Science.gov

Sample records for management risks prevention

  1. Risk Management and Prevention.

    ERIC Educational Resources Information Center

    Letzring, Timothy D.

    1999-01-01

    Schools cannot eliminate all risks but can manage them so they minimally affect the "bottom line." A sound risk-management program has four categories: risk avoidance, control, transfer, and retention. Schools retain some risk in situations when insurance is unavailable, costs are negligible, or loss probabilities are remote. (MLH)

  2. Risk Management and Prevention.

    ERIC Educational Resources Information Center

    Letzring, Timothy D.

    1999-01-01

    Schools cannot eliminate all risks but can manage them so they minimally affect the "bottom line." A sound risk-management program has four categories: risk avoidance, control, transfer, and retention. Schools retain some risk in situations when insurance is unavailable, costs are negligible, or loss probabilities are remote. (MLH)

  3. Prevention through health risk management.

    PubMed

    Friedman, G M

    1992-08-01

    Risk can lead to catastrophe. Risk-management systems are highly effective in preventing the catastrophes of fire, earthquakes, and work-site injuries. No such effective systems are present to prevent health and social problems. A practical, cost-effective system to manage risk in children is being developed by the nonprofit Arizona Health Evaluation and Longevity Planning (HELP) Foundation. Information regarding such risk is collected in the school setting. This voluntary information comes from the administration, the school nurse, physical fitness testing, blood testing by the local hospital, self-esteem instruments, and parent, teacher, and child questionnaires. The HELP Foundation then develops an individual child and class risk profile that is presented to the teacher, school nurse, principal, and parent. Those involved with each child then prioritize, plan, and implement programs and activities to manage the identified risk(s). Risks is tracked throughout the child's school career by periodic reassessment. Evaluation of change in problem outcome will be a natural extension of the process.

  4. Striae gravidarum: Risk factors, prevention, and management.

    PubMed

    Farahnik, B; Park, K; Kroumpouzos, G; Murase, J

    2017-06-01

    Striae gravidarum (SG) are atrophic linear scars that represent one of the most common connective tissue changes during pregnancy. SG can cause emotional and psychological distress for many women. Research on risk factors, prevention, and management of SG has been often inconclusive. We conducted a literature search using textbooks, PubMed, and Medline databases to assess research performed on the risk factors, prevention, and management of SG. The search included the following key words: striae gravidarum, pregnancy stretch marks, and pregnancy stretch. We also reviewed citations within articles to identify relevant sources. Younger age, maternal and family history of SG, increased pre-pregnancy and pre-delivery weight, and increased birth weight were the most significant risk factors identified for SG. Although few studies have confirmed effective prevention methods, Centella asiatica extract, hyaluronic acid, and daily massages showed some promise. Treatment for general striae has greatly improved over the last few years. Topical tretinoin ≥ 0.05% has demonstrated up to 47% improvement of SG and non-ablative fractional lasers have consistently demonstrated 50 to 75% improvement in treated lesions of striae distensae. Overall, SG has seen a resurgence in research over the last few years with promising data being released. Results of recent studies provide dermatologists with new options for the many women who are affected by these disfiguring marks of pregnancy.

  5. Preventing delirium in dementia: Managing risk factors.

    PubMed

    Ford, Andrew H

    2016-10-01

    Delirium is a common, disabling medical condition that is associated with numerous adverse outcomes. A number of inter-related factors, including pre-existing cognitive impairment, usually contribute to the development of delirium in a particular susceptible individual. Non-pharmacological approaches to prevention typically target multiple risk factors in a systematic manner (multicomponent interventions). There is generally good evidence that multicomponent interventions reduce the incidence of delirium in hospital populations but there are limited data in people with dementia and those living in the community. It is likely that there is a differential effect of specific interventions in those with cognitive impairment (e.g. people with dementia may respond better to simpler, more pragmatic interventions rather than complex procedures) but this cannot be determined from the existing data. Targeted interventions focussed on hydration, medication rationalization and sleep promotion may also be effective in reducing the incidence of delirium, as well as the active involvement of family members in the care of the elderly hospitalized patient. Hospitalization itself is a potential risk factor for delirium and promising data are emerging of the benefits of home-based care as an alternative to hospitalization but this is restricted to specific sub-populations of patients and is reliant on these services being available. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Risk assessment and management to prevent preterm birth.

    PubMed

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers.

  7. Stroke prevention care delivery: predictors of risk factor management outcomes.

    PubMed

    Ireland, Sandra E; Arthur, Heather M; Gunn, Elizabeth A; Oczkowski, Wieslaw

    2011-02-01

    Internationally, the development and implementation of stroke care guidelines have resulted in the evolution of stroke prevention outpatient clinics designed to accelerate patient access to treatment and behavioral risk reduction following transient ischemic attack or stroke. To examine the extent to which selected demographic, social-psychological, physiological, and adherence characteristics predicted achievement of blood pressure and glucose targets in a group of patients referred to a Canadian stroke prevention clinic with confirmed transient ischemic attack (TIA) or stroke and hypertension and/or diabetes. A total of 313, English speaking, adult patients who were referred from family or emergency department physicians to a stroke prevention clinic provided demographic data and received social-psychological screening testing at intake. Of these, 93 participants who met criteria of confirmed TIA or stroke plus hypertension and/or diabetes were identified as the study group. Seventy-seven of study group participants completed a 6-month follow-up. Admission screening tests included the Modified and Mini-Mental State Examinations, Trail Making Test, Clock Drawing Test, a medication self-efficacy scale, the Lubben Social Network Scale and the Geriatric Depression Scale. Family physician follow-up was ascertained 4-8 weeks after intake. At approximately 6 months after the initial screening measures, 77 study group participants completed additional measures of adherence, blood pressure and/or glycated hemoglobin. Transient ischemic attack was confirmed in 58% and stroke in 42% of the study group. Mean age was 69 years (SD=11); 53% were male; 97% had hypertension; and 25% were diabetic; some had both. Twenty-three percent were not followed-up by family practitioners. At 6-month follow-up, 97% reported ≥80% adherence to medication; only 57% met treatment targets. A logistic regression analysis identified three independent predictors of achieving blood pressure and

  8. Preventing sexual attacks in healthcare facilities: risk management considerations.

    PubMed

    Banja, John D

    2014-01-01

    Reports or allegations of sexual attacks in healthcare facilities are extremely upsetting and sometimes not given the attention they deserve. In June 2011, the United States Government Accountability Office (GAO) issued a remarkable report on sexual attacks occurring in Veterans Affairs (VA) health facilities that not only raised awareness of the magnitude of the problem but that detailed numerous system weaknesses in VA facilities that might have enabled such attacks. This article discusses some of the GAO's findings as well as other instances of sexual attacks, such as occurred in the criminal prosecution of Paul Serdula, a former health professional who might have sexually assaulted hundreds of women. Some of Serdula's victims have subsequently sued in civil court, charging Serdula's employers with lack of supervision and raising the possibility of serial sexual attacks such as his evolving into large-scale patient safety disasters. This article will review certain ethical and legal considerations bearing on the liability of healthcare facilities in which sexual attacks are alleged to have occurred. Following a discussion of how two courts have used the legal construct of "foreseeability" in determining a healthcare facility's liability when an employee is charged with sexual assault, the article will conclude with a host of patient safety recommendations aimed at discouraging or deterring the occurrence of sexual attacks. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

  9. Understanding cardiovascular risk in hemophilia: A step towards prevention and management.

    PubMed

    Sousos, Nikolaos; Gavriilaki, Eleni; Vakalopoulou, Sofia; Garipidou, Vasileia

    2016-04-01

    Advances in hemophilia care have led to increased life expectancy and new challenges in the management of the aging hemophilia population, including cardiovascular risk. Despite the deep knowledge into cardiovascular disease in terms of pathophysiology, risk prediction, prevention, early detection and management gained over the last decades, studies in hemophiliacs are scarce and mainly descriptive. As a growing amount of evidence points towards a similar or increased prevalence of traditional cardiovascular risk factors in hemophilia compared to the general population, the role of non-traditional, disease-related and treatment-related cardiovascular risk factors remains under investigation. Better understanding of cardiovascular risk in hemophilia is mandatory for proper cardiovascular risk prevention and management. Therefore, this review aims to summarize current knowledge on cardiovascular risk in hemophilia patients focusing on a) cardiovascular risk factors (traditional, non-traditional, disease-related and treatment-related), b) cardiovascular morbidity and mortality and c) cardiovascular prevention and management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Pediatric Dental Care: Prevention and Management Protocols Based on Caries Risk Assessment

    PubMed Central

    RAMOS-GOMEZ, FRANCISCO J.; CRYSTAL, YASMI O.; NG, MAN WAI; CRALL, JAMES J.; FEATHERSTONE, JOHN D.B.

    2012-01-01

    Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model.1–3 This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment, CAMBRA, in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. PMID:21162350

  11. Pediatric dental care: prevention and management protocols based on caries risk assessment.

    PubMed

    Ramos-Gomez, Francisco J; Crystal, Yasmi O; Ng, Man Wai; Crall, James J; Featherstone, John D B

    2010-10-01

    Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model. This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. [corrected

  12. The management of risk. Part 1: Why complaints happen and how to prevent them.

    PubMed

    Collier, Andrew

    2014-03-01

    There is increasing concern amongst dentists, and dental care professionals (DCPs), about the risks associated with complaints from patients and the possibility of escalation to legal action or referral to the General Dental Council (GDC). This is the first of a series of four articles considering the management of risk. It will describe why complaints happen, how to identify problems at an early stage and strategies for preventing complaints occurring. The prevention of complaints will reduce stress and anxiety for all members of the dental team.

  13. Ovarian Hyperstimulation Syndrome: Current Views on Pathophysiology, Risk Factors, Prevention, and Management

    PubMed Central

    Alper, Michael M; Smith, Laura P; Sills, Eric Scott

    2009-01-01

    Objective: To summarize current views on the pathophysiology, risk factors, prevention, clinical features, and management of Ovarian Hyperstimulation Syndrome (OHSS). Design: Literature review Results: OHSS is a condition characterized by increased capillary permeability, and experimental evidence has identified a provocative link to pathologic vasoactive cytokine actions. Although the ultimate physiologic mechanism of OHSS is not yet known, there are well-known risk factors that must be considered during the administration of medications to treat infertility. Clinical features are consequences of third-spaced intravascular fluid, and OHSS may become life-threatening secondary to thromboembolism or compromised pulmonary or cardiovascular function. Cornerstones of prevention have historically included cycle cancellation, coasting, decreased dosing of human chorionic gonadotropin (hCG) trigger, use of an agonist trigger, and cryopreservation of all embryos. Newer methods of prevention include the administration of a dopamine agonist medication. Management options for OHSS include outpatient transvaginal paracentesis, outpatient transabdominal paracentesis, and inpatient hospitalization with or without paracentesis. Conclusions: OHSS continues to be a serious complication of assisted reproductive therapy (ART), with no universally agreed upon best method of prevention. Coasting and cryopreservation of all embryos are the most commonly used approaches in the literature, but cycle cancellation is the only method that can completely prevent the development of OHSS. Dopamine agonists are currently being investigated to both prevent and improve the clinical course in OHSS. Recent publications suggest that outpatient paracentesis both prevents the need for inpatient hospitalization and is a cost-effective strategy. PMID:20485578

  14. Risk Management

    NASA Technical Reports Server (NTRS)

    Thomas, Lloyd

    1998-01-01

    This presentation focuses on the identification of risk management, risk management processes such as: quantification and prioritization; mitigation planning; implementation of risk reduction; and tracking process. It develops examples and answers questions about Risk Management.

  15. 75 FR 40845 - Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at Structure Fires

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-14

    ... HUMAN SERVICES Centers for Disease Control and Prevention Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at Structure Fires AGENCY: National Institute for Occupational... Fire Fighters Using Risk Management Principles at Structure Fires.'' The final document can be found...

  16. How to use security risk assessments to manage risks, prevent violence and deal with new threats.

    PubMed

    Ramsey-Hamilton, Caroline

    2015-01-01

    With a growing number of healthcare security requirements from states as well as regulators like FEMA, CMS, and DHS, the need to conduct comprehensive Security Risk Assessments has become essential, according to the author. In this article, she provides the basic elements of such assessments as well as guidance on how to apply them to a facility report and how to present the report to management.

  17. Risk Management.

    ERIC Educational Resources Information Center

    Randal, L. Nathan

    This chapter of "Principles of School Business Management" presents an overview of risk management for school districts. The chapter first discusses four fundamental elements of risk management: (1) identifying and measuring risks; (2) reducing or eliminating risks; (3) transferring unassumable risks; and (4) assuming remaining risks.…

  18. Risk Management.

    ERIC Educational Resources Information Center

    Randal, L. Nathan

    This chapter of "Principles of School Business Management" presents an overview of risk management for school districts. The chapter first discusses four fundamental elements of risk management: (1) identifying and measuring risks; (2) reducing or eliminating risks; (3) transferring unassumable risks; and (4) assuming remaining risks.…

  19. Caries management by risk assessment: A review on current strategies for caries prevention and management

    PubMed Central

    Maheswari, S. Uma; Raja, Jacob; Kumar, Arvind; Seelan, R. Gnana

    2015-01-01

    The current trend in treating dental caries is using nondestructive risk-based caries management strategies rather than focusing on the restorative treatment alone. Currently, there have been many changes in understanding of the multifaceted nature of caries process and its management. Caries Management by Risk Assessment (CAMBRA) which is an evidence-based approach focuses on determining many factors causing the expression of disease and take corrective action. The clinicians can ascertain what behaviors are increasing a patient's risk for disease and disease progression by evaluating the current caries risk of a patient. With this modern CAMBRA protocol, a novel treatment plan can be designed to arrest dental caries thereby decreasing the chance of cavitation. After the recognition of the multi factorial nature of caries involving the biofilm, the contemporary approaches focused mainly on the various options to cope with the locally out-of-balance oral biofilm and stop the progression of the disease. The initial caries lesions can be diagnosed with modern diagnostic aids and with the help of CAMBRA, reestablishment of the integrity of the tooth surface early on in the caries process will bring great rewards for patients. This review focuses on the repair of hard tooth tissues using noninvasive strategies. PMID:26538870

  20. Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management

    PubMed Central

    Cheung, Ka-Shing; Leung, Wai K

    2017-01-01

    Novel oral anticoagulants (NOACs), which include direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of venous thromboembolism. However, similar to traditional anticoagulants, NOACs have the side effects of bleeding, including gastrointestinal bleeding (GIB). Results from both randomized clinical trials and observations studies suggest that high-dose dabigatran (150 mg b.i.d), rivaroxaban and high-dose edoxaban (60 mg daily) are associated with a higher risk of GIB compared with warfarin. Other risk factors of NOAC-related GIB include concomitant use of ulcerogenic agents, older age, renal impairment, Helicobacter pylori infection and a past history of GIB. Prevention of NOAC-related GIB includes proper patient selection, using a lower dose of certain NOACs and in patients with renal impairment, correction of modifiable risk factors, and prescription of gastroprotective agents. Overt GIB can be managed by withholding NOACs followed by delayed endoscopic treatment. In severe bleeding, additional measures include administration of activated charcoal, use of specific reversal agents such as idarucizumab for dabigatran and andexanent alfa for factor Xa inhibitors, and urgent endoscopic management. PMID:28373761

  1. Predicting global invasion risks: a management tool to prevent future introductions

    PubMed Central

    Fletcher, D. H.; Gillingham, P. K.; Britton, J. R.; Blanchet, S.; Gozlan, R. E.

    2016-01-01

    Predicting regions at risk from introductions of non-native species and the subsequent invasions is a fundamental aspect of horizon scanning activities that enable the development of more effective preventative actions and planning of management measures. The Asian cyprinid fish topmouth gudgeon Pseudorasbora parva has proved highly invasive across Europe since its introduction in the 1960s. In addition to direct negative impacts on native fish populations, P. parva has potential for further damage through transmission of an emergent infectious disease, known to cause mortality in other species. To quantify its invasion risk, in regions where it has yet to be introduced, we trained 900 ecological niche models and constructed an Ensemble Model predicting suitability, then integrated a proxy for introduction likelihood. This revealed high potential for P. parva to invade regions well beyond its current invasive range. These included areas in all modelled continents, with several hotspots of climatic suitability and risk of introduction. We believe that these methods are easily adapted for a variety of other invasive species and that such risk maps could be used by policy-makers and managers in hotspots to formulate increased surveillance and early-warning systems that aim to prevent introductions and subsequent invasions. PMID:27199300

  2. Lifestyle changes and the risk of developing endometrial and ovarian cancers: opportunities for prevention and management

    PubMed Central

    Beavis, Anna L; Smith, Anna Jo Bodurtha; Fader, Amanda Nickles

    2016-01-01

    Modifiable lifestyle factors, such as obesity, lack of physical activity, and smoking, contribute greatly to cancer and chronic disease morbidity and mortality worldwide. This review appraises recent evidence on modifiable lifestyle factors in the prevention of endometrial cancer (EC) and ovarian cancer (OC) as well as new evidence for lifestyle management of EC and OC survivors. For EC, obesity continues to be the strongest risk factor, while new evidence suggests that physical activity, oral contraceptive pills, and bariatric surgery may be protective against EC. Other medications, such as metformin and nonsteroidal anti-inflammatory drugs, may be protective, and interventional research is ongoing. For OC, we find increasing evidence to support the hypothesis that obesity and hormone replacement therapy increase the risk of developing OC. Oral contraceptive pills are protective against OC but are underutilized. Dietary factors such as the Mediterranean diet and alcohol consumption do not seem to affect the risk of either OC or EC. For EC and OC survivors, physical activity and weight loss are associated with improved quality of life. Small interventional trials show promise in increasing physical activity and weight maintenance for EC and OC survivors, although the impact on long-term health, including cancer recurrence and overall mortality, is unknown. Women’s health providers should integrate counseling about these modifiable lifestyle factors into both the discussion of prevention for all women and the management of survivors of gynecologic cancers. PMID:27284267

  3. Framingham Risk Score underestimates cardiovascular disease risk in severe psoriatic patients: implications in cardiovascular risk factors management and primary prevention of cardiovascular disease.

    PubMed

    Torres, Tiago; Sales, Rita; Vasconcelos, Carlos; Martins da Silva, Berta; Selores, Manuela

    2013-11-01

    Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors and premature atherosclerosis, as a consequence of its systemic inflammation. Recently, it has been estimated that severe psoriasis may confer an increased 6.2% on long-term risk of cardiovascular disease based on Framingham Risk Score, which can have practical implications in the treatment of cardiovascular risk factors and primary prevention of cardiovascular disease, as treatment guidelines account for the risk of cardiovascular disease in treatment goals. The aim of this study was to analyze the influence of the attributable risk of severe psoriasis on long-term risk of cardiovascular disease and its implication on the correct treatment of cardiovascular risk factors and primary prevention of cardiovascular disease on a real-world cohort of patients. One hundred severe psoriasis patients without psoriatic arthritis or previous cardiovascular disease were evaluated and it was found that more than half of the patients were reclassified to a higher cardiovascular risk category with important clinical implications on the correct management of their cardiovascular risk factors and primary prevention of cardiovascular disease, as a considerable proportion of patients with hypertension, hypercholesterolemia and coronary heart disease equivalent risk were not being correctly managed.

  4. Prescribe by risk: the utility of a biomarker-based risk calculation in disease management to prevent heart disease.

    PubMed

    Root, Martin; Smith, Timothy

    2005-04-01

    Preventive treatment for those most at risk of heart disease rather than those with the highest blood pressure or cholesterol values may be a more efficacious strategy for disease management. This depends on accurate biomarker-based risk assessment tools. An evidence-based model of heart disease risk was developed using the Framingham model with an additional five risk factors, including three of the newer blood biomarkers. This was applied to the adult population of the 3rd National Health and Nutrition Examination Survey cohort. Additionally, the selection criteria for therapeutic intervention from the Adult Treatment Panel III guidelines (for hyperlipidemia) and the 7th Report of the Joint National Committee (for hypertension) were applied to the same subjects. Of this cohort 54% qualified for at least one of these medications while 18% qualified for both. Using this 18% cutoff, the 18% of the subjects with the highest calculated heart disease risk were also identified using the developed risk model. We applied established therapeutic reductions in heart disease probability to those identified by guidelines and to those identified by risk. Applying both drugs to the high-risk group (one third the size of the guidelines group) achieved the same reduction in population risk (about one fourth) as applying the drugs to the guideline groups and required only half as many prescriptions. Intermediate results were found when an intervention group was identified by a combination of both high risk and high levels of risk factors. In this simulation, identifying patients by heart disease risk level resulted in substantially fewer people being treated with fewer drugs and achieving a similar reduction in disease risk.

  5. Risk Factors and Prevention

    MedlinePlus

    ... Resources Risk Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and ... Blood Pressure , high cholesterol, diabetes, and thyroid disease. Risk Factors For Arrhythmias and Heart Disease The following ...

  6. Pancreatic fistula after pancreatectomy: definitions, risk factors, preventive measures, and management-review.

    PubMed

    Machado, Norman Oneil

    2012-01-01

    Resection of pancreas, in particular pancreaticoduodenectomy, is a complex procedure, commonly performed in appropriately selected patients with benign and malignant disease of the pancreas and periampullary region. Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the "Achilles heel" of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. The morbidity rate after pancreaticoduodenectomy remains high in the range of 30% to 65%, although the mortality has significantly dropped to below 5%. Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur.

  7. [Cardiac and metabolic risk factors in severe mental disorders. Task of a prevention manager].

    PubMed

    Lederbogen, F; Schwarz, P; Häfner, S; Schweiger, U; Bohus, M; Deuschle, M

    2015-07-01

    People with severe mental disorders have a reduction in life expectancy of 13-30 % compared with the general population. This severe disadvantage is primarily due to an increased prevalence of cardiac and metabolic disorders, especially coronary heart disease (CHD) and type 2 diabetes mellitus and are the result of untoward health behavior characterized by smoking, low levels of physical activity and unhealthy dietary habits. Obesity, arterial hypertension and lipid disorders are also associated with this behavior and further increase the risk of CHD and type 2 diabetes. Thus, people with mental disorders constitute a population with a high risk of cardiovascular events. Appropriate measures for prevention and therapy are urgently indicated but rarely applied. This article presents new organizational structures to overcome this deficit with a prevention manager playing a central role in organizing and applying preventive and therapeutic care. Results from cardiology and diabetic medicine have shown the effectiveness of pooling this responsibility. The measure has the potential to reduce the increased mortality of people with severe mental disorders.

  8. Prevention of thyroid associated-ophthalmopathy in children and adults: current views and management of preventable risk factors.

    PubMed

    Krassas, Gerasimos E; Perros, Petros

    2007-03-01

    Primary, secondary and tertiary prevention are defined according to the timing of the preventive intervention in the natural history of a disease. Secondary prevention in Graves' ophthalmopathy (GO) is challenging in the absence of reliable specific serum markers for subclinical GO that would allow an early diagnosis. Some risk factors for occurrence or progression of GO have been identified. Cigarette smoking, thyroid dysfunction and radioactive iodine (RAI) are known preventable risk factors. The list is probably much longer, and future research should be aimed at identifying more. Smoking cessation, restoration of euthyroidism by antithyroid drugs or L-thyroxine, glucocorticoid coverage after RAI or deferring RAI until the eye disease is inactive, may prevent progression of GO. Passive smoking seems to exacerbate autoimmune thyroid disease (AITD) in general, and may have a deleterious effect on childhood GO in particular, therefore avoidance of passive smoking is likely to be beneficial.

  9. 61 FR 31668 - Accidental Release Prevention Requirements: Risk Management Programs Under Clean Air Act Section...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1996-06-20

    ... compliance with the prevention requirements under OSHA's Process Safety Management Standard. Processes that... history of accidental releases and processes already complying with OSHA's Process Safety Management... applies to all processes subject to the OSHA Process Safety Management (PSM) standard (29 CFR...

  10. [Experience with prevention and control of legionellosis in Germany : plea for proactive risk management].

    PubMed

    Exner, M; Pleischl, S; Grummt, H-J; Engelhart, S

    2011-06-01

    Legionellosis is meanwhile the most important specific water-associated infectious disease in developed countries, which is completely preventable, if water distribution systems are correctly planned and operated. This assumes clear criteria for risk regulation and for verification, including microbiological monitoring for Legionella. There are different reactive and proactive strategies in the USA and in Europe. The common premises for prevention and control of legionellosis in Germany, relevant facts for risk regulation, experience in Germany toward proactive risk regulation, and the current approach of the amended drinking water ordinance are discussed. The article concludes with a short discussion of the controversial approaches for the prevention of legionellosis in Germany.

  11. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles

    PubMed Central

    Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred

    2011-01-01

    Abstract Objective To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). Methods CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40–64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. Findings A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100 000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Conclusion Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles. PMID:21479093

  12. Fact Sheet: Clean Air Act Section 112(r): Accidental Release Prevention / Risk Management Plan Rule

    EPA Pesticide Factsheets

    EPA is required to publish regulations and guidance for chemical accident prevention at facilities that pose the greatest risk of harm from accidental releases of regulated flammable and toxic substances above threshold quantities.

  13. Risk management.

    PubMed

    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.

  14. [Hormone replacement therapy in the management of postmenopausal osteoporosis and prevention of fracture risk].

    PubMed

    Ribot, Claude; Trémollières, Florence

    2006-10-01

    The consequences to the bone of estrogen deficiency are early and irreversible. Effective prevention of postmenopausal osteoporosis at the individual level requires early screening of women at risk of fractures and their early treatment. Hormone treatment prevents bone loss and has been proven effective in preventing fractures, even in situations of low risk. The benefit/risk ratio of hormone treatment can be optimized by the choice of the 'right moment' and the 'right treatment'. HRT, administered early and for a limited period, must be integrated into a strategy of long-term osteoporosis prevention that includes using the (drug and nondrug) means most appropriate to the patient's age and clinical condition and choosing the 'right moment' and 'right treatment.'

  15. [Sleep disorders and work: guidelines for health surveillance, risk management and prevention].

    PubMed

    Costa, G; Accattoli, Maria Patrizia; Garbarino, S; Magnavita, N; Roscelli, F

    2013-01-01

    Sleep disorders and related diseases are becoming increasingly relevant for the health and wellbeing of the general and working populations. Sleep disorders affect all aspects of health, showing a bi-directionality with health conditions and comorbidity with several diseases. Consequently, sleep disorders may have severe negative consequences both for the individual and the enterprise, as well as for society on the whole, in terms of health, productivity and social costs. When considering the disturbances of the sleep/wake cycle, it is important to distinguish between those connected with endogenous biological factors from those related to socio-environmental conditions, including work, and those associated with mental and physical diseases, that are often associated and interact with each other. Many sleep disorders are still underestimated and under-valued in clinical practice and, to a much greater extent, in workers' health surveillance. The present paper is aimed at drawing the attention of the occupational health physician to some key issues, particularly regarding excessive daytime sleepiness, obstructive sleep apnea syndrome and shift and night work, as well as their implications in terms of health and occupational consequences. Information on the main aspects of clinical diagnosis and health surveillance, as well as risk management and prevention at the workplace, are provided.

  16. Barriers to cardiovascular risk prevention and management in Germany--an analysis of the EURIKA study.

    PubMed

    Schmieder, Roland E; Goebel, Matthias; Bramlage, Peter

    2012-01-01

    Despite the availability of risk engines to determine cardiovascular risk, risk factor control is suboptimal. Using EURIKA data we compared risk factor control in Germany with that of 11 other European countries (rest of Europe [ROE]) to identify differences and opportunities for improvement. EURIKA was a multinational, cross-sectional study in 12 European countries including Germany from May 2009 to January 2010. Physicians' attitudes to risk factor control based on the 2007 European guidelines on cardiovascular disease (CVD) prevention in a representative cohort of 7641 primary care outpatients aged ≥ 50 years with no CV disease and at least one major CV risk factor were determined. Compared to the ROE, German physicians were more frequently male (72.7% vs 62.6%), had a higher mean age (51.7 ± 8.4 vs 47.0 ± 9.7 years), faced higher patient loads (37.9% vs 16.5% had >199 patients/week), and involved other health sector professionals (dieticians, psychologists) less (31.8% vs 41.0% in the ROE). The European Society of Cardiology (ESC) guidelines on CVD prevention were more important for German physicians (60.6% vs 55.9%), while those who didn't use them gave reasons for nonuse as too many (62.5% vs 46.2%), too confusing, unrealistic, or not applicable to their patients. Risk engines were used less (54.5% vs 70.7%), with perceived lack of time (65.5% vs 60.2%) a frequent reason for nonuse. Risk factor control in German patients was inadequate (control rates: hypertension 36.3%, dyslipidemia 30.4%, type 2 diabetes 40.6%, obesity 28.8%) but largely comparable to other ROE countries; however, physicians tended to overestimate control rates. EURIKA provides comprehensive data on the status of primary prevention of CVD in clinical practice in Germany and reveals considerable potential for improving the primary prevention of CVD.

  17. Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA)

    PubMed Central

    2010-01-01

    Background The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD) across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice. Methods/Design Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers. Discussion Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336.) PMID:20591142

  18. Preventing cardiovascular disease in primary care: role of a national risk factor management program.

    PubMed

    McGrath, Emer R; Glynn, Liam G; Murphy, Andrew W; O Conghaile, Aengus; Canavan, Michelle; Reid, Claire; Moloney, Brian; O'Donnell, Martin J

    2012-04-01

    Heartwatch, a structured risk factor modification program for secondary prevention of cardiovascular (CV) disease (CVD) in primary care, is associated with improvements in CV risk factors in participating patients. However, it is not known whether Heartwatch translates into reductions in clinically important CV events. The aim of the study was to determine the association between participation in Heartwatch and future risk of CV events in patients with CVD. The study consisted of a prospective cohort of 1,609 patients with CVD in primary care practices. Of these, 97.5% had data available on Heartwatch participation status, of whom 15.2% were Heartwatch participants. Cox proportional hazards models were used to determine the association between Heartwatch participation and risk of the CV composite (CV death, nonfatal myocardial infarction, heart failure, and nonfatal stroke). All-cause mortality and CV mortality were secondary outcome measures. During follow-up, the CV composite occurred in 208 patients (13.6%). Of Heartwatch participants, 8.4% experienced the CV composite compared with 14.5% of nonparticipants (P = .003). Participation in Heartwatch was associated with a significantly reduced risk of the CV composite (hazard ratio [HR] 0.52, 95% CI, 0.31-0.87), CV mortality (HR 0.31, 95% CI, 0.11-0.89), and all-cause mortality (HR 0.32, 95% CI, 0.15-0.68). Heartwatch participation was also associated with greater reductions in mean systolic blood pressure (P = .047), mean diastolic blood pressure (P < .001), and greater use of secondary preventative therapies for CVD, such as lipid-lowering agents (P < .001), β-blockers (P < .001), and angiotensin-converting enzyme inhibitors (P < .001). Heartwatch is associated with a reduced risk of major vascular events and improved risk factor modification, supporting its potential as a nationwide program for secondary prevention of CVD. Copyright © 2012 Mosby, Inc. All rights reserved.

  19. Caries diagnosis and risk assessment. A review of preventive strategies and management.

    PubMed

    1995-06-01

    The scientific basis for caries risk assessment, prevention and treatment on an individual patient basis requires further development, specification and continuing validation. Still, current technologies and techniques, taken together, can provide enhanced capabilities over those that have been employed traditionally. Undoubtedly, the clinical tools for carrying out these responsibilities will be refined and expanded in the future in response to the changing clinical profile of caries in the population. For example, bacteriologic testing methods have become easier and more reliable, and will become more widely used. Other effective methods to detect the early, pre-cavitation stage of caries also should become more available in the future. Practitioners will be continually challenged and responsible for evaluating the effectiveness and value of emerging technologies in their practices and in light of their patients' needs. But how can this be accomplished best? Effectiveness claims will be made for new drugs and devices that come onto the market. There are several sources of information to assist the practitioner in making such decisions. The American Dental Association acceptance programs (voluntary) and the U.S. Food and Drug Administration compliance programs (law) provide standards and guidance as to product safety and effectiveness. Without such determinations, the practitioner must judge independently product claims and clinical studies. Marketing materials by themselves (advertisements, videos, pamphlets) may not be sufficient evidence of effectiveness particularly when scientific references supporting claims either are not provided or are inadequate. Peer-reviewed scientific literature in publications of the major scientific and professional associations can be viewed as generally reliable. Changing the way dental caries is managed in clinical practice will require integrating new scientific information and technology into workable clinical procedures

  20. Risky Business: Risk Management, Loss Prevention and Insurance Procurement for Colleges and Universities. NACUA Publication Series.

    ERIC Educational Resources Information Center

    Bennett, Barbara

    No matter what type of insurance or how much actual coverage an individual college or university obtains, it will always pay for its own losses one way or another. This pamphlet is intended to assist colleges and universities to meet that challenge by providing administrators with a structure for analyzing and managing risks and determining the…

  1. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    ERIC Educational Resources Information Center

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  2. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    ERIC Educational Resources Information Center

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  3. The Green, Amber, Red Delineation of Risk and Need (GARDIAN) management system: a pragmatic approach to optimizing heart health from primary prevention to chronic disease management.

    PubMed

    Carrington, Melinda J; Kok, Simone; Jansen, Kiki; Stewart, Simon

    2013-08-01

    A sustained epidemic of cardiovascular disease and related risk factors is a global phenomenon contributing significantly to premature deaths and costly morbidity. Preventative strategies across the full continuum of life, from a population to individual perspective, are not optimally applied. This paper describes a simple and adaptable 'traffic-light' system we have developed to systematically perform individual risk and need delineation in order to 'titrate' the intensity and frequency of healthcare intervention in a cost-effective manner. The GARDIAN (Green Amber Red Delineation of Risk and Need) system is an individual assessment of risk and need that modulates the frequency and intensity of future healthcare intervention. Individual assessment of risk and need for ongoing intervention and support is determined with reference to three domains: (1) clinical stability, (2) gold-standard management, and (3) a broader, holistic assessment of individual circumstance. This can be applied from a primary prevention, secondary prevention, or chronic disease management perspective. Our experience with applying and validating GARDIAN to titrate healthcare resources according to need has been extensive to date, with >5000 individuals profiled in a host of clinical settings. A series of clinical randomized trials will determine the impact of the GARDIAN system on important indices of healthcare utilization and health status. The GARDIAN model to delineating risk and need for varied intensity of management shows strong potential to cost effectively improve health outcomes for both individuals at risk of heart disease and those with established heart disease.

  4. Risk Management.

    ERIC Educational Resources Information Center

    Rakich, Ronald

    1982-01-01

    Beginning on the front page, this article explains ways of establishing a sound risk management insurance program that can improve a school district's financial position. Organizations that can help are listed. Available from the American Association of School Administrators, 1801 North Moore Street, Arlington, VA 22209. (MLF)

  5. [Delivery management for the prevention of shoulder dystocia in case of identified risk factors].

    PubMed

    Schmitz, T

    2015-12-01

    To determine the impact of (i) computed tomographic (CT) pelvimetry for the choice of the mode of delivery, (ii) cesarean, (iii) induction of labor, and of (iv) various delivery managements on the risk of shoulder dystocia in case of fetal macrosomia, with or without maternal diabetes, and in women with previous history of shoulder dystocia. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In case of clinically suspected macrosomia, a sonography should be performed to increase diagnostic performances and to assist in decision-making (Professional consensus). Because CT pelvimetry is associated with high false positive rates and increases cesarean deliveries, its use is not recommended to prevent shoulder dystocia in case of fetal macrosomia (Professional consensus). To avoid the neonatal complications of shoulder dystocia, mainly permanent brachial plexus palsy, cesarean delivery is recommended in case of estimated fetal weight (EFW) greater than 4500 g if associated with maternal diabetes (grade C), and greater than 5000 g in the absence of maternal diabetes (grade C). The published data do not provide definitive evidences to recommend systematic labor induction in case of impending fetal macrosomia (Professional consensus). In case of favourable cervix and gestational age greater than 39 weeks of gestation, labor induction should be promoted (Professional consensus). Prophylactic McRoberts maneuver is not recommended to prevent shoulder dystocia in case of fetal macrosomia (grade C). Because data are lacking, no recommendation is possible regarding the use of episiotomy. In case of fetal macrosomia and failure to progress in the second stage of labor, midpelvic and higher instrumental deliveries are not recommended and a cesarean delivery should be preferred (grade C), if the fetal head is at or lower than a +2 station, cesarean delivery is not recommended and an

  6. [Efforts to prevent adverse events in the United States--health care risk management and a fresh perspective on adverse events prevention].

    PubMed

    Ayuzawa, J

    2001-03-01

    Not causing adverse events is never-ceasing issue in the health care field. However, the advances and greater specialization of medical technologies and the increasing number of elderly people, are all factors in the occurrence of adverse events. At the same time, greater efficiency is now demanded in the health care field, and the problem of preventing adverse events has become tougher than ever before. Given the situation, a fresh perspective on attempts to prevent adverse events may be important. One hint for such a new perspective is the health care risk management that is widely practiced in the health care field in the United States. This was introduced in the mid-1970s to counter the disputes and lawsuits at the time, but over the years the focus has shifted to the importance of prevention, and is now recognized as a means to work toward the assurance of quality of health care. Hints are also found in the suggestions related to adverse events prevention. In "To Err Is Human," published in November 1999 in the United States, includes proposals to "respect human limits in process design" and "promote effective team functioning," which are just the approaches we should adopt for a new perspective. I would also like to draw attention to the idea that there should be investigations into "developing effective mechanisms for identifying and dealing with unsafe practitioners" and the importance of "protecting voluntary reporting systems" that is mentioned. Adopting American methods unchanged to the health care system in Japan may not be appropriate, but the way of thinking and know-how from health care risk management, as well as the suggestions for adverse events prevention will provide us new perspectives on adverse events prevention, from which we should work toward a system of more efficient, and high-quality adverse events prevention.

  7. A novel community-based model to enhance health promotion, risk factor management and chronic disease prevention.

    PubMed

    Carson, Shannon Ryan; Carr, Caroline; Kohler, Graeme; Edwards, Lynn; Gibson, Rick; Sampalli, Tara

    2014-01-01

    Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence suggests that impacting modifiable behaviours and risk management factors in the areas of physical inactivity, unhealthy diet, stress and obesity can alleviate the burden of chronic disease problem to a large extent. Despite this recognition, the challenge is embedding these recognized priorities into the community and in primary care in a sustainable and meaningful manner. Primary Health Care in Capital Health responded to this challenge by developing and implementing a free, interprofessional and community-based service, namely, the Community Health Teams (CHTs), that offers health and wellness, risk factor management, wellness navigation and behaviour-based programming. In this paper, the development and implementation of the CHTs are discussed. Preliminary outcomes for the model are significant and promising. Formal and large-scale studies are planned to validate these outcomes with additional research rigour. Copyright © 2014 Longwoods Publishing.

  8. Management of women at high risk of hereditary breast cancer in the Veneto Regional Program for Prevention.

    PubMed

    Del Sole, Annamaria; Cinquetti, Sandro; Fedato, Chiara; Montagna, Marco; Russo, Francesca; Sbrogiò, Luca Gino; Zorzi, Manuel

    2015-01-01

    Today it is well-known that high risk of genetic breast cancer concerns a very limited part of the population: no more than 2-3 women are affected every thousand and this condition as a whole accounts for no more than 3%-5% of all breast cancers. Following the directions contained in the 2014-2018 National Prevention Plan, Veneto's 2014-2018 Regional Program of Prevention (PRP), approved by Regional Council Resolution (DGR) No. 749 of 14.5.2015, consolidation of a pathway of diagnosis, observation, and prophylaxis for women at high risk of hereditary breast carcinoma is thus proposed. The principal activities of this policy will be the following: creation of a regional working group, survey of currently existing pathways for the identification of women at risk of hereditary breast cancer and adoption of the same, approval and consolidation of a structured regional pathway for women at high risk of hereditary breast and/or ovarian cancer, from paths of oncogenetic consultation and genetic testing to management of disease risk. Subsequent to the recognition of the pathway of diagnosis, observation, and prophylaxis for women at high risk of hereditary breast carcinoma, the Veneto region undertakes to develop a co-ordinated program of information and training on this pathway directed at the population and healthcare workers. It is firmly hoped that with the inclusion of a program for the management of women at high risk of hereditary breast cancer within the Veneto PRP this topic may become more defined and structured in terms of sustainability, integration with the existing regional networks (mammography network, Breast Unit), contrasting inequality, monitoring and evaluation, in this way pursuing the objectives of a reduction of cause-specific mortality and improvement of quality of life.

  9. Osteoporosis Prevention and Management.

    PubMed

    Pai, Muralidhar V

    2017-08-01

    Osteoporosis, defined by BMD at the hip or lumbar spine that is less than or equal to 2.5 standard deviations below the mean BMD of a young-adult reference population, is the most common bone disease in humans affecting both sexes and all races. It's a silent killer affecting the quality of life due to fractures and postural changes. In osteoporosis there is an imbalance between bone formation and bone resorption in favor of latter. Preventive measures and treatments are available to combat this evil. Counseling is the integral part of prevention as well as treatment of osteoporosis. Preventive strategy includes life style changes, exercise, intake of calcium and vitamin D, avoiding alcohol, smoking and excessive intake of salt. Estrogen therapy/estrogen+progesterone therapy (ET/EPT) is no longer recommended as a first-line therapy for the prevention of osteoporosis. They may be used in the therapy for osteoporosis in women under 60. Diagnosis and classification are made by assessment of BMD using DEXA or ultrasound and laboratory investigations. Management includes estimation of 10-year fracture risk using FRAX, life style and diet modification and pharmacological therapy. The drugs used in osteoporosis may be those that inhibit bone resorption-bisphosphonates, denosumab, calcitonin, SERMs, estrogen and progesterone-or that stimulate bone formation-PTH, Teriparatide. Combination therapies are not recommended as they do not have proven additional BMD/fracture benefits. No therapy should be indefinite in duration. There are no uniform recommendations to all patients. Duration decisions need to be individualized. While on treatment monitoring should be done with BMD assessment by DEXA/ultrasound and bone turnover markers.

  10. A Primer for School Risk Management: Creating and Maintaining District and Site-Based Liability Prevention Programs.

    ERIC Educational Resources Information Center

    Dunklee, Dennis R.; Shoop, Robert J.

    This book offers guidelines for school district authorities in establishing or expanding the role of districtwide risk management and gives direction for the development of individual school-based risk-management programs. Part 1 relates fundamental constructs of risk management to school site-level and district-level management. Chapters address…

  11. A Primer for School Risk Management: Creating and Maintaining District and Site-Based Liability Prevention Programs.

    ERIC Educational Resources Information Center

    Dunklee, Dennis R.; Shoop, Robert J.

    This book offers guidelines for school district authorities in establishing or expanding the role of districtwide risk management and gives direction for the development of individual school-based risk-management programs. Part 1 relates fundamental constructs of risk management to school site-level and district-level management. Chapters address…

  12. Risk management in primary apicultural production. Part 1: bee health and disease prevention and associated best practices.

    PubMed

    Formato, Giovanni; Smulders, Frans J M

    2011-03-01

    Prompted by FAO/WHO's and the European Commission's recognition that documents on Good Farming Practices (GFPs) and Good Veterinary Practices (GVPs) in apicultural production are hardly available, part 1 of this contribution provides an update of current apicultural production and associated best practices to ensure animal and public health. Major bee health and disease prevention issues and risk management options at the primary production level are summarised with particular reference to the role of the veterinary practitioner/consultant and the official veterinarian in a control function in the safe production of honey.

  13. How risk management can prevent future wildfire disasters in the wildland-urban interface

    PubMed Central

    Calkin, David E.; Cohen, Jack D.; Finney, Mark A.; Thompson, Matthew P.

    2014-01-01

    Recent fire seasons in the western United States are some of the most damaging and costly on record. Wildfires in the wildland-urban interface on the Colorado Front Range, resulting in thousands of homes burned and civilian fatalities, although devastating, are not without historical reference. These fires are consistent with the characteristics of large, damaging, interface fires that threaten communities across much of the western United States. Wildfires are inevitable, but the destruction of homes, ecosystems, and lives is not. We propose the principles of risk analysis to provide land management agencies, first responders, and affected communities who face the inevitability of wildfires the ability to reduce the potential for loss. Overcoming perceptions of wildland-urban interface fire disasters as a wildfire control problem rather than a home ignition problem, determined by home ignition conditions, will reduce home loss. PMID:24344292

  14. How risk management can prevent future wildfire disasters in the wildland-urban interface.

    PubMed

    Calkin, David E; Cohen, Jack D; Finney, Mark A; Thompson, Matthew P

    2014-01-14

    Recent fire seasons in the western United States are some of the most damaging and costly on record. Wildfires in the wildland-urban interface on the Colorado Front Range, resulting in thousands of homes burned and civilian fatalities, although devastating, are not without historical reference. These fires are consistent with the characteristics of large, damaging, interface fires that threaten communities across much of the western United States. Wildfires are inevitable, but the destruction of homes, ecosystems, and lives is not. We propose the principles of risk analysis to provide land management agencies, first responders, and affected communities who face the inevitability of wildfires the ability to reduce the potential for loss. Overcoming perceptions of wildland-urban interface fire disasters as a wildfire control problem rather than a home ignition problem, determined by home ignition conditions, will reduce home loss.

  15. Risk factors, management and primary prevention of thrombotic complications related to the use of central venous catheters.

    PubMed

    Linnemann, Birgit; Lindhoff-Last, Edelgard

    2012-09-01

    An adequate vascular access is of importance for the treatment of patients with cancer and complex illnesses in the intensive, perioperative or palliative care setting. Deep vein thrombosis and thrombotic occlusion are the most common complications attributed to central venous catheters in short-term and, especially, in long-term use. In this review we will focus on the risk factors, management and prevention strategies of catheter-related thrombosis and occlusion. Due to the lack of randomised controlled trials, there is still controversy about the optimal treatment of catheter-related thrombotic complications, and therapy has been widely adopted using the evidence concerning lower extremity deep vein thrombosis. Given the increasing use of central venous catheters in patients that require long-term intravenous therapy, the problem of upper extremity deep venous thrombosis can be expected to increase in the future. We provide data for establishing a more uniform strategy for preventing, diagnosing and treating catheter-related thrombotic complications.

  16. [Dementia: management and prevention].

    PubMed

    Daher, Oscar; Nguyen, Sylvain; Smith, Cindi; Büla, Christophe; Démonet, Jean-François

    2016-04-20

    Dementia represents a great challenge for health care providers. Detection of cognitive impairment is critical for early diagnosis of dementia. Early diagnosis allows to initiate individualized management that focuses on maintaining patient's autonomy and supporting their caregivers. Proposed multimodal interventions include physical activity, cognitive training, mediterranean diet, and management of cardiovascular risk factors. Before the initiation of pro-cognitive therapy, medication review is essential to evaluate current treament and determine specific therapeutic objectives, based on patient's overall health and preferences. Overall risk reduction for dementia revolves around similar measures that target physical activity, cognition, diet and management of cardiovascular risk factors.

  17. Risk Management: A Leader's Responsibility.

    ERIC Educational Resources Information Center

    Rowe, Roger E.

    1997-01-01

    Discusses what facilities management leaders can do to ensure the safety of students and employees. Focuses on six specific tasks, such as detecting hazards and assessing the risks, and offers three rules underlying the application of risk management, including do not accept unnecessary risk. Provides an outline of prevention responsibilities.…

  18. A novel approach to cardiovascular health by optimizing risk management (ANCHOR): a primary prevention initiative examining the impact of health risk factor assessment and management on cardiac wellness.

    PubMed

    Cox, Jafna L; Carr, Brendan; Vallis, T Michael; Szpilfogel, Claudine; O'Neill, Blair J

    2011-01-01

    Cardiovascular disease (CVD) represents an increasing burden to health care systems. Modifiable risk factors figure prominently in the population-attributable risk for premature coronary artery disease. Primary care is well placed to facilitate CVD risk improvement. We plan to evaluate the ability of a novel primary care intervention providing systematic risk factor screening, risk-weighted behavioural counselling and pharmacological intervention to achieve 2 objectives: (1) optimized management of global CVD risk of patients and (2) increased patient adherence to lifestyle and pharmaceutical interventions aimed at decreasing global CVD risk. A pre-post longitudinal prospective design with a nonrandomized comparison group is being undertaken in 2 geographically diverse primary care practices in Nova Scotia with differing reimbursement models. Participants will complete a readiness to change and pre-post health risk assessment (HRA), that will trigger a 1-year intervention individualized around risk and readiness. The primary outcome will be the proportion of participants with Framingham moderate and high-risk strata that reduce their absolute risk by 10% and 25%, respectively. The secondary outcome will be the proportion of moderate and high-risk participants who reduce their risk category. The impact of the intervention on clinical and behavioural variables will also be examined. Low risk participants will be separately analyzed. Data from participants unable to change from the high risk category because of diabetes mellitus or established atherosclerotic disease will also be analyzed separately, with changes in clinical measures from baseline being assessed. A health economic analysis is planned. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  19. 79 FR 44603 - Accidental Release Prevention Requirements: Risk Management Programs Under the Clean Air Act...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2014-07-31

    ... specific regulatory elements and process safety management approaches, the public and environmental health... RFI designed to identify issues related to modernization of the Process Safety Management (PSM... Process Safety Management Standard (PSM) and determine if the RMP or PSM can and should be expanded...

  20. 82 FR 4594 - Accidental Release Prevention Requirements: Risk Management Programs Under the Clean Air Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2017-01-13

    ... to improve chemical process safety, assist local emergency authorities in planning for and responding... environment from chemical hazards through advancement of process safety management based on lessons learned. 2... CFR 1910.119 Process Safety Management (PSM) standard were authorized in the CAA Amendments of...

  1. NASA's Risk Management System

    NASA Technical Reports Server (NTRS)

    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.

  2. Evaluation of in-hospital management of fracture risk in older patients: a chart review study of tertiary prevention.

    PubMed

    Byszewski, Anna M; Cranney, Ann; Man-Son-Hing, Malcolm; Azad, Nahid; Amos, Stephanie

    2006-01-01

    Hip fractures are associated with considerable morbidity and mortality in the elderly. Both fall prevention strategies and bone integrity/osteoporosis assessment should be addressed in this population. This study's goal was to evaluate the management of potential re-fracture risk after a hip fracture in an acute care setting. This was a retrospective chart review of patients who were admitted with a hip fracture over the course of one year to the Ottawa Hospital, Civic Campus, Ottawa, Canada. The charts of 147 patients with hip fractures met the inclusion criteria. Use of sedatives on admission was significant (24.5%). Fifty (34%) had some form of osteoporosis management ordered during their hospital stay. The medication recommendations consisted of only 14% being prescribed Vitamin D and 15.6% being prescribed calcium supplementation. Merely 7 (4.8%) patients of the total sample were prescribed bisphosphonates at time of discharge. This study documents a significant care gap in re-fracture management at the time of acute hospitalization after an acute hip fracture. Interventions are required to increase the awareness that this problem is not being addressed at the time of hospitalization and that on discharge, patients will need follow-up by the treating community physician.

  3. The value of prevention: managing the risks associated with targeted violence and active shooters.

    PubMed

    Doherty, Matthew

    2016-01-01

    Every time we turn on the news, or open our Internet browsers, a story about an active shooter--at a school, house of worship, public place and even in our workplace--spills onto the page, the author reports. In this article he focuses on how we can prevent these incidents from occurring. What exactly is "targeted violence"--and why is what experts call "behavioral threat assessment" one of the single most effective ways to prevent the next active shooter incident in any organization?

  4. Model for integrated management of quality, labor risks prevention, environment and ethical aspects, applied to R&D&I and production processes in an organization

    NASA Astrophysics Data System (ADS)

    González, M. R.; Torres, F.; Yoldi, V.; Arcega, F.; Plaza, I.

    2012-04-01

    It is proposed an integrated management model for an organization. This model is based on the continuous improvement Plan-Do-Check-Act cycle and it intends to integrate the environmental, risk prevention and ethical aspects as well as research, development and innovation projects management in the general quality management structure proposed by ISO 9001:2008. It aims to fulfill the standards ISO 9001, ISO 14001, OSHAS 18001, SGE 21 y 166002.

  5. Risk management in surgery

    PubMed Central

    MESSANO, G.A.; SPAZIANI, E.; TURCHETTA, F.; CECI, F.; CORELLI, S.; CASCIARO, G.; MARTELLUCCI, A.; COSTANTINO, A.; NAPOLEONI, A.; CIPRIANI, B.; NICODEMI, S.; DI GRAZIA, C.; MOSILLO, R.; AVALLONE, M.; ORSINI, S.; TUDISCO, A.; AIUTI, F.; STAGNITTI, F.

    2013-01-01

    Summary Malpractice is the responsible for the greatest number of legal claims. At the present time, legal actions against physicians in Italy are 15,000 per year, and a stunning increase about costs to refund patients injured by therapeutic and diagnostic errors is expected. The method for the medical prevention is “Risk Management”, that is the setting-up of organizational instruments, methods and actions that enable the measurement or estimation of medical risk; it allows to develop strategies to govern and reduce medical error. In the present work, the reconstruction about the history of risk management in Italy was carried out. After then the latest initiatives undertaken by Italy about the issue of risk management were examined. PMID:24091181

  6. 81 FR 13637 - Accidental Release Prevention Requirements: Risk Management Programs Under the Clean Air Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2016-03-14

    ... to improve chemical process safety, assist local emergency authorities in planning for and responding... Chemical Process Safety CEM European Committee for Standardization CFATS Chemical Facility Anti-Terrorism... MKOPSC Mary Kay O'Connor Process Safety Center MOC management of change NACD National Association...

  7. NASA's Risk Management System

    NASA Technical Reports Server (NTRS)

    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.

  8. The incidental pulmonary nodule in a child. Part 2: Commentary and suggestions for clinical management, risk communication and prevention.

    PubMed

    Westra, Sjirk J; Thacker, Paul G; Podberesky, Daniel J; Lee, Edward Y; Iyer, Ramesh S; Hegde, Shilpa V; Guillerman, R Paul; Mahani, Maryam Ghadimi

    2015-04-01

    The incidental detection of small lung nodules in children is a vexing consequence of an increased reliance on CT. We present an algorithm for the management of lung nodules detected on CT in children, based on the presence or absence of symptoms, the presence or absence of elements in the clinical history that might explain these nodules, and the imaging characteristics of the nodules (such as attenuation measurements within the nodule). We provide suggestions on how to perform a thoughtfully directed and focused search for clinically occult extrathoracic disease processes (including malignant disease) that may present as an incidentally detected lung nodule on CT. This algorithm emphasizes that because of the lack of definitive information on the natural history of small solid nodules that are truly detected incidentally, their clinical management is highly dependent on the caregivers' individual risk tolerance. In addition, we present strategies to reduce the prevalence of these incidental findings, by preventing unnecessary chest CT scans or inadvertent inclusion of portions of the lungs in scans of adjacent body parts. Application of these guidelines provides pediatric radiologists with an important opportunity to practice patient-centered and evidence-based medicine.

  9. Managing Risks

    ERIC Educational Resources Information Center

    Osborn, John E.

    2006-01-01

    Colleges and universities face a wide range of environmental risk. In spite of this, with proper planning, they can avoid emergencies or surprises. Advanced planning, coupled with strategic, technical environmental and legal advice, enable higher-education institutions to keep their environmental budgets under control and predictable. This article…

  10. Managing Risks

    ERIC Educational Resources Information Center

    Osborn, John E.

    2006-01-01

    Colleges and universities face a wide range of environmental risk. In spite of this, with proper planning, they can avoid emergencies or surprises. Advanced planning, coupled with strategic, technical environmental and legal advice, enable higher-education institutions to keep their environmental budgets under control and predictable. This article…

  11. Risk Management for Schools.

    ERIC Educational Resources Information Center

    National Association of Independent Schools, Boston, MA.

    This manual focuses on the promotion of good risk management practices. The first of four sections presents an overview of risk management in terms of risk management concepts and avoiding, transferring, controlling, and financing risk. Second, the manual present methods for identifying and assessing risk. The third section discusses different…

  12. Risk Management for Schools.

    ERIC Educational Resources Information Center

    National Association of Independent Schools, Boston, MA.

    This manual focuses on the promotion of good risk management practices. The first of four sections presents an overview of risk management in terms of risk management concepts and avoiding, transferring, controlling, and financing risk. Second, the manual present methods for identifying and assessing risk. The third section discusses different…

  13. Project Risk Management

    NASA Technical Reports Server (NTRS)

    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.

  14. Project Risk Management

    NASA Technical Reports Server (NTRS)

    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.

  15. Conflicts and dilemmas in prevention of cardiovascular disease. The new, Norwegian guidelines--a new approach to risk management.

    PubMed

    Gjelsvik, Bjørn

    2012-03-01

    Prevention of cardiovascular disease (CVD) has been debated for many years, between an organ-specialist perspective versus a public health view. As an illustration, the Wonca Europe Council decided in 2004 to withdraw its support to the 2003 European Guidelines. This paper discusses the main sources of disagreement, most important the levels of risk when treatment should be offered. The Norwegian Guideline for primary prevention of CVD (2009) introduced a new principle of age-differentiated risk levels. Pharmacological treatment should be offered to all persons aged 40-49 years with 10-year mortality risk ≥ 1%, all persons aged 50-59 years at ≥ 5% risk, and all persons aged 60-69 years at ≥ 10% risk. Lower thresholds for younger persons are based on the fact that life years lost, will be considerable if drugs are prescribed only for risk levels above 5%. For persons aged 60-69 years, age is the dominant risk factor and the benefits of treatment are smaller. The implications of the recommendation are discussed, both at an individual and a societal level. Compared to the European 2007 guidelines, the total sum of life years gained is about the same, but the number of patients treated is considerably lower.

  16. Risk Management in EVA

    NASA Technical Reports Server (NTRS)

    Hall, Jonathan; Lutomski, M.

    2006-01-01

    This viewgraph presentation reviews the use of risk management in Extravehicular Activities (EVA). The contents include: 1) EVA Office at NASA - JSC; 2) EVA Project Risk Management: Why and When; 3) EVA Office Risk Management: How; 4) Criteria for Closing a Risk; 5) Criteria for Accepting a Risk; 6) ISS IRMA Reference Card Data Entry Requirement s; 7) XA/ EVA Office Risk Activity Summary; 8) EVA Significant Change Summary; 9) Integrated Risk Management Application (XA) Matrix, March 31, 2004; 10) ISS Watch Item: 50XX Summary Report; and 11) EVA Project RM Usefulness

  17. Managing Corporate Risk through Better Knowledge Management

    ERIC Educational Resources Information Center

    Neef, Dale

    2005-01-01

    Purpose: To explain how progressive companies are using a combination of knowledge and risk management (KRM) systems and techniques in order to help them to prevent, or respond most effectively to, ethical or reputation-damaging incidents. Design/methodology/approach: The paper explains KRM, develops a corporate integrity framework, and then…

  18. Managing Corporate Risk through Better Knowledge Management

    ERIC Educational Resources Information Center

    Neef, Dale

    2005-01-01

    Purpose: To explain how progressive companies are using a combination of knowledge and risk management (KRM) systems and techniques in order to help them to prevent, or respond most effectively to, ethical or reputation-damaging incidents. Design/methodology/approach: The paper explains KRM, develops a corporate integrity framework, and then…

  19. A review of multidisciplinary clinical practice guidelines in suicide prevention: toward an emerging standard in suicide risk assessment and management, training and practice.

    PubMed

    Bernert, Rebecca A; Hom, Melanie A; Roberts, Laura Weiss

    2014-10-01

    The current paper aims to: (1) examine clinical practice guidelines in suicide prevention across fields, organizations, and clinical specialties and (2) inform emerging standards in clinical practice, research, and training. The authors conducted a systematic literature review to identify clinical practice guidelines and resource documents in suicide prevention and risk management. The authors used PubMed, Google Scholar, and Google Search, and keywords included: clinical practice guideline, practice guideline, practice parameters, suicide, suicidality, suicidal behaviors, assessment, and management. To assess for commonalities, the authors reviewed guidelines and resource documents across 13 key content categories and assessed whether each document suggested validated assessment measures. The search generated 101 source documents, which included N = 10 clinical practice guidelines and N = 12 additional resource documents (e.g., non-formalized guidelines, tool-kits). All guidelines (100 %) provided detailed recommendations for the use of evidence-based risk factors and protective factors, 80 % provided brief (but not detailed) recommendations for the assessment of suicidal intent, and 70 % recommended risk management strategies. By comparison, only 30 % discussed standardization of risk-level categorizations and other content areas considered central to best practices in suicide prevention (e.g., restricting access to means, ethical considerations, confidentiality/legal issues, training, and postvention practices). Resource documents were largely consistent with these findings. Current guidelines address similar aspects of suicide risk assessment and management, but significant discrepancies exist. A lack of consensus was evident in recommendations across core competencies, which may be improved by increased standardization in practice and training. Additional resources appear useful for supplemental use.

  20. Evaluation of equine breeding farm management and preventative health practices as risk factors for development of Rhodococcus equi pneumonia in foals.

    PubMed

    Chaffin, M Keith; Cohen, Noah D; Martens, Ronald J

    2003-02-15

    To determine whether foal management practices, environmental management, and preventative health practices are risk factors for development of Rhodococcus equi pneumonia in foals. Prospective matched case-control study. 2,764 foals on 64 equine breeding farms with 9,991 horses. During 1997, participating veterinarians completed paired data collection forms for comparison; 1 for an affected farm (containing > or = 1 foal with pneumonia caused by R equi) and 1 for a control farm. Information collected pertained to stabling facilities, environmental management, foal husbandry, and preventative equine health practices. Matched farm data compared by use of conditional logistic regression indicated that personnel on affected farms were more likely to attend foal births, test foals for adequacy of passive immunity, administer plasma or other treatments to foals to supplement serum immunoglobulin concentrations, administer hyperimmune plasma prophylactically to foals, vaccinate mares and foals against Streptococcus equi infection, and use multiple anthelmintics in deworming programs. Affected farms were also more likely to have foals that developed other respiratory tract disorders and were approximately 4 times as likely to have dirt floors in stalls used for housing foals as were control farms. Rhodococcus equi pneumonia does not appear to be associated with poor farm management or a lack of attention to preventative health practices. Housing foals in stalls with dirt floors may increase the risk for development of R equi pneumonia.

  1. [Global risk management].

    PubMed

    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.

  2. Travellers and influenza: risks and prevention

    PubMed Central

    van Genderen, P.; Ward, B. J.; Wilder-Smith, A.; Steffen, R.; Osterhaus, A. D. M. E.

    2017-01-01

    Background: Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. Methods: We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Results: Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Conclusions: Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some

  3. Managing risks and hazardous in industrial operations

    SciTech Connect

    Almaula, S.C.

    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.

  4. Preventive Classroom Management.

    ERIC Educational Resources Information Center

    Evertson, Carolyn M.; Emmer, Edmund T.

    This chapter of "Helping Teachers Manage Classrooms" presents strategies and processes that teachers can use to establish well-managed classrooms. These recommendations are based on the results of year-long descriptive studies of the management methods used by third grade teachers and by seventh and eighth grade English and mathematics teachers.…

  5. Risk Management Implementation Tool

    NASA Technical Reports Server (NTRS)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

  6. Risk Management Implementation Tool

    NASA Technical Reports Server (NTRS)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

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

    PubMed Central

    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

  8. [Introduction of operating room checklists as a part of clinical risk management: are there hard facts on complication prevention available?].

    PubMed

    Busemann, A; Schreiber, A; Heidecke, C-D

    2012-11-01

    For approximately the past 10 years the aspects of quality and risk management have spread widely not only into the realm of hospitals but also into overall general medicine, which is viewed by many physicians as a paradigmatic change. The required use of the WHO operating room (OR) checklist has in the meantime become routine procedure in many hospitals but with varying degrees of acceptance. Current data reaffirm the positive effect of the checklist in lowering complication and mortality rates. This effect can be directly traced to a higher level for safety culture in the OR.

  9. [Introduction of operating room checklists as a part of clinical risk management : are there hard facts on complication prevention available?].

    PubMed

    Busemann, A; Schreiber, A; Heidecke, C-D

    2012-07-01

    For approximately the past 10 years the aspects of quality and risk management have spread widely not only into the realm of hospitals but also into overall general medicine, which is viewed by many physicians as a paradigmatic change. The required use of the WHO operating room (OR) checklist has in the meantime become routine procedure in many hospitals but with varying degrees of acceptance. Current data reaffirm the positive effect of the checklist in lowering complication and mortality rates. This effect can be directly traced to a higher level for safety culture in the OR.

  10. Chorioamnionitis: prevention and management.

    PubMed

    Hastings-Tolsma, Marie; Bernard, Rachel; Brody, Mollie Gilbert; Hensley, Jennifer; Koschoreck, Kate; Patterson, Elisa

    2013-01-01

    Chorioamnionitis most often occurs during labor, affecting as many as 10% of laboring women. When intrapartum chorioamnionitis occurs, women are at peripartal risk for endometritis, cesarean birth, and postpartum hemorrhage; and the neonate is at significant risk for sepsis, pneumonia, respiratory distress, and death. The impact is greater for preterm infants where the incidence of chorioamnionitis is nearly 30%. When chorioamnionitis is believed to be present, antibiotics are administered, but not without potential adverse consequence to the mother/fetus, as well as significantly increased healthcare cost. A number of factors increase the risk of chorioamnionitis, including use of intrauterine pressure catheters and fetal scalp electrodes, urogenital tract infections, prolonged rupture of membranes, digital vaginal examinations, and the nature of perineal hygiene. This article presents key intrapartum factors and those nursing actions that can help to reduce rates of chorioamnionitis and improve perinatal outcomes.

  11. Perspectives: Intellectual Risk Management

    ERIC Educational Resources Information Center

    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…

  12. Perspectives: Intellectual Risk Management

    ERIC Educational Resources Information Center

    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…

  13. Obstetrics Hospitalists: Risk Management Implications.

    PubMed

    Veltman, Larry

    2015-09-01

    The concept of having an in-house obstetrician (serving as an obstetrics [OB] hospitalist) available 24 hours a day, 7 days a week provides a safety net for OB events that many need immediate intervention for a successful outcome. A key precept of risk management, that of loss prevention, fits perfectly with the addition of an OB hospitalist role in the perinatal department. Inherent in the role of OB hospitalists are the patient safety and risk management principles of improved communication, enhanced readiness, and immediate availability. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Contrast-Induced Nephropathy: Identifying the Risks, Choosing the Right Agent, and Reviewing Effective Prevention and Management Methods.

    PubMed

    Nicola, Refky; Shaqdan, Khalid W; Aran, Khalid; Mansouri, Mohammad; Singh, Ajay; Abujudeh, Hani H

    2015-01-01

    With the rise in the use of intravenous iodinated contrast media for both computed tomography scan and angiographic studies, there is a greater likelihood of complications. One of the most well-known adverse effects is contrast-induced media nephropathy, which is also called contrast-induced acute kidney injury. This is third most common cause of hospital acquired acute renal failure. It is associated with an increase in morbidity, mortality, and greater financial burden on healthcare system. Because of these factors, it is important for the radiologist to not only recognize risk factors, as well as the signs and symptoms, but also to know how to manage patients appropriately. Copyright © 2015 Mosby, Inc. All rights reserved.

  15. Risk minimization practices for pregnancy prevention: understanding risk, selecting tools.

    PubMed

    Uhl, Kathleen; Trontell, Anne; Kennedy, Dianne

    2007-03-01

    According to the March of Dimes, approximately 4% (1/28) of babies are born in the US each year with a birth defect. For the majority of birth defects the etiology is unknown, although chemicals, including drug exposures, probably account for less than 1% of all birth defects. The identification of potential human teratogenicity during drug development is important because drug-induced adverse fetal effects are potentially preventable with the application of risk assessment strategies and risk minimization tools and programs to minimize risk of pregnancy exposure while preserving access to drug benefits; risk assessment and risk minimization together comprise risk management. It is important that risk minimization programs intended to limit fetal exposure use a consistent approach and are tailored to the product-specific risk concerns in order to optimize the benefit-risk balance for a particular drug. This paper highlights general considerations in developing specific risk minimization programs to prevent fetal drug exposure including the relative advantages and disadvantages of each strategy.

  16. ASPIRE-2-PREVENT: a survey of lifestyle, risk factor management and cardioprotective medication in patients with coronary heart disease and people at high risk of developing cardiovascular disease in the UK.

    PubMed

    Kotseva, Kornelia; Jennings, Catriona S; Turner, Elizabeth L; Mead, Alison; Connolly, Susan; Jones, Jennifer; Bowker, Timothy J; Wood, David A

    2012-06-01

    To determine in patients with coronary heart disease (CHD) and people at high risk of developing cardiovascular disease (CVD) whether the Joint British Societies' guidelines on CVD prevention (JBS2) are followed in everyday clinical practice. A cross-sectional survey was undertaken of medical records and patient interviews and examinations at least 6 months after the recruiting event or diagnosis using standardised instruments and a central laboratory for measurement of lipids and glucose. The ASPIRE-2-PREVENT survey was undertaken in 19 randomly selected hospitals and 19 randomly selected general practices in 12 geographical regions in England, Northern Ireland, Wales and Scotland. In hospitals, 1474 consecutive patients with CHD were identified and 676 (25.6% women) were interviewed. In general practice, 943 people at high CVD risk were identified and 446 (46.5% women) were interviewed. The prevalence of risk factors in patients with CHD and high-risk individuals was, respectively: smoking 14.1%, 13.3%; obesity 38%, 50.2%; not reaching physical activity target 83.3%, 85.4%; blood pressure ≥130/80 mm Hg (patients with CHD and self-reported diabetes) or ≥140/85 mm Hg (high-risk individuals) 46.9%, 51.3%; total cholesterol ≥4 mmol/l 52.6%, 78.7%; and diabetes 17.8%, 43.8%. The potential among patients with CHD and individuals at high risk of developing CVD in the UK to achieve the JBS2 lifestyle and risk factor targets is considerable. CVD prevention needs a comprehensive multidisciplinary approach, addressing all aspects of lifestyle and risk factor management. The challenge is to engage and motivate cardiologists, physicians and other health professionals to routinely practice high quality preventive cardiology in a healthcare system which must invest in prevention.

  17. Issue Management Risk Ranking Systems

    SciTech Connect

    Novack, Steven David; Marshall, Frances Mc Clellan; Stromberg, Howard Merion; Grant, Gary Michael

    1999-06-01

    Thousands of safety issues have been collected on-line at the Idaho National Engineering and Environmental Laboratory (INEEL) as part of the Issue Management Plan. However, there has been no established approach to prioritize collected and future issues. The authors developed a methodology, based on hazards assessment, to identify and risk rank over 5000 safety issues collected at INEEL. This approach required that it was easily applied and understandable for site adaptation and commensurate with the Integrated Safety Plan. High-risk issues were investigated and mitigative/preventive measures were suggested and ranked based on a cost-benefit scheme to provide risk-informed safety measures. This methodology was consistent with other integrated safety management goals and tasks providing a site-wide risk informed decision tool to reduce hazardous conditions and focus resources on high-risk safety issues. As part of the issue management plan, this methodology was incorporated at the issue collection level and training was provided to management to better familiarize decision-makers with concepts of safety and risk. This prioritization methodology and issue dissemination procedure will be discussed. Results of issue prioritization and training efforts will be summarized. Difficulties and advantages of the process will be reported. Development and incorporation of this process into INEELs lessons learned reporting and the site-wide integrated safety management program will be shown with an emphasis on establishing self reliance and ownership of safety issues.

  18. Issue Management Risk Ranking Systems

    SciTech Connect

    F. M. Marshall; G. M. Grant; H. M. Stromberg; S. D. Novack

    1999-06-01

    Thousands of safety issues have been collected on-line at the Idaho National Engineering and Environmental Laboratory (INEEL) as part of the Issue Management Plan. However, there has been no established approach to prioritize collected and future issues. The authors developed a methodology, based on hazards assessment, to identify and risk rank over 5000 safety issues collected at INEEL. This approach required that it was easily applied and understandable for site adaptation and commensurate with the Integrated Safety Plan. High-risk issues were investigated and mitigative/preventive measures were suggested and ranked based on a cost-benefit scheme to provide risk-informed safety measures. This methodology was consistent with other integrated safety management goals and tasks providing a site-wide risk-informed decision tool to reduce hazardous conditions and focus resources on high-risk safety issues. As part of the issue management plan, this methodology was incorporated at the issue collection level and training was provided to management to better familiarize decision-makers with concepts of safety and risk. This prioritization methodology and issue dissemination procedure will be discussed. Results of issue prioritization and training efforts will be summarized. Difficulties and advantages of the process will be reported. Development and incorporation of this process into INEEL's lessons learned reporting and the site-wide integrated safety management program will be shown with an emphasis on establishing self reliance and ownership of safety issues.

  19. Risk Management Certainty Act

    THOMAS, 113th Congress

    Rep. Hudson, Richard [R-NC-8

    2014-01-07

    House - 02/12/2014 Referred to the Subcommittee on General Farm Commodities and Risk Management. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  20. Risk Management Plan Rule

    EPA Pesticide Factsheets

    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.

  1. Risk assessment and risk management of mycotoxins.

    PubMed

    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.

  2. Groundwater Risk Management Handbook

    DTIC Science & Technology

    2008-01-01

    management approach. • Section 6.0 Case Studies : Provides examples of two sites where risk management approaches were employed to develop...unacceptable risk, but in some cases the remedy can be limited to land use controls (LUCs) with limited long- term monitoring, as discussed in the case study ...cost avoidance of $1,250,000 over active remediation. For more information on this equipment and additional case studies , view the Web tool at http

  3. Today's School Risk Manager

    ERIC Educational Resources Information Center

    Johnson, Cheryl P.; Levering, Steve

    2009-01-01

    School districts are held accountable not only for the monies that contribute to the education system but also for mitigating any issues that threaten student learning. Some school districts are fortunate to have professional risk managers on staff who can identify and control the many risks that are unique to school systems. Most schools,…

  4. Routine culture-based screening versus risk-based management for the prevention of early-onset group B streptococcus disease in the neonate: a systematic review.

    PubMed

    Kurz, Ella; Davis, Deborah

    2015-04-17

    Early-onset group B streptococcus disease, recognized as the most common cause of early onset neonatal sepsis in developed countries, is transmitted vertically from the group B streptococcus carrier mother to the neonate in the peripartum. Accordingly, early-onset group B streptococcus disease is prevented by halting the transmission of the microorganism from the mother to the infant. Two main methods, routine culture-based screening and risk-based management, may be used in the identification of mothers requiring intrapartum antibiotic prophylaxis in labor. While there are advantages and disadvantages to each, there is limited high level evidence available as to which method is superior. To identify the effectiveness of risk-based management versus routine culture-based screening in the prevention of early-onset group B streptococcus disease in the neonate. This review considered studies which treated pregnant women with intrapartum antibiotic prophylaxis following risk- and culture-based protocols for the prevention of early-onset group B streptococcus disease in the neonate. Types of intervention: This review considered studies that evaluated risk-based management against routine culture-based screening for the prevention of early-onset group B streptococcus disease in the neonate. Types of studies: This review looked for highest evidence available which in this case consisted of one quasi experimental study and eight comparative cohort studies with historical or concurrent control groups. Types of outcomes: Incidence of early-onset group B streptococcus disease in neonates as measured by positive group B streptococcus culture from an otherwise sterile site. Secondary outcomes include neonatal death due to group B streptococcus sepsis and percentage of women who received intrapartum antibiotic prophylaxis. A multi-step search strategy was used to find studies which were limited to the English language and published between January 2000 and June 2013. The quality

  5. Small Business and the Risk Management Program

    EPA Pesticide Factsheets

    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.

  6. Adaptation and risk management

    SciTech Connect

    Preston, Benjamin L

    2011-01-01

    Adaptation assessment methods are compatible with the international risk management standard ISO:31000. Risk management approaches are increasingly being recommended for adaptation assessments at both national and local levels. Two orientations to assessments can commonly be identified: top-down and bottom-up, and prescriptive and diagnostic. Combinations of these orientations favor different types of assessments. The choice of orientation can be related to uncertainties in prediction and taking action, in the type of adaptation and in the degree of system stress. Adopting multiple viewpoints is to be encouraged, especially in complex situations. The bulk of current guidance material is consistent with top-down and predictive approaches, thus is most suitable for risk scoping and identification. Abroad range ofmaterial fromwithin and beyond the climate change literature can be used to select methods to be used in assessing and implementing adaptation. The framing of risk, correct formulation of the questions being investigated and assessment methodology are critical aspects of the scoping phase. Only when these issues have been addressed should be issue of specific methods and tools be addressed. The reorientation of adaptation from an assessment focused solely on anthropogenic climate change to broader issues of vulnerability/resilience, sustainable development and disaster risk, especially through a risk management framework, can draw from existing policy and management understanding in communities, professions and agencies, incorporating existing agendas, knowledge, risks, and issues they already face.

  7. Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic

    PubMed Central

    Cheng, Henry G.; Patel, Birju S.; Martin, Seth S.; Blaha, Michael; Doneen, Amy; Bale, Brad

    2016-01-01

    Introduction The aim of the study was to examine changes in carotid intima-media thickness (CIMT) and carotid plaque morphology in patients receiving multifactorial cardiovascular disease (CVD) risk factor management in a community-based prevention clinic. Quantitative changes in CIMT and qualitative changes in carotid plaque morphology may be measured non-invasively by ultrasound. Material and methods This is a retrospective study on a cohort of 324 patients who received multifactorial cardiovascular risk reduction treatment at a community prevention clinic. All patients received lipid-lowering medications (statin, niacin, and/or ezetimibe) and lifestyle modification. All patients underwent at least one follow-up CIMT measurement after starting their regimen. Annual biomarker, CIMT, and plaque measurements were analyzed for associations with CVD risk reduction treatment. Results Median time to last CIMT was 3.0 years. Compared to baseline, follow-up analysis of all treatment groups at 2 years showed a 52.7% decrease in max CIMT, a 3.0% decrease in mean CIMT, and an 87.0% decrease in the difference between max and mean CIMT (p < 0.001). Plaque composition changes occurred, including a decrease in lipid-rich plaques of 78.4% within the first 2 years (p < 0.001). After the first 2 years, CIMT and lipid-rich plaques continued to decline at reduced rates. Conclusion In a cohort of patients receiving comprehensive CVD risk reduction therapy, delipidation of subclinical carotid plaque and reductions in CIMT predominantly occurred within 2 years, and correlated with changes in traditional biomarkers. These observations, generated from existing clinical data, provide unique insight into the longitudinal on-treatment changes in carotid plaque. PMID:27478452

  8. [The relevance of clinical risk management].

    PubMed

    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.

  9. Air quality risk management.

    PubMed

    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.

  10. Comparing ELISA test-positive prevalence, risk factors and management recommendations for Johne's disease prevention between organic and conventional dairy farms in Ontario, Canada.

    PubMed

    Pieper, Laura; Sorge, Ulrike S; DeVries, Trevor; Godkin, Ann; Lissemore, Kerry; Kelton, David

    2015-11-01

    Johne's disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary JD control program was successfully launched in Ontario, Canada, including a Risk Assessment and Management Plan (RAMP) and JD ELISA testing of the entire milking herd. Over the last decade, the organic dairy sector has been growing. However, organic farming regulations and philosophies may influence the risk for JD transmission on Ontario organic dairy farms. The aim of this cross-sectional study was to investigate differences in JD ELISA test positive prevalence, risk factors for JD and recommendations for JD prevention between organic and conventional dairy herds in Ontario. RAMP results (i.e. RAMP scores and recommendations) and ELISA results were available for 2103 dairy herds, including 42 organic herds. If available, additional data on milk production, milk quality, and herd characteristics were gathered. Organic and conventional herds had a similar herd-level JD ELISA test-positive prevalence (26.2% and 27.2%, respectively). Organic herds (4.2%) had a higher within-herd JD ELISA test-positive prevalence compared to conventional herds (2.3%) if they had at least one JD test-positive animal on the farm. Organic farms had lower risk scores for biosecurity (9 points lower), and higher scores in the calving (7 points higher) and the calf-rearing management areas (4 points higher). After accounting for RAMP score, organic farms received fewer recommendations for the calving management area (Odds Ratio=0.41) and more recommendations in the adult cow management area (Odds Ratio=2.70). A zero-inflated negative binomial model was built with purchase of animals and the herd size included in the logistic portion of the model. Herd type (organic or conventional), colostrum and milk feeding practices, average bulk tank somatic cell count, and presence of non-Holstein breeds were included in the negative binomial portion of the model. Organic farms had a higher number of

  11. The Peer and Non-peer: the potential of risk management for HIV prevention in contexts of prostitution.

    PubMed

    Leite, Gabriela Silva; Murray, Laura; Lenz, Flavio

    2015-09-01

    Sex workers have been the protagonists and focus of HIV prevention campaigns and research since the late 1980s in Brazil. Through a review of national and international literature, combined with a history of sex workers' involvement in the construction of the Brazilian response, this article explores the overlaps and disconnects between research and practice in contexts of prostitution over the past three decades. We review the scientific literature on the epidemiology of HIV among sex workers and prevention methodologies. We conclude that although research focus and designs often reinforce the idea that sex workers' vulnerability is due to their sexual relationships with clients, their greatest vulnerability has been found to be with their nonpaying intimate partners. Few studies explore their work contexts and structural factors that influence safe sex practices with both types of partners. The negative effects of criminalization, stigma, and exclusively biomedical and peer education-based approaches are well documented in the scientific literature and experiences of sex worker activists, as is the importance of prevention programs that combine empowerment and human rights-based approach to reduce HIV infection rates. We conclude that there is a need for actions, policies, and research that encompass the environment and context of sex workers' lives and reincorporate the human rights and citizenship frame that dominated the Brazilian response until the end of the 2000s. As part of HIV prevention efforts, female sex workers need to be considered above all as women, equal to all others.

  12. Integrated risk management

    NASA Technical Reports Server (NTRS)

    Hunsucker, J. L.

    1993-01-01

    The purpose of this report is to first present a basis or foundation for the building of an integrated risk management plan and them to present the plan. The integration referred to is across both the temporal and the hierarchical dimensions. Complexity, consequence, and credibility seem to be driving the need for the consideration of risk. Reduction of personal bias and reproducibility of the decision making process seem to be driving the consideration of a formal risk plan. While risk can be used as either a selection tool or a control tool, this paper concentrates on the selection usage. Risk relies on stated purpose. The tightness of the definition of purpose and success is directly reflected in the definition and control of risk. Much of a risk management plan could be designed by the answers to the questions of why, what, who, when, and where. However, any plan must provide the following information about a threat or risk: likelihood, consequence, predictability, reliability, and reproducibility. While the environment at NASA is seen as warm, but not hot, for the introduction of a risk program, some encouragement is seen if the following problems are addressed: no champion, no commitment of resource, confused definitions, lack of direction and focus, a hard sell, NASA culture, many choices of assessment methods, and cost. The plan is designed to follow the normal method of doing work and is structured to follow either the work break down structure or a functional structure very well. The parts of the plan include: defining purpose and success, initial threat assessment, initial risk assessment, reconciling threats and parameters, putting part of the information down and factoring the information back into the decision process as it comes back up, and developing inferences. Two major suggestions are presented. One is to build an office of risk management to be used as a resource by managers in doing the risk process. Another is to form a pilot program to try

  13. Navigator program risk management

    NASA Technical Reports Server (NTRS)

    Wessen, Randii R.; Padilla, Deborah A.

    2004-01-01

    In this paper, program risk management as applied to the Navigator Program: In Search of New Worlds will be discussed. The Navigator Program's goals are to learn how planetary systems form and to search for those worlds that could or do harbor life.

  14. Navigator program risk management

    NASA Technical Reports Server (NTRS)

    Wessen, Randii R.; Padilla, Deborah A.

    2004-01-01

    In this paper, program risk management as applied to the Navigator Program: In Search of New Worlds will be discussed. The Navigator Program's goals are to learn how planetary systems form and to search for those worlds that could or do harbor life.

  15. Children's views of accident risks and prevention: a qualitative study

    PubMed Central

    Green, J.; Hart, L.

    1998-01-01

    Objectives—To examine children's accounts of injury risks and opportunities for prevention. Setting—Schools, youth clubs, and a holiday activity scheme in the south east of England. Methods—Sixteen focus groups were held with 7–11 year old children. Transcripts of the discussions were analysed using qualitative methods. Results—Children were knowledgeable about injury risks and how to reduce them. They also saw injury prevention as primarily their own responsibility. However, they were also sophisticated in their criticisms of generalised prevention advice, and evaluated safety messages in the light of local environmental and social knowledge. Personal experience was more often reported as a reason for risk reduction than formal prevention advice. Risks for injury were not isolated from other risks faced. Conclusions—Effective educational interventions aimed at changing children's risk behaviour should build more on children's own competence and knowledge of their local environment, and stress the need to manage risks rather than avoid dangers. PMID:9595326

  16. Continuous Risk Management: An Overview

    NASA Technical Reports Server (NTRS)

    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.

  17. Airway fires during surgery: Management and prevention.

    PubMed

    Akhtar, Navaid; Ansar, Farrukh; Baig, Mirza Shahzad; Abbas, Akbar

    2016-01-01

    Airway fires pose a serious risk to surgical patients. Fires during surgery have been reported for many years with flammable anesthetic agents being the main culprits in the past. Association of airway fires with laser surgery is well-recognized, but there are reports of endotracheal tube fires ignited by electrocautery during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially grave consequences. While airway fires are relatively uncommon occurrences, they are very serious and can often be fatal. Success in preventing such events requires a thorough understanding of the components leading to a fire (fuel, oxidizer, and ignition source), as well as good communication between all members present to appropriately manage the fire and ensure patient safety. We present a case of fire in the airway during routine adenotonsillectomy. We will review the causes, preventive measures, and brief management for airway fires.

  18. [Profitability analysis of clinical risk management].

    PubMed

    Banduhn, C; Schlüchtermann, J

    2013-05-01

    Medical treatment entails many risks. Increasingly, the negative impact of these risks on patients' health is revealed and corresponding cases are reported to hospital insurances. A systematic clinical risk management can reduce risks. This analysis is designed to demonstrate the financial profitability of implementing a clinical risk management. The decision analysis of a clinical risk management includes information from published articles and studies, publicly available data from the Federal Statistical Office and expert interviews and was conducted in 2 scenarios. The 2 scenarios result from a maximum and minimum value of preventable adverse events reported in Germany. The planning horizon was a 1-year ­period. The analysis was performed from a hospital's perspective. Subsequently, a threshold-analysis of the reduction of preventable adverse events as an effect of clinical risk management was executed. Furthermore, a static capital budgeting over a 5-year period was added, complemented by a risk analysis. Regarding the given assumptions, the implementation of clinical risk management would save about 53 000 € or 175 000 €, respectively, for an average hospital within the first year. Only if the reduction of preventable adverse events is as low as 5.6 or 2.8%, respectively, will the implementation of clinical risk management produce losses. According to a comprehensive risk simulation this happens in less than one out of 1 million cases. The investment in a clinical risk management, based on a 5-year period and an interest rate of 5%, has an annually pay off of 81 000 € or 211 000 €, respectively. The implementation of clinical risk management in a hospital pays off within the first year. In the subsequent years the surplus is even higher due to the elimination of implementation costs. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Clinical Trials Management | Division of Cancer Prevention

    Cancer.gov

    Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office. | Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials.

  20. Cutaneous Scar Prevention and Management

    PubMed Central

    Al-Shaqsi, Sultan; Al-Bulushi, Taimoor

    2016-01-01

    Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management. PMID:26909210

  1. Risk-informed regulation and safety management of nuclear power plants--on the prevention of severe accidents.

    PubMed

    Himanen, Risto; Julin, Ari; Jänkälä, Kalle; Holmberg, Jan-Erik; Virolainen, Reino

    2012-11-01

    There are four operating nuclear power plant (NPP) units in Finland. The Teollisuuden Voima (TVO) power company has two 840 MWe BWR units supplied by Asea-Atom at the Olkiluoto site. The Fortum corporation (formerly IVO) has two 500 MWe VVER 440/213 units at the Loviisa site. In addition, a 1600 MWe European Pressurized Water Reactor supplied by AREVA NP (formerly the Framatome ANP--Siemens AG Consortium) is under construction at the Olkiluoto site. Recently, the Finnish Parliament ratified the government Decision in Principle that the utilities' applications to build two new NPP units are in line with the total good of the society. The Finnish utilities, Fenno power company, and TVO company are in progress of qualifying the type of the new nuclear builds. In Finland, risk-informed applications are formally integrated in the regulatory process of NPPs that are already in the early design phase and these are to run through the construction and operation phases all through the entire plant service time. A plant-specific full-scope probabilistic risk assessment (PRA) is required for each NPP. PRAs shall cover internal events, area events (fires, floods), and external events such as harsh weather conditions and seismic events in all operating modes. Special attention is devoted to the use of various risk-informed PRA applications in the licensing of Olkiluoto 3 NPP.

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

    PubMed

    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.

  3. Assessment, prevention and management of skin tears.

    PubMed

    Benbow, Maureen

    2017-04-28

    Skin tears are common in older people. They are acute wounds that are at high risk of becoming complex, chronic wounds due to the interplay between the physiological changes in the skin and trauma from the external environment. Skin tears have been reported to have prevalence rates equal to, or greater than, those for pressure ulcers. A comprehensive risk assessment should include assessment of the individual's general health (chronic/critical disease, polypharmacy and cognitive, sensory and nutritional status); mobility (history of falls, impaired mobility, dependent activities of daily living, and mechanical trauma); and skin (extremes of age, fragile skin and previous skin tears). A recognised classification system should be used to identify and document skin tears and guide treatment decisions in line with local wound management protocols. Nurses and carers are in a prime position to prevent, assess and manage skin tears.

  4. Identification, prevention and management of cardiovascular risk in chronic myeloid leukaemia patients candidate to ponatinib: an expert opinion.

    PubMed

    Breccia, Massimo; Pregno, Patrizia; Spallarossa, Paolo; Arboscello, Eleonora; Ciceri, Fabio; Giorgi, Mauro; Grossi, Alberto; Mallardo, Mario; Nodari, Savina; Ottolini, Stefano; Sala, Carla; Tortorella, Giovanni; Rosti, Gianantonio; Pane, Fabrizio; Minotti, Giorgio; Baccarani, Michele

    2017-04-01

    Ponatinib (Iclusig, ARIAD Pharmaceuticals-Incyte Co.) is a third-generation structure-guided tyrosine kinase inhibitor that is approved for treatment of Philadelphia chromosome-positive leukaemias resistant or intolerant to other inhibitors. The clinical use of ponatinib is complicated by the possible development of cardiovascular events, primarily hypertension and arterial or venous thrombotic events. The US Food and Drug Administration and the European Medicine Agency recommend that the cardiovascular profile of patients candidate for ponatinib should be carefully evaluated. For patients deemed to carry a high risk of cardiovascular events, other life-saving therapeutic options should be considered. When alternative options are not available, treatment with ponatinib is indicated but requires that haematologists and cardiologists collaborate and identify modalities of surveillance and risk mitigation in the best interest of the patient. This article reports on the expert opinion provided by a panel of Italian haematologists, cardiologists and clinical pharmacologists. It summarises suggestions that may help to improve the therapeutic index of ponatinib, primarily in the settings of chronic-phase chronic myeloid leukaemia.

  5. [Cardiovascular risk assessment and risk stratification- guided therapy: predict, prevent and individualize].

    PubMed

    Ural, Dilek

    2011-09-01

    Modern concept in primary prevention of cardiovascular diseases (CVD) entails assessing the person's global risk and making the right management in accordance with these results. Correspondingly, 3 steps recommended for the prevention of CVD under risk guidance are: (a) risk assessment via a proper system like Framingham Risk Score, SCORE, QRISK, PROCAM; (b) decision-making in the proper management in terms of informing the patient about lifestyle changes that he or she can cope and drug selection; and (c) evaluation of treatment decision in terms of cost effectiveness. Although, a significant decline is observed in CVD morbidity and mortality, particularly in the western countries, we still are trying to approach to competent quality measures about management under CV risk guidance. This review summarizes the main challenges regarding risk stratification-guided management strategy in primary prevention of CVD.

  6. [Continuing education aimed at occupational risk prevention].

    PubMed

    De Vito, G; Tibiletti, M; Stella, A

    2007-01-01

    The implementation of European Commission directives has radically modified occupational risk management. In fact, widespread and continuous education addressed to exposed workers is seen by the legislator as one of the most effective means to avoid occupational diseases. The recent establishment of Continuing Medical Education (CME) has helped the system grant CME credits to participants in occupational courses organized by health-care providers. Moreover, the constant development of new health technologies coupled with the high productivity of the legislator confer a short lifetime on the acquired knowledge. Biological risks, biomechanical overload of the lumbar spine, and stress are among the classical risks requiring attention, discussion, and regular updating. Not only health-care workers but also safety technicians, occupational physicians, managers and union representatives should receive scheduled refresher training. Modern technologies such as distance learning, interactive simulation software, and online training tools are often the best teaching solutions. Occupational disease prevention should no longer be seen as a cost but as a cost savings indicator. Since it is closely related to quality promotion, it should play a primary role in the core business of health-care providers.

  7. [From complexity to simplification: contribution of the EPM Research Unit to producing a toolkit for risk assessment and management of biomechanical overload and WMSDs prevention].

    PubMed

    Occhipinti, E; Colombini, Daniela

    2011-01-01

    When studying musculoskeletal disorders and their connection with working conditions (WMSDs), several factors of different nature (mechanical, organizational, psychophysical, individual) and their interrelationship have been considered important in general models for epidemiologic surveys and risk assessment and management. Hence the necessity of a "holistic" (that is to say complex, global, multifactorial and interdisciplinary) approach to MSD prevention, especially when establishing technical norms, guidelines and strategic plans of action at national or international level. On the other hand, considering the widespread presence of these factors and WMSDs in many working contexts, there is a great demand by OSH agencies and operators to develop "simple" tools for risk assessment and management, usable also by non-experts in both developed and developing countries. Both these needs are perfectly justified but are also to a certain extent in conflict. How can we address the problem, i.e., simplify complexity? METHODS AND CRITERIA: The proposals are based on two essential criteria: 1) Act on a step-by-step approach using basic tools first and more complex tools only when necessary. 2) Take into account the complexity and the presence of multiple influencing factors at every step (even if with different degrees of in-depth analysis). The proposals are mainly developed within the framework of an IEA-WHO collaboration initiative for a "Toolkit for MSD prevention" but they are also derived from other converging issues (i.e. ISO application document of LSO series 11228 on manual handling). The proposals consider: 1) A Basic Step devoted to preliminary occupational hazard identification and priority check by operative "key enter" questions (at this step all potential hazards--including those influencing WMSDs--should be considered). This step also can be carried out by non-experts with limited training. 2) First Step, focused on WMSDs risk factors, consisting of a "quick

  8. The risk of malaria in Ghanaian infants born to women managed in pregnancy with intermittent screening and treatment for malaria or intermittent preventive treatment with sulfadoxine/pyrimethamine.

    PubMed

    Awine, Timothy; Belko, Mark M; Oduro, Abraham R; Oyakhirome, Sunny; Tagbor, Harry; Chandramohan, Daniel; Milligan, Paul; Cairns, Matthew; Greenwood, Brian; Williams, John E

    2016-01-28

    Several studies have reported an association between malaria infection of the placenta and the risk of malaria in young children in the first year of life, but it is not known if this is causal, or influenced by malaria control measures during pregnancy. This paper compares the incidence of malaria in infants born to mothers who received either intermittent preventive treatment with sulfadoxine/pyrimethamine (IPTp-SP) or screening with a rapid diagnostic test and treatment with artemether-lumefantrine (ISTp-AL) during their pregnancy. From July 2011 to April 2013, 988 infants of women enrolled in a trial of IPTp-SP versus ISTp-AL in the Kassena-Nankana districts of northern Ghana were followed to determine the risk of clinical malaria during early life, and their risk of parasitaemia and anaemia at 6 and 12 months of age. In addition, the incidence of clinical malaria in infants whose mothers had malaria infection of the placenta was compared with that in infants born to women free of placental malaria. The incidence of clinical malaria was 0.237 and 0.211 episodes per child year in infants whose mothers had received ISTp-AL or IPTp-SP, respectively. The adjusted incidence rate ratio and the adjusted rate difference were 0.94 (95% CI 0.68, 1.33) and 0.029 (95% CI -0.053, 0.110) cases per child year at risk respectively. The incidence of clinical malaria was similar in infants born to women with placental malaria (0.195 episodes per child year) and in infants of women without placental malaria (0.224 episodes per child year) (rate ratio = 0.86 [95% CI 0.54, 1.37]). Infants born to women managed with ISTp-AL during pregnancy were not at greatly increased risk of malaria compared with infants born to women who had received IPTp-SP. The incidence of malaria in infants was similar whether or not their mother had had placental malaria.

  9. [Risk management project: reactive or proactive approach?].

    PubMed

    Vastola, Pasquale; Saracino, Donato M T

    2006-01-01

    Risk management in healthcare refers to the process of developing strategies aimed at preventing and controlling the risk of occurrence of errors and harmful events. The final objective is primarily that of increasing patient safety and secondarily, that of reducing the financial burden of adverse events. The implementation of a risk management system is therefore of vital strategic importance. Nevertheless, a fundamental question that needs to be answered in the operational phase is: should a proactive or reactive approach to risk management be taken? In our view, proactive risk management has many advantages over a reactive approach and is therefore preferable. The reactive approach should be taken exclusively to obtain information regarding risk and errors, in the preliminary, as well as monitoring and follow-up phases of the project.

  10. Continuous Risk Management Course. Revised

    NASA Technical Reports Server (NTRS)

    Hammer, Theodore F.

    1999-01-01

    This document includes a course plan for Continuous Risk Management taught by the Software Assurance Technology Center along with the Continuous Risk Management Guidebook of the Software Engineering Institute of Carnegie Mellon University and a description of Continuous Risk Management at NASA.

  11. Manual of Educational Risk Management.

    ERIC Educational Resources Information Center

    Cody, Frank J.; Dise, John H., Jr.

    This is the first risk management publication for school administrators that attempts to be comprehensive by addressing all potential areas of risk to school districts and offering specific guidelines on how to manage those areas. Chapter 1 gives directions on how to use the manual. Chapter 2 contains a complete overview of risk management,…

  12. Manual of Educational Risk Management.

    ERIC Educational Resources Information Center

    Cody, Frank J.; Dise, John H., Jr.

    This is the first risk management publication for school administrators that attempts to be comprehensive by addressing all potential areas of risk to school districts and offering specific guidelines on how to manage those areas. Chapter 1 gives directions on how to use the manual. Chapter 2 contains a complete overview of risk management,…

  13. Risk management of nanomaterials.

    PubMed

    Gwinn, Maureen R; Tran, Lang

    2010-01-01

    Nanotechnology has become the focus of a large amount of scientific, political, and financial interest. Limited information on the exposure to nanomaterials is available, with only a few occupational exposure studies having been performed. While laboratory animal studies on the biological effects of some nanomaterials have been published, no epidemiological studies have been reported to date. This lack of data on exposure and human health effects hinders risk assessment of these materials. As the use of nanomaterials increases rapidly, it is of vital importance that the risk assessment community understands the complexities of the issues surrounding the manufacture, use and disposal of nanomaterials, the potential of environmental and occupational exposure to human populations, as well as adverse health outcomes. For this to happen, it is in many ways necessary for the scientific community to also understand what questions risk assessors need to ask, and what research will best answer them. Risk management of nanomaterials requires more information as to the human and ecological effects of exposure to various nanomaterials. At this time, there are no specific regulations for nanomaterials, but a few efforts to include nanomaterials under existing environmental regulations have begun. The purpose of this article is to describe the potential regulations for nanomaterials, and the current issues related to the risk assessment of nanomaterials.

  14. Prevention and management of pelvic organ prolapse

    PubMed Central

    Giarenis, Ilias

    2014-01-01

    Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. Surgical trends are currently changing due to the controversial issues surrounding the use of mesh and the increasing demand for uterine preservation. The evolution of laparoscopic and robotic surgery has increased the use of these techniques in pelvic floor surgery. PMID:25343034

  15. Risk determination and prevention of breast cancer.

    PubMed

    Howell, Anthony; Anderson, Annie S; Clarke, Robert B; Duffy, Stephen W; Evans, D Gareth; Garcia-Closas, Montserat; Gescher, Andy J; Key, Timothy J; Saxton, John M; Harvie, Michelle N

    2014-09-28

    Breast cancer is an increasing public health problem. Substantial advances have been made in the treatment of breast cancer, but the introduction of methods to predict women at elevated risk and prevent the disease has been less successful. Here, we summarize recent data on newer approaches to risk prediction, available approaches to prevention, how new approaches may be made, and the difficult problem of using what we already know to prevent breast cancer in populations. During 2012, the Breast Cancer Campaign facilitated a series of workshops, each covering a specialty area of breast cancer to identify gaps in our knowledge. The risk-and-prevention panel involved in this exercise was asked to expand and update its report and review recent relevant peer-reviewed literature. The enlarged position paper presented here highlights the key gaps in risk-and-prevention research that were identified, together with recommendations for action. The panel estimated from the relevant literature that potentially 50% of breast cancer could be prevented in the subgroup of women at high and moderate risk of breast cancer by using current chemoprevention (tamoxifen, raloxifene, exemestane, and anastrozole) and that, in all women, lifestyle measures, including weight control, exercise, and moderating alcohol intake, could reduce breast cancer risk by about 30%. Risk may be estimated by standard models potentially with the addition of, for example, mammographic density and appropriate single-nucleotide polymorphisms. This review expands on four areas: (a) the prediction of breast cancer risk, (b) the evidence for the effectiveness of preventive therapy and lifestyle approaches to prevention, (c) how understanding the biology of the breast may lead to new targets for prevention, and (d) a summary of published guidelines for preventive approaches and measures required for their implementation. We hope that efforts to fill these and other gaps will lead to considerable advances in our

  16. Sports-related workload and injury risk: simply knowing the risks will not prevent injuries.

    PubMed

    Drew, Michael K; Cook, Jill; Finch, Caroline F

    2016-05-10

    Training loads contribute to sports injury risk but their mitigation has rarely been considered in a sports injury prevention framework. A key concept behind monitoring training loads for injury prevention is to screen for those at increased risk of injury so that workloads can be adjusted to minimise these risks. This review describes how advances in management of workload can be applied as a preventive measure. Primary prevention involves screening for preparticipation load risk factors, such as low training loads, prior to a training period or competition. Secondary prevention involves screening for workloads that are known to precede an injury developing so that modification can be undertaken to mitigate this risk. Tertiary prevention involves rehabilitation practices that include a graded return to training programme to reduce the risk of sustaining a subsequent injury. The association of training loads with injury incidence is now established. Prevention measures such as rule changes that affect the workload of an athlete are universal whereas those that address risk factors of an asymptomatic subgroup are more selective. Prevention measures, when implemented for asymptomatic individuals exhibiting possible injury risk factors, are indicated for an athlete at risk of developing a sports injury. Seven key indicated risks and associated prevention measures are proposed.

  17. Managing Risks and Beyond

    DTIC Science & Technology

    2010-04-01

    situation occurring and its undesirable consequences          • Risk (Project Management Body of Knowledge  PMBOK ) – An uncertain even or condition that, if it...favorable or advantageous combination of circumstances – A chance for progress or advancement  • Opportunity ( PMBOK ) – A condition or situation favorable to...opportunities and reduce threats to project objectives      PMBOK – Includes Mitigation and Contingencies – Includes acceptance of the risk or issue

  18. Primordial Prevention of Cardiometabolic Risk in Childhood.

    PubMed

    Tanrikulu, Meryem A; Agirbasli, Mehmet; Berenson, Gerald

    2017-01-01

    Fetal life and childhood are important in the development of cardiometabolic risk and later clinical disease of atherosclerosis, hypertension and diabetes mellitus. Molecular and environmental conditions leading to cardiometabolic risk in early life bring us a challenge to develop effective prevention and intervention strategies to reduce cardiovascular (CV) risk in children and later disease. It is important that prevention strategies begin at an early age to reduce future CV morbidity and mortality. Pioneering work from longitudinal studies such as Bogalusa Heart Study (BHS), the Finnish Youth Study and other programs provide an awareness of the need for public and health services to begin primordial prevention. The impending CV risk beginning in childhood has a significant socioeconomic burden. Directions to achieve primordial prevention of cardiometabolic risk in children have been developed by prior longitudinal studies. Based on those studies that show risk factors in childhood as precursors of adult CV risk, implementation of primordial prevention will have effects at broad levels. Considering the epidemic of obesity, the high prevalence of hypertension and cardiometabolic risk, prevention early in life is valuable. Comprehensive health education, such as 'Health Ahead/Heart Smart', for all elementary school age children is one approach to begin primordial prevention and can be included in public education beginning in kindergarten along with the traditional education subject matter.

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

    PubMed

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

    2003-01-01

    (formative, process, and outcome evaluation), and be prepared to change the decision if new information becomes available. Comprehensive and sound principles are critical to providing structure and integrity to risk management frameworks. Guiding principles are intended to provide an ethical grounding for considering the many factors involved in risk management decision making. Ten principles are proposed to guide risk management decision making. The first four principles were adapted and modified from Hattis (1996) along with the addition of two more principles by Hrudey (2000). These have been supplemented by another four principles to make the 10 presented. The principles are based in fundamental ethical principles and values. These principles are intended to be aspirational rather than prescriptive--their application requires flexibility and practical judgement. Risk management is inherently a process in search of balance among competing interests and concerns. Each risk management decision will be "balancing act" of competing priorities, and trade-offs may sometimes have to be made between seemingly conflicting principles. The 10 decision-making principles, with the corresponding ethical principle in italics are: 1. Do more good than harm (beneficence, nonmalificence).- The ultimate goal of good risk management is to prevent or minimize risk, or to "do good" as much as possible. 2. Fair process of decision making (fairness, natural justice). - Risk management must be just, equitable, impartial, unbiased, dispassionate, and objective as far as possible given the circumstances of each situation. 3. Ensure an equitable distribution of risk (equity). - An equitable process of risk management would ensure fair outcomes and equal treatment of all concerned through an equal distribution of benefits and burdens (includes the concept of distributive justice, i.e., equal opportunities for all individuals). 4. Seek optimal use of limited risk management resources (utility

  20. Eastern European risk management

    SciTech Connect

    Honey, J.A. )

    1992-01-01

    Here the authors assess Eastern European risk management practices through the evaluation of the nuclear power plants in the region. This evaluation is limited to the Soviet-designed and -built VVER-440 pressurized water reactors (PWRs) that are currently operating in Bulgaria, Czechoslovakia, Hungary, Russia, and the Ukraine and until recently operated at Greifswald in the former East Germany. This evaluation is based on the basic design of the plants, a safety evaluation of the Greifswald facility by representatives from the Federal Republic of Germany and personal visits by the author to Greifswald and Loviisa.

  1. Communicating Risk to Program Managers

    NASA Technical Reports Server (NTRS)

    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).

  2. Prevention and Management of Chronic Hepatitis B

    PubMed Central

    Bhat, Mamatha; Ghali, Peter; Deschenes, Marc; Wong, Philip

    2014-01-01

    Chronic hepatitis B virus (HBV) infection affects an estimated 370 million people worldwide. HBV is endemic throughout the world, and insidiously causes liver damage over years and decades without any warning symptoms or signs. Up to 25–35% of infected individuals eventually die due to complications of liver cirrhosis and hepatocellular carcinoma (HCC) induced by HBV. Screening those individuals at risk of acquiring hepatitis B, and universal vaccination for prevention, would help in limiting the spread and public health repercussions of the virus. Although many new antiviral therapies have been developed for the management of hepatitis B, they still do not offer the possibility of cure. Most individuals who begin oral suppressive therapy will be indefinitely treated. Continuous suppression of HBV replication in individuals with advanced liver disease prolongs life, decreases the need for liver transplantation, and potentially reduces the risk for HCC. In this clinical review, we present a practical approach to prevention of HBV, its natural history and life cycle, as well as its management. PMID:26622990

  3. Managing information technology security risk

    NASA Technical Reports Server (NTRS)

    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.

  4. Managing information technology security risk

    NASA Technical Reports Server (NTRS)

    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.

  5. Using a national guideline to prevent and manage pressure ulcers.

    PubMed

    Neilson, Julie; Avital, Liz; Willock, Jane; Broad, Nigel

    2014-05-01

    Developing pressure ulcers is a painful and distressing event for patients, and one that can be prevented. The National Institute for Health and Care Excellence pressure ulcer guideline has recently been updated to cover the prevention and management of this condition. This article focuses on the recommendations that are relevant to nurses, covering areas such as risk assessment, skin assessment, repositioning, pressure-redistributing devices, dressings, patient and carer information, and training and education. It also identifies what senior nurses and nurse managers must do to ensure their staff can prevent and manage pressure ulcers effectively.

  6. Stroke Risk Factors, Genetics, and Prevention.

    PubMed

    Boehme, Amelia K; Esenwa, Charles; Elkind, Mitchell S V

    2017-02-03

    Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention. © 2017 American Heart Association, Inc.

  7. Knowledge management: an application to wildfire prevention planning

    Treesearch

    Daniel L Schmoldt

    1989-01-01

    Residential encroachment into wildland areas places an additional burden on fire management activities. Prevention programs, fuel management efforts, and suppression strategies, previously employed in wildland areas, require modification for protection of increased values at risk in this interface area. Knowledge-based computer systems are being investigated as...

  8. [Bibliografic resources on chemical risk administration and prevention].

    PubMed

    Calera Rubio, Alfonso A; Juan Quilis, Verónica; López Samaniego, Luz M; Caballero Pérez, Pablo; Ronda Pérez, Elena

    2005-01-01

    The documentation produced by public and private institutions in relation to the chemical risk constitutes an essential tool for prevention. The objective of this research is to locate and to revise the documents related to the management of the prevention of chemical risk focus to PYMES in Spain from 1995 to 2004. The methodology carried out for the selection of the bibliographical materials has been the consultation of automated databases and Web pages. 812 documents have been identified. Most corresponds to grey literature. The thematic more frequent has been the security and the most frequent objective of the papers has been the prevention. Most of the documents go to the technical sector. The results suggest that although that there is a great diversity of documents in Spain dedicated to the prevention of chemical risk it seems convenient: 1) to increase their diffusion, 2) to pay attention to the communication of the risks, 3) to investigate and to translate the research in good practice.

  9. Managing demographic risk.

    PubMed

    Strack, Rainer; Baier, Jens; Fahlander, Anders

    2008-02-01

    In developed nations, the workforce is aging rapidly. That trend has serious implications. Companies could face severe labor shortages in a few years as workers retire, taking critical knowledge with them. Businesses may also see productivity decline among older employees, especially in physically demanding jobs. The authors, partners at Boston Consulting Group, offer managers a systematic way to assess these dual threats--capacity risk and productivity risk--at their companies. It involves studying the age distribution of their employees to see if large percentages fall within high age brackets and then projecting--by location, unit, and job category--how the distribution will change over the next 15 years. Managers must also factor in both the impact of strategic moves on personnel needs and the future supply of workers in the market. When RWE Power analyzed its trends, the company learned that in 2018 almost 80% of its workers would be over 50. What's more, in certain critical areas its labor surplus was about to become a sizable shortfall. For instance, a shortage of specialized engineers would develop in the company just as their ranks in the job market thinned and competition to hire them intensified. Reversing its downsizing course, RWE Power took steps to increase its supply of workers in those key positions. The authors show how companies that face talent gaps, as RWE Power did, can close them through training, transfers, recruitment, retention, productivity improvements, and outsourcing. They also describe measures that companies can take to keep older workers productive, including workplace accommodations, revised compensation structures, performance incentives, and targeted health care management. The key is to identify and address potential problems early. Firms that do so will gain an edge on rivals that are still relentlessly focused on reducing head count.

  10. Prevention for positives: challenges and opportunities for integrating prevention into HIV case management.

    PubMed

    Mitchell, C G; Linsk, N L

    2001-10-01

    Despite nearly 20 years of HIV prevention efforts, rates of new HIV infection persist at an alarming rate. As successful antiretroviral medications enable many HIV infected persons to live longer, healthier lives, interventions are necessary to support ongoing prevention and reduced risk behaviors. This article describes a survey that was used to assess the opportunities and challenges related to the integration of prevention screening into the work of HIV/AIDS case managers. The article describes the survey, reports the findings (N = 101), and concludes with a discussion of issues that must be addressed prior to incorporating prevention screening into HIV/AIDS case management.

  11. Future directions in Alzheimer's disease from risk factors to prevention.

    PubMed

    Imtiaz, Bushra; Tolppanen, Anna-Maija; Kivipelto, Miia; Soininen, Hilkka

    2014-04-15

    The increase in life expectancy has resulted in a high occurrence of dementia and Alzheimer's disease (AD). Research on AD has undergone a paradigm shift from viewing it as a disease of old age to taking a life course perspective. Several vascular, lifestyle, psychological and genetic risk factors influencing this latent period have been recognized and they may act both independently and by potentiating each other. These risk factors have consequently been used to derive risk scores for predicting the likelihood of dementia. Despite population differences, age, low education and vascular risk factors were identified as key factors in all scoring systems. Risk scores can help to identify high-risk individuals who might benefit from different interventions. The European Dementia Prevention Initiative (EDPI), an international collaboration, encourages data sharing between different randomized controlled trials. At the moment, it includes three large ongoing European trials: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), Prevention of Dementia by Intensive Vascular Care (preDIVA), and Multidomain Alzheimer Prevention study (MAPT). Recently EDPI has developed a "Healthy Aging through Internet Counseling in Elderly" (HATICE) program, which intends to manage modifiable risk factors in an aged population through an easily accessible Internet platform. Thus, the focus of dementia research has shifted from identification of potential risk factors to using this information for developing interventions to prevent or delay the onset of dementia as well as identifying special high-risk populations who could be targeted in intervention trials.

  12. Evaluating the impact of caries prevention and management by caries risk assessment guidelines on clinical practice in a dental teaching hospital.

    PubMed

    Lee, Gillian H M; McGrath, Colman; Yiu, Cynthia K Y

    2016-05-26

    Clinical practice guidelines on 'Dental caries prevention and management by caries risk assessment for pre-school children in Hong Kong' were developed using ADAPTE process and Delphi consensus technique. This study aimed to evaluate the feasibility of disseminating and implementing the guidelines, and to evaluate their effectiveness in changing clinical practice. The study was conducted in two phases, examining clinical records of pre-school aged patients being treated by non-academic clinical staff in the Paediatric Dentistry Clinic of a dental teaching hospital in Hong Kong. The clinical guidelines were introduced to the staff in a departmental seminar at the end of pre-intervention phase. Post-intervention phase began one month after the introduction of guidelines. Clinical records for three consecutive months were reviewed against standards and recommendations derived from the newly developed clinical guidelines in both phases. The results were assessed by Chi-square test, ANOVA and regression analyses. A total of 237 and 147 clinical records were reviewed in pre-intervention and post-intervention phases, respectively. Guideline adherence percentage increased significantly on almost all aspects of the guidelines in the post-intervention phase (P < 0.05). There were a significant difference in the mean overall guideline adherence score (pre-intervention phase: [Formula: see text] = 14.86 ± 6.11; post-intervention phase: [Formula: see text] = 28.88 ± 8.75) and sub-domain adherence scores between the two phases (P < 0.001). The training grade of the clinicians was the factor associated with changes in evidence-based practice (P < 0.001). The developed guidelines were effective in translating evidence into best practice. The findings have implication for widespread implementation.

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

    SciTech Connect

    John Collins; John M. Beck

    2011-11-01

    The Next Generation Nuclear Plant (NGNP) Risk Management System (RMS) is a database used to maintain the project risk register. The RMS also maps risk reduction activities to specific identified risks. Further functionality of the RMS includes mapping reactor suppliers Design Data Needs (DDNs) to risk reduction tasks and mapping Phenomena Identification Ranking Table (PIRTs) to associated risks. This document outlines the basic instructions on how to use the RMS. This document constitutes Revision 1 of the NGNP Risk Management Database: A Model for Managing Risk. It incorporates the latest enhancements to the RMS. The enhancements include six new custom views of risk data - Impact/Consequence, Tasks by Project Phase, Tasks by Status, Tasks by Project Phase/Status, Tasks by Impact/WBS, and Tasks by Phase/Impact/WBS.

  14. [The economics of preventing psycho-social risks].

    PubMed

    Golzio, Luigi

    2014-01-01

    The aim of the essay is to show the SHIELD methodology for helping the firm management to improve the risks prevention policy. It has been tested in the field with positive results. SHIELD is a cost-benefit analysis application to compare prevention and non-prevention costs, which arise from non-market risks. In the economic perspective safety risks (which include psycho-social risks) are non-market ones as they cause injures to workers during the job. SHIELD (Social Health Indicators for Economic Labour Decisions), is the original method proposed by the author. It is a cost benefits analysis application, which compares safety prevention and non-prevention costs. The comparison allow stop management to evaluate the efficiency of the current safety prevention policy as it helps top management to answer to the policy question: how much to invest in prevention costs? The costs comparison is obtained through the reclassification of safety costs between prevention and non-prevention costs (which are composed by claim damages and penalty sanction costs). SHIELD has been tested empirically in four companies operating in the agribusiness sector during a research financed by the Assessorato all'Agricoltura and INAI Regionale of Emilia Romagna Region. Results are postive: it has been found that the increase of prevention costs causes the cut of non-prevention costs in all companies looked into, as assumed by the high reliability organization theory. SHIELD can be applied to all companies which must have an accounting system by law, no matter of the industry they act. Its application has limited costs as SHIELD doesn't need changes in the accounting system. Safety costs sustained by the company are simply reclassified in prevention and non-prevention costs. The comparison of these two costs categories has been appreciated by top management of companies investigated as a useful support to decide the risks prevention policy for the company. The SHIELD original feature compared

  15. Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montréal.

    PubMed

    Provost, Sylvie; Pineault, Raynald; Tousignant, Pierre; Hamel, Marjolaine; Da Silva, Roxane Borgès

    2011-11-10

    The goal of this project is to evaluate the implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk (PCMR). The intervention is based on the Chronic Care Model. The study will evaluate the implementation of the PCMR in 6 of the 12 health and social services centres (CSSS) in Montréal, and the effects of the PCMR on patients and the practice of their primary care physicians up to 40 months following implementation, as well as the sustainability of the program. Objectives are: 1-to evaluate the effects of the PCMR and their persistence on patients registered in the program and the practice of their primary care physicians, by implementation site and degree of exposure to the program; 2-to assess the degree of implementation of PCMR in each CSSS territory and identify related contextual factors; 3-to establish the relationships between the effects observed, the degree of PCMR implementation and the related contextual factors; 4-to assess the impact of the PCMR on strengthening local services networks. The evaluation will use a mixed design that includes two complementary research strategies. The first strategy is similar to a quasi-experimental "before-after" design, based on a quantitative approach; it will look at the program's effects and their variations among the six territories. The effects analysis will use data from a clinical database and from questionnaires completed by participating patients and physicians. Over 3000 patients will be recruited. The second strategy corresponds to a multiple case study approach, where each of the six CSSS constitutes a case. With this strategy, qualitative methods will set out the context of implementation using data from semi-structured interviews with program managers. The quantitative data will be analyzed using linear or multilevel models complemented with an interpretive approach to qualitative data analysis. Our study will identify contextual factors

  16. Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montréal

    PubMed Central

    2011-01-01

    Background The goal of this project is to evaluate the implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk (PCMR). The intervention is based on the Chronic Care Model. The study will evaluate the implementation of the PCMR in 6 of the 12 health and social services centres (CSSS) in Montréal, and the effects of the PCMR on patients and the practice of their primary care physicians up to 40 months following implementation, as well as the sustainability of the program. Objectives are: 1-to evaluate the effects of the PCMR and their persistence on patients registered in the program and the practice of their primary care physicians, by implementation site and degree of exposure to the program; 2-to assess the degree of implementation of PCMR in each CSSS territory and identify related contextual factors; 3-to establish the relationships between the effects observed, the degree of PCMR implementation and the related contextual factors; 4-to assess the impact of the PCMR on strengthening local services networks. Methods/Design The evaluation will use a mixed design that includes two complementary research strategies. The first strategy is similar to a quasi-experimental "before-after" design, based on a quantitative approach; it will look at the program's effects and their variations among the six territories. The effects analysis will use data from a clinical database and from questionnaires completed by participating patients and physicians. Over 3000 patients will be recruited. The second strategy corresponds to a multiple case study approach, where each of the six CSSS constitutes a case. With this strategy, qualitative methods will set out the context of implementation using data from semi-structured interviews with program managers. The quantitative data will be analyzed using linear or multilevel models complemented with an interpretive approach to qualitative data analysis. Discussion Our study will

  17. Radiation risk management at DOE accelerator facilities

    SciTech Connect

    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..

  18. RISK MANAGEMENT USING PROJECT RECON

    DTIC Science & Technology

    2016-11-28

    Risk Management Using Project Recon UNCLASSIFIED: Distribution Statement A. Approved for public release; distribution is unlimited. Bonnie Leece...Project Recon Lead What is Project Recon? • A web-based GOTS tool designed to capture, manage , and link Risks, Issues, and Opportunities in a...centralized database. • Project Recon (formerly Risk Recon) is designed to be used by all Program Management Offices, Integrated Project Teams and any

  19. Dental fluorosis: exposure, prevention and management.

    PubMed

    Abanto Alvarez, Jenny; Rezende, Karla Mayra P C; Marocho, Susana María Salazar; Alves, Fabiana B T; Celiberti, Paula; Ciamponi, Ana Lidia

    2009-02-01

    Dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. The severity of dental fluorosis depends on when and for how long the overexposure to fluoride occurs, the individual response, weight, degree of physical activity, nutritional factors and bone growth. The risk period for esthetic changes in permanent teeth is between 20 and 30 months of age. The recommended level for daily fluoride intake is 0.05 - 0.07 mg F/Kg/day, which is considered of great help in preventing dental caries, acting in remineralization. A daily intake above this safe level leads to an increased risk of dental fluorosis. Currently recommended procedures for diagnosis of fluorosis should discriminate between symmetrical and asymmetrical and/or discrete patterns of opaque defects. Fluorosis can be prevented by having an adequate knowledge of the fluoride sources, knowing how to manage this issue and therefore, avoid overexposure.

  20. Improving Information Security Risk Management

    ERIC Educational Resources Information Center

    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…

  1. Improving Information Security Risk Management

    ERIC Educational Resources Information Center

    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…

  2. Challenges to sustainable risk management

    SciTech Connect

    Pinto, Ariel C., Aurora, Ashish, Hall, Dennis E.,

    2004-08-09

    This paper summarizes the intermediate lessons learned from the analyses of the risk management problems in three technological endeavors. These problems are: the absence of a structure for rewarding successful project risk management; the need for an ever-more accurate economic measure of risk; and the difficulty of transferring risks to contract-bound independent outsourcing entity. This paper also describes recent advancement towards providing answers to these challenges and future research endeavors in this field.

  3. Managing the risks of risk management on large fires

    Treesearch

    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...

  4. The Active Management of Risk in Nulliparous Pregnancy at Term: association between a higher preventive labor induction rate and improved birth outcomes

    PubMed Central

    NICHOLSON, James M.; STENSON, Ms. Morghan H.; KELLAR, Lisa; CAUGHEY, Aaron B.; MACONES, George A.

    2009-01-01

    Objective To determine if exposure of nulliparous women to a high rate of preventive labor induction was associated with improvement in birth health. Study Design A risk-scoring system was used to guide the frequent use of preventive labor induction in 100 nulliparous women. The birth outcomes of this group were compared to those of 352 nulliparous women who received usual care. Cesarean delivery was the primary study outcome. The Adverse Outcome Index and the rate of uncomplicated vaginal delivery were used to measure overall birth health. Results The exposed group experienced a higher labor induction rate (48% vs. 23.6%, p = <0.001), a lower cesarean rate (9% vs. 25.8%, aOR 0.36 p=0.02), and better composite birth outcomes. Conclusion Exposure of nulliparous women to a high preventive induction rate was significantly associated with improvement in birth health. Prospective randomized trials are needed to further explore the utility of risk-guided preventive labor induction. PMID:19168168

  5. Management of drought risk under global warming

    NASA Astrophysics Data System (ADS)

    Zhang, Qiang; Han, Lanying; Jia, Jianying; Song, Lingling; Wang, Jinsong

    2016-07-01

    Drought is a serious ecological problem around the world, and its impact on crops and water availability for humans can jeopardize human life. Although drought has always been common, the drought risk has become increasingly prominent because of the climatic warming that has occurred during the past century. However, it still does not comprehensively understand the mechanisms that determine the occurrence of the drought risk it poses to humans, particularly in the context of global climate change. In this paper, we summarize the progress of research on drought and the associated risk, introduce the principle of a drought "transition" from one stage to another, synthesize the characteristics of key factors and their interactions, discuss the potential effect of climatic warming on drought risk, and use this discussion to define the basic requirements for a drought risk management system. We also discuss the main measures that can be used to prevent or mitigate droughts in the context of a risk management strategy.

  6. Knowledge management: an innovative risk management strategy.

    PubMed

    Zipperer, Lorri; Amori, Geri

    2011-01-01

    Knowledge management effectively lends itself to the enterprise risk process. The authors introduce the concept of knowledge management as a strategy to drive innovation and support risk management. They align this work with organizational efforts to improve patient safety and quality through the effective sharing of experience and lessons learned. The article closes with suggestions on how to develop a knowledge management initiative at an organization, who should be on the team, and how to sustain this effort and build the culture it requires to drive success.

  7. Continuous Risk Management at NASA

    NASA Technical Reports Server (NTRS)

    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.

  8. Impact of the Prevention Plan on Employee Health Risk Reduction

    PubMed Central

    Edington, Dee W.; Bég, Sami

    2010-01-01

    Abstract This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coaching, contests, group events, and employer incentives. Specifically, we analyzed changes in 15 health risk measures among a cohort of 2606 employees from multiple employer groups who completed a baseline health risk appraisal, blood tests, and biometric screening in 2008 and who were reassessed in 2009. We then compared the data to the Edington Natural Flow of risks. The cohort showed significant reduction in 10 of the health risks measured (9 at P ≤ 0.01 and 1 at P ≤ 0.05). The most noticeable changes in health risks were a reduction in the proportion of employees with high-risk blood pressure (42.78%), high-risk fasting blood sugar (31.13%), and high-risk stress (24.94%). There was an overall health risk transition among the cohort with net movement from higher risk levels to lower risk levels (P < 0.01). There was a net increase of 9.40% of people in the low-risk category, a decrease of 3.61% in the moderate-risk category, and a 5.79% decrease in the high-risk category. Compared to Edington's Natural Flow model, 48.70% of individuals in the high-risk category moved from high risk to moderate risk (Natural Flow 31%), 46.35% moved from moderate risk to low risk (Natural Flow 35%), 15.65% moved from high risk to low risk (Natural Flow 6%), and 87.33% remained in the low-risk category (Natural Flow 70%) (P < 0.001). (Population Health Management 2010;13:275–284) PMID:20879909

  9. Drivers and barriers among householders to managing domestic wastewater treatment systems in the Republic of Ireland; implications for risk prevention behaviour

    NASA Astrophysics Data System (ADS)

    Devitt, Catherine; O'Neill, Eoin; Waldron, Richard

    2016-04-01

    Septic systems that are malfunctioning, improperly sited or designed, present a contamination risk to drinking water sources, and subsequently, to human health. However, the international literature identifies gaps in householder knowledge regarding the function and maintenance requirements of septic systems, and also the potential health and environmental risk implications. Allied with householder fears related to the financial cost of risk management, these factors tend to reduce concern to recognise a malfunctioning system. In the Republic of Ireland, three-quarters of households in rural areas utilise an individual domestic wastewater treatment system (or septic system). Consequently, a significant portion of rural households that rely on groundwater sources via private-well use are at risk. Ireland reports one of the highest crude incidence rates of Verotoxigenic Escherichia coli (VTEC) infection in the European Union, and waterborne transmission related to contact with untreated or poorly treated water from private water sources is a factor in its transmission. Following recent Irish legislative change that places a duty of care on individual householders to ensure a proper system functioning, this exploratory study examines perceptions towards the risk management of septic systems among Irish householders. Using qualitative research methods, four focus groups selected on the basis of geographical variation, and two semi-structured interviews were conducted. While most householders agreed that poorly maintained septic systems represented a threat to the environment and to public health, none reported to having a regular maintenance routine in place. Thematic analysis revealed the drivers and barriers to septic system maintenance, and preferences of householders pertaining to communication on septic systems. The Health Belief Model is employed to help understand results. Results suggest that householder capacity to engage in regular risk management is reduced

  10. Feedback on flood risk management

    NASA Astrophysics Data System (ADS)

    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 developed 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. With the help of Meteo France datas and experts, Predict services helps local communities and companies in decision making for flood management. 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

  11. Managing the Risks of School District Special Events.

    ERIC Educational Resources Information Center

    Berlonghi, Alexander

    1991-01-01

    A school district's risk manager must provide the leadership in risk management for district special events. Tables list the following: (1) seven reasons for event failures, and preventive measures to take; (2) risk analysis checklist; and (3) event planning outline. (MLF)

  12. Primary prevention of periodontitis: managing gingivitis.

    PubMed

    Chapple, Iain L C; Van der Weijden, Fridus; Doerfer, Christof; Herrera, David; Shapira, Lior; Polak, David; Madianos, Phoebus; Louropoulou, Anna; Machtei, Eli; Donos, Nikos; Greenwell, Henry; Van Winkelhoff, Ari J; Eren Kuru, Bahar; Arweiler, Nicole; Teughels, Wim; Aimetti, Mario; Molina, Ana; Montero, Eduardo; Graziani, Filippo

    2015-04-01

    Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal

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

    SciTech Connect

    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.

  14. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Risk management. 917.3 Section 917.3 Banks and... RESPONSIBILITIES OF BANK BOARDS OF DIRECTORS AND SENIOR MANAGEMENT § 917.3 Risk management. (a) Risk management... all times a risk management policy that addresses the Bank's exposure to credit risk, market risk...

  15. Alcohol Risk Management Survey Summary.

    ERIC Educational Resources Information Center

    Janosik, Steven M.; Anderson, David S.

    Results of the Alcohol Risk Management Survey, which was completed by 325 college chief student affairs officers at four-year institutions, are presented. Adapted from the "Collegiate Alcohol Risk Assessment Guide," the survey assesses the management of alcohol-related activities on the college campus, with a focus on policy, procedure,…

  16. Continuous Risk Management

    NASA Technical Reports Server (NTRS)

    Sabelhaus, Phil

    2002-01-01

    Risk identification is an ongoing activity that takes place during the routine project work flow. Project activities such as programmatic and technical meetings, telecons, reviews, and other forms of communication often bring to light project risks. When this occurs, we record and analyze the risk on a Risk Information Sheet. This process helps the project team identify and cope with project risks throughout the life of the project.

  17. Pollution prevention and total quality management

    SciTech Connect

    Baker, G.E.

    1995-09-01

    Both quality management and pollution prevention are paradigms for their respective concepts to be followed and put into effect in industrial production. They each represent a framework for making things better, and for the examination and evaluation of current practices. Both pollution prevention and total quality management welcome innovative thought and the mandate to question the validity of practices. This chapter investigates the similarities of purpose and content of pollution prevention and total quality management techniques for industrial wastes. It also examines the reasons and directions that industry is following to make both paradigms integral parts of conducting business.

  18. Managing and Preventing Temper Tantrums

    MedlinePlus

    ... However, it is not a sign of bad parenting, but rather of a frustrated child. Plan ahead ... Resources Centers for Disease Control and Prevention, Positive Parenting Tips Last Updated: January 2017 This article was ...

  19. Neurocysticercosis: risk and primary prevention strategies update.

    PubMed

    Enander, Richard T; Ramirez Amaya, Antonio; Enander, Richard A; Gute, David M

    2010-10-01

    Neurocysticercosis results from the infestation of the central nervous system with invading tapeworm larvae. Though uncommon in the US prior to 1965, new cases are currently being diagnosed at an unprecedented rate. Drawing on environmental health, intervention and risk data retrieved from standard/alternative databases and in-country sources, we present an update and summary of modifiable risk factors and field-tested primary prevention measures. While points of intervention, subpopulations at risk and overall magnitude of the problem are addressed, particular attention is paid to defining risk reduction measures that can be adopted by individuals and high risk groups in the near-term to interrupt or eliminate pathways of exposure leading to disease transmission. Though global eradication is not attainable in the near future, effective preventative measures exist and should be taken now by international travellers and workers, US/foreign government agencies, and individuals living in endemic regions to reduce human suffering.

  20. Managing Risk in Systems Development.

    ERIC Educational Resources Information Center

    DePaoli, Marilyn M.; And Others

    Stanford University's use of a risk assessment methodology to improve the management of systems development projects is discussed. After examining the concepts of hazard, peril, and risk as they relate to the system development process, three ways to assess risk are covered: size, structure, and technology. The overall objective for Stanford…

  1. Managing Risk in Systems Development.

    ERIC Educational Resources Information Center

    DePaoli, Marilyn M.; And Others

    Stanford University's use of a risk assessment methodology to improve the management of systems development projects is discussed. After examining the concepts of hazard, peril, and risk as they relate to the system development process, three ways to assess risk are covered: size, structure, and technology. The overall objective for Stanford…

  2. Preventing adolescent pregnancy and associated risks.

    PubMed Central

    Miller, R.

    1995-01-01

    Adolescent pregnancy is a complex and frustrating problem that exacts a large social and personal cost. This year approximately 40,000 Canadian teenagers will become pregnant. With proper prevention, this number could be reduced. Pregnant teenagers seem to be at increased risk for some obstetric complications and their children for some neonatal complications. Family physicians who see patients over the course of a lifetime are in a good position to prevent adolescent pregnancy and the associated complications. PMID:8520241

  3. Preventing adolescent pregnancy and associated risks.

    PubMed

    Miller, R

    1995-09-01

    Adolescent pregnancy is a complex and frustrating problem that exacts a large social and personal cost. This year approximately 40,000 Canadian teenagers will become pregnant. With proper prevention, this number could be reduced. Pregnant teenagers seem to be at increased risk for some obstetric complications and their children for some neonatal complications. Family physicians who see patients over the course of a lifetime are in a good position to prevent adolescent pregnancy and the associated complications.

  4. Smart Grid Risk Management

    NASA Astrophysics Data System (ADS)

    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

  5. Risk management in waste water treatment.

    PubMed

    Wagner, M; Strube, I

    2005-01-01

    With the continuous restructuring of the water market due to liberalisation, privatisation and internationalisation processes, the requirements on waste water disposal companies have grown. Increasing competition requires a target-oriented and clearly structured procedure. At the same time it is necessary to meet the environment-relevant legal requirements and to design the processes to be environment-oriented. The implementation of risk management and the integration of such a management instrument in an existing system in addition to the use of modern technologies and procedures can help to make the operation of the waste water treatment safer and consequently strengthen market position. The risk management process consists of three phases, risk identification, risk analysis/risk assessment and risk handling, which are based on each other, as well as of the risk managing. To achieve an identification of the risks as complete as possible, a subdivision of the kind of risks (e.g. legal, financial, market, operational) is suggested. One possibility to assess risks is the portfolio method which offers clear representation. It allows a division of the risks into classes showing which areas need handling. The determination of the appropriate measures to handle a risk (e.g. avoidance, reduction, shift) is included in the concluding third phase. Different strategies can be applied here. On the one hand, the cause-oriented strategy, aiming at preventive measures which aim to reduce the probability of occurrence of a risk (e.g. creation of redundancy, systems with low susceptibility to malfunction). On the other hand, the effect-oriented strategy, aiming to minimise the level of damage in case of an undesired occurrence (e.g. use of alarm systems, insurance cover).

  6. [Prediction, prevention and management of shoulder dystocia].

    PubMed

    Csorba, Roland

    2012-05-20

    Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2-0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4-16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia.

  7. Risk Management Issues - An Aerospace Perspective

    NASA Technical Reports Server (NTRS)

    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.

  8. Risk based tiered approach (RBTASM) for pollution prevention.

    PubMed

    Elves, R G; Sweeney, L M; Tomljanovic, C

    1997-11-01

    Effective management of human health and ecological hazards in the manufacturing and maintenance environment can be achieved by focusing on the risks associated with these operations. The NDCEE Industrial Health Risk Assessment (IHRA) Program is developing a comprehensive approach to risk analysis applied to existing processes and used to evaluate alternatives. The IHRA Risk-Based Tiered Approach (RBTASM) builds on the American Society for Testing and Materials (ASTM) Risk-Based Corrective Action (RBCA) effort to remediate underground storage tanks. Using readily available information, a semi-quantitative ranking of alternatives based on environmental, safety, and occupational health criteria was produced. A Rapid Screening Assessment of alternative corrosion protection products was performed on behalf of the Joint Group on Acquisition Pollution Prevention (JG-APP). Using the RBTASM in pollution prevention alternative selection required higher tiered analysis and more detailed assessment of human health risks under site-specific conditions. This example illustrates the RBTASM for a organic finishing line using three different products (one conventional spray and two alternative powder coats). The human health risk information developed using the RBTASM is considered along with product performance, regulatory, and cost information by risk managers downselecting alternatives for implementation or further analysis.

  9. Patient safety incident prevention and management among Finnish dentists.

    PubMed

    Hiivala, Nora; Mussalo-Rauhamaa, Helena; Murtomaa, Heikki

    2013-11-01

    Assessing current patient safety incident (PSI) prevention measures and risk management practices among Finnish dentists. A total of 1041 dentists practicing in the private or public sectors in southern Finland completed an online questionnaire concerning PSI prevention, PSI-reporting systems, feedback and knowledge gained from device incidents and patient-generated safety information and the knowledge of national PS-guidance. The answers were handled anonymously. Statistical evaluations were performed using chi-square analysis. Dentists suggested multiple methods for preventing PSIs related to dental diagnostics, various treatments, equipment and devices, medications, communication, infection control and general practice safety. Preventive methods reported most frequently included working with caution and forethought, keeping accurate patient records and the availability of correct patient information. A special PSI-reporting system was used by less than one third of respondents. Feedback received on PS-related data and the utilization of guidebooks varied significantly between the studied dentist groups. Several PSI prevention techniques are already used in Finland. However, wide variation exists in PSI prevention and risk management practices among Finnish dentists. Systematic implementation of available safety methods would probably prevent several PSIs. The results indicate that the more dentists know about PS risks, the easier it is for them to recognize situations possibly leading to patient harm. Anonymous PSI reports, patient complaints and claims data should, therefore, be actively used for mutual learning. Increased PS education in dentistry is also needed.

  10. The Active Management of Risk in Multiparous Pregnancy at Term: association between a higher preventive labor induction rate and improved birth outcomes

    PubMed Central

    Nicholson, James M.; Caughey, Aaron; Stenson, Ms. Morghan H.; Cronholm, Peter; Kellar, Lisa; Bennett, Ian; Margo, Katie; Stratton, Joseph

    2009-01-01

    Objective To determine if exposure of multiparous women to a high rate of preventive labor induction was associated with a significantly lower cesarean delivery rate. Study Design Retrospective cohort study involving 123 multiparas, who were exposed to the frequent use of preventive labor induction, and 304 multiparas, who received standard management. Rates of cesarean delivery and other adverse birth outcomes were compared in the two groups. Logistic regression controlled for confounding covariates. Results The exposed group had a lower cesarean delivery rate (aOR 0.09, 0.8% vs. 9.9%, p = 0.02) and a higher uncomplicated vaginal delivery rate (OR 0.53, 78.9% vs. 66.4%, p=0.01). Exposure was not associated with higher rates of other adverse birth outcomes. Conclusion Exposure of multiparas to a high rate of preventive labor induction was significantly associated with improved birth outcomes including a very low cesarean delivery rate. A prospective randomized trial is needed to determine causality. PMID:19254584

  11. Risk Management in the Clinical Laboratory

    PubMed Central

    Njoroge, Sarah W

    2014-01-01

    Clinical laboratory tests play an integral role in medical decision-making and as such must be reliable and accurate. Unfortunately, no laboratory tests or devices are foolproof and errors can occur at pre-analytical, analytical and post-analytical phases of testing. Evaluating possible conditions that could lead to errors and outlining the necessary steps to detect and prevent errors before they cause patient harm is therefore an important part of laboratory testing. This can be achieved through the practice of risk management. EP23-A is a new guideline from the CLSI that introduces risk management principles to the clinical laboratory. This guideline borrows concepts from the manufacturing industry and encourages laboratories to develop risk management plans that address the specific risks inherent to each lab. Once the risks have been identified, the laboratory must implement control processes and continuously monitor and modify them to make certain that risk is maintained at a clinically acceptable level. This review summarizes the principles of risk management in the clinical laboratory and describes various quality control activities employed by the laboratory to achieve the goal of reporting valid, accurate and reliable test results. PMID:24982831

  12. Postmenopausal osteoporosis: fracture risk and prevention.

    PubMed

    Kaunitz, Andrew M; McClung, Michael R; Feldman, Robert G; Wysocki, Susan

    2009-11-01

    In the estrogen-regulated RANK ligand (RANKL)/RANK/osteoprotegerin (OPG) pathway, estrogen deficiency favors osteoclast maturation, leading to increased bone resorption compared with bone formation. Treatment of low bone mineral density (BMD) should be based on fracture risk, assessed using the WHO Fracture Risk Algorithm (FRAX(R)). Criteria for treatment are 10-year overall fracture risk ≥ 20% or 10-year hip fracture risk ≥ 3%. Vitamin D supplementation at levels higher than those traditionally recommended may be appropriate for healthy menopausal women. Multiple strategies are needed to effectively manage osteoporosis in postmenopausal women.

  13. They're Suing Us? Liability and Risk Management.

    ERIC Educational Resources Information Center

    Hollander, Patricia A.

    1982-01-01

    Legal issues in liability for and prevention of injuries through negligence are discussed: proving negligence, who is owed a duty of care, who may be sued, remedies, risk management (shifting risk, insurance, indemnification, waivers and releases), and preventing claims (warning of known danger, proper supervision, school maintenance, security,…

  14. They're Suing Us? Liability and Risk Management.

    ERIC Educational Resources Information Center

    Hollander, Patricia A.

    1982-01-01

    Legal issues in liability for and prevention of injuries through negligence are discussed: proving negligence, who is owed a duty of care, who may be sued, remedies, risk management (shifting risk, insurance, indemnification, waivers and releases), and preventing claims (warning of known danger, proper supervision, school maintenance, security,…

  15. Risk Management Plan

    SciTech Connect

    HODGES, ANN LOUISE; FROEHLICH, GARY K.; PILCH, MARTIN; PEERCY, DAVID E.

    2002-04-01

    This document describes a proactive plan for assessing and controlling sources of risk for the ASCI (Accelerated Strategic Computing Initiative) V&V program at Sandia National Laboratories. It offers a graded approach for identifying, analyzing, prioritizing, responding to, and monitoring risks.

  16. Managing Plagiarism: A Preventative Approach

    ERIC Educational Resources Information Center

    Insley, Robert

    2011-01-01

    Plagiarism is a reality in most college classes where some students plagiarize unknowingly and others do so knowingly. This situation requires instructors to decide how to manage the situation. Some may take the easy way out by ignoring the problem, simply pretending that none of their students plagiarize. In contrast, other instructors embrace…

  17. Emerging Risk Factors and Prevention of Perioperative Pulmonary Complications

    PubMed Central

    2014-01-01

    Modern surgery is faced with the emergence of newer “risk factors” and the challenges associated with identifying and managing these risks in the perioperative period. Obstructive sleep apnea and obesity hypoventilation syndrome pose unique challenges in the perioperative setting. Recent studies have identified some of the specific risks arising from caring for such patients in the surgical setting. While all possible postoperative complications are not yet fully established or understood, the prevention and management of these complications pose even greater challenges. Pulmonary hypertension with its changing epidemiology and novel management strategies is another new disease for the surgeon and the anesthesiologist in the noncardiac surgical setting. Traditionally most such patients were not considered surgical candidates for any required elective surgery. Our review discusses these disease entities which are often undiagnosed before elective noncardiac surgery. PMID:24578647

  18. Human Research Risk Management

    NASA Image and Video Library

    Crew health and performance is critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) investigates and mitigates the highest risks to human health and per...

  19. Risk analysis and management

    NASA Technical Reports Server (NTRS)

    Smith, H. E.

    1990-01-01

    Present software development accomplishments are indicative of the emerging interest in and increasing efforts to provide risk assessment backbone tools in the manned spacecraft engineering community. There are indications that similar efforts are underway in the chemical processes industry and are probably being planned for other high risk ground base environments. It appears that complex flight systems intended for extended manned planetary exploration will drive this technology.

  20. Feedback on flood risk management

    NASA Astrophysics Data System (ADS)

    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

  1. The risk management implications of NUREG--1150 methods and results

    SciTech Connect

    Camp, A.L.; Maloney, K.J.; Sype, T.T. )

    1989-09-01

    This report describes the potential uses of NUREG-1150 and similar Probabilistic Risk Assessments (PRAs) in NRC and industry risk management programs. NUREG-1150 uses state-of-the-art PRA techniques to estimate the risk from five nuclear power plants. The methods and results produced in NUREG-1150 provide a framework within which current risk management strategies can be evaluated, and future risk management programs can be developed and assessed. While the development of plant-specific risk management strategies is beyond the scope of this document, examples of the use of the NUREG-1150 framework for identifying and evaluating risk management options are presented. All phases of risk management from prevention of initiating events though reduction of offsite consequences are discussed, with particular attention given to the early phase of accidents. 14 refs., 9 figs., 28 tabs.

  2. Prevention of accidental exposure in radiotherapy: the risk matrix approach.

    PubMed

    Vilaragut, J J; Duménigo, C; Delgado, J M; Morales, J; McDonnell, J D; Ferro, R; Ortiz López, P; Ramírez, M L; Pérez Mulas, A; Papadopulos, S; Gonçalves, M; López Morones, R; Sánchez Cayuela, C; Cascajo Castresana, A; Somoano, F; Álvarez, C; Guillén, A; Rodríguez, M; Pereira, P P; Nader, A

    2013-02-01

    Knowledge and lessons from past accidental exposures in radiotherapy are very helpful in finding safety provisions to prevent recurrence. Disseminating lessons is necessary but not sufficient. There may be additional latent risks for other accidental exposures, which have not been reported or have not occurred, but are possible and may occur in the future if not identified, analyzed, and prevented by safety provisions. Proactive methods are available for anticipating and quantifying risk from potential event sequences. In this work, proactive methods, successfully used in industry, have been adapted and used in radiotherapy. Risk matrix is a tool that can be used in individual hospitals to classify event sequences in levels of risk. As with any anticipative method, the risk matrix involves a systematic search for potential risks; that is, any situation that can cause an accidental exposure. The method contributes new insights: The application of the risk matrix approach has identified that another group of less catastrophic but still severe single-patient events may have a higher probability, resulting in higher risk. The use of the risk matrix approach for safety assessment in individual hospitals would provide an opportunity for self-evaluation and managing the safety measures that are most suitable to the hospital's own conditions.

  3. 78 FR 36784 - Survey of Nanomaterial Risk Management Practices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Survey of Nanomaterial Risk Management... of Nanomaterial Risk Management Practices; Notice of Public Meeting and Request for Comments. SUMMARY... nanomaterial producers, distributors, end-users, and R&D laboratories for inclusion in a sampling frame? (3) A...

  4. Influenza prevention and population health management.

    PubMed

    Kuhn, Alyce

    2008-10-01

    Modifiable health risk factors can be improved through effective health promotion and disease management efforts, such as vaccinations. Employers must understand that employee illness is related to not only medical and pharmaceutical costs, but to productivity costs as well.

  5. Pollution prevention: Avoiding the need to manage wastes

    SciTech Connect

    Meltzer, M.

    1993-12-01

    Today`s industrial processes generate many types of waste products that constitute risks to human health and the surrounding environment. While proper waste management procedures can lower this risk, prevention of the waste`s generation will eliminate the risk. For this reason, the United States has established pollution prevention as a national objective, through the passage of its Pollution Prevention Act of 1990. Pollution prevention involves a wide range of approaches, all with the same objective: to reduce or eliminate the creation of waste at its source in other words, within the process that generates it. This objective, so beneficial to the environment, also coincides with industrial economic interests. Pollution prevention measures and greater process efficiency go hand in hand, and typically result in lower operating costs as well as greatly reduced waste management expenses. The US Environmental Protection Agency defines pollution prevention as the maximum feasible reduction of all wastes generated at production sites. This objective is accomplished largely through source reduction and reuse of input materials during production.

  6. Flood Risk and Asset Management

    DTIC Science & Technology

    2011-06-15

    WN911NF-10-2-0104 FLOOD RISK AND ASSET MANGEMENT PN 01 1 R. 1.0 WN911NF-10-2-0104 FLOOD RISK AND ASSET MANAGEMENT Progress Note 2... MANGEMENT PN 01 2 R. 1.0 Contents 1. Progress statement...0104 FLOOD RISK AND ASSET MANGEMENT PN 01 3 R. 1.0 The next stages in the project, until the end of July, are described below: • HR

  7. Preterm Labor: Prevention and Management.

    PubMed

    Rundell, Kristen; Panchal, Bethany

    2017-03-15

    In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1.5 to two times more likely to have a subsequent preterm delivery. Antenatal progesterone is associated with a significant decrease in subsequent preterm delivery in certain pregnant women. Current recommendations are to prescribe vaginal progesterone in women with a shortened cervix and no history of preterm delivery, and to use progesterone supplementation regardless of cervical length in women with a history of spontaneous preterm delivery. Cervical cerclage has been used to help correct structural defects or cervical weakening in high-risk women with a shortened cervix. A course of corticosteroids is the only antenatal intervention that has been shown to improve postdelivery neonatal outcomes, including a reduction in neonatal mortality, intracranial hemorrhage, necrotizing enterocolitis, and neonatal infection. Tocolytics, especially prostaglandin inhibitors and calcium channel blockers, may allow time for the administration of antenatal corticosteroids and transfer to a tertiary care facility if necessary. When used in specific at-risk populations, magnesium sulfate provides neuroprotection and decreases the incidence of cerebral palsy in preterm infants.

  8. Fact Sheet: Risk Management Plan (RMP) Audit Program

    EPA Pesticide Factsheets

    Risk management programs, which consist of a hazard assessment, a prevention program, and an emergency response program; must be periodically audited to assess whether the plans are adequate or need to be revised to comply with the regulation.

  9. LNG risk management

    NASA Astrophysics Data System (ADS)

    Martino, P.

    1980-12-01

    A general methodology is presented for conducting an analysis of the various aspects of the hazards associated with the storage and transportation of liquefied natural gas (LNG) which should be considered during the planning stages of a typical LNG ship terminal. The procedure includes the performance of a hazards and system analysis of the proposed site, a probability analysis of accident scenarios and safety impacts, an analysis of the consequences of credible accidents such as tanker accidents, spills and fires, the assessment of risks and the design and evaluation of risk mitigation measures.

  10. [The tropical traveling child: risks and prevention].

    PubMed

    Alcoba, G; Chappuis, F

    2015-05-06

    Children increasingly travel to the tropics. Compared with adults, the risks of severe malaria, dehydration due to diarrhea, and the number of infectious episodes, are higher. Paradoxically, children receive less pre-travel advice than adults, and some parents are opposed to vaccinations. The consultation must target essential prevention topics. We present the age-related schedules for immunizations against yellow and typhoid fevers, hepatitis A and B, tick-borne and Japanese encephalitis, and rabies. We discuss the preventive measures for malaria, accidents, altitude, and prescriptions for antimalarial drugs, rehydration solutions and standby antibiotics according to weight.

  11. The NASA Continuous Risk Management Process

    NASA Technical Reports Server (NTRS)

    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

  12. The NASA Continuous Risk Management Process

    NASA Technical Reports Server (NTRS)

    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

  13. Pravastatin reduces the risk for cardiovascular disease in Japanese hypercholesterolemic patients with impaired fasting glucose or diabetes: diabetes subanalysis of the Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study.

    PubMed

    Tajima, Naoko; Kurata, Hideaki; Nakaya, Noriaki; Mizuno, Kyoichi; Ohashi, Yasuo; Kushiro, Toshio; Teramoto, Tamio; Uchiyama, Shinichiro; Nakamura, Haruo

    2008-08-01

    Diabetes mellitus (DM) is a major risk factor for cardiovascular disease (CVD) in patients with no history of CVD. Evidence for the effect of statins on CVD in the diabetic population in low-risk populations (e.g., Japanese) is limited. We evaluated the effect of pravastatin on risk reduction of CVD related to baseline glucose status in a primary prevention setting. The Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study, in patients with mild-to-moderate hypercholesterolemia (220-270 mg/dL), showed that low-dose pravastatin significantly reduced the risk for CVD by 26%. This exploratory subanalyses examined the efficacy of diet plus pravastatin on CVD in 2210 patients with abnormal fasting glucose (AFG, including 1746 patients with DM and 464 patients with impaired fasting glucose (IFG) at 5 years in the MEGA Study. CVD was threefold higher in AFG patients (threefold higher in DM, and twofold higher in IFG) compared with normal fasting glucose (NFG) patients in the diet group. Diet plus pravastatin treatment significantly reduced the risk of CVD by 32% (hazard ratio 0.68, 95% CI 0.48-0.96, number needed to treat, 42) in the AFG group compared with the diet alone group, and no significant interaction between AFG and NFG (interaction P=0.85) was found. Safety problems were not observed during long-term treatment with pravastatin. In conclusion, pravastatin reduces the risk of CVD in subjects with hypercholesterolemia and abnormal fasting glucose in the primary prevention setting in Japan.

  14. Managing Multiple Risk Factors.

    DTIC Science & Technology

    1998-09-01

    cardiovascular disease among black women can be better controlled through the use of a stress reduction intervention that reduces the sympathetic nervous...All participants will have high normal (130/80) or mild hypertension and at least two additional risk factors for cardiovascular disease (e.g

  15. Blood pressure control versus atrial fibrillation management in stroke prevention.

    PubMed

    Savoia, Carmine; Sada, Lidia; Volpe, Massimo

    2015-06-01

    Hypertension is one of the major risk factors for atrial fibrillation which in turn is the most prevalent concomitant condition in hypertensive patients. While both these pathological conditions are independent risk factors for stroke, the association of hypertension and atrial fibrillation increases the incidence of disabling strokes. Moreover, documented or silent atrial fibrillation doubles the rate of cardiovascular death. Lowering blood pressure is strongly recommended, particularly for primary stroke prevention. However, a relatively small percentage of hypertensive patients still achieve the recommended blood pressure goals. The management of atrial fibrillation with respect to stroke prevention is changing. New oral anticoagulants represent a major advancement in long-term anticoagulation therapy in non valvular atrial fibrillation. They have several benefits over warfarin, including improved adherence to the anticoagulation therapy. This is an important issue since non-adherence to stroke prevention medications is a risk factor for first and recurrent strokes.

  16. Pleural procedural complications: prevention and management

    PubMed Central

    Psallidas, Ioannis; Wrightson, John M.; Hallifax, Robert J.; Rahman, Najib M.

    2015-01-01

    Pleural disease is common with a rising case frequency. Many of these patients will be symptomatic and require diagnostic and/or therapeutic procedures. Patients with pleural disease present to a number of different medical specialties, and an equally broad range of clinicians are therefore required to have practical knowledge of these procedures. There is often underestimation of the morbidity and mortality associated with pleural interventions, even those regarded as being relatively straightforward, with potentially significant implications for processes relating to patient safety and informed consent. The advent of thoracic ultrasound (TUS) has had a major influence on patient safety and the number of physicians with the necessary skill set to perform pleural procedures. As the variety and complexity of pleural interventions increases, there is increasing recognition that early specialist input can reduce the risk of complications and number of procedures a patient requires. This review looks at the means by which complications of pleural procedures arise, along with how they can be managed or ideally prevented. PMID:26150919

  17. Risk management in radiology departments

    PubMed Central

    Craciun, Horea; Mankad, Kshitij; Lynch, Jeremy

    2015-01-01

    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as a result of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients. PMID:26120383

  18. Risk management in radiology departments.

    PubMed

    Craciun, Horea; Mankad, Kshitij; Lynch, Jeremy

    2015-06-28

    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as a result of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients.

  19. Management and prevention of occupational asthma.

    PubMed

    Tarlo, Susan M

    2017-06-01

    Occupational asthma is a potential preventable form of asthma. This review of diagnosis, management and prevention focuses mainly on publications from the past three years. Early suspicion of the diagnosis is essential for a timely diagnosis and management and the possibility may first be raised by the patient or may need to be elicited by careful history by the health care provider. Objective diagnostic steps are needed, as have been detailed in consensus statements and guidelines. A combination of tests is often needed for diagnosis and these are most easily obtained while the patient is still employed. Management includes consideration of safe future workplace accommodation and of preventive measures for the patient and for other workers.

  20. Overview, prevention and management of chemotherapy extravasation

    PubMed Central

    Kreidieh, Firas Y; Moukadem, Hiba A; El Saghir, Nagi S

    2016-01-01

    Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. We review in this article the clinical aspects of chemotherapy extravasation and latest advances in definitions, classification, prevention, management and guidelines. We review the grading of extravasation and tissue damage according to various chemotherapeutic drugs and present an update on treatment and new antidotes including dexrazoxane for anthracyclines extravasation. We highlight the importance of education and training of the oncology team for prevention and prompt pharmacological and non-pharmacological management and stress the availability of new antidotes like dexrazoxane wherever anthracyclines are being infused. PMID:26862492

  1. Risk factors for asthma: is prevention possible?

    PubMed

    Beasley, Richard; Semprini, Alex; Mitchell, Edwin A

    2015-09-12

    Asthma is one of the most common diseases in the world, resulting in a substantial burden of disease. Although rates of deaths due to asthma worldwide have reduced greatly over the past 25 years, no available therapeutic regimens can cure asthma, and the burden of asthma will continue to be driven by increasing prevalence. The reasons for the increase in asthma prevalence have not been defined, which limits the opportunities to develop targeted primary prevention measures. Although associations are reported between a wide range of risk factors and childhood asthma, substantiation of causality is inherently difficult from observational studies, and few risk factors have been assessed in primary prevention studies. Furthermore, none of the primary prevention intervention strategies that have undergone scrutiny in randomised controlled trials has provided sufficient evidence to lead to widespread implementation in clinical practice. A better understanding of the factors that cause asthma is urgently needed, and this knowledge could be used to develop public health and pharmacological primary prevention measures that are effective in reducing the prevalence of asthma worldwide. To achieve this it will be necessary to think outside the box, not only in terms of risk factors for the causation of asthma, but also the types of novel primary prevention strategies that are developed, and the research methods used to provide the evidence base for their implementation. In the interim, public health efforts should remain focused on measures with the potential to improve lung and general health, such as: reducing tobacco smoking and environmental tobacco smoke exposure; reducing indoor and outdoor air pollution and occupational exposures; reducing childhood obesity and encouraging a diet high in vegetables and fruit; improving feto-maternal health; encouraging breastfeeding; promoting childhood vaccinations; and reducing social inequalities.

  2. Managing cardiovascular risk inpatients with metabolic syndrome.

    PubMed

    Nesto, Richard W

    2005-01-01

    The metabolic syndrome is a constellation of risk factors that contribute to the onset of type 2 diabetes mellitus and cardiovascular disease (CVD). CVD has been identified by the National Cholesterol Education Program (NCEP) as the primary clinical outcome of the metabolic syndrome. Although no algorithm is currently available for estimating the absolute risk of CVD for patients with the metabolic syndrome, screening for cardiovascular (CV) risk in these patients involves testing for lipoprotein abnormalities (namely, an analysis of specific low-density lipoprotein particle numbers) and an assessment of various surrogate markers for subclinical coronary artery disease. Such screening can be used to help predict the development of CVD and thereby allow for effective interventions to help prevent coronary events. Strategies for reducing CV risk in patients with the metabolic syndrome are multifactorial. In addition to placing an emphasis on therapeutic lifestyle changes that increase levels of physical activity, dietary modification, and weight reduction, several pharmacologic therapies are available. One novel approach for managing CV risk in patients with the metabolic syndrome involves the inhibition of the endocannabinoid system, including the use of rimonabant. A review of CV risk factors in patients with the metabolic syndrome is beneficial for clinicians to apply in the care of their patients, along with a discussion about strategies for identifying at-risk patients and managing CVD risk for these patients.

  3. Successful Acquisition Risk Management: A Concept,

    DTIC Science & Technology

    analysis, has recently been advocating a shift from a focus on risk assessment and risk acceptance analysis towards risk management . The purpose of this...risk managers fail to realize their true and productive role in the risk management process. Finally, it is possible that the Deming management...philosophy underlying his quality control concepts can be adapted to aid more effective DoD systems acquisition risk management . (Author)

  4. Shoulder dystocia: risk factors, predictability, and preventability.

    PubMed

    Mehta, Shobha H; Sokol, Robert J

    2014-06-01

    Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Managing the Library Fire Risk.

    ERIC Educational Resources Information Center

    Morris, John

    A discussion of fire risks, causes, prevention, and salvage in libraries is presented in text and photographs. A description of some historic library fires demonstrates the value of adequate protection and preparedness programs to minimize loss and damage. The need for fire retardant construction and protection from valdalism and arson are…

  6. Managing the Library Fire Risk.

    ERIC Educational Resources Information Center

    Morris, John

    A discussion of fire risks, causes, prevention, and salvage in libraries is presented in text and photographs. A description of some historic library fires demonstrates the value of adequate protection and preparedness programs to minimize loss and damage. The need for fire retardant construction and protection from valdalism and arson are…

  7. Prevention and management of stroke in women.

    PubMed

    Howe, Matthew D; McCullough, Louise D

    2015-04-01

    Stroke is the leading cause of acquired disability and the third leading cause of death in women worldwide. Sex differences in risk factors, treatment response and quality of life after stroke complicate stroke management in women. Women have an increased lifetime incidence of stroke compared to men, largely due to a sharp increase in stroke risk in older postmenopausal women. Women also have an increased lifetime prevalence of stroke risk factors, including hypertension and atrial fibrillation in postmenopausal women, as well as abdominal obesity and metabolic syndrome in middle-aged women. Controversy continues over the risks of oral contraceptives, hormone therapy and surgical intervention for carotid stenosis in women. Pregnancy and the postpartum period represent a time of increased risk, presenting challenges to stroke management. Recognition of these issues is critical to improving acute care and functional recovery after stroke in women.

  8. Risk Management Programs for Defense Acquisition Systems

    DTIC Science & Technology

    2007-11-02

    The audit objective was to evaluate the effectiveness of risk management programs for Defense acquisition systems. Specifically, we determined whether DoD risk management policies and procedures for Defense acquisition systems were effectively implemented and what impact risk management programs bad on reducing program risks and costs. We also reviewed management controls as they applied to the audit objectives.

  9. Intensive risk factor control in stroke prevention

    PubMed Central

    2013-01-01

    Stroke prevention is an urgent priority because of the aging of the population and the steep association of age and risk of stroke. Direct costs of stroke are expected to more than double in the US between 2012 and 2030. By getting everything right, patients can reduce the risk of stroke by 80% or more; however, getting everything right is a tall order. Roughly in order of importance, this requires smoking cessation, maintenance of a healthy weight, a Cretan Mediterranean diet, blood pressure control, lipid-lowering drugs, appropriate use of antiplatelet agents and anticoagulants, and appropriate carotid endarterectomy and stenting. A new approach called “treating arteries instead of targeting risk factors” appears promising but requires validation in randomized trials. PMID:24167723

  10. Risk factors and prevention of venous thromboembolism.

    PubMed

    Storti, S; Crucitti, P; Cina, G

    1996-01-01

    In the last 20 years within the clinical research on venous thromboembolism a major objective was to identify and develop increasingly effective and safe methods of prevention. This trend is justified by the high incidence of thromboembolism as well as by the relevant mortality for acute pulmonary embolism and postphlebitic sequels of difficult treatment. A significant contribution to the rational application of methods of prevention was given by the knowledge of risk factors. Together with acquired risks, as surgery, age, malignant tumors, in the last 30 years some conditions of thrombophilia were identified. They are caused by deficiencies in coagulation inhibitors (antithrombin III, protein C, protein S) or other alteration of the anticoagulation system as resistance to activated protein C or antiphospholipid antibodies. The primary prophylaxis of venous thromboembolism is aimed at the prevention of thrombosis by pharmacologic methods able to oppose the procoagulant alterations while avoiding hemorrhagic complications. The physical methods tend to reduce the stasis in the veins of the lower extremities. Subcutaneous calcium heparin at the dose of 5000 U twice or three times a day is the most common pharmacologic method used. It was shown to be safe and effective especially in postoperative prophylaxis of venous thromboembolism in general surgery. More recently, low molecular weight heparin fractions have been introduced. As compared to standard heparin they have the advantage of a single daily dose and a better efficacy in some groups of patients, as those undergoing hip replacement. Among the substances under clinical experimentation, dermatan sulfate seems promising. Most common physical prevention methods consist in the use of elastic graduated compression stockings and systems of intermittent pneumatic calf compression. The former can be used also in presence of a hemorrhagic risk as in neurosurgery. The latter have shown a good efficacy in increasing flow

  11. Student Aggression: Prevention, Management, and Replacement Training.

    ERIC Educational Resources Information Center

    Goldstein, Arnold P.; And Others

    American society is violent, a fact which is well-reflected in schools. This book, designed specifically for school personnel, presents the primary techniques currently being employed by educators to prevent, manage, and replace student aggression. The volume opens with a description of the origins of aggressive behavior and offers some…

  12. Nuts for diabetes prevention and management

    USDA-ARS?s Scientific Manuscript database

    Type 2 diabetes mellitus is an important preventable disease and a growing public health problem. Epidemiologic and clinical studies suggest that healthy eating, physical activity, and body weight control are the main driving forces to reduce diabetes risk. Owing to their low available carbohydrate ...

  13. Risk Management: Realistic Training to Standard

    DTIC Science & Technology

    2000-01-01

    analysis and execution and allows commands to manaqe risk. Risk management is, in reality, smart decision making. It focuses on mission accomplishment...make decisions that entail hazardous operations, risk management techniques are applicable to soldiers at all levels. Leaders must be trained to use... risk management skills and techniques to establish "situational" standards that effectively balance risk with operational objectives.

  14. Risk Management Concepts and Guidance

    DTIC Science & Technology

    1989-03-01

    Baillie, Allan S., "Management of Risk and Uncertainty," Research Management, Vol. 23, No. 2, March 1980, pp. 20-24. 34. Banash, Robert C., and...Monterey), 1974. 106. Edgar , J.D., LTC USAF, "Controlling Murphy: How to Budget for Program Risk, Concepts," - The Journal of Defense Systems...Secretary of Defense (OSD), 5-57 Point Cost Estimate ( POE ), 5-39 thru 5-43 OPERA, 5-33 Polaris Submarine Program, 5-29 Operating Cost, 5-35, 5-59, 6

  15. Cyber Insurance - Managing Cyber Risk

    DTIC Science & Technology

    2015-04-01

    regulations with respect to data breaches. The Health Insur - ance Portability and Accountability Act (HIPPA) Breach Notification Rule 45 CFR §§ 164.400...I N S T I T U T E F O R D E F E N S E A N A L Y S E S Cyber Insurance – Managing Cyber Risk Laura A. Odell, Project Leader...license under the clause at DFARS 252.227-7013 (a)(16) [Jun 2013]. Cyber Insurance – Managing Cyber Risk Data breaches involving

  16. Prevention and management of ovarian hyperstimulation syndrome.

    PubMed

    Nelson, Scott M

    2017-03-01

    Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovarian stimulation. It is feasible to identify patients at risk, modify stimulation strategies to ameliorate risk, and initiate out-patient treatments that alter disease pathophysiology to reduce disease severity. Mitigation of OHSS risk and severity, through innovative approaches prior to treatment, during treatment and after treatment should now be standard care. This review summarizes recent developments and provides recommendations on the prevention and treatment of OHSS. © 2017 Elsevier Ltd. All rights reserved.

  17. Risk Management Structured for Today's Environment

    NASA Technical Reports Server (NTRS)

    Greenfield, Michael A.

    1998-01-01

    In NPG (NASA Procedures and Guidelines) 7120.5A, we define risk management as "an organized, systematic decision-making process that efficiently identifies, analyzes, plans, tracks, controls, and communicates and documents risk in order to increase the likelihood of achieving program/project goals." Effective risk management depends upon a thorough understanding of the concept of risk, the principles of risk management and the formation of a disciplined risk management process. In human spaceflight programs, NASA has always maintained a rigorous and highly structured risk management effort. When lives are at stake, NASA's missions must be 100% safe; the risk management approach used in human spaceflight has always been comprehensive.

  18. [Practice and exploration of medical equipment's preventive maintenance based on risk analysis].

    PubMed

    Chen, Miankang; Yu, Shizhun; Bao, Juncheng; Zhang, Wenlong; Zhou, Na; Xia, Guanqun

    2014-03-01

    This paper analyzes the characteristics of medical equipment's preventive maintenance, and it expounds the objective and methods of introducing risk management to medical equipment's preventive maintenance,what's more,the problem of establishment object and cycle of preventive maintenance was solved scientifically.

  19. Hazardous waste management and pollution prevention

    SciTech Connect

    Chiu, Shen-yann

    1992-03-01

    The management of hazardous wastes is one of the most critical environmental issues that faces many developing countries. It is one of the areas where institutional control and treatment and disposal technology has not kept pace with economic development. This paper reviews the development of hazardous waste management methods over the past decades, and provides the information on the status and trends of hazardous waste management strategy in selected western nations. Several issues pertinent to hazardous waste management will be reviewed, including: (1) definition of hazard; (2) why are we concerned with hazardous wastes; (3) aspects of hazardous waste management system; and (4) prioritization of hazardous waste management options. Due to regulatory and economic pressure on hazardous waste management, pollution prevention has become a very important environmental strategy in many developed countries. In many developed countries, industry is increasingly considering such alternative approaches, and finding many opportunities for their cost effective implementation. This paper provides a review of the status and trends of pollution prevention in selected western nations.

  20. Hazardous waste management and pollution prevention

    SciTech Connect

    Chiu, Shen-yann.

    1992-01-01

    The management of hazardous wastes is one of the most critical environmental issues that faces many developing countries. It is one of the areas where institutional control and treatment and disposal technology has not kept pace with economic development. This paper reviews the development of hazardous waste management methods over the past decades, and provides the information on the status and trends of hazardous waste management strategy in selected western nations. Several issues pertinent to hazardous waste management will be reviewed, including: (1) definition of hazard; (2) why are we concerned with hazardous wastes; (3) aspects of hazardous waste management system; and (4) prioritization of hazardous waste management options. Due to regulatory and economic pressure on hazardous waste management, pollution prevention has become a very important environmental strategy in many developed countries. In many developed countries, industry is increasingly considering such alternative approaches, and finding many opportunities for their cost effective implementation. This paper provides a review of the status and trends of pollution prevention in selected western nations.

  1. Structured prototyping as risk management

    NASA Technical Reports Server (NTRS)

    Hornstein, Rhoda SH.; Gardner, J. A.; Willoughby, J. K.

    1991-01-01

    A methodology is presented for integrating the systems-engineering management recommendation of prototyping into the traditional project-management process for developing large-scale systems. The suggested methodology begins with the identification of life-cycle risk areas, outlines the structure and conduct of the prototyping process, and defines the composition of the prototyping team. The methodology includes a step-by-step procedure for creating, executing, and documenting a prototyping test plan to evaluate design alternatives. It is argued that managers who adopt this methodology and apply it rigorously will increase the likelihood that the systems they build will be operationally effective and will be accepted by the intended users.

  2. Evaluating the benefits of risk prevention initiatives

    NASA Astrophysics Data System (ADS)

    Di Baldassarre, G.

    2012-04-01

    The likelihood and adverse impacts of water-related disasters, such as floods and landslides, are increasing in many countries because of changes in climate and land-use. This presentation illustrates some preliminary results of a comprehensive demonstration of the benefits of risk prevention measures, carried out within the European FP7 KULTURisk project. The study is performed by using a variety of case studies characterised by diverse socio-economic contexts, different types of water-related hazards (floods, debris flows and landslides, storm surges) and space-time scales. In particular, the benefits of state-of-the-art prevention initiatives, such as early warning systems, non-structural options (e.g. mapping and planning), risk transfer strategies (e.g. insurance policy), and structural measures, are showed. Lastly, the importance of homogenising criteria to create hazard inventories and build memory, efficient risk communication and warning methods as well as active dialogue with and between public and private stakeholders, is highlighted.

  3. [Chronic migraine and work: occupational risks and prevention].

    PubMed

    Vicente-Herrero, M T; Ramírez Iñiguez de la Torre, M V; Capdevila García, L M; López-González, Á A; Terradillos García, M J

    2013-09-01

    Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources.

  4. Ideology and Environmental Risk Management.

    ERIC Educational Resources Information Center

    Miller, Alan

    1985-01-01

    Discusses the influence of ideology (including both psychological and political dimensions) on an individual's approach to environmental risk management. Compares and contrasts technocratic and humanist forms of environmental ideologies. Also reviews the implications of socio-political and psychological constraints on environmental decision…

  5. Risk Management for Wilderness Programs.

    ERIC Educational Resources Information Center

    Schimelpfenig, Tod

    This paper discusses subjective hazards in wilderness activities and suggests means of assessing and managing related risks. Wilderness educators conveniently group hazards into objective and subjective ones. Objective hazards such as rockfall, moving water, and weather, while not necessarily predictable, are visible and understandable. Subjective…

  6. Accidental injury: risk and preventative interventions

    PubMed Central

    van Weeghel, I.; Kendrick, D.; Marsh, P.

    1997-01-01

    Accepted 16 April 1997
 OBJECTIVE—To evaluate the relation between risk factors for childhood unintentional injury and requests for injury prevention interventions as part of the Nottingham Safe at Home project, a primary care based controlled intervention study assessing the effectiveness of a package of injury prevention interventions.
SETTING—17 practices in Nottingham randomly selected from 55 practices volunteering to take part in the study.
METHODS—Postal questionnaire to all parents of children aged 3 to 12 months registered with the intervention practices (n = 1124) to assess risk factors for injury and to elicit requests for three injury prevention interventions: free home safety checks, low cost safety equipment, and free first aid training.
RESULTS—73% of parents responded to the questionnaire. The distribution of sociodemographic variables among responders was similar to that for the population of Nottingham. One third of parents (34%) requested one intervention, 21% requested two interventions, and 10% requested three. Receipt of means tested benefits, ethnicity, and residence in a deprived area were independently associated with requesting home safety checks. Non-owner occupation, lack of access to a car, receipt of means tested benefits, ethnicity, and unemployment were independently associated with requesting low cost safety equipment. Non-owner occupiers were less likely to request first aid training.
CONCLUSIONS—Families with risk factors for childhood unintentional injury do request home safety checks and low cost safety equipment, but they are less likely to request first aid training. Other methods for providing first aid advice may be needed to reach such families.

 PMID:9279147

  7. Acrylamide: considerations for risk management.

    PubMed

    Slayne, Martin A; Lineback, David R

    2005-01-01

    The presence of acrylamide in many carbohydrate-rich foods is due to its formation during conventional heating and preparation methods. Although acrylamide is established to be a toxic substance, the implications to public health from the amounts found in food are not clear. A better scientific understanding is required to help determine whether, and to what extent, formal risk management action might be necessary. Since acrylamide in food was highlighted in 2002, numerous investigations and initiatives have been developed, including international collaborations across governments, industry, research organizations, and consumer representations. The newly generated information is being used to help the overall understanding of this issue. In particular, new information on health aspects will be important to update the scientific risk assessment. The basis for decisions on possible risk management measures would then be clearer. If future risk assessment concludes that the amounts of acrylamide in food can pose a health threat, then options for risk management will need to be considered, such as limits, guide levels, codes of practice, guidance information, and advice to the food and catering industries and to consumers. In the meantime, it is possible to benefit from progress already made on how acrylamide is formed in food and on ways to lower the amounts present. Raising awareness to the approaches that can reduce the presence of acrylamide in food should be encouraged. Where feasible, such approaches can be assessed for practical use in production, processing, and preparation of the relevant food products.

  8. Overview of the Hanford risk management plan

    SciTech Connect

    Halverson, T.G.

    1998-03-26

    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.

  9. Guidelines for the diagnosis, prevention and management of osteoporosis.

    PubMed

    Rossini, M; Adami, S; Bertoldo, F; Diacinti, D; Gatti, D; Giannini, S; Giusti, A; Malavolta, N; Minisola, S; Osella, G; Pedrazzoni, M; Sinigaglia, L; Viapiana, O; Isaia, G C

    2016-06-23

    Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management.

  10. Risk management and climate change

    NASA Astrophysics Data System (ADS)

    Kunreuther, Howard; Heal, Geoffrey; Allen, Myles; Edenhofer, Ottmar; Field, Christopher B.; Yohe, Gary

    2013-05-01

    The selection of climate policies should be an exercise in risk management reflecting the many relevant sources of uncertainty. Studies of climate change and its impacts rarely yield consensus on the distribution of exposure, vulnerability or possible outcomes. Hence policy analysis cannot effectively evaluate alternatives using standard approaches, such as expected utility theory and benefit-cost analysis. This Perspective highlights the value of robust decision-making tools designed for situations such as evaluating climate policies, where consensus on probability distributions is not available and stakeholders differ in their degree of risk tolerance. A broader risk-management approach enables a range of possible outcomes to be examined, as well as the uncertainty surrounding their likelihoods.

  11. Aspirin dosing in cardiovascular disease prevention and management: an update.

    PubMed

    Ganjehei, Leila; Becker, Richard C

    2015-11-01

    Aspirin has been in use for prevention and management of cardiovascular diseases for several decades. Clinical and epidemiological literature suggests that while net benefits of aspirin in primary prevention of CVDs are less clear, the benefits of aspirin in acute scenarios and secondary prevention settings are well established. However, its optimum dosing requirements have been up for debate especially in various settings of acute coronary syndrome and stable ischemic heart disease. The role of clinician in stratifying individual risk score to achieve net clinical benefit is an important determinant of initiating aspirin therapy. The purpose of this article is to review association of aspirin and CVD in general, and to review its dosing regimens in acute settings as well as primary and secondary prevention as suggested by various established guidelines. We also aim to provide the readers an update on recent changes and current evidence based practice trends.

  12. Risk Management of NASA Projects

    NASA Technical Reports Server (NTRS)

    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.

  13. United States Environmental Protection Agency: Use of risk assessment and risk management methodologies. Master's thesis

    SciTech Connect

    Lamuro, R.J.

    1992-09-30

    Make a full investigation of the policy implications and appropriate uses of risk assessment and risk management in regulatory programs under various Federal laws to prevent cancer and other chronic health effects which may result from exposure to hazardous substances. This is the primary mission of the Risk Assessment and Management Commission (Risk Commission). The Clean Air Act Amendments of 1990 (CAAA), created the Risk Commission reflecting Congress' concern over agency use of risk assessment and risk management techniques and methodologies to implement federal laws protective of human health. The Risk Commission is to consider: methods for measuring and describing risks of chronic health effects from hazardous substances; methods to reflect uncertainties associated with estimation techniques, and whether it is possible or desirable to develop a consistent risk assessment methodology or a consistent standard of acceptable risk for various federal programs.

  14. Engineered nanomaterials: exposures, hazards, and risk prevention

    PubMed Central

    2011-01-01

    Nanotechnology presents the possibility of revolutionizing many aspects of our lives. People in many settings (academic, small and large industrial, and the general public in industrialized nations) are either developing or using engineered nanomaterials (ENMs) or ENM-containing products. However, our understanding of the occupational, health and safety aspects of ENMs is still in its formative stage. A survey of the literature indicates the available information is incomplete, many of the early findings have not been independently verified, and some may have been over-interpreted. This review describes ENMs briefly, their application, the ENM workforce, the major routes of human exposure, some examples of uptake and adverse effects, what little has been reported on occupational exposure assessment, and approaches to minimize exposure and health hazards. These latter approaches include engineering controls such as fume hoods and personal protective equipment. Results showing the effectiveness - or lack thereof - of some of these controls are also included. This review is presented in the context of the Risk Assessment/Risk Management framework, as a paradigm to systematically work through issues regarding human health hazards of ENMs. Examples are discussed of current knowledge of nanoscale materials for each component of the Risk Assessment/Risk Management framework. Given the notable lack of information, current recommendations to minimize exposure and hazards are largely based on common sense, knowledge by analogy to ultrafine material toxicity, and general health and safety recommendations. This review may serve as an overview for health and safety personnel, management, and ENM workers to establish and maintain a safe work environment. Small start-up companies and research institutions with limited personnel or expertise in nanotechnology health and safety issues may find this review particularly useful. PMID:21418643

  15. Supporting At-Risk Youth and Their Families to Manage and Prevent Diabetes: Developing a National Partnership of Medical Residency Programs and High Schools

    PubMed Central

    Gefter, Liana; Morioka-Douglas, Nancy; Srivastava, Ashini; Rodriguez, Eunice

    2016-01-01

    Background The Stanford Youth Diabetes Coaches Program (SYDCP) is a school based health program in which Family Medicine residents train healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes. This study evaluates the impact of the SYDCP when disseminated to remote sites. Additionally, this study aims to assess perceived benefit of enhanced curriculum. Methods From 2012–2015, 10 high schools and one summer camp in the US and Canada and five residency programs were selected to participate. Physicians and other health providers implemented the SYDCP with racial/ethnic-minority students from low-income communities. Student coaches completed pre- and posttest surveys which included knowledge, health behavior, and psychosocial asset questions (i.e., worth and resilience), as well as open-ended feedback questions. T-test pre-post comparisons were used to determine differences in knowledge and psychosocial assets, and open and axial coding methods were used to analyze qualitative data. Results A total of 216 participating high school students completed both pre-and posttests, and 96 nonparticipating students also completed pre- and posttests. Student coaches improved from pre- to posttest significantly on knowledge (p<0.005 in 2012–13, 2014 camp, and 2014–15); worth (p<0.1 in 2014–15); problem solving (p<0.005 in 2014 camp and p<0.1 in 2014–15); and self-efficacy (p<0.05 in 2014 camp). Eighty-two percent of student coaches reported that they considered making a behavior change to improve their own health as a result of program participation. Qualitative feedback themes included acknowledgment of usefulness and relevance of the program, appreciation for physician instructors, knowledge gain, pride in helping family members, improved relationships and connectedness with family members, and lifestyle improvements. Conclusion Overall, when disseminated, this program can increase health knowledge and some psychosocial

  16. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2010 CFR

    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...

  17. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 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...

  18. Health Risk Management for Bioenvironmental Engineering

    DTIC Science & Technology

    2013-06-01

    Health Risk Management ( HRM ). HRM is a decision-making process to evaluate and...4.1 Health Risk Management Interface HRM and RM decisions are based on operations and scenarios; therefore, an HRA may provide a COA that interferes... health risk estimate HRM health risk management OEH occupational and environmental health PH Public Health PPE personal protective

  19. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2010 CFR

    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...

  20. Risk Management and the Joint Military Commander.

    DTIC Science & Technology

    1997-02-01

    risk assessment, is the process called risk management . Practiced repeatedly, personal and professional risk management can become ’common sense...war and military operations other than war (MOOTW). This report discusses the USA Five Step Process, from which users develop tools, techniques, and procedures for applying risk management in their areas of responsibility.

  1. [Cell phones: health risks and prevention].

    PubMed

    Talamanca, I Figà; Giliberti, C; Salerno, S

    2012-01-01

    The paper describes first of all the electromagnetic radiation of cellular phones and presents the physical parameters used to measure and evaluate the absorption of emissions of radio stations and cellular phones. It then presents selected research results of the experimental studies in vivo and in vitro which examine the biological effects of the emissions of cellular phones. The review of the epidemiologic evidence focuses in particular the epidemiologic studies on the use of cell phones and brain tumours, identifying some of the reasons of the conflicting results obtained. Studies dealing with the health risks involved in the increasing use of cellular phones by adolescents and children, more sensitive to this exposure, are also presented showing the need for special caution. The problem of hypersensitivity observed in some individuals is also briefly discussed. Finally the paper presents a summary of the main prevention measures necessary in order to reduce the risks in the framework of the "precautionary principle" including prevention policies and exposure limits in various countries.

  2. Risk management for assuring safe drinking water.

    PubMed

    Hrudey, Steve E; Hrudey, Elizabeth J; Pollard, Simon J T

    2006-12-01

    Millions of people die every year around the world from diarrheal diseases much of which is caused by contaminated drinking water. By contrast, drinking water safety is largely taken for granted by many citizens of affluent nations. The ability to drink water that is delivered into households without fear of becoming ill may be one of the key defining characteristics of developed nations in relation to the majority of the world. Yet there is well-documented evidence that disease outbreaks remain a risk that could be better managed and prevented even in affluent nations. A detailed retrospective analysis of more than 70 case studies of disease outbreaks in 15 affluent nations over the past 30 years provides the basis for much of our discussion [Hrudey, S.E. and Hrudey, E.J. Safe Drinking Water--Lessons from Recent Outbreaks in Affluent Nations. London, UK: IWA Publishing; 2004.]. The insights provided can assist in developing a better understanding within the water industry of the causes of drinking water disease outbreaks, so that more effective preventive measures can be adopted by water systems that are vulnerable. This preventive feature lies at the core of risk management for the provision of safe drinking water.

  3. Prevention and management of influenza in pregnancy.

    PubMed

    Beigi, Richard H

    2014-12-01

    Influenza infections are an important global source of morbidity and mortality. Pregnant and postpartum women are at increased risk for serious disease, related complications, and death from influenza infection. This increased risk is thought to be mostly caused by the altered physiologic and immunologic specifics of pregnancy. The morbidity of influenza infection during pregnancy is compounded by the potential for adverse obstetric, fetal, and neonatal outcomes. Importantly, influenza vaccination to prevent or minimize the severity of influenza infection during pregnancy (and the neonatal period) is recommended for all women who are or will be pregnant during influenza season. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Preventing Sickness Absence With Career Management Intervention

    PubMed Central

    Toppinen-Tanner, Salla; Böckerman, Petri; Mutanen, Pertti; Martimo, Kari-Pekka; Vuori, Jukka

    2016-01-01

    This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence. Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a randomized controlled trial. Sickness absence data were collected covering a period from 1 year before (baseline) to approximately 2 years after the intervention (follow-up). The data were analyzed using zero-inflated negative binomial models. After controlling for baseline absence, age, gender, and organization, the intervention was effective in decreasing the number of longer sickness absences (lasting longer than > 2 weeks), but no other significant effects were found. These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations. PMID:27930479

  5. Management and prevention of neonatal anemia: current evidence and guidelines.

    PubMed

    von Lindern, Jeannette S; Lopriore, Enrico

    2014-04-01

    Neonatal anemia is a common disorder, particularly in (very) preterm neonates. Management of neonatal anemia is based principally on red blood cell (RBC) transfusion. Although the use of blood products is nowadays widespread in neonatal medicine, evidence on the potential benefit is extremely limited. Recent studies suggest that RBC transfusions in newborns may be associated with an increased risk for necrotizing enterocolitis, transfer of infectious agents and negative effects on neurodevelopmental outcome. Whether the benefits of RBC transfusions outweigh the risks is controversial and requires further studies. In this review, we summarize the current evidence on the management of neonatal anemia and compare the various international guidelines. In addition, we discuss the various strategies to prevent neonatal anemia and reduce the need for RBC transfusions and discuss important trials currently enrolling patients to improve the management in neonatal anemia.

  6. Prevention and management of post-ERCP pancreatitis.

    PubMed

    Sahakian, Ara B; Buxbaum, James L; Van Dam, Jacques

    2014-11-28

    Pancreatitis remains as one of the most frequent and serious complications of ERCP. Research has identified several patient-related and procedural risk factors, which help guide the endoscopist in prophylaxis and management of pancreatitis. Recent studies have had a major impact on both procedural techniques and pharmacological methods for prophylaxis of post-ERCP pancreatitis. The purpose of this article is to review the relevant literature and describe the most recent and effective approaches in prevention and management of post-ERCP pancreatitis.

  7. Environmental Management Approach to Improve College Student and Community Relations to Reduce Binge and High-Risk Alcohol Use and Other Drug Problems. Prevention Update

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2011

    2011-01-01

    A central feature of the U.S. Department of Education's Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention is the promotion of multiple prevention strategies that affect campus and surrounding community environments as a whole and can, thereby, have a large-scale effect on the entire campus community. In outlining the…

  8. Clinical risk management in obstetrics.

    PubMed

    Holden, Deborah A; Quin, Maureen; Holden, Des P

    2004-04-01

    Over recent years there has been a growing appreciation that a small but significant proportion of patients experience (sometimes serious) adverse events in the hands of health care workers. Although research in this area is very much in its infancy there has been an increasing move towards applying principles of risk management from industry to health care organizations. With the particularly disastrous and costly nature of adverse outcomes in obstetrics it is appropriate to review clinical risk management issues in maternity. This review explores the appropriateness of applying lessons learned in industry to maternity. The classification of errors into individual and latent, or organizational, is examined. Furthermore, the way in which these errors can be identified and subsequently analysed, with examples from maternity units in the UK and USA, is discussed. The importance of an educational and supportive environment, rather than a blame culture, for both reporting of incidents and learning from adverse outcomes is emphasized. Improvement in patient experience of health care rests not just with improved treatments, but also with a reduction in the adverse events which occur in health care institutions. The principles by which risk can be identified prospectively and retrospectively, and the mechanisms for both local risk management and regional/national reporting and learning are considered.

  9. Management and prevention of exacerbations of COPD.

    PubMed

    Aaron, Shawn D

    2014-09-22

    Patients with chronic obstructive pulmonary disease (COPD) are prone to acute respiratory exacerbations, which can develop suddenly or subacutely over the course of several days. Exacerbations have a detrimental effect on patients' health status and increase the burden on the healthcare system. Initial treatment is unsuccessful in 24-27% of patients, who have a relapse or a second exacerbation within 30 days of the initial event. No obvious benefit has been seen in recent clinical trials of anti-tumour necrosis factor therapy, anti-leukotriene therapy, intensive chest physiotherapy, or early inpatient pulmonary rehabilitation for treatment of exacerbations. By contrast, clinical trials of prevention rather than acute treatment have shown promising results. Long acting β agonist (LABA) or long acting anti-muscarinic (LAMA) bronchodilators and inhaled corticosteroid-LABA combinations prevent exacerbations in patients at risk, with relative risk reductions averaging 14-27% for each of these drugs relative to placebo. Triple therapy with inhaled corticosteroid-LABA plus LAMA may provide additional benefit, although study results to date are heterogeneous and more studies are needed. Pneumonia is an important complication of treatment with inhaled corticosteroid-LABA products, and the risk of pneumonia seems to be doubled in patients with COPD who use fluticasone. The addition of azithromycin to usual COPD therapy prevents exacerbations, although it may prolong the Q-T interval and increase the risk of death from cardiovascular disease in patients prone to arrhythmia. New potential drugs--including mitogen activated protein kinase inhibitors, phosphodiesterase 3 inhibitors, and monoclonal antibodies to the interleukin 1 receptor--offer additional hope for treatments that may prevent exacerbations in the future.

  10. Suicide: risk factors and prevention in refractory major depression.

    PubMed

    Oquendo, M A; Malone, K M; Mann, J J

    1997-01-01

    The literature regarding risk factors for suicidal behavior in the context of major depressive episode is reviewed. An organized framework for prevention strategies is provided. Risk factors for suicide in major depression can be organized according to whether their effect is on the threshold for suicidal acts or whether they serve mainly as triggers or precipitants of suicidal acts. For patients sufficiently depressed to present for evaluation and treatment, severity of depression is a poor guide to risk for suicidal acts. The best predictors relate to the threshold or predisposition to suicidal acts in response to major depression. Although available literature on suicidal behavior focuses on major depression in general, the findings may be usefully applied in refractory depression. Guidelines for assessment and management of suicidal behavior in major depression are offered.

  11. The Xyrem risk management program.

    PubMed

    Fuller, David E; Hornfeldt, Carl S; Kelloway, Judy S; Stahl, Pamela J; Anderson, Todd F

    2004-01-01

    Sodium oxybate, also known as gamma-hydroxybutyric acid (GHB), was discovered in 1960 and has been described both as a therapeutic agent with high medical value and, more recently, a substance of abuse. The naturally occurring form of this drug is found in various body tissues but has been studied most extensively in the CNS where its possible function as a neurotransmitter continues to be studied. Sodium oxybate has been approved in different countries for such varied uses as general anaesthesia, the treatment of alcohol withdrawal and addiction, and, most recently, cataplexy associated with narcolepsy. During the 1980s, easy access to GHB-containing products led to various unapproved uses, including weight loss, bodybuilding and the treatment of sleeplessness, sometimes with serious long-term effects. The availability of these unapproved and unregulated forms of the drug led to GHB and its analogues being popularised as substances of abuse and subsequent notoriety as agents used in drug-facilitated sexual assault, or 'date rape', eventually leading to the prohibition of GHB sales in the US. Legal efforts to control the sale and distribution of GHB and its analogues nearly prevented the clinical development of sodium oxybate for narcolepsy in the US. However, following extensive discussions with a variety of interested parties, a satisfactory solution was devised, including legislative action and the development of the Xyrem Risk Management Program. Amendments to the US Controlled Substances Act made GHB a schedule I drug, but also contained provisions that allow US FDA-approved products to be placed under schedule III. This unique, bifurcated schedule for sodium oxybate/GHB allowed the clinical development of sodium oxybate to proceed and, in July 2002, it was approved by the FDA as an orphan drug for the treatment of cataplexy in patients with narcolepsy as Xyrem(sodium oxybate) oral solution. To promote the safe use of sodium oxybate, as well as alleviate

  12. Hanford Tanks Initiative risk management guide

    SciTech Connect

    Schaus, P.S.

    1997-10-29

    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.

  13. A Stress Management Curriculum for At-Risk Youth.

    ERIC Educational Resources Information Center

    Rollin, S. A.; Arnold, A. R.; Solomon, S.; Rubin, R. I.; Holland, J. L.

    2003-01-01

    Project KICK (Kids in Cooperation with Kids) is a delinquency prevention program for at-risk youth that uses nontraditional approaches to stress management. Twelve African American children who were taught physical, cognitive, and experiential models of stress reduction and management reported that they enjoyed the program, and they demonstrated…

  14. [Risk factors for Alzheimer: towards prevention?].

    PubMed

    Vogel, Thomas; Benetos, Athanase; Verreault, René; Kaltenbach, Georges; Kiesmann, Michèle; Berthel, Marc

    2006-09-01

    Recent longitudinal studies have highlighted associations between Alzheimer's disease (AD) and several factors, especially some cardiovascular risk factors, including hypertension, diabetes, diet, obesity, and elevated levels of homocysteine and lipids in the blood. The strongest associations are with hypertension and diabetes. Moderate alcohol consumption also appears to be associated with a decreased risk of incident AD. Studies of the effect of interventions to control these risk factors on the onset and course of dementia report encouraging results about antihypertensive agents and statins. Benefits from other drug therapies such as nonsteroidal antiinflammatory drugs and antioxidants remain uncertain, and initial hopes for hormonal replacement therapy for postmenopausal women have not been confirmed. Physical, cognitive and leisure activities seem to provide protection against incident AD. Cautious interpretation is necessary in view of the possible biases in these studies (confounding factors as well as survival, regression dilution, and indication biases). These epidemiologic data raise questions about the diagnostic boundaries between AD and vascular dementia. Additional studies are needed to validate these concepts and to confirm the possible benefits of preventive measures.

  15. [Risk and risk management in aviation].

    PubMed

    Müller, Manfred

    2004-10-01

    RISK MANAGEMENT: The large proportion of human errors in aviation accidents suggested the solution--at first sight brilliant--to replace the fallible human being by an "infallible" digitally-operating computer. However, even after the introduction of the so-called HITEC-airplanes, the factor human error still accounts for 75% of all accidents. Thus, if the computer is ruled out as the ultimate safety system, how else can complex operations involving quick and difficult decisions be controlled? OPTIMIZED TEAM INTERACTION/PARALLEL CONNECTION OF THOUGHT MACHINES: Since a single person is always "highly error-prone", support and control have to be guaranteed by a second person. The independent work of mind results in a safety network that more efficiently cushions human errors. NON-PUNITIVE ERROR MANAGEMENT: To be able to tackle the actual problems, the open discussion of intervened errors must not be endangered by the threat of punishment. It has been shown in the past that progress is primarily achieved by investigating and following up mistakes, failures and catastrophes shortly after they happened. HUMAN FACTOR RESEARCH PROJECT: A comprehensive survey showed the following result: By far the most frequent safety-critical situation (37.8% of all events) consists of the following combination of risk factors: 1. A complication develops. 2. In this situation of increased stress a human error occurs. 3. The negative effects of the error cannot be corrected or eased because there are deficiencies in team interaction on the flight deck. This means, for example, that a negative social climate has the effect of a "turbocharger" when a human error occurs. It needs to be pointed out that a negative social climate is not identical with a dispute. In many cases the working climate is burdened without the responsible person even noticing it: A first negative impression, too much or too little respect, contempt, misunderstandings, not expressing unclear concern, etc. can

  16. Contemporary Issues in the Prevention and Management of Postthrombotic Syndrome

    PubMed Central

    Vazquez, Sara R; Freeman, Andrew; VanWoerkom, Ryan C; Rondina, Matthew T

    2011-01-01

    OBJECTIVE To provide an evidence-based review and clinical summary of postthrombotic syndrome (PTS). DATA SOURCES A literature review was performed via MEDLINE (1950–July 1, 2009) and International Pharmaceutical Abstracts (1970–June 2009) searches using the terms post-thrombotic syndrome, post-phlebitic syndrome, deep vein thrombosis, and compression stockings. DATA SYNTHESIS PTS is best characterized as a chronic syndrome of clinical signs and symptoms including pain, swelling, parasthesias, and ulceration in the affected limb following deep vein thrombosis (DVT). It occurs in up to half of patients with symptomatic DVT, usually within the first 2 years. Although the pathophysiology of PTS is not well understood, a thrombus may cause venous hypertension and valvular incompetence resulting in edema, tissue hypoxia, and in severe cases, ulceration. Risk factors for PTS include recurrent ipsilateral DVT, obesity, and poor quality of anticoagulant therapy. PTS diagnosis is based on the presence of typical signs and symptoms and may be made using one of several clinical scoring systems. Prevention of PTS should focus on DVT prevention and the use of elastic compression stockings following DVT, while fibrinolysis remains under investigation as an effective method for PTS prevention. The treatment of PTS may include either pharmacologic or mechanical modalities, although none of these regimens has been rigorously tested. Pharmacists have the opportunity to provide more comprehensive antithrombotic management by educating patients and providers on PTS, recommending appropriate preventive therapy, assisting patients in obtaining and adhering to this therapy, and assisting providers with the management of PTS. CONCLUSIONS Providers should be proactive in preventing PTS, with pharmacists taking an active role in optimal DVT prevention, identifying patients at risk for PTS, and counseling and directing preventive therapies. PMID:19737994

  17. Functional foods for dyslipidaemia and cardiovascular risk prevention.

    PubMed

    Sirtori, Cesare R; Galli, Claudio; Anderson, James W; Sirtori, Elena; Arnoldi, Anna

    2009-12-01

    A food can be regarded as 'functional' if it can demonstrate a beneficial efficacy on one or more target functions in the body in a convincing way. Beyond adequate nutritional qualities, functional foods should either improve the state of health and wellbeing and/or reduce the risk of disease. Functional foods that are marketed with claims of heart disease reduction focus primarily on the major risk factors, i.e. cholesterol, diabetes and hypertension. Some of the most innovative products are designed to be enriched with 'protective' ingredients, believed to reduce risk. They may contain, for example, soluble fibre (from oat and psyllium), useful both for lowering cholesterol and blood pressure, or fructans, effective in diabetes. Phytosterols and stanols lower LDL-cholesterol in a dose-dependent manner. Soya protein is more hypocholesterolaemic in subjects with very high initial cholesterol and recent data indicate also favourable activities in the metabolic syndrome. n-3 Fatty acids appear to exert significant hypotriacylglycerolaemic effects, possibly partly responsible for their preventive activity. Dark chocolate is gaining much attention for its multifunctional activities, useful both for the prevention of dyslipidaemia as well as hypertension. Finally, consensus opinions about tea and coffee have not emerged yet, and the benefits of vitamin E, garlic, fenugreek and policosanols in the management of dyslipidaemia and prevention of arterial disease are still controversial.

  18. [Risk management and patient safety].

    PubMed

    Lessing, C

    2009-06-01

    Risk management and patient safety are of indisputable importance for the quality of health care. At the same time they confront all professional groups in the health system with high demands. The Action Alliance for Patient Safety inc. wants to demonstrate ways in which measures for avoiding errors and improving safety can reach the healthcare practice. Interdisciplinary cooperation and the availability of mutually developed materials are the maxims of the work of the society.

  19. Managing and Preventing Acute Urinary Retention

    PubMed Central

    Lepor, Herbert

    2005-01-01

    Acute urinary retention (AUR), an uncomfortable and potentially dangerous condition, often occurs in men who have benign prostatic hyperplasia. Although the reported incidence of AUR varies in the literature, there are a number of events that are known to precipitate episodes of AUR, including ingestion of certain agents, infection, general anesthesia, and performance of various diagnostic genitourinary procedures. Because it is preferable to avoid the need for catheterization (and the associated risks) in men at high risk for AUR, certain measures have been studied as means to prevent AUR episodes. Specifically, α-blockers and 5-α-reductase inhibitors have been shown to reduce the incidence of initial and subsequent AUR episodes in certain at-risk men. PMID:16985887

  20. Clinical management and prevention of sudden cardiac death.

    PubMed

    Yousuf, Omair; Chrispin, Jonathan; Tomaselli, Gordon F; Berger, Ronald D

    2015-06-05

    Despite the revolutionary advancements in the past 3 decades in the treatment of ventricular tachyarrhythmias with device-based therapy, sudden cardiac death (SCD) remains an enormous public health burden. Survivors of SCD are generally at high risk for recurrent events. The clinical management of such patients requires a multidisciplinary approach from postresuscitative care to a thorough cardiovascular investigation in an attempt to identify the underlying substrate, with potential to eliminate or modify the triggers through catheter ablation and ultimately an implantable cardioverter-defibrillator (ICD) for prompt treatment of recurrences in those at risk. Early recognition of low left ventricular ejection fraction as a strong predictor of death and association of ventricular arrhythmias with sudden death led to significant investigation with antiarrhythmic drugs. The lack of efficacy and the proarrhythmic effects of drugs catalyzed the development and investigation of the ICD through several major clinical trials that proved the efficacy of ICD as a bedrock tool to detect and promptly treat life-threatening arrhythmias. The ICD therapy is routinely used for primary prevention of SCD in patients with cardiomyopathy and high risk inherited arrhythmic conditions and secondary prevention in survivors of sudden cardiac arrest. This compendium will review the clinical management of those surviving SCD and discuss landmark studies of antiarrhythmic drugs, ICD, and cardiac resynchronization therapy in the primary and secondary prevention of SCD.

  1. Does self-management prevent severe exacerbations?

    PubMed

    Pinnock, Hilary; Thomas, Mike

    2015-01-01

    Despite effective therapies, asthma outcomes remain suboptimal. Education in self-management is crucial to maintaining control in a variable condition such as asthma and reducing the risk of severe asthma exacerbations, hospitalizations and deaths. This review considers the evidence for supported self-management. Recent systematic reviews have clarified and confirmed the major benefits from effective self-management education, but have also shown that implementation is rare in routine practice, with consequent avoidable morbidity and mortality. Recent research has focused on the most effective ways of delivering and supporting self-management in different patient groups and has clarified the relative effectiveness of the different components. Self-management support using new digital technologies has been investigated. All clinicians treating patients with asthma should be supporting their patients to understand and manage their own condition. Optimal self-management incorporates education, provision of a personalized asthma action plan and is supported by regular professional review. Action plans in a written or digital format should advise on recognizing deterioration and the actions to take, including when to seek professional help, appropriate changes in medication dose or commencing rescue oral steroids. Action plans should be personalized and agreed by the patient, and provided in a culturally tailored form.

  2. Tips for Disaster Responders: Preventing and Managing Stress

    MedlinePlus

    ... samhsa.gov TIPS FOR DISASTER RESPONDERS: PREVENTING AND MANAGING STRESS Verify your response duties and reporting lines ... gov 3 TIPS FOR DISASTER RESPONDERS: PREVENTING AND MANAGING STRESS Signs of Stress What are common signs ...

  3. [Surgical smoke: risks and preventive measures].

    PubMed

    Carbajo-Rodríguez, Hilario; Aguayo-Albasini, José Luis; Soria-Aledo, Víctor; García-López, Concepción

    2009-05-01

    The application of the advanced technologies in medicine has led to the appearance of new risk factors for health personnel. One of these could be the surgical smoke produced by electrosurgical instruments, ultrasounds or laser. However, there is still insufficient evidence in the published population studies on the detrimental effects of chronic exposure to surgical smoke. The main concern on the possible damage to the health of operating room staff is mainly based on the components currently detected until the date and laboratory experiments. Caution must also be used when extrapolating the results of in vitro studies to daily clinical practice. The organisations responsible for protecting the health of the workers in different countries have still not issued guidelines for the treatment and removal of the surgical smoke generated in both open and laparoscopic procedures. In this article we try to present a view of the consequences that surgical smoke has on health and the preventive measures that can be adopted.

  4. Risk Management On-the-Run.

    ERIC Educational Resources Information Center

    Pope, Daniel C.

    1985-01-01

    Presents the options available in risk management insurance and group health insurance programs, while outlining recent changes in the industry and their effects on school risk management programs. (MD)

  5. Risk Management Practices and Accounting Requirements.

    ERIC Educational Resources Information Center

    Cheng, Rita Hartung; Yahr, Robert B.

    1989-01-01

    Reviews current school district risk management practices and the related accounting requirements. Summarizes the Governmental Accounting Standards Board's proposed accounting standards and the impact of these on school districts' risk management practices and on their financial statements. (11 references) (MLF)

  6. Risk Management On-the-Run.

    ERIC Educational Resources Information Center

    Pope, Daniel C.

    1985-01-01

    Presents the options available in risk management insurance and group health insurance programs, while outlining recent changes in the industry and their effects on school risk management programs. (MD)

  7. You can manage construction risks.

    PubMed

    Macomber, J D

    1989-01-01

    A construction project is about the riskiest thing any company does in the normal course of business. Hundreds of things can go wrong, dozens will. But officers who analyze and manage every other sort of risk often ignore construction risk as if it were uncontrollable. The truth is, it can't be eliminated, but it can be controlled. Construction is not a product but a confusing and often exasperating service. A group of experts--architects, bankers, consultants, contractors, engineers, users, city officials--coordinate the activities of an army of suppliers, laborers, designers, subcontractors, and inspectors. The job of the company officers is to coordinate the coordinators; to make prompt, informed decisions as the work progresses; to take and retain project responsibility at the highest level; and to analyze and manage the entire process in the following seven stages: 1. Study the types and phases of construction risk. 2. Assess the risks of the company's particular project. 3. Match these risks with the in-house capabilities. 4. Define a building strategy. 5. Pick the right kind of contract. 6. Choose a contractor. 7. Monitor construction. Analyzing risk is largely a matter of assessing the complexity of the building, the site, the financing, the schedule, and the special uses and problems of the project. This analysis then drives the choice of contract and contractor. The range runs from low-cost providers, lump sum contracts and very little teamwork at one end of the spectrum to highly differentiated construction companies, guaranteed-maximum-prince contracts, and consultative coordination at the other.

  8. An Extensible Information Grid for Risk Management

    NASA Technical Reports Server (NTRS)

    Maluf, David A.; Bell, David G.

    2003-01-01

    This paper describes recent work on developing an extensible information grid for risk management at NASA - a RISK INFORMATION GRID. This grid is being developed by integrating information grid technology with risk management processes for a variety of risk related applications. To date, RISK GRID applications are being developed for three main NASA processes: risk management - a closed-loop iterative process for explicit risk management, program/project management - a proactive process that includes risk management, and mishap management - a feedback loop for learning from historical risks that escaped other processes. This is enabled through an architecture involving an extensible database, structuring information with XML, schemaless mapping of XML, and secure server-mediated communication using standard protocols.

  9. An Extensible Information Grid for Risk Management

    NASA Technical Reports Server (NTRS)

    Maluf, David A.; Bell, David G.

    2003-01-01

    This paper describes recent work on developing an extensible information grid for risk management at NASA - a RISK INFORMATION GRID. This grid is being developed by integrating information grid technology with risk management processes for a variety of risk related applications. To date, RISK GRID applications are being developed for three main NASA processes: risk management - a closed-loop iterative process for explicit risk management, program/project management - a proactive process that includes risk management, and mishap management - a feedback loop for learning from historical risks that escaped other processes. This is enabled through an architecture involving an extensible database, structuring information with XML, schemaless mapping of XML, and secure server-mediated communication using standard protocols.

  10. Controlling Legal Risk for Effective Hospital Management.

    PubMed

    Park, Hyun Jun; Cho, Duk Young; Park, Yong Sug; Kim, Sun Wook; Park, Jae-Hong; Park, Nam Cheol

    2016-04-01

    To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.

  11. Prevention and management of hip fracture in older patients.

    PubMed

    Swift, Cameron G

    2011-09-01

    The average age at hip fracture is 83 for women and 84 for men, with about 80% of cases in women. The 30% mortality and 20% new institutionalisation rates at 12 months reflect the high prevalence of comorbidity and to some extent suboptimal management at the time of the fracture. With timely intervention and better clinical management many fractures can be prevented and when they do occur their human and economic costs can be greatly reduced. Fragility fractures occur in those with demonstrable osteoporosis or osteopaenia and/or risk factors. The goal of prevention is to identify and treat those at risk UK clinicians lack a single universally endorsed, decision support resource. The prudent strategy is to become familiar with all three available risk measures, introduce fracture risk assessment into routine practice, and allow clinical judgement to prevail in cases of doubt (perhaps, especially in very elderly people, more often in the direction of intervention). The classical signs after a fall by an older person, of severe pain, shortening and external rotation of the affected limb, and loss of mobility, should result in immediate and rapid transfer to hospital. It is not rare in the case of intracapsular fractures for mobility to be deceptively maintained on a moderately or minimally painful hip.

  12. Risk Management for Human Support Technology Development

    NASA Technical Reports Server (NTRS)

    jones, Harry

    2005-01-01

    NASA requires continuous risk management for all programs and projects. The risk management process identifies risks, analyzes their impact, prioritizes them, develops and carries out plans to mitigate or accept them, tracks risks and mitigation plans, and communicates and documents risk information. Project risk management is driven by the project goal and is performed by the entire team. Risk management begins early in the formulation phase with initial risk identification and development of a risk management plan and continues throughout the project life cycle. This paper describes the risk management approach that is suggested for use in NASA's Human Support Technology Development. The first step in risk management is to identify the detailed technical and programmatic risks specific to a project. Each individual risk should be described in detail. The identified risks are summarized in a complete risk list. Risk analysis provides estimates of the likelihood and the qualitative impact of a risk. The likelihood and impact of the risk are used to define its priority location in the risk matrix. The approaches for responding to risk are either to mitigate it by eliminating or reducing the effect or likelihood of a risk, to accept it with a documented rationale and contingency plan, or to research or monitor the risk, The Human Support Technology Development program includes many projects with independently achievable goals. Each project must do independent risk management, considering all its risks together and trading them against performance, budget, and schedule. Since the program can succeed even if some projects fail, the program risk has a complex dependence on the individual project risks.

  13. Risk Management for Human Support Technology Development

    NASA Technical Reports Server (NTRS)

    jones, Harry

    2005-01-01

    NASA requires continuous risk management for all programs and projects. The risk management process identifies risks, analyzes their impact, prioritizes them, develops and carries out plans to mitigate or accept them, tracks risks and mitigation plans, and communicates and documents risk information. Project risk management is driven by the project goal and is performed by the entire team. Risk management begins early in the formulation phase with initial risk identification and development of a risk management plan and continues throughout the project life cycle. This paper describes the risk management approach that is suggested for use in NASA's Human Support Technology Development. The first step in risk management is to identify the detailed technical and programmatic risks specific to a project. Each individual risk should be described in detail. The identified risks are summarized in a complete risk list. Risk analysis provides estimates of the likelihood and the qualitative impact of a risk. The likelihood and impact of the risk are used to define its priority location in the risk matrix. The approaches for responding to risk are either to mitigate it by eliminating or reducing the effect or likelihood of a risk, to accept it with a documented rationale and contingency plan, or to research or monitor the risk, The Human Support Technology Development program includes many projects with independently achievable goals. Each project must do independent risk management, considering all its risks together and trading them against performance, budget, and schedule. Since the program can succeed even if some projects fail, the program risk has a complex dependence on the individual project risks.

  14. Managing Risk Assessment in Science Departments.

    ERIC Educational Resources Information Center

    Forlin, Peter; Forlin, Chris

    1997-01-01

    Describes a health-and-safety risk-management audit in four Queensland, Australia high schools. One major outcome of this research project is the development of a comprehensive risk-management policy in compliance with the law. Other outcomes include the preparation of a professional-development package in risk-management policy for use as a…

  15. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 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...

  16. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2010 CFR

    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...

  17. Determining hospital risk management staffing through analytics.

    PubMed

    Howard, Chrystina M; Felton, Kenneth W

    2013-01-01

    This article presents the development of an independent research project to gather time data from hospital risk managers in order to establish an objective, justifiable means of determining staffing levels recommended to support risk management activities and department functions. © 2013 American Society for Healthcare Risk Management of the American Hospital Association.

  18. Risk Management in Student Personnel Administration.

    ERIC Educational Resources Information Center

    Hammond, Edward H.; Hagan, Charles F.

    1979-01-01

    A risk management plan is an effective tool for postsecondary institutions to utilize in organizing management of both personal and institutional liability. Important considerations involve criminal and civil liabilities, causes of risk, and integral elements of a good risk management plan. (NRB)

  19. The prevention and management of postdermabrasion complications.

    PubMed

    Fulton, J E

    1991-05-01

    The complications of keloids, pigment changes, loss of skin texture, and enlarged facial pores remain a problem with dermabrasion patients. Their occurrence can be reduced by proper patient selection, proper dermabrasion technique, proper wound management, and prompt treatment. Keloids are rapidly resolved with the use of flurandrenolide tape covered with positive-pressure chin-strap dressings. Streaks of hyperpigmentation are lightened with a combination of sunscreen, opaque makeup, tretinoin, and hydroquinone lotions. The loss of skin texture can be prevented by not abrading too deeply and avoiding subsequent bacterial contamination during wound healing. However, enlarged skin pores in the central portion of the face and hypopigmentation can be permanent complications.

  20. Risk Management in High Adventure Outdoor Pursuits.

    ERIC Educational Resources Information Center

    Cinnamon, Jerry

    This paper outlines management guidelines for outdoor adventure pursuits based on analysis of accident case studies in the literature. Managing risk, to a large degree, involves managing human errors related to natural environmental hazards. The knowledge needed to manage risk may be gained through personal experience (the most dangerous way),…

  1. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Self-Directed Personal Assistance Services Program § 441.476 Risk management. (a) The State must specify the risk assessment methods it uses to identify potential risks to the participant. (b) The State... 42 Public Health 4 2014-10-01 2014-10-01 false Risk management. 441.476 Section 441.476...

  2. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... requirement, and for the risk assessment procedures and controls (whether established as part of its risk... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Risk management. 932.1 Section 932.1 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS...

  3. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... requirement, and for the risk assessment procedures and controls (whether established as part of its risk... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Risk management. 932.1 Section 932.1 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS...

  4. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... requirement, and for the risk assessment procedures and controls (whether established as part of its risk... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Risk management. 932.1 Section 932.1 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS...

  5. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Self-Directed Personal Assistance Services Program § 441.476 Risk management. (a) The State must specify the risk assessment methods it uses to identify potential risks to the participant. (b) The State... 42 Public Health 4 2013-10-01 2013-10-01 false Risk management. 441.476 Section 441.476...

  6. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... risk, including contingency plans where appropriate. (c) Risk assessment. The senior management of each Bank shall perform, at least annually, a risk assessment that is reasonably designed to identify and... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Risk management. 917.3 Section 917.3 Banks...

  7. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... risk, including contingency plans where appropriate. (c) Risk assessment. The senior management of each Bank shall perform, at least annually, a risk assessment that is reasonably designed to identify and... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Risk management. 917.3 Section 917.3 Banks...

  8. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Self-Directed Personal Assistance Services Program § 441.476 Risk management. (a) The State must specify the risk assessment methods it uses to identify potential risks to the participant. (b) The State... 42 Public Health 4 2012-10-01 2012-10-01 false Risk management. 441.476 Section 441.476...

  9. The Gatekeeper Program: proactive identification and case management of at-risk older adults prevents nursing home placement, saving healthcare dollars program evaluation.

    PubMed

    Barrett, Donna L; Secic, Michelle; Borowske, Debbie

    2010-03-01

    The Gatekeeper Program is an innovative community and hospital partnership focused on prevention of premature nursing home placement. Utilizing trained volunteers, who come into contact with older adults through their everyday jobs, the program provides assistance to over 1600 older adults. Positive program outcomes include reducing emergency department (ED) and hospital admissions and a 14 million dollar savings in healthcare costs related to nursing home placement.

  10. Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

    PubMed

    Yazdani, Amin; Wells, Richard

    2012-01-01

    The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

  11. The Role of Risk and Risk Management in Experiential Education.

    ERIC Educational Resources Information Center

    Mobley, Michael

    A monograph examines the role of risk and risk management in experiential education, particularly stress/challenge programming. Definitions of risk are presented. The importance of risk and stress in experiential education is emphasized. Implications of subjective versus objective risk assessment in adventure education are discussed, with…

  12. HIV in Indian prisons: Risk behaviour, prevalence, prevention & treatment

    PubMed Central

    Dolan, Kate; Larney, Sarah

    2010-01-01

    Background & Objectives: HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Methods: Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. Results: No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). Interpretation & conclusions: HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided. PMID:21245617

  13. Overview of surgical scar prevention and management.

    PubMed

    Son, Daegu; Harijan, Aram

    2014-06-01

    Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.

  14. The prevention and management of pressure ulcers.

    PubMed

    Goode, P S; Allman, R M

    1989-11-01

    Pressure ulcers are a common problem for older persons. Complications associated with pressure ulcers include infection and even death for some patients. Pressure is the primary pathogenic factor, but shearing forces, friction, and moisture are also important. Immobility, nutritional status, and age-related factors seem to be significant risk factors. Preventive care includes use of assessment tools to identify high risk patients, frequent repositioning, air or foam mattresses that reduce pressure over bony prominences, as well as careful attention to optimizing the overall patient condition. When pressure ulcers do develop, the treatment plan should include adequate nutrition including protein, vitamin C, and zinc supplements as indicated; systemic antibiotics for sepsis, cellulitis, osteomyelitis, or the prevention of bacterial endocarditis; and local wound care that eliminates necrotic tissue, decreases bacterial load, and provides a physiologic, pressure-free environment allowing the wound to heal. Specialized beds may be considered in some patients, particularly those with larger ulcers. Surgery is an option in older persons who are operative candidates. For some patients with pressure ulcers, appropriate treatment goals may focus on providing comfort rather than curing the ulcer.

  15. [How to prevent drug therapy risk].

    PubMed

    Bouvenot, G

    2001-12-01

    Therapeutic risk is largely foreseeable and can also largely be avoided. The art of prescription consists of favoring the beneficial effect of the medicament while taking all useful precautions to minimize undesirable effects. The appropriate method is correct use of the medicament at the collective and individual level. This is based on respect of reference systems and firstly on the particulars of the marketing license and the summary of the characteristics of the product, which provide validated knowledge concerning the medication. However, these may also be gray areas, insufficient updating, and insufficiently clear and concrete information on the expected therapeutic benefit as opposed to the pernicious effects feared. It is also based on opposing medical references, which attract attention to dangerous prescription practices. Moreover, for an individualized prescription it is necessary to take into account the actual patient, here and now, and not only the standard patient of clinical trials. Prescription priority must also be organized to favor indispensable medications only. In some cases drug monitoring based on personalized pharmacokinetics should be performed. Monitoring and informing of the patient must be strict for maximum safety; however, this is never complete. In this connection, lack of hindsight, premature enthusiasm, and falsely reassuring surveillance should be taken into account, particularly where undesirable effects not dependent on dosage are concerned. Health education for the public, improved training of health staff as concerns iatrogenic effects and, shortly, computerized risk prevention with suitable software and data banks, systematic reviews and meta-analyses of therapeutic safety will help provide the patient with improved protection. This constitutes a major scientific, economic and ethical challenge for our societies.

  16. Early Childhood Caries: Prevalence, Risk Factors, and Prevention.

    PubMed

    Anil, Sukumaran; Anand, Pradeep S

    2017-01-01

    Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC.

  17. Early Childhood Caries: Prevalence, Risk Factors, and Prevention

    PubMed Central

    Anil, Sukumaran; Anand, Pradeep S.

    2017-01-01

    Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC. PMID:28770188

  18. Calysto: Risk Management for Commercial Manned Spaceflight

    NASA Technical Reports Server (NTRS)

    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.

  19. Pre-eclampsia part 2: prediction, prevention and management.

    PubMed

    Chaiworapongsa, Tinnakorn; Chaemsaithong, Piya; Korzeniewski, Steven J; Yeo, Lami; Romero, Roberto

    2014-09-01

    An antiangiogenic state might constitute a terminal pathway for the multiple aetiologies of pre-eclampsia, especially those resulting from placental abnormalities. The levels of angiogenic and antiangiogenic proteins in maternal blood change prior to a diagnosis of pre-eclampsia, correlate with disease severity and have prognostic value in identifying women who will develop maternal and/or perinatal complications. Potential interventions exist to ameliorate the imbalance of angiogenesis and, hence, might provide opportunities to improve maternal and/or perinatal outcomes in pre-eclampsia. Current strategies for managing pre-eclampsia consist of controlling hypertension, preventing seizures and timely delivery of the fetus. Prediction of pre-eclampsia in the first trimester is of great interest, as early administration of aspirin might reduce the risk of pre-eclampsia, albeit modestly. Combinations of biomarkers typically predict pre-eclampsia better than single biomarkers; however, the encouraging initial results of biomarker studies require external validation in other populations before they can be used to facilitate intervention in patients identified as at increased risk. Angiogenic and antiangiogenic factors might also be useful in triage of symptomatic patients with suspected pre-eclampsia, differentiating pre-eclampsia from exacerbations of pre-existing medical conditions and performing risk assessment in asymptomatic women. This Review article discusses the performance of predictive and prognostic biomarkers for pre-eclampsia, current strategies for preventing and managing the condition and its long-term consequences.

  20. Prevention and management of ventilator-associated pneumonia.

    PubMed

    Ewig, Santiago; Torres, Antoni

    2002-02-01

    Worldwide, the increasing rates of microbial resistance represent a serious public health problem. Therefore, measures to prevent ventilator-associated pneumonia gain increasing importance. Because antimicrobial treatment in the ICU is a major source of microbial resistance, prevention should be understood not only as the sum of preventive measures but also as part of any management strategy. In this year of review, several important contributions have been made to a better understanding of the relative role of preventive measures. This is particularly true of noninvasive ventilation, continuous aspiration of subglottic secretions, and closed endotracheal suctioning. Management strategies for ventilator-assisted pneumonia remain highly controversial. Despite two decades of vigorous research, there is still no evidence that invasive bronchoscopic techniques should form part of a routine approach to suspected ventilator-assisted pneumonia. Moreover, an impact in terms of important outcome variables could not be consistently demonstrated. In the authors' view, the controversy regarding the relative validity of diagnostic tools should end, and the focus should shift to strategies that define low-risk patients with suspected ventilator-assisted pneumonia who can safely be treated by short-term monotherapy. Finally, several contributions have refined the established treatment regimen. Several new drugs for the treatment of ventilator-assisted pneumonia caused by Gram-positive multiresistant pathogens have been evaluated with promising results.

  1. [Mass gatherings - health risks and preventive strategies].

    PubMed

    Steffen, Robert

    2013-06-01

    Experience from mass gatherings - usually attended by at least 25'000 persons - shows that approximately one in a thousand participants will consult with an on-site medical emergency service. Communicable diseases usually play a minor role. Historically outbreaks of meningococcal disease were recorded after the hajj, but this has been well controlled in the past few years subsequent to vaccinations and other measures required by the Kingdom of Saudi Arabia health authorities. Major stress of the regional public health system is associated with accidents and non-communicable diseases, the majority being trivial. Host and environmental risk factors can result in a dramatic increase in the rate of consultations: Age and pre-existing illness play a decisive role particularly in pilgrims, be that in Mecca or Lourdes. Emotional factors may influence behavior; aggressions can develop. Alcohol and drugs, also the duration of an event may play a decisive role. Extreme climatic conditions, both heat and cold, also exhaustion result in a dramatic increase of emergency consultations. Infrastructure must be adapted for the crowd size, particularly stampede associated disasters can be avoided. The World Health Organization and other interested expert groups have in the past few years formulated interdisciplinary programs for prevention.

  2. Staff burn-out prevention and stress management.

    PubMed

    Paisley, Karen; Powell, Gwynn M

    2007-10-01

    In many ways, adolescent seasonal camp staff are asked to do what no parent would likely be capable of doing: to be best friend, role model, and risk manager for a group of young strangers. The high expectations for camp responsibility converge at a time when the developmental stages of most camp staff and their growing skill sets may be most challenged. What we ask of seasonal staff may, in fact, be at direct odds with their developmental capabilities as adolescents. This conflict may be a primary source of daily hassle-type stress, which has been shown to have tremendous impact on health and general well-being. To help prevent or, at least, mitigate this impact, the combination of administrative structure, supervisory support, and peer and self-care is critical to staff development. This article provides a brief exploration of the developmental stages and capabilities of seasonal staff and, an overview of methods to support and empower staff while on the job to help prevent burnout and encourage stress management. The focus of this article is on mechanical and procedural prevention as a stress management tool.

  3. Aspiration pneumonia. Pathophysiological aspects, prevention and management. A review.

    PubMed

    Petroianni, A; Ceccarelli, D; Conti, V; Terzano, C

    2006-12-01

    Aspiration pneumonias occur more frequently than reported and, in many cases, the disease is not recognised. In hospitalised and institutionalised patients with predisposing diseases prompt diagnosis of this complication and correct preventive measures can drastically reduce the worsening of clinical conditions and the deaths due to aspiration pneumonia. Normal airway structure, effective defence mechanisms, and preventive measures are decisive in reducing aspiration episodes. An increased aspiration risk for food, fluids, medications, or secretions may lead to the development of pneumonia. Pneumonia is the most common respiratory complication in all stroke deaths and in mechanical ventilation patients. In addition, the increased incidence of aspiration pneumonia with aging may be a consequence of impairment of swallowing and the cough reflex. Dysphagia, compromised consciousness, invasive procedures, anaesthesia, insufficient oral care, sleep disorders, and vomiting are all risk factors. Aspiration pneumonia includes different characteristic syndromes based on the amount (massive, acute, chronic) and physical character of the aspirated material (acid, infected, lipoid), needing a different therapeutic approach. Chronic patients education and correct health care practices are the keys for preventing the events of aspiration. In patients at risk a clinical and instrumental assessment of dysphagia should be evaluated. Management includes the removal of etiologic factors (drugs, tubes, mobilisation, oral hygiene), supportive care, and in bacterial pneumonias a specific antibiotic therapy for community-acquired or nosocomial events.

  4. POLLUTION PREVENTION RESEARCH ONGOING - EPA'S RISK REDUCTION ENGINEERING LABORATORY

    EPA Science Inventory

    The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied researc...

  5. Prevention and management of viral hepatitis in pregnancy.

    PubMed

    Rac, Martha W F; Sheffield, Jeanne S

    2014-12-01

    Of the 5 types of viral hepatitis (HAV-HEV), HBV and HCV are by far the most common causes of chronic hepatitis in both pregnant and nonpregnant populations, causing more than 50% of cirrhosis cases and 78% of cases of primary liver cancer. Infection during pregnancy can have adverse effects on both the mother and her fetus. For all 5 viral hepatitis syndromes, early identification allows appropriate measures to be taken to optimize pregnancy outcomes and minimize the risk of perinatal transmission. This article reviews the prevention and management of all 5 viral hepatitis syndromes during pregnancy. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Prevention and management of incontinence-associated dermatitis.

    PubMed

    Nix, Denise; Haugen, Vicki

    2010-06-01

    Perineal dermatitis, recently relabelled 'incontinence-associated dermatitis' (IAD), is an inflammation of the skin that occurs when urine and/or stool comes into contact with the skin. It can range in severity from erythema with or without loss of skin integrity to infection. IAD affects as many as 41% of adults in long-term care; it is costly, painful and, for the most part, preventable. An effective plan of care for individuals with IAD must include assessment and management of incontinence aetiology, perineal skin and risk assessment, gentle cleansing and moisturization, application of skin barriers and treatment of secondary infection, and the use of containment devices if indicated.

  7. High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

    PubMed Central

    Taylor, Andrew T.

    2011-01-01

    High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS) which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler. PMID:23908794

  8. Fall prevention practices in adult medical-surgical nursing units described by nurse managers.

    PubMed

    Shever, Leah L; Titler, Marita G; Mackin, Melissa Lehan; Kueny, Angela

    2011-04-01

    The purpose of this article was to describe nursing practices (e.g., assessment, interventions) around fall prevention, as perceived by nurse managers in adult, medical-surgical nursing units. One hundred forty nurse managers from 51 hospitals from across the United States participated. Descriptive frequencies are used to describe nurse manager responses. The most commonly used fall risk assessment tool was the Morse Fall Risk Assessment Tool (40%). The most common fall prevention interventions included bed alarms (90%), rounds (70%), sitters (68%), and relocating the patient closer to the nurses' station (56%). Twenty-nine percent of nurse managers identified physical restraints as an intervention to prevent falls whereas only 10% mentioned ambulation. No nurse manager identified that RN hours per patient-day were adjusted to prevent falls or fall-related injuries. More work is needed to build systems that ensure evidence-based nursing interventions are consistently applied in acute care.

  9. Commercializing fuel cells: managing risks

    NASA Astrophysics Data System (ADS)

    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

  10. Acquisition Program Risk Management: Does the Department of Defense Risk Management Practices Guide Provide an Effective Risk Tool for Program Managers in Today’s Acquisition Environment?

    DTIC Science & Technology

    2012-05-01

    Management Definition ........................................................................................... 32 Table 16. Risk Management Tracking...Other (please specify) 5 Table 15. Risk Management Definition Question 7: Does your Program Office or Risk Management IPT track risks for cost...aligned to collect information on program risk definition. Question 6 was designed to collect information on risk management definition . Participants

  11. High Risk Pregnancy: Detection and Management

    PubMed Central

    Fellows, G. Fraser; Chance, Graham W.

    1982-01-01

    Risk in pregnancy relates to events which lead to perinatal morbidity and mortality. Numerous risk scoring systems have been devised to bring attention to risk factors so that problems can be prevented, identified and treated. However, by carrying out very few fundamental assessments at regular antenatal office visits: checking blood pressure, testing urine for protein, measuring the symphysis to fundus height and carefully establishing the expected date of confinement during the first trimester, the principal causes of perinatal morbidity and mortality—intrauterine growth retardation, prematurity, congenital anomalies, infection, abruptio placentae and meconium aspiration—can be identified and treated. Appropriate perinatal management of the very premature fetus/neonate (less than 34 weeks gestation) is a critical factor which will influence outcome. Whenever possible the mother should be transferred to a centre equipped and staffed for all necessary intrapartum and neonatal care, to minimize the risk of adverse outcome: postnatal transfer of the deteriorating, sick, small neonate is at best hazardous. PMID:21286514

  12. [Integrated risk profiling allows prevention and early intervention].

    PubMed

    Stegeman, Inge; Kraaijenhagen, Roderik A; Bossuyt, Patrick M M

    2010-01-01

    Prevention and early intervention can alter the course and incidence of several chronic diseases. Integrated risk profiling is based on the fact that a single risk factor affects more than one condition. Integrated risk profiling uses these overlapping risk factors to calculate the risks of a number of conditions. When used in screening, these risks can be communicated to participants, providing feedback and helping them understand the conditions they are at risk of, eventually leading to better compliance with preventive and therapeutic interventions. In this paper we discuss the underlying principles and background of the rise in integrated risk profiling in public health. We demonstrate why the attractive concept of risk profiling needs further assessment to estimate its effectiveness relative to other methods of prevention, population screening and case finding.

  13. Patients at risk of onychomycosis--risk factor identification and active prevention.

    PubMed

    Tosti, A; Hay, R; Arenas-Guzmán, R

    2005-09-01

    The aims of this workshop were to identify risk factors for onychomycosis and to reach consensus on the management of high-risk groups to allow the development of guidelines to help doctors recognize risk factors that complicate treatment. Previous Trichophyton rubrum infection, older age, abnormal nail morphology, immunodeficiency and genetic factors were identified as risk factors for initial infections. Risk factors for recurrence (relapse and re-infection) are largely the same. The experts agreed that the prevention of onychomycosis and its recurrence should be based on the correct treatment of tinea pedis, screening family members and adequate patient education. In addition, generic management recommendations for each high-risk group were discussed: * Immunosuppressed patients Usual dose and treatment length not appropriate Follow-up required Beware of drug interactions * Diabetics Prophylactic foot care combined with nail treatment Good opportunity for patient education, footwear, foot care, etc. Beware of drug interactions * Psoriatics and patients with abnormal nails Dermatophyte eradication does not restore normal nails * Children High failure rate possibly due to compliance problems.

  14. Understanding managed care risk sharing arrangements.

    PubMed

    Leigh, J R

    1995-01-01

    A risk sharing agreement between a managed care organization and an employer can be used by employers to either guarantee a managed care plan's short-term success or mitigate its failure. Under such arrangements, the managed care organization financially shares the employer's risk of unfavorable claims experience.

  15. Manejo de riesgo (Risk Management). ERIC Digest.

    ERIC Educational Resources Information Center

    Gaustad, Joan

    The ordinary conduct of school business is accompanied today by risks that were rare or unknown a few decades ago. This ERIC Digest in Spanish discusses how risk management, a concept long used by corporate decision makers, can help school boards and administrators conserve their districts' assets. Risk management is a coordinated effort to…

  16. Risk Management. ERIC Digest, Number 86.

    ERIC Educational Resources Information Center

    Gaustad, Joan

    The ordinary conduct of school business is accompanied today by risks that were rare or unknown a few decades ago. This ERIC Digest discusses how risk management, a concept long used by corporate decision makers, can help school boards and administrators conserve their districts' assets. Risk management is a coordinated effort to protect an…

  17. Risk Management (Is Not) for Dummies

    DTIC Science & Technology

    2005-02-01

    FEB 2005 2. REPORT TYPE 3. DATES COVERED 00-00-2005 to 00-00-2005 4. TITLE AND SUBTITLE Risk Management (Is Not) for Dummies 5a. CONTRACT NUMBER...recorded for each Open Forum Risk Management (Is Not) For Dummies February 2005 www.stsc.hill.af.mil 29 risk? Who will use the data and how? Now

  18. Complications of Blepharoplasty: Prevention and Management

    PubMed Central

    Oestreicher, James; Mehta, Sonul

    2012-01-01

    Blepharoplasty is an operation to modify the contour and configuration of the eyelids in order to restore a more youthful appearance. The surgery involves removing redundant skin, fat, and muscle. In addition, supporting structures such as canthal tendons are tightened. Other conditions such as ptosis, brow ptosis, entropion, ectropion, or eyelid retraction may also need to be corrected at the time a blepharoplasty is performed to ensure the best functional and aesthetic result. Due to the complexity and intricate nature of eyelid anatomy, complications do exist. In addition to a thorough pre operative assessment and meticulous surgical planning, understanding the etiology of complications is key to prevention. Finally, management of complications is just as important as surgical technique. PMID:22655191

  19. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    PubMed Central

    Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

    2008-01-01

    Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. PMID:19005579

  20. Ciguatera fish poisoning: treatment, prevention and management.

    PubMed

    Friedman, Melissa A; Fleming, Lora E; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

    2008-01-01

    Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

  1. Identifying risks in the realm of enterprise risk management.

    PubMed

    Carroll, Roberta

    2016-01-01

    An enterprise risk management (ERM) discipline is comprehensive and organization-wide. The effectiveness of ERM is governed in part by the strength and breadth of its practices and processes. An essential element in decision making is a thorough process by which organizational risks and value opportunities can be identified. This article will offer identification techniques that go beyond those used in traditional risk management programs and demonstrate how these techniques can be used to identify risks and opportunity in the ERM environment.

  2. Pediatric heat-related illness: recommendations for prevention and management

    PubMed

    Dunn, Roberta J.; Kim, Tommy Y.

    2017-08-01

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. Copyright © 2017 EB Medicine

  3. [Prevention of shoulder dystocia risk factors before delivery].

    PubMed

    Fuchs, F

    2015-12-01

    To determine whether it is possible to prevent the occurrence of risk factors for shoulder dystocia before or during pregnancy. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Studied measures were exercise before or during pregnancy, dietary management, and gestational diabetes management in obese and non-obese patients. No study has proven that the correction of these risk factors (except gestational diabetes) would reduce the risk of shoulder dystocia. In the general population, physical exercise is recommended either before or during pregnancy to reduce the risk of gestational diabetes (physical activity before pregnancy) (grade B), fetal macrosomia (grade C) or maternal weight gain during pregnancy (grade C). No dietary regimen is recommended to reduce these issues (grade B). In overweight or obese (body mass index [BMI]>25), physical activity coupled with dietary management is recommended (grade A) because it reduces fetal macrosomia (EL1). In addition, it allows a modest reduction in maternal weight gain during pregnancy (EL2), but did have an effect on the occurrence of gestational diabetes (EL1). In case of gestational diabetes, diabetes care is recommended (diabetic diet, glucose monitoring, insulin if needed) (grade A) as it reduces the risk of macrosomia and shoulder dystocia (EL1). The recommended weight gain during pregnancy is 11.5 kg to 16 kg for normal BMI patients (grade B). Obese patients should be aware of the importance of controlling their weight gain during pregnancy (professional consensus). It is recommended that patients regain their pre-conception weight, and ideally a BMI between 18 and 25 kg/m(2), 6 months postpartum (grade B) to reduce the risk of gestational diabetes and macrosomia in a subsequent pregnancy (EL2). Physical activity is recommended before and during pregnancy to reduce the occurrence of risk factors for shoulder dystocia

  4. A Prevention Program for Middle-School High Risk Youth.

    ERIC Educational Resources Information Center

    Gittman, Elizabeth; Cassata, Marian

    A 5-year federally funded substance abuse prevention program targeted 426 high risk middle-school youth from 4 school districts in Nassau County, New York. Combining a child-centered model with a systemic approach, the program's goal was to prevent or delay the onset of alcohol and other drug use. High-risk youth were identified by school…

  5. Quick Fix for Managing Risks

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Under a Phase II SBIR contract, Kennedy and Lumina Decision Systems, Inc., jointly developed the Schedule and Cost Risk Analysis Modeling (SCRAM) system, based on a version of Lumina's flagship software product, Analytica(R). Acclaimed as "the best single decision-analysis program yet produced" by MacWorld magazine, Analytica is a "visual" tool used in decision-making environments worldwide to build, revise, and present business models, minus the time-consuming difficulty commonly associated with spreadsheets. With Analytica as their platform, Kennedy and Lumina created the SCRAM system in response to NASA's need to identify the importance of major delays in Shuttle ground processing, a critical function in project management and process improvement. As part of the SCRAM development project, Lumina designed a version of Analytica called the Analytica Design Engine (ADE) that can be easily incorporated into larger software systems. ADE was commercialized and utilized in many other developments, including web-based decision support.

  6. Continuous Risk Management: A NASA Program Initiative

    NASA Technical Reports Server (NTRS)

    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.

  7. Rural Residents' Perspectives on Multiple Morbidity Management and Disease Prevention.

    PubMed

    Bardach, Shoshana H; Schoenberg, Nancy E; Tarasenko, Yelena N; Fleming, Steven T

    2011-12-01

    Middle-aged and older adults often experience several simultaneously occurring chronic conditions or "multiple morbidity" (MM). The task of both managing MM and preventing chronic conditions can be overwhelming, particularly in populations with high disease burdens, low socioeconomic status, and health care provider shortages. This article sought to understand Appalachian residents' perspectives on MM management and prevention. Forty-one rural Appalachian residents aged 50 and above with MM were interviewed about disease management and colorectal cancer (CRC) prevention. Transcripts were examined for overall analytic categories and coded using techniques to enhance transferability and rigor. Participants indicate facing various challenges to prevention due, in part, to conditions within their rural environment. Patients and providers spend significant time and energy on MM management, often precluding prevention activities. This article discusses implications of MM management for CRC prevention and strategies to increase disease prevention among this rural, vulnerable population burdened by MM.

  8. Managing Risk in Hodgkin Lymphoma.

    PubMed

    Armitage, James O; Chen, Robert W; Moskowitz, Craig H; Sweetenham, John

    2015-02-01

    Approximately 90% of patients with limited-stage Hodgkin lymphoma are cured. The cure rate in advanced-stage Hodgkin lymphoma is dramatically better than it once was, but it is still lower than the rate in patients with limited disease. The choice of treatment is based on several factors, including symptoms, disease stage, extent of tumor burden, and prognosis. Positron emission tomography scanning can be used to assess the patient's stage of disease, which can allow further individualization of therapy. Traditional frontline treatment options include doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and, for high-risk patients, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP). Autologous stem cell transplantation cures approximately 50% of patients. The antibody-drug conjugate brentuximab vedotin is very active in relapsed/refractory Hodgkin lymphoma. Data presented at the 2014 meeting of the American Society of Hematology (ASH) showed that brentuximab vedotin was beneficial in several settings, including as consolidation therapy posttransplant in patients at high risk for relapse, as first-line salvage therapy in relapsed/refractory Hodgkin lymphoma prior to autologous hematopoietic cell transplantation, and in combination with bendamustine in relapsed/refractory disease. The ASH meeting also offered promising data on novel agents, such as the programmed cell death 1 (PD-1) inhibitors. In this monograph, 4 experts in the management of Hodgkin lymphoma discuss various aspects of the disease and provide their perspectives on the new data presented at the ASH meeting.

  9. Nurses' Psychosocial Barriers to Suicide Risk Management

    PubMed Central

    Valente, Sharon

    2011-01-01

    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 (n = 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. PMID:21994837

  10. Prevention and Management of Pregnancy in Adolescents with Endocrine Disorders.

    PubMed

    Hillard, Paula J Adams

    2015-08-01

    Because 83% of adolescent pregnancies among teens 15 to 19 years old are unintended and because adolescents with chronic medical conditions are as likely to be sexually involved as are healthy teens, preventing unintended pregnancies among teens with chronic endocrine conditions, including diabetes mellitus (both types 1 and 2), PCOS, and thyroid dysfunction, is critically important. Evidence-based guidelines are available to assist with assessment of the risks versus the benefits of specific options for contraception in teens with these and other medical conditions. In many teens, including those with chronic medical conditions, the top-tier contraceptive methods--implants and intrauterine devices--represent the most effective, safest, and most successful contraceptive options for adolescents. Prepregnancy counseling can be an important tool for managing chronic endocrine conditions and lowering the risks for both mother and fetus, but it is underutilized among all women, particularly adolescents. The management of pregnancies complicated by DM, PCOS, and thyroid conditions is facilitated by a coordinated effort among obstetricians, endocrinologists, dietitians, and nurse educators. Primary physicians should be aware of their potential role in preventing unplanned pregnancies among all adolescents, but particularly among those with chronic medical conditions.

  11. Business resilience: Reframing healthcare risk management.

    PubMed

    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.

  12. Risk Management for Brigades and Battalions

    DTIC Science & Technology

    1995-05-01

    This report describes a concept, with procedures and responsibilities, for risk management in brigades and battlalions during Mission Essential Task...FM 100-5, Operations. The risk management procedures and responsibilities are consistent with those presented in FM 101-5, Command and Control for... risk management tactics, techniques and procedures published in the Center for Army Lessons Learned Newsletter, "Force Protection (Safety)", No. 9, December 1993.

  13. Managing financial risk with options on futures.

    PubMed

    Bond, M T; Marshall, B S

    1995-05-01

    With the rise of managed care and capitation, more providers will be sharing in the financial risk of providing care. To help protect their organizations from the risk of unexpectedly high utilization under such a fixed-payment system, healthcare financial managers soon will be able to use options on futures contracts. These contracts provide wide profit potential but limited loss potential. Before investing in options on futures, however, healthcare financial managers should consider issues such as basis risk and trading costs.

  14. Absolute coronary risk analyser--a tool for managing coronary heart disease risk.

    PubMed

    Mitrabasu, P P B; Shahapurkar, J S; Sreekumar, T P; Vyawahare, M K; Sarma, C G S

    2003-06-01

    The aim of the present study was to develop a coronary risk analyser which can calculate authentically the absolute coronary risk of an individual for coronary risk management. After extensive literature survey was done to derive the most appropriate method to calculate the absolute coronary risk. Joint British recommendations derived from Framingham's heart study were adopted for its supreme sensitivity and specificity. A windows based software is developed using Visual basic programming language. The software is easily installable in any pentium PC with windows operating system and requires entry of a detailed medical profile of an individual for the calculation of absolute coronary risk. Coronary risk analyser developed by DEBEL effectively calculates the absolute coronary risk of an individual over 2, 5 or 10 years and stores the patient's data properly. The software is a tool to manage the coronary risk of a patient in the field of preventive cardiology.

  15. Prevention and Management of Infectious Complications of Percutaneous Interventions

    PubMed Central

    Huang, Steven Y.; Philip, Asher; Richter, Michael D.; Gupta, Sanjay; Lessne, Mark L.; Kim, Charles Y.

    2015-01-01

    Infectious complications following interventional radiology (IR) procedures can cause significant patient morbidity and, potentially, mortality. As the number and breadth of IR procedures grow, it becomes increasingly evident that interventional radiologists must possess a thorough understanding of these potential infectious complications. Furthermore, given the increasing incidence of antibiotic-resistant bacteria, emphasis on cost containment, and attention to quality of care, it is critical to have infection control strategies to maximize patient safety. This article reviews infectious complications associated with percutaneous ablation of liver tumors, transarterial embolization of liver tumors, uterine fibroid embolization, percutaneous nephrostomy, percutaneous biliary interventions, central venous catheters, and intravascular stents. Emphasis is placed on incidence, risk factors, prevention, and management. With the use of these strategies, IR procedures can be performed with reduced risk of infectious complications. PMID:26038616

  16. Managing Research in a Risk World

    NASA Technical Reports Server (NTRS)

    Anton, W.; Havenhill, M.

    2014-01-01

    The Office of Chief Medical Officer (OCHMO) owns all human health and performance risks managed by the Human System Risk Board (HSRB). While the HSRB manages the risks, the Human Research Program (HRP) manages the research portion of the overall risk mitigation strategy for these risks. The HSRB manages risks according to a process that identifies and analyzes risks, plans risk mitigation and tracks and reviews the implementation of these strategies according to its decisions pertaining to the OCHMO risk posture. HRP manages risk research work using an architecture that describes evidence-based risks, gaps in our knowledge about characterizing or mitigating the risk, and the tasks needed to produce deliverables to fill the gaps and reduce the risk. A planning schedule reflecting expected research milestones is developed, and as deliverables and new evidence are generated, research progress is tracked via the Path to Risk Reduction (PRR) that reflects a risk's research plan for a design reference mission. HRP's risk research process closely interfaces with the HSRB risk management process. As research progresses, new deliverables and evidence are used by the HSRB in conjunction with other operational and non-research evidence to inform decisions pertaining to the likelihood and consequence of the risk and risk posture. Those decisions in turn guide forward work for research as it contributes to overall risk mitigation strategies. As HRP tracks its research work, it aligns its priorities by assessing the effectiveness of its contributions and maintaining specific core competencies that would be invaluable for future work for exploration missions.

  17. Secondary Prevention--Serving Families at Risk.

    ERIC Educational Resources Information Center

    Thyen, Ute; And Others

    1995-01-01

    The Child Protection Center in Lubeck (Germany) offers a nonpunitive, self-help approach to prevent child abuse by encouraging families to determine their own needs. Over half of families served over a two-year period were self-reported and almost one-fifth received help to prevent violence against children before the occurrence of child abuse or…

  18. Rape prevention with college men: evaluating risk status.

    PubMed

    Stephens, Kari A; George, William H

    2009-06-01

    This study evaluates the effectiveness of a theoretically based rape prevention intervention with college men who were at high or low risk to perpetrate sexually coercive behavior. Participants (N = 146) are randomly assigned to the intervention or control group. Outcomes include rape myth acceptance, victim empathy, attraction to sexual aggression, sex-related alcohol expectancies, and behavioral indicators, measured across three time points. Positive effects are found for rape myth acceptance, victim empathy, attraction to sexual aggression, and behavioral intentions to rape. Only rape myth acceptance and victim empathy effects sustain at the 5-week follow-up. High-risk men are generally unaffected by the intervention although low-risk men produced larger effects than the entire sample. Results suggest rape prevention studies must assess risk status moderation effects to maximize prevention for high-risk men. More research is needed to develop effective rape prevention with men who are at high risk to rape.

  19. Best practice of nurse managers in risk management.

    PubMed

    Costa, Veridiana Tavares; Meirelles, Betina Hörner Schlindwein; Erdmann, Alacoque Lorenzini

    2013-01-01

    To identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. A case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analyzed through practical measures. Educational actions, the critical analysis of the context, and the multiple dimensions of the management were evidenced as best practice. The broadening of understanding regarding risk management best practice offers further support for nurse managers to achieve excellence in their actions and thus provide safe and quality care.

  20. DDP - a tool for life-cycle risk management

    NASA Technical Reports Server (NTRS)

    Cornford, S. L.; Feather, M. S.; Hicks, K. A.

    2001-01-01

    At JPL we have developed, and implemented, a process for achieving life-cycle risk management. This process has been embodied in a software tool and is called Defect Detection and Prevention (DDP). The DDP process can be succinctly stated as: determine where we want to be, what could get in the way and how we will get there.

  1. Risk Management: Getting the Most for Your Insurance Dollars

    ERIC Educational Resources Information Center

    Abramson, Paul

    1973-01-01

    Analyze what insurance is intended to do by going through the risk management process: identify exposures to loss, measure their financial impact on the institution, rationalize the means of controlling exposures, prevent loss, and set up a program to minimize the impact of loss through insurance or other means. (Author)

  2. Risk Management: Getting the Most for Your Insurance Dollars

    ERIC Educational Resources Information Center

    Abramson, Paul

    1973-01-01

    Analyze what insurance is intended to do by going through the risk management process: identify exposures to loss, measure their financial impact on the institution, rationalize the means of controlling exposures, prevent loss, and set up a program to minimize the impact of loss through insurance or other means. (Author)

  3. DDP - a tool for life-cycle risk management

    NASA Technical Reports Server (NTRS)

    Cornford, S. L.; Feather, M. S.; Hicks, K. A.

    2001-01-01

    At JPL we have developed, and implemented, a process for achieving life-cycle risk management. This process has been embodied in a software tool and is called Defect Detection and Prevention (DDP). The DDP process can be succinctly stated as: determine where we want to be, what could get in the way and how we will get there.

  4. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

    PubMed Central

    Munns, Craig F.; Shaw, Nick; Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M.; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary

    2016-01-01

    Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. PMID:26745253

  5. Risk Management Questions for News Reporting Classes.

    ERIC Educational Resources Information Center

    Stiff, Cindy

    1995-01-01

    Reviews court rulings which demonstrate that the potential for liability is significant when students are injured on journalism assignments. Offers guidelines on risk management for journalism professors. (SR)

  6. Educational Risk Management: Eliminate, Assume, or Transfer.

    ERIC Educational Resources Information Center

    Shoop, Robert J.; Dunklee, Dennis R.

    1989-01-01

    An Educational Risk Management Plan (ERMP) should be incorporated throughout every school district. Discusses property and liability insurance classifications and features of a good ERMP. (12 references) (MLF)

  7. Assessing and Managing Risk with Suicidal Individuals

    ERIC Educational Resources Information Center

    Linehan, Marsh M.; Comtois, Katherine A.; Ward-Ciesielski, Erin F.

    2012-01-01

    The University of Washington Risk Assessment Protocol (UWRAP) and Risk Assessment and Management Protocol (UWRAMP) have been used in numerous clinical trials treating high-risk suicidal individuals over several years. These protocols structure assessors and treatment providers to provide a thorough suicide risk assessment, review standards of care…

  8. Assessing and Managing Risk with Suicidal Individuals

    ERIC Educational Resources Information Center

    Linehan, Marsh M.; Comtois, Katherine A.; Ward-Ciesielski, Erin F.

    2012-01-01

    The University of Washington Risk Assessment Protocol (UWRAP) and Risk Assessment and Management Protocol (UWRAMP) have been used in numerous clinical trials treating high-risk suicidal individuals over several years. These protocols structure assessors and treatment providers to provide a thorough suicide risk assessment, review standards of care…

  9. COMMUNICATING PROBABILISTIC RISK OUTCOMES TO RISK MANAGERS

    EPA Science Inventory

    Increasingly, risk assessors are moving away from simple deterministic assessments to probabilistic approaches that explicitly incorporate ecological variability, measurement imprecision, and lack of knowledge (collectively termed "uncertainty"). While the new methods provide an...

  10. Safety risk management for ESA space systems

    NASA Astrophysics Data System (ADS)

    Wright, K. M.

    1991-08-01

    ESA's safety program as defined in ESA PSS-01-40, system safety requirements for ESA space systems, comprise the systematic identification and evaluation of space system hazardous characteristics and their associated risks, together with a process of safety optimization through hazard and risk reduction, and implementation verification. This safety optimization and verification process is termed safety risk management. The fundamental principles of safety risk management are discussed.

  11. Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine.

    PubMed

    Thornton, Jane S; Frémont, Pierre; Khan, Karim; Poirier, Paul; Fowles, Jonathon; Wells, Greg D; Frankovich, Renata J

    2016-09-01

    Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field.Author note This position statement has been endorsed by the following nine sport medicine societies: Australasian College of Sports and Exercise Physicians (ACSEP), American Medical Society for Sports Medicine (AMSSM), British Association of Sports and Exercise Medicine (BASEM), European College of Sport & Exercise Physicians (ECOSEP), Norsk forening for idrettsmedisin og fysisk aktivite (NIMF), South African Sports Medicine Association (SASMA), Schweizerische Gesellschaft für Sportmedizin

  12. Risk Management for the International Space Station

    NASA Technical Reports Server (NTRS)

    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.

  13. Application of a risk management system to improve drinking water safety.

    PubMed

    Jayaratne, Asoka

    2008-12-01

    The use of a comprehensive risk management framework is considered a very effective means of managing water quality risks. There are many risk-based systems available to water utilities such as ISO 9001 and Hazard Analysis and Critical Control Point (HACCP). In 2004, the World Health Organization's (WHO) Guidelines for Drinking Water Quality recommended the use of preventive risk management approaches to manage water quality risks. This paper describes the framework adopted by Yarra Valley Water for the development of its Drinking Water Quality Risk Management Plan incorporating HACCP and ISO 9001 systems and demonstrates benefits of Water Safety Plans such as HACCP.

  14. Concussion risk factors and strategies for prevention.

    PubMed

    Kerr, Hamish A

    2014-12-01

    Concussion in children is frequently related to participation in sports. It requires a traumatic event to occur that transmits acceleration to the brain. Some children may have intrinsic risk factors that place them at greater risk for this type of injury. Comorbidities such as attention-deficit/hyperactivity disorder, migraine headaches, and mood disorders may place athletes at increased risk of more severe injury. A previous concussion is probably the most important influence on risk for future injury. Extrinsic risk factors include coaching techniques, officiating, and choice of sport. Helmet choice does not diminish concussion risk, nor does the use of mouth guards. Education of athletes, coaches, parents, and physicians is very important in improving recognition of potential concussive injury and helping child athletes and their parents understand the risks involved in sport participation.

  15. Classification of transmission risk of vaccine-preventable diseases based on vaccination indicators in Brazilian municipalities.

    PubMed

    Braz, Rui Moreira; Domingues, Carla Magda Allan S; Teixeira, Antônia Maria da Silva; Luna, Expedito José de Albuquerque

    2016-01-01

    to describe the transmission risk classification of vaccine-preventable diseases in Brazilian municipalities. this was a descriptive epidemiologic study using 2014 data of the Brazilian National Immunization Program Information System; the vaccine coverage indicators were used to classify the transmission risk of vaccine-preventable diseases in the municipalities. of the 5,570 Brazilian municipalities, 12.0% were classified as very low risk, 29.6% as low risk, 2.2% as medium risk, 54.3% as high risk and 1.8% as very high risk. the vaccination coverage surveillance allowed to identify most of the municipalities in high risk situation and the minority of children living in municipalities with appropriate coverage; the vaccination coverage surveillance using indicators of the Brazilian National Health System (SUS) is a new tool for identifying priority areas where the actions can be more successful for health managers and improve the quality and the success of the immunizations program.

  16. Prescribing physical activity to prevent and manage gestational diabetes

    PubMed Central

    Colberg, Sheri R; Castorino, Kristin; Jovanovič, Lois

    2013-01-01

    Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. Women diagnosed with GDM have a substantially greater risk of developing type 2 diabetes within 5-10 years after delivery, and the risk is increased by excess body weight. Uncontrolled hyperglycemia during pregnancy is potentially harmful to both mother and fetus, resulting in a greater need for Caesarian-section deliveries, delivery of larger infants with more excess body fat, a greater risk of infant death and stillbirth, and an elevated risk of infant hypoglycemia immediately after birth. Fortunately, engaging in physical activity prior to and during pregnancy may lower the risk of developing GDM. Pregnant women should also be advised how to safely increase their physical activity during pregnancy and the postpartum period. An initial approach to becoming more physically active can simply be to encourage women to incorporate more unstructured physical activity into daily living, both before and during pregnancy. Giving women an appropriate exercise prescription can encourage them to participate in physical activity safely and effectively throughout pregnancy to prevent and/or manage GDM. Engaging in 30 min of moderate intensity physical activity on most, if not all, days of the week has been adopted as a recommendation for all pregnant women. PMID:24379915

  17. The Impact of Managed Care on Efforts To Prevent Serious Emotional Disturbance in Young Children.

    ERIC Educational Resources Information Center

    Hocutt, Anne; McKinney, James; Montague, Marjorie

    This report explores the impact of managed care on providing preventative mental health services to young children at risk for serious emotional disturbances (SED). The study included a sample of kindergarten and 1st grade children (n=121) at-risk for SED that were identified in two public schools. Results of the study indicated that the move to…

  18. Working with Youth in High-Risk Environments: Experiences in Prevention. OSAP Prevention Monograph-12.

    ERIC Educational Resources Information Center

    Marcus, Carol E., Ed.; Swisher, John D., Ed.

    This report focuses on prevention programs developed with support from the Office for Substance Abuse Prevention's (OSAP) High-Risk Youth Demonstration Grant Program. Included are an Introduction (Eric Goplerud and others) and the following reports: (1) "Athletes Coaching Teens for Substance Abuse Prevention: Alcohol and Other Drug Use and Risk…

  19. Ductal carcinoma in situ - update on risk assessment and management.

    PubMed

    Pang, Jia-Min B; Gorringe, Kylie L; Fox, Stephen B

    2016-01-01

    Ductal carcinoma in situ (DCIS) accounts for ~20-25% of breast cancers. While DCIS is not life-threatening, it may progress to invasive carcinoma over time, and treatment intended to prevent invasive progression may itself cause significant morbidity. Accurate risk assessment is therefore necessary to avoid over- or undertreatment of an individual patient. In this review we will outline the evidence for current management of DCIS, discuss approaches to DCIS risk assessment and challenges facing identification of novel DCIS biomarkers.

  20. Risk factors for gout and prevention: a systematic review of the literature.

    PubMed

    Singh, Jasvinder A; Reddy, Supriya G; Kundukulam, Joseph

    2011-03-01

    Our objective was to perform a systematic review of risk factors and prevention of gout. We searched Medline for fully published reports in English using keywords including but not limited to 'gout', 'epidemiology', 'primary prevention', 'secondary prevention', 'risk factors'. Data from relevant articles meeting inclusion criteria were extracted using standardized forms. Of the 751 titles and abstracts, 53 studies met the criteria and were included in the review. Several risk factors were studied. Alcohol consumption increased the risk of incident gout, especially beer and hard liquor. Several dietary factors increased the risk of incident gout, including meat intake, seafood intake, sugar sweetened soft drinks, and consumption of foods high in fructose. Diary intake, folate intake, and coffee consumption were each associated with a lower risk of incident gout and in some cases a lower rate of gout flares. Thiazide and loop diuretics were associated with higher risk of incident gout and higher rate of gout flares. Hypertension, renal insufficiency, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, diabetes, obesity, and early menopause were each associated with a higher risk of incident gout and/or gout flares. Several dietary risk factors for incident gout and gout flares are modifiable. Prevention and optimal management of comorbidities are likely to decreased risk of gout. Research in preventive strategies for the treatment of gout is needed.

  1. Diagnosis and Management of High Risk Group for Gastric Cancer

    PubMed Central

    Yoon, Hyuk; Kim, Nayoung

    2015-01-01

    Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

  2. Frequency, Risk Factors, and Outcome of Coexistent Small Vessel Disease and Intracranial Arterial Stenosis: Results From the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial.

    PubMed

    Kwon, Hyung-Min; Lynn, Michael J; Turan, Tanya N; Derdeyn, Colin P; Fiorella, David; Lane, Bethany F; Montgomery, Jean; Janis, L Scott; Rumboldt, Zoran; Chimowitz, Marc I

    2016-01-01

    Intracranial arterial stenosis (ICAS) and small vessel disease (SVD) may coexist. There are limited data on the frequency and risk factors for coexistent SVD and the effect of SVD on stroke recurrence in patients receiving medical treatment for ICAS. To investigate the frequency and risk factors for SVD and the effect of SVD on stroke recurrence in patients with ICAS. A post hoc analysis of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study, a prospective, multicenter clinical trial. Among 451 participants, 313 (69.4%) had baseline brain magnetic resonance imaging scans read centrally for SVD that was defined by any of the following: old lacunar infarction, grade 2 to 3 on the Fazekas scale (for high-grade white matter hyperintensities), or microbleeds. Patient enrollment in SAMMPRIS began November 25, 2008, and follow-up ended on April 30, 2013. Data analysis for the present study was performed from May 13, 2014, to July 29, 2015. Risk factors in patients with vs without SVD and the association between SVD and other baseline risk factors with any ischemic stroke and ischemic stroke in the territory of the stenotic artery determined using proportional hazards regression. Of 313 patients, 155 individuals (49.5%) had SVD noted on baseline magnetic resonance imaging. Variables that were significantly higher in patients with SVD, reported as mean (SD), included age, 63.5 (10.5) years (P < .001), systolic blood pressure, 149 (22) mm Hg (P < .001), glucose level, 130 (50) mg/dL (P = .03), and lower Montreal Cognitive Assessment scores (median, ≥24 [interquartile range, 20-26]; P = .02).Other significant variables were the number of patients with diabetes mellitus (88 of 155 [56.8%]; P = .003), coronary artery disease (46 [29.7%]; P = .004), stroke before the qualifying event (59 [38.1%]; P < .001), old infarct in the territory of the stenotic intracranial artery (88 [56

  3. Overview of Risk Management for Engineered Nanomaterials

    NASA Astrophysics Data System (ADS)

    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.

  4. Overview of Risk Management for Engineered Nanomaterials.

    PubMed

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

    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.

  5. ESMD Risk Management Workshop: Systems Engineering and Integration Risks

    NASA Technical Reports Server (NTRS)

    Thomas, L. Dale

    2005-01-01

    This report has been developed by the National Aeronautics and Space Administration (NASA) Exploration Systems Mission Directorate (ESMD) Risk Management team in close coordination with the Systems Engineering Team. This document provides a point-in-time, cumulative, summary of key lessons learned derived from the SE RFP Development process. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

  6. National Ignition Facility Risk Management Plan

    SciTech Connect

    Brereton, S.J.

    1997-02-01

    The NIF Risk Management Plan has been prepared in accordance with the DOE Life Cycle Asset Management Good Practice Guide to support Critical Decision 3 of the NIF Project. The objectives of the plan are to: 1) identify the risks to the completion of the Project in terms of meeting technical and regulatory requirements, cost, and schedule, 2) assess the risks in terms of likelihood of occurrence and their impact potential relative to technical performance, ES&H (environment, safety and health), costs, and schedule, and 3) address each identified risk in terms of suitable risk mitigation measures. The documents that form the basis for this risk assessment are as follows: 1. Final Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (DOE, 1996a) and Record of Decision (DOE, 1996b), 2. Preliminary Hazards Analysis (Brereton, 1993), 3. Fire Hazards Analysis (Jensen, 1997), 4. Preliminary Safety Analysis Report (LLNL, 1996a), 5. Reliability, Availability and Maintainability Report, 6. Radiation Protection Evaluation, 7. Primary Criteria and Functional Requirements (LLNL, 1996b), 8. Project Execution Plan (DOE, 1996c), 9. Schedule Risk Assessment, 10. Construction Safety Program (LLNL, 1997), 11. Title I Design Media, 12. Congressional Data Sheet. The process used in developing this plan was to form a Risk Assessment team of knowledgeable project personnel. This included: Assurances Manager, Systems Integration Manager, Project Control Manager, a Risk Management consultant, Deputy Associate Project Engineer for Activation and Start-up (Co-chairperson), and Lead Engineer for Safety Analysis (Co-chairperson). They were familiar with the risk basis documents and developed a list of the key risk elements. A methodology for assigning likelihoods, consequences, and risks was developed. Risk elements were then reviewed, and likelihoods, consequences, and risks were assigned. Risk mitigation measures were then developed. Comments were obtained

  7. How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey

    PubMed Central

    Chicoulaa, Bruno; Haas, Hervé; Viala, Jérôme; Salvetat, Maryline; Olives, Jean-Pierre

    2017-01-01

    Background Recurrent respiratory tract infections (RRTIs) are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs) opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84%) prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse. They have a prevention-oriented approach, implement preventive measures when possible and prescribe products for prevention. PMID:28293116

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

    PubMed

    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.

  9. The prevention of health risks in Cuba.

    PubMed

    Guttmacher, S

    1987-01-01

    Cuba still has a double burden of health risks. It must contend with some risks to health that persist in underdeveloped rural areas, and it must also deal with the risk factors associated with modern, urban living conditions. The economic and social changes fostered in the postrevolutionary period have reduced the relative importance of the first set of factors, but the changes have also introduced or intensified a myriad of factors derived from their own successes. In this article, the risk factors of greatest concern in contemporary Cuba are described, and the strategies adopted to combat these risk factors, together with the ways in which such strategies are shaped by Cuba's social and economic development are discussed.

  10. Perioperative risk and management in patients with pulmonary hypertension.

    PubMed

    Minai, Omar A; Yared, Jean-Pierre; Kaw, Roop; Subramaniam, Kathirvel; Hill, Nicholas S

    2013-07-01

    Pulmonary hypertension (PH) is a known risk factor for perioperative complications. Unlike in the case of cardiac surgery, PH is currently not listed as an independent risk factor for postoperative complications in guidelines for the management of noncardiac surgery. Despite the paucity of data, though, patients with PH are often counseled against having elective procedures because early and sudden postoperative deaths have been reported. Patients with PH are unable to accommodate alterations in right ventricular (RV) preload or afterload induced by fluid shifts, medications, or changes in the autonomic nervous system precipitated by hypoxia or hypercapnia. These factors become magnified in situations of added stress such as surgical intervention. Systemic hypotension and arrhythmias may precipitate RV ischemia, further worsening RV function. Patient and surgical characteristics and choice of anesthetic technique are crucial factors in perioperative management. The two main principles of perioperative management are the prevention of systemic hypotension (risk of RV ischemia) and the prevention of acute elevations in pulmonary arterial pressure (risk of RV failure). Close monitoring, optimization of systemic BP, pain control, oxygenation and ventilation, avoidance of exacerbating factors, and use of vasopressors and pulmonary vasodilators as necessary are essential elements of management. Understanding the pathophysiology, cause, and severity of PH in the individual perioperative patient allows accurate risk assessment, optimization of PH and RV function prior to surgery, and appropriate intraoperative and postoperative management.

  11. Risk Communication: the connection between assessment and management of changing risks

    NASA Astrophysics Data System (ADS)

    Sprague, Teresa; Prenger-Berninghoff, Kathrin; Charrière, Marie

    2013-04-01

    Working toward effective risk mitigation strategies amidst ever-present and increasingly changing risks requires first effective communication between assessment and management spheres. This notion permeates the spectrum of what can be considered the physical changing risk inputs that feed into the risk governance processes of assessment, management and communication of risks. Close connections and overlaps between assessment and management requires communication to serve as the crux for the close collaboration necessary for encouraging preventative, long-term strategies for reducing disaster risks.1 More specifically, communication of risk information plays this connective role by informing and advising policy and decision making processes conducted by actors such as spatial planners who receive this information. In this way, those who assess the risks provide information to those who must manage these risks. When this one-directional communication pathway is reciprocated, risk managers provide information to risk assessors, enabling two-way communication amongst actors working toward risk reduction. This communication and exchange of information enables development of strategies and actions taken toward creating and improving risk mitigation measures within a given territory and community. Further, management actions taken (especially for mitigative measures) can alter the physical and social elements of the spatial context of their territory.2 This demands an adjustment of the previous risk assessment information and communication of the change in potential risk. These conceptual underpinnings are addressed and presented through explanation of an analytical framework encompassing changing risk inputs into risk governance processes. The framework elaborates the risk communication component and is supported by practical examples from stakeholder meetings and site visits in the Polish and Romania case study areas of the Marie Curie ITN, CHANGES.3 Specific examples

  12. Risk Management In Perspective Of Knowledge Management A Brief Survey

    NASA Astrophysics Data System (ADS)

    Rehman, Zobia; Kifor, Claudiu V.

    2015-09-01

    This article explains the application of knowledge management for project risk management in industry. Combination of knowledge management and risk management is becoming a dire need for industries nowadays, because it has become necessary to make information reach timely to its destined users to achieve the desired goals. Quick decisions are needed throughout a project life cycle to mitigate or avoid a risk, but they are only possible when knowledge about it is in hand and can be inferred for fruitful decisions. Quality engineers make huge effort in analyzing and mitigating the risk and prepare various documents about different risk management stages. But this knowledge resides in documents or underutilized databases without any relation to each other that makes it useless for complex decision making. This article shall explain how knowledge management activities are helpful in risk management and the advantages of their fusion. It will also present a conceptual architecture of an Information Technology based solution for risk management and knowledge management combination.

  13. Physical activity in the prevention and management of bladder cancer.

    PubMed

    Shephard, Roy J

    2017-10-01

    The aim was to examine the role of physical activity in reducing the risk of bladder cancer, and in managing established disease. A systematic search of Ovid/Medline from 1996 to June 2016 coupled the term urinary bladder neoplasms (25,061 hits) with markers of physical activity (exercise, physical activity, physical education/training, athletes, and physical fitness, a total of 246,683 unique entries). Of 42 titles identified, 18 relevant abstracts were supplemented by reviewing reference lists and personal files to yield 21 articles on prevention of bladder cancer, and 8 on physical activity in disease management. Three cohort and 3 case-control studies examined occupational activity. One report found a statistically significant 40% increase in bladder cancers with a sedentary job, and 2 of 5 other reports found a non-significant trend to decreased risk with physically demanding work. Of 9 cohort and 2 case-control leisure analyses, 1 found significant benefit from physical activity, and 6 others trended to a 11-34% reduction of risk, with adverse effects in only 2 studies. After development of bladder cancer, physical activity was commonly low. However, greater physical activity decreased the risks of cystectomy and increased the quality of life following surgery. Better categorization of lifetime activity and fuller allowance for co-variates seems needed to establish conclusively that greater habitual physical activity will reduce the risk of bladder cancer. Nevertheless, an active lifestyle should be encouraged pending definitive information, because of positive trends and the more general health advantages of regular exercise.

  14. Cancer risk and preventive behavior: persuasion as an intervention strategy.

    PubMed

    Tonani, Marcela; Carvalho, Emilia Campos de

    2008-01-01

    The effectiveness of interventions for health promotion, protection, and early diagnosis may include the process of persuasion employed. This study aims to evaluate the risk level of developing cancer, considering the pertinent risk factors, and the presence of persuasion and characteristics in communication regarding cancer prevention and early detection. It is an observational study, conducted among 110 inhabitants of a neighborhood in Ribeirao Preto, Sao Paulo, Brazil. It was confirmed that there are high risks for colon/rectum, cervical, and endometrial cancer; and moderate risks for the above as well as lung and breast cancer. In terms of persuasion, it was observed that cancer information was spread but not sustained for long periods. Moreover, there was no reinforcement. In view of cancer risk and the identified preventive behaviors, persuasion is considered a useful strategy to reduce these risks, as well as to encourage and sustain preventive behaviors, since it indicates routes to be followed.

  15. Assessing the infection prevention components of home health emergency management plans.

    PubMed

    Rebmann, Terri; Citarella, Barbara; Subramaniam, Dipti P; Subramaniam, Divya S

    2011-12-01

    Home health emergency management plans are essential and must address infection prevention issues. Few home health planning documents exist, and many of those that have been developed do not address infection prevention issues, combine them with non-infection prevention issues, or are disease/event-specific. An all-encompassing home health infection prevention emergency management planning guide is needed. A literature review and Internet search were conducted in the summer of 2010, and data from relevant sources were extracted. A spreadsheet was created delineating home health emergency management plan components related to infection prevention. Of the sources screened, 41 were deemed relevant. Ten domains were identified: (1) having a plan; (2) assessing agency readiness; (3) having infection prevention policies and procedures; (4) having occupational health policies and procedures; (5) conducting surveillance and triage; (6) reporting incidents, having a communication plan, and managing information; (7) addressing surge capacity issues; (8) having anti-infective therapy and/or vaccines; (9) providing infection prevention education; and (10) managing water and waste management issues. Home health disaster planners or managers should use this article as an assessment tool for evaluating their agency's emergency management plan and for developing policies and procedures that will decrease the risk of infection transmission during a mass casualty event. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Tsunami disaster risk management capabilities in Greece

    NASA Astrophysics Data System (ADS)

    Marios Karagiannis, Georgios; Synolakis, Costas

    2015-04-01

    Greece is vulnerable to tsunamis, due to the length of the coastline, its islands and its geographical proximity to the Hellenic Arc, an active subduction zone. Historically, about 10% of all world tsunamis occur in the Mediterranean region. Here we review existing tsunami disaster risk management capabilities in Greece. We analyze capabilities across the disaster management continuum, including prevention, preparedness, response and recovery. Specifically, we focus on issues like legal requirements, stakeholders, hazard mitigation practices, emergency operations plans, public awareness and education, community-based approaches and early-warning systems. Our research is based on a review of existing literature and official documentation, on previous projects, as well as on interviews with civil protection officials in Greece. In terms of tsunami disaster prevention and hazard mitigation, the lack of tsunami inundation maps, except for some areas in Crete, makes it quite difficult to get public support for hazard mitigation practices. Urban and spatial planning tools in Greece allow the planner to take into account hazards and establish buffer zones near hazard areas. However, the application of such ordinances at the local and regional levels is often difficult. Eminent domain is not supported by law and there are no regulatory provisions regarding tax abatement as a disaster prevention tool. Building codes require buildings and other structures to withstand lateral dynamic earthquake loads, but there are no provisions for resistance to impact loading from water born debris Public education about tsunamis has increased during the last half-decade but remains sporadic. In terms of disaster preparedness, Greece does have a National Tsunami Warning Center (NTWC) and is a Member of UNESCO's Tsunami Program for North-eastern Atlantic, the Mediterranean and connected seas (NEAM) region. Several exercises have been organized in the framework of the NEAM Tsunami Warning

  17. Nano risk analysis: advancing the science for nanomaterials risk management.

    PubMed

    Shatkin, Jo Anne; Abbott, Linda Carolyn; Bradley, Ann E; Canady, Richard Alan; Guidotti, Tee; Kulinowski, Kristen M; Löfstedt, Ragnar E; Louis, Garrick; MacDonell, Margaret; Macdonell, Margaret; Maynard, Andrew D; Paoli, Greg; Sheremeta, Lorraine; Walker, Nigel; White, Ronald; Williams, Richard

    2010-11-01

    Scientists, activists, industry, and governments have raised concerns about health and environmental risks of nanoscale materials. The Society for Risk Analysis convened experts in September 2008 in Washington, DC to deliberate on issues relating to the unique attributes of nanoscale materials that raise novel concerns about health risks. This article reports on the overall themes and findings of the workshop, uncovering the underlying issues for each of these topics that become recurring themes. The attributes of nanoscale particles and other nanomaterials that present novel issues for risk analysis are evaluated in a risk analysis framework, identifying challenges and opportunities for risk analysts and others seeking to assess and manage the risks from emerging nanoscale materials and nanotechnologies. Workshop deliberations and recommendations for advancing the risk analysis and management of nanotechnologies are presented.

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

    Treesearch

    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:...

  19. Risk management - What about software?

    SciTech Connect

    1996-07-01

    Risks in software systems arise from many directions. There are risks that the software is faulty, that the system may be attacked, that safety hazards exist, that the system may be inoperable or untimely, that an abnormal event may cause unexpected actions, etc. Risk analysis tools should support and document risk-mitigation decisions and facilitate understanding of residual risks. These tools must be based on a sound theory of risk, which does not exist today. Probabilistic risk assessment techniques apply to physically-based systems where failure modes and event dependence are fairly well understood. But they cannot be blindly applied to software systems, which do not share these characteristics. Moreover, we need to meld many diverse aspects of risk for software systems. This presentation will explore some thought-provoking ideas about modeling, problem spaces, solution approaches, math, decision friendly output, and the role of risk analysis in the software lifecycle.

  20. Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

    MedlinePlus

    ... STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend on Facebook Tweet Share Compartir Many ... and School Health addresses HIV, other STDS, and teen pregnancy through Data collection and analysis Science-based guidance ...

  1. Systems approach to project risk management

    SciTech Connect

    Kindinger, J. 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.

  2. Occupational safety risk management in Australian mining.

    PubMed

    Joy, J

    2004-08-01

    In the past 15 years, there has been a major safety improvement in the Australian mining industry. Part of this change can be attributed to the development and application of risk assessment methods. These systematic, team-based techniques identify, assess and control unacceptable risks to people, assets, the environment and production. The outcomes have improved mine management systems. This paper discusses the risk assessment approach applied to equipment design and mining operations, as well as the specific risk assessment methodology. The paper also discusses the reactive side of risk management, incident and accident investigation. Systematic analytical methods have also been adopted by regulatory authorities and mining companies to investigate major losses.

  3. Gouty Arthritis: A Review of Acute Management and Prevention.

    PubMed

    Wilson, Liza; Saseen, Joseph J

    2016-08-01

    Gouty arthritis is one of the most common rheumatic diseases. The clinical burden of gouty arthritis has historically been well recognized; however, gout is often misdiagnosed and mismanaged. The prevalence of gout is rising and is likely attributed to several factors including increased incidence of comorbidities, lifestyle factors, and increased use of causative medications. With the increasing prevalence, there have been several innovations and evidence-based updates related to the diagnosis and management of gout. Acute gouty arthritis should be treated with nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, or corticosteroids, or a combination of two agents. Xanthine oxidase inhibitor therapy remains the consensus first-line treatment option for the prevention of recurrent gout. Add-on therapies that reduce serum urate concentration include traditional uricosuric agents and a novel uric acid reabsorption inhibitor. Prophylaxis of acute gout with NSAIDs, colchicine, or corticosteroids is universally recommended when initiating any urate-lowering therapy in order to prevent acute gouty arthritis for a period of at least 6 months. In this review, we discuss the epidemiology and risk factors for gouty arthritis and evaluate diagnostic strategies and therapeutic regimens for the management of gout, including a new drug approval.

  4. Japanese workplace health management in pneumoconiosis prevention.

    PubMed

    Jp, Naw Awn; Imanaka, Momo; Suganuma, Narufumi

    2017-03-28

    The Japanese government established the Pneumoconiosis Law in 1960 to protect health and promote the welfare of workers engaged in dust-exposed works. This article describes Japanese practice in workplace health management as regulated by the Pneumoconiosis Law to reduce pneumoconiosis in Japan. We collected information addressing pneumoconiosis and the health care of dust-exposed workers. We included all types of scientific papers found through a PubMed search as well as official reports, guidelines, and relevant laws published by the Ministry of Health, Labour and Welfare (MHLW) of Japan and other academic institutions. In the past, pneumoconiosis has been a major cause of mortality and morbidity for Japanese workers engaged in dust-exposed work. The Pneumoconiosis Law introduced a system of pneumoconiosis health examination and health supervision to protect workers' health. According to the periodic pneumoconiosis health examination reports in Japan, the prevalence of pneumoconiosis fell from the highest reported figure of 17.4% in 1982, where 265,720 examinations were conducted, to 1% in 2013 in which 243,740 workers were examined. The number of new cases of pneumoconiosis dropped from 6,842 cases in 1980 to 227 cases in 2013. One hundred and seventy two workers were diagnosed as having pneumoconiosis complications in 1980; however, the number fell to five in 2013. After reaching its peak in the 1980s, pneumoconiosis and its complications fell each year. The achievement of Japanese pneumoconiosis prevention can be credited to a comprehensive provision for worker health, regulated by a thorough legal framework.

  5. Legacy Risk Measure for Environmental Management Waste

    SciTech Connect

    Eide, Steven Arvid; Nitschke, Robert Leon

    2002-02-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) is investigating the development of a comprehensive and quantitative risk model framework for environmental management activities at the site. Included are waste management programs (high-level waste, transuranic waste, low-level waste, mixed low-level waste, spent nuclear fuel, and special nuclear materials), major environmental restoration efforts, major decontamination and decommissioning projects, and planned long-term stewardship activities. Two basic types of risk estimates are included: risks from environmental management activities, and long-term legacy risks from wastes/materials. Both types of risks are estimated using the Environment, Safety, and Health Risk Assessment Program (ESHRAP) developed at the INEEL. Given these two types of risk calculations, the following evaluations can be performed: • Risk evaluation of an entire program (covering waste/material as it now exists through disposal or other end states) • Risk comparisons of alternative programs or activities • Comparisons of risk benefit versus risk cost for activities or entire programs • Ranking of programs or activities by risk • Ranking of wastes/materials by risk • Evaluation of site risk changes with time as activities progress • Integrated performance measurement using indicators such as injury/death and exposure rates. This paper discusses the definition and calculation of legacy risk measures and associated issues. The legacy risk measure is needed to support three of the seven types of evaluations listed above: comparisons of risk benefit versus risk cost, ranking of wastes/materials by risk, and evaluation of site risk changes with time.

  6. Affect Management for HIV Prevention with Adolescents in Therapeutic Schools: The immediate impact of Project Balance

    PubMed Central

    Brown, Larry K.; Houck, Christopher; Donenberg, Geri; Emerson, Erin; Donahue, Kelly; Misbin, Jesse

    2013-01-01

    Adolescents in therapeutic schools are at greater risk for HIV and other STIs than their peers due to earlier higher rates of sexual risk and difficulty managing strong emotions. HIV prevention programs that incorporate techniques for affect management during sexual situations may be beneficial. This paper determined the immediate impact of such an intervention, Affect Management (AM), compared to a standard, skills-based HIV prevention intervention (SB) and a general health promotion intervention (HP) for 377 youth, ages 13 to 19, in therapeutic schools in two cities. One month after the intervention, analyses that adjusted for the baseline scores found adolescents in AM were more likely to report condom use at last sex than those in HP (.89 vs. .67, p=.02) and that their HIV knowledge was significantly greater. These data suggest that affect management techniques might improve the impact of standard skills-based prevention programs for adolescents in therapeutic schools. PMID:23975475

  7. Risk managers, physicians, and disclosure of harmful medical errors.

    PubMed

    Loren, David J; Garbutt, Jane; Dunagan, W Claiborne; Bommarito, Kerry M; Ebers, Alison G; Levinson, Wendy; Waterman, Amy D; Fraser, Victoria J; Summy, Elizabeth A; Gallagher, Thomas H

    2010-03-01

    Physicians are encouraged to disclose medical errors to patients, which often requires close collaboration between physicians and risk managers. An anonymous national survey of 2,988 healthcare facility-based risk managers was conducted between November 2004 and March 2005, and results were compared with those of a previous survey (conducted between July 2003 and March 2004) of 1,311 medical physicians in Washington and Missouri. Both surveys included an error-disclosure scenario for an obvious and a less obvious error with scripted response options. More risk managers than physicians were aware that an error-reporting system was present at their hospital (81% versus 39%, p < .001) and believed that mechanisms to inform physicians about errors in their hospital were adequate (51% versus 17%, p < .001). More risk managers than physicians strongly agreed that serious errors should be disclosed to patients (70% versus 49%, p < .001). Across both error scenario, risk managers were more likely than physicians to definitely recommend that the error be disclosed (76% versus 50%, p < .001) and to provide full details about how the error would be prevented in the future (62% versus 51%, p < .001). However, physicians were more likely than risk managers to provide a full apology recognizing the harm caused by the error (39% versus 21%, p < .001). Risk managers have more favorable attitudes about disclosing errors to patients compared with physicians but are less supportive of providing a full apology. These differences may create conflicts between risk managers and physicians regarding disclosure. Health care institutions should promote greater collaboration between these two key participants in disclosure conversations.

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

    PubMed

    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 (<10%), 21% had an intermediate risk (10-19%), 53% a high risk (⩾20%) and 9% had CVD. In total, 69% had an indication for preventive treatment (cholesterol-lowering or antihypertensive drugs). Of those, 42% received inadequate treatment and 40% received no treatment at all. Optimal 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.

  9. Guidelines on the management and prevention of prediabetes.

    PubMed

    2014-10-01

    Pandemic obesity and diabetes mellitus (DM), particularly type-2 DM (T2DM) now has become a serious threat for people worldwide. The International Diabetes Federation (IDF) suggests that the prevalence of DM in the world is 1.9% and it has made DM as the 7th leading cause of death worldwide. It has been estimated that the prevalence of diabetes between 1994 and 2010 was projected as much as 215.6 milion people; however an evaluation in 2007 revealed that the number of diabetic patients has reached 246 million people and it has been concerned that the number would increase in 2025 reaching more than 300 million people. Patients with DM may have various complilcations, including macrovascular diseases (heart disease, stroke and peripheral vascular disease) and microvascular diseases (retinopathy, neuropathy and nephropathy). Complications of DM have started early before the diagnosis of DM has been made. About 50% of patients have alreadly had one chronic complication at the time of diagnosis. Therefore, it is necessary to have a guideline on management of prediabetes condition associated with prevention of chonic complication and cardiovascular risk of diabetes. The guideline is expected to improve the skills of health care professionals in recognizing prediabetes condition, identifying people at high risk for diabetes and providing an appropriate management so that the incidence and complication of DM can be reduced.

  10. Rh immunization in Manitoba: progress in prevention and management.

    PubMed Central

    Bowman, J. M.; Pollock, J.

    1983-01-01

    For two decades the perinatal mortality caused by erythroblastosis has been decreasing in Manitoba. The improved management of Rh-immunized pregnancies has lowered the death rate among affected infants from 10.8% to 3.4%, while the prevention of Rh immunization has reduced its incidence from 9.1 to 2.2 per 1000 total births. In its first 6 years and 8 months Manitoba's antenatal prophylaxis program, in which immunoglobulin is administered to Rh-negative women at 28 weeks' gestation, reduced the incidence of Rh immunization during pregnancy by 93%. In combination with post-abortion and postpartum prophylaxis the antenatal treatment has provided a protection rate of 98.6% among primigravidas at risk. Further improvements are expected. PMID:6409390

  11. An Introduction to Team Risk Management. (Version 1.0)

    DTIC Science & Technology

    1994-05-01

    Team Risk Management defines the organizational structure and operational activities for managing risks throughout all phases of the life- cycle of a...program are participating team members. Through the adoption of team risk management , the government and contractor are provided with processes...introduces the team risk management approach for managing risks within a software-dependent development program.

  12. A drop-out prevention program for high-risk inner-city youth.

    PubMed

    Lever, Nancy; Sander, Mark A; Lombardo, Sylvie; Randall, Camille; Axelrod, Jennifer; Rubenstein, Michelle; Weist, Mark D

    2004-07-01

    Inner-city youth are at high risk for dropping out of high school. Within this article, risk factors associated with dropout and strategies for effective prevention and intervention are reviewed. An example of a school-based drop-out prevention program is highlighted. The FUTURES Program is a school-based drop-out prevention program designed to address the needs of high-risk youth through smaller classes, character development, career preparation, case management/mentoring, positive incentives, and access to mental health services. Components of the program are described in detail and data evaluating the effectiveness of the program are presented. Directions for the future development of programs and conducting research to prevent dropout by inner-city youth are discussed.

  13. Risk management at Los Alamos National Laboratory

    SciTech Connect

    Brooks, D.G.; Stack, D.W.

    1993-11-01

    Los Alamos National Laboratory has risk management programs at a number of administrative levels. Each line organization has responsibility for risk management for routine operations. The Facility Risk Management group (HS-3) is the Los Alamos organization with the primary responsibility for risk management including providing input and expertise to facilities and line managers in the management and documentation of ES&H hazards and risks associated with existing and new activities. One of the major contributions this group has made to laboratory risk management program is to develop and implement a hazard identification and classification methodology that is readily adaptable to continuously changing classification guidelines such as DOE-STD-1027. The increased emphasis on safety at Los Alamos has led to the formation of additional safety oversight organization such as the Integration and Coordination Office (ICO), which is responsible for prioritization of risk management activities. In the fall of 1991, nearly 170 DOE inspectors spent 6 weeks analyzing the environmental, safety, and health activities at Los Alamos. The result of this audit was a list of over 1000 findings, each indicating some deficiency in current Laboratory operations relative to DOE and other government regulation. The audit team`s findings were consolidated and ``action plans`` were developed to address the findings. This resulted in over 200 action plans with a total estimated cost of almost $1 billion. The Laboratory adopted a risk-based prioritization process to attempt to achieve as much risk reduction as possible with the available resources. This paper describes the risk based prioritization model that was developed.

  14. Risk Management in Biologics Technology Transfer.

    PubMed

    Toso, Robert; Tsang, Jonathan; Xie, Jasmina; Hohwald, Stephen; Bain, David; Willison-Parry, Derek

    Technology transfer of biological products is a complex process that is important for product commercialization. To achieve a successful technology transfer, the risks that arise from changes throughout the project must be managed. Iterative risk analysis and mitigation tools can be used to both evaluate and reduce risk. The technology transfer stage gate model is used as an example tool to help manage risks derived from both designed process change and unplanned changes that arise due to unforeseen circumstances. The strategy of risk assessment for a change can be tailored to the type of change. In addition, a cross-functional team and centralized documentation helps maximize risk management efficiency to achieve a successful technology transfer. © PDA, Inc. 2016.

  15. Use of Mobile Health Technology in the Prevention and Management of Diabetes Mellitus.

    PubMed

    Hartz, Jacob; Yingling, Leah; Powell-Wiley, Tiffany M

    2016-12-01

    Cardiovascular disease is the leading cause of morbidity and mortality globally, with diabetes being an independent risk factor. Adequate diabetes management has proven to be resource-intensive, requiring frequent lab work, primary care and specialist visits, and time-consuming record-keeping by the patient and care team. New mobile health (mHealth) technologies have enhanced how diabetes is managed and care is delivered. While more recent work has investigated mHealth devices as complementary tools in behavioral interventions for diabetes prevention and management, little is still known about the effectiveness of mHealth technology as stand-alone intervention tools for reducing diabetes risk. In addition, more work is needed to identify the role of mHealth technology in treating vulnerable populations to ameliorate cardiovascular health disparities. With advances in mobile health technology development for diabetes prevention and management, these modalities will likely play an increasingly prominent role in reducing cardiometabolic risk for the US population.

  16. Iatrogenic disease in the elderly: risk factors, consequences, and prevention

    PubMed Central

    Permpongkosol, Sompol

    2011-01-01

    The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units. PMID:21472095

  17. AIDS risk and prevention for the chronic mentally ill.

    PubMed

    Carmen, E; Brady, S M

    1990-06-01

    Some chronic mentally ill populations are at high risk for infection with human immunodeficiency virus. The authors argue that stereotypes of the mentally ill as asexual or neutered have had dangerous consequences, namely the absence of sex education and AIDS prevention as an integral part of treatment. To counter this neglect, the authors developed an AIDS prevention program in a large inner-city mental health center that serves primarily black and Latino patients. Prevention efforts include individual risk assessments and an innovative drop-in group. Central to effective patient education are the distribution of condoms and concrete instruction in their use.

  18. Do Health Professionals Need Additional Competencies for Stratified Cancer Prevention Based on Genetic Risk Profiling?

    PubMed Central

    Chowdhury, Susmita; Henneman, Lidewij; Dent, Tom; Hall, Alison; Burton, Alice; Pharoah, Paul; Pashayan, Nora; Burton, Hilary

    2015-01-01

    There is growing evidence that inclusion of genetic information about known common susceptibility variants may enable population risk-stratification and personalized prevention for common diseases including cancer. This would require the inclusion of genetic testing as an integral part of individual risk assessment of an asymptomatic individual. Front line health professionals would be expected to interact with and assist asymptomatic individuals through the risk stratification process. In that case, additional knowledge and skills may be needed. Current guidelines and frameworks for genetic competencies of non-specialist health professionals place an emphasis on rare inherited genetic diseases. For common diseases, health professionals do use risk assessment tools but such tools currently do not assess genetic susceptibility of individuals. In this article, we compare the skills and knowledge needed by non-genetic health professionals, if risk-stratified prevention is implemented, with existing competence recommendations from the UK, USA and Europe, in order to assess the gaps in current competences. We found that health professionals would benefit from understanding the contribution of common genetic variations in disease risk, the rationale for a risk-stratified prevention pathway, and the implications of using genomic information in risk-assessment and risk management of asymptomatic individuals for common disease prevention. PMID:26068647

  19. Do Health Professionals Need Additional Competencies for Stratified Cancer Prevention Based on Genetic Risk Profiling?

    PubMed

    Chowdhury, Susmita; Henneman, Lidewij; Dent, Tom; Hall, Alison; Burton, Alice; Pharoah, Paul; Pashayan, Nora; Burton, Hilary

    2015-06-09

    There is growing evidence that inclusion of genetic information about known common susceptibility variants may enable population risk-stratification and personalized prevention for common diseases including cancer. This would require the inclusion of genetic testing as an integral part of individual risk assessment of an asymptomatic individual. Front line health professionals would be expected to interact with and assist asymptomatic individuals through the risk stratification process. In that case, additional knowledge and skills may be needed. Current guidelines and frameworks for genetic competencies of non-specialist health professionals place an emphasis on rare inherited genetic diseases. For common diseases, health professionals do use risk assessment tools but such tools currently do not assess genetic susceptibility of individuals. In this article, we compare the skills and knowledge needed by non-genetic health professionals, if risk-stratified prevention is implemented, with existing competence recommendations from the UK, USA and Europe, in order to assess the gaps in current competences. We found that health professionals would benefit from understanding the contribution of common genetic variations in disease risk, the rationale for a risk-stratified prevention pathway, and the implications of using genomic information in risk-assessment and risk management of asymptomatic individuals for common disease prevention.

  20. Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods

    PubMed Central

    Kataoka, Yosuke; Tsuji, Yosuke; Sakaguchi, Yoshiki; Minatsuki, Chihiro; Asada-Hirayama, Itsuko; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Fujishiro, Mitsuhiro; Koike, Kazuhiko

    2016-01-01

    Endoscopic submucosal dissection (ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection (EMR), but the associated risks of perioperative adverse events are higher than in EMR. Bleeding after ESD is the most frequent among these adverse events. Although post-ESD bleeding can be controlled by endoscopic hemostasis in most cases, it may lead to serious conditions including hemorrhagic shock. Even with preventive methods including administration of acid secretion inhibitors and preventive hemostasis, post-ESD bleeding cannot be completely prevented. In addition high-risk cases for post-ESD bleeding, which include cases with the use of antithrombotic agents or which require large resection, are increasing. Although there have been many reports about associated risk factors and methods of preventing post-ESD bleeding, many issues remain unsolved. Therefore, in this review, we have overviewed risk factors and methods of preventing post-ESD bleeding from previous studies. Endoscopists should have sufficient knowledge of these risk factors and preventive methods when performing ESD. PMID:27468187

  1. E-dating, identity and HIV prevention: theorising sexualities, risk and network society.

    PubMed

    Davis, Mark; Hart, Graham; Bolding, Graham; Sherr, Lorraine; Elford, Jonathan

    2006-05-01

    This paper addresses how London gay men use the internet to meet sexual partners, or for e-dating. Based on qualitative interviews conducted face-to-face or via the internet, this research develops an account of how information technologies mediate the negotiation of identity and risk in connection with sexual practice. E-dating itself is a bricolage, or heterogeneous DIY practice of internet-based-communication (IBC). A central aspect of IBC is "filtering" in and out prospective e-dates based on the images and texts used to depict sexual identities. Interpretations and depictions of personal HIV risk management approaches in IBC are framed by the meanings of different identities, such as the stigma associated with being HIV positive. This paper argues for a sexualities perspective in a theory of network society. Further, HIV prevention in e-dating can potentially be addressed by considering the interplay of the HIV prevention imperatives associated with different HIV serostatus identities. There is a case for encouraging more explicit IBC about risk in e-dating and incorporating the expertise of e-daters in prevention activity. There is also a need to rethink traditional conceptions of risk management in HIV prevention to make space for the risk management bricolage of network society.

  2. Bow-tie diagrams for risk management in anaesthesia.

    PubMed

    Culwick, M D; Merry, A F; Clarke, D M; Taraporewalla, K J; Gibbs, N M

    2016-11-01

    Bow-tie analysis is a risk analysis and management tool that has been readily adopted into routine practice in many high reliability industries such as engineering, aviation and emergency services. However, it has received little exposure so far in healthcare. Nevertheless, its simplicity, versatility, and pictorial display may have benefits for the analysis of a range of healthcare risks, including complex and multiple risks and their interactions. Bow-tie diagrams are a combination of a fault tree and an event tree, which when combined take the shape of a bow tie. Central to bow-tie methodology is the concept of an undesired or 'Top Event', which occurs if a hazard progresses past all prevention controls. Top Events may also occasionally occur idiosyncratically. Irrespective of the cause of a Top Event, mitigation and recovery controls may influence the outcome. Hence the relationship of hazard to outcome can be viewed in one diagram along with possible causal sequences or accident trajectories. Potential uses for bow-tie diagrams in anaesthesia risk management include improved understanding of anaesthesia hazards and risks, pre-emptive identification of absent or inadequate hazard controls, investigation of clinical incidents, teaching anaesthesia risk management, and demonstrating risk management strategies to third parties when required.

  3. Nuadu concept for personal management of lifestyle related health risks.

    PubMed

    Mattila, E; Korhonen, I; Lappalainen, R; Ahtinen, A; Hopsu, L; Leino, T

    2008-01-01

    Majority of the health risks and diseases in the modern world are related to lifestyles, e.g., overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress. Behavioral change towards healthy lifestyles is the key to the prevention and management of these risks, but early and efficient interventions are scarcely available. We present the Nuadu Concept, an ICT (Information and Communication Technologies) assisted wellness toolbox for the management of multiple, behavior-originated health risks. The concept is based on psychological models, which provide methods and motivation for behavior change. The individual is considered as the best expert of his/her own wellness. Thus, the Nuadu Concept provides a variety of personal wellness technologies and services, among which the user may freely choose the best tools for him/herself. We believe this approach has the potential to provide efficient, acceptable, available, and affordable wellness management support for a significant number of people.

  4. Imagining flood futures: risk assessment and management in practice.

    PubMed

    Lane, Stuart N; Landström, Catharina; Whatmore, Sarah J

    2011-05-13

    The mantra that policy and management should be 'evidence-based' is well established. Less so are the implications that follow from 'evidence' being predictions of the future (forecasts, scenarios, horizons) even though such futures define the actions taken today to make the future sustainable. Here, we consider the tension between 'evidence', reliable because it is observed, and predictions of the future, unobservable in conventional terms. For flood risk management in England and Wales, we show that futures are actively constituted, and so imagined, through 'suites of practices' entwining policy, management and scientific analysis. Management has to constrain analysis because of the many ways in which flood futures can be constructed, but also because of commitment to an accounting calculus, which requires risk to be expressed in monetary terms. It is grounded in numerical simulation, undertaken by scientific consultants who follow policy/management guidelines that define the futures to be considered. Historical evidence is needed to deal with process and parameter uncertainties and the futures imagined are tied to pasts experienced. Reliance on past events is a challenge for prediction, given changing probability (e.g. climate change) and consequence (e.g. development on floodplains). So, risk management allows some elements of risk analysis to become unstable (notably in relation to climate change) but forces others to remain stable (e.g. invoking regulation to prevent inappropriate floodplain development). We conclude that the assumed separation of risk assessment and management is false because the risk calculation has to be defined by management. Making this process accountable requires openness about the procedures that make flood risk analysis more (or less) reliable to those we entrust to produce and act upon them such that, unlike the 'pseudosciences', they can be put to the test of public interrogation by those who have to live with their consequences.

  5. Improving risk management: from lame excuses to principled practice.

    PubMed

    Paté-Cornell, Elisabeth; Cox, Louis Anthony

    2014-07-01

    The three classic pillars of risk analysis are risk assessment (how big is the risk and how sure can we be?), risk management (what shall we do about it?), and risk communication (what shall we say about it, to whom, when, and how?). We propose two complements as important parts of these three bases: risk attribution (who or what addressable conditions actually caused an accident or loss?) and learning from experience about risk reduction (what works, and how well?). Failures in complex systems usually evoke blame, often with insufficient attention to root causes of failure, including some aspects of the situation, design decisions, or social norms and culture. Focusing on blame, however, can inhibit effective learning, instead eliciting excuses to deflect attention and perceived culpability. Productive understanding of what went wrong, and how to do better, thus requires moving past recrimination and excuses. This article identifies common blame-shifting "lame excuses" for poor risk management. These generally contribute little to effective improvements and may leave real risks and preventable causes unaddressed. We propose principles from risk and decision sciences and organizational design to improve results. These start with organizational leadership. More specifically, they include: deliberate testing and learning-especially from near-misses and accident precursors; careful causal analysis of accidents; risk quantification; candid expression of uncertainties about costs and benefits of risk-reduction options; optimization of tradeoffs between gathering additional information and immediate action; promotion of safety culture; and mindful allocation of people, responsibilities, and resources to reduce risks. We propose that these principles provide sound foundations for improving successful risk management.

  6. Risk perception as a driver for risk management policies

    NASA Astrophysics Data System (ADS)

    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

  7. [Occupational risk factors and medical prevention in corrections officers].

    PubMed

    Mennoial, Nunzio Valerio; Napoli, Paola; Battaglia, Andrea; Candura, Stefano M

    2014-01-01

    In Italy, the Law n. 395/1990 defines the tasks and attributions of prison officers. According to the article 25 of the Legislative Decree n. 81/2008, the occupational physician should participate to risk assessment, and carry out the sanitary surveillance. This report analyzes the various tasks of prison staff, identifies the risk factors, and discusses the preventive strategies, including workers formation and education. Biological agents and work-related stress are the main risk factors, as a consequence of prison overcrowding, personnel shortage and work organization complexity. In his preventive action, and particularly in formulating the judgment on work fitness, the occupational physician often clashes with inadequate ministerial funding.

  8. Driving forces and risk management

    EPA Science Inventory

    From a public health perspective, food safety is the overall goal and there are two distinct areas where interventions to this end can take place – either pre- or post-harvest. In pre-harvest, water quality management is the focus whereas post-harvest quality management depends ...

  9. Driving forces and risk management

    EPA Science Inventory

    From a public health perspective, food safety is the overall goal and there are two distinct areas where interventions to this end can take place – either pre- or post-harvest. In pre-harvest, water quality management is the focus whereas post-harvest quality management depends ...

  10. Risk Management: An International Perspective.

    ERIC Educational Resources Information Center

    Garvey, Daniel

    1998-01-01

    Focuses on risks and challenges of conducting adventure programming in foreign countries. Recommends actions to take before the crisis (involving assumptions, risk evaluation, emergency evacuation plans, awareness of medical-care costs, and foreign communications systems, family procedures plan, briefings); during the crisis (meeting staff and…

  11. Safety optimization through risk management

    NASA Astrophysics Data System (ADS)

    Wright, K.; Peltonen, P.

    The paper discusses the overall process of system safety optimization in the space program environment and addresses in particular methods that enhance the efficiency of this activity. Effective system safety optimization is achieved by concentrating the available engineering and safety assurance resouces on the main risk contributors. The qualitative risk contributor identification by means of the hazard analyses and the FMECA constitute the basis for the system safety process. The risk contributors are ranked firstly on a qualitative basis according to the consequence severities. This ranking is then refined by mishap propagation/recovery time considerations and by probabilistic means (PRA). Finally, in order to broaden and extend the use of risk contributor ranking as a managerial tool in project resource assignment, quality, manufacturing and operations related critical characteristics, i.e. risk influencing factors, are identified for managerial visibility.

  12. Intelligent adversary risk analysis: a bioterrorism risk management model.

    PubMed

    Parnell, Gregory S; Smith, Christopher M; Moxley, Frederick I

    2010-01-01

    The tragic events of 9/11 and the concerns about the potential for a terrorist or hostile state attack with weapons of mass destruction have led to an increased emphasis on risk analysis for homeland security. Uncertain hazards (natural and engineering) have been successfully analyzed using probabilistic risk analysis (PRA). Unlike uncertain hazards, terrorists and hostile states are intelligent adversaries who can observe our vulnerabilities and dynamically adapt their plans and actions to achieve their objectives. This article compares uncertain hazard risk analysis with intelligent adversary risk analysis, describes the intelligent adversary risk analysis challenges, and presents a probabilistic defender-attacker-defender model to evaluate the baseline risk and the potential risk reduction provided by defender investments. The model includes defender decisions prior to an attack; attacker decisions during the attack; defender actions after an attack; and the uncertainties of attack implementation, detection, and consequences. The risk management model is demonstrated with an illustrative bioterrorism problem with notional data.

  13. Security Risks: Management and Mitigation in the Software Life Cycle

    NASA Technical Reports Server (NTRS)

    Gilliam, David P.

    2004-01-01

    A formal approach to managing and mitigating security risks in the software life cycle is requisite to developing software that has a higher degree of assurance that it is free of security defects which pose risk to the computing environment and the organization. Due to its criticality, security should be integrated as a formal approach in the software life cycle. Both a software security checklist and assessment tools should be incorporated into this life cycle process and integrated with a security risk assessment and mitigation tool. The current research at JPL addresses these areas through the development of a Sotfware Security Assessment Instrument (SSAI) and integrating it with a Defect Detection and Prevention (DDP) risk management tool.

  14. Security Risks: Management and Mitigation in the Software Life Cycle

    NASA Technical Reports Server (NTRS)

    Gilliam, David P.

    2004-01-01

    A formal approach to managing and mitigating security risks in the software life cycle is requisite to developing software that has a higher degree of assurance that it is free of security defects which pose risk to the computing environment and the organization. Due to its criticality, security should be integrated as a formal approach in the software life cycle. Both a software security checklist and assessment tools should be incorporated into this life cycle process and integrated with a security risk assessment and mitigation tool. The current research at JPL addresses these areas through the development of a Sotfware Security Assessment Instrument (SSAI) and integrating it with a Defect Detection and Prevention (DDP) risk management tool.

  15. Risk management integration into complex project organizations

    NASA Technical Reports Server (NTRS)

    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.

  16. Risk management integration into complex project organizations

    NASA Technical Reports Server (NTRS)

    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.

  17. Biosecurity and risk management for dairy replacements.

    PubMed

    Maunsell, Fiona; Donovan, G Arthur

    2008-03-01

    Biosecurity, biocontainment, and disease risk management on dairy replacement operations are time- and labor-intensive, planned programs. Oftentimes the value of these programs is realized only after disease is introduced to a facility or a disease outbreak occurs. There is no "one-plan-fits-all;" each plan must be tailored to meet the needs of management's goals and expectations and problems specific to a production enterprise or geographic region. A standard framework applicable to biosecurity programs includes: (1) hazard identification, (2) exposure assessment, (3) risk characterization, and (4) risk management. The discussion presented here helps lay the framework for development and implementation of biosecurity and risk-management programs within dairy replacement facilities.

  18. Wildfire Risk Management: Challenges and Opportunities

    NASA Astrophysics Data System (ADS)

    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

  19. 76 FR 57723 - Electricity Sector Cybersecurity Risk Management Process Guideline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... Electricity Sector Cybersecurity Risk Management Process Guideline AGENCY: Department of Energy. ACTION... to publish the Electricity Sector Cybersecurity Risk Management Process Guideline. The guideline describes a risk management process that is targeted to the specific needs of electricity...

  20. The Struggle to Prevent and Evaluate: Application of Population Attributable Risk and Preventive Fraction to Suicide Prevention Research

    ERIC Educational Resources Information Center

    Krysinska, Karolina; Martin, Graham

    2009-01-01

    Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness…

  1. The Struggle to Prevent and Evaluate: Application of Population Attributable Risk and Preventive Fraction to Suicide Prevention Research

    ERIC Educational Resources Information Center

    Krysinska, Karolina; Martin, Graham

    2009-01-01

    Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness…

  2. Interdisciplinary task force designs risk management program.

    PubMed

    Van Sluyter, C K; Hays, P G

    1978-08-01

    When a hospital decided to self-insure, it also realized that it needed a more comprehensive risk management program to protect its operating assets. To develop this program, an interdisciplinary task force and its five subcommittees involved as many staff members as possible in studying and proposing risk management efforts related to policies and procedures, hiring practices, staffpatient interactions, staff and community education, and claims review.

  3. Teaching Risk Management: Addressing ACGME Core Competencies.

    PubMed

    Nissen, Kiki; Angus, Steven V; Miller, Wendy; Silverman, Adam R

    2010-12-01

    Risk management is an important aspect of education for all residents. Unfortunately, few curricula currently exist to fulfill this educational need. We developed a curriculum that teaches residents basic principles of risk management with the goals of (1) educating residents about the medical-legal environment in which they operate, (2) helping residents identify common malpractice exposures, and (3) teaching practical risk management/patient safety interventions that can be implemented in their practice that could reduce malpractice exposure and improve patient safety. The curriculum was developed by Medical Risk Management, LLC, a Connecticut-based risk management firm, in conjunction with academic leadership at the University of Connecticut. The program uses 3 learning modalities: live lectures, web-based video modules, and e-mailed learning publications. Gains in resident knowledge through participation in the curriculum were measured using pretests and posttests. Learner satisfaction with the curriculum was measured through web-based surveys. We found a significant improvement in knowledge in residents who took the pretest and posttest (P < .001). Of the survey respondents, 97% said the content was relevant to their specialty practice and 95% responded that these sessions should be held annually. Most respondents indicated they would change their practice as a result of what they learned from the live lectures. This risk management curriculum has been successful in providing our residents with learning activities in risk management, improving their knowledge of risk management principles, and changing their attitudes and behaviors. These improvements may lead to fewer malpractice claims against them and the hospitals they train in.

  4. Operational Risk Management and Military Aviation Safety

    DTIC Science & Technology

    1999-09-01

    accidents has caused the leadership to seek to reduce its mishap rate. 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 (ORM) is how the Air Force will reduce, even eliminate, mishaps. With current budget constraints, ORM is considered to be the most cost

  5. Landowner's perception of flood risk and preventive actions in estuarine environment: An empirical investigation.

    PubMed

    Rambonilaza, Tina; Joalland, Olivier; Brahic, Elodie

    2016-09-15

    Within Europe, flood and coastal risk management is undergoing a major paradigm shift as it moves from an approach dominated by investment in flood defence and control infrastructure to another one in which non-structural measures are favoured. One research challenge consists in developing a better understanding of local population risk perception and its effects on prevention and preparedness actions in order to improve social acceptability of adaptive flood risk management. Landowners' involvement in wetland management offer benefits beyond the line of their property. Accordingly, the purpose of this study is to achieve an empirical understanding of risk perception and self-protective behaviour among the landowners of the riparian marshes in the Gironde Estuary, in France. Application of the psychometric approach reveals that flood risk perception among landowners can be characterised by three synthetic variables that indicate on the degree of exposure, the sense of control and knowledge of the risk. Examining the relationships between these perceived risk dimensions and landowners' participation in water structures management provides three profiles of self-protective behaviour distinguishing "vulnerable", "autonomous", and "passive" individuals. Finally, implications of our findings for the management of flood risk in estuarine environment which is often drained areas are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Risk Factors for Gout and Prevention: A Systematic Review of the Literature

    PubMed Central

    Singh, Jasvinder A.; Reddy, Supriya G.; Kundukulam, Joseph

    2014-01-01

    Purpose Our objective was to perform a systematic review of risk factors and prevention of gout. We searched Medline for fully published reports in English using keywords including but not limited to “gout”, “epidemiology”, “primary prevention”, “secondary prevention”, “risk factors’. Data from relevant articles meeting inclusion criteria was extracted using standardized forms. Main Findings Of the 751 titles and abstracts, 53 studies met the criteria and were included in the review. Several risk factors were studied. Alcohol consumption increased the risk of incident gout, especially beer and hard liquor. Several dietary factors increased the risk of incident gout, including meat intake, seafood intake, sugar sweetened soft drinks, and consumption of foods high in fructose. Diary intake, folate intake and coffee consumption were each associated with a lower risk of incident gout and in some cases a lower rate of gout flares. Thiazide and loop diuretics were associated with higher risk of incident gout and higher rate of gout flares. Hypertension, renal insufficiency, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, diabetes, obesity and early menopause were each associated with a higher risk of incident gout and/or gout flares. Summary Several dietary risk factors for incident gout and gout flares are modifiable. Prevention and optimal management of comorbidities is likely to decreased risk of gout. Research in preventive strategies for the treatment of gout is needed. PMID:21285714

  7. Disaster Risk Management - The Kenyan Challenge

    NASA Astrophysics Data System (ADS)

    Nabutola, W.; Scheer, S.

    2009-04-01

    opportunities they see for Kenyans. EXPECTED OUTCOMES OF MY STUDY • Petition for and inform the need for the establishment and development of an Integrated Disaster Risk Management Centre in Kenya • Enhance a national contingency management bill to cater for the increased frequency and variety of disasters in Kenya • Set up a national awareness campaign of potential risks in Kenyans' daily endeavours, including Early Warning Systems, perhaps with support from those who have had to deal with similar, like the European Union, and devise ways and means to mitigate them when they occur. Better still work on well tested methods of preventing their happening in the first place. • Decentralize the whole issue of management of disasters considering that they can occur anywhere in the country and a response from Nairobi is not useful if it takes hours to reach the point of reference LESSONS LEARNT I am curious to establish what lessons we have learnt to inform the way we manage disasters in general and natural disasters in particular. Disasters are getting more frightening and intense. The advancement in technology should be useful in dealing with disasters. Given the recent events in 2008 alone, we need to commit much more resources to research and development to deal with disasters however they are caused. We should work towards being able to continue with our lives regardless of the risks and disasters that come our way as individuals and as a nation, by designing a strategy and policies that have worked elsewhere.

  8. Disaster Risk Management - The Kenyan Challenges

    NASA Astrophysics Data System (ADS)

    Nabutola, W.

    2009-04-01

    opportunities they see for Kenyans. EXPECTED OUTCOMES OF MY STUDY • Petition for and inform the need for the establishment and development of an Integrated Disaster Risk Management Centre in Kenya • Enhance a national contingency management bill to cater for the increased frequency and variety of disasters in Kenya • Set up a national awareness campaign of potential risks in Kenyans' daily endeavours, including Early Warning Systems, perhaps with support from those who have had to deal with similar, like the European Union, and devise ways and means to mitigate them when they occur. Better still work on well tested methods of preventing their happening in the first place. • Decentralize the whole issue of management of disasters considering that they can occur anywhere in the country and a response from Nairobi is not useful if it takes hours to reach the point of reference LESSONS LEARNT I am curious to establish what lessons we have learnt to inform the way we manage disasters in general and natural disasters in particular. Disasters are getting more frightening and intense. The advancement in technology should be useful in dealing with disasters. Given the recent events in 2008 alone, we need to commit much more resources to research and development to deal with disasters however they are caused. We should work towards being able to continue with our lives regardless of the risks and disasters that come our way as individuals and as a nation, by designing a strategy and policies that have worked elsewhere.

  9. Flood Risk and Asset Management

    DTIC Science & Technology

    2011-10-14

    WN911NF-10-2-0104  FLOOD RISK AND ASSET MANGEMENT ----Approved for Public Release, distribution unlimited PN 01 1 R. 1.0 WN911NF-10-2-0104... MANGEMENT PN 01 2 R. 1.0 Contents 1. Progress statement...7 1. Progress statement Following the workshop at HR Wallingford in February 2011, a system flood risk model of the St Paul Minnesota

  10. Managing multihazards risk in metropolitan USA

    NASA Astrophysics Data System (ADS)

    Aktan, A. Emin; Comfort, Louise K.; Shanis, Donald S.

    2003-07-01

    This proposal outlines an action plan for risk management in the Delaware Valley Metropolitan Region. This plan is consistent with the goals for strengthening homeland security announced by President Bush, and is designed to complement efforts currently under development by Pennsylvania Emergency Management Agency and Department of Health. This plan proposes the formation of a Delaware Valley Risk Management Consortium, representing the critical disciplines and organizations related to risk assessment and management. This group would have membership from academic institutions, government agencies, industry, and nonprofit organizations. This Consortium would develop a systemic scope of work with the appropriate recommendations for technology acquisition, development and integration with risk management policies and procedures. This scope of work would include the development of two related information systems for the Delaware Valley Region. The first would be a comprehensive 'health monitoring' system to assess the continuity of operations, which would use integrated remote sensing and imaging, information gathering, communication, computation, and, information processing and management over wide-area networks covering the entire metropolitan area. The second would use real-time information from the health monitoring system to support interactive communication, search and information exchange needed to coordinate action among the relevant agencies to mitigate risk, respond to hazards and manage its resources efficiently and effectively.

  11. The state of risk prevention in a sample of Australian hospitals, medical centres and allied health services.

    PubMed

    Canyon, Deon V

    2013-01-01

    This paper reports on an investigation into five risk prevention factors (technology, people, organisational structure, culture and top management psychology) to inform organisational preparedness planning and to update managers on the state of health care services. Data were collected by means of a 10-question, cross-sectional survey of key decision-making executives in eight different types of 75 health care organisations. Many organisations were found to have deficient risk prevention practices and allied health organisations were considerably worse than health organisations. Forty per cent of hospitals and chiropractic practices had out-dated or poor technology. Results on organisational culture and structure found that many executives associate these factors with risk prevention, but none of them appreciate the relationship between these factors and crisis causation. Gaps and areas for improvement are identified and a change in top management attitude is recommended to address resource allocation and implement appropriate risk prevention systems and mechanisms. Reactive managers need to increase their awareness of risks in order to become capable of preventing them. Proactive managers are those who invest in risk prevention.

  12. Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management

    PubMed Central

    Levy, Lauren L; Emer, Jason J

    2012-01-01

    Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care. PMID:23060707

  13. The prevention and management of seafarers' fatigue: a review.

    PubMed

    Allen, Paul; Wadsworth, Emma; Smith, Andy

    2007-01-01

    Global concern about the extent of seafarer fatigue is widely evident across the shipping industry. This paper provides an evaluation of the extent to which fatigue can be prevented and managed. Given the diversity of activities undertaken in the maritime sector, and the different profiles of fatigue risk factors in different work groups, it is clear that a range of strategies will need to be implemented. One conclusion from the review is that current legislation and guidance on fatigue has not had the desired effect. The way forward is to treat seafarers' fatigue as a serious health and safety issue. A starting point must be to take a more robust approach to regulation. Manning levels need to be addressed in a realistic way, that prevents economic advantage accruing to those operating at bare minimum and the issue of false record-keeping requires urgent attention. This must be supplemented with appropriate training and guidance regarding avoidance of fatigue and the creation of optimum working conditions. Lessons can be learned from other transport industries and it is important to seek examples of best practice and apply these in an effective way to the maritime sector. Methods of addressing issues specific to seafaring are now well developed and a holistic approach to the problem of fatigue can lead to a culture that benefits the industry as a whole.

  14. Managing Risk on the Final Frontier

    NASA Technical Reports Server (NTRS)

    Lengyel, David M.; Newman, J. S.

    2009-01-01

    The National Aeronautics and Space Administration (NASA). Exploration Systems Mission Directorate (ESMD) has combined the Continuous Risk Management (CRM) discipline with innovative knowledge management (KM) practices to more effectively enable the accomplishment of work. CRM enables proactive problem identification and problem solving in the complex world of rocket science. while KM is used to improve this process.

  15. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Banking FEDERAL HOUSING FINANCE BOARD GOVERNANCE AND MANAGEMENT OF THE FEDERAL HOME LOAN BANKS POWERS AND... this section and to all applicable Finance Board regulations and policies. (2) Review and compliance... forth in this chapter, each Bank's risk management policy shall: (1) After the Finance Board has...

  16. Lessons Learned in Risk Management on NCSX

    SciTech Connect

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

    2009-07-21

    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.

  17. Lessons Learned in Risk Management on NCSX

    SciTech Connect

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

    2009-02-11

    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.

  18. 76 FR 45724 - Clearing Member Risk Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... for adherence to the risk-based limits intra-day and overnight; (4) Conduct stress tests of all... intermediary's existing position or credit limits. Stress tests are an essential risk management tool. The purpose in conducting stress tests is to determine the potential for significant losses in the event...

  19. Risk management, derivatives and shariah compliance

    NASA Astrophysics Data System (ADS)

    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.

  20. Brugada Syndrome:Risk Stratification And Management.

    PubMed

    Letsas Md Fesc, Konstantinos P; Georgopoulos Md, Stamatis; Vlachos Md, Konstantinos; Karamichalakis Md, Nikolaos; Liatakis Md, Ioannis; Korantzopoulos Md PhD, Panagiotis; Liu Md PhD, Tong; Efremidis Md, Michael; Sideris Md, Antonios

    2016-01-01

    The Brugada syndrome (BrS) is an arrhythmogenic disease associated with an increased risk of ventricular fibrillation and sudden cardiac death. The risk stratification and management of BrS patients, particularly of asymptomatic ones, still remains challenging. A previous history of aborted sudden cardiac death or arrhythmic syncope in the presence of spontaneous type 1 ECG pattern of BrS phenotype appear to be the most reliable predictors of future arrhythmic events. Several other ECG parameters have been proposed for risk stratification. Among these ECG markers, QRS-fragmentation appears very promising. Although the value of electrophysiological study still remains controversial, it appears to add important information on risk stratification, particularly when incorporated in multiparametric scores in combination with other known risk factors. The present review article provides an update on the pathophysiology, risk stratification and management of patients with BrS.

  1. Chronic disease prevention and management: some uncomfortable questions.

    PubMed

    Trypuc, Joann; Hudson, Alan

    2007-01-01

    Morgan, Zamora and Hindmarsh make a compelling case for a national strategy on chronic disease prevention and management. The truths raised in the lead paper are not particularly inconvenient, but they do raise a number of uncomfortable questions: (1) Why are physicians not taking a more responsible and active role to prevent and manage chronic diseases on behalf of their patients? (Physicians must recognize that it is their professional responsibility and their job to provide their patients with the appropriate level of care for chronic conditions.) (2) Why are non-physician healthcare providers not playing a larger role to prevent and manage chronic diseases? (3) Why is there a greater focus on managing chronic diseases than on preventing or delaying them from happening? (4) Have we forgotten the profound impact of the social determinants of health on illness, life expectancy and death?

  2. Diagnosing and managing post menopausal osteoporosis: opportunities for fracture prevention.

    PubMed

    McGarry, Kelly A; Tammaro, Dominick; Cyr, Michele G

    2003-01-01

    Osteoporosis is an asymptomatic disease until a fracture occurs. Management includes primary prevention, early detection through targeted screening, and implementation of appropriate treatment and monitoring strategies. This article explores these issues in depth.

  3. An Innovative Partnership Approach for Environmental Management and Pollution Prevention.

    ERIC Educational Resources Information Center

    Erten-Unal, Mujde; Aydlett, Guy M.

    1997-01-01

    A partnership between a university and a government regulatory agency sought to assist industries with pollution prevention and waste management. Economic incentives were developed to promote waste minimization. (SK)

  4. Information needs for risk management/communication

    SciTech Connect

    Bennett, D.A.

    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.

  5. Cost effective management of space venture risks

    NASA Technical Reports Server (NTRS)

    Giuntini, Ronald E.; Storm, Richard E.

    1986-01-01

    The development of a model for the cost-effective management of space venture risks is discussed. The risk assessment and control program of insurance companies is examined. A simplified system development cycle which consists of a conceptual design phase, a preliminary design phase, a final design phase, a construction phase, and a system operations and maintenance phase is described. The model incorporates insurance safety risk methods and reliability engineering, and testing practices used in the development of large aerospace and defense systems.

  6. Cost effective management of space venture risks

    NASA Technical Reports Server (NTRS)

    Giuntini, Ronald E.; Storm, Richard E.

    1986-01-01

    The development of a model for the cost-effective management of space venture risks is discussed. The risk assessment and control program of insurance companies is examined. A simplified system development cycle which consists of a conceptual design phase, a preliminary design phase, a final design phase, a construction phase, and a system operations and maintenance phase is described. The model incorporates insurance safety risk methods and reliability engineering, and testing practices used in the development of large aerospace and defense systems.

  7. Prevention and nonsurgical management of dental caries over the life course for individuals with special health care needs.

    PubMed

    Chi, Donald L; Ettinger, Ronald L

    2014-07-01

    Traditional approaches to caries prevention and management are unlikely to result in successful outcomes for individuals with special health care needs. Intensive prevention-oriented and minimally invasive restorative approaches have the greatest potential to address oral health disparities affecting vulnerable populations. This paper introduces readers to oral health-related issues for patients with special health care needs across the life course and outlines clinical strategies to prevent and manage caries in high-risk patients.

  8. NATIONAL RISK MANAGEMENT RESEARCH LABORATORY: PROVIDING SOLUTIONS FOR A BETTER TOMORROW

    EPA Science Inventory

    This small, two-fold flyer contains general information introducing EPA's National Risk Management Research Laboratory and its research program. The key overarching areas of research described are: Protection of drinking water; control of air pollution; pollution prevention and e...

  9. Can child injury prevention include healthy risk promotion?

    PubMed Central

    Brussoni, Mariana; Brunelle, Sara; Pike, Ian; Sandseter, Ellen Beate Hansen; Herrington, Susan; Turner, Heather; Belair, Scott; Logan, Louise; Fuselli, Pamela; Ball, David J

    2015-01-01

    To reflect on the role of risk-taking and risky play in child development and consider recommendations for the injury prevention field, a symposium was held prior to the November 2013 Canadian Injury Prevention and Safety Promotion Conference. Delegates heard from Canadian and international researchers, practitioners and play safety experts on child development, play space design and playground safety, provision of recreation, and legal and societal perceptions of risk and hazard. The presenters provided multidisciplinary evidence and perspectives indicating the potential negative effect on children's development of approaches to injury prevention that prioritise safety and limit children's opportunities for risky play. Delegates considered the state of the field of injury prevention and whether alternative approaches were warranted. Each presenter prepared a discussion paper to provide the opportunity for dialogue beyond attendees at the symposium. The resulting discussion papers provide a unique opportunity to consider and learn from multiple perspectives in order to develop a path forward. PMID:25535208

  10. Climate Change Risk Management: CRE Adaptation Projects and the Risk Management Process

    EPA Pesticide Factsheets

    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.

  11. Managing auricular haematoma to prevent 'cauliflower ear'.

    PubMed

    Summers, Anthony

    2012-09-01

    This article describes the typical signs of auricular haematoma, how people who have the condition should be treated in emergency departments and the problems that can arise if they are managed inappropriately.

  12. Sacral Neuromodulation Implant Infection: Risk Factors and Prevention.

    PubMed

    Lee, Calvin; Pizarro-Berdichevsky, Javier; Clifton, Marisa M; Vasavada, Sandip P

    2017-02-01

    Device infection is one of the most common complications of sacral nerve stimulator placement and occurs in approximately 3-10% of cases. Infection is a serious complication, as it often requires complete explantation of the device. Not much is known regarding risk factors for and methods of preventing infection in sacral nerve stimulation. Multiple risk factors have been linked to device infection including prolonged percutaneous testing and choice of preoperative antibiotic. Methods of infection prevention have also been studied recently, including antibiotic-impregnated collage and type of skin preparation. This review will discuss the recent literature identifying risk factors and means of preventing infection in sacral nerve stimulation. Finally, we will outline a protocol we have enacted at our institution which has resulted in an incidence of infection of 1.6%.

  13. Public sector risk management: a specific model.

    PubMed

    Lawlor, Ted

    2002-07-01

    Risk management programs for state mental health authorities are generally limited in scope and reactive in nature. Recent changes in how mental health care is provided render it necessary to redirect the risk management focus from its present institutional basis to a statewide, network-based paradigm that is integrated across public and private inpatient and community programs alike. These changes include treating an increasing number of individuals in less-secure settings and contracting for an increasing number of public mental health services with private providers. The model proposed here is closely linked to the Quality Management Process.

  14. Wildland Fire Prevention: Today, Intuition--Tomorrow, Management

    Treesearch

    Albert J. Simard; Linda R. Donoghue

    1987-01-01

    Describes, from a historical perspective, methods used to characterize fire prevention problems and evaluate prevention programs and discusses past research efforts to bolster these analytical and management efforts. Highlights research on the sociological perspectives of the wildfire problem and on quantitative fire occurrence prediction and program evaluation systems...

  15. Preventable hospitalizations and Medicare managed care: a small area analysis.

    PubMed

    Basu, Jayasree

    2012-08-01

    To examine the association between preventable hospitalization rates and proportions of managed care enrollment at the primary care service area level. Multivariate design. The study used the Healthcare Cost and Utilization Project State Inpatient Data from the Agency for Healthcare Research and Quality for Arizona, Massachusetts, and New York for the years 1995 and 2005 to examine the association between preventable hospitalization rates and proportions of managed care enrollment in 1995 and 2005. The period 1995-2005 was marked by the beginning and end of several legislative and policy initiatives causing changes in elderly hospitalization patterns as well as Medicare managed care enrollment patterns. The study used ordinary least squares regressions, adjusting for heteroscedasticity. A cross-sectional analysis was used to examine the association each year. A pooled sample analysis over years tested the changes in relative contributions of managed care over time. Preventable hospitalization rates were inversely associated with Medicare managed enrollment in both years. This association was, however, found to be weaker in 2005 than in 1995. The decline in contributions of managed care was also statistically significant. Despite increased managed care enrollment, the role of Medicare managed care in explaining declines in preventable hospitalization rates diminished over time. The results could be explained by the growth of private fee-for-service types of managed care plans and the resultant decline in emphasis on care coordination relative to health maintenance organization plans.

  16. Evidence-based prevention, management, and monitoring of dental caries.

    PubMed

    Barber, Lois Rigmont; Wilkins, Esther M

    2002-01-01

    Dental caries, not unlike periodontal diseases, is now recognized as an infectious, transmissible, multifactorial disease of bacterial origin. Current evidence-based emphasis is on the need to recognize a carious lesion in its earliest stage before demineralization has produced a cavitated lesion that requires restoration by a dentist. As a result of current understanding of caries control, the dental hygienist's role as a prevention specialist is to determine the dental caries risk factors for patients of all ages and to introduce remineralization strategies into the patient's dental hygiene care plan. Conservative strategies of a concentrated program include initial infection control with a chlorhexidine rinse; extra daily fluoride exposures; placement of pit and fissure sealants where indicated; control of sucrose exposures; use of sugar substitutes, particularly xylitol-containing sugar-free chewing gum; and an emphasis on a daily bacterial plaque removal routine. Evidence supports the management and monitoring of dental caries. Caries risk level must be reevaluated at each maintenance appointment. Appropriate in-office strategies to preserve tooth structure should be carried out and followed by applicable home regimens that are based on need, not age.

  17. 10 Commandments of Risk Management.

    ERIC Educational Resources Information Center

    Dworken, Bari S.

    1998-01-01

    Gives 10 strategies and examples for camp crisis-management: a written, implemented emergency plan; clear, honest communication; trained staff; good community relationships; learning from experience; knowing the local environment; preparing for the media; considering long-term impacts; avoiding adverse effects; and recognizing good things that…

  18. Recommendations for Insulin Dose Calculator Risk Management.

    PubMed

    Rees, Christen

    2014-01-01

    Several studies have shown the usefulness of an automated insulin dose bolus advisor (BA) in achieving improved glycemic control for insulin-using diabetes patients. Although regulatory agencies have approved several BAs over the past decades, these devices are not standardized in their approach to dosage calculation and include many features that may introduce risk to patients. Moreover, there is no single standard of care for diabetes worldwide and no guidance documents for BAs, specifically. Given the emerging and more stringent regulations on software used in medical devices, the approval process is becoming more difficult for manufacturers to navigate, with some manufacturers opting to remove BAs from their products altogether. A comprehensive literature search was performed, including publications discussing: diabetes BA use and benefit, infusion pump safety and regulation, regulatory submissions, novel BAs, and recommendations for regulation and risk management of BAs. Also included were country-specific and international guidance documents for medical device, infusion pump, medical software, and mobile medical application risk management and regulation. No definitive worldwide guidance exists regarding risk management requirements for BAs, specifically. However, local and international guidance documents for medical devices, infusion pumps, and medical device software offer guidance that can be applied to this technology. In addition, risk management exercises that are algorithm-specific can help prepare manufacturers for regulatory submissions. This article discusses key issues relevant to BA use and safety, and recommends risk management activities incorporating current research and guidance.

  19. Recommendations for Insulin Dose Calculator Risk Management

    PubMed Central

    2014-01-01

    Several studies have shown the usefulness of an automated insulin dose bolus advisor (BA) in achieving improved glycemic control for insulin-using diabetes patients. Although regulatory agencies have approved several BAs over the past decades, these devices are not standardized in their approach to dosage calculation and include many features that may introduce risk to patients. Moreover, there is no single standard of care for diabetes worldwide and no guidance documents for BAs, specifically. Given the emerging and more stringent regulations on software used in medical devices, the approval process is becoming more difficult for manufacturers to navigate, with some manufacturers opting to remove BAs from their products altogether. A comprehensive literature search was performed, including publications discussing: diabetes BA use and benefit, infusion pump safety and regulation, regulatory submissions, novel BAs, and recommendations for regulation and risk management of BAs. Also included were country-specific and international guidance documents for medical device, infusion pump, medical software, and mobile medical application risk management and regulation. No definitive worldwide guidance exists regarding risk management requirements for BAs, specifically. However, local and international guidance documents for medical devices, infusion pumps, and medical device software offer guidance that can be applied to this technology. In addition, risk management exercises that are algorithm-specific can help prepare manufacturers for regulatory submissions. This article discusses key issues relevant to BA use and safety, and recommends risk management activities incorporating current research and guidance. PMID:24876550

  20. Prevention and Management of Neonatal Hypothermia in Rural Zambia

    PubMed Central

    Lunze, Karsten; Yeboah-Antwi, Kojo; Marsh, David R.; Kafwanda, Sarah Ngolofwana; Musso, Austen; Semrau, Katherine; Waltensperger, Karen Z.; Hamer, Davidson H.

    2014-01-01

    Background Neonatal hypothermia is increasingly recognized as a risk factor for newborn survival. The World Health Organization recommends maintaining a warm chain and skin-to-skin care for thermoprotection of newborn children. Since little is known about practices related to newborn hypothermia in rural Africa, this study's goal was to characterize relevant practices, attitudes, and beliefs in rural Zambia. Methods and Findings We conducted 14 focus group discussions with mothers and grandmothers and 31 in-depth interviews with community leaders and health officers in Lufwanyama District, a rural area in the Copperbelt Province, Zambia, enrolling a total of 171 participants. We analyzed data using domain analysis. In rural Lufwanyama, community members were aware of the danger of neonatal hypothermia. Caregivers' and health workers' knowledge of thermoprotective practices included birthplace warming, drying and wrapping of the newborn, delayed bathing, and immediate and exclusive breastfeeding. However, this warm chain was not consistently maintained in the first hours postpartum, when newborns are at greatest risk. Skin-to-skin care was not practiced in the study area. Having to assume household and agricultural labor responsibilities in the immediate postnatal period was a challenge for mothers to provide continuous thermal care to their newborns. Conclusions Understanding and addressing community-based practices on hypothermia prevention and management might help improve newborn survival in resource-limited settings. Possible interventions include the implementation of skin-to-skin care in rural areas and the use of appropriate, low-cost newborn warmers to prevent hypothermia and support families in their provision of newborn thermal protection. Training family members to support mothers in the provision of thermoprotection for their newborns could facilitate these practices. PMID:24714630

  1. Prevention

    MedlinePlus

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  2. Applying Atherosclerotic Risk Prevention Guidelines to Elderly Patients: A Bridge Too Far?

    PubMed

    Feldman, Ross D; Harris, Stewart B; Hegele, Robert A; Pickering, J Geoffrey; Rockwood, Kenneth

    2016-05-01

    The primary prevention of atherosclerotic disease is on the basis of optimal management of the major risk factors. For the major risk factors of diabetes, hypertension, and dyslipidemia, management for most patients is on the basis of well developed and extensive evidence-based diagnostic and therapeutic guidelines. However, for a growing segment of the population who are at the highest risk for atherosclerotic disease (ie, older adults), the application of these guidelines is problematic. First, few studies that form the evidence base for these primary prevention guidelines actually include substantial numbers of elderly subjects. Second, elderly patients represent a special population from multiple perspectives related to their accumulation of health deficits and in their development of frailty. These patients with frailty and multiple comorbidities have been mostly excluded from the primary prevention studies upon which the guidelines are based yet comprise a very significant proportion of the very elderly population. Third, elderly people are at most risk from adverse drug reactions because of the increasing number of medications prescribed in this patient population. When applying the existing guidelines to elderly people the limitations of our knowledge must be recognized regarding how best to mitigate the high risk of heart disease in our aging population and how to generalize these recommendations to the management of the largest subgroup of elderly patients (ie, those with multiple comorbidities and frail older adults). Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. Risk management in a university environment.

    PubMed

    Brewer, Ann; Walker, Ian

    2011-06-01

    Risk is an integral part of quality assurance in higher education in Australia. This paper describes a generic methodology for the identification and management of risk in a university or similar tertiary education environment and outlines a framework that enables the management of risk to be incorporated in the institution's governance cycle. The new approach here is that risk is embedded in the quality assurance framework and, in turn, in the strategic planning and budgeting processes. In many organisations, risk is implemented as a separate process and not considered in any meaningful way as integral to the strategic direction and performance of the university. The paper is based on work carried out by the authors and others between March 2008 and April 2009 to develop a comprehensive system for managing risk in a major Australian university, including processes whereby risk management could be integrated with, and add value to, the overall governance of the university. The case study is described in the appendix to this paper.

  4. The management of risk. Part 3: Recording your way out of trouble.

    PubMed

    Collier, Andrew

    2014-05-01

    Clinical and ethical risk management requires not only the correct treatment being provided, and appropriate consent obtained, but also good records of that treatment. This third article of the series describes the characteristics of good records and their role in helping to prevent the progression of complaints, General Dental Council (GDC) cases and legal claims. Good records are of fundamental importance in managing risk and preventing and resolving complaints and legal claims.

  5. Epidemiology, risk factors, intervention, and prevention of adolescent suicide.

    PubMed

    Rosewater, K M; Burr, B H

    1998-08-01

    Increasing rates of adolescent suicide are a significant health concern and the third leading cause of death for this age group. Recent research into psychiatric, gender-related, family, cultural and neurobiologic risk factors is reviewed. The effects of suicide exposure and media influences are also examined. Although many risk factors have been identified, the application of this knowledge to clinical practice requires further study. The limited number of studies on prevention and intervention strategies are discussed. High rates of nonadherence to follow-up remain problematic. More research is needed to develop appropriate treatments, prevention programs and outcome measures.

  6. Influenza in travelers: epidemiology, risk, prevention, and control issues.

    PubMed

    Steffen, Robert

    2010-05-01

    Influenza is the most frequent travel related infection preventable by universally available vaccines, but preventive measures were neglected until recently. Since the spread of pandemic (H1N1) 2009, various public health measures have been promoted first to contain, then to mitigate, the pandemic. Some of these measures contradicted recommendations issued by the World Health Organization and were of questionable efficacy. However, travelers may benefit from targeted recommendations on influenza risk reduction (eg, by social distancing or immunization). These recommendations are particularly indicated for those with an increased personal risk profile and for those likely to be exposed to influenza patients.

  7. Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

    PubMed

    Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

    2008-06-01

    This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented.

  8. The Effect of Genetic Risk Information and Health Risk Assessment on Compliance with Preventive Behaviors.

    ERIC Educational Resources Information Center

    Bamberg, Richard; And Others

    1990-01-01

    Results from a study of 82 males provide no statistical support and limited encouragement that genetic risk information may motivate persons to make positive changes in preventive health behaviors. Health risk assessments were used to identify subjects at risk for coronary heart disease or lung cancer because of genetic factors. (IAH)

  9. The Effect of Genetic Risk Information and Health Risk Assessment on Compliance with Preventive Behaviors.

    ERIC Educational Resources Information Center

    Bamberg, Richard; And Others

    1990-01-01

    Results from a study of 82 males provide no statistical support and limited encouragement that genetic risk information may motivate persons to make positive changes in preventive health behaviors. Health risk assessments were used to identify subjects at risk for coronary heart disease or lung cancer because of genetic factors. (IAH)

  10. A Framework for Drought Risk Management

    NASA Astrophysics Data System (ADS)

    Apurv, T.; Cai, X.

    2016-12-01

    Drought is one of the most expensive natural disasters as it affects many sectors of the economy. The threat posed by droughts is expected to further increase due to increasing water demands fuelled by increasing population and also due to climate change in many regions. Management of the increasing drought risk requires shift from traditional crisis management approaches to long term strategic planning for reduction of drought risk. This study proposes a framework for management of long term drought risk. The framework uses the system based approach proposed by Tsakiris et al. (2013), in which a watershed is considered as a system and different water sources in the watershed (like groundwater, reservoirs, streams etc.) are considered as subsystems associated with certain water requirements of different sectors. Droughts are defined separately for each subsystem considering water availability and requirement. The percentile based drought indicator framework proposed by Steinemann et al. (2015) is used for defining drought for each subsystem, allowing the selection of thresholds, variables of interest, and time scale which are most relevant for stakeholders dependent on a particular subsystem. Future drought risk under different drought management strategies are assessed using hydrologic models that model both hydrologic and human components of a watershed. The robustness of a management strategy is assessed by simulating system response across a wide range of stochastically generated future climate scenarios. The framework is useful for operational drought management as it allows direct management of drought risks with consideration of different water sources and water users. Steinemann, A., Iacobellis, S.F., Cayan, D.R., (2015) "Developing and evaluating drought indicators for decision-making" J. Hydrometeor. 16 (4), 1793-1803 Tsakiris, G, Nalbantis, I, Vangelis, H, Verbeiren, B, Huysmans, M, Tychon, B, Jacquemin, I, Canters, F, Vanderhaegen, S, Engelen, G

  11. Managing risk: An environmental engineering perspective

    SciTech Connect

    Arnold, M.A.; Weisberg, J.L.; Apel, S.R.

    1998-07-01

    Due to the nature of environmental investigation, remediation and design, the environmental engineer faces a large potential risk of receiving a claim on almost every project regardless of size. The liability for such a claim can be many times the negotiated fee for the project. While the risk of claims cannot be eliminated, the cost of such risk can be managed through an understanding of the nature of potential liabilities, the utilization of contractual allocation, and the purchase of insurance. Once claims are received, a proper use of appropriate legal defenses, will facilitate the resolution of such claims. While an exhaustive description of all risks encountered by an environmental engineer is beyond the scope of this paper, the following will address the risks most often encountered, which if not properly managed, can result in large costs to the engineer.

  12. Thalassemia in Iran: epidemiology, prevention, and management.

    PubMed

    Abolghasemi, Hassan; Amid, Ali; Zeinali, Sirous; Radfar, Mohammad H; Eshghi, Peyman; Rahiminejad, Mohammad S; Ehsani, Mohammad A; Najmabadi, Hossein; Akbari, Mohammad T; Afrasiabi, Abdolreza; Akhavan-Niaki, Haleh; Hoorfar, Hamid

    2007-04-01

    To determine the prevalence and geographic distribution of thalassemia and to evaluate the success of the thalassemia prevention and treatment programs in Iran. Data were obtained from the National Thalassemia Registry of Iran, Iranian Blood Transfusion Organization, genetic laboratories involved in prenatal diagnosis, related pharmaceutical companies, and centers performing bone marrow transplantation for thalassemic patients. A total of 13,879 living patients have been registered, mostly from the northern and southern parts of Iran with the median age of 15 years. Twenty-three percent of patients were older than 20 years. The number of newly diagnosed cases has been decreased considerably after the start of the prevention program. Since the introduction of prenatal diagnosis, 2819 couples (2549 fetuses) have been tested, with only 6 false results. Elective abortion was not performed in 10 affected fetuses. Most common mutations detected were IVS II-1 and IVS I-5. In 2003, approximately 25% of the national blood products and 6 million vials of desferal were used for thalassemic patients. Overall, 340 patients have received allogeneic bone marrow transplantation, of those 46 patients deceased. Bloodborne infections have also been decreased significantly owing to the national screening of blood products for bloodborne viral infections. Owing to the national prevention program and provided special care, the age distribution of thalassemic patients in Iran is getting adapted to a full prevention and treatment program and life expectancy of these patients has been increased considerably. This shift in the age distribution of thalassemia, a traditionally considered pediatric disease, will face us with new challenges and the health care system should be prepared for this new face of thalassemia.

  13. Risk management in pregnancy termination.

    PubMed

    Burnhill, M S

    1986-03-01

    This chapter reminds those who provide abortion services that crises are inevitable in the medical, counselling and administrative areas of the facility. After more than 10 years of providing safe, legal abortions, the author notes that the different types of crises that occur are already known and that it is possible to prepare for them. Indeed, it is necessary to prepare for a crisis before it occurs. The essence of crisis management is to: (a) identify each possible crisis and prepare a plan to cope with it, (b) train personnel to avert and/or manage a crisis, and to be sure that this training is carried out at appropriate intervals to provide sufficient trained staff at all times and (c) have on hand an up-to-date, adequate stock of the appropriate supplies and equipment to deal with medical and other emergencies. Four crisis management 'dicta' are given: Prepare yourself, your personnel, and your facility to be able to handle crisis. When a medical crisis, as listed, has occurred, the patient should be rapidly transported to the hospital and observed there for a suitable period of time. A medical crisis must be treated as the life-threatening event that it is, regardless of personal ego damage, social disruptions and/or financial considerations. The more personnel trained in cardiopulmonary resuscitation, the better.

  14. Managed care, consumerism, preventive medicine: does a causal connection exist?

    PubMed

    Rizzo, John A; Xie, Yang

    2006-07-01

    Managed care plans, and HMOs in particular, have long touted that their emphasis is on preventive care, to avoid expensive illness later in life. However, few articles in the contemporary literature adequately address this claim. The available evidence seems to support that HMOs do, in fact, provide greater access to preventive services, but the limitations of this research are substantial. This article discusses the scientific evidence on the relationships between managed care arrangements and the implications for preventive care in the current era, emphasizing consumer choices and less-restrictive plan structures.

  15. AEGIS: a wildfire prevention and management information system

    Treesearch

    Kostas Kalabokidis; Alan Ager; Mark Finney; Nikos Athanasis; Palaiologos Palaiologou; Christos Vasilakos

    2016-01-01

    We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to...

  16. Transjugular Intrahepatic Portosystemic Shunt Complications: Prevention and Management

    PubMed Central

    Suhocki, Paul V.; Lungren, Matthew P.; Kapoor, Baljendra; Kim, Charles Y.

    2015-01-01

    Transjugular intrahepatic portosystemic shunt (TIPS) insertion has been well established as an effective treatment in the management of sequelae of portal hypertension. There are a wide variety of complications that can be encountered, such as hemorrhage, encephalopathy, TIPS dysfunction, and liver failure. This review article summarizes various approaches to preventing and managing these complications. PMID:26038620

  17. Impact of a classroom behavior management intervention on teacher risk ratings for student behavior.

    PubMed

    Hansen, William B; Bishop, Dana C; Jackson-Newsom, Julia

    2010-01-01

    Classroom behavior management interventions have been used successfully with drug prevention programs to prevent subsequent antisocial behavior and substance use among youth. This article presents results from implementation of the All Stars Challenge, a classroom-based behavior management component to a drug prevention program for fifth graders. Risk ratings for shyness and lack of awareness of social norms among high-risk students who received the All Stars Challenge were reduced compared with fifth graders who did not receive the intervention. In contrast, physical and social aggressivity among low-risk students who received the program increased when compared to similar control students.

  18. Managing acute upper GI bleeding, preventing recurrences.

    PubMed

    Albeldawi, Mazen; Qadeer, Mohammed A; Vargo, John J

    2010-02-01

    Acute upper gastrointestinal (GI) bleeding is common and potentially life-threatening and needs a prompt assessment and aggressive medical management. All patients need to undergo endoscopy to diagnose, assess, and possibly treat any underlying lesion. In addition, patients found to have bleeding ulcers should receive a proton pump inhibitor, the dosage and duration of treatment depending on the endoscopic findings and clinical factors.

  19. Adolescent Suicide: Prevention, Postvention and Crisis Management.

    ERIC Educational Resources Information Center

    Dineen, Peggy

    Suicide is the second leading cause of death among adolescents and young adults between the ages of 15-25. Every day, over 1,000 young adults attempt to destroy themselves. Although adolescents contemplate suicide for many reasons, research suggests that depression is the number one risk factor in suicide. Accordingly, this paper describes many of…

  20. Adolescent Suicide: Prevention, Postvention and Crisis Management.

    ERIC Educational Resources Information Center

    Dineen, Peggy

    Suicide is the second leading cause of death among adolescents and young adults between the ages of 15-25. Every day, over 1,000 young adults attempt to destroy themselves. Although adolescents contemplate suicide for many reasons, research suggests that depression is the number one risk factor in suicide. Accordingly, this paper describes many of…