standard due to the lack of implementation enablers, like risk culture, a real problem especially in an international environment.

  13. Perioperative management of vitamin K antagonists in patients with low thromboembolic risk undergoing elective surgery: A prospective experience.

    Science.gov (United States)

    Becerra, Ana Florencia; Cornavaca, María Teresita; Revigliono, José Ignacio; Contreras, Alejandro; Albertini, Ricardo; Tabares, Aldo Hugo

    2017-10-11

    To quantify thromboembolic and bleeding events in patients with low thromboembolic risk, who were chronically receiving vitamin K antagonists and undergoing elective surgery. A descriptive, prospective, single-center study was conducted between December 2010 and July 2014. Patients aged over 18 years old, chronically anticoagulated with vitamin K antagonists and admitted for elective surgery were included in the study. We excluded patients with a creatinine clearance120kg, heparin-induced thrombocytopenia, pregnant women, carriers of an epidural catheter for analgesia, patients who underwent unscheduled surgery and high thromboembolic risk-patients. Vitamin K antagonists were discontinued 5 days prior to the procedure without administering anticoagulant enoxaparin. The NIR was measured 24h before the procedure. A single dose of 3mg of vitamin K was administered in cases of a NIR>1.5. Vitamin K antagonists was resumed according to the surgical bleeding risk. Events were registered between 5 days prior to the procedure until 30 days after it. A total of 75 procedures were included in the study. Fifty-six patients (74.7%) received vitamin K antagonists for atrial fibrillation, 15 suffered from venous thromboembolism (20%) and 4 had mechanical heart valves (5.3%). Twenty-six patients (34.5%) underwent high-bleeding risk surgeries and 49 (65.5%) underwent low risk procedures. No thromboembolic event was recorded. Four bleeding events (5.3%) were reported, 3 of which were considered major bleeding events (2 fatal). Suspending vitamin K antagonists with no bridging therapy performed in patients with a low thromboembolic risk does not expose such patients to a significant risk of embolic events. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Szabo Alina

    2012-12-01

    Full Text Available Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in the area and the professional expertise, this article outlines an integrated approach to risk assessment and risk management reporting processes, by separating the risk in two main categories: strategic and operational risks. The focus is on risk prioritization and scoring; the final output will comprise a mix of strategic and operational (‘top 8-12’ risks, which should be used to establish the annual Internal Audit plan. Originality/value: By using an integrated approach to risk assessment and risk management will eliminate the need for a separate Internal Audit risk assessment over prevailing risks. It will reduce the level of risk assessment overlap by different functions (Tax, Treasury, Information System over the same risk categories as a single methodology, is used and will align timings of risk assessment exercises. The risk prioritization by usage of risk and control scoring criteria highlights the combination between financial and non-financial impact criteria allowing risks that do not naturally lend themselves to a financial amount to be also assessed consistently. It is emphasized the usage of score method to prioritize the risks included in the annual audit plan in order to increase accuracy and timelines.

  15. Innovations in Quantitative Risk Management

    CERN Document Server

    Scherer, Matthias; Zagst, Rudi

    2015-01-01

    Quantitative models are omnipresent –but often controversially discussed– in todays risk management practice. New regulations, innovative financial products, and advances in valuation techniques provide a continuous flow of challenging problems for financial engineers and risk managers alike. Designing a sound stochastic model requires finding a careful balance between parsimonious model assumptions, mathematical viability, and interpretability of the output. Moreover, data requirements and the end-user training are to be considered as well. The KPMG Center of Excellence in Risk Management conference Risk Management Reloaded and this proceedings volume contribute to bridging the gap between academia –providing methodological advances– and practice –having a firm understanding of the economic conditions in which a given model is used. Discussed fields of application range from asset management, credit risk, and energy to risk management issues in insurance. Methodologically, dependence modeling...

  16. Financial risk management of pharmacy benefits.

    Science.gov (United States)

    Saikami, D

    1997-10-01

    Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

  17. A literature review on cardiovascular risk in human immunodeficiency virus-infected patients: implications for clinical management

    Directory of Open Access Journals (Sweden)

    Mansueto Gomes Neto

    Full Text Available INTRODUCTION: In recent years, there has been growing concern about an increasing rate of cardiovascular diseases in human immunodeficiency virus-infected patients, which could be associated with side effects of highly active antiretroviral therapy. It is likely that the metabolic disorders related to anti-human immunodeficiency virus treatment will eventually translate into a increased cardiovascular risk in patients submitted to such regimens. OBJECTIVE: To evaluate if human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy are at higher risk of cardiovascular diseases than human immunodeficiency virus infected patients not receiving highly active antiretroviral therapy, or the general population. RESEARCH DESIGN AND METHODS: We conducted a computer-based search in representative databases, and also performed manual tracking of citations in selected articles. RESULT: The available evidence suggests an excess risk of cardiovascular events in human immunodeficiency virus-infected persons compared to non-human immunodeficiency virus infected individuals. The use of highly active antiretroviral therapy is associated with increased levels of total cholesterol, triglycerides, low-density lipoprotein and morphological signs of cardiovascular diseases. Some evidence suggested that human immunodeficiency virus-infected individuals on highly active antiretroviral therapy regimens are at increased risk of dyslipidemia, ischemic heart disease, and myocardial infarction, particularly if the highly active antiretroviral therapy regimen contains a protease inhibitor. CONCLUSION: Physicians must weigh the cardiovascular risk against potential benefits when prescribing highly active antiretroviral therapy. Careful cardiac screening is warranted for patients who are being evaluated for, or who are receiving highly active antiretroviral therapy regimens, particularly for those with known underlying cardiovascular risk

  18. Patient blood management -- the GP's guide.

    Science.gov (United States)

    Minck, Sandra; Robinson, Kathryn; Saxon, Ben; Spigiel, Tracey; Thomson, Amanda

    2013-05-01

    There is accumulating evidence of a strong association between blood transfusion and adverse patient outcomes. Patient blood management aims to achieve improved patient outcomes by avoiding unnecessary exposure to blood products through effective conservation and management of a patient's own blood. To introduce the general practitioner's role in patient blood management. There are a number of ways in which GPs can contribute to patient blood management, particularly in the care of patients scheduled for elective surgery. These include awareness, identification, investigation and management of patients with or at risk of anaemia; assessment of the adequacy of iron stores in patients undergoing planned procedures in which substantial blood loss is anticipated; awareness and assessment of medications and complementary medicines that might increase bleeding risk; and awareness of and ability to discuss with patients, the possible risks associated with blood transfusion and alternatives that may be available.

  19. RISK MANAGEMENT IN CUSTOMS CONTROL

    Directory of Open Access Journals (Sweden)

    Elena Valerievna Drobot

    2017-06-01

    Full Text Available Customs administrations operating in the modern global economy are faced with a complex range of challenges. The prime responsibilities remain the collection of revenues and the protection of the society, but these demanding tasks must be performed effectively and efficiently, whilst at the same time facilitating the flow of legitimate goods. Risk management is a logical and systematic method of identifying, analyzing and managing risks. Risk management can be associated with any activity, function or process within the organization and will enable the organization to take advantage of opportunities and minimize potential losses. Minimization of the human factor in customs control through the implementation of non-intrusive inspection equipment can be very useful. The particularities of risk-management system (RMS implementation within customs control are discussed in the article. The authors single out the elements of the risk-management system, evaluate the effectiveness of risk-management in customs control. The main reasons for non-implementation of the risk-management system in customs control are described as well. The particular attention is paid to the benefits of customs risk management. The authors’ hypothesis is that risk management in customs control must find a balance between costs and benefits to address all risks equally. Criteria are needed to decide what constitutes an acceptable or unacceptable risk. Thus, system analysis and risk management system are the effective mechanisms for acceleration of customs clearance and improve the quality of customs control. As a conclusion, the authors give recommendations for the improvement of the effectiveness of risk management system in customs control.

  20. Risk management and corporate value

    Directory of Open Access Journals (Sweden)

    Milan Cupic

    2015-12-01

    Full Text Available The paper presents a theoretical framework for assessing the impact of risk management on corporate value. As the relevant factors that determine this impact, the paper analyzes market imperfections and investors’ risk aversion. The results of the present research indicate that risk management contributes to an increase in corporate value if, under the influence of market imperfections, corporate risk exposure is concave. As an expression of market imperfections, the paper analyzes the costs of financial distress, agency costs, and taxation. The results of the research also indicate that the risk management policy should not aim to minimize, but rather optimize risk exposure, by taking into account the costs of risk management, investors’ risk aversion and the competitive advantage a corporation has on the relevant market.

  1. Risk management of precious metals

    NARCIS (Netherlands)

    S.M. Hammoudeh (Shawkat); F. Malik (Farooq); M.J. McAleer (Michael)

    2010-01-01

    textabstractThis paper examines volatility and correlation dynamics in price returns of gold, silver, platinum and palladium, and explores the corresponding risk management implications for market risk and hedging. Value-at-Risk (VaR) is used to analyze the downside market risk associated with

  2. Risk Management in Logystics Chains

    OpenAIRE

    Butrin, Andrey; Vikulov, Vladimir

    2013-01-01

    Article is devoted to risk management of supply chain. The authors considered indicators of supply chain risks, including risks caused by supplier. Authors formed a method of optimizing the level of supply chain risk in the integration with suppliers and customers.

  3. Improving Information Security Risk Management

    Science.gov (United States)

    Singh, Anand

    2009-01-01

    manaOptimizing risk to information to protect the enterprise as well as to satisfy government and industry mandates is a core function of most information security departments. Risk management is the discipline that is focused on assessing, mitigating, monitoring and optimizing risks to information. Risk assessments and analyses are critical…

  4. Investigating patients' and general practitioners' views of computerised decision support software for the assessment and management of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Anne Wilson

    2007-01-01

    Conclusion Computer decision support programs are becoming more prevalent, but little is known about their usability and acceptability to both health professionals and consumers. The complexities of cardiovascular risk assessment and management can be adequately managed with such programs. As a contemporary report this study contributes to the growing knowledge required for developers of medical software and decision support systems to better understand the needs of endusers.

  5. RISKS MANAGEMENT: NEW LITERATURE REVIEW

    OpenAIRE

    Ennouri Wissem

    2013-01-01

    The complexity of the industrial activities and the important mass of flows crossing the supply chain promotes the emergence of risks that must be considered in the decision process. For this reason, we have developed this paper to clarify the basics of risk management through a short new suggestion of literature review for risk management. Our justification of this attempt is that this area is the most discussed in our days and it is impossible to present all definition of the risk concept, ...

  6. Integrated supply chain risk management

    OpenAIRE

    Riaan Bredell; Jackie Walters

    2007-01-01

    Integrated supply chain risk management (ISCRM) has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly ...

  7. Managing the risks of risk management on large fires

    Science.gov (United States)

    Donald G. MacGregor; Armando González-Cabán

    2013-01-01

    Large fires pose risks to a number of important values, including the ecology, property and the lives of incident responders. A relatively unstudied aspect of fire management is the risks to which incident managers are exposed due to organizational and sociopolitical factors that put them in a position of, for example, potential liability or degradation of their image...

  8. Definition and Validation of “Favorable High-Risk Prostate Cancer”: Implications for Personalizing Treatment of Radiation-Managed Patients

    International Nuclear Information System (INIS)

    Muralidhar, Vinayak; Chen, Ming-Hui; Reznor, Gally; Moran, Brian J.; Braccioforte, Michelle H.; Beard, Clair J.; Feng, Felix Y.; Hoffman, Karen E.; Choueiri, Toni K.; Martin, Neil E.; Sweeney, Christopher J.; Trinh, Quoc-Dien; Nguyen, Paul L.

    2015-01-01

    Purpose: To define and validate a classification of favorable high-risk prostate cancer that could be used to personalize therapy, given that consensus guidelines recommend similar treatments for all radiation-managed patients with high-risk disease. Methods and Materials: We studied 3618 patients with cT1-T3aN0M0 high-risk or unfavorable intermediate-risk prostate adenocarcinoma treated with radiation at a single institution between 1997 and 2013. Favorable high-risk was defined as T1c disease with either Gleason 4 + 4 = 8 and prostate-specific antigen 20 ng/mL. Competing risks regression was used to determine differences in the risk of prostate cancer–specific mortality (PCSM) after controlling for baseline factors and treatment. Our results were validated in a cohort of 13,275 patients using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results: Patients with favorable high-risk disease had significantly better PCSM than other men with high-risk disease (adjusted hazard ratio [AHR] 0.42, 95% confidence interval [CI] 0.18-0.996, P=.049) and similar PCSM as men with unfavorable intermediate-risk disease (AHR 1.17, 95% CI 0.50-2.75, P=.710). We observed very similar results within the SEER-Medicare cohort (favorable high-risk vs other high-risk: AHR 0.21, 95% CI 0.11-0.41, P<.001; favorable high-risk vs unfavorable intermediate-risk: AHR 0.67, 95% CI 0.33-1.36, P=.268). Conclusions: Patients with favorable high-risk prostate cancer have significantly better PCSM than other patients with high-risk disease and similar PCSM as those with unfavorable intermediate-risk disease, who are typically treated with shorter-course androgen deprivation therapy. This new classification system may allow for personalization of treatment within high-risk disease, such as consideration of shorter-course androgen deprivation therapy for favorable high-risk disease.

  9. Definition and Validation of “Favorable High-Risk Prostate Cancer”: Implications for Personalizing Treatment of Radiation-Managed Patients

    Energy Technology Data Exchange (ETDEWEB)

    Muralidhar, Vinayak [Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Reznor, Gally [Center for Surgery and Public Health, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Moran, Brian J.; Braccioforte, Michelle H. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Hoffman, Karen E. [Department of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas (United States); Choueiri, Toni K. [Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Martin, Neil E. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Sweeney, Christopher J. [Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Trinh, Quoc-Dien [Department of Urology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2015-11-15

    Purpose: To define and validate a classification of favorable high-risk prostate cancer that could be used to personalize therapy, given that consensus guidelines recommend similar treatments for all radiation-managed patients with high-risk disease. Methods and Materials: We studied 3618 patients with cT1-T3aN0M0 high-risk or unfavorable intermediate-risk prostate adenocarcinoma treated with radiation at a single institution between 1997 and 2013. Favorable high-risk was defined as T1c disease with either Gleason 4 + 4 = 8 and prostate-specific antigen <10 ng/mL or Gleason 6 and prostate-specific antigen >20 ng/mL. Competing risks regression was used to determine differences in the risk of prostate cancer–specific mortality (PCSM) after controlling for baseline factors and treatment. Our results were validated in a cohort of 13,275 patients using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results: Patients with favorable high-risk disease had significantly better PCSM than other men with high-risk disease (adjusted hazard ratio [AHR] 0.42, 95% confidence interval [CI] 0.18-0.996, P=.049) and similar PCSM as men with unfavorable intermediate-risk disease (AHR 1.17, 95% CI 0.50-2.75, P=.710). We observed very similar results within the SEER-Medicare cohort (favorable high-risk vs other high-risk: AHR 0.21, 95% CI 0.11-0.41, P<.001; favorable high-risk vs unfavorable intermediate-risk: AHR 0.67, 95% CI 0.33-1.36, P=.268). Conclusions: Patients with favorable high-risk prostate cancer have significantly better PCSM than other patients with high-risk disease and similar PCSM as those with unfavorable intermediate-risk disease, who are typically treated with shorter-course androgen deprivation therapy. This new classification system may allow for personalization of treatment within high-risk disease, such as consideration of shorter-course androgen deprivation therapy for favorable high-risk disease.

  10. The Uncertainties of Risk Management

    DEFF Research Database (Denmark)

    Vinnari, Eija; Skærbæk, Peter

    2014-01-01

    for expanding risk management. More generally, such uncertainties relate to the professional identities and responsibilities of operational managers as defined by the framing devices. Originality/value – The paper offers three contributions to the extant literature: first, it shows how risk management itself......Purpose – The purpose of this paper is to analyse the implementation of risk management as a tool for internal audit activities, focusing on unexpected effects or uncertainties generated during its application. Design/methodology/approach – Public and confidential documents as well as semi......-structured interviews are analysed through the lens of actor-network theory to identify the effects of risk management devices in a Finnish municipality. Findings – The authors found that risk management, rather than reducing uncertainty, itself created unexpected uncertainties that would otherwise not have emerged...

  11. When bad things happen: adverse event reporting and disclosure as patient safety and risk management tools in the neonatal intensive care unit.

    Science.gov (United States)

    Donn, Steven M; McDonnell, William M

    2012-01-01

    The Institute of Medicine has recommended a change in culture from "name and blame" to patient safety. This will require system redesign to identify and address errors, establish performance standards, and set safety expectations. This approach, however, is at odds with the present medical malpractice (tort) system. The current system is outcomes-based, meaning that health care providers and institutions are often sued despite providing appropriate care. Nevertheless, the focus should remain to provide the safest patient care. Effective peer review may be hindered by the present tort system. Reporting of medical errors is a key piece of peer review and education, and both anonymous reporting and confidential reporting of errors have potential disadvantages. Diagnostic and treatment errors continue to be the leading sources of allegations of malpractice in pediatrics, and the neonatal intensive care unit is uniquely vulnerable. Most errors result from systems failures rather than human error. Risk management can be an effective process to identify, evaluate, and address problems that may injure patients, lead to malpractice claims, and result in financial losses. Risk management identifies risk or potential risk, calculates the probability of an adverse event arising from a risk, estimates the impact of the adverse event, and attempts to control the risk. Implementation of a successful risk management program requires a positive attitude, sufficient knowledge base, and a commitment to improvement. Transparency in the disclosure of medical errors and a strategy of prospective risk management in dealing with medical errors may result in a substantial reduction in medical malpractice lawsuits, lower litigation costs, and a more safety-conscious environment. Thieme Medical Publishers, Inc.

  12. Continuous Risk Management at NASA

    Science.gov (United States)

    Hammer, Theodore F.; Rosenberg, Linda

    1999-01-01

    NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions. This risk management structure of functions has been taught to projects at all NASA Centers and is being successfully implemented on many projects. This presentation will give project managers the information they need to understand if risk management is to be effectively implemented on their projects at a cost they can afford.

  13. DEFENSE PROGRAMS RISK MANAGEMENT FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2012-01-01

    Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.

  14. [What Surgeons Should Know about Risk Management].

    Science.gov (United States)

    Strametz, R; Tannheimer, M; Rall, M

    2017-02-01

    Background: The fact that medical treatment is associated with errors has long been recognized. Based on the principle of "first do no harm", numerous efforts have since been made to prevent such errors or limit their impact. However, recent statistics show that these measures do not sufficiently prevent grave mistakes with serious consequences. Preventable mistakes such as wrong patient or wrong site surgery still frequently occur in error statistics. Methods: Based on insight from research on human error, in due consideration of recent legislative regulations in Germany, the authors give an overview of the clinical risk management tools needed to identify risks in surgery, analyse their causes, and determine adequate measures to manage those risks depending on their relevance. The use and limitations of critical incident reporting systems (CIRS), safety checklists and crisis resource management (CRM) are highlighted. Also the rationale for IT systems to support the risk management process is addressed. Results/Conclusion: No single tool of risk management can be effective as a standalone instrument, but unfolds its effect only when embedded in a superordinate risk management system, which integrates tailor-made elements to increase patient safety into the workflows of each organisation. Competence in choosing adequate tools, effective IT systems to support the risk management process as well as leadership and commitment to constructive handling of human error are crucial components to establish a safety culture in surgery. Georg Thieme Verlag KG Stuttgart · New York.

  15. Risk profile, management, and outcomes of patients with venous thromboembolism attended in Spanish Emergency Departments: The ESPHERIA registry.

    Science.gov (United States)

    Jimenez, Sonia; Ruiz-Artacho, Pedro; Merlo, Marta; Suero, Coral; Antolin, Albert; Casal, José Ramón; Sanchez, Marta; Ortega-Duarte, Alejandra; Genis, Mar; Piñera, Pascual

    2017-12-01

    The objective of this study was to determine the clinical profile of and diagnostic and therapeutic approach to patients with venous thromboembolism (VTE) in Spanish Emergency Departments (EDs). Risk factors, adherence to clinical practice guidelines, and outcomes were also evaluated.Patients with VTE diagnosed in 53 Spanish EDs were prospectively and consecutively included. Demographic data, comorbidities, risk factors for VTE, index event characteristics, hemorrhagic risk, and mortality were evaluated. Adherence to clinical practice guidelines was assessed based on clinical probability scales, requests for determination of D-dimer, use of anticoagulant treatment before confirmation of diagnosis, and assessment of bleeding and prognostic risk. Recurrence, bleeding, and death during admission and at 30, 90, and 180 days after diagnosis in the EDs were recorded.From 549,840 ED visits made over a mean period of 40 days, 905 patients were diagnosed with VTE (incidence 1.6 diagnoses per 1000 visits). The final analysis included 801 patients, of whom 49.8% had pulmonary embolism. The most frequent risk factors for VTE were age (≥70 years), obesity, and new immobility. Clinical probability, prognosis, and bleeding risk scales were recorded in only 7.6%, 7.5%, and 1% of cases, respectively. D-dimer was determined in 87.2% of patients with a high clinical probability of VTE, and treatment was initiated before confirmation in only 35.9% of these patients. In patients with pulmonary embolism, 31.3% had a low risk of VTE. Overall, 98.7% of patients with pulmonary embolism and 50.2% of patients with deep venous thrombosis were admitted. During follow-up, total bleeding was more frequent than recurrences: the rates of any bleeding event were 4.4%, 3.9%, 5.3%, and 3.5% at admission and at 30 and 90, and 180 days, respectively; the rates of VTE recurrence were 2.3%, 1.3%, 1.7%, and 0.6%, respectively. Mortality rates were 3.4%, 3.1%, 4.1%, and 2.6% during hospitalization and at

  16. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    OpenAIRE

    Szabo Alina

    2012-01-01

    Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in ...

  17. NGNP Risk Management Database: A Model for Managing Risk

    International Nuclear Information System (INIS)

    Collins, John

    2009-01-01

    To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft(reg s ign) Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool's design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

  18. NGNP Risk Management Database: A Model for Managing Risk

    Energy Technology Data Exchange (ETDEWEB)

    John Collins

    2009-09-01

    To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft® Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool’s design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

  19. Selecting Copulas for Risk Management

    NARCIS (Netherlands)

    H.J.W.G. Kole (Erik); C.G. Koedijk (Kees); M.J.C.M. Verbeek (Marno)

    2006-01-01

    textabstractCopulas offer financial risk managers a powerful tool to model the dependence between the different elements of a portfolio and are preferable to the traditional, correlation-based approach. In this paper we show the importance of selecting an accurate copula for risk management. We

  20. Corporate risk management : an overview

    NARCIS (Netherlands)

    Oosterhof, Casper M.

    2001-01-01

    Corporate risk management and hedging are important activities within financial as well as non-financial corporations. Under the assumptions of Modigliani and Miller [1958], corporate risk management is a redundant activity. However, the existence of market imperfections can explain the corporate

  1. Risk assessment of forensic patients: nurses' role.

    Science.gov (United States)

    Encinares, Maxima; McMaster, Jeff James; McNamee, Jim

    2005-03-01

    One of the unique roles of forensic nurses is to conduct risk assessments. Establishing a therapeutic nurse-patient relationship helps forensic nurses perform accurate and useful risk assessments. Accurate risk assessments can facilitate formulation of individualized risk management plans, designed to meet patients' needs and ensure public safety. The importance of forensic nurses' knowledge and application of appropriate communication and proper documentation cannot be overemphasized.

  2. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management

    DEFF Research Database (Denmark)

    Chapman, M John; Ginsberg, Henry N; Amarenco, Pierre

    2011-01-01

    Even at low-density lipoprotein cholesterol (LDL-C) goal, patients with cardiometabolic abnormalities remain at high risk of cardiovascular events. This paper aims (i) to critically appraise evidence for elevated levels of triglyceride-rich lipoproteins (TRLs) and low levels of high......-density lipoprotein cholesterol (HDL-C) as cardiovascular risk factors, and (ii) to advise on therapeutic strategies for management. Current evidence supports a causal association between elevated TRL and their remnants, low HDL-C, and cardiovascular risk. This interpretation is based on mechanistic and genetic...

  3. Perioperative challenges in management of a deaf and dumb patient posted for high-risk cardiac surgery.

    Science.gov (United States)

    Chowdhry, Vivek; Padhi, Manoranjan; Mohanty, B B; Biswal, Suvakanta

    2016-01-01

    Perioperative management of deaf and dumb patients can be a challenging task. For smooth postoperative recovery, proper care should begin in the preoperative period. Understanding the patients' needs and training him to follow the instructions requires to involve a communication specialist. Judicious use of sedatives and analgesics is essential to keep the patient pain-free and comfortable. Postoperatively, the patient should be kept awake, enough to understand the internal need of the body and to make a meaningful response to external stimuli. Adequate preoperative planning and coordinated team efforts with involvement of specialists can help in delivering better postoperative care.

  4. The Supply Chain Risk Management

    OpenAIRE

    Skitsko Volodymyr I.; Voynikov Mykola Yu.

    2018-01-01

    The article considers current approaches of risk-management in supply chains, the main steps of the risk management process are analyzed and detailed both for a separate enterprise – participant of supply chain, for the supply chain in general, and for the Beer game, based on the international risk management standards. The article provides a way to assess the risks of the «producer» in the Beer game according to the three strategies of its behavior, which presumably can correspond to differe...

  5. Risk management for whales

    OpenAIRE

    Cont, R; Wagalath, L

    2016-01-01

    We propose framework for modeling portfolio risk which integrates market risk with liquidation costs which may arise in stress scenarios. Our model provides a systematic method for computing liquidation-adjusted risk measures for a portfolio. Calculation of Liquidation-adjusted VaR (LVaR) for sample portfolios reveals a substantial impact of liquidation costs on portfolio risk for portfolios with large concentrated positions.

  6. Business risk management

    International Nuclear Information System (INIS)

    Cosby, C.

    2015-01-01

    Bruce Power's definition: an emerging and demonstrable event or change in business plan assumptions that could impact Bruce Power's achievement of its business plan objectives and results. Risks can be either negative (threats) or positive (opportunities). Risks against the 5 year business plan Net Risk = impact * probability.

  7. Business risk management

    Energy Technology Data Exchange (ETDEWEB)

    Cosby, C., E-mail: Christine.cosby@brucepower.com [Bruce Power, Tiverton, ON (Canada)

    2015-07-01

    Bruce Power's definition: an emerging and demonstrable event or change in business plan assumptions that could impact Bruce Power's achievement of its business plan objectives and results. Risks can be either negative (threats) or positive (opportunities). Risks against the 5 year business plan Net Risk = impact * probability.

  8. Patient-centered blood management.

    Science.gov (United States)

    Hohmuth, Benjamin; Ozawa, Sherri; Ashton, Maria; Melseth, Richard L

    2014-01-01

    Transfusions are common in hospitalized patients but carry significant risk, with associated morbidity and mortality that increases with each unit of blood received. Clinical trials consistently support a conservative over a liberal approach to transfusion. Yet there remains wide variation in practice, and more than half of red cell transfusions may be inappropriate. Adopting a more comprehensive approach to the bleeding, coagulopathic, or anemic patient has the potential to improve patient care. We present a patient-centered blood management (PBM) paradigm. The 4 guiding principles of effective PBM that we present include anemia management, coagulation optimization, blood conservation, and patient-centered decision making. PBM has the potential to decrease transfusion rates, decrease practice variation, and improve patient outcomes. PBM's value proposition is highly aligned with that of hospital medicine. Hospitalists' dual role as front-line care providers and quality improvement leaders make them the ideal candidates to develop, implement, and practice PBM. © 2013 Society of Hospital Medicine.

  9. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from

  10. Specifying nurse’s experiences of risk management is one of the patient security challenges in social security hospital: A phenomenological approach

    Directory of Open Access Journals (Sweden)

    Sedighe Teimuri

    2016-06-01

    Full Text Available Patient safety is regarded as prevention and damage adjustment due to elimination of errors related to mentioned hygienic care which decreases the mistakes by the help of applying practical methods and causes not occurrence of events. So this study was conducted aimed at specifying the experiences of nurses as a challenge to patient safety in social security hospital of Zahedan in 2015. This study is a qualitative research with a phenomenological approach. Participants of this study have been selected from nurse population on the basis of purposeful sampling. The sampling continued until the completeness of the data. 14 participants of this study consist of 2 supervisors, 1 head nurse and 11 nurses aged from 22-45 years old and all married. Data collection developed through deep, nonstructural interviews which were tape recorded and transcribed word by word. The data were then analyzed in Collaizzi’s7 step method. At the end of interview analysis, 130 codes were elicited and two themes were drawn named risk management and human resources management. Risk management consists of sub concepts; the policy of punishments of managers, inefficient management of medical errors and human resources management include sub concepts; The shortage of nurse forces, inefficient selection of nurses and increase in authenticity requirements. inefficient risk management is one of the most important patient safety challenges related to medical errors which should be specifically taken into account and intensify the encouragement system and the policy of not punishing nurses should be used in order to remove the mentioned challenges related to establishment of patient safety system.

  11. TRManager – Technical Risk Manager

    Directory of Open Access Journals (Sweden)

    Mark A. Gregory

    2009-06-01

    Full Text Available This paper presents research into the development of a new information management technique called Technical Risk Manager. Project management involves the use of processes and information management techniques to aid decision making in the pursuit of project success. Project success may be achieved by meeting time, cost or performance criteria. Current project management practices focus on achieving time and cost project success criteria by using three information management techniques developed in the 1950s: Gantt, PERT and Critical Path Method. Technical Risk Manager has been developed to provide an information management technique that may be used to aid project management decision making in the pursuit of achieving the performance project success criteria.

  12. Smart Grid Risk Management

    Science.gov (United States)

    Abad Lopez, Carlos Adrian

    Current electricity infrastructure is being stressed from several directions -- high demand, unreliable supply, extreme weather conditions, accidents, among others. Infrastructure planners have, traditionally, focused on only the cost of the system; today, resilience and sustainability are increasingly becoming more important. In this dissertation, we develop computational tools for efficiently managing electricity resources to help create a more reliable and sustainable electrical grid. The tools we present in this work will help electric utilities coordinate demand to allow the smooth and large scale integration of renewable sources of energy into traditional grids, as well as provide infrastructure planners and operators in developing countries a framework for making informed planning and control decisions in the presence of uncertainty. Demand-side management is considered as the most viable solution for maintaining grid stability as generation from intermittent renewable sources increases. Demand-side management, particularly demand response (DR) programs that attempt to alter the energy consumption of customers either by using price-based incentives or up-front power interruption contracts, is more cost-effective and sustainable in addressing short-term supply-demand imbalances when compared with the alternative that involves increasing fossil fuel-based fast spinning reserves. An essential step in compensating participating customers and benchmarking the effectiveness of DR programs is to be able to independently detect the load reduction from observed meter data. Electric utilities implementing automated DR programs through direct load control switches are also interested in detecting the reduction in demand to efficiently pinpoint non-functioning devices to reduce maintenance costs. We develop sparse optimization methods for detecting a small change in the demand for electricity of a customer in response to a price change or signal from the utility

  13. INTERNAL AUDIT AND RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Elena RUSE

    2014-04-01

    Full Text Available The existence of risk in economic activity can not be denied. In fact, the risk is a concept which exists in every activity, the term of risk being identified with uncertainty, respectively the (unchance to produce an undesirable event. Internal audit and risk management aim at the same goal, namely the control of risks. Internal Audit performs several roles in risk management plan. The objectives of the internal audit function varies from company to company, but in all economic entities internal audit department aims to improve performance management, enterprise performance and thus improve the internal control system. This paper aims to demonstrate, among other things, that any event that may result in failure is unquestionably classified as risk.

  14. Integrated supply chain risk management

    Directory of Open Access Journals (Sweden)

    Riaan Bredell

    2007-11-01

    Full Text Available Integrated supply chain risk management (ISCRM has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly applied, this process may optimise management decision-making and assist in the protection and enhancement of shareholder value.

  15. Risk of Nonfatal Stroke in Type 2 Diabetes Mellitus Patients: A Retrospective Comparison Between Disease Management Programs and Standard Care.

    Science.gov (United States)

    Wiefarn, Stefan; Heumann, Christian; Rettelbach, Anja; Kostev, Karel

    2017-07-01

    The present retrospective study examines the influence of disease management programs on nonfatal stroke in type 2 diabetes mellitus (T2DM) patients in Germany. The evaluation is based on retrospective patient data from the Disease Analyzer (IMS Health). The analysis included 169 414 T2DM patients aged 40 years and older with an initial prescription of antihyperglycemic therapy between January 2004 and December 2014. A total of 86 713 patients participated in a disease management program (DMP) for T2DM and 82 701 patients received standard care. The main outcome measure of this study was nonfatal stroke. Kaplan-Meier curves of DMP and SC patients were compared using log rank test. The Cox proportional hazards model was used to provide an adjusted estimate of the DMP effect. It is apparent from the baseline characteristics that the general health of patients receiving standard care was poorer than that of patients participating in a DMP. The baseline HbA1c value was 7.6% in the DMP group and 7.8% in the SC group. Furthermore, the SC group had a higher proportion of preexisting conditions, such as coronary heart disease (CHD), peripheral arterial occlusive disease (pAOD), and renal insufficiency. The proportion of patients who received insulin in first year therapy was higher in the SC group. Time to event analysis showed that DMP was associated with a delayed occurrence of stroke, because stroke occurred an average of 350 days later in DMP patients than in patients receiving SC (DMP: 1.216 days, RV: 866 days). The Cox model with covariable adjustment confirmed the significant association of DMPs with nonfatal stroke in patients with type 2 diabetes mellitus (HR 0.71; 95% CI: 0.69-0.74). The present study indicates that DMPs are positively associated with stroke. The possible reasons for this must be verified in further studies.

  16. Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

    Directory of Open Access Journals (Sweden)

    Patricia Echeverría

    2014-01-01

    Full Text Available Background. There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF in HIV-infected patients. Methods. We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results. We identified 81 patients with a history of a coronary event (prevalence 2.15%; 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus. Other CVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol P=0.025 and LDL-cholesterol P=0.004 was observed. However, the percentage of patients who maintained LDL-cholesterol > 100 mg/dL remained stable (from 46% to 41%, P=0.103. Patients using protease inhibitors associated with a favorable lipid profile increased over time P=0.028. Conclusions. The prevalence of coronary events in our cohort is low. CVRF prevalence is high and their management is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

  17. Perioperative challenges in management of a deaf and dumb patient posted for high-risk cardiac surgery

    Directory of Open Access Journals (Sweden)

    Vivek Chowdhry

    2016-01-01

    Full Text Available Perioperative management of deaf and dumb patients can be a challenging task. For smooth postoperative recovery, proper care should begin in the preoperative period. Understanding the patients′ needs and training him to follow the instructions requires to involve a communication specialist. Judicious use of sedatives and analgesics is essential to keep the patient pain-free and comfortable. Postoperatively, the patient should be kept awake, enough to understand the internal need of the body and to make a meaningful response to external stimuli. Adequate preoperative planning and coordinated team efforts with involvement of specialists can help in delivering better postoperative care.

  18. Enterprise risk management and disclosure

    Directory of Open Access Journals (Sweden)

    Nicoleta Farcane

    2008-01-01

    Full Text Available Our paper deals with aspects regarding risk and uncertainty. Many risk management methods are today implemented in organizations. This perspective reveals that managers are linked in different forms to the activities they are managing, depending on the conditions and levels of uncertainty they are in. Actually, these multiple levels of uncertainty lead to the conclusion that any situation in an organizational system can be classified in two different models of organizational phenomena: the organizational phenomena that are putting managers and stakeholders in conditions of risk and the organizational phenomena that are putting them in condition of uncertainty. Using content analyze in this paper we survey the disclosure level of risk management information in the annual report of top Romanian listed companies.

  19. Endodontic management of nonrestorable teeth in patients at risk of developing osteonecrosis of the jaw: Case series

    Directory of Open Access Journals (Sweden)

    Fahd Alsalleeh

    2016-01-01

    Full Text Available Osteoradionecrosis of the jaws is one of the most serious oral complications of head and neck cancer radiation therapy. It is a self-progressive process of bone destruction that is very difficult to treat. In this report, four patients who are susceptible to osteonecrosis of the jaw presented for endodontic management of nonrestorable teeth. The first patient had two molar teeth with necrotic pulp and was treated with nonsurgical root canal therapy (NSRCT followed by crown amputation and hemisection. The second patient had a molar tooth that was previously treated with acute apical abscess. Crown amputation and hemisection were performed. The third patient had a molar tooth with necrotic pulp and asymptomatic apical periodontitis. NSRCT followed by occlusal reduction were completed. The fourth patient had a molar tooth with necrotic pulp and symptomatic apical periodontitis. NSRCT and crown amputation were performed. All cases had a minimum recall of 12-months. The tooth in case #1 developed a periapical pathosis, and other teeth in case #1–#3 had healing of periapical lesions. The tooth in case #4 was exfoliated. None had developed osteonecrosis. These results suggest that NSRCT is the treatment option to manage nonrestorable teeth in postradiation patients or patients taking bisphosphonate drugs to prevent osteonecrosis.

  20. RISKS IN INVESTMENT AND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ms. Tatiana A. Ykovleva

    2016-12-01

    Full Text Available The article discusses the features of investment risks and their causes, as well as provides a detailed classification of investment risks. The authors reveal the essence and content of the investment process, risk management, providing material for presentation in the form of a diagram. In conclusion, the article explains the use of the system of specialized institutions as a way to exclude the basic, or primary investment risk.

  1. Pre-test probability risk scores and their use in contemporary management of patients with chest pain: One year stress echo cohort study

    Science.gov (United States)

    Demarco, Daniela Cassar; Papachristidis, Alexandros; Roper, Damian; Tsironis, Ioannis; Byrne, Jonathan; Monaghan, Mark

    2015-01-01

    Objectives To compare how patients with chest pain would be investigated, based on the two guidelines available for UK cardiologists, on the management of patients with stable chest pain. The UK National Institute of Clinical Excellence (NICE) guideline which was published in 2010 and the European society of cardiology (ESC) guideline published in 2013. Both guidelines utilise pre-test probability risk scores, to guide the choice of investigation. Design We undertook a large retrospective study to investigate the outcomes of stress echocardiography. Setting A large tertiary centre in the UK in a contemporary clinical practice. Participants Two thirds of the patients in the cohort were referred from our rapid access chest pain clinics. Results We found that the NICE risk score overestimates risk by 20% compared to the ESC Risk score. We also found that based on the NICE guidelines, 44% of the patients presenting with chest pain, in this cohort, would have been investigated invasively, with diagnostic coronary angiography. Using the ESC guidelines, only 0.3% of the patients would be investigated invasively. Conclusion The large discrepancy between the two guidelines can be easily reduced if NICE adopted the ESC risk score. PMID:26673458

  2. [Management of coronary artery disease in diabetic patients with lower limb critical ischaemia: assessment of operational risk, drug therapy and indications for interventions].

    Science.gov (United States)

    Dedov, I I; Kalashnikov, V Iu; Terekhin, S A; Melkozerov, K V

    2012-01-01

    Despite obvious progress in management of diabetes mellitus, the DM-related complications rate remains inadmissibly high. Macroangiopathy is known to rank first amongst complications of diabetes mellitus, and coronary artery disease remains to be the major cause of death. Analysed herein are peculiarities of the clinical course in diabetic patients presenting with coronary artery disease and lower limb critical ischaemia, followed by discussing the issues concerning drug therapy, preoperative examination, and methods of diagnosis in this cohort of patients prior to vascular operations, assessment of the preoperative risk, indications for coronarography and myocardial revascularization. Also presented are the results of the main clinical trials dedicated to preoperative myocardial revascularization, including those in diabetic patients with limb critical ischaemia, and finally highlighting current importance of optimizing approaches to managing and working out algorithms of treatment policy for diabetic patients with a combination of coronary artery disease, diabetes mellitus, and critical limb ischaemia.

  3. Risk Management Issues - An Aerospace Perspective

    Science.gov (United States)

    Perera, Jeevan S.

    2011-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks--risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements.. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner, Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  4. Patient Safety in Complementary Medicine through the Application of Clinical Risk Management in the Public Health System.

    Science.gov (United States)

    Rossi, Elio G; Bellandi, Tommaso; Picchi, Marco; Baccetti, Sonia; Monechi, Maria Valeria; Vuono, Catia; Sabatini, Federica; Traversi, Antonella; Di Stefano, Mariella; Firenzuoli, Fabio; Albolino, Sara; Tartaglia, Riccardo

    2017-12-16

    Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM.

  5. Patient Safety in Complementary Medicine through the Application of Clinical Risk Management in the Public Health System

    Directory of Open Access Journals (Sweden)

    Elio G. Rossi

    2017-12-01

    Full Text Available Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA and failure modes and effects analysis (FMEA. Methods: SEA is the selected tool for studying adverse events (AE and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS. This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN, and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM.

  6. Improving Operational Risk Management Using Business Performance Management Technologies

    OpenAIRE

    Bram Pieket Weeserik; Marco Spruit

    2018-01-01

    Operational Risk Management (ORM) comprises the continuous management of risks resulting from: human actions, internal processes, systems, and external events. With increasing requirements, complexity and a growing volume of risks, information systems provide benefits for integrating risk management activities and optimizing performance. Business Performance Management (BPM) technologies are believed to provide a solution for effective Operational Risk Management by offering several combined ...

  7. Scope of environmental risk management

    Energy Technology Data Exchange (ETDEWEB)

    O' Riordan, T

    1979-01-01

    Environmental risk management embraces three techniques for project appraisal: cost/benefit analysis, environmental impact analysis and risk assessment. It also explicitly relates scientific investigations to political judgments, sometimes so closely that the two cannot be separated. Indeed it is now apparent that environmental risk management encompasses procedures both to review the relative merits and priorities of policies as well as to appraise the environmental risks of particular schemes. Until recently this relationship has not been fully appreciated, so much imagination and innovation is still required to develop the most-suitable mechanisms for review.

  8. The Theme of Risk Management

    Directory of Open Access Journals (Sweden)

    Chua, D. K. H.

    2014-07-01

    Full Text Available The papers in this issue of the Journal come from different industry sectors, yet there can be a common theme that ties them together. Two of the papers address explicitly the issue of risk management, while the other three may be related to it in different degrees. One of the critical factors for project success is risk identification, as determined by Chua et al. (1999. The importance of risk management cannot be overemphasized. Failure to identify crucial risk elements in a project can lead to significant project failures in terms of cost and schedule.

  9. Tailoring Risk Management in Design

    DEFF Research Database (Denmark)

    Tegeltija, M.; Oehmen, J.; McMahon, C. A.

    2018-01-01

    While risk quantification research has grown over the last few decades, only a limited number of studies have addressed the overall process integration of these approaches in design risk management. This paper argues that the choice of risk quantification method has strong implications for several...... process aspects. We investigate current risk management maturity models and suggest an expansion to accommodate requirements originating from the choice of quantification method, and to inform the choice of quantification method, based on other process parameters, validated through 3 case companies....

  10. Continuing to Confront COPD International Surveys: comparison of patient and physician perceptions about COPD risk and management

    Directory of Open Access Journals (Sweden)

    Menezes AM

    2015-01-01

    regarding COPD management practices, including the use of spirometry (86% of physicians and 76% of patients reporting they used/had undergone a spirometry test and smoking cessation counseling (76% of physicians reported they counseled their smoking patients at every clinic visit, and 71% of smoking patients stated that they had received counseling in the past year. However, the groups differed in their perception about the role of smoking in COPD, with 78% of physicians versus 38% of patients strongly agreeing with the statement “smoking is the cause of most cases of COPD”. Conclusion: The Continuing to Confront COPD International Surveys demonstrate that while physicians and patients largely agreed about COPD management practices and the need for more effective treatments for COPD, a gap exists about the causal role of smoking in COPD. Keywords: chronic obstructive pulmonary disease, physician survey, patient survey, beliefs, perceptions

  11. Applied software risk management a guide for software project managers

    CERN Document Server

    Pandian, C Ravindranath

    2006-01-01

    Few software projects are completed on time, on budget, and to their original specifications. Focusing on what practitioners need to know about risk in the pursuit of delivering software projects, Applied Software Risk Management: A Guide for Software Project Managers covers key components of the risk management process and the software development process, as well as best practices for software risk identification, risk planning, and risk analysis. Written in a clear and concise manner, this resource presents concepts and practical insight into managing risk. It first covers risk-driven project management, risk management processes, risk attributes, risk identification, and risk analysis. The book continues by examining responses to risk, the tracking and modeling of risks, intelligence gathering, and integrated risk management. It concludes with details on drafting and implementing procedures. A diary of a risk manager provides insight in implementing risk management processes.Bringing together concepts ...

  12. Managing Multiple Risk Factors

    National Research Council Canada - National Science Library

    Lollis, Charlie

    1998-01-01

    ...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...

  13. Knowledge management in support of enterprise risk management

    OpenAIRE

    Rodriguez, Eduardo; Edwards, John S.

    2014-01-01

    Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs relate...

  14. The NASA risk management program

    International Nuclear Information System (INIS)

    Buchbinder, B.; Philipson, L.L.

    1989-01-01

    This paper reports that the NASA Risk Management Program has been established to ensure the appropriate application of risk-based procedures in support of the elimination, reduction, or acceptance of significant safety risks of concern in NASA. The term appropriate is emphasized, in that the particular procedures applied to each given risk are to reflect its character and prioritized importance, the technological and economic feasibility of its treatment. A number of key documents have been produced in support of this implementation. Databases, risk analysis tools, and risk communication procedures requisite to the execution of the risk management functions also are being developed or documented. Several risk management applications have been made and a comprehensive application to a major new NASA program is underway. This paper summarizes the development and current status of the NASA Risk Management Program. Some principal actions that have been carried out in NASA in consonance with the program are noted particularly, and views are presented on the program's likely future directions

  15. How to manage risk better

    CSIR Research Space (South Africa)

    Walwyn, DR

    2002-09-01

    Full Text Available Risk management practices in the R&D departments of many chemical and pharmaceutical companies lack much of the rigor and sophistication of the equivalent corporation in the financial sector. For instance investment decisions on research projects...

  16. Risk Management and Value Creation

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Roggi, Oliviero

    Corporate failures, periodic recessions, regional debt crises and volatile financial markets have intensified the focus on risk management as the means to deal with turbulent conditions. The ability to respond effectively to abrupt environmental impacts is considered an important source...... of competitive advantage. Yet, surprisingly little research has analyzed whether the presumed advantages of effective risk management are associated with superior outcomes. Here we present a comprehensive study of risk management effectiveness and the relationship to corporate performance based on more than 33......,500 observations in 3,400 firms over the turbulent 20-year period 1991-2010. Determining effective risk management as the ability to reduce earnings and cash flow volatility, we find that both have significant positive relationships to lagged performance measures after controlling for industry effects, company...

  17. Risk assessment and risk management of mycotoxins.

    Science.gov (United States)

    2012-01-01

    Risk assessment is the process of quantifying the magnitude and exposure, or probability, of a harmful effect to individuals or populations from certain agents or activities. Here, we summarize the four steps of risk assessment: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Risk assessments using these principles have been conducted on the major mycotoxins (aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, and zearalenone) by various regulatory agencies for the purpose of setting food safety guidelines. We critically evaluate the impact of these risk assessment parameters on the estimated global burden of the associated diseases as well as the impact of regulatory measures on food supply and international trade. Apart from the well-established risk posed by aflatoxins, many uncertainties still exist about risk assessments for the other major mycotoxins, often reflecting a lack of epidemiological data. Differences exist in the risk management strategies and in the ways different governments impose regulations and technologies to reduce levels of mycotoxins in the food-chain. Regulatory measures have very little impact on remote rural and subsistence farming communities in developing countries, in contrast to developed countries, where regulations are strictly enforced to reduce and/or remove mycotoxin contamination. However, in the absence of the relevant technologies or the necessary infrastructure, we highlight simple intervention practices to reduce mycotoxin contamination in the field and/or prevent mycotoxin formation during storage.

  18. Influence of surgical implantation angle of left ventricular assist device outflow graft and management of aortic valve opening on the risk of stroke in heart failure patients

    Science.gov (United States)

    Chivukula, V. Keshav; McGah, Patrick; Prisco, Anthony; Beckman, Jennifer; Mokadam, Nanush; Mahr, Claudius; Aliseda, Alberto

    2016-11-01

    Flow in the aortic vasculature may impact stroke risk in patients with left ventricular assist devices (LVAD) due to severely altered hemodynamics. Patient-specific 3D models of the aortic arch and great vessels were created with an LVAD outflow graft at 45, 60 and 90° from centerline of the ascending aorta, in order to understand the effect of surgical placement on hemodynamics and thrombotic risk. Intermittent aortic valve opening (once every five cardiac cycles) was simulated and the impact of this residual native output investigated for the potential to wash out stagnant flow in the aortic root region. Unsteady CFD simulations with patient-specific boundary conditions were performed. Particle tracking for 10 cardiac cycles was used to determine platelet residence times and shear stress histories. Thrombosis risk was assessed by a combination of Eulerian and Lagrangian metrics and a newly developed thrombogenic potential metric. Results show a strong influence of LVAD outflow graft angle on hemodynamics in the ascending aorta and consequently on stroke risk, with a highly positive impact of aortic valve opening, even at low frequencies. Optimization of LVAD implantation and management strategies based on patient-specific simulations to minimize stroke risk will be presented

  19. International comparative analyses of healthcare risk management.

    Science.gov (United States)

    Sun, Niuyun; Wang, Li; Zhou, Jun; Yuan, Qiang; Zhang, Zongjiu; Li, Youping; Liang, Minghui; Cheng, Lan; Gao, Guangming; Cui, Xiaohui

    2011-02-01

    Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province, hospital, and non-governmental organization. The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an "NGO-led mode" represented by the United States and Canada and a "government-led mode" represented by the United Kingdom, Australia, and Taiwan. © 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  20. 76 FR 45724 - Clearing Member Risk Management

    Science.gov (United States)

    2011-08-01

    ... proposed rules address risk management for cleared trades by futures commission merchants, swap dealers... Commission has proposed extensive regulations addressing open access and risk management at the derivatives..., 2011) (Risk Management Requirements for Derivatives Clearing Organizations). These proposed regulations...

  1. Producers' Complex Risk Management Choices

    NARCIS (Netherlands)

    Pennings, J.M.E.; Isengildina, O.; Irwin, S.H.; Garcia, P.; Good, D.L.

    2008-01-01

    Producers have a wide variety of risk management instruments available, making their choice(s) complex. The way producers deal with this complexity can vary and may influence the impact that the determinants, such as risk aversion, have on their choices. A recently developed choice bracketing

  2. Legal risk management in shipping

    DEFF Research Database (Denmark)

    Siig, Kristina

    The book discusses the most typical legal challenges met in the chartering, broker, agent or port management part of the shipping industry. It discusses these issues in both English and Scandinavian law and gives indications on how to best ensure your legal risk management in these parts...

  3. Should systematic risk assessment and immediate intervention of the acutely ill patient replace the traditional management paradigm?

    LENUS (Irish Health Repository)

    Kellett, John

    2012-01-01

    The outcome of the traditional diagnostic history and physical depends entirely on the availability, ability and diligence of an individual doctor. An alternative is a team-based approach that performs the following tasks: a focused assessment, monitoring of the response to initial treatment, and then determining what further management is appropriate (calling for urgent help if it is required). This concept is based on risk prediction rather than diagnosis, and is captured by the mnemonic FAITH3 (Focused Assessment, Initial Treatment, hAssessing response, calling for Help and Handing over care).

  4. Price Risk and Risk Management in Agriculture

    Directory of Open Access Journals (Sweden)

    Udo Broll

    2013-06-01

    Full Text Available This note studies the risk-management decisions of a risk-averse farmer. The farmer faces multiple sources of price uncertainty. He sells commodities to two markets at two prices, but only one of these markets has a futures market. We show that the farmer’s optimal commodity futures market position, i.e., a cross-hedge strategy, is actually an over-hedge, a full-hedge, or an under-hedge strategy, depending on whether the two prices are strongly positively correlated, uncorrelated, or negatively correlated, respectively.

  5. Glycaemic control and cardiovascular risk factor management in patients with diabetes with and without coronary artery disease: insights from the diabetes mellitus status in Canada survey.

    Science.gov (United States)

    Grenier, Jasmine; Leiter, Lawrence A; Langer, Anatoly; Goldin, Lianne; Teoh, Hwee; Connelly, Kim A; Cheng, Alice Y Y; Tan, Mary K; Fitchett, David; McGuire, Darren K; Goodman, Shaun G; Yan, Andrew T

    2016-10-01

    Current diabetes guidelines recommend an individualized approach to glycaemic control. There are limited data on the contemporary and comprehensive management of patients with diabetes in relation to coronary artery disease (CAD). The Diabetes Mellitus Status in Canada (DM-SCAN) survey included 5123 patients with type 2 diabetes seen in primary care in November 2012. Primary care physicians (PCPs) collected clinical data and specified the A1C target for each patient on standardized forms. We compared management strategies and achievement of treatment targets in patients with and without CAD. Among the 4994 patients with data on CAD history, 22.5% had CAD. Primary care physicians were more likely to select a higher A1C target for patients with CAD (≤7.5 or ≤8.0%) versus without (≤7.0%). There was no difference in median A1C or in the proportion of patients with A1C ≤7.0% between the two groups. Compared with the group without known CAD, patients with CAD had a higher reported prevalence of hypoglycaemia in the preceding 6 months; more frequently received aspirin, statins, ACE inhibitors, or angiotensin receptor blockers, and were more likely to achieve blood pressure and low-density lipoprotein-cholesterol targets. Only 15.4 and 12.0% of patients with and without CAD (P = 0.002), respectively, achieved all three guideline-recommended targets. Compared with patients with diabetes without CAD, those with CAD more frequently had a less stringent A1C target selected by their PCPs but achieved similar glycaemic control. Overall, risk factor management remained suboptimal in both groups. There remains an important opportunity to improve the care and outcome of patients with diabetes.

  6. Managing Supplier Sustainability Risk

    OpenAIRE

    Harilainen, Hanna-Riitta

    2014-01-01

    Supply chains are increasingly global, often reaching to developing regions. The media pressure brand owners to be responsible, but a product is only as sustainable as the practices of all the companies involved in manufacturing it are. It’s not enough that the brand owner acts responsibly; sustainable practices have to reach component and raw material suppliers upstream. Image risk has often been recognized as reason for investing in sustainability. In the supply chain context, supplier m...

  7. Energy price risk management

    International Nuclear Information System (INIS)

    Evans, J.W.G.

    1998-01-01

    While long term, fixed price contracts for fuel procurement and export of excess power may lock in the economics of a CHP plant, these do not necessarily give the best pricing opportunities that may exist during the life of those contracts. A more prudent approach may be to vary the length of the contracts and markets are now developing in gas and electricity to assist in the management of such a portfolio. (Author)

  8. Underground risk management information systems

    Energy Technology Data Exchange (ETDEWEB)

    Matsuyama, S.; Inoue, M.; Sakai, T.

    2006-03-15

    JCOAL has conducted Joint Research on an Underground Communication and Risk Management Information System with CSIRO of Australia under a commissioned study project for the promotion of coal use starting in fiscal 2002. The goal of this research project is the establishment of a new Safety System focusing on the comprehensive risk management information system by the name of Nexsys. The main components of the system are the Ethernet type underground communication system that represents the data communication base, and the risk management information system that permits risk analysis in real-time and provides decision support based on the collected data. The Nexsys is an open system and is a core element of the underground monitoring system. Using a vast amount of underground data, it is capable of accommodating a wide range of functions that were not available in the past. Because of it, it is possible to construct an advanced underground safety system. 14 figs., 4 tabs.

  9. Risk management for noncombustion wastes

    International Nuclear Information System (INIS)

    Connor, K.K.; Rice, J.S.

    1991-01-01

    The Noncombustion Waste Risk Management Project is designed to incorporate the insights and information developed in these projects into tools that will help utilities make better noncombustion waste management decisions. Specific project goals are to synthesize information useful to utilities on noncombustion wastes, emphasize waste reduction as a priority over end-of-pipe management, develop methods to manage the costs and risks associated with noncombustion wastes (e.g., direct costs, permitting costs, liability costs, public relations costs), develop software and documentation to deliver the information and analysis methods to the industry. This project was initiated EPRI's Environment Division in late 1988. The early phases of the project involved gathering information on current noncombustion waste management practices, specific utility problems and concerns with respect to these wastes, current and potential future regulations, and current and emerging management options. Recent efforts have focused on characterizing the direct and indirect (e.g., lawsuits, remedial action) costs of managing these wastes and on developing and implementing risk management methods for a subset of wastes. The remainder of this paper describes the specific issues addressed by and the results and insights from the three completed waste-specific studies

  10. Risk factors for multidrug resistant tuberculosis patients in Amhara ...

    African Journals Online (AJOL)

    Risk factors for multidrug resistant tuberculosis patients in Amhara National ... risk factors of MDR-TB patients in Amhara National Regional State, Ethiopia. ... strict adherence to directly observed therapy, appropriate management of TB ...

  11. Risk Management in the Exchange Fund Account

    OpenAIRE

    Michel Rochette

    2002-01-01

    In this article, author Michel Rochette of the Bank's Risk-Management Unit briefly describes the initiatives undertaken to identify, analyze, model, and manage the principal risks inherent in the transactions of the Exchange Fund Account (EFA), where the international reserves of the federal government are held. The author focuses on five types of risk: credit risk, market risk, liquidity risk, operational risk, and legal risk. In addition, the author presents the risk-management principles u...

  12. Managing nuclear supplier risks

    International Nuclear Information System (INIS)

    Ramberg, B.

    1990-01-01

    This paper reports that with the appearance of such third-tier suppliers as Argentina, Brazil, South Korea, Taiwan, China, and others capable of producing nuclear components and sensitive nuclear materials, assurance that importers are using nuclear energy benignly and safely may become more uncertain. It is therefore important to integrate emerging exporters and importers into a regime of norms designed to minimize nuclear risks. The experience of the London Nuclear Suppliers Group (NSG) to arrive at a code of conduct is encouraging. Placed in the context of the larger evolving nuclear energy regime that seeks to address nuclear safety, proliferation, terrorism, and military attacks on reactors, the international community has made substantial progress. Still, there is much that remains to be done

  13. Risk management through concurrency

    International Nuclear Information System (INIS)

    Childress, J.R.; Briant, V.B.

    1991-01-01

    More than ever before, management and technical professionals are concerned with the subtle and dynamic relationships between safety and performance in complex and hazardous industries. This is certainly true in the nuclear power industry. With the US electric energy industry on the verge of deregulation and increased competition, and with a virtual stoppage on building new nuclear power plants, the increasing demand for reliable sources of efficient electric energy is pressing the nuclear utilities to increase production. At the same time, public sentiment and regulatory pressures are increasing their focus on safety at all costs. The purpose of this paper is to present a proven approach to creating a new work culture for improved nuclear safety and performance. The concepts and material which make up this paper have been taken from both authors experience, research, and consulting in the nuclear industry for several years, as well as from over 20 years of consulting work on the relationships between organizational behavior, culture, and productivity

  14. Managing economic risks through simulation

    International Nuclear Information System (INIS)

    Griffin, B.J.; Eresman, R.K.

    1994-01-01

    Industrial operations are commonly managed in terms of such factors as raw material requirements, throughput, equipment reliability, and operator productivity. Simulation can be used to transform standard management performance measures into probabilistic measures which define the associated risks. These results provide valuable insight for effective management of economic risks. Case studies are presented using the Monte Carlo simulation method to demonstrate different applications of simulation techniques, various result formats, and their use for optimizing economic returns. In the first case study, design criteria for a large gas distribution system originally developed from worst-case demand estimates were modelled to provide a risk basis for decisions on alternative upgrading options. In the second, a commercial gas storage facility operation was modelled to develop economic marketing strategies balancing supply and demand requirements from multiple clients. 3 refs

  15. Branding and the Risk Management Imperative

    Directory of Open Access Journals (Sweden)

    Fournier Susan

    2018-05-01

    Full Text Available In an increasingly risky socioeconomic environment, management needs to proactively consider brand-related risks. To understand brands as tools for risk management, they need to understand four types of brand risk: brand reputation risk, brand dilution risk, brand cannibalization risk and brand stretch risk.

  16. Branding and the Risk Management Imperative

    OpenAIRE

    Fournier Susan; Srinivasan Shuba

    2018-01-01

    In an increasingly risky socioeconomic environment, management needs to proactively consider brand-related risks. To understand brands as tools for risk management, they need to understand four types of brand risk: brand reputation risk, brand dilution risk, brand cannibalization risk and brand stretch risk.

  17. Supply Chain Risk Management

    OpenAIRE

    Babková, Ivana

    2008-01-01

    Práce se zabývá problematikou řízení rizika v logistických řetězcích se zaměřením na jeden konkrétní článek řetězce. Definuje základní oblasti risk managementu, jeho hlavní aspekty a systém spojitého plánování. Zabývá se bezpečností práce v pojetí EU, České republiky a Velké Británie. V aplikační části uvádí řízení rizika v jednom článku logistického řetězce, skladu poskytovatele logistických služeb ve Velké Británii.

  18. Risk management for industrial safety

    International Nuclear Information System (INIS)

    Novogno, A.

    1989-01-01

    The catastrophic accidents which have occurred in the last decade, in both developed and developing countries, have drawn the attention of decision-makers in the safety area to the urgent necessity to assess and manage risks from hazardous industrial activities which are concentrated in large industrialized areas. The aim of this paper is to review experience gained in conducting studies in the area of 'comparisons of risks in energy systems' and on the practical application of 'cost effectiveness of risk reduction analysis among different energy systems' (case studies). It is also the aim of the paper to discuss and propose a general framework for defining an 'integrated approach' to risk assessment and management in highly industrialized regions within a country. (author)

  19. 12 CFR 917.3 - Risk management.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Risk management. 917.3 Section 917.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD GOVERNANCE AND MANAGEMENT OF THE FEDERAL HOME LOAN BANKS POWERS AND RESPONSIBILITIES OF BANK BOARDS OF DIRECTORS AND SENIOR MANAGEMENT § 917.3 Risk management. (a) Risk management...

  20. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.

    Science.gov (United States)

    Sendlhofer, Gerald; Brunner, Gernot; Tax, Christa; Falzberger, Gebhard; Smolle, Josef; Leitgeb, Karina; Kober, Brigitte; Kamolz, Lars Peter

    2015-01-01

    For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks. CRM implementation into routine procedures within complex hospital organizations is challenging, as in the past, organizational change strategies using a top-down approach have often failed. Therefore, one of our main objectives was to educate a certain number of risk managers in facilitating CRM using a bottom-up approach. To achieve our primary purpose, five project strands were developed, and consequently followed, introducing CRM: corporate governance, risk management (RM) training, CRM process, information, and involvement. The core part of the CRM process involved the education of risk managers within each organizational unit. To account for the size of the existing organization, we assumed that a minimum of 1 % of the workforce had to be trained in RM to disseminate the continuous improvement of quality and safety. Following a roll-out plan, CRM was introduced in each unit and potential risks were identified. Alongside the changes in the corporate governance, a hospital-wide CRM process was introduced resulting in 158 trained risk managers correlating to 2.0 % of the total workforce. Currently, risk managers are present in every unit and have identified 360 operational risks. Among those, 176 risks were scored as strategic and clustered together into top risks. Effective meeting structures and opportunities to share information and knowledge were introduced. Thus far, 31 units have been externally audited in CRM. The CRM approach is unique with respect to its dimension; members of all health care professions were trained to be able to identify potential risks. A network of risk

  1. [Risk Assessment and Risk Management of Chemicals in China].

    Science.gov (United States)

    Wang, Tie-yu; Zhou, Yun-qiao; Li, Qi-feng; Lü, Yong-long

    2016-02-15

    Risk assessment and risk management have been increasingly approved as an effective approach for appropriate disposal and scientific management of chemicals. This study systematically analyzed the risk assessment methods of chemicals from three aspects including health risk, ecological risk and regional risk. Based on the current situation of classification and management towards chemicals in China, a specific framework of risk management on chemicals was proposed by selecting target chemicals, predominant industries and related stakeholders as the objects. The results of the present study will provide scientific support for improving risk assessment and reasonable management of chemicals in China.

  2. A view on risk management

    International Nuclear Information System (INIS)

    Joksimovich, V.

    1991-01-01

    The world at large has enjoyed the benefits of industrial technology for almost two centuries. The managers of industrial facilities as well as members of the public focused on the benefits and typically ignored or underestimated the inherent risks entailed in deployment of these technologies. Two examples will be given for the sake of illustration. In the chemical industry, the impacts of various chemicals on humans are insufficiently understood. In addition, it was not even known that some hazardous chemicals could be formed in the chemical reactions taking place in various chemical reactors. This is equivalent to not knowing that Cesium-iodide compound can be formed within nuclear fuel nor the impact it might have on humans if released, which is inconceivable in the nuclear industry. In the era of risk recognition, many industrial managers proclaimed that safety is everybody's business. The basic premise behind this was that since everyone is responsible, no one can be blamed for accidents. This is, however, shifting because both economics and litigation are now compelling industrial managers to consider risk in conjunction with the benefit. The government managers in many cases interpreted their charter to reap benefits first and pay the price of risks later; e.g., the case of nuclear weapons production facilities seriously contaminated by radioactive and other hazardous materials. Cost of clean-up was estimated at more than $100 billion. Of course, the authors have similar examples in many other industries, e.g., Superfund project of chemical waste sites. The challenge for the technologists is to maximize the benefit/risk ratio, keeping the risks, real or perceived, acceptably small. This brings us to the issue of acceptable risks, the topic of this paper

  3. Developing Risk Management as a Competitive Capability

    OpenAIRE

    Silva, E.; Wu, Y.; Ojiako, U.

    2013-01-01

    At the level of the firm, three major parameters are found to influence the ability of SMEs to develop risk management competencies; these are enterprise risk management, internal control, and risk culture.

  4. Risk management at GPU Nuclear

    International Nuclear Information System (INIS)

    Long, R.L.

    1991-01-01

    This paper reports on GPU Nuclear. Among other goals, it established the independence of key safety functions as highlighted by the lessons learned from the accident. In particular, an independent Nuclear Assurance Division was established which include Quality Assurance, Training and Education, Emergency Preparedness, and Nuclear Safety Assessment. The latter consisted of corporate and site independent-safety-review groups. As the GPU Nuclear organization matured, a mid-1987 reorganization created an even more focused Planning and Nuclear Safety Division bringing together Nuclear Safety Assessment with Licensing and Regulatory Affairs and Risk Management. The Risk Management Group (RMG), which began its work in fall 1987, was formed to develop a framework for proactive identification, evaluation, and cost-effective reduction and management of risks of all types. The RMG set out to learn as much as possible about risks and their management in nuclear and other high-technology industries. This began with a thorough literature search. It progressed to interviews with individuals and organizations which have demonstrated innovative ideas, experience, and reputations for safe and reliable operation

  5. RISK MANAGEMENT USING PROJECT RECON

    Science.gov (United States)

    2016-11-28

    centralized database . • Project Recon (formerly Risk Recon) is designed to be used by all Program Management Offices, Integrated Project Teams and any...Create growth plans to proactively capture benefits • Customize reports to group opportunities by programmatic, technical, business, contracting, and

  6. Integrated Foreign Exchange Risk Management

    DEFF Research Database (Denmark)

    Aabo, Tom; Høg, Esben; Kuhn, Jochen

    Empirical research has focused on export as a proxy for the exchange rate exposure and the use of foreign exchange derivatives as the instrument to deal with this exposure. This empirical study applies an integrated foreign exchange risk management approach with a particular focus on the role...

  7. CEA: assessment of risk management 2011

    International Nuclear Information System (INIS)

    2012-06-01

    This report proposes an overview of CEA activities in the field of risk management in different areas: impact on the environment, installation safety, management of occupational risks (occupational health and safety), radiological protection of workers, transportation of hazardous materials, waste management, protection of sites, installations and heritage, management of emergency situations, management of law risks, controls and audits. It finally presents the risk management department

  8. PROJECT MANAGER SKILLS, RISK MANAGEMENT TOOLS

    Directory of Open Access Journals (Sweden)

    Vladut Iacob

    2013-12-01

    Full Text Available Although the projects are different from each other there are many common things that contribute to their success. Looked overall, the success of a project is the result of a multitude of factors. This person is considered the "engine" of the project. The man who makes the action set for the achievement of project objectives to be brought to an end. The project manager must have the technical knowledge and economic diverse. He should be able to choose a team and lead. You must be tenacious, combative, to know how to communicate both within the team and beyond. In a word, the project manager must have an impressive stock of knowledge, skills and abilities and appreciate as Peter Drucker, to "exist for the organization. To be its servant. Any management who forget this will only cause damage to the organization. "This study will focus on highlighting the skills of the project manager and their role in managing difficult situations or risk.

  9. Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Markotic F

    2016-11-01

    Full Text Available Filipa Markotic,1 Livia Puljak2 1Centre for Clinical Pharmacology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; 2Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Background: Understanding and improving patient safety is a key issue in medicine. One of the potential threats to patient safety is the sharing of medication among patients, which is a form of self-medication. This study analyzed experiences and attitudes of pain management physicians (PMPs about sharing prescription analgesics among patients.Methods: This qualitative study was conducted by semi-structured interviews among PMPs employed in Croatian pain clinics. The study involved two researchers and 15 PMPs.Results: Among PMPs, 80% have seen patients who share their prescription analgesics with other patients for whom prescription is not intended. Most PMPs consider prescription analgesics sharing a risky and negative behavior. Some of them, however, found certain positive aspects associated to it, such as being a benevolent behavior, helping patients to get medications when they need them, and helping them cope with pain.Conclusion: The majority of physicians specialized in pain management encountered patients sharing prescription analgesics. Most of them considered this as risky behavior with a number of potential consequences. It has been noted that this problem is neglected and that physicians should inquire about medication sharing. Direct-to-consumers advertising was perceived as a factor contributing to such behavior. Patient education and more involvement of physicians in identifying this behavior were cited as potential remedies for preventing sharing of prescription analgesics. Keywords: analgesics, sharing, lending, borrowing, risks

  10. Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.

    Science.gov (United States)

    Blaha, Michael J; Silverman, Michael G; Budoff, Matthew J

    2014-03-01

    Although risk factors have proven to be useful therapeutic targets, they are poor predictors of risk. Traditional risk scores are moderately successful in predicting future CHD events and can be a starting place for general risk categorization. However, there is substantial heterogeneity between traditional risk and actual atherosclerosis burden, with event rates predominantly driven by burden of atherosclerosis. Serum biomarkers have yet to show any clinically significant incremental value to the FRS and even when combined cannot match the predictive value of atherosclerosis imaging. As clinicians, are we willing to base therapy decisions on risk models that lack optimum-achievable accuracy and limit personalization? The decision to treat a patient in primary prevention must be a careful one because the benefit of therapy in an asymptomatic patient must clearly outweigh the potential risk. CAC, in particular, provides a personalized assessment of risk and may identify patients who will be expected to derive the most, and the least, net absolute benefit from treatment. Emerging evidence hints that CAC may also promote long-term adherence to aspirin, exercise, diet, and statin therapy. When potentially lifelong treatment decisions are on the line, clinicians must arm their patients with the most accurate risk prediction tools, and subclinical atherosclerosis testing with CAC is, at the present time, superior to any combination of risk factors and serum biomarkers.

  11. Evaluation of the quality of care of a multi-disciplinary risk factor assessment and management programme (RAMP for diabetic patients

    Directory of Open Access Journals (Sweden)

    Fung Colman SC

    2012-12-01

    Full Text Available Abstract Background Type 2 Diabetes Mellitus (DM is a common chronic disease associated with multiple clinical complications. Management guidelines have been established which recommend a risk-stratified approach to managing these patients in primary care. This study aims to evaluate the quality of care (QOC and effectiveness of a multi-disciplinary risk assessment and management programme (RAMP for type 2 diabetic patients attending government-funded primary care clinics in Hong Kong. The evaluation will be conducted using a structured and comprehensive evidence-based evaluation framework. Method/design For evaluation of the quality of care, a longitudinal study will be conducted using the Action Learning and Audit Spiral methodologies to measure whether the pre-set target standards for criteria related to the structure and process of care are achieved. Each participating clinic will be invited to complete a Structure of Care Questionnaire evaluating pre-defined indicators which reflect the setting in which care is delivered, while process of care will be evaluated against the pre-defined indicators in the evaluation framework. Effectiveness of the programme will be evaluated in terms of clinical outcomes, service utilization outcomes, and patient-reported outcomes. A cohort study will be conducted on all eligible diabetic patients who have enrolled into RAMP for more than one year to compare their clinical and public service utilization outcomes of RAMP participants and non-participants. Clinical outcome measures will include HbA1c, blood pressure (both systolic and diastolic, lipids (low-density lipoprotein cholesterol and future cardiovascular diseases risk prediction; and public health service utilization rate will include general and specialist outpatient, emergency department attendances, and hospital admissions annually within 5 years. For patient-reported outcomes, a total of 550 participants and another 550 non-participants will be

  12. Tank waste remediation system risk management plan

    International Nuclear Information System (INIS)

    Zimmerman, B.D.

    1998-01-01

    The purpose of the Tank Waste Remediation System (TWRS) Risk Management Plan is to describe a consistent approach to risk management such that TWRS Project risks are identified and managed to achieve TWRS Project success. The Risk Management Plan implements the requirements of the Tank Waste Remediation System Systems Engineering Management Plan in the area of risk management. Figure ES-1 shows the relationship of the TWRS Risk Management Plan to other major TWRS Project documents. As the figure indicates, the Risk Management Plan is a tool used to develop and control TWRS Project work. It provides guidance on how TWRS Project risks will be assessed, analyzed, and handled, and it specifies format and content for the risk management lists, which are a primary product of the risk management process. In many instances, the Risk Management Plan references the TWRS Risk Management Procedure, which provides more detailed discussion of many risk management activities. The TWRS Risk Management Plan describes an ongoing program within the TWRS Project. The Risk Management Plan also provides guidance in support of the TWRS Readiness To-Proceed (RTP) assessment package

  13. Case histories in pharmaceutical risk management.

    Science.gov (United States)

    McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

    2009-12-01

    The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS).

  14. Reducing the risk, managing safety.

    Science.gov (United States)

    Aldridge, Peter

    2016-02-01

    Fire safety in healthcare premises has always been a challenge to those that discharge this duty. Statutory compliance should be a matter of course, but in an ever increasingly challenged NHS, even this is not a given. While the NHS is driven by managing very complex risk to deliver cutting edge healthcare, providers cannot be risk averse. Which risk, however, takes priority? Here Peter Aldridge, fire and corporate services manager at Leeds Teaching Hospitals NHS Trust, and Secretary to the National Association of Healthcare Fire Officers (NAHFO)--which will this month and next jointly stage fire safety seminars with IHEEM; see page 8--considers the key issues, with input from a fire officer at a leading mental health and community Trust.

  15. Risk Management Practices: The Ghanaian Firms' Perspective ...

    African Journals Online (AJOL)

    Using a quantitative approach the findings of the study are that Ghanaian firms understand risk and risk management. Additionally, operational, liquidity and credit risk are the most dominant risks experienced while risk identification and selection jointly determine risk management practices in Ghana. Based on the findings ...

  16. Risk Management of NASA Projects

    Science.gov (United States)

    Sarper, Hueseyin

    1997-01-01

    Various NASA Langley Research Center and other center projects were attempted for analysis to obtain historical data comparing pre-phase A study and the final outcome for each project. This attempt, however, was abandoned once it became clear that very little documentation was available. Next, extensive literature search was conducted on the role of risk and reliability concepts in project management. Probabilistic risk assessment (PRA) techniques are being used with increasing regularity both in and outside of NASA. The value and the usage of PRA techniques were reviewed for large projects. It was found that both civilian and military branches of the space industry have traditionally refrained from using PRA, which was developed and expanded by nuclear industry. Although much has changed with the end of the cold war and the Challenger disaster, it was found that ingrained anti-PRA culture is hard to stop. Examples of skepticism against the use of risk management and assessment techniques were found both in the literature and in conversations with some technical staff. Program and project managers need to be convinced that the applicability and use of risk management and risk assessment techniques is much broader than just in the traditional safety-related areas of application. The time has come to begin to uniformly apply these techniques. The whole idea of risk-based system can maximize the 'return on investment' that the public demands. Also, it would be very useful if all project documents of NASA Langley Research Center, pre-phase A through final report, are carefully stored in a central repository preferably in electronic format.

  17. Overview of the Hanford risk management plan

    International Nuclear Information System (INIS)

    Halverson, T.G.

    1998-01-01

    The Project Hanford Management Contract called for the enhancement of site-wide decision processes, and development of a Hanford Risk Management Plan to adopt or develop a risk management system for the Hanford Site. This Plan provides a consistent foundation for Site issues and addresses site-wide management of risks of all types. It supports the Department of Energy planning and sitewide decision making policy. Added to this requirement is a risk performance report to characterize the risk management accomplishments. This paper presents the development of risk management within the context of work planning and performance. Also discussed are four risk elements which add value to the context

  18. Risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients: design and rationale of the ROADMAP clinical trial.

    Science.gov (United States)

    Rogers, Joseph G; Boyle, Andrew J; O'Connell, John B; Horstmanshof, Douglas A; Haas, Donald C; Slaughter, Mark S; Park, Soon J; Farrar, David J; Starling, Randall C

    2015-02-01

    Mechanical circulatory support is now a proven therapy for the treatment of patients with advanced heart failure and cardiogenic shock. The role for this therapy in patients with less severe heart failure is unknown. The objective of this study is to examine the impact of mechanically assisted circulation using the HeartMate II left ventricular assist device in patients who meet current US Food and Drug Administration-defined criteria for treatment but are not yet receiving intravenous inotropic therapy. This is a prospective, nonrandomized clinical trial of 200 patients treated with either optimal medical management or a mechanical circulatory support device. This trial will be the first prospective clinical evaluation comparing outcomes of patients with advanced ambulatory heart failure treated with either ongoing medical therapy or a left ventricular assist device. It is anticipated to provide novel insights regarding relative outcomes with each treatment and an understanding of patient and provider acceptance of the ventricular assist device therapy. This trial will also provide information regarding the risk of events in "stable" patients with advanced heart failure and guidance for the optimal timing of left ventricular assist device therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Pro-Active Fall-Risk Management is Mandatory to Sustain in Hospital-Fall Prevention in Older Patients--Validation of the LUCAS Fall-Risk Screening in 2,337 Patients.

    Science.gov (United States)

    Hoffmann, V S; Neumann, L; Golgert, S; von Renteln-Kruse, W

    2015-12-01

    Prevention of in-hospital falls contributes to improvement of patient safety. However, the identification of high-risk patients remains a challenge despite knowledge of fall-risk factors. Hence, objective was to prospectively validate the performance of the LUCAS (Longitudinal Urban Cohort Ageing Study) fall-risk screening, based on routine data (fall history, mobility, mental status) and applied by nurses. Observational study comparing two groups of patients who underwent different fall-risk screenings; the LUCAS screening (2010 - 2011) and the STRATIFY (St. Thomas's Risk Assessment Tool In Falling Elderly Inpatients) (2004 - 2006). Urban teaching hospital. Consecutively hospitalized patients (≥ 65 years old) were screened on admission; LUCAS n = 2,337, STRATIFY n = 4,735. The proportions of fallers were compared between the STRATIFY and the LUCAS time periods. The number of fallers expected was compared to that observed in the LUCAS time period. Standardized fall-incidence recording included case-note checks for unreported falls. Plausibility checks of fall-risk factors and logistic regression analysis for variable fall-risk factors were performed. The proportions of fallers during the two time periods were LUCAS n = 291/2,337 (12.5%) vs. STRATIFY n = 508/4,735 (10.7%). After adjustment for risk-factor prevalence, the proportion of fallers expected was 14.5% (334/2,337), the proportion observed was 12.5% (291/2,337) (p = 0.038). In-hospital fall prevention including systematic use of the LUCAS fall-risk screening reduced the proportion of fallers compared to that expected from the patients' fall-risk profile. Raw proportions of fallers are not suitable to evaluate fall prevention in hospital because of variable prevalence of patients' fall-risk factors over time. Continuous communication, education and training is needed to sustain in-hospital falls prevention.

  20. Risk Management for e-Business

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available In the new Internet economy, risk management plays a critical role to protect the organization and its ability to perform their business mission, not just its IT assets. Risk management is the process of identifying risk, assessing risk, and taking steps to reduce risk to an acceptable level. The risk management is an important component of a IT security program. Information and communications technology management and IT security are responsible for ensuring that technology risks are managed appropriately. These risks originate from the deployment and use of IT assets in various ways, such as configuring systems incorrectly or gaining access to restricted software.

  1. Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation.

    Science.gov (United States)

    Bassand, Jean-Pierre; Accetta, Gabriele; Al Mahmeed, Wael; Corbalan, Ramon; Eikelboom, John; Fitzmaurice, David A; Fox, Keith A A; Gao, Haiyan; Goldhaber, Samuel Z; Goto, Shinya; Haas, Sylvia; Kayani, Gloria; Pieper, Karen; Turpie, Alexander G G; van Eickels, Martin; Verheugt, Freek W A; Kakkar, Ajay K

    2018-01-01

    The factors influencing three major outcomes-death, stroke/systemic embolism (SE), and major bleeding-have not been investigated in a large international cohort of unselected patients with newly diagnosed atrial fibrillation (AF). In 28,628 patients prospectively enrolled in the GARFIELD-AF registry with 2-year follow-up, we aimed at analysing: (1) the variables influencing outcomes; (2) the extent of implementation of guideline-recommended therapies in comorbidities that strongly affect outcomes. Median (IQR) age was 71.0 (63.0 to 78.0) years, 44.4% of patients were female, median (IQR) CHA2DS2-VASc score was 3.0 (2.0 to 4.0); 63.3% of patients were on anticoagulants (ACs) with or without antiplatelet (AP) therapy, 24.5% AP monotherapy, and 12.2% no antithrombotic therapy. At 2 years, rates (95% CI) of death, stroke/SE, and major bleeding were 3.84 (3.68; 4.02), 1.27 (1.18; 1.38), and 0.71 (0.64; 0.79) per 100 person-years. Age, history of stroke/SE, vascular disease (VascD), and chronic kidney disease (CKD) were associated with the risks of all three outcomes. Congestive heart failure (CHF) was associated with the risks of death and stroke/SE. Smoking, non-paroxysmal forms of AF, and history of bleeding were associated with the risk of death, female sex and heavy drinking with the risk of stroke/SE. Asian race was associated with lower risks of death and major bleeding versus other races. AC treatment was associated with 30% and 28% lower risks of death and stroke/SE, respectively, compared with no AC treatment. Rates of prescription of guideline-recommended drugs were suboptimal in patients with CHF, VascD, or CKD. Our data show that several variables are associated with the risk of one or more outcomes, in terms of death, stroke/SE, and major bleeding. Comprehensive management of AF should encompass, besides anticoagulation, improved implementation of guideline-recommended therapies for comorbidities strongly associated with outcomes, namely CHF, VascD, and CKD

  2. Risk Management Practices by Barbadian Banks

    Directory of Open Access Journals (Sweden)

    Anthony Wood

    2013-07-01

    The main findings of the paper are: risk managers perceive risk management as critical to their banks’ performance; the types of risks causing the greatest exposures are credit risk, operational risk, country/sovereign risk, interest rate risk and market risk; there was a high level of success with current risk management practices and these practices have evolved over time in line with the changing economic environment and regulatory updates. Overall, the findings suggest strongly that in light of the current depressed economic climate, banks operating in Barbados are indeed risk-focused or might we say “risk intelligent”.

  3. Quality risk management in pharmaceutical development.

    Science.gov (United States)

    Charoo, Naseem Ahmad; Ali, Areeg Anwer

    2013-07-01

    The objective of ICH Q8, Q9 and Q10 documents is application of systemic and science based approach to formulation development for building quality into product. There is always some uncertainty in new product development. Good risk management practice is essential for success of new product development in decreasing this uncertainty. In quality by design paradigm, the product performance properties relevant to the patient are predefined in target product profile (TPP). Together with prior knowledge and experience, TPP helps in identification of critical quality attributes (CQA's). Initial risk assessment which identifies risks to these CQA's provides impetus for product development. Product and process are designed to gain knowledge about these risks, devise strategies to eliminate or mitigate these risks and meet objectives set in TPP. By laying more emphasis on high risk events the protection level of patient is increased. The process being scientifically driven improves the transparency and reliability of the manufacturer. The focus on risk to the patient together with flexible development approach saves invaluable resources, increases confidence on quality and reduces compliance risk. The knowledge acquired in analysing risks to CQA's permits construction of meaningful design space. Within the boundaries of the design space, variation in critical material characteristics and process parameters must be managed in order to yield a product having the desired characteristics. Specifications based on product and process understanding are established such that product will meet the specifications if tested. In this way, the product is amenable to real time release, since specifications only confirm quality but they do not serve as a means of effective process control.

  4. Effects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care: a longitudinal comparative study.

    Science.gov (United States)

    Jiao, Fang Fang; Fung, Colman Siu Cheung; Wong, Carlos King Ho; Wan, Yuk Fai; Dai, Daisy; Kwok, Ruby; Lam, Cindy Lo Kuen

    2014-08-21

    To assess whether the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) led to improvements in biomedical outcomes, observed cardiovascular events and predicted cardiovascular risks after 12-month intervention in the primary care setting. A random sample of 1,248 people with diabetes enrolled to RAMP-DM for at least 12 months was selected and 1,248 people with diabetes under the usual primary care were matched by age, sex, and HbA1c level at baseline as the usual care group. Biomedical and cardiovascular outcomes were measured at baseline and at 12-month after the enrollment. Difference-in-differences approach was employed to measure the effect of RAMP-DM on the changes in biomedical outcomes, proportion of subjects reaching treatment targets, observed and predicted cardiovascular risks. Compared to the usual care group, RAMP-DM group had lower cardiovascular events incidence (1.21% vs 2.89%, P = 0.003), and net decrease in HbA1c (-0.20%, P risks (total CVD risk, -2.06%, P risk, -1.43%, P risk, -0.71%, P risks. The RAMP-DM resulted in greater improvements in HbA1c and reduction in observed and predicted cardiovascular risks at 12 months follow-up, which indicated a risk-stratification multidisciplinary intervention was an effective strategy for managing Chinese people with diabetes in the primary care setting. ClinicalTrials.gov, NCT02034695.

  5. Tank waste remediation system risk management list

    International Nuclear Information System (INIS)

    Collard, L.B.

    1995-01-01

    The Tank Waste Remedation System (TWRS) Risk Management List and it's subset of critical risks, the Critical Risk Management List, provide a tool to senior RL and WHC management (Level-1 and -2) to manage programmatic risks that may significantly impact the TWRS program. The programmatic risks include cost, schedule, and performance risks. Performance risk includes technical risk, supportability risk (such as maintainability and availability), and external risk (i.e., beyond program control, for example, changes in regulations). The risk information includes a description, its impacts, as evaluation of the likelihood, consequences and risk value, possible mitigating actions, and responsible RL and WHC managers. The issues that typically form the basis for the risks are presented in a separate table and the affected functions are provided on the management lists

  6. International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer

    NARCIS (Netherlands)

    Canto, Marcia Irene; Harinck, Femme; Hruban, Ralph H.; Offerhaus, George Johan; Poley, Jan-Werner; Kamel, Ihab; Nio, Yung; Schulick, Richard S.; Bassi, Claudio; Kluijt, Irma; Levy, Michael J.; Chak, Amitabh; Fockens, Paul; Goggins, Michael; Bruno, Marco; Arcidiacono, Paolo Giorgio; Bartsch, Detlef; Biermann, Katharina; Brentnall, Terri; Dite, Petr; Donahue, Timothy; Early, Dayna; Farrell, James; Fernandez-del Castillo, Carlos; Frucht, Harold; Fukushima, Noriyoshi; Geurts, Jenny; Hamell, Pascal; Iglesias-Garcia, Julio; Klein, Alison; Kloeppel, Guenter; Lachter, Jesse; Langer, Peter; Lee, Jeffrey; Levy, Michael; Maguchi, Hiroyuki; Margolis, Daniel; Ohtsuka, Takao; Olson, Sara; Petersen, Gloria; Savides, Thomas; Syngal, Sapna; Tamm, Eric; Tanaka, Masao; Vasen, Hans; Wagner, Anja; Wang, Huamin; Williams, David; Yamao, Kenjii

    2013-01-01

    Screening individuals at increased risk for pancreatic cancer (PC) detects early, potentially curable, pancreatic neoplasia. To develop consortium statements on screening, surveillance and management of high-risk individuals with an inherited predisposition to PC. A 49-expert multidisciplinary

  7. Risk Management for Food Allergy

    DEFF Research Database (Denmark)

    Risk Management for Food Allergy is developed by a team of scientists and industry professionals who understand the importance of allergen risk assessment and presents practical, real-world guidance for food manufacturers. With more than 12 million Americans suffering from food allergies and little...... appropriate "safe" thresholds of ingredients, the food industry must take increasingly proactive steps to avoid direct or cross-contamination as well as ensuring that their products are appropriately labeled and identified for those at risk. This book covers a range of critical topics in this area, including...... indication of what is causing that number to continue to grow, food producers, packagers and distributors need to appropriately process, label and deliver their products to ensure the safety of customers with allergic conditions. By identifying risk factors during processing as well as determining...

  8. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management

    Science.gov (United States)

    Chapman, M. John; Ginsberg, Henry N.; Amarenco, Pierre; Andreotti, Felicita; Borén, Jan; Catapano, Alberico L.; Descamps, Olivier S.; Fisher, Edward; Kovanen, Petri T.; Kuivenhoven, Jan Albert; Lesnik, Philippe; Masana, Luis; Nordestgaard, Børge G.; Ray, Kausik K.; Reiner, Zeljko; Taskinen, Marja-Riitta; Tokgözoglu, Lale; Tybjærg-Hansen, Anne; Watts, Gerald F.

    2011-01-01

    Even at low-density lipoprotein cholesterol (LDL-C) goal, patients with cardiometabolic abnormalities remain at high risk of cardiovascular events. This paper aims (i) to critically appraise evidence for elevated levels of triglyceride-rich lipoproteins (TRLs) and low levels of high-density lipoprotein cholesterol (HDL-C) as cardiovascular risk factors, and (ii) to advise on therapeutic strategies for management. Current evidence supports a causal association between elevated TRL and their remnants, low HDL-C, and cardiovascular risk. This interpretation is based on mechanistic and genetic studies for TRL and remnants, together with the epidemiological data suggestive of the association for circulating triglycerides and cardiovascular disease. For HDL, epidemiological, mechanistic, and clinical intervention data are consistent with the view that low HDL-C contributes to elevated cardiovascular risk; genetic evidence is unclear however, potentially reflecting the complexity of HDL metabolism. The Panel believes that therapeutic targeting of elevated triglycerides (≥1.7 mmol/L or 150 mg/dL), a marker of TRL and their remnants, and/or low HDL-C (<1.0 mmol/L or 40 mg/dL) may provide further benefit. The first step should be lifestyle interventions together with consideration of compliance with pharmacotherapy and secondary causes of dyslipidaemia. If inadequately corrected, adding niacin or a fibrate, or intensifying LDL-C lowering therapy may be considered. Treatment decisions regarding statin combination therapy should take into account relevant safety concerns, i.e. the risk of elevation of blood glucose, uric acid or liver enzymes with niacin, and myopathy, increased serum creatinine and cholelithiasis with fibrates. These recommendations will facilitate reduction in the substantial cardiovascular risk that persists in patients with cardiometabolic abnormalities at LDL-C goal. PMID:21531743

  9. Assessing Bleeding Risk in Patients Taking Anticoagulants

    Science.gov (United States)

    Shoeb, Marwa; Fang, Margaret C.

    2013-01-01

    Anticoagulant medications are commonly used for the prevention and treatment of thromboembolism. Although highly effective, they are also associated with significant bleeding risks. Numerous individual clinical factors have been linked to an increased risk of hemorrhage, including older age, anemia, and renal disease. To help quantify hemorrhage risk for individual patients, a number of clinical risk prediction tools have been developed. These risk prediction tools differ in how they were derived and how they identify and weight individual risk factors. At present, their ability to effective predict anticoagulant-associated hemorrhage remains modest. Use of risk prediction tools to estimate bleeding in clinical practice is most influential when applied to patients at the lower spectrum of thromboembolic risk, when the risk of hemorrhage will more strongly affect clinical decisions about anticoagulation. Using risk tools may also help counsel and inform patients about their potential risk for hemorrhage while on anticoagulants, and can identify patients who might benefit from more careful management of anticoagulation. PMID:23479259

  10. 42 CFR 441.476 - Risk management.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Risk management. 441.476 Section 441.476 Public... Self-Directed Personal Assistance Services Program § 441.476 Risk management. (a) The State must... plan for how identified risks will be mitigated. (d) The State must ensure that the risk management...

  11. Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30- and 60-Day Hospitalization: The Depression Care for Patients at Home Cluster-Randomized Trial.

    Science.gov (United States)

    Bruce, Martha L; Lohman, Matthew C; Greenberg, Rebecca L; Bao, Yuhua; Raue, Patrick J

    2016-11-01

    To determine whether a depression care management intervention in Medicare home health recipients decreases risk of hospitalization. Cluster-randomized trial. Nurse teams were randomized to intervention (12 teams) or enhanced usual care (EUC; 9 teams). Six home health agencies from distinct geographic regions. Home health recipients were interviewed at home and over the telephone. Individuals aged 65 and older who screened positive for depression on nurse assessments (N = 755) and a subset who consented to interviews (n = 306). The Depression CARE for PATients at Home (CAREPATH) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted telephone conferences with team supervisors every 2 weeks. Hospitalization while receiving home health services was assessed using data from the home health record. Hospitalization within 30 days of starting home health, regardless of how long recipients received home health services, was assessed using data from the home care record and research assessments. The relative hazard of being admitted to the hospital directly from home health was 35% lower within 30 days of starting home health care (hazard ratio (HR) = 0.65, P = .01) and 28% lower within 60 days (HR = 0.72, P = .03) for CAREPATH participants than for participants receiving EUC. In participants referred to home health directly from the hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, P = .001) for CAREPATH participants. Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk in older adults receiving Medicare home health nursing services. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. Risk evaluation mitigation strategies: the evolution of risk management policy.

    Science.gov (United States)

    Hollingsworth, Kristen; Toscani, Michael

    2013-04-01

    The United States Food and Drug Administration (FDA) has the primary regulatory responsibility to ensure that medications are safe and effective both prior to drug approval and while the medication is being actively marketed by manufacturers. The responsibility for safe medications prior to marketing was signed into law in 1938 under the Federal Food, Drug, and Cosmetic Act; however, a significant risk management evolution has taken place since 1938. Additional federal rules, entitled the Food and Drug Administration Amendments Act, were established in 2007 and extended the government's oversight through the addition of a Risk Evaluation and Mitigation Strategy (REMS) for certain drugs. REMS is a mandated strategy to manage a known or potentially serious risk associated with a medication or biological product. Reasons for this extension of oversight were driven primarily by the FDA's movement to ensure that patients and providers are better informed of drug therapies and their specific benefits and risks prior to initiation. This article provides an historical perspective of the evolution of medication risk management policy and includes a review of REMS programs, an assessment of the positive and negative aspects of REMS, and provides suggestions for planning and measuring outcomes. In particular, this publication presents an overview of the evolution of the REMS program and its implications.

  13. Advances in the management of cardiovascular risk for patients with type 2 diabetes: perspectives from the Academy for Cardiovascular Risk, Outcomes and Safety Studies in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Schernthaner G

    2017-01-01

    Full Text Available Guntram Schernthaner,1 Sarah Jarvis,2 Chaim Lotan,3 Martin Prázný,4 Christoph Wanner,5 Thomas C Wascher6 1Department of Medicine, Rudolfstiftung Hospital, Vienna, Austria; 2Richford Gate Medical Practice, London, UK; 3Cardiovascular Division, Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; 4First Faculty of Medicine, Charles University, Prague, Czech Republic; 5Department of Medicine, University Hospital, Würzburg, Germany; 6First Medical Department, Hanusch-Krankenhaus, Vienna, Austria Abstract: Diabetes is a global health emergency projected to affect 642 million people by 2040. Type 2 diabetes (T2D represents 90% of diabetes cases and is associated with a range of cardiovascular (CV risk factors that are more than double the incidence of CV disease and significantly increase mortality rates. Diabetes treatments have typically focused on improving glycemic control but their effect on CV outcomes has remained uncertain. In 2008, the US Food and Drug Administration (FDA looked to address this knowledge gap and mandated CV outcome trials (CVOTs for all new antidiabetic therapies. In 2015, EMPA-REG OUTCOME® became the first CVOT to present results for a sodium/glucose cotransporter 2 (SGLT2; also known as SLC5A2 inhibitor, empagliflozin. Subsequently, a regional meeting of the Academy for Cardiovascular Risk, Outcomes and Safety Studies in Type 2 Diabetes (ACROSS T2D brought together a respected faculty of international experts and 150 physicians from 14 countries to discuss the current unmet medical needs of patients with T2D, the results from the EMPA-REG OUTCOME study and the implications of these results for clinical practice. This article summarizes the current scientific evidence and the discussions that took place at the ACROSS T2D regional meeting, which was held in Vienna, Austria, on May 30, 2016. Keywords: type 2 diabetes, cardiovascular risk, SGLT2 inhibitor, CVOTs, empagliflozin

  14. Probabilistic risk assessment as an aid to risk management

    International Nuclear Information System (INIS)

    Garrick, B.J.

    1982-01-01

    Probabilistic risk assessments are providing important insights into nuclear power plant safety. Their value is two-fold: first as a means of quantifying nuclear plant risk including contributors to risk, and second as an aid to risk management. A risk assessment provides an analytical plant model that can be the basis for performing meaningful decision analyses for controlling safety. It is the aspect of quantitative risk management that makes probabilistic risk assessment an important technical discipline of the future

  15. Online professional networks for physicians: risk management.

    Science.gov (United States)

    Hyman, Jon L; Luks, Howard J; Sechrest, Randale

    2012-05-01

    The rapidly developing array of online physician-only communities represents a potential extraordinary advance in the availability of educational and informational resources to physicians. These online communities provide physicians with a new range of controls over the information they process, but use of this social media technology carries some risk. The purpose of this review was to help physicians manage the risks of online professional networking and discuss the potential benefits that may come with such networks. This article explores the risks and benefits of physicians engaging in online professional networking with peers and provides suggestions on risk management. Through an Internet search and literature review, we scrutinized available case law, federal regulatory code, and guidelines of conduct from professional organizations and consultants. We reviewed the OrthoMind.com site as a case example because it is currently the only online social network exclusively for orthopaedic surgeons. Existing case law suggests potential liability for orthopaedic surgeons who engage with patients on openly accessible social network platforms. Current society guidelines in both the United States and Britain provide sensible rules that may mitigate such risks. However, the overall lack of a strong body of legal opinions, government regulations as well as practical experience for most surgeons limit the suitability of such platforms. Closed platforms that are restricted to validated orthopaedic surgeons may limit these downside risks and hence allow surgeons to collaborate with one another both as clinicians and practice owners. Educating surgeons about the pros and cons of participating in these networking platforms is helping them more astutely manage risks and optimize benefits. This evolving online environment of professional interaction is one of few precedents, but the application of risk management strategies that physicians use in daily practice carries over

  16. Considerations on Integrating Risk and Quality Management

    Directory of Open Access Journals (Sweden)

    Maria POPESCU

    2011-03-01

    Full Text Available This paper aims to highlight the links between risk management and quality management and to study the possibility of their integrated approach. The study reviews the evolution of risk approach within organizations and stresses the need to increase the effectiveness of this approach by incorporating risk management methodology in the quality management system. Starting from this idea, the authors present the current state of risk approach into quality management, basic rules of integrated quality-risk management and major difficulties which may arise in the implementation of integrated quality–risk systems.

  17. Managing risks and hazardous in industrial operations

    Energy Technology Data Exchange (ETDEWEB)

    Almaula, S.C. [Woodward-Clyde International, Oakland, CA (United States)

    1996-12-31

    The main objective of this paper is to demonstrate that it makes good business sense to identify risks and hazards of an operation and take appropriate steps to manage them effectively. Developing and implementing an effective risk and hazard management plan also contibutes to other industry requirements and standards. Development of a risk management system, key elements of a risk management plan, and hazards and risk analysis methods are outlined. Comparing potential risk to the cost of prevention is also discussed. It is estimated that the cost of developing and preparing the first risk management plan varies between $50,000 to $200,000. 3 refs., 2 figs., 1 tab.

  18. Hanford Tanks Initiative risk management guide

    International Nuclear Information System (INIS)

    Schaus, P.S.

    1997-01-01

    This project-specific Risk Management Guide describes the general approach and process being used by the HTI Project to manage risk associated with execution of the HTI mission. It includes the initial identification of risk and the quantification of its likelihood and severity of its consequences. It further addresses the formulation of risk mitigation plans, periodic statusing of the Risk Management List, and risk closure

  19. Managing IT Integration Risk in Acquisitions

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Kettinger, William J.

    2016-01-01

    The article discusses a framework for evaluating risk of information technology (IT) integration in acquisitions. Topics include the use of the experience of serial acquirer Trelleborg AB to show the merits of the framework for managing the risk and to determine low-risk acquisitions......, the importance of managing IT integration risk, and various risk areas for acquisition IT integration....

  20. Risk management in microfinance institutions

    OpenAIRE

    Batin, Artyom

    2014-01-01

    In the following paper I have tried to find the correlation between type of ownership and effective risk management in the operations of microfinance institutions in India. The results found are consistent with the current findings of how the type of ownership does not impact both the financial or social performance of MFIs. Dataset of 72 MFIs was acquired from the Microfinance Information Exchange on MFIs and evaluated using an OLS regression. The results show that the type of ownership insi...

  1. Risk management in nuclear power social aspects

    International Nuclear Information System (INIS)

    Sappa, N.N.

    1996-01-01

    Problems connected with safety evaluation and risk management during operation of nuclear power installations are considered. Social aspects of risk assessment of enterprises with increased danger are discussed

  2. Recent advances in the management of chronic stable angina I: Approach to the patient, diagnosis, pathophysiology, risk stratification, and gender disparities

    Science.gov (United States)

    Kones, Richard

    2010-01-01

    The potential importance of both prevention and personal responsibility in controlling heart disease, the leading cause of death in the USA and elsewhere, has attracted renewed attention. Coronary artery disease is preventable, using relatively simple and inexpensive lifestyle changes. The inexorable rise in the prevalence of obesity, diabetes, dyslipidemia, and hypertension, often in the risk cluster known as the metabolic syndrome, drives the ever-increasing incidence of heart disease. Population-wide improvements in personal health habits appear to be a fundamental, evidence based public health measure, yet numerous barriers prevent implementation. A common symptom in patients with coronary artery disease, classical angina refers to the typical chest pressure or discomfort that results when myocardial oxygen demand rises and coronary blood flow is reduced by fixed, atherosclerotic, obstructive lesions. Different forms of angina and diagnosis, with a short description of the significance of pain and silent ischemia, are discussed in this review. The well accepted concept of myocardial oxygen imbalance in the genesis of angina is presented with new data about clinical pathology of stable angina and acute coronary syndromes. The roles of stress electrocardiography and stress myocardial perfusion scintigraphic imaging are reviewed, along with the information these tests provide about risk and prognosis. Finally, the current status of gender disparities in heart disease is summarized. Enhanced risk stratification and identification of patients in whom procedures will meaningfully change management is an ongoing quest. Current guidelines emphasize efficient triage of patients with suspected coronary artery disease. Many experts believe the predictive value of current decision protocols for coronary artery disease still needs improvement in order to optimize outcomes, yet avoid unnecessary coronary angiograms and radiation exposure. Coronary angiography remains the

  3. Recent advances in the management of chronic stable angina I: approach to the patient, diagnosis, pathophysiology, risk stratification, and gender disparities.

    Science.gov (United States)

    Kones, Richard

    2010-08-09

    The potential importance of both prevention and personal responsibility in controlling heart disease, the leading cause of death in the USA and elsewhere, has attracted renewed attention. Coronary artery disease is preventable, using relatively simple and inexpensive lifestyle changes. The inexorable rise in the prevalence of obesity, diabetes, dyslipidemia, and hypertension, often in the risk cluster known as the metabolic syndrome, drives the ever-increasing incidence of heart disease. Population-wide improvements in personal health habits appear to be a fundamental, evidence based public health measure, yet numerous barriers prevent implementation. A common symptom in patients with coronary artery disease, classical angina refers to the typical chest pressure or discomfort that results when myocardial oxygen demand rises and coronary blood flow is reduced by fixed, atherosclerotic, obstructive lesions. Different forms of angina and diagnosis, with a short description of the significance of pain and silent ischemia, are discussed in this review. The well accepted concept of myocardial oxygen imbalance in the genesis of angina is presented with new data about clinical pathology of stable angina and acute coronary syndromes. The roles of stress electrocardiography and stress myocardial perfusion scintigraphic imaging are reviewed, along with the information these tests provide about risk and prognosis. Finally, the current status of gender disparities in heart disease is summarized. Enhanced risk stratification and identification of patients in whom procedures will meaningfully change management is an ongoing quest. Current guidelines emphasize efficient triage of patients with suspected coronary artery disease. Many experts believe the predictive value of current decision protocols for coronary artery disease still needs improvement in order to optimize outcomes, yet avoid unnecessary coronary angiograms and radiation exposure. Coronary angiography remains the

  4. A collaborative cardiologist-pharmacist care model to improve hypertension management in patients with or at high risk for cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Irons BK

    2012-03-01

    Full Text Available Physician led collaborative drug therapy management utilizing clinical pharmacists to aid in the medication management of patients with hypertension has been shown to improve blood pressure control. With recommendations for lower blood pressures in patients with coronary artery disease, a cardiologist-pharmacist collaborative care model may be a novel way to achieve these more rigorous goals of therapy. Objective: The purpose of this project was to evaluate this type of care model in a high cardiac risk patient population. Methods: A retrospective cohort study determined the ability of a cardiologist-pharmacist care model (n=59 to lower blood pressure and achieve blood pressure goals (< 130/80 mmHg in patients with or at high risk for coronary artery disease compared to usual cardiologist care (n=58 in the same clinical setting. Results: The cardiologist-pharmacist care model showed a higher percentage of patients obtaining their goal blood pressure compared to cardiologist care alone, 49.2% versus 31.0% respectively, p=0.0456. Greater reductions in systolic blood pressure (-22 mmHg versus -12 mmHg, p=0.0077 and pulse pressure (-15 mmHg versus -7 mmHg, p=0.0153 were noted in the cardiologist-pharmacist care model. No differences in diastolic blood pressure were found. There was a shorter duration of clinic follow-up (7.0 versus 13.2 months, p=0.0013 but a higher frequency of clinic visits (10.7 versus 3.45, p<0.0001 in the cardiologist-pharmacist care model compared to usual care. The number of antihypertensive agents used did not change over the time period evaluated. Conclusion: This study suggests a team-based approach to hypertensive care using a collaborative cardiologist-pharmacist care model improves blood pressure from baseline in a high cardiac risk patient population and was more likely to obtain more stringent blood pressure goals than usual care.

  5. Strategic raw materials. Risk management

    International Nuclear Information System (INIS)

    Bertau, Martin; Matschullat, Joerg; Kausch, Peter

    2014-01-01

    This volume is divided into four chapters: (1) Raw material management, (2) Primary raw materials, (3) Secondary raw materials and recycling, (4). Processing and products. The topics for the chapter ''Raw material management'' are: Substitution of raw materials - framework conditions and implementation; Thales: Strategic raw materials; Time for cooperation between the EU and China in raw materials policy; Availability of elements for the semiconductor industry; Market price risks of raw material-intensive companies - identification and management. The topics on the second item ''Primary raw materials'' are: The supply of economic-critical raw materials - A search and analysis for causes; Lithium extraction from primary raw materials - state and perspectives; The global market of rare earths - A balancing act; Rare earth deposits in Namibia; New technologies in exploration and discovery - Focus on activities in Europe. The third chapter, ''Secondary Raw Materials and Recycling'', covered the topics: Technology metals - Systemic Requirements along the recycling chain; Integrated re-use of high-tech and greentech wastes; From the sewage sludge ash to the phosphorus fertilizer RecoPhos P38 in the stress field of waste, fertilizer and soil protection. In chapter 4. ''Processing and products'' are the topics: Treatment and processing of rare earth metals; Processing of mineral resources - opportunities and challenges; Consequences of modern germanium chemistry; Strategic resources - Risk management. A review and outlook with a pinch of fantasy.. [de

  6. Value at Risk models for Energy Risk Management

    OpenAIRE

    Novák, Martin

    2010-01-01

    The main focus of this thesis lies on description of Risk Management in context of Energy Trading. The paper will predominantly discuss Value at Risk and its modifications as a main overall indicator of Energy Risk.

  7. Risk management in product innovation projects

    NARCIS (Netherlands)

    Halman, J.I.M.; Keizer, J.A.

    1993-01-01

    In product innovation projects risk management has become increasingly important. Technological and commercial developments ask for effective and efficient product innovation. Systematic diagnosing and management of risks can help to make product innovation projects successful. In this paper a

  8. Drug utilization research and risk management

    NARCIS (Netherlands)

    Mazzaglia, Giampiero; Mol, Peter G. M.; Elseviers, Monique; Wettermark, Björn; Almarsdóttir, Anna Birna; Andersen, Morten; Benko, Ria; Bennie, Marion; Eriksson, Irene; Godman, Brian; Krska, Janet; Poluzzi, Elisabetta; Taxis, Katja; Vlahovic-Palcevski, Vera; Stichele, Robert Vander

    2016-01-01

    Good risk management requires continuous evaluation and improvement of planned activities. The evaluation impact of risk management activities requires robust study designs and carefully selected outcome measures. Key learnings and caveats from drug utilization research should be applied to the

  9. Operational Risk Management and Military Aviation Safety

    National Research Council Canada - National Science Library

    Ashley, Park

    1999-01-01

    .... The Army's Class A aviation mishap rate declined after it implemented risk management (RM) principles in 1987. This reduction caught the attention of Air Force leadership who have since stated that the application of operational risk management...

  10. Continuing to Confront COPD International Surveys : comparison of patient and physician perceptions about COPD risk and management

    NARCIS (Netherlands)

    Menezes, Ana M.; Landis, Sarah H.; Han, MeiLan K.; Muellerova, Hana; Aisanov, Zaurbek; van der Molen, Thys; Oh, Yeon-Mok; Ichinose, Masakazu; Mannino, David M.; Davis, Kourtney J.

    2015-01-01

    Purpose: Using data from the Continuing to Confront COPD International Physician and Patient Surveys, this paper describes physicians' attitudes and beliefs regarding chronic obstructive pulmonary disease (COPD) prognosis, and compares physician and patient perceptions with respect to COPD. Methods:

  11. THEORETICAL BASIS FOR MANAGEMENT OF PERSONNEL RISKS

    OpenAIRE

    Haliashova, Katsiaryna

    2017-01-01

    Necessity of personnel risks management is based on research results. The authors' approaches to the determination of personnel risks and to their management have been explored. The author's definition of the concept of "personnel risks" is proposed. A classification of personnel risks is developed depending on the stage of origin and the tasks of the personnel policy, as well as the methods of management personnel risks in the organization. The article presents a methodical approach to perso...

  12. 12 CFR 932.1 - Risk management.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Risk management. 932.1 Section 932.1 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.1 Risk management. Before its new capital plan may take...

  13. Study of International Standards of Risk Management

    Directory of Open Access Journals (Sweden)

    Dykan Volodymyr L.

    2014-01-01

    Full Text Available The goal of the article lies in the study of existing international standards of risk management, an important factor of improvement of risk management in domestic corporations and enterprises and development of recommendations on application of international standards in Ukraine, in particular, within the framework of building corporate systems of risk management. The conducted study shows that approaches on organisation of the process of risk management, used in standards of risk management, are of general character and differ with the degree of detailing. Their undoubted value in development of risk management in Ukraine is identification of a general direction of building corporate systems of risk management in practice. The said approaches at the national and corporate levels of standardisation in Ukraine within the framework of building corporate systems of risk management would allow improvement of risk management in corporations and enterprises. The prospect of further studies of domestic specialists in the field of risk management is development of the domestic standard of risk management with consideration of modern domestic specific features of development of risk management in Ukraine and leading foreign experience.

  14. Construction Management Risk System (CMRS for Construction Management (CM Firms

    Directory of Open Access Journals (Sweden)

    Kyungmo Park

    2017-02-01

    Full Text Available After the global financial crisis of 2008, the need for risk management arose because it was necessary to minimize the losses in construction management (CM firms. This was caused by a decreased amount of orders in the Korean CM market, which intensified order competition between companies. However, research results revealed that risks were not being systematically managed owing to the absence of risk management systems. Thus, it was concluded that it was necessary to develop standard operating systems and implement risk management systems in order to manage risks effectively. Therefore, the purpose of this study was to develop a construction risk management system (CRMS for systematically managing risks. For this purpose, the field operation managers of CM firms were interviewed and surveyed in order to define risk factors. Upon this, a risk assessment priority analysis was performed. Finally, a risk management system that comprised seven modules and 20 sub-modules and was capable of responding systematically to risks was proposed. Furthermore, the effectiveness of this system was verified through on-site inspection. This system allows early response to risks, accountability verification and immediate response to legal disputes with clients by managing risk records.

  15. Development of funding project risk management tools.

    Science.gov (United States)

    2013-11-01

    Funding project risk management is a process for identifying, assessing, and prioritizing project funding risks. To plan to : minimize or eliminate the impact of negative events, one must identify what projects have higher risk to respond to potentia...

  16. Risk management and audit | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... a well defined strategic and program framework and sound management processes; and ... A Risk Management Committee supports and monitors the Centre's ... placed on our highly qualified staff in our management of human resources.

  17. Managing the difficult penile prosthesis patient.

    Science.gov (United States)

    Trost, Landon W; Baum, Neil; Hellstrom, Wayne J G

    2013-04-01

    Inflatable penile prostheses (IPPs) are associated with excellent long-term outcomes and patient/partner satisfaction. A small percentage of patients remain dissatisfied, despite acceptable surgical results. This study aims to evaluate factors associated with patient satisfaction and dissatisfaction, define patient characteristics, which may identify elevated risk of postoperative dissatisfaction, and describe management strategies to optimize functional and psychological patient outcomes. A review of urologic and non-urologic cosmetic surgery literature was performed to identify factors associated with patient satisfaction/dissatisfaction. Emphasis was placed on articles defining "high risk" or psychologically challenging patients. Preoperative factors associated with patient satisfaction/dissatisfaction and character traits, which may identify elevated risk of postoperative dissatisfaction or otherwise indicate a psychologically challenging patient. Contemporary patient and partner satisfaction rates following IPP are 92-100% and 91-95%, respectively. Factors associated with satisfaction include decreased preoperative expectations, favorable female partner sexual function, body mass index ≤30, and absence of Peyronie's disease or prior prostatectomy. Determinants of dissatisfaction include perceived/actual loss of penile length, decreased glanular engorgement, altered erectile/ejaculatory sensation, pain, diminished cosmetic outcome, difficulty with device function, partner dissatisfaction and perception of unnatural sensation, complications, and extent of alternative treatments offered. Personality characteristics which may indicate psychologically challenging IPP patients include obsessive/compulsive tendencies, unrealistic expectations, patients undergoing revision surgery, those seeking multiple surgical opinions, feeling of entitlement, patients in denial of their prior erectile/sexual function and current disease status, or those with other psychiatric

  18. Managing risk with renewable resources

    International Nuclear Information System (INIS)

    Brower, M.C.; Bernow, S.; Duckworth, M.; Spinney, P.; Bell, K.

    1997-01-01

    One approach to managing risk is for a utility company to invest in diverse power sources such as wind power plants. Since wind plants consume no fuel, can be built in relatively small increments with short construction lead times, and generate no pollutants, it is often said that they offer significant protection from risks associated with conventional fossil-fuel power plants. With assistance from Convergence Research, Charles River Associates, and the Tellus Institute, the authors tested this hypothesis by conducting an in-depth analysis of the risk implications of a decision to build a 1,600 MW wind power plant instead of a 400 MW gas-fired combined cycle plant. (The two plants were assumed to have equal firm capacity.) The case study utility was Texas Utilities Electric, a very large investor-owned company serving an area with substantial, high-quality wind resources. The uncertain inputs included fuel prices, environmental regulations (specifically, CO 2 and air pollution controls), wind plant output, conventional plant availability, and load growth. Two different market scenarios were examined: traditional regulation and an unregulated wholesale market characterized either by a power pool or fixed-price contracts of varying duration. Conclusions are striking: under traditional regulation, wind energy provides a net present-value risk-reduction benefit of $3.4 to $7.8/MWh

  19. Managing risks: Seveso and Harrisburg

    International Nuclear Information System (INIS)

    Conrads-Herzog, A.; Krebsbach-Gnath, C.

    1980-01-01

    The publications dealing with the technical, organisation-relevant, and social preconditions for risk strategies rely on second-hand information, i.e. the conclusions which are drawn from the production accident in Seveso and the TMI-accident. A comparison results in common facts as well as in fundamental differences. In contrast to the authorities in Italy the authorities in the United States intervened more rapidly; the management of necessary measures was taken over by the authorities and very good information was given. (DG) [de

  20. Managing risk: clinical decision-making in mental health services.

    Science.gov (United States)

    Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

    2011-01-01

    Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

  1. Managing project risks and uncertainties

    Directory of Open Access Journals (Sweden)

    Mike Mentis

    2015-01-01

    Full Text Available This article considers threats to a project slipping on budget, schedule and fit-for-purpose. Threat is used here as the collective for risks (quantifiable bad things that can happen and uncertainties (poorly or not quantifiable bad possible events. Based on experience with projects in developing countries this review considers that (a project slippage is due to uncertainties rather than risks, (b while eventuation of some bad things is beyond control, managed execution and oversight are still the primary means to keeping within budget, on time and fit-for-purpose, (c improving project delivery is less about bigger and more complex and more about coordinated focus, effectiveness and developing thought-out heuristics, and (d projects take longer and cost more partly because threat identification is inaccurate, the scope of identified threats is too narrow, and the threat assessment product is not integrated into overall project decision-making and execution. Almost by definition, what is poorly known is likely to cause problems. Yet it is not just the unquantifiability and intangibility of uncertainties causing project slippage, but that they are insufficiently taken into account in project planning and execution that cause budget and time overruns. Improving project performance requires purpose-driven and managed deployment of scarce seasoned professionals. This can be aided with independent oversight by deeply experienced panelists who contribute technical insights and can potentially show that diligence is seen to be done.

  2. Enterprise Content Management Implementation and Risk

    Directory of Open Access Journals (Sweden)

    Jaroslava Klegová

    2015-01-01

    Full Text Available Enterprise Content Management (ECM solutions are commonly used in many areas such as document management, record management, digital asset management, etc. Key features of ECM systems are capturing, indexing, preserving and retrieving of digital information. The state-of-the- art ECM solution can help revolutionize document management and further automated business processes which can lead to better decisions and competitive advantage. Risk management can reduce project failure and that is why controlling risk in ECM implementation projects is considered to be a major contributor to project success. To manage software risk, the first step is to identify a list of ECM projects’ risks. The present paper provides an overview of ECM implementation risks and contains findings from a small survey on experience of ECM implementation and risk in Czech enterprises. Risk of implementation in the public sector is discussed more deeply with case study examples.

  3. Risk management and energy systems

    International Nuclear Information System (INIS)

    Carlevaro, F.; Romerio, F.

    1992-01-01

    In five sessions the following topics were dealt with: risk problems, risk analysis and evaluation tools, risks in industrial societies, risks of energy production, technological risks, ethics and political-social consensus. figs., tabs., refs

  4. PERFORMANCE IN INTERNAL CONTROL AND RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    JELER (POPA IOANA

    2017-06-01

    Full Text Available The purpose of this article is to highlight the importance of internal control and risk management. In practice, economic entities meet a variety of risks that have the origins from the internal environment or the external one. Although there are different of views on addressing the concept of risk - threats or opportunities, event or action, accordingly uncertain, proposed by specialists in risk management in this article we try to present these issues and identify techniques to counter risks occurrence. In this article we present also means managing risk and why needs to be implemented at institutional level a risk management. The paper concludes by highlight the role of efficient risk management in the company’s management and company's activities.

  5. Calysto: Risk Management for Commercial Manned Spaceflight

    Science.gov (United States)

    Dillaman, Gary

    2012-01-01

    The Calysto: Risk Management for Commercial Manned Spaceflight study analyzes risk management in large enterprises and how to effectively communicate risks across organizations. The Calysto Risk Management tool developed by NASA's Kennedy Space Center's SharePoint team is used and referenced throughout the study. Calysto is a web-base tool built on Microsoft's SharePoint platform. The risk management process at NASA is examined and incorporated in the study. Using risk management standards from industry and specific organizations at the Kennedy Space Center, three methods of communicating and elevating risk are examined. Each method describes details of the effectiveness and plausibility of using the method in the Calysto Risk Management Tool. At the end of the study suggestions are made for future renditions of Calysto.

  6. Nurses' Psychosocial Barriers to Suicide Risk Management

    Directory of Open Access Journals (Sweden)

    Sharon Valente

    2011-01-01

    Full Text Available Suicide remains a serious health care problem and a sentinel event tracked by The Joint Commission. Nurses are pivotal in evaluating risk and preventing suicide. Analysis of nurses' barriers to risk management may lead to interventions to improve management of suicidal patients. These data emerged from a random survey of 454 oncology nurses' attitudes, knowledge of suicide, and justifications for euthanasia. Instruments included a vignette of a suicidal patient and a suicide attitude questionnaire. Results. Psychological factors (emotions, unresolved grief, communication, and negative judgments about suicide complicate the nurse's assessment and treatment of suicidal patients. Some nurses (=122 indicated that euthanasia was never justified and 11 were unsure of justifications and evaluated each case on its merits. Justifications for euthanasia included poor symptom control, poor quality of life, incurable illness or permanent disability, terminal illness, and terminal illness with inadequate symptom control or impending death, patient autonomy, and clinical organ death. The nurses indicated some confusion and misconceptions about definitions and examples of euthanasia, assisted suicide, and double effect. Strategies for interdisciplinary clinical intervention are suggested to identify and resolve these psychosocial barriers.

  7. Review article: Practical management issues for the Helicobacter pylori-infected patient at risk of gastric cancer

    NARCIS (Netherlands)

    Tytgat, G. N.

    1998-01-01

    The public health implications of H. pylori infection are considerable in view of the universality of the infection and its attributable risk in cancer causation. Education of the population as to hygiene and nutrition are prerequisites. Total testing/screening and treatment of the infected

  8. Commercializing fuel cells: managing risks

    Science.gov (United States)

    Bos, Peter B.

    Commercialization of fuel cells, like any other product, entails both financial and technical risks. Most of the fuel cell literature has focussed upon technical risks, however, the most significant risks during commercialization may well be associated with the financial funding requirements of this process. Successful commercialization requires an integrated management of these risks. Like any developing technology, fuel cells face the typical 'Catch-22' of commercialization: "to enter the market, the production costs must come down, however, to lower these costs, the cumulative production must be greatly increased, i.e. significant market penetration must occur". Unless explicit steps are taken to address this dilemma, fuel cell commercialization will remain slow and require large subsidies for market entry. To successfully address this commercialization dilemma, it is necessary to follow a market-driven commercialization strategy that identifies high-value entry markets while minimizing the financial and technical risks of market entry. The financial and technical risks of fuel cell commercialization are minimized, both for vendors and end-users, with the initial market entry of small-scale systems into high-value stationary applications. Small-scale systems, in the order of 1-40 kW, benefit from economies of production — as opposed to economies to scale — to attain rapid cost reductions from production learning and continuous technological innovation. These capital costs reductions will accelerate their commercialization through market pull as the fuel cell systems become progressively more viable, starting with various high-value stationary and, eventually, for high-volume mobile applications. To facilitate market penetration via market pull, fuel cell systems must meet market-derived economic and technical specifications and be compatible with existing market and fuels infrastructures. Compatibility with the fuels infrastructure is facilitated by a

  9. Managing Risks in Dry Port Operations

    OpenAIRE

    Ciortescu Cezar-Gabriel; Pãvãla?cu Narcis Sebastian

    2012-01-01

    The purpose of this paper is to have an in-depth look into the phenomenon of risk assessment and risk management strategies in managing dry port operations as an integrated part into international containerized freight trade. The fact that world crises take the form of disruptions, bankruptcies, breakdowns, macroeconomic and political changes, and disasters leads to higher risks and makes risk management more and more difficult. This paper aims to discuss the theory behind the dry port concep...

  10. BEHAVIOURAL INSIGHTS INTO SUPPLY CHAIN RISK MANAGEMENT

    OpenAIRE

    Alexandra-Codruta Popescu (Bîzoi); Cristian-Gabriel Bîzoi

    2015-01-01

    Literature has focused largely on the field of supply chain risk management. Numerous risks occur within supply chain management. Until lately, behavioural risks (implying large amount of losses) have been neglected and considered not relevant. In this paper we provide an analysis of the importance of including behavioural research in logistics and supply chain risk management, what has been written so far and potential future research directions. Until now, literature on logistics and supply...

  11. Risk management frameworks for human health and environmental risks.

    Science.gov (United States)

    Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

    2003-01-01

    A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

  12. Credit Risk Evaluation : Modeling - Analysis - Management

    OpenAIRE

    Wehrspohn, Uwe

    2002-01-01

    An analysis and further development of the building blocks of modern credit risk management: -Definitions of default -Estimation of default probabilities -Exposures -Recovery Rates -Pricing -Concepts of portfolio dependence -Time horizons for risk calculations -Quantification of portfolio risk -Estimation of risk measures -Portfolio analysis and portfolio improvement -Evaluation and comparison of credit risk models -Analytic portfolio loss distributions The thesis contributes to the evaluatio...

  13. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study

    Science.gov (United States)

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-ichi; Takishita, Shu-ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-01-01

    Objectives Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Design Multicentre, unblinded, pragmatic, randomised, controlled trial with blinded assessment of end points and intention-to-treat analysis that was started in 2004 and finished in 2012. Setting Hypertension clinics at 106 sites in Japan, including general practitioners’ offices and teaching hospitals. Participants Non-diabetic patients with essential hypertension. Interventions Antihypertensive treatment with low-dose thiazide diuretics at 12.5 mg/day of hydrochlorothiazide or equivalent (Diuretics group) or that without thiazide diuretics (No-diuretics group). Main outcome The primary outcome was new onset of type 2 diabetes diagnosed according to WHO criteria and the criteria of Japanese Society of Diabetes. Results 1130 patients were allocated to Diuretics (n=544) or No-diuretics group (n=586). Complete end point information was collected for 1049 participants after a median follow-up of 4.4 years. Diabetes developed in 25 (4.6%) participants in the Diuretics group, as compared with 29 (4.9%) in the No-diuretics group (HR 0.93; 95% CI 0.55 to 1.58; p=0.800). Conclusions Antihypertensive treatment with thiazide diuretics at low doses may not be associated with an increased risk for new onset of type 2 diabetes. This result might suggest safety of use of low doses of thiazide diuretics. Trial registration number ClinicalTrials.gov NCT00131846. PMID:25031188

  14. RISK MANAGEMENT OF GERMAN FRUIT PRODUCERS

    Directory of Open Access Journals (Sweden)

    Annkatrin PORSCH

    2018-03-01

    Full Text Available Horticultural farms in Germany face substantial business risks. However, fruit farms often struggle to implement appropriate risk management processes, and the risk management literature widely has ignored this farm type. The aim of the study was to improve the assessment of risks by farmers and the choice of suitable risk management instruments. Therefore, a risk management process based on subjective probabilities and suitable for small and medium-sized farms was developed, considering the specific needs of family run businesses. An online survey was conducted to achieve a comprehensive view of the risk perception and risk management practices of German fruit producers. Price and production risks are the most relevant risk categories for fruit farmers. However, among single risk sources, those in the people risk category were seen as the most important. Results show significant interactions among risk categories and a significant correlation between loss experience and the rating of risk categories. The assumption that risk averse farmers generally rate risks higher than risk neutral or risk seeking farmers cannot be confirmed. Diversification seems to be the most important risk management instrument for many fruit producers, especially diversification of marketing channels, farm income, and production activities. Further research should focus on the apparent inconsistency between the satisfaction with instruments reported by farmers and the actual implementation of many of them (e.g., hail insurance and anti-hail net. Furthermore, there is a need for research, to develop decision models considering the interactions of risks and risk management instruments, loss experience and risk seeking attitudes.

  15. Patient risk from interproximal radiography

    International Nuclear Information System (INIS)

    Gibbs, S.J.; Pujol, A. Jr.; Chen, T.S.; Malcolm, A.W.; James, A.E. Jr.

    1984-01-01

    Computer simulation methods for determining patient dose from dental radiography have demonstrated that patient risk from a two-film interproximal examination ranges from 1.1 X 10(-8) to 3.4 X 10(-7) using 90-kVp beams, depending on film speed, projection technique, and age and sex of the patient. Further, changing from a short-cone round-beam to a long-cone technique with rectangular collimation reduces risk by a factor of 2.9, independent of other factors

  16. CEA - Assessment of risk management 2013

    International Nuclear Information System (INIS)

    Bigot, Bernard; Bonnevie, Edwige; Maillot, Bernard

    2014-06-01

    After some introducing texts by CEA managers, this report proposes a rather detailed overview and presentation of CEA activities, objectives and obtained results in different fields: protection and control of the environment, installation safety, health, safety and radiation protection, transports of hazardous materials, waste management, protection of sites, installations and heritage, management of emergency situations, management of legal risks, internal controls and audits, activity of the risk management department, CEA activities from research to industry

  17. Prognostic implications of serial risk score assessments in patients with pulmonary arterial hypertension: a Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) analysis.

    Science.gov (United States)

    Benza, Raymond L; Miller, Dave P; Foreman, Aimee J; Frost, Adaani E; Badesch, David B; Benton, Wade W; McGoon, Michael D

    2015-03-01

    Data from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) were used previously to develop a risk score calculator to predict 1-year survival. We evaluated prognostic implications of changes in the risk score and individual risk-score parameters over 12 months. Patients were grouped by decreased, unchanged, or increased risk score from enrollment to 12 months. Kaplan-Meier estimates of subsequent 1-year survival were made based on change in the risk score during the initial 12 months of follow-up. Cox regression was used for multivariable analysis. Of 2,529 patients in the analysis cohort, the risk score was decreased in 800, unchanged in 959, and increased in 770 at 12 months post-enrollment. Six parameters (functional class, systolic blood pressure, heart rate, 6-minute walk distance, brain natriuretic peptide levels, and pericardial effusion) each changed sufficiently over time to improve or worsen risk scores in ≥5% of patients. One-year survival estimates in the subsequent year were 93.7%, 90.3%, and 84.6% in patients with a decreased, unchanged, and increased risk score at 12 months, respectively. Change in risk score significantly predicted future survival, adjusting for risk at enrollment. Considering follow-up risk concurrently with risk at enrollment, follow-up risk was a much stronger predictor, although risk at enrollment maintained a significant effect on future survival. Changes in REVEAL risk scores occur in most patients with pulmonary arterial hypertension over a 12-month period and are predictive of survival. Thus, serial risk score assessments can identify changes in disease trajectory that may warrant treatment modifications. Copyright © 2015 International Society for Heart and Lung Transplantation. All rights reserved.

  18. Contradictions Between Risk Management and Sustainable Development

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Odd Einar; Langhelle, Oluf; Engen, Ole A. [Univ. of Stavanger (Norway). Dept. of Media, Culture and Social Science

    2006-09-15

    The aim of this paper is to discuss how risk management as a methodology and mindset influence on priorities and decisions concerning sustainable development. Management of risks and hazards often rely on partial analysis with a limited time frame. This may lead to a paradoxical situation where risk management and extended use of risk analysis could hamper long term sustainable development. The question is: Does the use of risk and vulnerability analysis (RaV-analysis) hamper or contribute to sustainable development? Because risk management and assessment has a more narrow scope and a limited time perspective based on well established methodologies, the tangible impacts of risk reducing measures in a project is easier to calculate than long-term and intangible impacts on global development. Empirical evidence is still scarce, but our preliminary conclusion is that mainstream risk management and assessments is counterproductive to sustainable development.

  19. Contradictions Between Risk Management and Sustainable Development

    International Nuclear Information System (INIS)

    Olsen, Odd Einar; Langhelle, Oluf; Engen, Ole A.

    2006-01-01

    The aim of this paper is to discuss how risk management as a methodology and mindset influence on priorities and decisions concerning sustainable development. Management of risks and hazards often rely on partial analysis with a limited time frame. This may lead to a paradoxical situation where risk management and extended use of risk analysis could hamper long term sustainable development. The question is: Does the use of risk and vulnerability analysis (RaV-analysis) hamper or contribute to sustainable development? Because risk management and assessment has a more narrow scope and a limited time perspective based on well established methodologies, the tangible impacts of risk reducing measures in a project is easier to calculate than long-term and intangible impacts on global development. Empirical evidence is still scarce, but our preliminary conclusion is that mainstream risk management and assessments is counterproductive to sustainable development

  20. Risk management with options and futures under liquidity risk

    OpenAIRE

    Adam-Müller, A F A; Panaretou, A

    2009-01-01

    Futures hedging creates liquidity risk through marking to market. Liquidity risk matters if interim losses on a futures position have to be financed at a markup over the risk-free rate. This study analyzes the optimal risk management and production decisions of a firm facing joint price and liquidity risk. It provides a rationale for the use of options on futures in imperfect capital markets. If liquidity risk materializes, the firm sells options on futures in order to partly cover this liqui...

  1. Cattle farmers’ perceptions of risk and risk management strategies

    DEFF Research Database (Denmark)

    Bishu, Kinfe G.; O'Reilly, Seamus; Lahiff, Edward

    2018-01-01

    This study analyzes cattle farmers’ perceptions of risk and risk management strategies in Tigray, Northern Ethiopia. We use survey data from a sample of 356 farmers based on multistage random sampling. Factor analysis is employed to classify scores of risk and management strategies, and multiple...... utilization were perceived as the most important strategies for managing risks. Livestock disease and labor shortage were perceived as less of a risk by farmers who adopted the practice of zero grazing compared to other farmers, pointing to the potential of this practice for risk reduction. We find strong...... evidence that farmers engage in multiple risk management practices in order to reduce losses from cattle morbidity and mortality. The results suggest that government strategies that aim at reducing farmers’ risk need to be tailored to specific farm and farmer characteristics. Findings from this study have...

  2. Hazard evaluation and risk management

    International Nuclear Information System (INIS)

    Fritzsche, A.F.

    1986-01-01

    The eigth chapter deals with the actual handling of hazards. The principal issue concerns man's behaviour towards hazards as an individual formerly and today; the evaluation of expected results of both a positive and a negative kind as determined by the individual's values which may differ and vary greatly from one individual to the next. The evaluation of benefit and hazard as well as the risk management resulting from decision-taking are political processes in the democratic state. Formal decision-taking tools play a major role in this process which concerns such central issues like who will participate; how the decision is arrived at; the participation of citizens; specialist knowledge and participation of the general public. (HSCH) [de

  3. Benchmarking Outdoor Expeditionary Program Risk Management Strategies

    Science.gov (United States)

    Meerts-Brandsma, Lisa; Furman, Nate; Sibthorp, Jim

    2017-01-01

    In 2003, the University of Utah and the National Outdoor Leadership School (NOLS) completed a study that developed a risk management taxonomy in the outdoor adventure industry and assessed how different outdoor expeditionary programs (OEPs) managed risk (Szolosi, Sibthorp, Paisley, & Gookin, 2003). By unifying the language around risk, the…

  4. Information risk management a practitioner's guide

    CERN Document Server

    Sutton, David

    2014-01-01

    Information risk management (IRM) is about identifying, assessing and prioritising risks to keep information secure and available. This accessible book provides practical guidance to the principles and development of a strategic approach to an IRM programme. The only textbook for the BCS Practitioner Certificate in Information Risk Management.

  5. Active Risk Management and Banking Stability

    NARCIS (Netherlands)

    Silva Buston, C.F.

    2013-01-01

    Abstract: This paper analyzes the net impact of two opposing effects of active risk management at banks on their stability: higher risk-taking incentives and better isolation of credit supply from varying economic conditions. We present a model where banks actively manage their portfolio risk by

  6. Risk Management and Financial Derivatives: An Overview

    NARCIS (Netherlands)

    S.M. Hammoudeh (Shawkat); M.J. McAleer (Michael)

    2012-01-01

    textabstractRisk management is crucial for optimal portfolio management. One of the fastest growing areas in empirical finance is the expansion of financial derivatives. The purpose of this special issue on “Risk Management and Financial Derivatives” is to highlight some areas in which novel

  7. Risk management at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    Cummings, G.E.; Strait, R.S.

    1993-10-01

    Managing risks at a large national laboratory presents a unique set of challenges. These challenges include the management of a broad diversity of activities, the need to balance research flexibility against management control, and a plethora of requirements flowing from regulatory and oversight bodies. This paper will present the experiences of Lawrence Livermore National Laboratory (LLNL) in risk management and in dealing with these challenges. While general risk management has been practiced successfully by all levels of Laboratory management, this paper will focus on the Laboratory's use of probabilistic safety assessment and prioritization techniques and the integration of these techniques into Laboratory operations

  8. Risk management: correct patient and specimen identification in a surgical pathology laboratory. The experience of Infermi Hospital, Rimini, Italy.

    Science.gov (United States)

    Fabbretti, G

    2010-06-01

    Because of its complex nature, surgical pathology practice is prone to error. In this report, we describe our methods for reducing error as much as possible during the pre-analytical and analytical phases. This was achieved by revising procedures, and by using computer technology and automation. Most mistakes are the result of human error in the identification and matching of patient and samples. To avoid faulty data interpretation, we employed a new comprehensive computer system that acquires all patient ID information directly from the hospital's database with a remote order entry; it also provides label and request forms via-Web where clinical information is required before sending the sample. Both patient and sample are identified directly and immediately at the site where the surgical procedures are performed. Barcode technology is used to input information at every step and automation is used for sample blocks and slides to avoid errors that occur when information is recorded or transferred by hand. Quality control checks occur at every step of the process to ensure that none of the steps are left to chance and that no phase is dependent on a single operator. The system also provides statistical analysis of errors so that new strategies can be implemented to avoid repetition. In addition, the staff receives frequent training on avoiding errors and new developments. The results have been shown promising results with a very low error rate (0.27%). None of these compromised patient health and all errors were detected before the release of the diagnosis report.

  9. Coagulation management in patients undergoing neurosurgical procedures.

    Science.gov (United States)

    Robba, Chiara; Bertuetti, Rita; Rasulo, Frank; Bertuccio, Alessando; Matta, Basil

    2017-10-01

    Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures. Antihemostatic and anticoagulant drugs have shown to be associated with perioperative bleeding. On the other hand, an increased risk of venous thromboembolism and hypercoagulative state after elective and emergency neurosurgery, in particular after brain tumor surgery, has been described in several patients. To balance the risk between thrombosis and bleeding, it is important to be familiar with the perioperative changes in coagulation and with the recent management guidelines for anticoagulated patients undergoing neurosurgical procedures, in particular for those taking new direct anticoagulants. We have considered the current clinical trials and literature regarding both safety and efficacy of deep venous thrombosis prophylaxis in the neurosurgical population. These were mainly trials concerning both elective surgical and intensive care patients with a poor grade intracranial bleed or multiple traumas with an associated severe traumatic brain injury (TBI). Coagulation management remains a major issue in patients undergoing neurosurgical procedures. However, in this field of research, literature quality is poor and further studies are necessary to identify the best strategies to minimize risks in this group of patients.

  10. MANAGEMENT PATIENT OF SWINE INFLUENZA

    Directory of Open Access Journals (Sweden)

    Endra Gunawan

    2015-05-01

    Full Text Available Influenza is an acute respiratory diseases caused by various influenza virus which infect the upper and lower respiratory tract and often accompanied by systemic symptoms such as fever, headache and muscle pain. Influenza spreads through the air. Swine influenza comes from swine and can cause an outbreaks in pig flocks. Even this is a kind of a rare case but the swine influenza could be transmitted to human by direct contact with infected swine or through environment that already being contaminated by swine influenza virus. There are 3 types of swine influenza virus namely H1N1, H3N2 and H1N2. Type H1N1 swine-virus had been known since 1918. Avian influenza virus infection is transmitted from one person to another through secret containing virus. Virus is binded into the mucous cells of respiratory tract before it is finally infecting the cells itself. Management patients with H1N1 influenza is based on the complications and the risk. Besides, it is also need to consider the clinical criteria of the patient. Therapy medicamentosa is applied to the patients by giving an antiviral, antibiotics and symptomatic therapy. Prevention can be done by avoid contact with infected animal or environment, having antiviral prophylaxis and vaccination.

  11. Risk factor management: antiatherogenic therapies.

    Science.gov (United States)

    Gielen, Stephan; Sandri, Marcus; Schuler, Gerhard; Teupser, Daniel

    2009-08-01

    Despite the advances in interventional techniques, the management of stable atherosclerosis remains the domain of optimal guideline-oriented therapy. Recent studies on the effects of aggressive lipid lowering on atheroma volume changes using intravascular ultrasound indicate that it is possible to achieve atherosclerosis regression by reaching low-density lipoprotein (LDL) levels less than 75 mg/dl. The pleiotropic anti-inflammatory effects of statins contribute to the reduction of cardiovascular (CV) event observed with aggressive lipid lowering. As a second important strategy to prevent disease progression, lifestyle changes with regular physical exercise are capable of halting the atherosclerotic process and reducing angina symptoms and CV events. Optimal medical therapy, a healthy lifestyle with regular physical exercise, and coronary interventions are not mutually exclusive treatment strategies. Over the last few decades, both have proved to be effective in significantly reducing the CV mortality in the Western world. However, risk factor modification contributed to at least half the effect in the reduction of CV mortality. This figure provides an estimate of what could be achieved if we were to take risk factor modification more seriously - especially in the acute care setting. The knowledge is there: today we have a better understanding on how to stop progression and even induce regression of atherosclerosis. Much research still needs to be done and will be done. In the meantime, however, our primary focus should lie in implementing what is already known. In addition, it is essential not just to treat CV risk factors, but also to treat them to achieve the target values as set by the guidelines of European Society of Cardiology.

  12. Strategies for successful software development risk management

    Directory of Open Access Journals (Sweden)

    Marija Boban

    2003-01-01

    Full Text Available Nowadays, software is becoming a major part of enterprise business. Software development is activity connected with advanced technology and high level of knowledge. Risks on software development projects must be successfully mitigated to produce successful software systems. Lack of a defined approach to risk management is one of the common causes for project failures. To improve project chances for success, this work investigates common risk impact areas to perceive a foundation that can be used to define a common approach to software risk management. Based on typical risk impact areas on software development projects, we propose three risk management strategies suitable for a broad area of enterprises and software development projects with different amounts of connected risks. Proposed strategies define activities that should be performed for successful risk management, the one that will enable software development projects to perceive risks as soon as possible and to solve problems connected with risk materialization. We also propose a risk-based approach to software development planning and risk management as attempts to address and retire the highest impact risks as early as possible in the development process. Proposed strategies should improve risk management on software development projects and help create a successful software solution.

  13. Risk and/or resilience management

    Directory of Open Access Journals (Sweden)

    Jean-Paul Louisot

    2015-06-01

    Full Text Available Risk management aims at managing all the uncertainties that may interfere with the objectives and missions of the organization. Resilience engineering aims at building its capacity to get over disturbances or stress while keeping the functionalities needed to survive, and possibly thrive. A recently open debate on an Internet blog launched by the risk managers of the Scottish Widows Bank seems to arise from what some professionals see as two competing branches of the management sciences. Whereas through the development of ERM – Enterprise-wide Risk Managementrisk management is emerging at last to become a science, as well as an art and a practice, the mentioned above centered on the role of a newly forged name “resilience management”. This opens a new front of the many debates that could derail the path to maturity of Risk Management as a science and reopen new silos much as Business Impact Analysis, BIA, or continuity management, might do if a clear distinction is not made between science, objectives and tools. However, because organizations are so interconnected today in the supply cloud that it is inevitable that they will face catastrophic risk and this is why resilience needs to be a core objective of any risk management plan? Whereas traditional risk management techniques alone may not be adequate to deal with such pervasive and insipient risk scenarios, resilience is ingrained into ERM

  14. Big data in health care: using analytics to identify and manage high-risk and high-cost patients.

    Science.gov (United States)

    Bates, David W; Saria, Suchi; Ohno-Machado, Lucila; Shah, Anand; Escobar, Gabriel

    2014-07-01

    The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid progress has been made in clinical analytics--techniques for analyzing large quantities of data and gleaning new insights from that analysis--which is part of what is known as big data. As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States. We present six use cases--that is, key examples--where some of the clearest opportunities exist to reduce costs through the use of big data: high-cost patients, readmissions, triage, decompensation (when a patient's condition worsens), adverse events, and treatment optimization for diseases affecting multiple organ systems. We discuss the types of insights that are likely to emerge from clinical analytics, the types of data needed to obtain such insights, and the infrastructure--analytics, algorithms, registries, assessment scores, monitoring devices, and so forth--that organizations will need to perform the necessary analyses and to implement changes that will improve care while reducing costs. Our findings have policy implications for regulatory oversight, ways to address privacy concerns, and the support of research on analytics. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Risk Management in Mergers and Acquisitions

    Directory of Open Access Journals (Sweden)

    Dmitry O. Verdiev

    2015-01-01

    Full Text Available M&A statistics show that less than a third of newly merged companies has realized their planned synergistic effects and increased shareholder value. According to the author, such disgusting situation is due to improper planning and failure of corporate management to understand the importance of risk management in M&A. Lack of practice in identification, evaluation, mitigation and regular monitoring of risks leads to the situation when many companies merge despite the fact that the merger bears substantial risks. Corporate management fails to include risk mitigation expenses in merger costs. In many cases, risk mitigation expenses may be so substantive that the merger loses its attractiveness. Only few companies implement risk management methodology while planning M&A activity. This methodology may anticipate and minimize the consequences of various risk factors that negatively influence integration process. The article suggests an implementation of risk management best practice. This risk management best practice may act as an effective tool of successful realization of synergistic effects in M&A and may be helpful in increasing shareholder value in post-merger period. Risk management is conducted throughout the stages of merger and includes identification, analysis, assessment, management and monitoring of risks. Implementation of risk management at early stages of merger planning significantly decreases uncertainty in relation to achievement of financial and operational goals of newly merged company. The article provides with typical M&A risk matrix that may be adapted for specific M&A project. Risk matrix includes a register of risks sorted by stages of M&A deal, quality assessment of their probability, influence and impact on merger as well as risk mitigation methods.

  16. 77 FR 13585 - Electricity Subsector Cybersecurity Risk Management Process Guideline

    Science.gov (United States)

    2012-03-07

    ... DEPARTMENT OF ENERGY Electricity Subsector Cybersecurity Risk Management Process Guideline AGENCY... Electricity Subsector Cybersecurity Risk Management Process guideline. The guideline describes a risk... Cybersecurity Risk Management Process Guideline. The primary goal of this guideline is to describe a risk...

  17. Ethics and risk management in administrative child and adolescent psychiatry.

    Science.gov (United States)

    Sondheimer, Adrian

    2010-01-01

    This article examines ethics (the philosophic study of "doing the right thing") and risk management (the practice that seeks to manage the likelihood of "doing the wrong thing") and the relationship between them in the context of administrative child and adolescent psychiatry. Issues that affect child and adolescent psychiatrists who manage staff and business units and clinical practitioners who treat and manage individual patients are addressed. Malpractice, budgeting, credentialing, boundaries, assessment, documentation, treatment, research, dangerousness, and confidentiality are among the topics reviewed.

  18. Identifying patient risks during hospitalization

    Directory of Open Access Journals (Sweden)

    Lucélia Ferreira Lima

    2008-12-01

    Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.

  19. Hybrid Risk Management Methodology: A Case Study

    Directory of Open Access Journals (Sweden)

    Jacky Siu-Lun Ting

    2009-10-01

    Full Text Available Risk management is a decision-making process involving considerations of political, social, economic and engineering factors with relevant risk assessments relating to a potential hazard. In the last decade, a number of risk management tools are introduced and employed to manage and minimize the uncertainty and threats realization to the organizations. However, the focus of these methodologies are different; in which companies need to adopt various risk management principles to visualize a full picture of the organizational risk level. Regarding to this, this paper presents a new approach of risk management that integrates Hierarchical Holographic Modeling (HHM, Enterprise Risk Management (ERM and Business Recovery Planning (BCP for identifying and assessing risks as well as managing the consequences of realized residual risks. To illustrate the procedures of the proposed methodology, a logistic company ABC Limited is chosen to serve as a case study Through applying HHM and ERM to investigate and assess the risk, ABC Limited can be better evaluated the potential risks and then took the responsive actions (e.g. BCP to handle the risks and crisis in near future.

  20. Improving patient adherence to lifestyle advice (IMPALA: a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol

    Directory of Open Access Journals (Sweden)

    Grol Richard

    2008-01-01

    Full Text Available Abstract Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52

  1. Continuous Risk Management: A NASA Program Initiative

    Science.gov (United States)

    Hammer, Theodore F.; Rosenberg, Linda

    1999-01-01

    NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

  2. Software And Systems Engineering Risk Management

    Science.gov (United States)

    2010-04-01

    RSKM 2004 COSO Enterprise RSKM Framework 2006 ISO/IEC 16085 Risk Management Process 2008 ISO/IEC 12207 Software Lifecycle Processes 2009 ISO/IEC...1 Software And Systems Engineering Risk Management John Walz VP Technical and Conferences Activities, IEEE Computer Society Vice-Chair Planning...Software & Systems Engineering Standards Committee, IEEE Computer Society US TAG to ISO TMB Risk Management Working Group Systems and Software

  3. Implications of Risk Management Practices on Financial ...

    African Journals Online (AJOL)

    Implications of Risk Management Practices on Financial Performance of Sugar ... The respondents were functional heads of the companies under the survey. ... of downside losses in order to minimize the negative impact of risk on returns.

  4. RISK MANAGEMENT MECHANISM OF GRAIN PROCESSING ENTERPRISES

    Directory of Open Access Journals (Sweden)

    I. P. Bogomolova

    2013-01-01

    Full Text Available In article the main characteristics of a control system by risks (the purpose, properties, the principles, requirements are defined, and also the possible mechanism of risk management of the flour-grinding enterprises is considered.

  5. Risk factors and effective management of preeclampsia

    Directory of Open Access Journals (Sweden)

    English FA

    2015-03-01

    Full Text Available Fred A English,1 Louise C Kenny,1 Fergus P McCarthy1,2 1Irish Centre for Fetal and Neonatal Translational Research (INFANT, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; 2Women’s Health Academic Centre, King's Health Partners, St Thomas' Hospital, London, UK Abstract: Preeclampsia, a hypertensive disorder of pregnancy is estimated to complicate 2%–8% of pregnancies and remains a principal cause of maternal and fetal morbidity and mortality. Preeclampsia may present at any gestation but is more commonly encountered in the third trimester. Multiple risk factors have been documented, including: family history, nulliparity, egg donation, diabetes, and obesity. Significant progress has been made in developing tests to predict risk of preeclampsia in pregnancy, but these remain confined to clinical trial settings and center around measuring angiogenic profiles, including placental growth factor or newer tests involving metabolomics. Less progress has been made in developing new treatments and therapeutic targets, and aspirin remains one of the few agents shown to consistently reduce the risk of developing preeclampsia. This review serves to discuss recent advances in risk factor identification, prediction techniques, and management of preeclampsia in antenatal, intrapartum, and postnatal patients. Keywords: pregnancy, treatment, risk reduction, prediction

  6. Business managers turn to risk assessment

    International Nuclear Information System (INIS)

    Allen, Frank

    1993-01-01

    Risk assessments have evolved to help technical managers in nuclear and other industries to design and operate plant with safety in mind. However, they are now developing into the area of business management. (author)

  7. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

  8. Business resilience: Reframing healthcare risk management.

    Science.gov (United States)

    Simeone, Cynthia L

    2015-09-01

    The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.

  9. Probabilistic risk assessment methodology for risk management and regulatory applications

    International Nuclear Information System (INIS)

    See Meng Wong; Kelly, D.L.; Riley, J.E.

    1997-01-01

    This paper discusses the development and potential applications of PRA methodology for risk management and regulatory applications in the U.S. nuclear industry. The new PRA methodology centers on the development of This paper discusses the time-dependent configuration risk profile for evaluating the effectiveness of operational risk management programs at U.S. nuclear power plants. Configuration-risk profiles have been used as risk-information tools for (1) a better understanding of the impact of daily operational activities on plant safety, and (2) proactive planning of operational activities to manage risk. Trial applications of the methodology were undertaken to demonstrate that configuration-risk profiles can be developed routinely, and can be useful for various industry and regulatory applications. Lessons learned include a better understanding of the issues and characteristics of PRA models available to industry, and identifying the attributes and pitfalls in the developement of risk profiles

  10. THE ANALYSIS OF RISK MANAGEMENT PROCESS WITHIN MANAGEMENT

    Directory of Open Access Journals (Sweden)

    ROMANESCU MARCEL LAURENTIU

    2016-10-01

    Full Text Available This article highlights the risk analysis within management, focusing on how a company could practicaly integrate the risks management in the existing leading process. Subsequently, it is exemplified the way of manage risk effectively, which gives numerous advantages to all firms, including improving their decision-making process. All these lead to the conclusion that the degree of risk specific to companies is very high, but if managers make the best decisions then it can diminish it and all business activitiy and its income are not influenced by factors that could disturb in a negative way .

  11. Economic Exposure and Integrated Risk Management

    OpenAIRE

    Miller, Kent D.

    1994-01-01

    Most corporate risk management research focuses on particular risk exposures to the exclusion of other interrelated exposures. By contrast, this study models corporate risk exposures using a multivariate approach integrating the distinct exposures of interest to finance and strategy researchers. The paper addresses the implications of multivariate modeling for corporate risk management, some key methodological issues arising in empirical estimation of corporate economic exposrues, and direc...

  12. PERFORMANCE IN INTERNAL CONTROL AND RISK MANAGEMENT

    OpenAIRE

    JELER (POPA) IOANA; FOCŞAN ELEONORA IONELA; CORICI MARIAN CĂTĂLIN

    2017-01-01

    The purpose of this article is to highlight the importance of internal control and risk management. In practice, economic entities meet a variety of risks that have the origins from the internal environment or the external one. Although there are different of views on addressing the concept of risk - threats or opportunities, event or action, accordingly uncertain, proposed by specialists in risk management in this article we try to present these issues and identify techniques to ...

  13. APPLIED ISSUES ABOUT BANKING RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Elena Geanina Clipici

    2017-09-01

    Full Text Available The following paper emphasizes the need to deepen the understanding of the notion of banking risk management by explaining the significant risks the bank encounters during financial exercises as well as their additional entries. The study of the paper will focus on UniCredit Bank during the years 2014 and  2015 on all types of risks, in which we will provide comprehensive data on how the UniCredit Bank management applies its risk policies.

  14. CEA - Assessment of risk management for 2012

    International Nuclear Information System (INIS)

    Bonnevie, Edwige

    2013-06-01

    This report proposes an overview of the main events, actions performed by the CEA, and facts for 2012 regarding protection and monitoring of the environment, installation safety, occupational health and safety, radiological protection of workers, transportation of hazardous materials, waste management, protection of sites, installations and heritage, emergency situation management, legal risk management, internal controls and audits. It also presents the organisation and action of the risk management department within the CEA

  15. Management Ownership and Risk-Shifting Investment

    OpenAIRE

    Nobuyuki Teshima

    2012-01-01

    This study analyzes the relationship between management ownership and its risk-shifting incentive. We first present a simple model showing that the risk-shifting incentive of management of financially distressed firms increases as the management ownership of the firm increases. Empirically, we test the hypothesis that under the former Japanese Corporate Reorganization Law, firms with higher management ownership are more likely to use legal rather than private reorganization. Since the reorgan...

  16. Feedback on flood risk management

    Science.gov (United States)

    Moreau, K.; Roumagnac, A.

    2009-09-01

    For several years, as floods were increasing in South of France, local communities felt deprive to assume their mission of protection and information of citizens, and were looking for assistance in flood management. In term of flood disaster, the fact is that physical protection is necessary but inevitably limited. Tools and structures of assistance to anticipation remain slightly developed. To manage repeated crisis, local authorities need to be able to base their policy against flood on prevention, warnings, post-crisis analysis and feedback from former experience. In this objective, after 3 years of test and improvement since 2003, the initiative Predict-Services was developped in South of France: it aims at helping communities and companies to face repeated flood crisis. The principle is to prepare emergency plans, to organize crisis management and reduce risks; to help and assist communities and companies during crisis to activate and adapt their emergency plans with enough of anticipation; and to analyse floods effects and improve emergency plans afterwards. In order to reduce risks, and to keep the benefits of such an initiative, local communities and companies have to maintain the awareness of risk of the citizens and employees. They also have to maintain their safety plans to keep them constantly operational. This is a part of the message relayed. Companies, Local communities, local government authorities and basin stakeholders are the decision makers. Companies and local communities have to involve themselves in the elaboration of safety plans. They are also completely involved in their activation that is their own responsability. This applies to other local government authorities, like districts one's and basin stakeholders, which participle in the financing community safety plans and adminitrative district which are responsible of the transmission of meteorological alert and of rescue actions. In the crossing of the géo-information stemming from the

  17. Risk Management for the International Space Station

    Science.gov (United States)

    Sebastian, J.; Brezovic, Philip

    2002-01-01

    The International Space Station (ISS) is an extremely complex system, both technically and programmatically. The Space Station must support a wide range of payloads and missions. It must be launched in numerous launch packages and be safely assembled and operated in the harsh environment of space. It is being designed and manufactured by many organizations, including the prime contractor, Boeing, the NASA institutions, and international partners and their contractors. Finally, the ISS has multiple customers, (e.g., the Administration, Congress, users, public, international partners, etc.) with contrasting needs and constraints. It is the ISS Risk Management Office strategy to proactively and systematically manages risks to help ensure ISS Program success. ISS program follows integrated risk management process (both quantitative and qualitative) and is integrated into ISS project management. The process and tools are simple and seamless and permeate to the lowest levels (at a level where effective management can be realized) and follows the continuous risk management methodology. The risk process assesses continually what could go wrong (risks), determine which risks need to be managed, implement strategies to deal with those risks, and measure effectiveness of the implemented strategies. The process integrates all facets of risk including cost, schedule and technical aspects. Support analysis risk tools like PRA are used to support programatic decisions and assist in analyzing risks.

  18. Social Risk and the Management of MNCs

    DEFF Research Database (Denmark)

    Taarup Esbensen, Jacob

    2015-01-01

    Multinational companies (MNCs) are increasing being exposed to risk that originate from local communities in the business environment where they operate. The response has been to implement systems for stakeholder engagement by including social issues into their risk management systems. However......” systems, which are based on the capability to identify frames and sensemaking processes. This paper show how social risk management can be conventionalised using distinct theoretical domains taking its outset in a sociological perspective on risk, linking International Business (IB) risk management...

  19. Risks management in project planning

    OpenAIRE

    Stankevičiūtė, Roberta

    2017-01-01

    Project management consists of two very important aspects – managing the right project and managing the project right. To know that you are managing the right project you need to ensure that your project is based on an actual requirement and that your project goal is relevant and beneficial. And professional project planning assists in managing project the right way. The project planning process is very time consuming and is one of the most important parts of the project management process. T...

  20. Redefining Diabetes and the Concept of Self-Management from a Patient's Perspective: Implications for Disease Risk Factor Management

    Science.gov (United States)

    Masupe, T. K.; Ndayi, K.; Tsolekile, L.; Delobelle, P.; Puoane, T.

    2018-01-01

    The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and…

  1. The total theory about risk management

    International Nuclear Information System (INIS)

    Furuya, Shunsuke

    2003-01-01

    A general working procedure of risk management, some example of other countries, topics and problems in the future are described. A definition of risk, risk assessment, risk management process, setting of aim and definite policy are explained. As a fundamental way of thinking, risk is controlled by ALARP (As Low As Reasonably Practicable). The upper and lower limit of risk level is called as Quantitative Safety Goal and Target Level of Safety, respectively. These limits in the atomic power and airplane are decided. Evaluation of risk, countermeasure and practice are explained. For example, a permissible range of risk and practical use in England, U.S.A, Holland and Japan are stated. Recently, accountability risk, missing demand risk and control risk are important. (S.Y.)

  2. Development of computerized risk management tool

    International Nuclear Information System (INIS)

    Kil Yoo Kim; Mee Jung Hwang; Seung Cheol Jang; Sang Hoon Han; Tae Woon Kim

    1997-01-01

    The author describes the kinds of efforts for the development of computerized risk management tool; (1) development of a risk monitor, Risk Monster, (2) improvement of McFarm (Missing Cutsets Finding Algorithm for Risk Monitor) and finally (3) development of reliability database management system, KwDBMan. Risk Monster supports for plant operators and maintenance schedulers to monitor plant risk and to avoid high peak risk by rearranging maintenance work schedule. Improved McFarm significantly improved calculation speed of Risk Monster for the cases of supporting system OOS (Out Of Service). KwDBMan manages event data, generic data and CCF (Common Cause Failure) data to support Risk Monster as well as PSA tool, KIRAP (KAERI Integrated Reliability Analysis Package)

  3. Risk management method for small photovoltaic plants

    Directory of Open Access Journals (Sweden)

    Kirova Milena

    2016-09-01

    Full Text Available Risk management is necessary for achieving the goals of the organization. There are many methods, approaches, and instruments in the literature concerning risk management. However, these are often highly specialized and transferring them to a different field can prove difficult. Therefore, managers often face situations where they have no tools to use for risk management. This is the case with small photovoltaic plants (according to a definition by the Bulgarian State Energy and Water Regulatory Commission small applies to systems with a total installed power of 200 kWp. There are some good practices in the energy field for minimizing risks, but they offer only partial risk prevention and are not sufficient. Therefore a new risk management method needs to be introduced. Small photovoltaic plants offer plenty of advantages in comparison to the other renewable energy sources which makes risk management in their case more important. There is no classification of risks for the exploitation of small photovoltaic systems in the available literature as well as to what degree the damages from those risks could spread. This makes risk analysis and evaluation necessary for obtaining information which could aid taking decisions for improving risk management. The owner of the invested capital takes a decision regarding the degree of acceptable risk for his organization and it must be protected depending on the goals set. Investors in small photovoltaic systems need to decide to what degree the existing risks can influence the goals previously set, the payback of the investment, and what is the acceptable level of damages for the investor. The purpose of this work is to present a risk management method, which currently does not exist in the Bulgaria, so that the risks and the damages that could occur during the exploitation of small photovoltaic plants could be identified and the investment in such technology – justified.

  4. Rethinking 'risk' and self-management for chronic illness.

    Science.gov (United States)

    Morden, Andrew; Jinks, Clare; Ong, Bie Nio

    2012-02-01

    Self-management for chronic illness is a current high profile UK healthcare policy. Policy and clinical recommendations relating to chronic illnesses are framed within a language of lifestyle risk management. This article argues the enactment of risk within current UK self-management policy is intimately related to neo-liberal ideology and is geared towards population governance. The approach that dominates policy perspectives to 'risk' management is critiqued for positioning people as rational subjects who calculate risk probabilities and act upon them. Furthermore this perspective fails to understand the lay person's construction and enactment of risk, their agenda and contextual needs when living with chronic illness. Of everyday relevance to lay people is the management of risk and uncertainty relating to social roles and obligations, the emotions involved when encountering the risk and uncertainty in chronic illness, and the challenges posed by social structural factors and social environments that have to be managed. Thus, clinical enactments of self-management policy would benefit from taking a more holistic view to patient need and seek to avoid solely communicating lifestyle risk factors to be self-managed.

  5. PERIOPERATIVE MANAGEMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    V. N. Amirdzhanova

    2014-01-01

    Full Text Available The paper considers the joint management of rheumatoid arthritis patients needing endoprosthetic replacement of the large joints of the lower extremities by rheumatologists and orthopedic traumatologists.Due to the fact that there are no conventional standards or guidelines for the perioperative management of patients with rheumatic diseases, adopted by international rheumatology associations, the authors generalize their experience in managing the patients in terms of international approaches and guidelines from different countries. The medical assessment and reduction of cardiovascular risks, the prevention of infectious complications, hemorrhages, and lower extremity deep vein thrombosis, and the specific features of management of patients with osteoporosis are under consideration. The authors' experience in managing the patients receiving antirheumatic therapy with nonsteroidal antiinflammatory and disease-modifying antirheumatic drugs, such as methotrexate, leflunomide, sulfasalazine, and hydroxychloroquine, is detailed. Recommendations for managing patients taking glucocorticoids and biologic agents (tumor necrosis factor-α inhibitors, anti-B-cell therapy, and interleukin-6 receptor inhibitors in the preoperative andpostoperative periods are given.

  6. Role of NDT in risk management

    International Nuclear Information System (INIS)

    Porter, Jr. James F.

    2009-01-01

    Risk management is identifying and then managing threats that could severely affect or bring down a company. This involves reviewing the operations of the company to include the process, equipment, procedures and personnel. Potential threats are then identified including their probability of occurrence, and then taking appropriate actions to address the most likely threats. Traditionally, risk management was thought of as mostly getting the right insurance. However, this impression of risk management has changed dramatically. With the recent increase in rules and regulations and optimizing utilization of key resources, risk management is becoming a management practice that is as important as financial or facilities management. In ideal risk management, a prioritization process is followed whereby the risks with the greatest loss and greatest probability of occurring are handled first, and risks with lower probability of occurrence and lower loss are handled in descending order. In practice the process can be very difficult, and balancing between risks with a high probability of occurrence but lower loss versus a risk with high but lower probability of occurrence can often be mishandled. (author)

  7. Risk Management and Uncertainty in Infrastructure Projects

    DEFF Research Database (Denmark)

    Harty, Chris; Neerup Themsen, Tim; Tryggestad, Kjell

    2014-01-01

    The assumption that large complex projects should be managed in order to reduce uncertainty and increase predictability is not new. What is relatively new, however, is that uncertainty reduction can and should be obtained through formal risk management approaches. We question both assumptions...... by addressing a more fundamental question about the role of knowledge in current risk management practices. Inquiries into the predominant approaches to risk management in large infrastructure and construction projects reveal their assumptions about knowledge and we discuss the ramifications these have...... for project and construction management. Our argument and claim is that predominant risk management approaches tends to reinforce conventional ideas of project control whilst undermining other notions of value and relevance of built assets and project management process. These approaches fail to consider...

  8. Risk management in a competitive electricity market

    International Nuclear Information System (INIS)

    Liu, Min; Wu, Felix F.

    2007-01-01

    In a competitive electricity market, it is necessary and important to develop an appropriate risk management scheme for trade with full utilization of the multi-market environment in order to maximize participants' benefits and minimize the corresponding risks. Based on the analyses to trading environments and risks in the electricity market, a layered framework of risk management for electric energy trading is proposed in this paper. Simulation results confirmed that trading among multiple markets is helpful to reduce the complete risk, and VaR provides a useful approach to judge whether the formed risk-control scheme is acceptable. (author)

  9. INVENTORY AND RISK MANAGEMENT: DECREASING DELIVERY RISK OF PURCHASERS

    Directory of Open Access Journals (Sweden)

    Grzegorz MICHALSKI

    2008-12-01

    Full Text Available The basic financial purpose of an enterprise is maximization of its value. Inventory management should also contribute to realization of this fundamental aim. The enterprise value maximization strategy is executed with a focus on risk and uncertainty. This article presents the consequences for the recipients firm that can result from operating risk that is related to delivery risk generated by the suppliers. The present article offers a method that uses portfolio management theory to choose the suppliers.

  10. Data Management in Metagenomics: A Risk Management Approach

    Directory of Open Access Journals (Sweden)

    Filipe Ferreira

    2014-07-01

    Full Text Available In eScience, where vast data collections are processed in scientific workflows, new risks and challenges are emerging. Those challenges are changing the eScience paradigm, mainly regarding digital preservation and scientific workflows. To address specific concerns with data management in these scenarios, the concept of the Data Management Plan was established, serving as a tool for enabling digital preservation in eScience research projects. We claim risk management can be jointly used with a Data Management Plan, so new risks and challenges can be easily tackled. Therefore, we propose an analysis process for eScience projects using a Data Management Plan and ISO 31000 in order to create a Risk Management Plan that can complement the Data Management Plan. The motivation, requirements and validation of this proposal are explored in the MetaGen-FRAME project, focused in Metagenomics.

  11. Guidelines for managing cardiovascular risk: an evolving area

    DEFF Research Database (Denmark)

    Currier, Judith S; Lundgren, Jens

    2008-01-01

    PURPOSE OF REVIEW: To reflect on the need for guidelines to assist clinicians in the management of cardiovascular risk in HIV-infected patients. RECENT FINDINGS: Over the past eight years guidelines for the management of dyslipidemia and metabolic complications of HIV infection have been developed...

  12. Overview of Risk Management for Engineered Nanomaterials

    International Nuclear Information System (INIS)

    Schulte, P A; Geraci, C L; Hodson, L L; Zumwalde, R D; Kuempel, E D; Murashov, V; Martinez, K F; Heidel, D S

    2013-01-01

    Occupational exposure to engineered nanomaterials (ENMs) is considered a new and challenging occurrence. Preliminary information from laboratory studies indicates that workers exposed to some kinds of ENMs could be at risk of adverse health effects. To protect the nanomaterial workforce, a precautionary risk management approach is warranted and given the newness of ENMs and emergence of nanotechnology, a naturalistic view of risk management is useful. Employers have the primary responsibility for providing a safe and healthy workplace. This is achieved by identifying and managing risks which include recognition of hazards, assessing exposures, characterizing actual risk, and implementing measures to control those risks. Following traditional risk management models for nanomaterials is challenging because of uncertainties about the nature of hazards, issues in exposure assessment, questions about appropriate control methods, and lack of occupational exposure limits (OELs) or nano-specific regulations. In the absence of OELs specific for nanomaterials, a precautionary approach has been recommended in many countries. The precautionary approach entails minimizing exposures by using engineering controls and personal protective equipment (PPE). Generally, risk management utilizes the hierarchy of controls. Ideally, risk management for nanomaterials should be part of an enterprise-wide risk management program or system and this should include both risk control and a medical surveillance program that assesses the frequency of adverse effects among groups of workers exposed to nanomaterials. In some cases, the medical surveillance could include medical screening of individual workers to detect early signs of work-related illnesses. All medical surveillance should be used to assess the effectiveness of risk management; however, medical surveillance should be considered as a second line of defense to ensure that implemented risk management practices are effective.

  13. Overview of Risk Management for Engineered Nanomaterials

    Science.gov (United States)

    Schulte, P. A.; Geraci, C. L.; Hodson, L. L.; Zumwalde, R. D.; Kuempel, E. D.; Murashov, V.; Martinez, K. F.; Heidel, D. S.

    2013-04-01

    Occupational exposure to engineered nanomaterials (ENMs) is considered a new and challenging occurrence. Preliminary information from laboratory studies indicates that workers exposed to some kinds of ENMs could be at risk of adverse health effects. To protect the nanomaterial workforce, a precautionary risk management approach is warranted and given the newness of ENMs and emergence of nanotechnology, a naturalistic view of risk management is useful. Employers have the primary responsibility for providing a safe and healthy workplace. This is achieved by identifying and managing risks which include recognition of hazards, assessing exposures, characterizing actual risk, and implementing measures to control those risks. Following traditional risk management models for nanomaterials is challenging because of uncertainties about the nature of hazards, issues in exposure assessment, questions about appropriate control methods, and lack of occupational exposure limits (OELs) or nano-specific regulations. In the absence of OELs specific for nanomaterials, a precautionary approach has been recommended in many countries. The precautionary approach entails minimizing exposures by using engineering controls and personal protective equipment (PPE). Generally, risk management utilizes the hierarchy of controls. Ideally, risk management for nanomaterials should be part of an enterprise-wide risk management program or system and this should include both risk control and a medical surveillance program that assesses the frequency of adverse effects among groups of workers exposed to nanomaterials. In some cases, the medical surveillance could include medical screening of individual workers to detect early signs of work-related illnesses. All medical surveillance should be used to assess the effectiveness of risk management; however, medical surveillance should be considered as a second line of defense to ensure that implemented risk management practices are effective.

  14. Model risk analysis for risk management and option pricing

    NARCIS (Netherlands)

    Kerkhof, F.L.J.

    2003-01-01

    Due to the growing complexity of products in financial markets, market participants rely more and more on quantitative models for trading and risk management decisions. This introduces a fairly new type of risk, namely, model risk. In the first part of this thesis we investigate the quantitative

  15. ANALYSIS AND MANAGEMENT RISK IN INTERNATIONAL AFFAIRS

    OpenAIRE

    Lăpăduşi Mihaela Loredana,; Căruntu Constantin

    2009-01-01

    The risk is one of the most controversial issues for all persons involved both in domestic and international world economic affairs. The need to analyze, understand and effectively manage risk is growing, the ultimate aim being to obtain a higher degree of successThe risk means exposure to an uncertain future, the opportunity to face danger or suffering a loss ( "Risk - possibility of loss or injury", Webster's, 1995) or the chance that things go wrong ( "Risk is the change that something wil...

  16. Managing flood risks in the Mekong Delta

    NARCIS (Netherlands)

    Hoang, Long Phi; Biesbroek, Robbert; Tri, Van Pham Dang; Kummu, Matti; Vliet, van Michelle T.H.; Leemans, Rik; Kabat, Pavel; Ludwig, Fulco

    2018-01-01

    Climate change and accelerating socioeconomic developments increasingly challenge flood-risk management in the Vietnamese Mekong River Delta—a typical large, economically dynamic and highly vulnerable delta. This study identifies and addresses the emerging challenges for flood-risk management.

  17. Acute Confusional State in Elderly Patients with Hip Fracture. Identification of risk factors and intervention using a prehospital and perioperative management program

    OpenAIRE

    Björkman Björkelund, Karin

    2008-01-01

    Abstract The overall aim of this thesis was to increase knowledge about underlying causes and perioperative risk factors of Acute Confusional State (ACS) in elderly patients with hip fracture and to investigate the effect of a multi-factorial intervention program in order to decrease the number of patients who develop ACS. The aim in paper I was to describe elderly patients with hip fracture on the basis of the American Society of Anesthesiologists’ ASA classification system and to identif...

  18. Hog Producers' Risk Management Attitudes and Desire for Additional Risk Management Education

    OpenAIRE

    Patrick, George F.; Peiter, Amy J.; Knight, Thomas O.; Coble, Keith H.; Baquet, Alan E.

    2007-01-01

    Hog producers in Indiana and Nebraska were surveyed about sources of risk, effectiveness of risk management strategies, and prior participation in and desire for additional risk management education. Ownership of hogs by the producer, size of the operation, and age did have significant effects on ratings of both sources of risk and effectiveness of risk management strategies. Probit analysis found age, prior attendance, knowledge and prior use of the tool, level of integration, and concern ab...

  19. Large dams and risk management

    International Nuclear Information System (INIS)

    Cazelais, N.

    2003-01-01

    In July 1996, Quebec's Saguenay region was subjected to intensive rainfall which caused severe floods and uncontrolled release of several reservoirs, resulting in extensive damage to dam structures and reservoirs. The probability of occurrence for that disaster was 1:10,000. Following the disaster, the Quebec government established a dam management body entitled the Commission scientifique et technique sur la gestion des barrages, which pointed out several safety shortcomings of existing dams. Many were either very old or had undergone significant function change without being subsequently re-evaluated. A report by the Commission stated that damage following the floods could have been limited if the design and operating standards of the dams had been more stringent. A Dam Safety Act was adopted by the Quebec National Assembly on May 30, 2000 following recommendations to retain safer structures. The Act demands regular reporting of operating procedures. Seismic activity was noted as being a topic that requires in-depth examination since Quebec's St. Lawrence Valley, particularly the Charlevoix region, is one of Canada's largest seismic zones. The other is on the west coast in British Columbia. Earthquakes in Quebec are less intense than the ones in British Columbia, but they have higher frequency content which exerts a quasi-resonance wave effect which impacts roads, bridges, buildings and hydroelectric generating facilities. Hydro-Quebec is a public utility which owns 563 retaining structures, of which 228 are ranked as large dams that measure more than 15 metres high, 400 metres long and with a reservoir capacity of more than 1 million cubic metres of water. Hydro-Quebec addresses hydrological, seismic, technological and human risks through a dam safety procedure that includes structured plans for choosing best alternatives through staged exercises. Hazard levels are minimized through the adoption of emergency, prevention and alleviation measures. The utility

  20. Environmental asset management: Risk management systems

    CSIR Research Space (South Africa)

    Naudé, Brian

    2017-07-01

    Full Text Available bnaude@csir.co.za Charl Petzer Council for Scientific and Industrial Research PO Box 395 Pretoria 0001 South Africa +2712 841 4292 CPetzer1@csir.co.za Copyright © 2017 by B Naudé, C Petzer. Published and used by INCOSE with permission.... Charl Petzer is registered professional engineer with 30 years of programme/project management as well as systems engineering experience in military and other environments. He has been the lead systems engineer, as well as programme manager on several...

  1. RISK MANAGEMENT PROCESSES IN SUPPLY CHAINS

    Directory of Open Access Journals (Sweden)

    Aleksandar Aleksić

    2009-06-01

    Full Text Available One of the keys of successful business last few years is effective dealing with risks in every meaning of that word. At the time when the world economic crisis largely limits business, successful Risk management is the only way of survival for a large number of business systems. This paper will present the processes of risk management in supply chains that are in accordance with the standards ISO 28000 and ISO 31000. By implementing a holistic, enterprise-wide supply chain risk management program, companies also can uphold their commitment to providing strong corporate governance on behalf of stakeholders and increase their market value.

  2. Strategic Risk Management and Corporate Value Creation

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Roggi, Oliviero

    Major corporate failures, periodic recessions, regional debt crises and volatile markets have intensified the focus on corporate risk management as the means to deal better with turbulent business conditions. Hence, the ability to respond effectively to the often dramatic environmental changes...... is considered an important source of competitive advantage. However, surprisingly little research has analyzed if the presumed advantages of effective risk management lead to superior performance or assessed important antecedents of effective risk management capabilities. Here we present a comprehensive study...... of risk management effectiveness and the relationship to corporate performance based on panel data for more than 3,400 firms accounting for over 33,500 annual observations during the turbulent period 1991-2010. Determining effective risk management as the ability to reduce earnings and cash flow...

  3. Anaesthetic management of patients with severe sepsis.

    Science.gov (United States)

    Eissa, D; Carton, E G; Buggy, D J

    2010-12-01

    Severe sepsis, a syndrome characterized by systemic inflammation and acute organ dysfunction in response to infection, is a major healthcare problem affecting all age groups throughout the world. Anaesthetists play a central role in the multidisciplinary management of patients with severe sepsis from their initial deterioration at ward level, transfer to the diagnostic imaging suite, and intraoperative management for emergency surgery. The timely administration of appropriate i.v. antimicrobial therapy is a crucial step in the care of patients with severe sepsis who may require surgery to control the source of sepsis. Preoperative resuscitation, aimed at optimizing major organ perfusion, is based on judicious use of fluids, vasopressors, and inotropes. Intraoperative anaesthesia management requires careful induction and maintenance of anaesthesia, optimizing intravascular volume status, avoidance of lung injury during mechanical ventilation, and ongoing monitoring of arterial blood gases, lactate concentration, haematological and renal indices, and electrolyte levels. Postoperative care overlaps with ongoing management of the severe sepsis syndrome patient in the intensive care unit. These patients are by definition, high risk, already requiring multiple supports, and require experienced and skilful decision-making to optimize their chances of a favourable outcome. Similar to acute myocardial infarction, stroke, or acute trauma, the initial hours (golden hours) of clinical management of severe sepsis represent an important opportunity to reduce morbidity and mortality. Rapid clinical assessment, resuscitation and surgical management by a focused multidisciplinary team, and early effective antimicrobial therapy are the key components to improved patient outcome.

  4. Risk, innovation and change : design propositions for implementing risk management in organizations

    NARCIS (Netherlands)

    van Staveren, Martinus Theodorus

    2009-01-01

    This Ph.D. research generated unique design propositions for implementing existing risk management methodologies in organizations. The resulting design propositions incorporate a synthesis of risk management, innovation management and change management. True implementation of risk management is

  5. 78 FR 4848 - Social Media: Consumer Compliance Risk Management Guidance

    Science.gov (United States)

    2013-01-23

    ...: Consumer Compliance Risk Management Guidance AGENCY: Federal Financial Institutions Examination Council... Media: Consumer Compliance Risk Management Guidance'' (guidance). Upon completion of the guidance, and... management practices adequately address the consumer compliance and legal risks, as well as related risks...

  6. Risk assessment and management logistics chains

    Directory of Open Access Journals (Sweden)

    Vladimir Vikulov

    2014-03-01

    Full Text Available Background: In the context of economic globalization and increasing complexity of economic relations enterprises need methods and techniques to improve and sustain their position on the global market. Integration processes offer business new opportunities, but at the same time present new challenges for the management, including the key objectives of the risk management. Method: On the basis of analysis tools known from the pertinent literature (Supply Chain Management and Supply Chain Risk Management methods, methods of probability theory, methods of risk management, methods of statistics the authors of this paper proposed their own risk assessment method and the method of management of logistics chains. The proposed tool is a specific hybrid of solutions known from the literature. Results: The presented method has been successfully used within the frames of economic-mathematical model of industrial enterprises. Indicators of supply chain risks, including risks caused by supplier are considered in this paper. Authors formed a method of optimizing the level of supply chain risk in the integration with suppliers and customers. Conclusion: Every organization, which starting the process of integration with supplier and customers, needs to use tools, methodologies and techniques for identification of "weak links" in the supply chain. The proposed method allows to fix risk origin places in various links of the supply chain and to identify "weak links" of a logistic chain that may occur in the future. The method is a useful tool for managing not only risks and risk situations, but also to improve the efficiency of current assets management by providing the ability to optimize the level of risk in the current assets management of the industrial enterprise.

  7. Internal audit risk management in metropolitan municipalities

    Directory of Open Access Journals (Sweden)

    Christo Ackermann

    2016-07-01

    Full Text Available Internal audit functions (IAFs of organisations are regarded as crucial components of the combined assurance model, alongside the audit committee, management and external auditors. The combined assurance model aims at having integrated and aligned assurance in organisations with the overall aim of maximising risk and governance oversight and control efficiencies. In this regard, internal audit plays a crucial role, insofar as it consists of experts in risk, governance and control consultancy who provide assurance to senior management and the audit committee. Audit committees are dependent on internal audit for information and their effectiveness revolves around a strong and well-resourced internal audit function which is able to aid audit committees to meet their oversight responsibilities. There is thus a growing demand for managing risk through the process of risk management and internal audit is in a perfect position to assist with the improvement of such processes. If internal auditors wish to continue being an important aspect of the combined assurance model, they need to address the critical area, amongst others, of risk management as part of their work. If not, it follows that the board, audit committees and other levels of management will remain uninformed on the status of these matters which, in turn, will negatively impact the ability of these stakeholders to discharge their responsibilities. This study therefore focuses on analysing the functioning of IAFs, with specific reference to their risk management mandate. The study followed a mixed method approach to describe internal audits risk management functioning in the big eight metropolitan municipalities in South Africa. The results show that internal audit provide a broad scope of risk management work which assist senior management in the discharge of their responsibilities. However, in the public eye, internal audits risk management functioning is scant

  8. Decisionmaking under risk in invasive species management: risk management theory and applications

    Science.gov (United States)

    Shefali V. Mehta; Robert G. Haight; Frances R. Homans

    2010-01-01

    Invasive species management is closely entwined with the assessment and management of risk that arises from the inherently random nature of the invasion process. The theory and application of risk management for invasive species with an economic perspective is reviewed in this synthesis. Invasive species management can be delineated into three general categories:...

  9. Risk management in HIV/AIDS: ethical and economic issues ...

    African Journals Online (AJOL)

    Risk management in HIV/AIDS: ethical and economic issues associated with restricting HAART access only to adherent patients. ... Using the software TreeAge Pro 2009, we developed a Markov model to project economic outcomes for a hypothetical cohort of HIV/AIDS patients on HAART. The model compared two ...

  10. Perioperative Management of Patients with Rheumatic Diseases

    Science.gov (United States)

    Bissar, Lina; Almoallim, Hani; Albazli, Khaled; Alotaibi, Manal; Alwafi, Samar

    2013-01-01

    This paper aims to explore the assessment of patients with rheumatologic diseases, especially rheumatoid arthritis (RA), before undergoing orthopedic surgery. Perioperative assessment ensures an early diagnosis of the patient's medical condition, overall health, medical co-morbidities, and the assessment of the risk factors associated with the proposed procedures. Perioperative assessment allows for proper postoperative management of complications and of the management of drugs such as disease-modifying anti-rheumatic drugs (DMARD) and anti-platelets, and corticosteroids. The assessment also supports follow up plans, and patient education. Perioperative assessment enables the discussion of the proposed treatment plans and the factors associated with them in each case among the different specialists involved to facilitate an appropriate early decision-making about the assessment and treatment of patients with rheumatologic diseases. It also enables the discussion of both condition and procedure with the patient to ensure a good postoperative care. The article identifies the components of perioperative medical evaluation, discusses perioperative management of co-morbidities and the management of specific clinical problems related to RA, systemic lupus erythematosus, the management of DMARDs, like methotrexate (MTX) and biologic therapies, prophylactic antibiotics, and postoperative follow up, including patient education and rehabilitation PMID:24062860

  11. Examining the realities of risk management

    International Nuclear Information System (INIS)

    Garrick, B.J.

    1985-01-01

    Sufficient experience now exists, especially in the nuclear industry, to consider the progress that has been made toward meaningful tools or aids for the control and, hence, management of risk. The considerable activity in the field of probabilistic risk assessment (PRA) suggests a high level of interest and application. It is the purpose of this paper to examine our own experience in this regard and to offer some observations and opinions about current practices in risk management and the requirements for success

  12. Project risk management in complex petrochemical system

    Directory of Open Access Journals (Sweden)

    Kirin Snežana

    2012-01-01

    Full Text Available Investigation of risk in complex industrial systems, as well as evaluation of main factors influencing decision making and implementation process using large petrochemical company as an example, has proved the importance of successful project risk management. This is even more emphasized when analyzing systems with complex structure, i.e. with several organizational units. It has been shown that successful risk management requires modern methods, based on adequate application of statistical analysis methods.

  13. Venous thromboembolism: Risk profile and management of ...

    African Journals Online (AJOL)

    surgery in a tertiary hospital and to audit the VTE prophylaxis prescribed. ... This group of patients require formal preoperative VTE risk assessment using a recognised scoring model. ... The aim of this study was to establish the VTE risk profile.

  14. Systems approach to project risk management

    Energy Technology Data Exchange (ETDEWEB)

    Kindinger, J. P. (John P.)

    2002-01-01

    This paper describes the need for better performance in the planning and execution of projects and examines the capabilities of two different project risk analysis methods for improving project performance. A quantitative approach based on concepts and tools adopted from the disciplines of systems analysis, probabilistic risk analysis, and other fields is advocated for managing risk in large and complex research & development projects. This paper also provides an overview of how this system analysis approach for project risk management is being used at Los Alamos National Laboratory along with examples of quantitative risk analysis results and their application to improve project performance.

  15. Risk Management Practices of Multinational and indigenous ...

    African Journals Online (AJOL)

    Construction projects' high uncertainty rates make them unattractive to non-risk takers. Construction companies are therefore necessarily risk takers, albeit, to varying degrees. This study made an inquiry into the risk management (RM) practices of multinational and indigenous construction companies (MCCs and ICCs, ...

  16. RISKS MANAGEMENT. A PROPENSITY SCORE APPLICATION

    Directory of Open Access Journals (Sweden)

    Constangioara Alexandru

    2008-05-01

    Full Text Available Risk management is relatively unexplored in Romania. Although Romanian specialists dwell on theoretical aspects such as the risks classification and the important distinction between risks and uncertainty the practical relevance of the matter is outside existing studies. Present paper uses a dataset of consumer data to build a propensity scorecard based on relevant quantitative modeling.

  17. Risk Management and Risk Psychology in Romanian Sme’s

    Directory of Open Access Journals (Sweden)

    Irina Dănciulescu

    2015-12-01

    Full Text Available Risk is one of the biggest and most fascinating challenges of all times for humanity, because of its presence in all fields. Risk management as a component of modern management, has become a main concern for the modern world and one of the “key mechanisms” of economic development, a complex processn that includes a series of activities meant to alleviate the impact of risk over business and planed or foreseen results. This paper wants to bring to attention the importance of risks and their management in today’s economic crisis. The sector presented is the IT& C, especially software, because Romania had a growth in this area for a few years but beginning the crisis this segment in economy had known a serious decrease. This paper tries to connect risk management and risk psychology to Romanian economy, culture and mentality. The paper presents in short some of risk management characteristics, definitions and few opinions; why in Romania this subject is not treated with the appropriate attention. The paper at hand focuses on the psychology of risk and how it affects the life of individuals and the existence of companies, the importance it should have on day to day basis, especially in Romania

  18. Nuclear power plant risk assembly and decomposition for risk management

    International Nuclear Information System (INIS)

    Iden, D.C.

    1985-01-01

    The state-of-the-art method for analyzing the risk from nuclear power plants is probabilistic risk assessment (PRA). The intermediate results of a PRA are first assembled to quantify the risk from operating a nuclear power plant in the form of (1) core damage (or core melt) frequency, (2) plant damage state frequencies, (3) release category frequencies, and (4) the frequency of exceeding specific levels of offsite consequences. Once the overall PRA results have been quantified, the next step is to decompose those results into the individual contributors to each of the four forms of risk in some rank order. The way in which the PRA model is set up to assemble and decompose the plant risk determines the ease and usefulness of the PRA model as a risk management tool for evaluating perturbations to the PRA model. These perturbations can take the form of technical specification changes, hardware modifications, procedural changes, etc. The matrix formalism developed by Dr. Stan Kaplan for risk assembly and decomposition represents a significant breakthrough in making the PRA model an effective risk management tool. The key to understanding the matrix formalism and making it a useful tool for managing nuclear power plant risk is the structure of the PRA model. PRA risk model structure and decomposition of the risk results are discussed with the Seabrook PRA as an example

  19. Models for assessing and managing credit risk

    Directory of Open Access Journals (Sweden)

    Neogradi Slađana

    2014-01-01

    Full Text Available This essay deals with the definition of a model for assessing and managing credit risk. Risk is an inseparable component of any average and normal credit transaction. Looking at the different aspects of the identification and classification of risk in the banking industry as well as representation of the key components of modern risk management. In the first part of the essay will analyze how the impact of credit risk on bank and empirical models for determining the financial difficulties in which the company can be found. Bank on the basis of these models can reduce number of approved risk assets. In the second part, we consider models for improving credit risk with emphasis on Basel I, II and III, and the third part, we conclude that the most appropriate model and gives the best effect for measuring credit risk in domestic banks.

  20. Quality Risk Management of Compliant Excipients

    Directory of Open Access Journals (Sweden)

    Brian Carlin

    2012-12-01

    Full Text Available Raw material compliance and GMP do not eliminate variability. Quality by Design should minimize the risk that raw material variability will adversely affect the finished product Critical Quality Attributes. The sources of technological risk from excipients are reviewed and approaches to excipient risk management are discussed. Supplier involvement throughout the product life-cycle is recommended to minimize excipient-related risk.

  1. FINANCIAL RISK MANAGEMENT IN TRADE BANKS

    Directory of Open Access Journals (Sweden)

    Ms. Tamara Ye. Kononenko

    2016-09-01

    Full Text Available The paper clarifies the concepts of «risk», «financial risk» in banking business, and considers the main problems of financial risk management in trade banks while financing borrowers. The authors single out the most relevant problems, and conduct the analysis of overdue payment in case of OJSC “Sberbank of Russia”. The authors also offer a number of measures to minimize financial risks in trade bank activities in modern conditions.

  2. Sustainable Risk Management in the Banking Sector

    Directory of Open Access Journals (Sweden)

    Županović Ivo

    2014-01-01

    Full Text Available The globalization of financial markets and negative consequences of the financial crisis resulted in negative connotations in the operation of many financial institutions, businesses and citizens and imposed the need to implement appropriate risk management measures in the banking sector. Evolution of the financial sector makes a lot of news in the field of risk management and particularly the modelling of market, credit and operational risk. The main methodology for risk management is the value-at-risk, which is used in practice with other techniques such as the capital- at-risk method in order to minimize business risks and achieve optimal results in the banking and, generally, financial operations. Accordingly, at all levels of governance in the banking sector, there are prudential policies in place governing the management of all types of financial and operational risks. Based on the abovementioned, the focus of the examination was on the above postulate, and prompt recognition, control and proper management of banking risks.

  3. The Strategic-Renovation Banks’ Risks Management

    Directory of Open Access Journals (Sweden)

    Yeremeychuk Raisa A.

    2017-04-01

    Full Text Available The article is aimed at developing approaches to implementation of the strategic-renovation risk management. Essence of risk theories was researched, the concept of «risk» in the bank’s management system were analyzed. On the basis of a theoretical generalization of scientific literature and the carried out analysis of existing risk management strategies to ensure the security of banking business, the strategy of renovation management has been selected. Because bank risks are part of the economic risk system, they are complex in their nature. However, given the importance of bank risks, the interpretation of their essence is still a debating matter. In a certain number of cases, their essence is replaced by the cause of occurrence, that is, all the different circumstances, factors that lead to the losses. So today, banks are considering risks, in particular, not only as a source of possible losses, but also as an opportunity to generate additional profits. An algorithm for taking a strategic-renovation decision on the banks’ risks management system has been proposed.

  4. Intentional risk management through complex networks analysis

    CERN Document Server

    Chapela, Victor; Moral, Santiago; Romance, Miguel

    2015-01-01

    This book combines game theory and complex networks to examine intentional technological risk through modeling. As information security risks are in constant evolution,  the methodologies and tools to manage them must evolve to an ever-changing environment. A formal global methodology is explained  in this book, which is able to analyze risks in cyber security based on complex network models and ideas extracted from the Nash equilibrium. A risk management methodology for IT critical infrastructures is introduced which provides guidance and analysis on decision making models and real situations. This model manages the risk of succumbing to a digital attack and assesses an attack from the following three variables: income obtained, expense needed to carry out an attack, and the potential consequences for an attack. Graduate students and researchers interested in cyber security, complex network applications and intentional risk will find this book useful as it is filled with a number of models, methodologies a...

  5. Risk management; Maitriser le risque

    Energy Technology Data Exchange (ETDEWEB)

    Magne, L

    1999-07-01

    There is always a risk of an accident occurring at a nuclear power plant, however small. The problem lies in estimating the probability of it occurring. The method of probabilistic safety assessment provides this estimate, and by identifying the sources of potential risk, makes it possible to prevent them from occurring. It is not, however, a substitute for other decision-making processes. (author)

  6. Managers facing the climatic risks

    International Nuclear Information System (INIS)

    2003-01-01

    This colloquium aimed to analyze the relations between the climatic changes and extreme meteorological events and on the associated risks. It provides information and knowledge on the state of the art concerning the today scientific knowledge, the prevention measures and the adaptation facing the risks and the difficult estimation of the climatic damages costs. (A.L.B.)

  7. Risk management and safety culture

    International Nuclear Information System (INIS)

    Takano, K.

    2007-01-01

    Paper informs on the efforts to elaborate a feedback system for risk comprehensive evaluation and a system to improve structure safety foreseeing the possibility to control the latent risk, ensuring the qualitative evaluation of the safety level and improvement of safety culture in various branches of industry, first and foremost, in the electricity producing sector including the nuclear power industry [ru

  8. Current Risk Management Practices in Psychotherapy Supervision.

    Science.gov (United States)

    Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

    2017-12-01

    Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

  9. CHOSEN ASPECTS OF RISK MANAGEMENT OCCUPATIONAL

    Directory of Open Access Journals (Sweden)

    Benedykt Bober

    2015-06-01

    Full Text Available In the present chapter there are discussed the threats appearing in the diagnostic and therapeutic process with particular consideration of ionizing radiation. The implementation of medical e-records, while creating the conditions of sharing them with patients and the medical staff, reduces the decision-making risk in the process of providing hospital services. Restructuring radiological diagnostics allows for the elimination of emission of dangerous substances and the implementation of eco-friendly procedures. The implementation of the process-based approach in servicing X-ray apparatus and controlling the dose of ionizing radiation brings about the quality, accuracy and effectiveness of the diagnosis. The process of reduction of the occupational exposure to cytostatic drugs is an essential element of total management of the public hospital.

  10. Credit risk management in the power sector

    International Nuclear Information System (INIS)

    Allen, D.

    2002-01-01

    Deregulation of the electric power industry has the potential to put power businesses at market risk particularly when the value of an asset or liability will change with market movements. Market risk gives rise to credit risk where a contract cannot be fulfilled. This presentation describes how credit risks can be identified and measured. Most practitioners use some variant of value-at-risk (VAR) technology for measuring market risk. Under this approach, risk is determined by the volatility implied by the market. Volatility of electricity prices and natural gas prices has increased significantly in Alberta in recent years. The consequence is an increase in both market and credit risk. The author described the difference between the two risks and their significance. An overview of credit risk management with derivatives, an over-the counter contract, was also presented. The author also discusses issue of protection buyers in the event of a failed contract. 9 figs

  11. Emergency thoracic ultrasound and clinical risk management

    Directory of Open Access Journals (Sweden)

    Interrigi MC

    2017-02-01

    Full Text Available Maria Concetta Interrigi,1 Francesca M Trovato,2,3 Daniela Catalano,3,4 Guglielmo M Trovato3,5 1Accident and Emergency Department, Ospedale Cannizzaro, Catania, 2Accident and Emergency Department, Ospedale Civile, Ragusa, 3Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania, 4Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania, 5Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy Purpose: Thoracic ultrasound (TUS has been proposed as an easy-option replacement for chest X-ray (CXR in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results: Three hundred and seventy emergency TUS scans (excluding trauma patients were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion; in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed

  12. Risk management in Swedish hedge funds

    OpenAIRE

    Fri, Samuel; Nilsson, Joakim

    2011-01-01

    Background: Risk management has always been a complex topic, especially when it comes to hedge funds. Since hedge funds are able to utilize many kinds of financial instruments it is difficult to find a risk management strategy that goes well with them. Not much research regarding the Swedish hedge fund industry and its risk management has been done; hence we find it an interesting topic to focus this thesis on. Purpose: The purpose of this thesis is to increase the knowledge of how Swedish he...

  13. Evaluating risk management strategies in resource planning

    International Nuclear Information System (INIS)

    Andrews, C.J.

    1995-01-01

    This paper discusses the evaluation of risk management strategies as a part of integrated resource planning. Value- and scope-related uncertainties can be addressed during the process of planning, but uncertainties in the operating environment require technical analysis within planning models. Flexibility and robustness are two key classes of strategies for managing the risk posed by these uncertainties. This paper reviews standard capacity expansion planning models and shows that they are poorly equipped to compare risk management strategies. Those that acknowledge uncertainty are better at evaluating robustness than flexibility, which implies a bias against flexible options. Techniques are available to overcome this bias

  14. Risk management and analysis: risk assessment (qualitative and quantitative)

    OpenAIRE

    Valentin Mazareanu

    2007-01-01

    We use to define risk as the possibility of suffering a loss. Starting this, risk management is defined as a business process whose purpose is to ensure that the organization is protected against risks and their effects. In order to prioritize, to develop a response plan and after that to monitor the identified risks we need to asses them. But at this point a question is born: should I choose a qualitative approach or a quantitative one? This paper will make a short overview over the risk eva...

  15. Risk perception as a driver for risk management policies

    Science.gov (United States)

    Carmona, María; Mañez, María

    2016-04-01

    Risk is generally defined as the "combination of the probability of the occurrence of an event and its negative consequences" ( UNISDR, 2009). However, the perception of a risk differs among cultures regarding different features such as the context,causes, benefits or damage. Risk perception is the subjective valuation of the probability of an event happening and how concerned individuals or groups are with the consequences (Sjöberg, 2004). Our study is based on an existing framework for risk perception (Rehn and Rohrmann, 2000). We analyse the characteristics of the risk perception regarding extreme events (e.g.droughts) and how the perception of the group drives the action to manage the risk. We do this to achieve an overview of the conditions that let stakeholders join each other to improve risk management especially when governments are not reacting properly. For our research, attention is paid on risk perception of Multi-Sector Partnerships not taking into account the individual level of risk perception. We focus on those factors that make risk management effective and increase resilience. Multi-Sector Partnerships, considered as significant governance structures for risk management, might contribute to reduce vulnerability in prone areas to natural hazards and disasters. The Multi-Sector Partnerships used for our research are existing partnerships identified in the cases studies of the European project ENHANCE. We implement a survey to analyse the perception of risk in the case studies. That survey is based on the Cultural Theory (Douglas and Wildavsky, 1982)and the Protection Motivation Theory (Rogers, 1975). We analyse the results using the Qualitative-Comparative Analysis proposed by Ragin in 1987. The results show the main characteristics of a risk culture that are beneficial to manage a risk. Those characteristics are shaped by the perception of risk of the people involved in the partnership, which in turn shapes their risk management. Nevertheless, we

  16. Practical Risk Management for the CIO

    CERN Document Server

    Scherling, Mark

    2007-01-01

    The growing complexity of today's interconnected systems has not only increased the need for improved information security, but also helped to move information from the IT backroom to the executive boardroom as a strategic asset. And, just like the tip of an iceberg is all you see until you run into it, the risks to your information are mostly invisible until disaster strikes. Detailing procedures that will help your team perform better risk assessments and aggregate results into more meaningful metrics, Practical Risk Management for the CIO approaches information risk management through impro

  17. Practical Methods for Information Security Risk Management

    Directory of Open Access Journals (Sweden)

    Cristian AMANCEI

    2011-01-01

    Full Text Available The purpose of this paper is to present some directions to perform the risk man-agement for information security. The article follows to practical methods through question-naire that asses the internal control, and through evaluation based on existing controls as part of vulnerability assessment. The methods presented contains all the key elements that concurs in risk management, through the elements proposed for evaluation questionnaire, list of threats, resource classification and evaluation, correlation between risks and controls and residual risk computation.

  18. Managing risk in statistics - "Relative risk" | Durrheim | South African ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 45, No 8 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Managing risk in statistics - "Relative risk". DN Durrheim ...

  19. The application of holistic risk management in the banking industry

    Directory of Open Access Journals (Sweden)

    J. Chibayambuya

    2007-12-01

    Full Text Available Purpose: The application of holistic risk management is fast becoming a standard measure of good governance in the business arena. What role can holistic risk management play in the management of risk in the financial services industry? The aim of this paper is to propose a holistic risk management framework for the management of risk. Design/Methodology/Approach: A comprehensive framework that covers the holistic view risk management is proposed/developed out of an extensive literature review. Findings: Given the deliberations of various frameworks, a holistic risk management is proposed. The proposed framework ensures that all components of risk management are taken into account when strategizing for risk management in general and holistic risk management in particular; thereby improving the management of risk in the banking industry. Implications: The article proposes a holistic approach to risk management which takes into account all the facets of risk management, e.g. analyzing, planning, strategy, communication, implementation, motivation, systems review and plan modification. This holistic approach, when implemented in the banking industry, can have a significant impact on the improved management of risk. Originality/Value: The new proposed holistic risk management framework offers a fresh perspective of strategizing for risk management in terms of risk analysis, risk planning, risk strategy, risk communication, risk implementation, risk motivation, risk review and risk plan modification.

  20. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management

    NARCIS (Netherlands)

    Chapman, M. John; Ginsberg, Henry N.; Amarenco, Pierre; Andreotti, Felicita; Borén, Jan; Catapano, Alberico L.; Descamps, Olivier S.; Fisher, Edward; Kovanen, Petri T.; Kuivenhoven, Jan Albert; Lesnik, Philippe; Masana, Luis; Nordestgaard, Børge G.; Ray, Kausik K.; Reiner, Zeljko; Taskinen, Marja-Riitta; Tokgözoglu, Lale; Tybjærg-Hansen, Anne; Watts, Gerald F.

    2011-01-01

    Even at low-density lipoprotein cholesterol (LDL-C) goal, patients with cardiometabolic abnormalities remain at high risk of cardiovascular events. This paper aims (i) to critically appraise evidence for elevated levels of triglyceride-rich lipoproteins (TRLs) and low levels of high-density

  1. Improving risk factor management for patients with poorly controlled type 2 diabetes: a systematic review of healthcare interventions in primary care and community settings.

    LENUS (Irish Health Repository)

    Murphy, Mark E

    2017-08-04

    Poorly controlled type 2 diabetes mellitus (T2DM) is a major international health problem. Our aim was to assess the effectiveness of healthcare interventions, specifically targeting patients with poorly controlled T2DM, which seek to improve glycaemic control and cardiovascular risk in primary care settings.

  2. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management

    DEFF Research Database (Denmark)

    Chapman, M John; Ginsberg, Henry N; Amarenco, Pierre

    2011-01-01

    Even at low-density lipoprotein cholesterol (LDL-C) goal, patients with cardiometabolic abnormalities remain at high risk of cardiovascular events. This paper aims (i) to critically appraise evidence for elevated levels of triglyceride-rich lipoproteins (TRLs) and low levels of high-density lipop...

  3. RISK MANAGEMENT IN THE ELECTRONIC BUSINESS

    Directory of Open Access Journals (Sweden)

    Georgeta Soava

    2016-12-01

    Full Text Available Risk should not be understood as a destructive phenomenon, but bear in mind that managers who know how to use it can lead to real opportunities. Manager must first recognize the existence of risk, namely to identify and then use specific methods to avoid or reduce the risk. The purpose of this paper is to enter the world, at all simple, of risk management, relatively easy concept to understand but not so easy to put into practice. Of course, the approach relates primarily at the risks inherent of the business in digital environments, but they not represent only a particular case of the risks they are exposed, in general, the companies. In the paper we put in evidence the significance in general business, risks in e-business, then we added a description of the types of security risks, an exemplification of these and a series of test scenarios, and finally to make a analysis of operational solutions of risk management

  4. Risk Management Considerations for Interoperable Acquisition

    National Research Council Canada - National Science Library

    Meyers, B. C

    2006-01-01

    .... The state of risk management practice -- the specification of standards and the methodologies to implement them -- is addressed and examined with respect to the needs of system-of-systems interoperability...

  5. Managing flood risk through collaborative governance | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2013-05-21

    May 21, 2013 ... Managing flood risk through collaborative governance ... This article profiles a project supported by IDRC's Climate Change and Water program, ... and in the intensity of extreme weather events are resulting in the erosion of lo.

  6. Risk management integration into complex project organizations

    Science.gov (United States)

    Fisher, K.; Greanias, G.; Rose, J.; Dumas, R.

    2002-01-01

    This paper describes the approach used in designing and adapting the SIRTF prototype, discusses some of the lessons learned in developing the SIRTF prototype, and explains the adaptability of the risk management database to varying levels project complexity.

  7. Managing risks in the project pipeline.

    Science.gov (United States)

    2013-08-01

    This research focuses on how to manage the risks of project costs and revenue uncertainties over the long-term, and identifies significant : process improvements to ensure projects are delivered on time and as intended, thus maximizing the miles pave...

  8. Small Business and the Risk Management Program

    Science.gov (United States)

    This factsheet helps small businesses comply with the regulation requiring companies that use regulated substances, hazardous chemical such as ammonia and chlorine, to develop a risk management plan, to help prevent accidental toxic or flammable releases.

  9. Roadway related tort liability and risk management.

    Science.gov (United States)

    2010-06-01

    This workbook provide government employees background information related to tort liability and risk management. Past experience with lawsuits against government entities are summarized. The reasons for the lawsuits and results are analyzed. The obje...

  10. From CSR to Social Risk Management

    DEFF Research Database (Denmark)

    Taarup Esbensen, Jacob

    2014-01-01

    When it comes to social risks multinational companies (MNC) within Mining are one of the most exposed businesses one can imagine. This paper examines how social risk management is practiced through the case of Teghout copper-molybdenum mine in North- Eastern Armenia, supplemented with evidence from...... other mining MNCs in the country, onsite fieldwork, interviews with key stakeholders, and public available information. This evidence suggest that a standards based social risk management strategy is adopted and that this strategy is based on international Corporate Social Responsibility (CSR) standards...... engagement management systems that is promoted through the standard. The implemented social risk management systems are ineffective because they makes the MNC unable to recognise the value of weak ties and fail to build legitimacy and trust with some of the key stakeholders resulting in the creation of more...

  11. Management of pregnant patient in dentistry.

    Science.gov (United States)

    Kurien, Sophia; Kattimani, Vivekanand S; Sriram, Roopa Rani; Sriram, Sanjay Krishna; Rao V K, Prabhakara; Bhupathi, Anitha; Bodduru, Rupa Rani; N Patil, Namrata

    2013-02-01

    The purpose of this article is to update general dentists and maxillofacial surgeons in the perioperative management of the pregnant patient. Pregnancy results in physiologic changes in almost all organ systems in the body mediated mainly by hormones; which influences the treatment schedule. Understanding these normal changes is essential for providing quality care for pregnant women. The general principles that apply in this situation are discussed, followed by the relevant physiologic changes and their treatment implications, the risks of various medications to the mother and fetus, the management of concomitant medical problems in the pregnant patient, appropriate timing of oral and maxillofacial surgery during pregnancy, and management of emergencies during pregnancy. Information about the compatibility, complications, and excretion of the common drugs during pregnancy is provided. Guidelines for the management of a pregnant patient in the dental office are summarized. How to cite this article: Kurien S, Kattimani V S, Sriram R, Sriram S K, Prabhakar Rao V K, Bhupathi A, Bodduru R, Patil N N. Management of Pregnant Patient in Dentistry. J Int Oral Health 2013; 5(1):88-97.

  12. Wildfire Risk Management: Challenges and Opportunities

    Science.gov (United States)

    Thompson, M.; Calkin, D. E.; Hand, M. S.; Kreitler, J.

    2014-12-01

    In this presentation we address federal wildfire risk management largely through the lens of economics, targeting questions related to costs, effectiveness, efficiency, and tradeoffs. Beyond risks to resources and assets such as wildlife habitat, watersheds, and homes, wildfires present financial risk and budgetary instability for federal wildfire management agencies due to highly variable annual suppression costs. Despite its variability, the costs of wildfire management have continued to escalate and account for an ever-growing share of overall agency budgets, compromising abilities to attain other objectives related to forest health, recreation, timber management, etc. Trends associated with a changing climate and human expansion into fire-prone areas could lead to additional suppression costs in the future, only further highlighting the need for an ability to evaluate economic tradeoffs in investments across the wildfire management spectrum. Critically, these economic analyses need to accurately capture the complex spatial and stochastic aspects of wildfire, the inherent uncertainty associated with monetizing environmental impacts of wildfire, the costs and effectiveness of alternative management policies, and linkages between pre-fire investments and active incident management. Investing in hazardous fuels reduction and forest restoration in particular is a major policy lever for pre-fire risk mitigation, and will be a primary focus of our presentation. Evaluating alternative fuel management and suppression policies could provide opportunities for significant efficiency improvements in the development of risk-informed management fire management strategies. Better understanding tradeoffs of fire impacts and costs can help inform policy questions such as how much of the landscape to treat and how to balance investments in treating new areas versus maintaining previous investments. We will summarize current data needs, knowledge gaps, and other factors

  13. Decision support for utility environmental risk management

    International Nuclear Information System (INIS)

    Balson, W.E.; Wilson, D.S.

    1991-01-01

    This paper reviews a number of decision support methods developed and applied by Decision Focus Incorporated to help utility personnel manage current environmental problems. This work has been performed for the Environmental Risk Analysis Program of EPRI's Environment Division, and also for a number of electric utilities across the country. These are two distinct types of decision support software tools that have been created: economic risk management and environmental risk analysis. These types differ primarily in the identification of who will make a decision. Economic risk management tools are directed primarily at decisions made by electric utilities. Environmental risk analysis tools are directed primarily at decisions made by legislative or regulatory agencies, about which a utility may wish to comment

  14. Radiation risk management at DOE accelerator facilities

    International Nuclear Information System (INIS)

    Dyck, O.B. van.

    1997-01-01

    The DOE accelerator contractors have been discussing among themselves and with the Department how to improve radiation safety risk management. This activity-how to assure prevention of unplanned high exposures-is separate from normal exposure management, which historically has been quite successful. The ad-hoc Committee on the Accelerator Safety Order and Guidance [CASOG], formed by the Accelerator Section of the HPS, has proposed a risk- based approach, which will be discussed. Concepts involved are risk quantification and comparison (including with non-radiation risk), passive and active (reacting) protection systems, and probabilistic analysis. Different models of risk management will be presented, and the changing regulatory environment will also be discussed

  15. From risk management to uncertainty management: a significant change in project management

    Institute of Scientific and Technical Information of China (English)

    LI Gui-jun; ZHANG Yue-song

    2006-01-01

    Starting with the meanings of the terms "risk" and "uncertainty,"" he paper compares uncertainty management with risk management in project management. We bring some doubt to the use of "risk" and "uncertainty" interchangeably in project management and deem their scope, methods, responses, monitoring and controlling should be different too. Illustrations are given covering terminology, description, and treatment from different perspectives of uncertainty management and risk management. Furthermore, the paper retains that project risk management (PRM) processes might be modified to facilitate an uncertainty management perspective,and we support that project uncertainty management (PUM) can enlarge its contribution to improving project management performance, which will result in a significant change in emphasis compared with most risk management.

  16. Plant risk status information management system

    International Nuclear Information System (INIS)

    Campbell, D.J.; Ellison, B.C.; Glynn, J.C.; Flanagan, G.F.

    1985-01-01

    The Plant Risk Status Information Management System (PRISIMS) is a PC program that presents information about a nuclear power plant's design, its operation, its technical specifications, and the results of the plant's probabilistic risk assessment (PRA) in a logically and easily accessible format. PRISIMS provides its user with unique information for integrating safety concerns into day-to-day operational decisions and/or long-range management planning

  17. Delegated Portfolio Management and Risk Taking Behavior

    OpenAIRE

    José Luiz Barros Fernandes; Juan Ignacio Peña; Benjamin Miranda Tabak

    2009-01-01

    Standard models of moral hazard predict a negative relationship between risk and incentives; however empirical studies on mutual funds present mixed results. In this paper, we propose a behavioral principal-agent model in the context of professional managers, focusing on active and passive investment strategies. Using this general framework, we evaluate how incentives affect the risk taking behavior of managers, using the standard moral hazard model as a special case; and solve the previous c...

  18. Fundamentals of risk management understanding, evaluating and implementing effective risk management

    CERN Document Server

    Hopkin, Paul

    2012-01-01

    Now more than ever, organizations must plan, response and recognize all forms of risks that they face. "Fundamentals of Risk Management", now in its second edition, provides a comprehensive introduction to the subject of commercial and business risk for anyone studying for a career in risk as well as a broad range of risk professionals. It examines the key components of risk management and its application with examples to demonstrate its benefit to organisations in the public and private sector. The second edition has been completely updated to take into account the greater influence of ISO 3100, the emergence of Governance Risk and Compliance (GRC) and the wide use of the bowtie method to illustrate risk management. In addition, there is now a chapter on the skills and competencies required by an effective risk manager.

  19. Risk management - unappreciated instrument of supply chain management strategy

    OpenAIRE

    Wojciech Machowiak

    2012-01-01

    Background: Unlike Enterprise Risk Management, which is certainly quite well rooted in business practice, Supply Chain Risk Management (SCRM) still continues to be dynamically developing subject of academic research, whereas its practical applications are rather scarce. Material and methods: On the basis of broad review of the current state of the art in world literature, significant  relevancies to the core processes and enterprise strategy are discussed.   Results: ...

  20. Mental Health Professionals' Suicide Risk Assessment and Management Practices.

    Science.gov (United States)

    Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

    2018-01-01

    Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

  1. Management of interest rate risk

    Directory of Open Access Journals (Sweden)

    Šabović Šerif

    2014-01-01

    Full Text Available Interest rate risk is one of the biggest and most dangerous risks that a bank is exposed to. When a change of interest rates occurs, the incomes of a bank based on credits and securities endure significant changes. Banks resources also endure some changes. The change of interest rates changes the value of the assets and liabilities of the bank and it's net and investment worth . The change of interest rates also affects bank's balance sheet, income sheet statement and bank's share capital.

  2. Risk management and oil trading contracts

    International Nuclear Information System (INIS)

    Sas, B.

    1992-01-01

    The oil market provides an excellent case study for an analysis of the commodity trading risks and the development of contractual instruments and market structures to meet these risks. The paper identifies the main risks, namely performance, credit/payment, price, regulatory, fiscal, and ''trading'' risk. A conceptual framework provides the basis to trace the evolution of the risk management instruments from relational (e.g. long-term), through ''transactional'' (e.g. spot and forwards) to ''institutional'' (e.g. futures and options) and finally ''pricing'' (e.g. swaps and trigger pricing) contracts. (author)

  3. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

    Houwing, R. H.; Rozendaal, M; Wouters-Wesseling, W; Buskens, E.; Keller, P; Haalboom, JRE

    Hip fracture patients have a high risk of pressure ulcers (PU). We followed 121 hip fracture patients for the development of pressure ulcers and evaluated a risk assessment tool for sensitivity and specificity. More than half of the patients presented with PU, mostly stage I. Risk factors for PU

  4. The NASA Continuous Risk Management Process

    Science.gov (United States)

    Pokorny, Frank M.

    2004-01-01

    As an intern this summer in the GRC Risk Management Office, I have become familiar with the NASA Continuous Risk Management Process. In this process, risk is considered in terms of the probability that an undesired event will occur and the impact of the event, should it occur (ref., NASA-NPG: 7120.5). Risk management belongs in every part of every project and should be ongoing from start to finish. Another key point is that a risk is not a problem until it has happened. With that in mind, there is a six step cycle for continuous risk management that prevents risks from becoming problems. The steps are: identify, analyze, plan, track, control, and communicate & document. Incorporated in the first step are several methods to identify risks such as brainstorming and using lessons learned. Once a risk is identified, a risk statement is made on a risk information sheet consisting of a single condition and one or more consequences. There can also be a context section where the risk is explained in more detail. Additionally there are three main goals of analyzing a risk, which are evaluate, classify, and prioritize. Here is where a value is given to the attributes of a risk &e., probability, impact, and timeframe) based on a multi-level classification system (e.g., low, medium, high). It is important to keep in mind that the definitions of these levels are probably different for each project. Furthermore the risks can be combined into groups. Then, the risks are prioritized to see what risk is necessary to mitigate first. After the risks are analyzed, a plan is made to mitigate as many risks as feasible. Each risk should be assigned to someone in the project with knowledge in the area of the risk. Then the possible approaches to choose from are: research, accept, watch, or mitigate. Next, all risks, mitigated or not, are tracked either individually or in groups. As the plan is executed, risks are re-evaluated, and the attribute values are adjusted as necessary. Metrics

  5. Lessons Learned in Risk Management on NCSX

    International Nuclear Information System (INIS)

    Neilson, G.H.; Gruber, C.O.; Harris, Jeffrey H.; Rej, D.J.; Simmons, R.T.; Strykowsky, R.L.

    2010-01-01

    The National Compact Stellarator Experiment (NCSX) was designed to test physics principles of an innovative stellarator design developed by Princeton Plasma Physics Laboratory and Oak Ridge National Laboratory. Construction of some of the major components and subassemblies was completed, but the estimated cost and schedule for completing the project grew as the technical requirements and risks became better understood, leading to its cancellation in 2008. The project's risks stemmed from its technical challenges, primarily the complex component geometries and tight tolerances that were required. The initial baseline, which was established in 2004, was supported by a risk management plan and risk-based contingencies, both of which proved to be inadequate. Technical successes were achieved in the construction of challenging components and subassemblies, but cost and schedule growth was experienced. As part of an effort to improve project performance, a new risk management program was devised and implemented in 2007-2008. It led to a better understanding of project risks, a sounder basis for contingency estimates, and improved management tools. Although the risks were ultimately unacceptable to the sponsor, valuable lessons in risk management were learned through the experiences with the NCSX project.

  6. Risk management, derivatives and shariah compliance

    Science.gov (United States)

    Bacha, Obiyathulla Ismath

    2013-04-01

    Despite the impressive growth of Islamic Banking and Finance (IBF), a number of weaknesses remain. The most important of this is perhaps the lack of shariah compliant risk management tools. While the risk sharing philosophy of Islamic Finance requires the acceptance of risk to justify returns, the shariah also requires adherents to avoid unnecessary risk-maysir. The requirement to avoid maysir is in essence a call for the prudent management of risk. Contemporary risk management revolves around financial engineering, the building blocks of which are financial derivatives. Despite the proven efficacy of derivatives in the management of risk in the conventional space, shariah scholars appear to be suspicious and uneasy with their use in IBF. Some have imposed outright prohibition of their use. This paper re-examines the issue of contemporary derivative instruments and shariah compliance. The shariah compatibility of derivatives is shown in a number of ways. First, by way of qualitative evaluation of whether derivatives can be made to comply with the key prohibitions of the sharia. Second, by way of comparing the payoff profiles of derivatives with risk sharing finance and Bai Salam contracts. Finally, the equivalence between shariah compliant derivatives like the IPRS and Islamic FX Currency Forwards with conventional ones is presented.

  7. Board of directors and risk management

    NARCIS (Netherlands)

    van der Elst, C.F.; Birkmose, H.; Neville, M.; Sorensen, K.

    2013-01-01

    The board of directors is responsible for an appropriate business risk management environment. The paper studies in a comparative way how legislators and courts fill this duty. We question whether the legislative and regulatory framework will improve the equilibrium between entrepreneurship and risk

  8. Lessons Learned in Risk Management on NCSX

    International Nuclear Information System (INIS)

    Neilson, G.H.; Gruber, C.O.; Harris, J.H.; Rej, D.J.; Simmons, R.T.; Strykowsky, R.L.

    2009-01-01

    The National Compact Stellarator Experiment (NCSX) was designed to test physics principles of an innovative stellarator design developed by the Princeton Plasma Physics Laboratory and Oak Ridge National Laboratory. Construction of some of the major components and sub-assemblies was completed, but the estimated cost and schedule for completing the project grew as the technical requirements and risks became better understood, leading to its cancellation in 2008. The project's risks stemmed from its technical challenges, primarily the complex component geometries and tight tolerances that were required. The initial baseline, established in 2004, was supported by a risk management plan and risk-based contingencies, both of which proved to be inadequate. Technical successes were achieved in the construction of challenging components and subassemblies, but cost and schedule growth was experienced. As part of an effort to improve project performance, a new risk management program was devised and implemented in 2007-08. It led to a better understanding of project risks, a sounder basis for contingency estimates, and improved management tools. Although the risks ultimately were unacceptable to the sponsor, valuable lessons in risk management were learned through the experiences with the NCSX project

  9. Managing Risk Areas in Software Development Offshoring

    DEFF Research Database (Denmark)

    Persson, John Stouby; Schlichter, Bjarne Rerup

    2015-01-01

    Software companies are increasingly offshoring development to countries with high expertise at lower cost. Offshoring involves particular risk areas that if ignored increase the likelihood of failure. However, the offshoring client’s maturity level may influence the management of these risk areas...

  10. Self-management of vascular risk factors

    NARCIS (Netherlands)

    Sol-de Rijk, B.G.M.

    2009-01-01

    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing

  11. Methodology of environmental risk assessment management

    Directory of Open Access Journals (Sweden)

    Saša T. Bakrač

    2012-04-01

    Full Text Available Successful protection of environment is mostly based on high-quality assessment of potential and present risks. Environmental risk management is a complex process which includes: identification, assessment and control of risk, namely taking measures in order to minimize the risk to an acceptable level. Environmental risk management methodology: In addition to these phases in the management of environmental risk, appropriate measures that affect the reduction of risk occurrence should be implemented: - normative and legal regulations (laws and regulations, - appropriate organizational structures in society, and - establishing quality monitoring of environment. The emphasis is placed on the application of assessment methodologies (three-model concept, as the most important aspect of successful management of environmental risk. Risk assessment methodology - European concept: The first concept of ecological risk assessment methodology is based on the so-called European model-concept. In order to better understand this ecological risk assessment methodology, two concepts - hazard and risk - are introduced. The European concept of environmental risk assessment has the following phases in its implementation: identification of hazard (danger, identification of consequences (if there is hazard, estimate of the scale of consequences, estimate of consequence probability and risk assessment (also called risk characterization. The European concept is often used to assess risk in the environment as a model for addressing the distribution of stressors along the source - path - receptor line. Risk assessment methodology - Canadian concept: The second concept of the methodology of environmental risk assessment is based on the so-called Canadian model-concept. The assessment of ecological risk includes risk arising from natural events (floods, extreme weather conditions, etc., technological processes and products, agents (chemical, biological, radiological, etc

  12. Telephone Care Management of Fall Risk:: A Feasibility Study.

    Science.gov (United States)

    Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

    2017-03-01

    Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Interplanetary Supply Chain Risk Management

    Science.gov (United States)

    Galluzzi, Michael C.

    2018-01-01

    Emphasis on KSC ground processing operations, reduced spares up-mass lift requirements and campaign-level flexible path perspective for space systems support as Regolith-based ISM is achieved by; Network modeling for sequencing space logistics and in-space logistics nodal positioning to include feedstock. Economic modeling to assess ISM 3D printing adaption and supply chain risk.

  14. Process-based project proposal risk management

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2016-12-01

    Full Text Available We all are aware of the organizational omnipresence. Projects within the organizations are ubiquitous too. Projects achieve their goals successfully if they are planned, scheduled, controlled and implemented well. The project lifecycle of initiating, planning, scheduling, controlling and implementing are very well-planned by project managers and the organizations. Successful projects have well-developed risk management plans to deal with situations impacting projects. Like any other organisation, a university does try to access funds for different purposes too. For such organisations, running a project is not the issue, rather getting a project proposal approved to fund a project is the key. Project proposal processing is done by the nodal office in every organisation. Usually, these nodal offices help in administration and submission of a project proposal for accessing funds. Seldom are these nodal project offices within the organizations facilitate a project proposal approval by proactively reaching out to the project managers. And as project managers prepare project proposals, little or no attention is made to prepare a project proposal risk plan so as to maximise project acquisition. Risk plans are submitted while preparing proposals but these risk plans cater to a requirement to address actual projects upon approval. Hence, a risk management plan for project proposal is either missing or very little effort is made to treat the risks inherent in project acquisition. This paper is an integral attempt to highlight the importance of risk treatment for project proposal stage as an extremely important step to preparing the risk management plan made for projects corresponding to their lifecycle phases. Several tools and techniques have been proposed in the paper to help and guide either the project owner (proposer or the main organisational unit responsible for project management. Development of tools and techniques to further enhance project

  15. Managing sovereign credit risk in bond portfolios

    OpenAIRE

    Bruder, Benjamin; Hereil, Pierre; Roncalli, Thierry

    2011-01-01

    With the recent development of the European debt crisis, traditional index bond management has been severely called into question. We focus here on the risk issues raised by the classical market-capitalization weighting scheme. We propose an approach to properly measure sovereign credit risk in a fixed-income portfolio. For that, we assume that CDS spreads follow a SABR process and we derive a sovereign credit risk measure based on CDS spreads and duration of portfolio bonds. We then consider...

  16. Loss Database Architecture for Disaster Risk Management

    OpenAIRE

    RIOS DIAZ FRANCISCO; MARIN FERRER MONTSERRAT

    2018-01-01

    The reformed Union civil protection legislation (Decision on a Union Civil Protection Mechanism), which entered into force on 1 January 2014, is paving the way for more resilient communities by including key actions related to disaster prevention such as developing national risk assessments and the refinement of risk management planning. Under the Decision, Member States agreed to “develop risk assessments at national or appropriate sub- national level and make available to the Commission a s...

  17. Management Risk Reporting Practices and their determinants

    OpenAIRE

    VANDEMAELE, Sigrid; VERGAUWEN, Philip; MICHIELS, Anneleen

    2009-01-01

    In recent years, the need for effective risk management, internal control and transparent risk reporting has become an important corporate governance principle and a predominant issue in business. Already in 1987, the AICPA[ ] report stated that shareholders are increasingly demanding that financial statements include more information concerning the risks and uncertainties companies are facing (Schrand and Elliott, 1998). Abraham and Cox (2007) claim that this information can help investors t...

  18. Credit Risk Management in Chinese Banking Industry

    OpenAIRE

    Zhang, Lei

    2006-01-01

    Abstract Credit risk is by far the most important risk faced by banks, and it influences the bank profitability and its long-term operation significantly. Well management on credit risk can be a competitive advantage for banks in the competitive banking industry. Chinese banks suffer from serious financial fragility manifested by high proportions of NPLs and low capital adequacy ratios (Bonin and Huang, 2001). This dissertation examines the real credit performance of Chinese banks ba...

  19. Critical infrastructure cyber-security risk management

    OpenAIRE

    Spyridopoulos, T.; Maraslis, K.; Tryfonas, T.; Oikonomou, G.

    2017-01-01

    Traditional IT cyber-security risk management methods are based on the evaluation of risks calculated as the likelihood of cyber-security incidents occurring. However, these probabilities are usually estimations or guesses based on past experience and incomplete data. Incorrect estimations can lead to errors in the evaluation of risks that can ultimately affect the protection of the system. This issue is also transferred to methods used in Industrial Control Systems (ICSs), as they are mainly...

  20. Ethical Aspects of Radiation Risk Management

    OpenAIRE

    Wikman-Svahn, Per

    2012-01-01

    This thesis is based on the assumption that the intersection of moral philosophy and practical risk management is a rewarding area to study. In particular, the thesis assumes that concepts, ideas, and methods that are used in moral philosophy can be of great benefit for risk analysis, but also that practices in risk regulation provide a useful testing ground for moral philosophical theories. The thesis consists of an introduction and five articles. Article I is a review article on social and ...

  1. Information needs for risk management/communication

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, D.A. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    The hazardous waste cleanup program under the Comprehensive Environmental Response, Compensation, and Liability Act (Superfund) is delegated to the ten Regions of the US Environmental Protection Agency (EPA) and has, to date, identified more than 33,000 sites for consideration. The size and complexity of the program places great demands on those who would provide information to achieve national consistency in application of risk assessment while meeting site-specific needs for risk management and risk communication.

  2. Patient Blood Management in Europe

    DEFF Research Database (Denmark)

    Bruun, M T; Pendry, K; Georgsen, J

    2016-01-01

    BACKGROUND AND OBJECTIVES: Patient Blood Management (PBM) in Europe is a working group of the European Blood Alliance with the initial objective to identify the starting position of the participating hospitals regarding PBM for benchmarking purposes, and to derive good practices in PBM from...

  3. Management of Patients with Oral Candidiasis

    DEFF Research Database (Denmark)

    Kragelund, Camilla; Reibel, Jesper; Pedersen, Anne Marie Lynge

    2016-01-01

    Oral candidal infections are medically treated with antifungal agents. In the fungal cell membrane, steroid ergosterol is the target of the antifungals on the market, but similarity with the human cell membrane may cause host toxicity and unintended reactions. Management of oral candidiasis depends...... in particular in patients with recurrent oral candidiasis. This risk can be reduced if different types of antifungal drugs are used over time or are combined. This chapter focuses on antifungal treatment of the medically compromised patient with oral candidiasis by highlighting the advantages and disadvantages...

  4. COORDINATES OF A RISK MANAGEMENT PROJECT

    Directory of Open Access Journals (Sweden)

    ALEXANDRU OLTEANU

    2013-05-01

    Full Text Available High risk – high benefit: a well-known correlation both in the economic field and in the day-to-day life. Another correlation, on which this article is based: large project – numerous participants – increased risks and other malfunctions. The risk management concept is challenged by those projects and is forced to find the most adequate “customized” ways for each project at its turn. In this respect, the assessment of management has followed the trend of the last three decades, marked by moving of management profit analysis by risk intermediation, respectively the transition from managing profit to risk-return relationship management. Such trend assumes the obligation of participants to identify objectives and expected benefits of the project on the basis of the strategies laid-down, the elements of risk management policies, in conjunction with the indication of the most negative scenarios which they may provide. This activity must take into consideration the process of obtaining and combining human, financial, physical and information resources in order to accomplish the primary goal of the proposed and wanted project by a certain segment of population. Project participants are directed to evaluate their own activities in terms of revenues and risks from the business access, opportunity, operating mode, as well as the limitations and boundaries on certain sides of activity. The paper focuses on the analysis and evaluation of incomes and risks, on simulations to streamline the activities and the determination of the optimal model of project choice. Also, the paper treats the risks that can be taken over by the sponsors, especially those related to implied guaranties, even implied guaranties.

  5. Comparisons on International Approaches of Business and Project Risk Management

    OpenAIRE

    Nadia Carmen ENE

    2005-01-01

    In this article we intend to present a comparative approach between three recognized international methodologies for risk management: RISKMAN, Project Management Institute Methodology-PMBoK and Project Risk Analysis and Management Guide (produced by Association for Project Management).

  6. COORDINATES OF A RISK MANAGEMENT PROJECT

    OpenAIRE

    ALEXANDRU OLTEANU; MĂDĂLINA ANTOANETA RĂDOI

    2013-01-01

    High risk – high benefit: a well-known correlation both in the economic field and in the day-to-day life. Another correlation, on which this article is based: large project – numerous participants – increased risks and other malfunctions. The risk management concept is challenged by those projects and is forced to find the most adequate “customized” ways for each project at its turn. In this respect, the assessment of management has followed the trend of the last three decades, marked by movi...

  7. THRMS: A pilot risk management system

    International Nuclear Information System (INIS)

    Xue, D.; Xu, Y.

    2000-01-01

    Daya Bay NPP is the first commercial nuclear power plant in China. This plant is interested in and pro-active towards the development and application of PSA and PSA tools. This, together with the support from the IAEA promoted the project 'THRMS: the pilot study of risk management system for NPP'. The objectives in development and implementation of THRMS includes: survey and discuss on the development of the approaches used in constructing plant risk models; design and study on the realization of a real-time risk management system. An overview of the project is presented in this paper. (author)

  8. An operations-partnered evaluation of care redesign for high-risk patients in the Veterans Health Administration (VHA): Study protocol for the PACT Intensive Management (PIM) randomized quality improvement evaluation.

    Science.gov (United States)

    Chang, Evelyn T; Zulman, Donna M; Asch, Steven M; Stockdale, Susan E; Yoon, Jean; Ong, Michael K; Lee, Martin; Simon, Alissa; Atkins, David; Schectman, Gordon; Kirsh, Susan R; Rubenstein, Lisa V

    2018-06-01

    Patient-centered medical homes have made great strides providing comprehensive care for patients with chronic conditions, but may not provide sufficient support for patients at highest risk for acute care use. To address this, the Veterans Health Administration (VHA) initiated a five-site demonstration project to evaluate the effectiveness of augmenting the VA's Patient Aligned Care Team (PACT) medical home with PACT Intensive Management (PIM) teams for Veterans at highest risk for hospitalization. Researchers partnered with VHA leadership to design a mixed-methods prospective multi-site evaluation that met leadership's desire for a rigorous evaluation conducted as quality improvement rather than research. We conducted a randomized QI evaluation and assigned high-risk patients to participate in PIM and compared them with high-risk Veterans receiving usual care through PACT. The summative evaluation examines whether PIM: 1) decreases VHA emergency department and hospital use; 2) increases satisfaction with VHA care; 3) decreases provider burnout; and 4) generates positive returns on investment. The formative evaluation aims to support improved care for high-risk patients at demonstration sites and to inform future initiatives for high-risk patients. The evaluation was reviewed by representatives from the VHA Office of Research and Development and the Office of Research Oversight and met criteria for quality improvement. VHA aims to function as a learning organization by rapidly implementing and rigorously testing QI innovations prior to final program or policy development. We observed challenges and opportunities in designing an evaluation consistent with QI standards and operations priorities, while also maintaining scientific rigor. This trial was retrospectively registered at ClinicalTrials.gov on April 3, 2017: NCT03100526. Protocol v1, FY14-17. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Managing cancer risk and decision making after kidney transplantation.

    Science.gov (United States)

    Webster, A C; Wong, G; Craig, J C; Chapman, J R

    2008-11-01

    Kidney transplant recipients are at higher risk of cancer at most sites, and cancer after transplantation causes considerable morbidity and mortality. To optimize long-term patient outcomes, clinicians balance the prospect of graft failure and dialysis, with competing risks of diabetes, cardiovascular and cerebrovascular disease and the risk of malignancy. In this paper we critically examine the assumptions underpinning primary prevention, immunization, chemoprevention and screening programs, and highlight considerations when applying evidence to the kidney transplant population, and suggest a clinical research agenda that aims to define a rational approach to managing posttransplant cancer risk.

  10. The role of risk perception for risk management

    International Nuclear Information System (INIS)

    Renn, Ortwin

    1998-01-01

    Are risks social constructions of different societal actors that can be checked at best against standards of consistency, cohesion and internal conventions of deduction, but cannot claim any validity outside of the actor's logical framework? Or are technical estimates of risk representations of real hazards that can and will affect people as predicted by the statistical values, regardless of the beliefs or convictions of those who conduct the assessments? Which of the two sides one takes determines the legitimate function of risk perception for management purposes. The paper argues that both extremes, the constructivist and the realist perspective, miss the point, as risks are always mental representations of threats that are capable of claiming real losses. Over the last two decades, risk analysts have dealt with both sides of risk in an additive fashion. In times in which risk management has been under serious pressure to demonstrate effectiveness and cost-efficiency, the parallel approach of pleasing the technical elite and the public alike has lost legitimacy. In order to integrate risk assessment and perception, the paper analyses the strengths and weaknesses of each approach to risk analysis and highlights the potential contributions that the technical sciences and the social sciences can offer to risk management. Technical assessments provide the best estimate for judging the average probability of an adverse effect linked to an object or activity. First, public perception should govern the selection of criteria on which acceptability or tolerability are to be judged. Second, public input is needed to determine the trade-offs between criteria. Third, public preferences are needed to design resilient strategies for coping with remaining uncertainties. A public participation model is introduced that promises an integration of analytic knowledge and deliberative process involving those who will be affected by the respective risk

  11. Remote Patient Management for Home Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Eric L. Wallace

    2017-11-01

    Full Text Available Remote patient management (RPM offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.

  12. Climate Change Risk Management: CRE Adaptation Projects and the Risk Management Process

    Science.gov (United States)

    This document describes National Estuary Program partner projects that demonstrate how risk management can be successfully applied to address environmental challenges in our country’s coastal areas.

  13. Transitioning leadership and risk management

    OpenAIRE

    Coulson-Thomas, Colin

    2017-01-01

    One of the dilemmas faced by directors and other corporate leaders is the need to be entrepreneurial in ensuring the future success of a company which involves risk, while at the same time retaining prudent control. Transitioning leadership suggests a process of adjustment, adaptation, transformation or metamorphosis from one condition, situation or state to another, depending upon the extent of the internal or external change required to continue to operate and cope. The process also involve...

  14. Original Research Identifying patients at high risk for obstructive ...

    African Journals Online (AJOL)

    determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

  15. Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis.

    Science.gov (United States)

    Lip, Gregory Y H; Andreotti, Felicita; Fauchier, Laurent; Huber, Kurt; Hylek, Elaine; Knight, Eve; Lane, Deirdre; Levi, Marcel; Marín, Francisco; Palareti, Gualtiero; Kirchhof, Paulus

    2011-12-01

    In this executive summary of a Consensus Document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in atrial fibrillation (AF) patients. The main aim of the document was to summarise 'best practice' in dealing with bleeding risk in AF patients when approaching antithrombotic therapy, by addressing the epidemiology and size of the problem, and review established bleeding risk factors. We also summarise definitions of bleeding in the published literature. Patient values and preferences balancing the risk of bleeding against thromboembolism as well as the prognostic implications of bleeding are reviewed. We also provide an overview of published bleeding risk stratification and bleeding risk schema. Brief discussion of special situations (e.g. periablation, peri-devices such as implantable cardioverter defibrillators [ICD] or pacemakers, presentation with acute coronary syndromes and/or requiring percutanous coronary interventions/stents and bridging therapy) is made, as well as a discussion of the prevention of bleeds and managing bleeding complications. Finally, this document puts forwards consensus statements that may help to define evidence gaps and assist in everyday clinical practice.

  16. A risk-adapted approach is beneficial in the management of bilateral femoral shaft fractures in multiple trauma patients: an analysis based on the trauma registry of the German Trauma Society.

    Science.gov (United States)

    Steinhausen, Eva; Lefering, Rolf; Tjardes, Thorsten; Neugebauer, Edmund A M; Bouillon, Bertil; Rixen, Dieter

    2014-05-01

    Today, there is a trend toward damage-control orthopedics (DCO) in the management of multiple trauma patients with long bone fractures. However, there is no widely accepted concept. A risk-adapted approach seems to result in low acute morbidity and mortality. Multiple trauma patients with bilateral femoral shaft fractures (FSFs) are considered to be more severely injured. The objective of this study was to validate the risk-adapted approach in the management of multiple trauma patients with bilateral FSF. Data analysis is based on the trauma registry of the German Trauma Society (1993-2008, n = 42,248). Multiple trauma patients with bilateral FSF were analyzed in subgroups according to the type of primary operative strategy. Outcome parameters were mortality and major complications as (multiple) organ failure and sepsis. A total of 379 patients with bilateral FSF were divided into four groups as follows: (1) no operation (8.4%), (2) bilateral temporary external fixation (DCO) (50.9%), bilateral primary definitive osteosynthesis (early total care [ETC]) (25.1%), and primary definitive osteosynthesis of one FSF and DCO contralaterally (mixed) (15.6%). Compared with the ETC group, the DCO group was more severely injured. The incidence of (multiple) organ failure and mortality rates were higher in the DCO group but without significance. Adjusted for injury severity, there was no significant difference of mortality rates between DCO and ETC. Injury severity and mortality rates were significantly increased in the no-operation group. The mixed group was similar to the ETC group regarding injury severity and outcome. In Germany, both DCO and ETC are practiced in multiple trauma patients with bilateral FSF so far. The unstable or potentially unstable patient is reasonably treated with DCO. The clearly stable patient is reasonably treated with nailing. When in doubt, the patient is probably not totally stable, and the safest precaution may be to use DCO as a risk

  17. The Role of risk perception for risk management

    International Nuclear Information System (INIS)

    Renn, Ortwin

    1999-01-01

    The list of individual and social factors that shape risk perception demonstrates that the intuitive understanding of risk is a multidimensional concept and cannot be reduced to the product of probabilities and consequences. Although risk perceptions differ considerably among social and cultural groups, the multi-dimensionality of risk and the integration of beliefs related to risk, the cause of risk, and its circumstances into a consistent belief system appear to be common characteristics of public risk perception in almost all countries in which such studies have been performed. Furthermore, the experience of risk is not limited to the threat of facing harm in the future. It includes subjective predictions of possible outcomes, the social and cultural context in which the risk is experienced, the mental images the risk situation evokes, the perception of the players who are involved in the risk situation and the judgments about fairness and equity related to the distribution of potential hazardous events. In this sense, risk is a social construct rather than a physical entity. Risk communication and conflict resolution is therefore a crucial element of any risk management strategy. The goal of risk communication and conflict resolution should not be to persuade people to accept whatever the communicator thinks is best for them. The ideal communication program envisions a receiver who processes all the available information to form a well-balanced judgement in accordance with the factual evidence, the arguments of all sides, and his/her own interests and preferences. The ultimate goal of risk communication is to reconcile expertise, interests, and public preferences. (EHS)

  18. Operational risk management for a NPP

    Energy Technology Data Exchange (ETDEWEB)

    Scott, C.K., E-mail: KScott@AtlanticNuclear.ca [Atlantic Nuclear Services Inc., Fredericton, New Brunswick (Canada)

    2013-07-01

    Organizational failures are a hazard to the successful operation of a nuclear power plant. Risk reduction strategies have been developed around two themes: using an understanding of the nature and mechanism of human failures to eliminate them by modifying work processes; or, modifying human behaviour by creating a strong safety culture that overrides the tendency to fail. This paper examines the problem from the perspective of operational risk management. It includes the internal management of operations and the influence of the external environment on the organization. A model is proposed that encompasses all the operational risk factors in the organization's decision making process. To prevent failure the organization must have the capability to adapt and the capacity to evolve. The hazards that would lead to an organizational failure are developed from this evolutionary model. The operational risk management program would include these hazards as well as the conventional nuclear safety hazards. (author)

  19. Probability distributions in risk management operations

    CERN Document Server

    Artikis, Constantinos

    2015-01-01

    This book is about the formulations, theoretical investigations, and practical applications of new stochastic models for fundamental concepts and operations of the discipline of risk management. It also examines how these models can be useful in the descriptions, measurements, evaluations, and treatments of risks threatening various modern organizations. Moreover, the book makes clear that such stochastic models constitute very strong analytical tools which substantially facilitate strategic thinking and strategic decision making in many significant areas of risk management. In particular the incorporation of fundamental probabilistic concepts such as the sum, minimum, and maximum of a random number of continuous, positive, independent, and identically distributed random variables in the mathematical structure of stochastic models significantly supports the suitability of these models in the developments, investigations, selections, and implementations of proactive and reactive risk management operations. The...

  20. Living with risk: a management question

    International Nuclear Information System (INIS)

    Ale, Ben J.M.

    2005-01-01

    Public authorities started to be really involved in risk management of hazardous materials some 30 years ago. Recent developments have led to fresh attention for this matter and many further developments are underway. The history of risk management and safety regulation is one of strongly variable interest, forgotten lessons and rude awakenings. The impetus exerted by accidents is short lived. Safety cases become documents to satisfy regulation rather than instruments to reduce risk. Deregulation, privatisation, and outsourcing pose new challenges to safety and risk management. Some of the unfortunate side effects have already become apparent. This invariably leads to the next disaster, which will have a striking resemblance to the previous one when abstracted from the immediate technological context. Lessons can be learned if we really want. The question remains: 'Do we?'