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. 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.

  3. 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. PMID:27621236

  4. 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.

  5. [Risk management of coronary heart disease-prevention].

    PubMed

    Dorner, Thomas; Rieder, Anita

    2004-06-01

    infarction in women increases significantly after the menopause, and mortality through coronary heart disease is higher amongst women than men. Hormonal status, use of oral contraceptives and pregnancy all influence risk for cardiovascular disease in women. Due to the enormity of the problem that cardiovascular disease presents to society and the great potential for management of risk factors for cardiovascular disease through preventive medicine, a number of health promotion and prevention programmes have been initiated by various national and global organisations. This paper presents an analysis of modifiable risk factors for cardiovascular disease together with a review of targeted prevention programmes aiming at reducing these risks. PMID:15287702

  6. Small watershed management as a tool of flood risk prevention

    NASA Astrophysics Data System (ADS)

    Jakubinsky, J.; Bacova, R.; Svobodova, E.; Kubicek, P.; Herber, V.

    2014-09-01

    According to the International Disaster Database (CRED 2009) frequency of extreme hydrological situations on a global scale is constantly increasing. The most typical example of a natural risk in Europe is flood - there is a decrease in the number of victims, but a significant increase in economic damage. A decrease in the number of victims is caused by the application of current hydrological management that focuses its attention primarily on large rivers and elimination of the damages caused by major flood situations. The growing economic losses, however, are a manifestation of the increasing intensity of floods on small watercourses, which are usually not sufficiently taken into account by the management approaches. The research of small streams should focus both on the study of the watercourse itself, especially its ecomorphological properties, and in particular on the possibility of flood control measures and their effectiveness. An important part of society's access to sustainable development is also the evolution of knowledge about the river landscape area, which is perceived as a significant component of global environmental security and resilience, thanks to its high compensatory potential for mitigation of environmental change. The findings discussed under this contribution are based on data obtained during implementation of the project "GeoRISK" (Geo-analysis of landscape level degradation and natural risks formation), which takes into account the above approaches applied in different case studies - catchments of small streams in different parts of the Czech Republic. Our findings offer an opportunity for practical application of field research knowledge in decision making processes within the national level of current water management.

  7. Preventing and Managing Cardiometabolic Risk: The Logic for Intervention

    PubMed Central

    Pereira, Mark A.; Kottke, Thomas E.; Jordan, Courtney; O’Connor, Patrick J.; Pronk, Nicolaas P.; Carreón, Rita

    2009-01-01

    Cardiometabolic risk (CMR), also known as metabolic syndrome or insulin resistance syndrome, comprises obesity (particularly central or abdominal obesity), high triglycerides, low HDL, elevated blood pressure, and elevated plasma glucose. Leading to death from diabetes, heart disease, and stroke, the root cause of CMR is inadequate physical activity, a Western diet identified primarily by low intake of fruits, vegetables, and whole grains, and high in saturated fat, as well as a number of yet-to-be-identified genetic factors. While the pathophysiological pathways related to CMR are complex, the universal need for adequate physical activity and a diet that emphasizes fruits and vegetables and whole grains, while minimizing food high in added sugars and saturated fat suggests that these behaviors are the appropriate focus of intervention. PMID:20054455

  8. iPrevent®: a tailored, web-based, decision support tool for breast cancer risk assessment and management.

    PubMed

    Collins, Ian M; Bickerstaffe, Adrian; Ranaweera, Thilina; Maddumarachchi, Sanjaya; Keogh, Louise; Emery, Jon; Mann, G Bruce; Butow, Phyllis; Weideman, Prue; Steel, Emma; Trainer, Alison; Bressel, Mathias; Hopper, John L; Cuzick, Jack; Antoniou, Antonis C; Phillips, Kelly-Anne

    2016-02-01

    We aimed to develop a user-centered, web-based, decision support tool for breast cancer risk assessment and personalized risk management. Using a novel model choice algorithm, iPrevent(®) selects one of two validated breast cancer risk estimation models (IBIS or BOADICEA), based on risk factor data entered by the user. Resulting risk estimates are presented in simple language and graphic formats for easy comprehension. iPrevent(®) then presents risk-adapted, evidence-based, guideline-endorsed management options. Development was an iterative process with regular feedback from multidisciplinary experts and consumers. To verify iPrevent(®), risk factor data for 127 cases derived from the Australian Breast Cancer Family Study were entered into iPrevent(®), IBIS (v7.02), and BOADICEA (v3.0). Consistency of the model chosen by iPrevent(®) (i.e., IBIS or BOADICEA) with the programmed iPrevent(®) model choice algorithm was assessed. Estimated breast cancer risks from iPrevent(®) were compared with those attained directly from the chosen risk assessment model (IBIS or BOADICEA). Risk management interventions displayed by iPrevent(®) were assessed for appropriateness. Risk estimation model choice was 100 % consistent with the programmed iPrevent(®) logic. Discrepant 10-year and residual lifetime risk estimates of >1 % were found for 1 and 4 cases, respectively, none was clinically significant (maximal variation 1.4 %). Risk management interventions suggested by iPrevent(®) were 100 % appropriate. iPrevent(®) successfully integrates the IBIS and BOADICEA risk assessment models into a decision support tool that provides evidence-based, risk-adapted risk management advice. This may help to facilitate precision breast cancer prevention discussions between women and their healthcare providers. PMID:26909793

  9. 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...

  10. 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.

  11. Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes

    PubMed Central

    Johansen Taber, Katherine A; Dickinson, Barry D

    2015-01-01

    Type 2 diabetes (T2D) is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D. PMID:25609992

  12. Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes.

    PubMed

    Johansen Taber, Katherine A; Dickinson, Barry D

    2015-01-01

    Type 2 diabetes (T2D) is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D.

  13. 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. The chapter…

  14. 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

  15. Preventing and managing dehydration.

    PubMed

    Suhayda, Rosemarie; Walton, Jane C

    2002-12-01

    Sufficient body water and electrolyte homeostasis are essential for healthy physiologic functioning. Nurses are key to preventing, detecting early, and treating fluid and electrolyte imbalances. Dehydration significantly alters both physical and psychological functioning, and older adults are at increased risk. Identifying fluid disorders early can prevent complications and reduce hospital stays. Understanding the mechanisms of fluid homeostasis enables nurses to assess, prevent, and collaborate in managing isotonic, hypertonic, and hypotonic dehydration.

  16. 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

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

    PubMed

    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

  18. [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.

  19. 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. PMID:21314051

  20. Occupational exposures to human immunodeficiency virus, hepatitis B virus, and hepatitis C virus: risk, prevention, and management.

    PubMed

    Cleveland, Jennifer L; Cardo, Denise M

    2003-10-01

    Current data indicate that the risk for transmitting bloodborne pathogens in dental health care settings is low. Pre-exposure hepatitis B vaccination and the use of standard precautions to prevent exposure to blood are the most effective strategies for preventing DHCP from occupational infection with HIV, HBV or HCV. Each dental health care facility should develop a comprehensive written program for preventing and managing occupational exposures to blood that: (1) describes the types of blood exposures that may place DHCP at risk for infection; (2) outlines procedures for promptly reporting and evaluating such exposures; and (3) identifies a health care professional who is qualified to provide counseling and perform all medical evaluations and procedures in accordance with the most current USPHS recommendations. Finally, resources should be available that permit rapid access to clinical care, testing, counseling, and PEP for exposed DHCP and the testing and counseling of source patients. PMID:14664459

  1. 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…

  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. 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. PMID:25591610

  4. 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.

  5. 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…

  6. 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

  7. 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.

  8. [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.

  9. [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. PMID:27276724

  10. [MEDICAL AND PREVENTIVE TECHNOLOGIES OF THE MANAGEMENT OF THE RISK OF HEALTH DISORDERS ASSOCIATED WITH EXPOSURE TO ADVERSE ENVIRONMENTAL FACTORS].

    PubMed

    Zaĭtseva, N V; Ustinova, O Iu; Zemlianova, M A

    2015-01-01

    It the article there are reported methodological approaches to the development of medical and preventive technologies for rendering specialized medical, diagnostic and preventive care to the population residing in polluted areas. There is proposed the classification of medical and preventive technologies of specialized care to the population with risk- associated pathologies based on principles of assessing the character and level of risk, etiopathogenetic regularities of the development of risk-associated pathological process and the extent of its clinical and laboratory manifestation. There were distinguished four groups of medical and preventive technologies having specific goals and tasks, there was determined the group targeting of the medical and preventive actions, the area of there application and forms of their implementation. There were presented the main directions of medical and preventive actions taken within the technologies applied to various groups.

  11. 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?

  12. 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? PMID:26978957

  13. Fungal Diseases: Ringworm Risk & Prevention

    MedlinePlus

    ... Foodborne, Waterborne, and Environmental Diseases Mycotic Diseases Branch Ringworm Risk & Prevention Recommend on Facebook Tweet Share Compartir Who gets ringworm? Ringworm is very common. Anyone can get ringworm, ...

  14. 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.

  15. 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.

  16. Preeclampsia prevention and management.

    PubMed

    Norwitz, E R; Repke, J T

    2000-01-01

    Preeclampsia is a multisystem disorder specific to pregnancy with a high maternal and perinatal morbidity and mortality. The cause of this disorder is unknown. Preeclampsia likely represents the clinical end point of multiple contributory factors, and it is unlikely that any single cause will be found. The blueprint for the development of preeclampsia is laid down early in pregnancy, and delivery of the fetus and placenta remains the only effective treatment. Efforts to prevent preeclampsia in women at high risk have been largely unsuccessful. Until the pathogenesis of preeclampsia is well defined, it is unlikely that effective preventive strategies will be developed. PMID:10732313

  17. 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

  18. 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.

  19. 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…

  20. Risk, HIV, and STD prevention.

    PubMed

    1999-06-01

    The risk of becoming infected with HIV and other sexually transmitted diseases (STDs) is discussed. The concept of risk is defined in three ways: the risk of exposure to an infectious agent, the risk of infection after exposure, and the risk of severe consequences after infection. Determining the most effective STD prevention intervention for a person involves assessing his or her beliefs regarding each type of risk and adapting the discussion of STD prevention accordingly. Preventive behavior questions should be phrased conditionally to indicate both use, and lack of use, of precautionary behaviors. This will aid a counselor's assessment of a client's beliefs and the resultant behavior. Some STDs, such as herpes simplex and chlamydia, are more common than HIV, increase susceptibility to HIV by two to six times, and should not be omitted from the discussion of risk of infection.

  1. Prevention of falls on the level in occupational situations: a major issue, a risk to be managed.

    PubMed

    Leclercq, Sylvie

    2002-01-01

    The terminology used to designate falls on the level is broadly based and the accidents concerned are only very rarely defined explicitly. A definition of falls on the level in occupational situations is therefore proposed. We attempt to define the issue represented by the prevention of such accidents on the basis of statistical data, prior to explaining the twin objectives focused on in the field of their prevention. We then propose a summary of unbalance risk factors in occupational situations. These factors are associated with different components of the occupational situation they concern: individuals, their tasks, the equipment used, or the working environment. The diversity of accident contexts and different in-company prevention possibilities are thereby highlighted. Finally, we discuss a number of consequences in prevention terms.

  2. 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.

  3. A Review of Multidisciplinary Clinical Practice Guidelines in Suicide Prevention: Toward an Emerging Standard in Suicide Risk Assessment and Management, Training and Practice

    PubMed Central

    Hom, Melanie A.; Roberts, Laura Weiss

    2014-01-01

    Objective 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. Methods 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. Results 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. Conclusions 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. PMID:25142247

  4. 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

  5. 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…

  6. Prevention Program Management. Trainer Manual.

    ERIC Educational Resources Information Center

    University Research Corp., Bethesda, MD.

    This training package, which centers on effective management and the operation of valid prevention programs, presents a five-day training experience designed to help managers of substance-abuse prevention programs. In this trainer manual, the introduction includes a list of course goals and objectives, a summary of the ten individual training…

  7. Prevention Program Management. Participant Manual.

    ERIC Educational Resources Information Center

    University Research Corp., Bethesda, MD.

    This training package, which centers on effective management and the operation of valid prevention programs, presents a five-day training experience designed to help managers of substance-abuse prevention programs. In this participant manual, the introduction includes a list of program goals and objectives and a summary of the ten individual…

  8. [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.

  9. Minimal intervention dentistry: part 3. Paediatric dental care--prevention and management protocols using caries risk assessment for infants and young children.

    PubMed

    Ramos-Gomez, F J; Crystal, Y O; Domejean, S; Featherstone, J D B

    2012-11-01

    Recent increases in caries prevalence in young children throughout the world highlight the need for a simple but effective infant oral care programme. This programme needs to include a medical disease prevention management model with an early establishment of a dental home and a treatment approach based on individual patient risk. This article presents an updated approach with practical forms and tools based on the principles of caries management by risk assessment, CAMBRA. This method will aid the general practitioner to develop and maintain a comprehensive protocol adequate for infant and young children oral care visits. Perinatal oral health is vitally important in preventing early childhood caries (ECC) in young children. Providing dental treatment to expectant mothers and their young children in a 'dual parallel track' is an effective innovative strategy and an efficient practice builder. It promotes prevention rather than intervention, and this may be the best way to achieve long-lasting oral health for young patients. General dental practice can adopt easy protocols that will promote early preventive visits and anticipatory guidance/counselling rather than waiting for the need for restorative treatment.

  10. 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.

  11. 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.

  12. 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

  13. Risk Management Plan

    SciTech Connect

    G. R. Stephenson

    2001-12-01

    The purpose of this Risk Management Plan (RMP) is to establish the concept and define the process to assure that National Nuclear Security Administration Nevada Operations Office Environmental Management (NNSA/NV EM) programs and projects incorporate appropriate, efficient, cost-effective measures to mitigate the impact of program-and/or project-related risks. In addition, it describes the roles and responsibilities of program personnel in performing the risk management functions, and defines reporting and tracking requirements for risk-related information. The product of this risk analysis will be a risk analysis report listing the various risks with their classification, mitigation and handling strategies, impact on cost and schedule, and action items. The risk management process will identify potential risk sources; assess individual risks and impacts on performance, cost, and schedule; evaluate alternative approaches to mitigate high and moderate risks; develop action plans to handle individual risks; and interface risks with other programs and/or projects. Risk management and risk assessment will be consistent with DOE Orders 430.1 and 413.3 and their associated guidance documentation. The RMP will remain valid for the life cycle of the program and/or projects and will be under configuration control with revisions to be conducted as required and approved.

  14. Risk perception in the U.K. oil and gas production industry: are expert loss-prevention managers' perceptions different from those of members of the public?

    PubMed

    Wright; Pearman; Yardley

    2000-10-01

    This article investigates potential differences in risk perception between experts (loss-prevention managers in the U.K. oil and gas production industry) and nonexperts (managers and students). Extant research on expert versus nonexpert perceptions of risk is reviewed, followed by the present study concerning risk perceptions of seven pen-picture scenarios involving the occurrence of hazardous events in the U.K. oil and gas production industry. In contrast to many of the earlier studies of expert versus nonexpert perceptions of risk, the present analysis concludes that experts did not judge the overall riskiness of the portrayed hazardous events as less risky than the nonexperts. Nevertheless, the experts believe more strongly than our nonexperts that the risks portrayed in the scenarios pose little threat to future generations, are more precisely known, and are relatively controllable. Use of multiple regression analysis to help uncover the basis of overall riskiness assessments for expert and lay respondents was inconclusive, however. Finally, little evidence was found that nonexperts were any more heterogeneous in their risk perceptions than experts. It may be that the nature of the risks assessed in the present study may account for the general lack of clear expert versus nonexpert differences in overall perceptions of the riskiness of hazardous events in the North Sea. Earlier findings of strong expert versus nonexpert differences in risk perception assessed hazards of major public concern. It is inferred that using such extreme hazards may have resulted in an exaggerated view of differences in expert versus public (nonexpert) perception of risk.

  15. Identifying and Managing Risk.

    ERIC Educational Resources Information Center

    Abraham, Janice M.

    1999-01-01

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

  16. Risk appraisal and HIV prevention.

    PubMed

    Odets, W

    1996-09-01

    Previous HIV prevention efforts, particularly for gay men, focused largely on the elimination of risk through condom use or abstinence. However, as evidenced by current levels of new HIV seroconversions, gay men are still practicing unprotected anal sex. Many public health officials previously attributed this behavior to continued ignorance, chemically-induced impairment, malice, or psychopathology. Evidence now demonstrates that these factors have had little influence on risky behaviors. Researchers are finding that what is absent from the risk elimination strategy are the feelings about trust, intimacy, and sexual communication. Exercising harm reduction approaches that weigh the relative value of the activity and the costs of taking the risks is a better strategy. Client-centered counseling is a key means of facilitating this harm reduction approach. Designed to address some of the psychosocial issues, client-centered counseling takes into account an individual's experience of the risks and benefits involved, and allows the client to weigh personal values against potential risks. However, the strategy can be flawed when educators are not properly trained. Counselors and educators may find client-centered approaches uncomfortable if they have not examined their own value systems. Respect for clients, their values, and their efforts are necessary for effective client-centered counseling.

  17. 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…

  18. 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.

  19. 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. PMID:23477199

  20. Osteoporosis: Prevention and Management Strategies

    PubMed Central

    Evers, Susan; Myers, Anita

    1987-01-01

    Osteoporosis is a major cause of morbidity in post-menopausal women. Strategies to prevent or delay bone loss in normal post-menopausal women and to reduce the risk of fractures in women with osteoporosis are within the scope of family practice. Certain factors, such as inadequate calcium intake, estrogen deficiency, cigarette smoking and lack of physical activity can be modified in peri- and post-menopausal women. For patients with osteoporosis, there is potential for lowering the risk of fractures by means of calcium supplements or other therapies, physical training and rehabilitation, and modification of factors associated with risk of falling. PMID:21267348

  1. 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

  2. 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,…

  3. Preventing and managing pediatric obesity

    PubMed Central

    Plourde, Gilles

    2006-01-01

    OBJECTIVE To review the evidence on prevention and management of childhood obesity and to offer suggestions for family physicians. QUALITY OF EVIDENCE Articles were obtained from a PubMed search. Most studies on pediatric obesity provide level II evidence. There are some level I studies on management. MAIN MESSAGE Pediatric obesity is underdiagnosed and undertreated. Prevention should be initiated as early as pregnancy. Prevention and treatment approaches should include patient and family interventions focusing on nutrition, physical activity, reduced television viewing, and behaviour modification. The effectiveness of such interventions by primary care physicians has not been totally demonstrated, but incorporating them into clinical practice routines is likely to be beneficial. CONCLUSION Family physicians have a role in promoting preventive measures and identifying and treating obesity-related comorbidity. Pediatric obesity is not an individual child’s problem, but a problem that involves the whole family and the community. Recommending a healthy diet and increased physical activity and counseling families on behaviour change is the best approach to preventing and managing childhood obesity. PMID:16572577

  4. 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

  5. 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

  6. Risk Management: Defusing the Dragon.

    ERIC Educational Resources Information Center

    Ewert, Alan; Boone, Timothy

    1987-01-01

    Discusses risk-management planning from the perspectives of the current state of risk-management, assumption of risk defense, participant and public attitudes, and specific techniques for constructing a risk-management plan. Offers practical suggestions for limiting risk and liability. Provides sample assumption of risk/liability release form.…

  7. 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.

  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. 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. PMID:26630296

  10. Managing risk at Hanford

    SciTech Connect

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

    1994-03-01

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

  11. Drug-induced QT interval prolongation and torsades de pointes: Role of the pharmacist in risk assessment, prevention and management.

    PubMed

    Tisdale, James E

    2016-05-01

    Torsades de pointes (TdP) is a life-threatening arrhythmia associated with prolongation of the corrected QT (QTc) interval on the electrocardiogram. More than 100 drugs available in Canada, including widely used antibiotics, antidepressants, cardiovascular drugs and many others, may cause QTc interval prolongation and TdP. Risk factors for TdP include QTc interval >500 ms, increase in QTc interval ≥60 ms from the pretreatment value, advanced age, female sex, acute myocardial infarction, heart failure with reduced ejection fraction, hypokalemia, hypomagnesemia, hypocalcemia, bradycardia, treatment with diuretics and elevated plasma concentrations of QTc interval-prolonging drugs due to drug interactions, inadequate dose adjustment of renally eliminated drugs in patients with kidney disease and rapid intravenous administration. Pharmacokinetic drug interactions associated with the highest risk of TdP include antifungal agents, macrolide antibiotics (except azithromycin) and drugs to treat human immunodeficiency virus interacting with amiodarone, disopyramide, dofetilide or pimozide. Other important pharmacokinetic interactions include antidepressants (bupropion, duloxetine, fluoxetine, paroxetine) interacting with flecainide, quinidine or thioridazine. Pharmacists play an important role in minimizing the risk of drug-induced QTc interval prolongation and TdP through knowledge of drugs that are associated with a known or possible risk of TdP, individualized assessment of risk of drug-induced QTc interval prolongation, awareness of drug interactions most likely to result in TdP and attention to dose reduction of renally eliminated QTc interval-prolonging drugs in patients with kidney disease. Treatment of hemodynamically stable TdP consists of discontinuation of the offending drug(s), correction of electrolyte abnormalities and administration of intravenous magnesium sulfate 1 to 2 g. PMID:27212965

  12. Children's Aquatics: Managing the Risk.

    ERIC Educational Resources Information Center

    Langendorfer, Stephen; And Others

    1989-01-01

    This article identifies the major risks faced by young children in aquatic programs, outlines several methods for managing risk factors, and discusses the steps involved in implementing a risk-management system. (IAH)

  13. 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

  14. 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.

  15. 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.

  16. Airway fires during surgery: Management and prevention

    PubMed Central

    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. PMID:27006554

  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. PMID:27006554

  18. 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.

  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. Prematurity prevention: who is at risk?

    PubMed

    Garbaciak, J A

    1992-06-01

    Previous preterm birth, previous preterm labor, regular uterine activity, uterine distention, and preterm cervical change are factors that are most often present in patients treated for preterm labor or in patients delivered prematurely. In addition to their frequency, their severity is also the highest in terms of patient risk. These factors usually are easily identified, and an appropriate management plan can be implemented to decrease the incidence of preterm births or to at least increase the fetal time in utero. Antenatal bleeding, chronic urinary tract infections, smoking, and maternal age are also associated with preterm labor. Although these factors are not present as often, they have the potential to precipitate preterm labor and preterm delivery. When they are identified, it is necessary to utilize the appropriate therapeutic measures commensurate to the number and/or the degree of the risk factors. Vaginal microbiology, maternal hematocrit, substance abuse, and coitus are factors that are undergoing active investigation in regards to precipitating preterm birth. They are frequently seen in normal pregnancies, but recently have been associated with a greater likelihood for preterm labor and preterm birth. Unequivocal evidence of this association is currently unavailable; however, more and more investigations are reporting a significant association of these factors with preterm births. The relative degree of risk and the optimal management plans for dealing with these factors also await further definition and refinement. We know that there is no surveillance technique, or combination of techniques, that will identify all patients who will eventually deliver preterm. In many reports, despite the diligent attention to many of the earlier-mentioned risk factors, almost two of three patients who have delivered preterm had no easily identified risk factor. In addition, many patients delivered preterm report no perception of uterine activity (Garbaciak JA, Desch

  1. Management and Prevention of Dystocia.

    PubMed

    Funnell, Bethany J; Hilton, W Mark

    2016-07-01

    Dystocia is an inevitable challenge in the livestock industries, particularly with primiparous female animals. Prevention and appropriate management will decrease cow and calf morbidity and mortality, which will improve the economic status of the beef or dairy operation. Early identification and proper intervention improves outcomes, and the use of selection tools to decrease the potential for dystocia will have positive returns. Assisted reproductive technologies present a unique set of challenges to the calving process that both the producer and practitioner should be prepared to address. PMID:27324453

  2. [Preventing cardiovascular risk in miners].

    PubMed

    Lipatova, L V; Izmailova, O A

    2016-01-01

    The article presents results concerning usage of intravenous laser radiation of blood in miners with cardiovascular diseases. After cardiovascular state assessment, the miners at high cardiovascular risk were subjected to prophylactic procedures with traditional medical treatment added by intravenous laser therapy. Findings are anti-arrhythmic, antihypertensive, antiatherogenic and anti-aggregation effects of complex treatment with intravenous laser radiation of blood in miners at high cardiovascular risk and its subsequent decrease due to treatment. PMID:27265943

  3. Preventing and managing skin tears: a review.

    PubMed

    Roberts, Mary J

    2007-01-01

    Skin tears are an increasingly common problem in frail elders, and the wound, ostomy, and continence (WOC) nurse must be knowledgeable regarding both prevention and management of these lesions. A literature review was conducted to identify current concepts regarding management of skin tears. Articles reviewed provided numerous suggested interventions and protocols. Recurring themes were prevention of skin tears whenever possible and management of existing lesions with products that manage the exudate, maintain a moist surface, and prevent additional trauma.

  4. 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

  5. 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.

  6. 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,…

  7. 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).

  8. 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.

  9. 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.

  10. 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.

  11. [Evaluation of operating theatre for the risk prevention].

    PubMed

    Torregrossa, M V; Trapani, S; Cardinale, A E

    2008-01-01

    In this study we analyse factors that predispose to risk and we value the importance of quality and reliability into operating theatre. Patient safety result from ability to plan and manage organizations able to reduce probability of mistakes (Prevention) and to recover and contain their consequences (Protection). The principal motives of mistakes are: - deficiency of sharing procedures between different professional figures for risk prevention; - deficiency of an effective integration between professional figures in operating theatre; - deficiency of charitable precise run to guarantee the continuity of interventions on patient. A risk management program have to take care on this sentinel events and to set up a survey-information system to characterize risks and correction strategies. To prevent patient change, wrong side identification, not working devices or deficiency of surgery materials, it would be useful for operating theatre figures and for anesthetists to work out all together a procedure for admission in operating theatre and a pre-operating check list. The best way to carry out a safety and quality attendance based on standardized procedures and protocols, is to set up risk management firm units. It is necessary to activate and to adjust survey system and effective management training. PMID:18693402

  12. [Risk management in dentistry].

    PubMed

    Admiraal, W J

    1993-01-01

    Riskmanagement means the prevention of all accidental damages, prevention of claims in general and prevention of paying excessive insurance premiums. The main objective of riskmanagement is promotion of quality care. The riskmanagement rules are presented and discussed.

  13. Management and Prevention of Anaphylaxis.

    PubMed

    Irani, Anne-Marie; Akl, Elias G

    2015-01-01

    Anaphylaxis prevalence has increased within the last few years. This may be due to a marked increase in allergic sensitization to foods especially in the pediatric population, as well as to an increase in outdoor recreational habits and the availability of new biologic medications.  Furthermore, guidelines for the diagnosis of anaphylaxis have been published, thus facilitating the recognition of this disorder. Diagnosis of anaphylaxis is mainly based on history and clinical criteria of organ system involvement. The serum tryptase assay is now commercially available and may be a helpful diagnostic tool in certain clinical situations involving hypotension, but not in the context of food-induced anaphylaxis. Treatment of anaphylaxis mainly involves the use of epinephrine as a first line medication for severe manifestations followed by  symptomatic management of specific  symptoms, such as antihistamines for urticaria and albuterol for wheezing. Although commonly practiced, treatment with systemic corticosteroids  is not supported by evidence-based literature. Observation in a medical facility for 4-6 hours is recommended to monitor for late phase reactions, although these rarely occur. Education is an essential component of management of a patient with a previous history of anaphylaxis, emphasizing early use of epinephrine and providing a written action plan. Referral to a board-certified allergist/immunologist is recommended to determine  the cause of the anaphylaxis as well as to rule out other potential conditions. In this review, our main focus will be on the treatment and prevention of anaphylaxis while providing our readers with a brief introduction to the diagnosis of anaphylaxis, its prevalence and its most common causes. PMID:26918144

  14. Management and Prevention of Anaphylaxis

    PubMed Central

    Irani, Anne-Marie; Akl, Elias G.

    2015-01-01

    Anaphylaxis prevalence has increased within the last few years. This may be due to a marked increase in allergic sensitization to foods especially in the pediatric population, as well as to an increase in outdoor recreational habits and the availability of new biologic medications.  Furthermore, guidelines for the diagnosis of anaphylaxis have been published, thus facilitating the recognition of this disorder. Diagnosis of anaphylaxis is mainly based on history and clinical criteria of organ system involvement. The serum tryptase assay is now commercially available and may be a helpful diagnostic tool in certain clinical situations involving hypotension, but not in the context of food-induced anaphylaxis. Treatment of anaphylaxis mainly involves the use of epinephrine as a first line medication for severe manifestations followed by  symptomatic management of specific  symptoms, such as antihistamines for urticaria and albuterol for wheezing. Although commonly practiced, treatment with systemic corticosteroids  is not supported by evidence-based literature. Observation in a medical facility for 4-6 hours is recommended to monitor for late phase reactions, although these rarely occur. Education is an essential component of management of a patient with a previous history of anaphylaxis, emphasizing early use of epinephrine and providing a written action plan. Referral to a board-certified allergist/immunologist is recommended to determine  the cause of the anaphylaxis as well as to rule out other potential conditions. In this review, our main focus will be on the treatment and prevention of anaphylaxis while providing our readers with a brief introduction to the diagnosis of anaphylaxis, its prevalence and its most common causes. PMID:26918144

  15. Management and prevention of gingival recession.

    PubMed

    Merijohn, George K

    2016-06-01

    Gingival recession is highly prevalent worldwide. It increases the risk for root caries and can interfere with patient comfort, function and esthetics. Progressive gingival recession also increases the risk of tooth loss secondary to clinical attachment loss. Although mitigating the causes of gingival recession decreases its incidence and severity, implementing practical management and prevention strategies in the clinical setting can be challenging. Identification of susceptible patients and evaluating them for the presence of modifiable risk exposures are essential first steps in developing action plans for appropriate interventions. This article reviews these steps and introduces chairside tools that can help in the selection of interventions designed to reduce the risk of future gingival recession and may also facilitate patient communication. Practical decision-making criteria are proposed for when and how to monitor gingival recession, for deciding when a patient is a candidate for surgical evaluation or referral to a periodontist, and, if surgery is the treatment of choice, what should be considered as key surgical outcome objectives. PMID:27045439

  16. 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.

  17. Risk Assessment/Management Tool

    2010-12-31

    RAMTool performs the following: • A tool to perform facility and programmatic risk assessments, produce risk registers, develop risk management plans (RMPs), link risks to improvement/risk-reduction projects, and actively manage risks • Ability to conduct risk assessments. Ease of determination of probability and consequence based on industry standard risk matrices. Complies with site risk management performance document. Provides multiple outputs/report for required risk forms. Conduct quick risk data analysis. • Performs/calculates a facility risk factormore » (RF) and a programmatic RF. Supports project and initiative prioritization and funding in order to make solid decisions on risk reduction. Assigns responsibility and accountability at a risk owner (RO) level. Monitors and tracks progress toward completing mitigation strategies. Ability to import massive amounts of data at the push of a button. Integrates development of a Risk Management Plan (RMP) Built for ease-of-use – design, built, and used by technical/management personnel. Can be customized (functions and/or reports) for further analysis« less

  18. Risk Assessment/Management Tool

    SciTech Connect

    Carlos Castillo, Jerel Nelson

    2010-12-31

    RAMTool performs the following: • A tool to perform facility and programmatic risk assessments, produce risk registers, develop risk management plans (RMPs), link risks to improvement/risk-reduction projects, and actively manage risks • Ability to conduct risk assessments. Ease of determination of probability and consequence based on industry standard risk matrices. Complies with site risk management performance document. Provides multiple outputs/report for required risk forms. Conduct quick risk data analysis. • Performs/calculates a facility risk factor (RF) and a programmatic RF. Supports project and initiative prioritization and funding in order to make solid decisions on risk reduction. Assigns responsibility and accountability at a risk owner (RO) level. Monitors and tracks progress toward completing mitigation strategies. Ability to import massive amounts of data at the push of a button. Integrates development of a Risk Management Plan (RMP) Built for ease-of-use – design, built, and used by technical/management personnel. Can be customized (functions and/or reports) for further analysis

  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. 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

  1. Childhood myopia: epidemiology, risk factors, and prevention.

    PubMed

    Recko, Matthew; Stahl, Erin Durrie

    2015-01-01

    Our understanding of the dynamic interaction between the eye's growth and its ability to adapt to maintain vision has shown that childhood myopia is a significant prediction of progressive myopia and the potentially severe ocular comorbidities associated with it. It is important for us to better understand this process and its risk factors in order to better develop a prevention and treatment strategy. This article will discuss the epidemiology, risk factors and current therapeutic regimens for reducing myopic progression. PMID:25958656

  2. 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…

  3. Strengthening bioterrorism prevention: global biological materials management.

    PubMed

    Salerno, Reynolds M; Hickok, Lauren T

    2007-06-01

    The anthrax attacks of 2001 demonstrated that bioterrorism poses a significant threat to U.S. national security. This threat is increasing as a result of the rapid expansion in scale and technical capabilities of the global biotechnology industry, which is broadening the availability of materials, technologies, and expertise needed to produce a biological weapon and is lowering the barriers to biological weapons terrorism and proliferation. At the same time, there has been a rise of sophisticated yet loosely networked transnational terrorist groups that have shown an interest in bioterrorism. The United States must confront this convergence. Although the U.S. government pursues many different biodefense programs to bolster its ability to detect and respond to a bioterrorist attack, these efforts must be augmented with preventive measures to meet today's international challenges. U.S. Homeland Security Presidential Directive 10 of April 2004 defines "Prevention and Protection" as one of the four essential pillars of the U.S. response to the bioterrorist threat. However, while bioscience and policy experts have proposed a variety of preventive initiatives, the creation of such programs has been slow and limited. Global biological materials management, which would focus on identifying and protecting those biological materials at the greatest risk of being used maliciously, is one potential solution. Such an approach would augment current U.S. biodefense efforts, provide the international community an effective means of mitigating the global threat of bioterrorism, and strengthen the international community's battle against emerging infectious disease.

  4. Strengthening bioterrorism prevention: global biological materials management.

    PubMed

    Salerno, Reynolds M; Hickok, Lauren T

    2007-06-01

    The anthrax attacks of 2001 demonstrated that bioterrorism poses a significant threat to U.S. national security. This threat is increasing as a result of the rapid expansion in scale and technical capabilities of the global biotechnology industry, which is broadening the availability of materials, technologies, and expertise needed to produce a biological weapon and is lowering the barriers to biological weapons terrorism and proliferation. At the same time, there has been a rise of sophisticated yet loosely networked transnational terrorist groups that have shown an interest in bioterrorism. The United States must confront this convergence. Although the U.S. government pursues many different biodefense programs to bolster its ability to detect and respond to a bioterrorist attack, these efforts must be augmented with preventive measures to meet today's international challenges. U.S. Homeland Security Presidential Directive 10 of April 2004 defines "Prevention and Protection" as one of the four essential pillars of the U.S. response to the bioterrorist threat. However, while bioscience and policy experts have proposed a variety of preventive initiatives, the creation of such programs has been slow and limited. Global biological materials management, which would focus on identifying and protecting those biological materials at the greatest risk of being used maliciously, is one potential solution. Such an approach would augment current U.S. biodefense efforts, provide the international community an effective means of mitigating the global threat of bioterrorism, and strengthen the international community's battle against emerging infectious disease. PMID:17608597

  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. 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.

  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. 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

  9. 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.

  10. Is risk management necessary?

    PubMed

    Dingwall, R; Fenn, P

    1991-01-01

    During the last 25 years, medical negligence claims in the United Kingdom have become increasingly frequent and problematical. In 1990, the Department of Health announced that district health authorities would assume vicarious liability for negligent acts by doctors in the course of their work for the National Health Service. A study of claims closed in the region covered by one Regional Health Authority shows that over a five-year period there were 7.8 claims per 100,000 population, levels in some other Regions ranging from 4.5 to 20.5 claims per 100,000, with a progressive increase. Obstetrics/Gynaecology and Anaesthetics are prominent areas for claims. It has been suggested that by the mid 1990s some 12% of the United Kingdom's National Health Service Budget might be absorbed in indemnity payments. Negligence litigation provides signals to health care providers about where they should invest in risk reduction rather than in bearing the cost of successful claims. At the national level it can be of value to create computerized data bases' of medical mishaps. Among the various types of activity which seem more practicable and worth exploring at the local level are the positive development of a "culture of safety" in health care, the creation of risk management teams to examine and document medical misadventure, and the establishment of health care organizations which do not feel threatened by their failures but which can respond in a caring, compassionate and concerned fashion to patients' distress and deal fairly with economic losses. PMID:23511861

  11. 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.

  12. [Occupational risk management: prognosis, causation and bioinformational technologies].

    PubMed

    Denisov, E I; Prokopenko, L V; Stepanov, I V

    2012-01-01

    Methodology of occupational risk management is outlined based on workers' health disorders forecast and causation (work-relatedness assessment). It originates from Labour Code of Russian Federation prescriptions and includes principles, methods and criteria of risk management and risk communication. The methodology is realized by means of bioinformational technologies as expert and analytical system in the form of interactive Web-based directory "occupational risk assessment" for practical use for occupational risk prevention.

  13. 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.

  14. 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. PMID:21506198

  15. 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. PMID:23274816

  16. Reducing Stress through Preventive Management.

    ERIC Educational Resources Information Center

    Quick, James C.; Quick, Jonathan D.

    1979-01-01

    Two levels of prevention can be used to counter the key stressors of personnel at work; the first deals with organizational techniques and the second with individual techniques such as systematic desensitization, biofeedback, or aerobic exercise. (Author)

  17. MORT (Management Oversight and Risk Tree) based risk management

    SciTech Connect

    Briscoe, G.J.

    1990-02-01

    Risk Management is the optimization of safety programs. This requires a formal systems approach to hazards identification, risk quantification, and resource allocation/risk acceptance as opposed to case-by-case decisions. The Management Oversight and Risk Tree (MORT) has gained wide acceptance as a comprehensive formal systems approach covering all aspects of risk management. It (MORT) is a comprehensive analytical procedure that provides a disciplined method for determining the causes and contributing factors of major accidents. Alternatively, it serves as a tool to evaluate the quality of an existing safety system. While similar in many respects to fault tree analysis, MORT is more generalized and presents over 1500 specific elements of an ideal ''universal'' management program for optimizing occupational safety.

  18. The NASA Risk Management Program

    NASA Technical Reports Server (NTRS)

    Buchbinder, Benjamin

    1990-01-01

    This paper describes the NASA Risk Management Program established by the Headquarters Office of Safety and Mission Quality (MSQ). Current agency policy is outlined, risk management assistance to the field is described, and examples are given of independent risk assessments conducted by SMQ. The motivation for and the structure of the program is placed in the historical context of pre- and post-Challenger environments.

  19. Managing risk in software systems

    SciTech Connect

    Fletcher, S.K.; Jansma, R.M.; Murphy, M.D.

    1995-07-01

    A methodology for risk management in the design of software systems is presented. It spans security, safety, and correct operation of software within the context of its environment, and produces a risk analysis and documented risk management strategy. It is designed to be iteratively applied, to attain appropriate levels of detail throughout the analysis. The methodology and supporting tools are discussed. The methodology is critiqued relative to other research in the field. Some sample applications of the methodology are presented.

  20. Legionnaires' disease--risk management.

    PubMed

    Mount, Steve

    2012-10-01

    Steve Mount, an independent Legionella management consultant and trainer with over 25 years' previous experience in microbiology and UKAS-accredited Legionella analysis, underlines the rising number of nosocomial cases of Legionnaires' disease in recent years, and explains the key risk assessment, management, and monitoring steps that must be taken by those responsible for hospital water systems to comply with legislation governing the 'control and management' of Legionella risk.

  1. Radiation induced cancer: risk assessment and prevention

    SciTech Connect

    Shore, R.E.

    1984-01-01

    A number of factors have to be considered in defining the cancer risk from ionizing radiation. These include the radiation sensitivity of the target tissue(s), the temporal pattern of risk, the shape of the dose-incidence curve, the effects of low dose rates, host susceptibility factors, and synergism with other environmental exposures. For the population as a whole the largest sources of radiation exposure are natural background radiation and medical/dental radiation. Radiation exposures in the medical field make up the largest volume of occupational exposures as well. Although new technologies offer opportunities to lower exposures, worker training, careful exposure monitoring with remedial feedback, and monitoring to prevent unnecessary radiodiagnostic procedures may be even more important means of reducing radiation exposure. Screening of irradiated populations can serve a useful preventive function, but only for those who have received very high doses.

  2. 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. PMID:26382999

  3. 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.

  4. 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.

  5. 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

  6. 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...

  7. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 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...

  8. [Efficient risk management].

    PubMed

    Admiraal, W J

    1991-10-01

    Probably dentists will be sued more and more by patients because of errors. An adequate professionalism, good social abilities, some juridic knowledge and a comprehensive administration are the tools to prevent loss of money and psychological problems.

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

    PubMed

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

    2014-03-01

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

  10. 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

  11. Postoperative infections: prevention and management.

    PubMed

    Gaston, R Glenn; Kuremsky, Marshall A

    2010-05-01

    Postoperative infections continue to be a challenging problem. The incidence of bacterial antibiotic resistance such as methicillin-resistant Staphylococcus aureus is rising. There are numerous intrinsic patient factors that should be optimized before surgery to minimize the risk of surgical site infections. When postoperative infections develop, treatment must be individualized. This article outlines the principles that can help guide treatment.

  12. How to measure and to manage the risk of stroke.

    PubMed

    Sterzi, R; Vidale, S

    2006-06-01

    Several risk factors for stroke have been identified. Some of them can be modified through pharmacological or non-pharmacological interventions. The presence of multiple risk factors has a factorial effect. Total risk estimation can be categorised into high, intermediate and low risk. However prevention should be considered as a continuum from low to high risk. Risk management strategies can be addressed to high-risk individuals and to populations. The more efficient and cost-effective strategies combine the two approaches. A number of tools for estimating risk of coronary heart disease or other atherosclerotic diseases have been developed, including risk score charts, risk assessment algorithms and computer software programmes. The Italian Guidelines for Stroke Prevention and Management, along with statements on pharmacological approach, provide recommendations concerning correct lifestyles to decrease stroke incidence and mortality in the entire population, but especially in subjects at high risk of vascular diseases.

  13. 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…

  14. Fixing responsibility for risk management.

    PubMed

    Maniccia, M D

    2000-01-01

    The responsibility for carrying financial risk for medical coverage has migrated from individuals to insurers to employers to providers, without finding a satisfactory home. Each shift further complicates the health care infrastructure, as other responsibilities in the management of benefits and provision of care gravitate to the stakeholder who accepts risk. The social imperative to broaden coverage is forcing a change in the mechanisms of risk management--from avoiding high-risk patients, to managing those patients to better outcomes. In this paper we seek to identify objectively the most appropriate party to carry the financial risk of medical coverage, consider what characteristics are necessary to make that a practical and enduring solution, and examine the secondary effects of the structure required to support that solution.

  15. Human Research Risk Management

    NASA Video Gallery

    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...

  16. 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.

  17. 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

  18. 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

  19. [AIDS: patients' rights, professional risks, preventive measures].

    PubMed

    Dionne-Proulx, J

    1994-11-01

    AIDS in the workplace poses distinct professional risks to health care providers. Identifying HIV carriers and providing specific preventive measures are not the only concerns. Societal prejudices that degenerate into attitudes and behaviors contrary to professional ethics can overwhelm nursing personnel. Their fears can lead them to make irrational decisions such as refusing to care for the client or divulging private information. The author emphasizes that nurses caring for clients with HIV or AIDS should develop a care approach based on two pivotal points. The first point is that nurses must ensure these clients receive appropriate care and that their fundamental rights are maintained. Secondly, nurses must be permitted to provide necessary care without exposing themselves to any associated health risk. The author asserts that nurses must count on complete, clear and accurate information about professional risks and preventative measures. She outlines the legal framework Canadian nurses can access and explains the legal protection available to health care providers. The development of clear and precise workplace policies based on provincial and federal laws can reduce crisis situations, workplace conflict and discrimination.

  20. [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.

  1. [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. PMID:24941785

  2. [Prevention programs of risk factors for falls].

    PubMed

    Kumagai, Shuzo; Sakita, Masahiro

    2014-10-01

    Approximately 17% of Japanese older people fall for a year. The femoral neck fractures with falls caused by various functional problems make them depress remarkably activities of daily living and quality of life. In risk factors for falls in old people, muscle weakness, balance and gait disorders particularly increases to falls. The major results from recent systematic reviews have indicated that interventions of exercise, multifactorial, environmental modification and gradual withdrawal of psychotropic medication in community-dwelling elderly people were effective for preventing falls. Regarding the older people in hospitals and sanatoriums, it appeared that comprehensive multifactorial interventions and vitamin D supplementation could be effective in falls rather than exercises intervention only. However, the short period of the exercise intervention may affect ineffectiveness in preventing falls.

  3. Cardiovascular risk stratification and management in pre-diabetes.

    PubMed

    Færch, Kristine; Vistisen, Dorte; Johansen, Nanna Borup; Jørgensen, Marit Eika

    2014-06-01

    Prediabetes, covering individuals with impaired fasting glycemia, impaired glucose tolerance, or high-risk HbA1c levels, is associated with a ∼20 % increased risk of developing cardiovascular disease (CVD) compared with normoglycemic individuals. It is well-known that lifestyle or pharmacologic interventions can prevent diabetes in prediabetic people; however, the evidence is less clear regarding prevention of CVD. Most diabetes prevention trials have failed to show beneficial effects on CVD morbidity and mortality despite significant improvements of CVD risk factors in individuals with prediabetes. Another challenge is how to estimate CVD risk in prediabetic people. In general, prediction models for CVD do not take glucose levels or prediabetes status into account, thereby underestimating CVD risk in these high-risk individuals. More evidence within risk stratification and management of CVD risk in prediabetes is needed in order to recommend useful and effective strategies for early prevention of CVD.

  4. [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.

  5. [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. PMID:24034760

  6. 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

  7. Frostbite: prevention and initial management.

    PubMed

    Zafren, Ken

    2013-03-01

    Frostbite is a local freezing injury that can cause tissue loss. Historically, it has been a disease of wars, but it is a hazard for anyone who ventures outdoors in cold weather. Frozen tissue is damaged both during freezing and rewarming. Frozen tissue is numb. Rewarming causes hyperemia and is often painful. Blisters and edema develop after rewarming. Hard eschar may form with healthy tissue deep to the eschar. Frostbite can be classified as superficial, without permanent tissue loss, or deep, with varying degrees of permanent tissue loss, often less than appearances suggest. It can be difficult to predict the amount of tissue loss at the time of presentation and early in the subsequent course. Prevention is better than treatment. It may be advisable not to rewarm frozen extremities in the field, but spontaneous thawing is often unavoidable. Extremities that have thawed should be protected from refreezing at all costs. Once in a protected environment, extremities that are still frozen should be rapidly thawed in warm water. Therapy with aspirin or ibuprofen may be helpful, but evidence is limited. Thrombolytic treatment within the first 24 hours after rewarming seems to be beneficial in some cases of severe frostbite. Prostacyclin therapy is very promising. PMID:23537254

  8. Preventing amputation in adults with diabetes: identifying the risks.

    PubMed

    Thomas, Eleanor

    2015-06-01

    Good management of diabetes can reduce the risk of complications of the disease. When not well managed, diabetes is associated with the complications of heart disease, stroke, blindness, kidney disease and amputations. Diabetes can reduce the blood supply to the feet and cause a loss of feeling. As a result, foot injuries do not heal well and the person may not realise that their foot is sore or injured. Damage to the foot may lead to the development of foot ulcers, which if left untreated may result in amputation of the limb. Preventive care is a priority, but when complications occur the next step is to halt progression. Therefore, effective foot care and timely treatment of foot ulcers are important in preserving foot function and mobility, and preventing amputation in adults with diabetes.

  9. Preventing amputation in adults with diabetes: identifying the risks.

    PubMed

    Thomas, Eleanor

    2015-06-01

    Good management of diabetes can reduce the risk of complications of the disease. When not well managed, diabetes is associated with the complications of heart disease, stroke, blindness, kidney disease and amputations. Diabetes can reduce the blood supply to the feet and cause a loss of feeling. As a result, foot injuries do not heal well and the person may not realise that their foot is sore or injured. Damage to the foot may lead to the development of foot ulcers, which if left untreated may result in amputation of the limb. Preventive care is a priority, but when complications occur the next step is to halt progression. Therefore, effective foot care and timely treatment of foot ulcers are important in preserving foot function and mobility, and preventing amputation in adults with diabetes. PMID:26036406

  10. Role of LEPCs in risk management and risk communication

    SciTech Connect

    Mannan, M.

    1995-12-31

    Under Section 112(r) of Title III of the Clean Air Act Amendments, the US Environmental Protection Agency (EPA) is required to develop regulations that would require development and implementation of risk management programs at facilities that manufacture, process, use, store, or otherwise handle regulated substances in quantities that exceed specified threshold quantities. On January 31, 1994, EPA published the final rule establishing the List of Regulated Substances and Thresholds for Accidental Release Prevention. The proposed rule will require covered facilities to develop and implement a risk management program. The proposed rule will also require facilities to communicate various information to the local emergency planning committee (LEPC). This information may be provided in the form of consultation and communication during the development of various elements of the risk management program and/or by providing access to the risk management plan (RMP). These requirements not only place an additional regulatory burden on facilities but also create the need for the LEPCs to start planning for strategies to deal with significant amount of technical information in a meaningful and effective manner. This paper presents a summary of EPA`s proposed rule, the role of LEPCs in the implementation of many aspects of the rule, and a description of the potential contents of an RMP. Covered facilities as well as the LEPCs may gain a significant advantage by engaging in early dialogue and proactive education to determine mutual needs.

  11. Caries management by risk assessment.

    PubMed

    Young, Douglas A; Featherstone, John D B

    2013-02-01

    Caries disease is multifactorial. Whether caries disease will be expressed and damage dental hard tissue is dependent on the patient's own unique make-up of pathogenic risk factors and protective factors. Objectives This manuscript will review the science of managing caries disease based on assessing caries risk. Methods The caries balance/imbalance model and a practical caries risk assessment procedure for patients aged 6 years through adult will illustrate how treatment options can be based on caries risk. Results Neither the forms nor the clinical protocols are meant to imply there is currently only one correct way this can be achieved, rather are used in this manuscript as examples only. Conclusions It is important to have the forms and protocols simple and easy to understand when implementing caries management by risk assessment into clinical practice. The science of CAMBRA based on the caries balance/imbalance model was reviewed and an example protocol was presented.

  12. 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…

  13. 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

  14. [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.

  15. 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

  16. Risk management or political micromanagement?

    PubMed

    Barton, E L

    1991-04-01

    A major healthcare issue of the 1990s is whether providers will create effective risk management programs to cope with government reform mandates or whether an increasingly costly and complex regulatory structure will force them to make changes. Compliance with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards on patient care will become increasingly important to healthcare risk management in the 1990s. The JCAHO standards create a benchmark from which government entities set their present standards and assemble agendas for the future. Another healthcare risk management factor is compliance with the National Practitioner Data Bank. The data bank is intended to protect healthcare consumers from providers who have demonstrated a tendency to commit malpractice. However, the data bank could cause problems for healthcare providers: Inaccurate or misleading data could unfairly haunt them. Healthcare risk managers should be familiar with the prohibitions on patient dumping found in the Consolidated Omnibus Budget Reconciliation Act of 1985. The amendments of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) do not create strict liability, nor do they impose traditional tort standards that could guide courts in cases that will inevitably result from new rules, creating a "litigation time bomb." And OBRA '90 significantly revises the law. Other risk management issues include the manner in which facilities handle and dispose of medical waste and the manner in which they resolve disputes.

  17. Nuts for diabetes prevention and management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 ...

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

    PubMed

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

    2016-02-15

    Risk assessment and risk management have been increasingly approved as an effective approach for appropriate disposal and scientific management of chemicals. This study systematically analyzed the risk assessment methods of chemicals from three aspects including health risk, ecological risk and regional risk. Based on the current situation of classification and management towards chemicals in China, a specific framework of risk management on chemicals was proposed by selecting target chemicals, predominant industries and related stakeholders as the objects. The results of the present study will provide scientific support for improving risk assessment and reasonable management of chemicals in China. PMID:27363124

  19. Increasing safety, managing risk.

    PubMed

    Long, R

    2001-06-01

    Before criminal background checks became standard industry practice, a long term care administrator in Illinois paid $15 per inquiry for such checks on potential hires for his facility. Management ordered the inquiries halted for budgetary reasons. A few months later, facing holiday staff shortages around Christmastime, the administrator hired two new aides to help round out a skeletal staff. "I did the registry checks, the reference checks, everything came in fine," recalls the administrator, who asked to remain anonymous in our reportage. "I came back in on Monday--Christmas was on Sunday--and got a report from [a resident's] family members that their mother had been sexually abused Christmas night." A year later, in legal proceedings over the incident, the administrator was summoned to give a deposition about the center's hiring practices. In fact, it had been discovered that one of the aides hired did have a record of abuse. Because the administrator cited that he was not permitted to perform criminal background checks, a decision with which he disagreed, he became a key witness for the plaintiff. Management admitted liability and paid $1 million in damages awarded the plaintiff.

  20. 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.

  1. 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.

  2. International standards for brucellosis prevention and management.

    PubMed

    Ragan, V; Vroegindewey, G; Babcock, S

    2013-04-01

    International standards are a crucial element in brucellosis prevention and management. They allow policy-makers, scientists, epidemiologists, laboratories and trade entities to have a common vocabulary for communication and understanding of the disease. These standards cover the entire spectrum of activities from surveillance, testing, prophylaxis, transport and trade to policy development, research and reporting. Developing, adhering to and monitoring standards increases both the effectiveness and efficiency of prevention and management programmes. Creating standards with the input of all stakeholders ensures that the standards do not adversely affect the requirements of any of the multiple parties involved. The World Organisation for Animal Health (OIE), in conjunction with its Member Countries, and through its standing and ad hoc committees plus expert input, has taken a key leadership role in developing and reviewing brucellosis standards. These standards are used to harmonise testing, prevention processes, vaccines and reporting, to support trade and to protect human and animal health. PMID:23837376

  3. Recent advances in the prevention and management of preterm birth

    PubMed Central

    Tan, Min Yi

    2015-01-01

    The management of preterm birth has seen major transformations in the last few decades with increasing interest worldwide, due to the impact of preterm birth on neonatal morbidity and mortality. The prevention strategies currently available for asymptomatic women at risk of preterm birth include progesterone, cervical cerclage and cervical pessary. Each approach has varying effects depending on the patient's prior history of preterm birth, cervical length and the presence of multiple gestations. There is a shift in the focus of antenatal treatment, with the use of prenatal magnesium sulphate and corticosteroids, to reduce neonatal intensive care admissions and longer-term disabilities associated with preterm birth, consequently relieving emotional and economical burden. This article provides an update on the recent advances in prevention and management approaches available for women at risk of preterm birth. PMID:26097713

  4. [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. PMID:19376504

  5. Risk Management: Research Needs and Status Report.

    ERIC Educational Resources Information Center

    Brown, Terry J.

    1998-01-01

    Summarizes risk-management research in categories of practical relevance to outdoor recreation stakeholders and the research community: conceptualization of risk; risk/benefit studies; risk monitoring; risk management in organizations and programs (identification, evaluation, control, planning, evaluation); legal issues; and risk communication.…

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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…

  12. Back pain: Prevention and management in the workplace.

    PubMed

    Schaafsma, Frederieke G; Anema, Johannes R; van der Beek, Allard J

    2015-06-01

    Despite all the efforts in studying work-related risk factors for low back pain (LBP), interventions targeting these risk factors to prevent LBP have no proven cost-effectiveness. Even with adequate implementation strategies for these interventions on group level, these did not result in the reduction of incident LBP. Physical exercise, however, does have a primary preventive effect on LBP. For secondary prevention, it seems that there are more opportunities to cost-effectively intervene in reducing the risk of long-term sickness absence due to LBP. Starting at the earliest moment possible with proper assessment of risk factors for long-term sickness absence related to the individual, the underlying mechanisms of the LBP, and also factors related to the workplace by a well-trained clinician, may increase the potential of effective return to work (RTW) management. More research on how to overcome barriers in the uptake of these effective interventions in relation to policy-specific environments, and with regard to proper financing of RTW management is necessary.

  13. 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.

  14. Responsible management of environmental risk

    SciTech Connect

    Browne, C.S.

    1996-12-31

    Responsible management of environmental risk means defining the components: renewable and nonrenewable resources, natural versus human-induced environmental impacts, and specific processes through the disciplines of geology, hydrology, soil science, geochemistry. Another part involves the economic effects of those risks. A prime example for utilizing management of economic effects is the controversy over the Pacific Salmon Fishery. Science holds many of the answers such as estuary management that impact the return of the salmon to spawning areas. Scientific examination of old maps to locate decades old earthen dams which may restrict the free flowing water in some of the Columbia River tributaries, subsequent removal of those dams may produce economic benefits. A multi-disciplined management review of all the environmental risks can produce acceptable alternatives for salmon fishery enhancement. Application of geochemistry holds many potential keys to resolving long-standing environmental concerns provided regulatory agencies have not formulated prohibitive standards. At the recent American Association of Petroleum Geologist Hedberg Conference on Rational Science for Public Policy, a simple geochemical model was presented to cope with soil containing hydrocarbon contamination. Using risk analysis for questions of natural background levels of contamination can foster lower costs of remedial clean ups, provide achievable environmental policies and regulations as well as foster greater education and acceptance by the general public. It is self-defeating to set standards for lower contamination limits than particular concentrations of certain elements that occur in nature.

  15. 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…

  16. Responsible management of environmental risk

    SciTech Connect

    Browne, C.S. )

    1996-01-01

    Responsible management of environmental risk means defining the components: renewable and nonrenewable resources, natural versus human-induced environmental impacts, and specific processes through the disciplines of geology, hydrology, soil science, geochemistry. Another part involves the economic effects of those risks. A prime example for utilizing management of economic effects is the controversy over the Pacific Salmon Fishery. Science holds many of the answers such as estuary management that impact the return of the salmon to spawning areas. Scientific examination of old maps to locate decades old earthen dams which may restrict the free flowing water in some of the Columbia River tributaries, subsequent removal of those dams may produce economic benefits. A multi-disciplined management review of all the environmental risks can produce acceptable alternatives for salmon fishery enhancement. Application of geochemistry holds many potential keys to resolving long-standing environmental concerns provided regulatory agencies have not formulated prohibitive standards. At the recent American Association of Petroleum Geologist Hedberg Conference on Rational Science for Public Policy, a simple geochemical model was presented to cope with soil containing hydrocarbon contamination. Using risk analysis for questions of natural background levels of contamination can foster lower costs of remedial clean ups, provide achievable environmental policies and regulations as well as foster greater education and acceptance by the general public. It is self-defeating to set standards for lower contamination limits than particular concentrations of certain elements that occur in nature.

  17. 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…

  18. Tank waste remediation system risk management list

    SciTech Connect

    Collard, L.B.

    1995-10-31

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

  19. Reducing the risk, managing safety.

    PubMed

    Aldridge, Peter

    2016-02-01

    Fire safety in healthcare premises has always been a challenge to those that discharge this duty. Statutory compliance should be a matter of course, but in an ever increasingly challenged NHS, even this is not a given. While the NHS is driven by managing very complex risk to deliver cutting edge healthcare, providers cannot be risk averse. Which risk, however, takes priority? Here Peter Aldridge, fire and corporate services manager at Leeds Teaching Hospitals NHS Trust, and Secretary to the National Association of Healthcare Fire Officers (NAHFO)--which will this month and next jointly stage fire safety seminars with IHEEM; see page 8--considers the key issues, with input from a fire officer at a leading mental health and community Trust. PMID:27017658

  20. 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.

  1. Knowledge of risk management strategies, and information and risk management preferences of women at increased risk for ovarian cancer.

    PubMed

    Tiller, K; Meiser, B; Gould, L; Tucker, K; Dudding, T; Franklin, J; Friedlander, M; Andrews, L

    2005-04-01

    Little research is available on the level of knowledge about ovarian cancer risk management options in women at increased risk for this disease. The study objectives were to evaluate this together with the information and ovarian cancer risk management preferences of high-risk women. One hundred and twenty-nine women were assessed after their attendance at one of six familial cancer clinics in relation to knowledge of surveillance and/or preventative strategies for reduction of ovarian cancer risk, preferences for particular strategies, and information preferences. Screening was selected by 57 (44%) women as the preferred risk management option. One hundred and five women (82%) indicated a wish for as much information as possible about ovarian cancer, including both good and bad outcomes and 114 (89%) reported a preference for sharing treatment decisions with their health professional. Participants' knowledge about ovarian cancer risk management options was significantly associated with educational levels (Z = -3.2, p=0.001) and whether or not ovarian cancer was included in the family history (Z = -2.3, p = 0.018). Findings from this present study indicate that women at increased risk of ovarian cancer who attend familial cancer clinics want as much information as possible about this disease and they want to be involved in the decision-making process. Women who reported a lower level of education (no post-school qualifications) may be most likely to benefit from additional educational strategies designed to supplement genetic counseling to improve their knowledge levels.

  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. Towards dynamics in mountain hazard risk management

    NASA Astrophysics Data System (ADS)

    Fuchs, Sven; Keiler, Margreth; Sokratov, Sergey; Shnyparkov, Alexander

    2013-04-01

    Starting with an overview on losses due to mountain hazards in the Russian Federation and the European Alps the question is raised why a substantial number of events still is recorded - despite considerable efforts in hazard mitigation and risk reduction. The main reason for this paradox lies in a missing dynamic risk-based approach, and it is shown that these dynamics have different roots: Firstly, neglecting climate change and systems dynamics, the development of hazard scenarios is based on the static approach of design events. Secondly, due to economic development and population dynamics, the elements at risk exposed are subject to spatial and temporal changes. These issues are discussed with respect to temporal and spatial demands. As a result, it is shown how risk is dynamic on a long-term and short term scale, which has to be acknowledged in the risk concept if this concept is targeted at a sustainable development of mountain regions. A conceptual model is presented that can be used for dynamical risk assessment, and it is shown by different management strategies how this model may be converted into practice. Furthermore, the interconnectedness and interaction between hazard and risk are addressed in order to enhance prevention, the level of protection and the degree of preparedness.

  4. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 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...

  5. 12 CFR 917.3 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 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...

  6. 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...

  7. Behavior-Based Safety and Occupational Risk Management

    ERIC Educational Resources Information Center

    Geller, E. Scott

    2005-01-01

    The behavior-based approach to managing occupational risk and preventing workplace injuries is reviewed. Unlike the typical top-down control approach to industrial safety, behavior-based safety (BBS) provides tools and procedures workers can use to take personal control of occupational risks. Strategies the author and his colleagues have been…

  8. 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...

  9. [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

  10. 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

  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. General population and HIV prevention: from risk to action.

    PubMed

    Paicheler, G

    1999-11-01

    Since knowledge about AIDS transmission now appears to be very good, many observers are surprised that more people do not practice behavior, like safer sex, designed to minimize risk of contracting the disease. Still, previous studies have not shown that there is a direct link between knowledge and behavior. New models, based on people's concrete experiences, are therefore needed. The goal of this qualitative research, based on 61 in-depth interviews conducted in France, is to describe how people understand the threat of AIDS and how they face the risk of transmission in their sex lives. In order to understand preventive actions, we must study how information is interpreted and how knowledge is integrated, so that people perceive general or personal risk. We must also specify the way in which people distinguish between aspects of risk perception and vulnerability; feelings of personal control, constructed on the basis of social experiences; characteristics of situations; and finally, the dynamics of action. The proposed risk management model accounts for these diverse factors in elucidating the great diversity of actions reported. This dynamic, non-linear model is designed to capture both the impact of perceptive and cognitive elements on action and vice versa.

  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. [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.

  15. 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

  16. 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.

  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.

  18. 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.

  19. The management and prevention of tetanus.

    PubMed

    Richardson, J P; Knight, A L

    1993-01-01

    Tetanus is a rare disease in the United States, but it has a high mortality rate and is preventable through immunization. Using a computerized literature search, we reviewed English language articles on tetanus in the United States. We found that despite the availability of an effective vaccine, tetanus still causes considerable morbidity. The elderly are at great risk of tetanus, because they have never been immunized or their immunity has waned. Emergency physicians can reduce the likelihood of tetanus by ensuring appropriate wound care, including tetanus immunization and use of tetanus immune globulin, as appropriate. Treatment consists of neutralization of circulating toxin, surgical excision to eliminate the source of toxin, control of muscle spasms, and prevention of respiratory and metabolic complications. A case-finding approach for all persons who receive care in emergency departments will reduce the size of the susceptible population. PMID:8157912

  20. 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…

  1. Controlling Legal Risk for Effective Hospital Management

    PubMed Central

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

    2016-01-01

    Purpose 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. Materials and Methods 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. Results 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). Conclusions 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. PMID:27169130

  2. 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...

  3. 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)

  4. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 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 FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.1 Risk management. Before its new capital plan may...

  5. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 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 FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.1 Risk management. Before its new capital plan may...

  6. 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...

  7. 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…

  8. 12 CFR 932.1 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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 FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.1 Risk management. Before its new capital plan may...

  9. 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...

  10. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 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...

  11. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 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...

  12. 42 CFR 441.476 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 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...

  13. 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...

  14. Decision Thresholds and Changes in Risk for Preventive Treatment.

    PubMed

    Courbage, Christophe; Rey, Béatrice

    2016-01-01

    This paper investigates the notion of treatment threshold for preventive treatment with potential side effects in the context of changes in risk. Changes in risk are defined by the concept of nth-order stochastic dominance and concern the effectiveness of preventive treatment, side effects, severity of the potential disease, and comorbidity risk. The impact of a riskier environment on the probability of disease threshold above which the preferable decision is to undergo preventive treatment is shown to depend on both mixed risk averse individual preferences and the configuration of increase in risk considered. These results suggest that neglecting differences between risks when evaluating the treatment threshold is likely to lead to substantial errors in most cost-benefit applications for preventive treatment.

  15. Risk Factor Research and Prevention for Anxiety Disorders: Introduction to the Special Series on Risk and Prevention of Anxiety Pathology

    ERIC Educational Resources Information Center

    Schmidt, Norman B.; Zvolensky, Michael J.

    2007-01-01

    In relation to treatment-related research in the United States, there is relatively little systematic effort focused on the combination of risk and prevention for anxiety pathology. This article broadly discusses risk factor research and prevention program development for anxiety psychopathology. The authors also specifically discuss papers in…

  16. Medical negligence--prevention and management.

    PubMed

    Chao, T C

    1987-04-01

    The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

  17. 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),…

  18. 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…

  19. 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. PMID:25486039

  20. 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…

  1. 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.

  2. [Primary and secondary prevention of arteriosclerosis. Risk stratification of hypertension].

    PubMed

    Gysan, D B

    2002-10-01

    Hypertension is one of the important risk factors in the pathogenesis of arteriosclerosis. The differences between primary and secondary prevention in diagnosis and therapeutic strategies are reviewed from international studies. The optimal therapy for hypertension and risk stratification, including all other risk factors, will reduce the incidence and mortality of coronary heart disease and stroke. PMID:12395218

  3. 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.

  4. An evaluation of EU legislation concerning risk assessment and preventive measures in occupational safety and health.

    PubMed

    Niskanen, Toivo; Naumanen, Paula; Hirvonen, Maria L

    2012-09-01

    The European Council Directive 89/391/EC of 12 June 1989 is concerned with the introduction of measures to encourage improvements in the occupational safety and health. For example, it deals with risk assessment and preventive measures. The Finnish legislation enacts the risk assessment and prevention measures in a similar way as the EU Directive 89/391/EC. The aim of this study was to examine: 1) the implementation of risk assessment process as a part of OSH management, and 2) the effectiveness of the OSH legislation concerned with risk assessment. The quantitative method involved an online questionnaire. The respondents were employers (N = 1478), workers (N = 1416) and occupational care (OHC) professionals' units (N = 469). Three quarters of the employer respondents and two thirds of the workers and OHC service providers felt that the EU legislative provisions have promoted the engagement of the management. According to the study, improvement is needed in ensuring the cooperation between employers and workers. The combined variables of Risk Assessment Process revealed positive impacts both on Cooperation and Management Measures and on the Concrete Preventive Measures among the employers and the workers. The combined variables of Use of Documents of Risk Assessments highlighted positive impacts on both the Exploiting of Results of Risk Assessments in Planning and Management and on the Exploiting of Results of Risk Assessment in Cooperation and Technology.

  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. PMID:25454991

  6. 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

  7. 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.

  8. 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…

  9. 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…

  10. Common genetic risk for melanoma encourages preventive behavior change.

    PubMed

    Diseati, Lori; Scheinfeldt, Laura B; Kasper, Rachel S; Zhaoyang, Ruixue; Gharani, Neda; Schmidlen, Tara J; Gordon, Erynn S; Sessions, Cecili K; Delaney, Susan K; Jarvis, Joseph P; Gerry, Norman; Christman, Michael

    2015-01-01

    There is currently great interest in using genetic risk estimates for common disease in personalized healthcare. Here we assess melanoma risk-related preventive behavioral change in the context of the Coriell Personalized Medicine Collaborative (CPMC). As part of on-going reporting activities within the project, participants received a personalized risk assessment including information related to their own self-reported family history of melanoma and a genetic risk variant showing a moderate effect size (1.7, 3.0 respectively for heterozygous and homozygous individuals). Participants who opted to view their report were sent an optional outcome survey assessing risk perception and behavioral change in the months that followed. Participants that report family history risk, genetic risk, or both risk factors for melanoma were significantly more likely to increase skin cancer preventive behaviors when compared to participants with neither risk factor (ORs = 2.04, 2.79, 4.06 and p-values = 0.02, 2.86 × 10-5, 4.67 × 10-5, respectively), and we found the relationship between risk information and behavior to be partially mediated by anxiety. Genomic risk assessments appear to encourage positive behavioral change in a manner that is complementary to family history risk information and therefore may represent a useful addition to standard of care for melanoma prevention. PMID:25695399

  11. 76 FR 45724 - Clearing Member Risk Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... COMMISSION 17 CFR Parts 1 and 23 RIN 3038-AD51 Clearing Member Risk Management AGENCY: Commodity Futures... management for cleared trades by futures commission merchants, swap dealers, and major swap participants that... extensive regulations addressing open access and risk management at the derivatives clearing...

  12. 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

  13. 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

  14. 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...

  15. [Risk management in cardiac anesthesia].

    PubMed

    Inada, Eiichi

    2008-05-01

    Cardiac anesthesia carries high risk because of the patient's cardiac and coexisting diseases and rapid and complex hemodynamic changes during surgery. We should be ready to treat hemodynamic changes which may rapidly deteriorate into a vicious cycle. Many potent drugs and life-support devices are used. The drugs should be properly labeled to avoid drug error. Prefilled drug syringes and ready-to-use bags are helpful to avoid mixture error. Syringe and infusion pumps should be properly set. All the infusion systems should be checked in a systematical way. Blood management including blood transfusion and coagulation is important. Heparin-induced thrombocytopenia (HIT) may cause thrombosis. Heparin and heparin-coated catheter should be avoided in patients with HIT. Causes of bleeding tendency should be sort out and treated accordingly. Protamine reactions including hypotension and pulmonary hypertension can be catastrophic. Lastly, intimate communication between surgeons, anesthesiologists, medical engineers, and nurses is essential to perform cardiac surgery safely.

  16. 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

  17. 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.

  18. 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.

  19. 78 FR 36784 - Survey of Nanomaterial Risk Management Practices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ...: The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control... HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Survey of Nanomaterial Risk Management Practices AGENCY: National Institute for Occupational Safety and Health (NIOSH) of the Centers for...

  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. 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…

  3. 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.

  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. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. Early Prevention and Intervention Programs for At-Risk Students.

    ERIC Educational Resources Information Center

    Howard, Katrena C.

    This document describes programs implemented in the DeKalb County (Georgia) school system that attempt to remediate at-risk status and prevent students from becoming at-risk. DeKalb's programs focus on improved academics and social and emotional well-being. The programs target children as young as 4 years of age, but continue through elementary…

  11. Drug Prevention with High Risk Families and Young Children.

    ERIC Educational Resources Information Center

    Hahn, Ellen J.; Hall, Lynne A.; Simpson, Mary Rado

    1998-01-01

    Examines the effects of a school and home-based drug-abuse prevention program on risk factors for subsequent alcohol, tobacco, and other drug (ATOD) use among children. The parent-child intervention had no effect on parent or child risk factors, but the program was favorably received by parents and children. (Author/MKA)

  12. 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

  13. Diagnosis and management of high risk group for gastric cancer.

    PubMed

    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.

  14. [The management of risks by the global risk analysis].

    PubMed

    Desroches, A

    2013-05-01

    After a reminder on the fundamental concepts of the management of risk, the author describes the overall analysis of risk (AGR), name given by the author to the up-to-date APR method which after several changes of the initial process aims to cover a perimeter of analysis and broader management both at the level of structural that business risks of any kind throughout the system development life cycle, of the study of its feasibility to dismantling.

  15. 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.

  16. 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

  17. 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

  18. [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.

  19. Overview of Risk Management for Engineered Nanomaterials

    PubMed Central

    Schulte, PA; Geraci, CL; Hodson, LL; Zumwalde, RD; Kuempel, ED; Murashov, V; Martinez, KF; Heidel, DS

    2015-01-01

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

  20. 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.

  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. 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

  3. 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.

  4. Prioritizing risk factors to identify preventive interventions for economic assessment

    PubMed Central

    Blakely, Tony; Foster, Rachel H; Hadorn, David; Vos, Theo

    2012-01-01

    Abstract Objective To explore a risk factor approach for identifying preventive interventions that require more in-depth economic assessment, including cost-effectiveness analyses. Methods A three-step approach was employed to: (i) identify the risk factors that contribute most substantially to disability-adjusted life years (DALYs); (ii) re-rank these risk factors based on the availability of effective preventive interventions warranting further cost-effectiveness analysis (and in some instances on evidence from existing cost-effectiveness analyses); and (iii) re-rank these risk factors in accordance with their relative contribution to health inequalities. Health inequalities between the Māori and non-Māori populations in New Zealand were used by way of illustration. Findings Seven of the top 10 risk factors prioritized for research on preventive interventions in New Zealand were also among the 10 risk factors most highly ranked as contributing to DALYs in high-income countries of the World Health Organization’s Western Pacific Region. The final list of priority risk factors included tobacco use; alcohol use; high blood pressure; high blood cholesterol; overweight/obesity, and physical inactivity. All of these factors contributed to health inequalities. Effective interventions for preventing all of them are available, and for each risk factor there is at least one documented cost-saving preventive intervention. Conclusion The straightforward approach to prioritizing risk factors described in this paper may be applicable in many countries, and even in those countries that lack the capacity to perform additional cost-effectiveness analyses, this approach will still make it possible to determine which cost-effective interventions should be implemented in the short run. PMID:22423159

  5. 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

  6. 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. PMID:26789745

  7. Fall prevention in our healthiest patients: assessing risk and preventing injury for moms and babies.

    PubMed

    Gaffey, Ann D

    2015-01-01

    Attention is needed in preventing patient falls in newborns and in obstetric units of hospitals. The majority of prenatal, postpartum, and newborn falls are preventable. Little effort has been made to address fall risk during the prenatal period, during labor, and after delivery in the postpartum period for moms and babies. Risk factors for falls in these populations have been identified, and targeted risk assessments and fall prevention interventions have been developed to eliminate these falls. Evidence demonstrates success in reducing falls with a variety of low-cost but high-return initiatives, comprising prenatal education, patient and family engagement, implementation of unique fall risk assessment tools, postpartum mobility assessments, and changes in patient rounding frequency.

  8. 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.

  9. 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.

  10. 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. PMID:27240203

  11. The synergy of quality management & risk management in home care.

    PubMed

    Rhinehart, E

    1996-09-01

    For a number of years the health care risk management industry has been addressing unplanned and unanticipated adverse events. Organizations that are proactive in their approach to risk and quality management will have big payoffs in clinical quality improvement, service quality improvement, employee satisfaction, and customer satisfaction. PMID:10160154

  12. [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.

  13. 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.

  14. [Management as a key professional competence of preventive medicine specialists].

    PubMed

    Fomina, E V; Nesvizhskiĭ, Iu V; Kucherenko, V Z; Svistunov, A A

    2010-01-01

    The paper deals with the strategy of training specialists in preventive medicine and improvement of their professional skills for the management of activities aimed at the maintenance of adequate population health status and prevention of adverse effects of environmental factors. Integration of managerial issues into curricula and teaching courses for preventive medicine specialists may be instrumental in upgrading their professional level.

  15. Preventing and managing unprofessionalism in medical school faculties.

    PubMed

    Binder, Renee; Friedli, Amy; Fuentes-Afflick, Elena

    2015-04-01

    Professionalism is a required competency for medical students, residents, practicing physicians, and academic faculty. Faculty members must adhere to codes of conduct or risk discipline. The authors describe issues of unprofessionalism that culminate in allegations of faculty misconduct or filing of grievances in academic medicine and outline strategies for early intervention and prevention. The authors, vice and associate deans and executive director of the office of faculty affairs at a large U.S. medical school, have handled many allegations of unprofessional conduct over the past decade. They present case examples based on behaviors such as lack of respect, inappropriate language and behavior, failure to cooperate with members of the health care team, and sexual harassment/discrimination. They discuss factors complicating evaluation of these behaviors, including variable definitions of respect, different cultural norms, and false allegations. The authors make recommendations for prevention and intervention, including early identification, performance management, education about sexual harassment, and referrals to professional coaches, anger management classes, and faculty-staff assistance programs.

  16. 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. PMID:27318031

  17. 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

  18. Can child injury prevention include healthy risk promotion?

    PubMed

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

    2015-10-01

    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.

  19. Can child injury prevention include healthy risk promotion?

    PubMed

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

    2015-10-01

    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

  20. 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. PMID:22950809

  1. Reformulating Suicide Risk Formulation: From Prediction to Prevention.

    PubMed

    Pisani, Anthony R; Murrie, Daniel C; Silverman, Morton M

    2016-08-01

    Psychiatrists-in-training typically learn that assessments of suicide risk should culminate in a probability judgment expressed as "low," "moderate," or "high." This way of formulating risk has predominated in psychiatric education and practice, despite little evidence for its validity, reliability, or utility. We present a model for teaching and communicating suicide risk assessments without categorical predictions. Instead, we propose risk formulations which synthesize data into four distinct judgments to directly inform intervention plans: (1) risk status (the patient's risk relative to a specified subpopulation), (2) risk state (the patient's risk compared to baseline or other specified time points), (3) available resources from which the patient can draw in crisis, and (4) foreseeable changes that may exacerbate risk. An example case illustrates the conceptual shift from a predictive to a preventive formulation, and we outline steps taken to implement the model in an academic psychiatry setting. Our goal is to inform educational leaders, as well as individual educators, who can together cast a prevention-oriented vision in their academic programs. PMID:26667005

  2. The Troll HSE Risk Management System

    SciTech Connect

    Wiig, E.; Berthelsen, I.; Donovan, K.

    1996-12-31

    The Petroleum Act and Internal Control regulations in Norway lay down requirements for how HSE shall be Managed and documented. To comply with the Norwegian legislation the Troll Project has developed an HSE Risk Management System (RMS) structured around Hazards and Effects Management. The resulting quality, technical and operating integrity, and HSE performance are an endorsement of the power of RMS.

  3. 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)

  4. Prevention and management of positional skull deformities in infants.

    PubMed

    Laughlin, James; Luerssen, Thomas G; Dias, Mark S

    2011-12-01

    Positional skull deformities may be present at birth or may develop during the first few months of life. Since the early 1990s, US pediatricians have seen an increase in the number of children with cranial asymmetry, particularly unilateral flattening of the occiput, likely attributable to parents following the American Academy of Pediatrics "Back to Sleep" positioning recommendations aimed at decreasing the risk of sudden infant death syndrome. Positional skull deformities are generally benign, reversible head-shape anomalies that do not require surgical intervention, as opposed to craniosynostosis, which can result in neurologic damage and progressive craniofacial distortion. Although associated with some risk of positional skull deformity, healthy young infants should be placed down for sleep on their backs. The practice of putting infants to sleep on their backs has been associated with a drastic decrease in the incidence of sudden infant death syndrome. Pediatricians need to be able to properly differentiate infants with benign skull deformities from those with craniosynostosis, educate parents on methods of proactively decreasing the likelihood of the development of occipital flattening, initiate appropriate management, and make referrals when necessary. This report provides guidance for the prevention, diagnosis, and management of positional skull deformity in an otherwise normal infant without evidence of associated anomalies, syndromes, or spinal disease. PMID:22123884

  5. 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

  6. Peri-operative renal dysfunction: prevention and management.

    PubMed

    Golden, D; Corbett, J; Forni, L G

    2016-01-01

    Postoperative increases in serum creatinine concentration, by amounts historically viewed as trivial, are associated with increased morbidity and mortality. Acute kidney injury is common, affecting one in five patients admitted with acute medical disease and up to four in five patients admitted to intensive care, of whom one in two have had operations. This review is focused principally on the identification of patients at risk of acute kidney injury and the prevention of injury. In the main, there are no interventions that directly treat the damaged kidney. The management of acute kidney injury is based on correction of dehydration, hypotension, and urinary tract obstruction, stopping nephrotoxic drugs, giving antibiotics for bacterial infection, and commencing renal replacement therapy if necessary. PMID:26620147

  7. Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

    PubMed

    Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard

    2015-11-01

    The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach.

  8. 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

  9. Vascular risk management through nurse-led self-management programs.

    PubMed

    Sol, Berna G M; van der Bijl, Jaap J; Banga, Jan-Dirk; Visseren, Frank L J

    2005-03-01

    In current clinical practice, adequate cardiovascular risk reduction is difficult to achieve. Treatment is primarily focused on clinical vascular disease and not on long-term risk reduction. Pertinent to success in vascular risk reduction are proper medication use, weight control, healthy food choices, smoking cessation, and physical exercise. Atherosclerotic vascular disease and its risk constitute a chronic condition, which poses specific requirements on affected patients and caregivers who should be aware of the chronicity. In patients with vascular disease, there is lack of awareness of their chronic condition because of the invisibility of most risk factors. In other patient groups with chronic illness, self-management programs were successful in achieving behavioral change. This strategy can also be useful for patients with vascular disease to adapt and adhere to an improved lifestyle. Self-management refers to the individual's ability to manage both physical and psychosocial consequences including lifestyle changes inherent to living with a chronic condition. Interventions that promote self-management are based on enhancing self-efficacy. In self-management, attention can be given to what is important and motivational to the individual patient. In this article the challenge of nursing care promoting self-management for patients with vascular risk and how this care can be applied will be explained. Nurses can play a central role in vascular risk management with a self-management approach for patients with chronic vascular disease. In vascular prevention clinics, nursing care can be delivered that includes medical treatment of vascular risks (hypertension, hypercholesterolemia, hyperglycemia, and hyperhomocystinemia) and counseling on promoting self-management (changes in diet, body weight, smoking habits, and level of exercise). Nursing interventions based on self-management promotion can provide a new and promising approach to actually achieve vascular risk

  10. Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

    PubMed

    Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

    2016-08-01

    Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism.

  11. Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

    PubMed

    Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

    2016-08-01

    Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism. PMID:27352090

  12. Risk management information for HIV infection.

    PubMed

    Edwards, A J

    1990-01-01

    This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE.

  13. 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

  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: 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…

  16. Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: a scoping review.

    PubMed

    Tung, James Y; Stead, Brent; Mann, William; Ba'Pham; Popovic, Milos R

    2015-01-01

    Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

  17. Rape Prevention with College Men: Evaluating Risk Status

    ERIC Educational Resources Information Center

    Stephens, Kari A.; George, William H.

    2009-01-01

    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…

  18. Risk Factors and Prevention Strategies for Suicide among the Elderly

    ERIC Educational Resources Information Center

    Franks, Rebecca; Burnett, Donna O.; Evans, Retta R.

    2012-01-01

    Suicide is a preventable public health concern affecting the nation as the 10th leading cause of death. The prevalence of suicide among the elderly is higher than any other group. Risk factors attributed to this phenomenon are depression, social isolation, substance abuse, poor physical health or function, financial stress, and access to lethal…

  19. Training Needs Assessment in Occupational Risk Prevention into Schools

    ERIC Educational Resources Information Center

    Burgos-Garcia, Antonio; Alonso-Morillejo, Enrique; Pozo-Munoz, Carmen

    2011-01-01

    The assessment of needs plays a relevant role in the training for preventing of risks at work into school, as it is a scientific procedure to identify and prioritise problems existing within an educative context. This type of assessment is the starting point for a subsequent planning of the educative interventions that will enable pupils and…

  20. Bienestar: A Diabetes Risk-Factor Prevention Program.

    ERIC Educational Resources Information Center

    Trevino, Robert P.; Pugh, Jacqueline A.; Hernandez, Arthur E.; Menchaca, Velma D.; Ramirez, Robert R.; Mendoza, Monica

    1998-01-01

    The Bienestar Health Program is a diabetes risk-factor prevention program targeting Mexican American fourth graders. Program goals are to decrease overweight and dietary fats. The program is based on social cognitive theory and uses culturally relevant material. Preliminary evaluation indicates the program significantly decreases dietary fat,…

  1. Youth-Initiated HIV Risk and Substance Use Prevention Program.

    ERIC Educational Resources Information Center

    Goggin, K.; Metcalf, K.; Wise, D.; Kennedy, S.; Murray, T.; Burgess, D.; Reese-Smith, J.; Terhune, N.; Broadus, K.; Downes, A.; Buckendahl, H.

    This study evaluates the first year of a novel HIV and substance use prevention program for inner city youth (Offering New Youth eXperiences--ONYX). Baseline and follow-up measures of knowledge, attitudes, and risk behaviors were administered seven months apart to 441 youth participating in the ONYX program. Youth (n=71) who provided data at both…

  2. Teen Risk-Taking: Promising Prevention Programs and Approaches.

    ERIC Educational Resources Information Center

    Eisen, Marvin; Pallitto, Christina; Bradner, Carolyn; Bolshun, Natalya

    This guidebook explores some of the practical issues associated with finding, choosing, and starting potentially effective prevention programs for at-risk preteens and teens. The guidebook is based on a study of 51 intervention programs that identified elements and delivery mechanisms that were associated with their effectiveness. A closer look at…

  3. College Alcohol Risk Assessment Guide: Environmental Approaches to Prevention

    ERIC Educational Resources Information Center

    Ryan, Barbara E.; Colthurst, Tom; Segars, Lance

    2009-01-01

    This guide is designed to help individuals identify and modify risks that contribute to alcohol-related problems within college and university communities. Despite general agreement among campus officials and students alike that alcohol use contributes to a range of problems confronting colleges and universities, prevention often does not command…

  4. Opportunities and strategies for breast cancer prevention through risk reduction.

    PubMed

    Mahoney, Martin C; Bevers, Therese; Linos, Eleni; Willett, Walter C

    2008-01-01

    Due to the high incidence of breast cancer among US females, risk-reduction strategies are essential. Before considering approaches to breast cancer risk reduction, it is important for clinicians to complete individualized qualitative and quantitative assessments of risk for their patients in order to inform physicians' clinical decision making and management and to engage patients collaboratively in a thorough discussion of risks and benefits. This review will summarize information on potential pharmacologic, nutritional, surgical, and behavioral approaches to reducing breast cancer risk. While there is no clear evidence that specific dietary components can effectively reduce breast cancer risk, weight gain and obesity in adulthood are risk factors for the development of postmenopausal breast cancer. Alcohol consumption, even at moderate levels, increases breast cancer risk, although some of the detrimental effects may be reduced by sufficient folate intake. Women at increased risk of breast cancer can opt to reduce their breast cancer risk through the use of tamoxifen or raloxifene; other chemopreventive agents remain under investigation. Surgical approaches to risk reductions are restricted to those patients with a substantially increased risk of developing breast cancer. Patients should be encouraged to maintain a healthy lifestyle for their overall well-being and to remain up to date with recommendations for screening and surveillance. PMID:18981297

  5. 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...

  6. 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 ...

  7. 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.

  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. 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.

  10. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies.

    PubMed

    Griffin, L Y; Agel, J; Albohm, M J; Arendt, E A; Dick, R W; Garrett, W E; Garrick, J G; Hewett, T E; Huston, L; Ireland, M L; Johnson, R J; Kibler, W B; Lephart, S; Lewis, J L; Lindenfeld, T N; Mandelbaum, B R; Marchak, P; Teitz, C C; Wojtys, E M

    2000-01-01

    An estimated 80,000 anterior cruciate ligament (ACL) tears occur annually in the United States. The highest incidence is in individuals 15 to 25 years old who participate in pivoting sports. With an estimated cost for these injuries of almost a billion dollars per year, the ability to identify risk factors and develop prevention strategies has widespread health and fiscal importance. Seventy percent of ACL injuries occur in noncontact situations. The risk factors for non-contact ACL injuries fall into four distinct categories: environmental, anatomic, hormonal, and biomechanical. Early data on existing neuromuscular training programs suggest that enhancing body control may decrease ACL injuries in women. Further investigation is needed prior to instituting prevention programs related to the other risk factors.

  11. Is Sex Like Driving? HIV Prevention and Risk Compensation*

    PubMed Central

    Wilson, Nicholas L.; Xiong, Wentao; Mattson, Christine L.

    2015-01-01

    Risk compensation has been called the “Achilles’ heel” of HIV prevention policies (Cassell et al 2006). This paper examines the behavioral response to male circumcision, a major HIV prevention policy currently being implemented throughout much of Sub-Saharan Africa. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision may reduce fatalism about acquiring HIV/AIDS and increase the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient’s belief about the reduction in the risk of acquiring HIV. PMID:26997745

  12. 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

  13. Adherence to cancer prevention guidelines and risk of breast cancer.

    PubMed

    Catsburg, Chelsea; Miller, Anthony B; Rohan, Thomas E

    2014-11-15

    Healthy eating patterns and keeping physically active are potentially more important for chronic disease prevention than intake or exclusion of specific food items or nutrients. To this end, many health organizations routinely publish dietary and lifestyle recommendations aimed at preventing chronic disease. Using data from the Canadian National Breast Screening Study, we investigated the association between breast cancer risk and adherence to two sets of guidelines specific for cancer prevention, namely the American Cancer Society (ACS) Guidelines and the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations. At baseline, 49,613 women completed dietary and lifestyle questionnaires and height and weight measurements were taken. During a mean follow-up of 16.6 years, 2,503 incident cases of breast cancer were ascertained. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of meeting each guideline, and number of guidelines met, with breast cancer risk. The two sets of guidelines yielded similar results. Specifically, adherence to all six ACS guidelines was associated with a 31% reduction in breast cancer risk when compared to subjects adhering to at most one guideline (HR=0.69; 95% CI=0.49-0.97); similarly, adherence to six or seven of the WCRF/AICR guidelines was also associated with a 31% reduction in breast cancer risk (HR=0.69; 95% CI=0.47-1.00). Under either classification, meeting each additional guideline was associated with a 4-6% reduction in breast cancer risk. These results suggest that adherence to cancer prevention guidelines is associated with a reduced risk of breast cancer.

  14. 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...

  15. 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. PMID:18350986

  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

    2009-02-11

    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.

  17. Lessons Learned in Risk Management on NCSX

    SciTech Connect

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

    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.

  18. A Humanistic Approach to Emotional Risk Management.

    ERIC Educational Resources Information Center

    Rubendall, Robert L.

    Adventure programs attempt to control or limit injuries in high-risk programming. This risk management has concentrated on the physical safety of participants at the expense of emotional and developmental security. In the zeal for accident-free statistics, a highly controlled, directive approach is created that treats individuals according to a…

  19. Essential features for proactive risk management

    NASA Astrophysics Data System (ADS)

    Murashov, Vladimir; Howard, John

    2009-08-01

    We propose a proactive approach to the management of occupational health risks in emerging technologies based on six features: qualitative risk assessment; the ability to adapt strategies and refine requirements; an appropriate level of precaution; global applicability; the ability to elicit voluntary cooperation by companies; and stakeholder involvement.

  20. 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.

  1. 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.

  2. 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.

  3. Prevention and Management of Nonhealing Perineal Wounds

    PubMed Central

    Kamrava, Allen; Mahmoud, Najjia N.

    2013-01-01

    Complex perineal wounds are at risk for nonhealing. High-risk procedures include proctectomy for Crohn disease, anal cancer and radiated distal rectal cancers. A basic understanding of both patient and procedural risk factors is helpful in planning and executing operative procedures for these conditions and to minimize associated wound complications. Diabetes, obesity, and malnutrition may contribute to wound breakdown and failure to heal. Delaying operative intervention, adding nutritional supplementation, and employing intestinal diversion as well as myocutaneous flaps may help optimize conditions for wound healing. PMID:24436658

  4. Cardiovascular implantable electronic device infections: associated risk factors and prevention.

    PubMed

    Rohacek, Martin; Baddour, Larry M

    2015-01-01

    Infections of cardiovascular implantable electric devices (CIED) are a burden on patients and healthcare systems and should be prevented. The most frequent pathogens are coagulase-negative staphylococci and Staphylococcus aureus. The most important risk factors for CIED infections are diabetes mellitus, renal and heart failure, corticosteroid use, oral anticoagulation, fever within 24 hours before the procedure and leucocytosis, implantable cardioverter defibrillator compared with pacemaker, especially in the case of Staphylococcus aureus bacteraemia, lack of antibiotic prophylaxis, and postoperative haematoma and other wound complications. Other important risk factors are history of prior procedures and previous CIED infections, number of leads, use of povidone-iodine compared with chlorhexidine-alcohol, and centres and operators with a low volume of implants. To prevent CIED infections, patients undergoing CIED procedures and appropriate devices should be carefully selected, and interventions should be performed by trained operators. Antibiotic prophylaxis should be administered, and skin antisepsis should be done with chlorhexidine-alcohol. Oral anticoagulation should be continued during CIED procedures in high-risk patients for thromboembolism, instead of bridging with heparin. Early reintervention in cases of haematoma or lead dislodgement should be avoided. The implementation of infection prevention programmes reduces infection rates. More randomised controlled studies are needed to evaluate prevention strategies, especially skin preparation and antibiotic prophylaxis with glycopeptides. PMID:26230056

  5. 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.

  6. Full-Time Risk, Part-Time Job--Effective Part-time Risk Management.

    ERIC Educational Resources Information Center

    Bieber, Robert M.

    1995-01-01

    Many school districts lack the resources to hire a full-time risk manager and often assign risk-management duties to a manager with other responsibilities. Offers steps that can help with risk-management procedures. Cooperation, communication, and, most important, the support of top management are critical for risk-management effectiveness. (MLF)

  7. 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.

  8. [Role and integration of technical prevention figures in the management system].

    PubMed

    Bartolucci, G B; Santantonio, P; Casciani, M; Dagazzini, I

    2010-01-01

    The multifarious issues of health and safety at work require multi-disciplinary skills, both in the risk assessment and in the subsequent definition and management of preventive measures, and this requires a renewed operational protocol that supports integration and co-operation between the technical prevention figures. Thus, between occupational physicians and technical advisers there should be a concrete and fruitful interaction, which should not be episodic or occasional, but a modus operandi systematic and constant. In this contribution is discussed as the technical prevention figures should be included in the Health and Safety Management System and should make a specific contribution in defining corporate policies on prevention. In particular it is outlined the role that the occupational physician may play in the development of prevention and health promotion activities within the strategies of corporate social responsibility. PMID:21086691

  9. 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

  10. Breast cancer risk accumulation starts early – Prevention must also

    PubMed Central

    Colditz, Graham A; Bohlke, Kari; Berkey, Catherine S.

    2014-01-01

    Purpose Nearly 1 in 4 breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. Methods Literature review Results Exposures during childhood and adolescence affect a woman’s long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies first pregnancy. Evidence on childhood diet and growth in height, and adolescent alcohol intake, among other adolescent factors are related to breast cancer risk and risk of premalignant proliferative benign lesions. Conclusion Breast cancer prevention efforts will have the greatest effect when initiated at an early age and continued over a lifetime. Gaps in knowledge are identified and deserve increase attention to inform prevention. PMID:24820413

  11. HIV risk and preventive interventions in transgender women sex workers

    PubMed Central

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  12. Risk Management in environmental geotechnical modelling

    NASA Astrophysics Data System (ADS)

    Tammemäe, Olavi; Torn, Hardi

    2008-01-01

    The objective of this article is to provide an overview of the basis of risk analysis, assessment and management, accompanying problems and principles of risk management when drafting an environmental geotechnical model, enabling the analysis of an entire territory or developed region as a whole. The environmental impact will remain within the limits of the criteria specified with the standards and will be acceptable for human health and environment. An essential part of the solution of the problem is the engineering-geological model based on risk analysis and the assessment and forecast of mutual effects of the processes.

  13. Managing Liability. Employment Discrimination: A Risk Management Strategy.

    ERIC Educational Resources Information Center

    McMullan, Sandra H.

    This booklet discusses the risks that educational institutions face in regard to employment discrimination litigation and outlines a program to effectively manage such risks. Institutions need to address three main types of employment discrimination issues: sexual harassment, disability-based discrimination, and age discrimination. To deal with…

  14. Building risk-on-a-chip models to improve breast cancer risk assessment and prevention

    PubMed Central

    Vidi, Pierre-Alexandre; Leary, James; Lelièvre, Sophie A.

    2013-01-01

    Summary Preventive actions for chronic diseases hold the promise of improving lives and reducing healthcare costs. For several diseases, including breast cancer, multiple risk and protective factors have been identified by epidemiologists. The impact of most of these factors has yet to be fully understood at the organism, tissue, cellular and molecular levels. Importantly, combinations of external and internal risk and protective factors involve cooperativity thus, synergizing or antagonizing disease onset. Models are needed to mechanistically decipher cancer risks under defined cellular and microenvironmental conditions. Here, we briefly review breast cancer risk models based on 3D cell culture and propose to improve risk modeling with lab-on-a-chip approaches. We suggest epithelial tissue polarity, DNA repair and epigenetic profiles as endpoints in risk assessment models and discuss the development of ‘risks-on-chips’ integrating biosensors of these endpoints and of general tissue homeostasis. Risks-on-chips will help identify biomarkers of risk, serve as screening platforms for cancer preventive agents, and provide a better understanding of risk mechanisms, hence resulting in novel developments in disease prevention. PMID:23681255

  15. 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.

  16. 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. PMID:18351452

  17. 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. PMID:26768032

  18. Preventing Chronic Pain following Acute Pain: Risk Factors, Preventive Strategies, and their Efficacy

    PubMed Central

    McGreevy, Kai; Bottros, Michael M.; Raja, Srinivasa N.

    2011-01-01

    Chronic pain is the leading cause of disability in the United States. The transition from acute to persistent pain is thought to arise from maladaptive neuroplastic mechanisms involving three intertwined processes, peripheral sensitization, central sensitization, and descending modulation. Strategies aimed at preventing persistent pain may target such processes. Models for studying preventive strategies include persistent post-surgical pain (PPP), persistent post-trauma pain (PTP) and post-herpetic neuralgia (PHN). Such entities allow a more defined acute onset of tissue injury after which study of the long-term effects is more easily examined. In this review, we examine the pathophysiology, epidemiology, risk factors, and treatment strategies for the prevention of chronic pain using these models. Both pharmacological and interventional approaches are described, as well as a discussion of preventive strategies on the horizon. PMID:22102847

  19. Menopause and risk of diabetes in the Diabetes Prevention Program

    PubMed Central

    Kim, Catherine; Edelstein, Sharon L.; Crandall, Jill P.; Dabelea, Dana; Kitabchi, Abbas E.; Hamman, Richard F.; Montez, Maria G.; Perreault, Leigh; Foulkes, Mary A.; Barrett-Connor, Elizabeth

    2012-01-01

    Objective The study objective was to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopausal status modifies response to diabetes prevention interventions. Methods The study population included women in premenopause (n=708), natural postmenopause (n=328), and bilateral oophorectomy (n=201) in the Diabetes Prevention Program (DPP), a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy (HT) use. Results After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (HR 0.19, 95% CI 0.04, 0.94), although observations were too few to determine if this was independent of HT use. No significant differences were seen in the metformin (HR 1.29, 95% CI 0.63, 2.64) or placebo arms (HR 1.37, 95% CI 0.74, 2.55). Conclusions Among women at high-risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with decreased diabetes risk. PMID:21709591

  20. Sustainable risk management of emerging contaminants in municipal wastewaters.

    PubMed

    Martin, O V; Voulvoulis, N

    2009-10-13

    The presence of emerging contaminants in municipal wastewaters, particularly endocrine-disrupting compounds such as oestrogenic substances, has been the focus of much public concern and scientific attention in recent years. Due to the scientific uncertainty still surrounding their effects, the Precautionary Principle could be invoked for the interim management of potential risks. Therefore, precautionary prevention risk-management measures could be employed to reduce human exposure to the compounds of concern. Steroid oestrogens are generally recognized as the most significant oestrogenically active substances in domestic sewage effluent. As a result, the UK Environment Agency has championed a 'Demonstration Programme' to investigate the potential for removal of steroid oestrogens and alkylphenol ethoxylates during sewage treatment. Ecological and human health risks are interdependent, and ecological injuries may result in increased human exposures to contaminants or other stressors. In this context of limiting exposure to potential contaminants, examining the relative contribution of various compounds and pathways should be taken into account when identifying effective risk-management measures. In addition, the explicit use of ecological objectives within the scope of the implementation of the EU Water Framework Directive poses new challenges and necessitates the development of ecosystem-based decision tools. This paper addresses some of these issues and proposes a species sensitivity distribution approach to support the decision-making process related to the need and implications of sewage treatment work upgrade as risk-management measures to the presence of oestrogenic compounds in sewage effluent. PMID:19736227

  1. Adverse Pregnancy Outcomes and Cardiovascular Risk Factor Management

    PubMed Central

    Mehta, Puja K.; Minissian, Margo; Merz, C. Noel Bairey

    2015-01-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to established risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman’s risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia be evaluated for hypertension and other CVD risk factors within 6 months to 1 year post-partum. Given the burden and impact of CVD on women our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors. PMID:26159741

  2. Adverse pregnancy outcomes and cardiovascular risk factor management.

    PubMed

    Mehta, Puja K; Minissian, Margo; Bairey Merz, C Noel

    2015-06-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman's risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia can be evaluated for hypertension and other CVD risk factors within 6 months to 1-year post-partum. Given the burden and impact of CVD on women in our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors. PMID:26159741

  3. Adverse pregnancy outcomes and cardiovascular risk factor management.

    PubMed

    Mehta, Puja K; Minissian, Margo; Bairey Merz, C Noel

    2015-06-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman's risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia can be evaluated for hypertension and other CVD risk factors within 6 months to 1-year post-partum. Given the burden and impact of CVD on women in our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors.

  4. Prevention and management of osteoporosis in women with breast cancer and men with prostate cancer.

    PubMed

    Hershman, Dawn; Narayanan, Rashmi

    2004-07-01

    Advances in cancer treatment have resulted in improved life expectancies for survivors of breast and prostate cancer. As the number of cancer survivors grows, the long-term side effects of treatment play an increasingly prominent role in the routine care of these patients. Due to similar management approaches, survivors of breast and prostate cancer are at increased risk for osteoporosis. This review summarizes the prevention and management of osteoporosis and osteopenia resulting from cancer treatment in survivors of breast and prostate cancer.

  5. The prevention and management of oral barotrauma.

    PubMed

    Kieser, J; Holborow, D

    1997-12-01

    The recent increase in the popularity of scuba diving has emphasised the role of the dentist in the prevention and treatment of oral barotrauma. Pain and injury to oral structures can result from rapid changes in pressure gradients, and involve enclosed spaces such as the sinuses, exposed dentinal tubules, or root canals. Three patients provide clinical examples of dental barotrauma and highlight the need for an awareness that some patients are divers who need meticulous restorative dentistry.

  6. [Risk in welding operations. Etiopathogenetic, preventive and legislative considerations].

    PubMed

    Coscia, G C; Vergnano, P; Discalzi, G L; Capellaro, E

    1983-01-01

    This work classifies different types of welding procedure, occasional and specific contaminating elements, both of the welding material, and of other possible substances (particularly plastic materials) used in the pre-treating phase. The authors show the risk evaluation factors of the welding operations and, moreover, suggest a diagnostic and prevention program on the exposed subjects. Finally they include a table of references on italian law concerning the contaminating substances produced by welding processes.

  7. [Postpartum depression: we know the risks, can it be prevented?].

    PubMed

    Zinga, Dawn; Phillips, Shauna Dae; Born, Leslie

    2005-10-01

    In the past 20 years, there has been increasing recognition that for some women, pregnancy may be burdened with mood problems, in particular depression, that may impact both mother and child. With identification of risk factors for postpartum depression and a growing knowledge about a biologic vulnerability for mood change following delivery, research has accumulated on attempts to prevent postpartum depression using various psychosocial, psychopharmacologic, and hormonal strategies. The majority of psychosocial and hormonal strategies have shown little effect on postpartum depression. Notwithstanding, results from preliminary trials of interpersonal therapy, cognitive-behavioural therapy, and antidepressants indicate that these strategies may be of benefit. Information on prevention of postpartum depression using dietary supplements is sparse and the available evidence is inconclusive. Although a few studies show promising results, more rigorous trials are required. The abounding negative evidence in the literature indicates that postpartum depression cannot be easily prevented, yet.

  8. Blueprint for communicating risk and preventing environmental injustice.

    PubMed

    Stokes, Shereitte C; Hood, Darryl B; Zokovitch, Jeanne; Close, Fran T

    2010-02-01

    Toxic environmental emissions have the potential to harm already susceptible populations living in close proximity to industries with pollutant emissions such as coal-fired electrical power plants. The organized dissemination of information in communities that find themselves susceptible to occupation by industries with pollutant emissions is a crucial step in the long and arduous process of preventing such harm. Here, we present a blueprint that can be used by community organizations to prevent industries that pollute the environment from locating in communities that are already disproportionately exposed to pollution (referred to here as environmental justice communities). We base this blueprint on a specific case in Taylor County, Florida, where the steps outlined successfully prevented the Taylor Energy Center (TEC) consortium from obtaining the necessary permits for the operation of a proposed coal-fired electrical power plant, thereby minimizing the risks of additional toxicant exposure to the affected community. PMID:20173254

  9. 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…

  10. [Management of blood pressure for stroke prevention].

    PubMed

    Tanahashi, Norio

    2016-04-01

    Hypertension is a major risk factor for both cerebral infarction and intracerebral hemorrhage. The relationship between blood pressure (BP) and stroke risk is strong and continuous. Throughout the usual range of BPs, including the nonhypertensive range, the higher the BP is, the greater the risk of stroke. Regular BP screening and appropriate treatment of patients with hypertension, including life style modification and pharmacotherapy, are recommended. Patients who have hypertension should be treated with antihypertensive drugs to a target BP of < 140/90 mmHg. Successful reduction of BP is more important in reducing stroke risk than the choice of a specific agent, and treatment should be individualized on the basis of other patient characteristics and medication tolerance. In hypertensive patients with stroke, subjects to be treated with antihypertensive drugs and the target level of BP control are determined on the basis of clinical disease type, interval after onset, severity, age, and the use of antithrombotic. drugs. According to the guideline of the Japanese Society of Hypertension (JSH 2014), in the chronic phase of cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage, target BP should be < 140/ 90 mmHg. In patients with lacunar infarction, those taking antithrombotic drugs, cerebral hemorrhage and subarachnoid hemorrhage, a lower level, < 130/80 mmHg should be targeted if possible. Oral antihypertensive drugs such as Ca channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diuretics are recommended for patients with stroke. PMID:27333760

  11. Improving interMediAte Risk management. MARK study

    PubMed Central

    2011-01-01

    Background Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate

  12. 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. PMID:3709010

  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. AIDS prevention among Hispanics: needs, risk behaviors, and cultural values.

    PubMed

    Marin, G

    1989-01-01

    Data from different sources show that Hispanics are over-represented in reported cases of acquired immunodeficiency syndrome (AIDS) (twice their proportion of the population) and that their rate of infection by human immunodeficiency virus (HIV) is three times higher than among non-Hispanic whites. The behavior risk factors most frequently associated with infection in AIDS cases are IV drug use in the Northeast and high-risk sexual behavior in the West. HIV infection prevention strategies for Hispanics need to address high risk behaviors, taking into consideration associated culture-specific characteristics. Strategies need to address as well conditions such as racism and ethnic prejudices that keep many Hispanic homosexuals and bisexuals away from white or non-Hispanic gay organizations and publications, the lack of culturally appropriate drug treatment centers, the level of mis-information among Hispanics, and the possible high incidence among men of sexual intercourse with prostitutes. Prevention campaigns need to include such Hispanic cultural values as simpatia, familialism, personalismo, and power distance, if prevention campaigns are going to be perceived as relevant by Hispanics. Appropriate wording and communication channels need to be identified in order to transmit messages that will be perceived as credible and that will reach the largest possible audience.

  15. AIDS prevention among Hispanics: needs, risk behaviors, and cultural values.

    PubMed Central

    Marin, G

    1989-01-01

    Data from different sources show that Hispanics are over-represented in reported cases of acquired immunodeficiency syndrome (AIDS) (twice their proportion of the population) and that their rate of infection by human immunodeficiency virus (HIV) is three times higher than among non-Hispanic whites. The behavior risk factors most frequently associated with infection in AIDS cases are IV drug use in the Northeast and high-risk sexual behavior in the West. HIV infection prevention strategies for Hispanics need to address high risk behaviors, taking into consideration associated culture-specific characteristics. Strategies need to address as well conditions such as racism and ethnic prejudices that keep many Hispanic homosexuals and bisexuals away from white or non-Hispanic gay organizations and publications, the lack of culturally appropriate drug treatment centers, the level of mis-information among Hispanics, and the possible high incidence among men of sexual intercourse with prostitutes. Prevention campaigns need to include such Hispanic cultural values as simpatia, familialism, personalismo, and power distance, if prevention campaigns are going to be perceived as relevant by Hispanics. Appropriate wording and communication channels need to be identified in order to transmit messages that will be perceived as credible and that will reach the largest possible audience. PMID:2508169

  16. Mediterranean Storms: An Integrated Approach of Risk Management

    NASA Astrophysics Data System (ADS)

    Karageorgou, H.; Riza, E.; Linos, A.; Papanikolaou, D.

    2010-09-01

    response. The available and applied science and technology in prediction and early warning systems rely on the close collaboration between scientists and policy makers to achieve effective disaster prevention of human life and mitigation of damages. Developing agencies approach risk management as an integral part of development and encourage activities and measures to reduce the exposure and vulnerability to natural hazards through early warning systems, building codes, land use plans and disaster sensitive development plans. The human settlement and investment in high risk floodplains place greater numbers of people and economic assets in danger of being affected by storms and floods. Disasters and development are highly inter-related. Recurrent disasters and frequent localized disasters erode development and conversely the development processes can reduce disaster risk, or create new risks. The private sector participation in risk reduction efforts can help local communities mitigate disasters and increases the benefits of the businesses. The private insurance sector is highly involved in the prevention of disaster caused by natural hazards especially storms and floods. The collaboration between academic community and the insurance sector indicates the linkages between the mutual insurance actions and risk culture. Also tourism industry and private critical infrastructure sector get involved in prevention measures and activities against storm and flood risks to build sustainable functionality and keep public trust. NGOs focus on social, cultural, environmental, educational, or health issues in disaster management and their members are educated and experienced on their area of operations. The staff of local and national NGOs is familiar with culture, languages, governance structures, social networks, climate and geography of the affected area and holds a unique understanding of the specific problems of the affected population. Additionally, NGO’s operations do not

  17. AEGIS: a wildfire prevention and management information system

    NASA Astrophysics Data System (ADS)

    Kalabokidis, Kostas; Ager, Alan; Finney, Mark; Athanasis, Nikos; Palaiologou, Palaiologos; Vasilakos, Christos

    2016-03-01

    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 information that is essential for wildfire management. The system uses a number of spatial and non-spatial data sources to support key system functionalities. Land use/land cover maps were produced by combining field inventory data with high-resolution multispectral satellite images (RapidEye). These data support wildfire simulation tools that allow the users to examine potential fire behavior and hazard with the Minimum Travel Time fire spread algorithm. End-users provide a minimum number of inputs such as fire duration, ignition point and weather information to conduct a fire simulation. AEGIS offers three types of simulations, i.e., single-fire propagation, point-scale calculation of potential fire behavior, and burn probability analysis, similar to the FlamMap fire behavior modeling software. Artificial neural networks (ANNs) were utilized for wildfire ignition risk assessment based on various parameters, training methods, activation functions, pre-processing methods and network structures. The combination of ANNs and expected burned area maps are used to generate integrated output map of fire hazard prediction. The system also incorporates weather information obtained from remote automatic weather stations and weather forecast maps. The system and associated computation algorithms leverage parallel processing techniques (i.e., High Performance Computing and Cloud Computing) that ensure computational power required for real-time application. All AEGIS functionalities are accessible to authorized end-users through a web-based graphical user interface. An

  18. Case histories in pharmaceutical risk management.

    PubMed

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

    2009-12-01

    The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS). PMID:19767156

  19. [Prevention and management of anterior resection syndrome].

    PubMed

    Gu, Jin; Pan, Hongda

    2016-04-01

    Because of the improvement of surgical technique and the widely use of multimodality therapy, more patients with rectal cancer undergo sphincter-preserving surgery. However, it has been reported that up to 90% of such patients will suffer from bowel dysfunction, ranging from increased bowel frequency to faecal incontinence or evacuatory dysfunction. This wide spectrum of symptoms after resection of the rectum has been termed anterior resection syndrome (ARS). This disordered bowel function has a substantial negative effect on quality of life, however, the causal mechanisms have not been clarified. The present review discusses the clinical manifestation, underlying mechanisms, as well as prevention and treatment strategies. PMID:27112463

  20. RISK MANAGEMENT OF SEDIMENT STRESS: A FRAMEWORK FOR SEDIMENT RISK MANAGEMENT RESEARCH

    EPA Science Inventory

    Research related to the ecological risk management of sediment stress in watersheds is placed under a common conceptual framework in order to help promote the timely advance of decision support methods for aquatic resource managers and watershed-level planning. The proposed risk ...

  1. Managing dynamic epidemiological risks through trade

    PubMed Central

    Horan, Richard D.; Fenichel, Eli P.; Finnoff, David; Wolf, Christopher A.

    2015-01-01

    There is growing concern that trade, by connecting geographically isolated regions, unintentionally facilitates the spread of invasive pathogens and pests – forms of biological pollution that pose significant risks to ecosystem and human health. We use a bioeconomic framework to examine whether trade always increases private risks, focusing specifically on pathogen risks from live animal trade. When the pathogens have already established and traders bear some private risk, we find two results that run counter to the conventional wisdom on trade. First, uncertainty about the disease status of individual animals held in inventory may increase the incentives to trade relative to the disease-free case. Second, trade may facilitate reduced long-run disease prevalence among buyers. These results arise because disease risks are endogenous due to dynamic feedback processes involving valuable inventories, and markets facilitate the management of private risks that producers face with or without trade. PMID:25914431

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

    PubMed

    Hollingsworth, Kristen; Toscani, Michael

    2013-04-01

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

  3. Venomous snakebite in mountainous terrain: prevention and management.

    PubMed

    Boyd, Jeff J; Agazzi, Giancelso; Svajda, Dario; Morgan, Arthur J; Ferrandis, Silvia; Norris, Robert L

    2007-01-01

    The prevention and management of venomous snakebite in the world's mountains present unique challenges. This paper presents a series of practical, clinically sound recommendations for management of venomous snakebite in a mountain environment. The authors performed an extensive review of current literature using search engines and manual searches. They then fused the abundant knowledge of snakebite with the realities of remote first aid and mountain rescue to develop recommendations. A summary is provided of the world's most troublesome mountain snakes and the mechanisms of toxicity from their bites. Preventive measures are described. Expected symptoms and signs are reviewed in lay and medical terms. A review of currently recommended first-aid measures and advanced medical management for physicians, paramedics, and other clinicians is included. Venomous snakebites in mountainous environments present unique challenges for management. This paper offers practical recommendations for managing such cases and summarizes the approach to first aid and advanced management in 2 algorithms.

  4. [Prevention of bacterial risk: pathogen inactivation/detection of bacteria].

    PubMed

    Morel, P; Naegelen, C; Deschaseaux, M; Bardiaux, L

    2013-05-01

    Bacterial contamination of blood products remains the most important infectious risk of blood transfusion in 2013. Platelet concentrates (PC) are in cause in the majority of the transfusion reaction due to bacterial contaminations. A lot of prevention methods have been developed over the last 10 years (pre-donation interview, skin decontamination, diversion of the first 30 mL of the donation, leuko-reduction...), they have focused on limiting the contamination of the donations and prevent the bacterial growth in donations and/or in the blood products. These measures were effective and led to significantly reducing the risk of adverse effects associated with bacterial growth. However, every year there are about six accidents (with a high level of imputability) and one death. The reduction of the bacterial risk remains a priority for the French Blood Establishment (EFS). The procedure for skin disinfection is going to be improved in order to further strengthen this crucial step to avoid the contamination of donation. Methods of pathogen inactivation applied to plasma and PC are available in France and their effectiveness is demonstrated on the bacterial risk. Methods for bacterial detection of PC are used in many countries now. Automated culture is the most common. Alternatives are now available in the form of rapid tests able to analyze the PC just before the delivery and avoid false negatives observed with automated culture. Assessments are under way to confirm these benefits in 2013.

  5. Environmental vascular risk factors: new perspectives for stroke prevention.

    PubMed

    Bernal-Pacheco, Oscar; Román, Gustavo C

    2007-11-15

    Despite intensive evaluation of acute stroke patients, perhaps only half of the attributable stroke risk is usually identified. In addition to traditional and non-traditional vascular risk factors-including most recently homocysteine, inflammation, and alterations of coagulation-a number of environmental risk factors for stroke have been identified in the last decade. In this update we review the following: lower education and poor socioeconomic status (probable surrogates for exposure to traditional high-risk behaviors such as smoking, poor nutrition, lack of prenatal control, absence of preventive medical and dental care, and non-compliance of treatment of conditions such as hypertension); depression, stress and affective disorders; obstructive sleep apnea; passive smoking and environmental pollution; infections, in particular periodontal diseases that increase C-reactive protein (CRP); raised body mass index (obesity); exercise, and diet. The possible role of high-fructose corn syrup in the epidemic of obesity in the USA is reviewed. Protective diets include higher consumption of fish, olive oil, grains, fruits and vegetables (Mediterranean diet), as well as probiotic bacteria in yogurt and dairy products. Careful attention should be given to the patient's environment looking for modifiable factors. The effects of clean environmental air and water, adequate diet and appropriate nutrition, healthy teeth, exercise, and refreshing sleep in the prevention of stroke and cardiovascular disease appear to be quite compelling. Although some of these modifiable risk factors lack evidence-based information, judicious clinical sense should be used to counteract the potentially damaging effects of adverse environmental vascular risk factors. PMID:17655871

  6. Parenteral nutrition: risks, complications, and management.

    PubMed

    Worthington, Patricia H; Gilbert, Karen A

    2012-01-01

    Parenteral nutrition is a life-saving modality, but one that also carries risks for potentially life-threatening complications. Comprehensive management of patients receiving parenteral nutrition includes careful selection of candidates, individualizing formulas to meet patients' unique needs, monitoring response to therapy, and implementing strategies designed to avoid complications. Measures to mitigate the risk of central line-associated bloodstream infections are particularly important. As with all complex therapies, a collaborative, multidisciplinary approach promotes optimal outcomes. PMID:22222292

  7. 75 FR 30106 - Terrorism Risk Insurance Program; Litigation Management Submissions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Terrorism Risk Insurance Program; Litigation Management Submissions AGENCY: Departmental Offices. ACTION..., the Terrorism Risk Insurance Program Office is seeking comments regarding Litigation Management..., preferably an original and two copies) to: Terrorism Risk Insurance Program, Public Comment Record,...

  8. Security risks in nuclear waste management: Exceptionalism, opaqueness and vulnerability.

    PubMed

    Vander Beken, Tom; Dorn, Nicholas; Van Daele, Stijn

    2010-01-01

    This paper analyses some potential security risks, concerning terrorism or more mundane forms of crime, such as fraud, in management of nuclear waste using a PEST scan (of political, economic, social and technical issues) and some insights of criminologists on crime prevention. Nuclear waste arises as spent fuel from ongoing energy generation or other nuclear operations, operational contamination or emissions, and decommissioning of obsolescent facilities. In international and EU political contexts, nuclear waste management is a sensitive issue, regulated specifically as part of the nuclear industry as well as in terms of hazardous waste policies. The industry involves state, commercial and mixed public-private bodies. The social and cultural dimensions--risk, uncertainty, and future generations--resonate more deeply here than in any other aspect of waste management. The paper argues that certain tendencies in regulation of the industry, claimed to be justified on security grounds, are decreasing transparency and veracity of reporting, opening up invisible spaces for management frauds, and in doing allowing a culture of impunity in which more serious criminal or terrorist risks could arise. What is needed is analysis of this 'exceptional' industry in terms of the normal cannons of risk assessment - a task that this paper begins.

  9. Security risks in nuclear waste management: Exceptionalism, opaqueness and vulnerability.

    PubMed

    Vander Beken, Tom; Dorn, Nicholas; Van Daele, Stijn

    2010-01-01

    This paper analyses some potential security risks, concerning terrorism or more mundane forms of crime, such as fraud, in management of nuclear waste using a PEST scan (of political, economic, social and technical issues) and some insights of criminologists on crime prevention. Nuclear waste arises as spent fuel from ongoing energy generation or other nuclear operations, operational contamination or emissions, and decommissioning of obsolescent facilities. In international and EU political contexts, nuclear waste management is a sensitive issue, regulated specifically as part of the nuclear industry as well as in terms of hazardous waste policies. The industry involves state, commercial and mixed public-private bodies. The social and cultural dimensions--risk, uncertainty, and future generations--resonate more deeply here than in any other aspect of waste management. The paper argues that certain tendencies in regulation of the industry, claimed to be justified on security grounds, are decreasing transparency and veracity of reporting, opening up invisible spaces for management frauds, and in doing allowing a culture of impunity in which more serious criminal or terrorist risks could arise. What is needed is analysis of this 'exceptional' industry in terms of the normal cannons of risk assessment - a task that this paper begins. PMID:20022419

  10. Minimizing bleeding risk in patients receiving direct oral anticoagulants for stroke prevention

    PubMed Central

    Habert, Jeffrey Steven

    2016-01-01

    Many primary care physicians are wary about using direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation (AF). Factors such as comorbidities, concomitant medications, and alcohol misuse increase concerns over bleeding risk, especially in elderly and frail patients with AF. This article discusses strategies to minimize the risk of major bleeding events in patients with AF who may benefit from oral anticoagulant therapy for stroke prevention. The potential benefits of the DOACs compared with vitamin K antagonists, in terms of a lower risk of intracranial hemorrhage, are discussed, together with the identification of reversible risk factors for bleeding and correct dose selection of the DOACs based on a patient’s characteristics and concomitant medications. Current bleeding management strategies, including the new reversal agents for the DOACs and the prevention of bleeding during preoperative anticoagulation treatment, in addition to health care resource use associated with anticoagulation treatment and bleeding, are also discussed. Implementing a structured approach at an individual patient level will minimize the overall risk of bleeding and should increase physician confidence in using the DOACs for stroke prevention in their patients with nonvalvular AF. PMID:27785089

  11. Handbook for Volcanic Risk Management: an outcome from MIAVITA project

    NASA Astrophysics Data System (ADS)

    Bignami, Christian; Bosi, Vittorio; Costantini, Licia; Cristiani, Chiara; Lavigne, Franck; Thierry, Pierre

    2013-04-01

    Volcanic eruptions are one of the most impressive, violent and dramatic agents of change on Earth, threatening hundreds of millions of people. The crises management implies a strong cooperation among the main stakeholders (e.g., civil protection authorities, scientific institutions, operational forces). Considering the great amount of different actions required during the whole volcanic cycle (e.g., preparedness, unrest phase, crisis management, resilience), the role and responsibilities of stakeholders should be clarified in advance. In particular, the role of scientists, fundamental in all the phases, should be well discussed with the other stakeholders and well defined, for every country. This will allow a better management and response, and contribute to avoid misunderstanding. The new "Handbook for Volcanic Risk Management" issued by the MIAVITA European project, funded by the European Commission (Mitigate and Assess risk from Volcanic Impact on Terrain and human Activities) gives a contribution to that. Indeed, this handbook aims at synthesizing the acquired knowledge on volcanic risk management, such as prevention, preparedness, mitigation, intervention, crisis management and resilience, in a practical and useful way. It promotes the creation of an ideal bridge between different actors involved in risk management, improving and facilitating interactions among authorities and scientists. This work is based on current scientific research and the shared experience of the different MIAVITA project partners as well as on international good practices previously recommended. The handbook is composed of six sections. The first one briefly explains the global volcanic context and the principles of corresponding risk management. Section 2 contains a description of volcanic phenomena, damage and understanding size and effects that can be expected. Sections 3, 4 and 5 meet preparation and prevention issues and describe actions to be undertaken during the response phase

  12. Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies.

    PubMed

    Caroly, S; Coutarel, F; Landry, A; Mary-Cheray, I

    2010-07-01

    To increase output and meet customers' needs, companies have turned to the development of production management systems: Kaizen, one piece flow, Kanban, etc. The aim of such systems is to accelerate decisions, react to environmental issues and manage various productions. In the main, this type of management system has led to the continuous improvement of production performance. Consequently, such production management systems can have unexpected negative effects on operators' health and safety. Conversely, regulation and control systems focusing on work-related risks have obliged firms to implement health and safety management systems such as OHSAS 18001. The purpose of this type of system, also based on continuous improvement, is to reduce risks, facilitate work-related activities and identify solutions in terms of equipment and tools. However, the prevention actions introduced through health and safety systems often result in other unexpected and unwanted effects on production. This paper shows how companies can improve the way they are run by taking into account both types of management system.

  13. Mediterranean Storms: An Integrated Approach of Risk Management

    NASA Astrophysics Data System (ADS)

    Karageorgou, H.; Riza, E.; Linos, A.; Papanikolaou, D.

    2010-09-01

    response. The available and applied science and technology in prediction and early warning systems rely on the close collaboration between scientists and policy makers to achieve effective disaster prevention of human life and mitigation of damages. Developing agencies approach risk management as an integral part of development and encourage activities and measures to reduce the exposure and vulnerability to natural hazards through early warning systems, building codes, land use plans and disaster sensitive development plans. The human settlement and investment in high risk floodplains place greater numbers of people and economic assets in danger of being affected by storms and floods. Disasters and development are highly inter-related. Recurrent disasters and frequent localized disasters erode development and conversely the development processes can reduce disaster risk, or create new risks. The private sector participation in risk reduction efforts can help local communities mitigate disasters and increases the benefits of the businesses. The private insurance sector is highly involved in the prevention of disaster caused by natural hazards especially storms and floods. The collaboration between academic community and the insurance sector indicates the linkages between the mutual insurance actions and risk culture. Also tourism industry and private critical infrastructure sector get involved in prevention measures and activities against storm and flood risks to build sustainable functionality and keep public trust. NGOs focus on social, cultural, environmental, educational, or health issues in disaster management and their members are educated and experienced on their area of operations. The staff of local and national NGOs is familiar with culture, languages, governance structures, social networks, climate and geography of the affected area and holds a unique understanding of the specific problems of the affected population. Additionally, NGO’s operations do not

  14. NGNP Risk Management through Assessing Technology Readiness

    SciTech Connect

    John W. Collins

    2010-08-01

    Throughout the Next Generation Nuclear Plant (NGNP) project life cycle, technical risks are identified, analyzed, and mitigated and decisions are made regarding the design and selection of plant and sub-system configurations, components and their fabrication materials, and operating conditions. Risk resolution and decision making are key elements that help achieve project completion within budget and schedule constraints and desired plant availability. To achieve this objective, a formal decision-making and risk management process was developed for NGNP, based on proven systems engineering principles that have guided aerospace and military applications.

  15. Fatigue Risk Management: A Maritime Framework

    PubMed Central

    Grech, Michelle Rita

    2016-01-01

    It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer’s role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this “poor compliance” trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue. PMID:26840326

  16. Fatigue Risk Management: A Maritime Framework.

    PubMed

    Grech, Michelle Rita

    2016-02-01

    It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer's role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this "poor compliance" trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue.

  17. Suicide on railway networks: epidemiology, risk factors and prevention.

    PubMed

    Krysinska, Karolina; De Leo, Diego

    2008-09-01

    The aim of the present study was to review international literature on the incidence of suicide on railway networks, describe risk factors associated with it, and examine existing prevention practices. Searches on Medline and PsycINFO for the period 1966-2007 were performed. Thirty original studies published in English on epidemiology of rail suicide were included in the review along with peer-reviewed articles on risk factors and prevention of rail suicide. Internationally, suicide by collision with a train accounted for 1-12% of all suicides, with up to 94% of all attempts resulting in death. Suicide by train seriously affects not only survivors, but also train drivers and bystanders. Correlations between density of rail network, number of passengers and number of suicides by train have been found. Conflicting data exist on gender ratio of this type of suicide, but studies are homogenous in identifying young adults (20-40 year of age) as those most exposed to train suicide. Documented psychiatric diagnoses were found in up to 83% of cases. Mid-seasonal peaks were also identified, with events occurring mostly during late morning and early afternoon. Limited evidence exists for effective suicide prevention practices. Successful examples are represented by pits and sliding door systems (Singapore Mass Rapid Transit System) and responsible media reporting (Viennese Subway). Suicide by train involves emotional and financial costs to individuals and society as a whole. A combination of different strategies might significantly reduce its effect.

  18. Prevention and management of obinutuzumab-associated toxicities: Australian experience.

    PubMed

    Snowden, Alicia; Hayden, Ingrid; Dixon, Joanna; Gregory, Gareth

    2015-12-01

    Patients with chronic lymphocytic leukaemia (CLL) are typically diagnosed at an advanced age and may have multiple co-existing conditions, augmenting the challenges of treating their CLL. Aggressive cytotoxic therapies are often poorly tolerated in this patient population. Obinutuzumab is a glycoengineered type II anti-CD20 monoclonal antibody indicated in combination with chlorambucil for previously untreated CLL. The approval of this drug was based on the pivotal CLL11 trial, which demonstrated longer progression-free survival vs. rituximab/chlorambucil and chlorambucil alone in patients with significant co-existing medical conditions and/or poor renal function. However, a higher risk of infusion-related reactions (IRRs) was demonstrated with obinutuzumab-based therapy. We highlight important nursing care considerations to help prevent and successfully manage IRRs and other important adverse events, to improve the treatment experience of patients receiving obinutuzumab infusions and to enable them to complete their treatment and receive optimal benefit. Premedication, drug handling, dosing, administration, monitoring and documentation are discussed. PMID:26681665

  19. Concise guidance: diagnosis, management and prevention of occupational asthma.

    PubMed

    Nicholson, Paul J; Cullinan, Paul; Burge, Sherwood

    2012-04-01

    This concise guidance, prepared for physicians, summarises the British Occupational Health Research Foundation guideline for the prevention, identification and management of occupational asthma. Approximately one in six people of working age who develop asthma have work-related asthma, where work has either caused or aggravated their disease. Physicians who assess working adults with asthma need to ask the patient about their job and the materials they work with, and be aware of those that carry particular risks; they should also ask whether symptoms improve regularly on days away from work. A diagnosis of occupational asthma (ie asthma caused by work) should not be made on the basis of history alone, but be supported by immunological and physiological investigations of proven diagnostic benefit. Following a validated diagnosis of occupational asthma, physicians should recommend early avoidance of further exposure, because this offers the best chance of complete recovery. If appropriate and timely interventions are not taken, the prognosis of occupational asthma is poor, with only approximately one-third of workers achieving full symptomatic recovery.

  20. Environmental management/pollution prevention/environmental electrochemistry opportunities

    SciTech Connect

    Nosenchuck, N.H.

    1994-12-31

    Thank you for inviting me to be your keynoter. I`m impressed by what you`ve accomplished through the years and the program that you`ve put together for this International Forum on Environmental Electrochemistry. Above all, we must remember what has brought us together. We must be aware of the challenge, the need, the opportunity we have before us. Sustainable economic development that is responsive to environmental concerns is vital to continued national prosperity. Coincidentally, there are boundless environmental electrochemistry opportunities in environmental management and pollution prevention. The basic approach to environmental protection in this country, for far too many years, has been, for the most part, reactive. As a society, we react to crisis; and in the environmental business, we react to environmental crisis. We react to problems that already were posing substantial ecological and human health risks and problems that already were causing significant public concern. We need both a quality and results-oriented national environmental electrochemistry program.

  1. Risk management and data: managed care company perspective.

    PubMed

    Kanwit, S W

    1998-11-01

    As both public and private health plans move increasingly to managed care, a vigorous debate is occurring about how to ensure health care quality for the American public, while at the same time managing the cost of that care. Health plans generate large volumes of data related to their networks and providers, plan sponsors, member care, and medical protocols. This data can help assure quality, and at the same time help managed care organizations deal with one of the most critical tasks facing them--risk management. This paper may be helpful in providing an outline of two key areas--managed care liability for quality of patient care, and privacy and confidentiality concerns from a managed care organization perspective--followed by suggestions to avoid or minimize liability. PMID:10028510

  2. Risk based management of piping systems

    SciTech Connect

    Conley, M.J.; Aller, J.E.; Tallin, A.; Weber, B.J.

    1996-07-01

    The API Piping Inspection Code is the first such Code to require classification of piping based on the consequences of failure, and to use this classification to influence inspection activity. Since this Code was published, progress has been made in the development of tools to improve on this approach by determining not only the consequences of failure, but also the likelihood of failure. ``Risk`` is defined as the product of the consequence and the likelihood. Measuring risk provides the means to formally manage risk by matching the inspection effort (costs) to the benefits of reduced risk. Using such a cost/benefit analysis allows the optimization of inspection budgets while meeting societal demands for reduction of the risk associated with process plant piping. This paper presents an overview of the tools developed to measure risk, and the methods to determine the effects of past and future inspections on the level of risk. The methodology is being developed as an industry-sponsored project under the direction of an API committee. The intent is to develop an API Recommended Practice that will be linked to In-Service Inspection Standards and the emerging Fitness for Service procedures. Actual studies using a similar approach have shown that a very high percentage of the risk due to piping in an operating facility is associated with relatively few pieces of piping. This permits inspection efforts to be focused on those piping systems that will result in the greatest risk reduction.

  3. Risk management for the Space Exploration Initiative

    NASA Technical Reports Server (NTRS)

    Buchbinder, Ben

    1993-01-01

    Probabilistic Risk Assessment (PRA) is a quantitative engineering process that provides the analytic structure and decision-making framework for total programmatic risk management. Ideally, it is initiated in the conceptual design phase and used throughout the program life cycle. Although PRA was developed for assessment of safety, reliability, and availability risk, it has far greater application. Throughout the design phase, PRA can guide trade-off studies among system performance, safety, reliability, cost, and schedule. These studies are based on the assessment of the risk of meeting each parameter goal, with full consideration of the uncertainties. Quantitative trade-off studies are essential, but without full identification, propagation, and display of uncertainties, poor decisions may result. PRA also can focus attention on risk drivers in situations where risk is too high. For example, if safety risk is unacceptable, the PRA prioritizes the risk contributors to guide the use of resources for risk mitigation. PRA is used in the Space Exploration Initiative (SEI) Program. To meet the stringent requirements of the SEI mission, within strict budgetary constraints, the PRA structure supports informed and traceable decision-making. This paper briefly describes the SEI PRA process.

  4. Diaper dermatitis: etiology, manifestations, prevention, and management.

    PubMed

    Stamatas, Georgios N; Tierney, Neena K

    2014-01-01

    Pediatricians and parents report diaper dermatitis (DD) to be one of the most common skin diseases that affects almost every child at some point during the early months and years of life. Diapered skin is exposed to friction and excessive hydration, has a higher pH than nondiapered skin, and is repeatedly soiled with feces that contains enzymes with high irritation potential for the skin. The combination of these factors frequently results in skin damage, leading to visible erythematous lesions that can be irritating and painful to the child. Behavioral changes such as increased crying and agitation and changes in eating and sleeping patterns indicate emotional distress. Appropriate skin care can help to prevent the occurrence of DD and to speed up the healing of affected skin. This includes frequent diaper changes and aeration, gentle cleansing, and the use of a barrier cream. Mild to moderate cases usually resolve after a few days of following this routine, but the use of harsh cleaning products can exacerbate DD.

  5. Diaper dermatitis: etiology, manifestations, prevention, and management.

    PubMed

    Stamatas, Georgios N; Tierney, Neena K

    2014-01-01

    Pediatricians and parents report diaper dermatitis (DD) to be one of the most common skin diseases that affects almost every child at some point during the early months and years of life. Diapered skin is exposed to friction and excessive hydration, has a higher pH than nondiapered skin, and is repeatedly soiled with feces that contains enzymes with high irritation potential for the skin. The combination of these factors frequently results in skin damage, leading to visible erythematous lesions that can be irritating and painful to the child. Behavioral changes such as increased crying and agitation and changes in eating and sleeping patterns indicate emotional distress. Appropriate skin care can help to prevent the occurrence of DD and to speed up the healing of affected skin. This includes frequent diaper changes and aeration, gentle cleansing, and the use of a barrier cream. Mild to moderate cases usually resolve after a few days of following this routine, but the use of harsh cleaning products can exacerbate DD. PMID:24224482

  6. RISK COMMUNICATION AS A RISK MANAGEMENT TOOL: A RISK COMMUNICATION WORKBOOK

    EPA Science Inventory

    Communicating information about environmental risk to the people most affected by it is one of the major challenges faced by risk managers and community decision makers. Changing human behavior is a far more complex task than designing water retention systems or managing storm wa...

  7. AEGIS: a wildfire prevention and management information system

    NASA Astrophysics Data System (ADS)

    Kalabokidis, K.; Ager, A.; Finney, M.; Athanasis, N.; Palaiologou, P.; Vasilakos, C.

    2015-10-01

    A Web-GIS wildfire prevention and management platform (AEGIS) was developed as an integrated and easy-to-use decision support tool (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing access to information that is essential for wildfire management. Databases were created with spatial and non-spatial data to support key system functionalities. Updated land use/land cover maps were produced by combining field inventory data with high resolution multispectral satellite images (RapidEye) to be used as inputs in fire propagation modeling with the Minimum Travel Time algorithm. End users provide a minimum number of inputs such as fire duration, ignition point and weather information to conduct a fire simulation. AEGIS offers three types of simulations; i.e. single-fire propagations, conditional burn probabilities and at the landscape-level, similar to the FlamMap fire behavior modeling software. Artificial neural networks (ANN) were utilized for wildfire ignition risk assessment based on various parameters, training methods, activation functions, pre-processing methods and network structures. The combination of ANNs and expected burned area maps produced an integrated output map for fire danger prediction. The system also incorporates weather measurements from remote automatic weather stations and weather forecast maps. The structure of the algorithms relies on parallel processing techniques (i.e. High Performance Computing and Cloud Computing) that ensure computational power and speed. All AEGIS functionalities are accessible to authorized end users through a web-based graphical user interface. An innovative mobile application, AEGIS App, acts as a complementary tool to the web-based version of the system.

  8. Gastric Cancer: Descriptive Epidemiology, Risk Factors, Screening, and Prevention

    PubMed Central

    Karimi, Parisa; Islami, Farhad; Anandasabapathy, Sharmila; Freedman, Neal D.; Kamangar, Farin

    2014-01-01

    Less than a century ago, gastric cancer (GC) was the most common cancer in the United States and perhaps throughout the world. Despite its worldwide decline in incidence over the past century, GC remains a major killer across the globe. This article reviews the epidemiology, screening, and prevention of gastric cancer. We first discuss the descriptive epidemiology of GC, including its incidence, survival, and mortality, including trends over time. Next, we characterize the risk factors for gastric cancer, both environmental and genetic. Serological markers and histological precursor lesions of GC and early detection of GC of using these markers is reviewed. Finally, we discuss prevention strategies and provide suggestions for further research. PMID:24618998

  9. Uncertainty and Risk Management in Cyber Situational Awareness

    NASA Astrophysics Data System (ADS)

    Li, Jason; Ou, Xinming; Rajagopalan, Raj

    Handling cyber threats unavoidably needs to deal with both uncertain and imprecise information. What we can observe as potential malicious activities can seldom give us 100% confidence on important questions we care about, e.g. what machines are compromised and what damage has been incurred. In security planning, we need information on how likely a vulnerability can lead to a successful compromise to better balance security and functionality, performance, and ease of use. These information are at best qualitative and are often vague and imprecise. In cyber situational awareness, we have to rely on such imperfect information to detect real attacks and to prevent an attack from happening through appropriate risk management. This chapter surveys existing technologies in handling uncertainty and risk management in cyber situational awareness.

  10. Managing oil and gas price risk

    SciTech Connect

    Edwards, T.K.

    1995-12-31

    This paper presents a review of managing oil and gas product price risk with the basic types of derivative products available to producers. Introducing the futures markets, basic types of hedges and factors affecting prices will be covered. Several case histories will be discussed in detail from the initial decision making process to actual performance to date.

  11. 17 CFR 39.13 - Risk management.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ORGANIZATIONS Compliance with Core Principles § 39.13 Risk management. (a) General. A derivatives clearing... product is a significant input into the other product(s); (C) The products share a significant common input; or (D) The prices of the products are influenced by common external factors. (ii) A...

  12. 17 CFR 39.13 - Risk management.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... ORGANIZATIONS Compliance with Core Principles § 39.13 Risk management. (a) General. A derivatives clearing... product is a significant input into the other product(s); (C) The products share a significant common input; or (D) The prices of the products are influenced by common external factors. (ii) A...

  13. UTILITY DATA ARCHIVING FOR RISK MANAGEMENT

    EPA Science Inventory

    EPA let a contract for a consultant to collect information about historical changes in operations and maintenance, design and construction, and planning and siting for water and wastewater infrastructure. The goal of this research study is to determine risk management alternativ...

  14. 17 CFR 39.13 - Risk management.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... clearing organization shall conduct stress tests, as defined in § 39.2 of this part, as follows: (i) On a daily basis, a derivatives clearing organization shall conduct stress tests with respect to each large... ORGANIZATIONS Compliance with Core Principles § 39.13 Risk management. (a) General. A derivatives...

  15. A Risk and Prevention Counselor Training Program Model: Theory and Practice

    ERIC Educational Resources Information Center

    Mason, Michael J.; Nakkula, Michael J.

    2008-01-01

    The need for training mental health counselors in risk and prevention is presented, and justification of the development of an innovative and integrative prevention training program is offered. Theoretical underpinnings that connect the counseling discipline to the field of prevention are described. A risk and prevention training model from…

  16. [Management of vascular risk factors in patients older than 80].

    PubMed

    Gómez-Huelgas, Ricardo; Martínez-Sellés, Manuel; Formiga, Francesc; Alemán Sánchez, José Juan; Camafort, Miguel; Galve, Enrique; Gil, Pedro; Lobos, José María

    2014-08-01

    The number of patients older than 80 years is steadily increasing and it represents the main basis for increasing population figures in developed countries. Cardiovascular diseases are the leading causes of mortality and disability causes result in a huge burden of disease in elderly people. However, available scientific evidence to support decision-making on cardiovascular prevention in elderly patients is scarce. Currently available risk assessment scales cannot be applied to elderly people. They are focused on cardiovascular mortality risk and do not provide information on factors with a proven prognostic value in the very old (functioning disability, dementia). Elderly people are a highly heterogeneous population, with a variety of co-morbidities, as well as several functional and cognitive impairment degrees. Furthermore, aging-associated physiological changes and common use of multiple drugs result in an increased risk of adverse drug reactions. Thus, drug use should always be based on a risk/benefit assessment in the elderly. Therefore, therapeutic decision-making in the very old must be an individually tailored and based on an appropriate clinical judgement and a comprehensive geriatric assessment. The current consensus report aims to present a proposal for clinical practices in the primary and secondary cardiovascular prevention in the very old and to provide a number of recommendations on lifestyle changes and drug therapy for the management of major cardiovascular risk factors.

  17. [Management of vascular risk factors in patients older than 80].

    PubMed

    Gómez-Huelgas, Ricardo; Martínez-Sellés, Manuel; Formiga, Francesc; Alemán Sánchez, José Juan; Camafort, Miguel; Galve, Enrique; Gil, Pedro; Lobos, José María

    2014-08-01

    The number of patients older than 80 years is steadily increasing and it represents the main basis for increasing population figures in developed countries. Cardiovascular diseases are the leading causes of mortality and disability causes result in a huge burden of disease in elderly people. However, available scientific evidence to support decision-making on cardiovascular prevention in elderly patients is scarce. Currently available risk assessment scales cannot be applied to elderly people. They are focused on cardiovascular mortality risk and do not provide information on factors with a proven prognostic value in the very old (functioning disability, dementia). Elderly people are a highly heterogeneous population, with a variety of co-morbidities, as well as several functional and cognitive impairment degrees. Furthermore, aging-associated physiological changes and common use of multiple drugs result in an increased risk of adverse drug reactions. Thus, drug use should always be based on a risk/benefit assessment in the elderly. Therefore, therapeutic decision-making in the very old must be an individually tailored and based on an appropriate clinical judgement and a comprehensive geriatric assessment. The current consensus report aims to present a proposal for clinical practices in the primary and secondary cardiovascular prevention in the very old and to provide a number of recommendations on lifestyle changes and drug therapy for the management of major cardiovascular risk factors. PMID:24908624

  18. An open framework for risk management

    SciTech Connect

    Craft, R.; Vandewart, R.; Wyss, G.; Funkhouser, D.

    1998-08-01

    Risk assessment methodologies are ready to enter their third generation. In this next generation, assessment will be based on a whole system understanding of the system to be assessed. To realize this vision of risk management, the authors have begun development of an extensible software tool kit. This tool kit breaks with the traditional approach to assessment by having the analyst spend the majority of the assessment time building an explicit model that documents in a single framework the various facets of the system, such as the system`s behavior, structure, and history. Given this explicit model of the system, a computer is able to automatically produce a standard assessment products, such as fault trees and event trees. This brings with it a number of advantages relative to current risk management tools. Among these are a greater sense of completeness and correctness in assessment results and the ability to preserve and later employ lessons learned.

  19. Developmental Science and Preventive Interventions for Children at Environmental Risk

    PubMed Central

    Guralnick, Michael J.

    2015-01-01

    The current status of preventive intervention programs for young children at environmental risk designed to reduce the school readiness gap is examined in the context of developmental science. A review of program effectiveness suggests that future progress may depend upon committing to a specific developmental approach consistent with the knowledge base of developmental science and establishing a generally agreed upon and unambiguous framework, set of goals, and associated mechanisms. The Developmental Systems Approach is suggested as one model that is consistent with developmental and existing intervention science, supporting an emphasis on program continuity, relationships, and comprehensiveness. A long-term plan for community-based systems development is presented. PMID:26213447

  20. Risking a Debate--Redefining Risk and Risk Management: A New Zealand Case Study.

    ERIC Educational Resources Information Center

    Zink, Robyn; Leberman, Sarah

    2001-01-01

    Interviews with 12 New Zealand outdoor instructors found that they viewed risk as an opportunity to gain something of value, as opposed to losing something of value. Repositioning risk in this manner could allow the debate around adventure education to move away from being dominated by risk management, allowing consideration of adventure…

  1. Risk and risk management for Australian sex workers.

    PubMed

    Harris, Margaret; Nilan, Pam; Kirby, Emma

    2011-03-01

    In this article, we address the experiences of female sex workers in urban Australia through analysis of interviews using a feminist approach. Although many previous studies have been conducted, our focus was on the voices of sex workers in an area that was rapidly gentrifying, leading to local community tensions. Intensive analysis of interview transcripts was employed to derive thematic codes for understanding how the women viewed and managed everyday risk in sex work. They were well aware of the health risks associated with sex work. For women working on premises, domain separation between sex work and other life domains was an important management strategy for maintaining self-esteem. For women working on the street, instincts honed by years of dangerous work provided a measure of safety. Our findings have implications for health and other agencies dealing with sex workers in situations in which community pressure is exerted to move sex workers away from the area. PMID:20952601

  2. Human System Risk Management for Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey

    2015-01-01

    This brief abstract reviews the development of the current day approach to human system risk management for space flight and the development of the critical components of this process over the past few years. The human system risk management process now provides a comprehensive assessment of each human system risk by design reference mission (DRM) and is evaluated not only for mission success but also for long-term health impacts for the astronauts. The discipline of bioastronautics is the study of the biological and medical effects of space flight on humans. In 1997, the Space Life Sciences Directorate (SLSD) initiated the Bioastronautics Roadmap (Roadmap) as the "Critical Path Roadmap", and in 1998 participation in the roadmap was expanded to include the National Space Biomedical Research Institute (NSBRI) and the external community. A total of 55 risks and 250 questions were identified and prioritized and in 2000, the Roadmap was base-lined and put under configuration control. The Roadmap took into account several major advisory committee reviews including the Institute of Medicine (IOM) "Safe Passage: Astronaut care for Exploration Missions", 2001. Subsequently, three collaborating organizations at NASA HQ (Chief Health and Medical Officer, Office of Space Flight and Office of Biological & Physical Research), published the Bioastronautics Strategy in 2003, that identified the human as a "critical subsystem of space flight" and noted that "tolerance limits and safe operating bands must be established" to enable human space flight. These offices also requested a review by the IOM of the Roadmap and that review was published in October 2005 as "A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA's Bioastronautics Roadmap", that noted several strengths and weaknesses of the Roadmap and made several recommendations. In parallel with the development of the Roadmap, the Office of the Chief Health and Medical Officer (OCHMO) began a process in

  3. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment.

    PubMed

    Bratland-Sanda, Solfrid; Sundgot-Borgen, Jorunn

    2013-01-01

    The prevalence of disordered eating and eating disorders vary from 0-19% in male athletes and 6-45% in female athletes. The objective of this paper is to present an overview of eating disorders in adolescent and adult athletes including: (1) prevalence data; (2) suggested sport- and gender-specific risk factors and (3) importance of early detection, management and prevention of eating disorders. Additionally, this paper presents suggestions for future research which includes: (1) the need for knowledge regarding possible gender-specific risk factors and sport- and gender-specific prevention programmes for eating disorders in sports; (2) suggestions for long-term follow-up for female and male athletes with eating disorders and (3) exploration of a possible male athlete triad.

  4. Osteoporosis prevention and management: nonpharmacologic and lifestyle options.

    PubMed

    Christianson, Mindy S; Shen, Wen

    2013-12-01

    The purpose of this review is to evaluate current evidence regarding the use of dietary and exercise interventions to prevent fractures in postmenopausal women with osteoporosis. The key lifestyle modifications that can decrease risk of fracture in postmenopausal women include regular weight-bearing exercise and a balanced diet with adequate calcium and vitamin D intake. Other modifiable lifestyle factors critical to bone health and to decrease fracture risk include the avoidance of smoking, an excessively low body weight, excessive alcohol intake, and fall risks at home. Emerging modifiable factors may include B-vitamin, omega-3 fatty acid, soy isoflavone, and dehydroepiandrosterone supplementation.

  5. Risk factors and prevention of vascular complications in polycythemia vera.

    PubMed

    Barbui, T; Finazzi, G

    1997-01-01

    Risk factors for vascular complications in polycythemia vera (PV) include laboratory and clinical findings. Among laboratory values, the hematocrit has been clearly associated with thrombosis, particularly in the cerebral circulation. Platelet count is a possible but not yet clearly established predictor of vascular complications. Platelet function tests are of little help in prognostic evaluation because most attempts to correlate these abnormalities with clinical events have been disappointing. Clinical predictors of thrombosis include increasing age and a previous history of vascular events. Identifying risk factors for thrombosis is important to initiate therapy. Phlebotomy is associated with an increased incidence of thrombosis in the first 3 to 5 years, whereas chemotherapy may induce a higher risk of secondary malignancies after 7 to 10 years of follow-up. New cytoreductive drugs virtually devoid of mutagenic risk include interferon-alpha and anagrelide, but their role in reducing thrombotic complications remains to be demonstrated. Antithrombotic drugs, such as aspirin, are frequently used in PV, despite doubts regarding safety and efficacy. Two recent studies from the Gruppo Italiano Studio Policitemia Vera (GISP) assessed the rate of major thrombosis as well as the tolerability of low-dose aspirin in PV patients. These investigations created a favorable scenario for launching a European collaborative clinical trial (ECLAP study) aimed at testing the efficacy of low-dose aspirin in preventing thrombosis and prolonging survival in patients with PV.

  6. 12 CFR 704.6 - Credit risk management.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Credit risk management. 704.6 Section 704.6... CREDIT UNIONS § 704.6 Credit risk management. (a) Policies. A corporate credit union must operate according to a credit risk management policy that is commensurate with the investment risks and...

  7. 12 CFR 704.6 - Credit risk management.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Credit risk management. 704.6 Section 704.6... CREDIT UNIONS § 704.6 Credit risk management. (a) Policies. A corporate credit union must operate according to a credit risk management policy that is commensurate with the investment risks and...

  8. 12 CFR 704.6 - Credit risk management.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Credit risk management. 704.6 Section 704.6... CREDIT UNIONS § 704.6 Credit risk management. (a) Policies. A corporate credit union must operate according to a credit risk management policy that is commensurate with the investment risks and...

  9. 12 CFR 704.6 - Credit risk management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Credit risk management. 704.6 Section 704.6... CREDIT UNIONS § 704.6 Credit risk management. (a) Policies. A corporate credit union must operate according to a credit risk management policy that is commensurate with the investment risks and...

  10. 12 CFR 704.6 - Credit risk management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Credit risk management. 704.6 Section 704.6... CREDIT UNIONS § 704.6 Credit risk management. (a) Policies. A corporate credit union must operate according to a credit risk management policy that is commensurate with the investment risks and...

  11. [Managing health risks of workers in business trip].

    PubMed

    Gevorkian, E V

    2014-01-01

    The article presents data of prospective observation over the risk management system concerning health of international oil and gas company workers in business trips. The management system included training and screening of workers under risk, specific prophylaxis and other measures. The authors described problems of the risk management system implementation, suggested recommendations to control risks connected with business trips.

  12. 77 FR 30517 - Electricity Subsector Cybersecurity Risk Management Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... to develop a flexible risk management process tuned to the diverse missions, equipment, and business... Electricity Subsector Cybersecurity Risk Management Process AGENCY: Office of Electricity Delivery and Energy... Management Process guideline. The guideline describes a risk management process that is targeted to...

  13. Risk management activities at the DOE Class A reactor facilities

    SciTech Connect

    Sharp, D.A.; Hill, D.J.; Linn, M.A.; Atkinson, S.A.; Hu, J.P.

    1993-12-31

    The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented.

  14. Risk management activities at the DOE Class A reactor facilities

    SciTech Connect

    Sharp, D.A. ); Hill, D.J. ); Linn, M.A. ); Atkinson, S.A. ); Hu, J.P. )

    1993-01-01

    The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented.

  15. NATIONAL RISK MANAGEMENT RESEARCH LABORATORY - PROVIDING SOLUTIONS FOR A BETTER TOMORROW

    EPA Science Inventory

    As part of the U.S. Environmental Protection Agency's Office of Research and Development, the National Risk Management Research Laboratory (NRMRL) conducts research into ways to prevent and reduce pollution risks that threaten human health and the environment. The laboratory inve...

  16. Integrating legal liabilities in nanomanufacturing risk management.

    PubMed

    Mohan, Mayank; Trump, Benjamin D; Bates, Matthew E; Monica, John C; Linkov, Igor

    2012-08-01

    Among other things, the wide-scale development and use of nanomaterials is expected to produce costly regulatory and civil liabilities for nanomanufacturers due to lingering uncertainties, unanticipated effects, and potential toxicity. The life-cycle environmental, health, and safety (EHS) risks of nanomaterials are currently being studied, but the corresponding legal risks have not been systematically addressed. With the aid of a systematic approach that holistically evaluates and accounts for uncertainties about the inherent properties of nanomaterials, it is possible to provide an order of magnitude estimate of liability risks from regulatory and litigious sources based on current knowledge. In this work, we present a conceptual framework for integrating estimated legal liabilities with EHS risks across nanomaterial life-cycle stages using empirical knowledge in the field, scientific and legal judgment, probabilistic risk assessment, and multicriteria decision analysis. Such estimates will provide investors and operators with a basis to compare different technologies and practices and will also inform regulatory and legislative bodies in determining standards that balance risks with technical advancement. We illustrate the framework through the hypothetical case of a manufacturer of nanoscale titanium dioxide and use the resulting expected legal costs to evaluate alternative risk-management actions.

  17. Integrating legal liabilities in nanomanufacturing risk management.

    PubMed

    Mohan, Mayank; Trump, Benjamin D; Bates, Matthew E; Monica, John C; Linkov, Igor

    2012-08-01

    Among other things, the wide-scale development and use of nanomaterials is expected to produce costly regulatory and civil liabilities for nanomanufacturers due to lingering uncertainties, unanticipated effects, and potential toxicity. The life-cycle environmental, health, and safety (EHS) risks of nanomaterials are currently being studied, but the corresponding legal risks have not been systematically addressed. With the aid of a systematic approach that holistically evaluates and accounts for uncertainties about the inherent properties of nanomaterials, it is possible to provide an order of magnitude estimate of liability risks from regulatory and litigious sources based on current knowledge. In this work, we present a conceptual framework for integrating estimated legal liabilities with EHS risks across nanomaterial life-cycle stages using empirical knowledge in the field, scientific and legal judgment, probabilistic risk assessment, and multicriteria decision analysis. Such estimates will provide investors and operators with a basis to compare different technologies and practices and will also inform regulatory and legislative bodies in determining standards that balance risks with technical advancement. We illustrate the framework through the hypothetical case of a manufacturer of nanoscale titanium dioxide and use the resulting expected legal costs to evaluate alternative risk-management actions. PMID:22717005

  18. Sustainable risk management for an evolving healthcare arena.

    PubMed

    Cole, Sarah A; Chaudhary, Raj; Bang, Derek A

    2014-06-01

    A sustainable risk management approach includes the use of extensive scenario analyses to mitigate the risk of reduced revenues from changes in payment and volume. A successful risk management program helps organizations prioritize strategies for risks that are likely to have the biggest impact on their business. Continually strengthening controls and mitigating risks through a risk management program can help to build an effective security and compliance program.

  19. Emergency department crowding and risk of preventable medical errors.

    PubMed

    Epstein, Stephen K; Huckins, David S; Liu, Shan W; Pallin, Daniel J; Sullivan, Ashley F; Lipton, Robert I; Camargo, Carlos A

    2012-04-01

    The objective of the study is to determine the association between emergency department (ED) crowding and preventable medical errors (PME). This was a retrospective cohort study of 533 ED patients enrolled in the National ED Safety Study (NEDSS) in four Massachusetts EDs. Individual patients' average exposure to ED crowding during their ED visit was compared with the occurrence of a PME (yes/no) for the three diagnostic categories in NEDSS: acute myocardial infarction, asthma exacerbation, and dislocation requiring procedural sedation. To accommodate site-to-site differences in available administrative data, ED crowding was measured using one of three previously validated crowding metrics (ED Work Index, ED Workscore, and ED Occupancy). At each site, the continuous measure was placed into site-specific quartiles, and these quartiles then were combined across sites. We found that 46 (8.6%; 95% confidence interval, 6.4-11.3%) of the 533 patients experienced a PME. For those seen during higher levels of ED crowding (quartile 4 vs. quartile 1), the occurrence of PMEs was more than twofold higher, both on unadjusted analysis and adjusting for two potential confounders (diagnosis, site). The association appeared non-linear, with most PMEs occurring at the highest crowding level. We identified a direct association between high levels of ED crowding and risk of preventable medical errors. Further study is needed to determine the generalizability of these results. Should such research confirm our findings, we would suggest that mitigating ED crowding may reduce the occurrence of preventable medical errors.

  20. Male Urinary Incontinence: Prevalence, Risk Factors, and Preventive Interventions

    PubMed Central

    Shamliyan, Tatyana A; Wyman, Jean F; Ping, Ryan; Wilt, Timothy J; Kane, Robert L

    2009-01-01

    Urinary incontinence (UI) in community-dwelling men affects quality of life and increases the risk of institutionalization. Observational studies and randomized, controlled trials published in English from 1990 to November 2007 on the epidemiology and prevention of UI were identified in several databases to abstract rates and adjusted odds ratios (OR) of incontinence, calculate absolute risk difference (ARD) after clinical interventions, and synthesize evidence with random-effects models. Of 1083 articles identified, 126 were eligible for analysis. Pooled prevalence of UI increased with age to 21% to 32% in elderly men. Poor general health, comorbidities, severe physical limitations, cognitive impairment, stroke (pooled OR 1.54; 95% confidence interval [CI], 1.14–2.1), urinary tract infections (pooled OR 3.49; 95% CI, 2.33–5.23), prostate diseases, and diabetes (pooled OR 1.36; 95% CI, 1.14–1.61) were associated with UI. Treatment with tolterodine alone (ARD 0.17; 95% CI, 0.02–0.32) or combined with tamsulosin (ARD 0.17; 95% CI, 0.08–0.25) resulted in greater self-reported benefit compared with placebo. Radical prostatectomy or radiotherapy for prostate cancer compared with watchful waiting increased UI. Short-term prevention of UI with pelvic floor muscle rehabilitation after prostatectomy was not consistently seen across randomized, controlled trials. The prevalence of incontinence increased with age and functional dependency. Stroke, diabetes, poor general health, radiation, and surgery for prostate cancer were associated with UI in community-dwelling men. Men reported overall benefit from drug treatments. Limited evidence of preventive effects of pelvic floor rehabilitation requires future investigation. PMID:19918340

  1. Optimal environmental management strategy and implementation for groundwater contamination prevention and restoration.

    PubMed

    Wang, Mingyu

    2006-04-01

    An innovative management strategy is proposed for optimized and integrated environmental management for regional or national groundwater contamination prevention and restoration allied with consideration of sustainable development. This management strategy accounts for availability of limited resources, human health and ecological risks from groundwater contamination, costs for groundwater protection measures, beneficial uses and values from groundwater protection, and sustainable development. Six different categories of costs are identified with regard to groundwater prevention and restoration. In addition, different environmental impacts from groundwater contamination including human health and ecological risks are individually taken into account. System optimization principles are implemented to accomplish decision-makings on the optimal resources allocations of the available resources or budgets to different existing contaminated sites and projected contamination sites for a maximal risk reduction. Established management constraints such as budget limitations under different categories of costs are satisfied at the optimal solution. A stepwise optimization process is proposed in which the first step is to select optimally a limited number of sites where remediation or prevention measures will be taken, from all the existing contaminated and projected contamination sites, based on a total regionally or nationally available budget in a certain time frame such as 10 years. Then, several optimization steps determined year-by-year optimal distributions of the available yearly budgets for those selected sites. A hypothetical case study is presented to demonstrate a practical implementation of the management strategy. Several issues pertaining to groundwater contamination exposure and risk assessments and remediation cost evaluations are briefly discussed for adequately understanding implementations of the management strategy.

  2. Multi-hazard risk analysis for management strategies

    NASA Astrophysics Data System (ADS)

    Kappes, M.; Keiler, M.; Bell, R.; Glade, T.

    2009-04-01

    Risk management is very often operating in a reactive way, responding to an event, instead of proactive starting with risk analysis and building up the whole process of risk evaluation, prevention, event management and regeneration. Since damage and losses from natural hazards raise continuously more and more studies, concepts (e.g. Switzerland or South Tyrol-Bolozano) and software packages (e.g. ARMAGEDOM, HAZUS or RiskScape) are developed to guide, standardize and facilitate the risk analysis. But these approaches focus on different aspects and are mostly closely adapted to the situation (legislation, organization of the administration, specific processes etc.) of the specific country or region. We propose in this study the development of a flexible methodology for multi-hazard risk analysis, identifying the stakeholders and their needs, processes and their characteristics, modeling approaches as well as incoherencies occurring by combining all these different aspects. Based on this concept a flexible software package will be established consisting of ArcGIS as central base and being complemented by various modules for hazard modeling, vulnerability assessment and risk calculation. Not all modules will be developed newly but taken from the current state-of-the-art and connected or integrated into ArcGIS. For this purpose two study sites, Valtellina in Italy and Bacelonnette in France, were chosen and the hazards types debris flows, rockfalls, landslides, avalanches and floods are planned to be included in the tool for a regional multi-hazard risk analysis. Since the central idea of this tool is its flexibility this will only be a first step, in the future further processes and scales can be included and the instrument thus adapted to any study site.

  3. The Prevention of Teacher Burnout Through Stress Management.

    ERIC Educational Resources Information Center

    Matthews, Doris B.

    The physical and emotional manifestations of burnout are described. A five-phase model is outlined for preventing extensive stress leading to teacher burnout. Phase One is predicated upon the notion that a professional cannot manage stress without the ability to identify it. Descriptions are given of the signs of physiological, psychological, and…

  4. The Prevention and Management of Air Leaks Following Pulmonary Resection.

    PubMed

    Burt, Bryan M; Shrager, Joseph B

    2015-11-01

    Alveolar air leaks are a common problem in the daily practice of thoracic surgeons. Prolonged air leak following pulmonary resection is associated with increased morbidity, increased length of hospital stay, and increased costs. This article reviews the evidence for the various intraoperative and postoperative options to prevent and manage postoperative air leak.

  5. Urological complications in pediatric renal transplantation: management and prevention.

    PubMed

    Zaontz, M R; Hatch, D A; Firlit, C F

    1988-11-01

    From 1973 through 1986, 166 consecutive renal transplants were performed in 143 patients. Urological complications included ureteral leakage/obstruction/necrosis, urinary tract infection, pyelonephritis, pelvic lymphocele, pelvic abscess, pelvic hematoma, infected hydrocele, bladder calculus, labial edema, renal artery/segmental stenosis, hydronephrosis, urinary incontinence, renal allograft malrotation and kidney rupture. Management options and preventive measures to avoid some of these dilemmas are highlighted.

  6. Multiattribute risk analysis in nuclear emergency management.

    PubMed

    Hämäläinen, R P; Lindstedt, M R; Sinkko, K

    2000-08-01

    Radiation protection authorities have seen a potential for applying multiattribute risk analysis in nuclear emergency management and planning to deal with conflicting objectives, different parties involved, and uncertainties. This type of approach is expected to help in the following areas: to ensure that all relevant attributes are considered in decision making; to enhance communication between the concerned parties, including the public; and to provide a method for explicitly including risk analysis in the process. A multiattribute utility theory analysis was used to select a strategy for protecting the population after a simulated nuclear accident. The value-focused approach and the use of a neutral facilitator were identified as being useful. PMID:11051070

  7. [Early detection, prevention and management of renal failure in liver transplantation].

    PubMed

    Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

    2014-10-01

    Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function.

  8. Meteorological risks as drivers of innovation for agroecosystem management

    NASA Astrophysics Data System (ADS)

    Gobin, Anne; Van de Vyver, Hans; Zamani, Sepideh; Curnel, Yannick; Planchon, Viviane; Verspecht, Ann; Van Huylenbroeck, Guido

    2015-04-01

    season. A methodology for identifying agro-ecosystem vulnerability was developed using spatially explicit information and was tested for arable crop production in Belgium. The different components of vulnerability for a region include spatial information on meteorology, soil available water content, soil erosion, the degree of waterlogging, crop share and the diversity of potato varieties. The level of vulnerability and resilience of an agro-ecosystem is also determined by risk management. The types of agricultural risk and their relative importance differ across sectors and farm types. Risk types are further distinguished according to production, market, institutional, financial and liability risks. Strategies are often combined in the risk management strategy of a farmer and include reduction and prevention, mitigation, coping and impact reduction. Based on an extensive literature review, a portfolio of potential strategies was identified at farm, market and policy level. Research hypotheses were tested using an on-line questionnaire on knowledge of agricultural risk, measuring the general risk aversion of the farmer and risk management strategies. The "chain of risk" approach adopted as a research methodology allows for investigating the hypothesis that meteorological risks act as drivers for agricultural innovation. Risks related to extreme weather events in Belgium are mainly caused by heat, frost, excess rainfall, drought and storms, and their impact is predominantly felt by arable, horticultural and extensive dairy farmers. Quantification of the risk is evaluated in terms of probability of occurrence, magnitude, frequency and extent of impact on several agro-ecosystems services. The spatial extent of vulnerability is developed by integrating different layers of geo-information, while risk management is analysed using questionnaires and economic modelling methods. Future work will concentrate on the further development and testing of the currently developed

  9. Meteorological risks as drivers of innovation for agroecosystem management

    NASA Astrophysics Data System (ADS)

    Gobin, Anne; Van de Vyver, Hans; Zamani, Sepideh; Curnel, Yannick; Planchon, Viviane; Verspecht, Ann; Van Huylenbroeck, Guido

    2015-04-01

    season. A methodology for identifying agro-ecosystem vulnerability was developed using spatially explicit information and was tested for arable crop production in Belgium. The different components of vulnerability for a region include spatial information on meteorology, soil available water content, soil erosion, the degree of waterlogging, crop share and the diversity of potato varieties. The level of vulnerability and resilience of an agro-ecosystem is also determined by risk management. The types of agricultural risk and their relative importance differ across sectors and farm types. Risk types are further distinguished according to production, market, institutional, financial and liability risks. Strategies are often combined in the risk management strategy of a farmer and include reduction and prevention, mitigation, coping and impact reduction. Based on an extensive literature review, a portfolio of potential strategies was identified at farm, market and policy level. Research hypotheses were tested using an on-line questionnaire on knowledge of agricultural risk, measuring the general risk aversion of the farmer and risk management strategies. The "chain of risk" approach adopted as a research methodology allows for investigating the hypothesis that meteorological risks act as drivers for agricultural innovation. Risks related to extreme weather events in Belgium are mainly caused by heat, frost, excess rainfall, drought and storms, and their impact is predominantly felt by arable, horticultural and extensive dairy farmers. Quantification of the risk is evaluated in terms of probability of occurrence, magnitude, frequency and extent of impact on several agro-ecosystems services. The spatial extent of vulnerability is developed by integrating different layers of geo-information, while risk management is analysed using questionnaires and economic modelling methods. Future work will concentrate on the further development and testing of the currently developed

  10. Evaluating Environmental Management Approaches to Alcohol and Other Drug Abuse Prevention. Prevention Updates

    ERIC Educational Resources Information Center

    DeJong, William; Langford, Linda M.

    2006-01-01

    Recent years have seen an upsurge in prevention work focused on changing the campus and community environments in which college students make decisions about alcohol and other drug (AOD) use. This approach, called "environmental management," is based on three fundamental premises: (1) Substance use problems are aggravated by a physical, social,…

  11. Mission Risk Reduction Regulatory Change Management

    NASA Technical Reports Server (NTRS)

    Scroggins, Sharon

    2007-01-01

    NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated

  12. Acute Urinary Retention: Risks and Management

    PubMed Central

    Roehrborn, Claus G

    2005-01-01

    Acute urinary retention (AUR) secondary to benign prostatic hyperplasia has in the past represented an immediate indication for surgery, and today most patients failing to void after an attempt at catheter removal still undergo surgery. The concept that this disease is in fact progressive in nature is slowly being accepted. Descriptive and analytical epidemiological data have shown that the incidence rate per 1000 person-years is less variable in the community than previously assumed; however, the risk is cumulative and increases with advancing age. The risk for patients diagnosed with benign prostatic hyperplasia is naturally higher, and analytical epidemiology has identified several strong risk factors, the most important one being serum prostate-specific antigen (PSA). In addition, prostate volume, maximum flow rate, and symptom severity should be considered when counseling patients presenting with lower urinary tract symptoms and clinical benign prostatic hyperplasia who are considering a course of watchful waiting. Efforts toward primary prevention of AUR should be directed to patients at increased risk, ie, those who are older and have more severe symptoms, larger glands, and higher PSA values. Risk reduction with finasteride has been demonstrated, and α-blockers have been shown to aid patients in achieving spontaneous voiding after an episode of AUR. PMID:16986053

  13. Risk Analysis Related to Quality Management Principles

    NASA Astrophysics Data System (ADS)

    Vykydal, David; Halfarová, Petra; Nenadál, Jaroslav; Plura, Jiří; Hekelová, Edita

    2012-12-01

    Efficient and effective implementation of quality management principles asks for a responsible approach from top managers' perspectives. A study of the current state of affairs in Czech organizations discovers a lot of shortcomings in this field that can be changed to vary managerial risks. The article identifies and analyses some of them and gives short guidance for appropriate treatment. Text of the article reflects the authors' experience as well as knowledge obtained from the systematic analysis of industrial companies' environments.

  14. [Management pattern of diabetes mellitus and prevention and control of diabetic retinopathy].

    PubMed

    Hui, Yan-nian

    2010-02-01

    The Bureau of Disease Prevention and Control, National Ministry of Health, recently released a project for the management of diabetes mellitus along with a technical operational manual. This is a landmark event in the prevention and management of ocular fundus diseases in China. This project will be carried out through collaboration of general hospitals, community health service units, and disease prevention and control organizations. It provides an excellent platform for the prevention and control of diabetic retinopathy. In order to prevent and control this disease, we should follow the patient-centered principle, which includes establishing individual health files, providing consultation for patients, performing screening of diabetic retinopathy, and providing lifelong regular examinations, follow-up and prompt treatments. We should also insist on the combination of prevention, treatment and scientific study to take advantage of a wide array of population resources for studying the pathogenesis and risk factors involved in the development of diabetic retinopathy, and making new contributions in the prevention of blindness due to diabetes.

  15. Complications in colorectal surgery: risk factors and preventive strategies

    PubMed Central

    2010-01-01

    Backround Open or laparoscopic colorectal surgery comprises of many different types of procedures for various diseases. Depending upon the operation and modifiable and non-modifiable risk factors the intra- and postoperative morbidity and mortality rate vary. In general, surgical complications can be divided into intraoperative and postoperative complications and usually occur while the patient is still in the hospital. Methods A literature search (1980-2009) was carried out, using MEDLINE, PubMed and the Cochrane library. Results This review provides an overview how to identify and minimize intra- and postoperative complications. The improvement of different treatment strategies and technical inventions in the recent decade has been enormous. This is mainly attributable to the increase in the laparoscopic approach, which is now well accepted for many procedures. Training of the surgeon, hospital volume and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise and cost effectiveness. In addition, standardization of perioperative care is essential to minimize postoperative complications. Conclusion This review summarizes the main perioperative complications of colorectal surgery and influencable and non-influencable risk factors which are important to the general surgeon and the relevant specialist as well. In order to minimize or even avoid complications it is crucial to know these risk factors and strategies to prevent, treat or reduce intra- and postoperative complications. PMID:20338045

  16. Risk management model of winter navigation operations.

    PubMed

    Valdez Banda, Osiris A; Goerlandt, Floris; Kuzmin, Vladimir; Kujala, Pentti; Montewka, Jakub

    2016-07-15

    The wintertime maritime traffic operations in the Gulf of Finland are managed through the Finnish-Swedish Winter Navigation System. This establishes the requirements and limitations for the vessels navigating when ice covers this area. During winter navigation in the Gulf of Finland, the largest risk stems from accidental ship collisions which may also trigger oil spills. In this article, a model for managing the risk of winter navigation operations is presented. The model analyses the probability of oil spills derived from collisions involving oil tanker vessels and other vessel types. The model structure is based on the steps provided in the Formal Safety Assessment (FSA) by the International Maritime Organization (IMO) and adapted into a Bayesian Network model. The results indicate that ship independent navigation and convoys are the operations with higher probability of oil spills. Minor spills are most probable, while major oil spills found very unlikely but possible.

  17. Risk management model of winter navigation operations.

    PubMed

    Valdez Banda, Osiris A; Goerlandt, Floris; Kuzmin, Vladimir; Kujala, Pentti; Montewka, Jakub

    2016-07-15

    The wintertime maritime traffic operations in the Gulf of Finland are managed through the Finnish-Swedish Winter Navigation System. This establishes the requirements and limitations for the vessels navigating when ice covers this area. During winter navigation in the Gulf of Finland, the largest risk stems from accidental ship collisions which may also trigger oil spills. In this article, a model for managing the risk of winter navigation operations is presented. The model analyses the probability of oil spills derived from collisions involving oil tanker vessels and other vessel types. The model structure is based on the steps provided in the Formal Safety Assessment (FSA) by the International Maritime Organization (IMO) and adapted into a Bayesian Network model. The results indicate that ship independent navigation and convoys are the operations with higher probability of oil spills. Minor spills are most probable, while major oil spills found very unlikely but possible. PMID:27207023

  18. Preventing risk and promoting resilience in radiation health.

    PubMed

    Kurth, Margaret H; Linkov, Igor

    2016-10-01

    Because risk assessment is fundamentally deficient in the face of unknown or unforeseeable events and disasters such as occurred in 2011 at the Fukushima Daiichi Nuclear Power Station in Japan, resilience thinking, which focuses on the ability of both natural and human-made systems to prepare for, absorb, and recover from an adverse event and to adapt to new conditions is an important additional consideration in decision making. Radiation contamination is an impediment to most critical functions of a community; resilience planning considers how those critical functions will be maintained in the event that radiation contamination does occur. Therefore, planning should begin with resilience-based thinking and should be complemented with risk assessment-based tools. Integr Environ Assess Manag 2016;12:677-679. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  19. Preventing risk and promoting resilience in radiation health.

    PubMed

    Kurth, Margaret H; Linkov, Igor

    2016-10-01

    Because risk assessment is fundamentally deficient in the face of unknown or unforeseeable events and disasters such as occurred in 2011 at the Fukushima Daiichi Nuclear Power Station in Japan, resilience thinking, which focuses on the ability of both natural and human-made systems to prepare for, absorb, and recover from an adverse event and to adapt to new conditions is an important additional consideration in decision making. Radiation contamination is an impediment to most critical functions of a community; resilience planning considers how those critical functions will be maintained in the event that radiation contamination does occur. Therefore, planning should begin with resilience-based thinking and should be complemented with risk assessment-based tools. Integr Environ Assess Manag 2016;12:677-679. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. PMID:27447754

  20. Cultural resource management: The risk of compliance

    SciTech Connect

    Curtis, S.A.

    1994-02-01

    The statutory mandate for federal agencies to involve American Indians in the management of cultural resources may create a cultural risk for the people those statutes are intended to protect. A conceptual framework is given to help understand this dilemma. Factors that can exacerbate the severity of the adverse cultural impacts for tribal people are also examined. Policy recommendations are offered for reducing tensions among an the participants in the statutory process.

  1. Prevention and Management of Health Care-Associated Infections.

    PubMed

    Govindarajan, Raghav

    2015-12-01

    Health care-associated infections (formerly called hospital-acquired infections or nosocomial infections) are a major public health concern. They place an enormous burden on the health care system, prolong hospitalization, and increase health care costs. Neurologists act as primary providers in the hospital or the clinic for patients with multiple comorbidities. We must be aware of the burden of health care-associated infections, their common types, risk factors, and various prevention strategies. Common strategies can be applied in day-to-day practice to help prevent health care-associated infections. PMID:26633788

  2. Cyanobacterial toxins: risk management for health protection.

    PubMed

    Codd, Geoffrey A; Morrison, Louise F; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles. PMID:15737680

  3. Cyanobacterial toxins: risk management for health protection

    SciTech Connect

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles.

  4. Desktop risk management and decision support

    SciTech Connect

    1997-07-01

    The world can be a risky place, and both seasoned petroleum veterans and relative newcomers know no industry exemplifies that better than oil and gas. For years, industry handled its inherent risk with diversification. In the past, {open_quotes}I`ll take part of your deal if you take part in mine{close_quotes} was an efficient way to control exposure in wells, fields and basins. Recently, more sophisticated methods of handling certain types of risks - generally financially oriented like commodity price or currency - have evolved that use financial-type tools such as futures or basis differential. However, the petroleum industry still struggles to quantify and manage its risk throughout the exploration and production chain.

  5. Natural-technological risk assessment and management

    NASA Astrophysics Data System (ADS)

    Burova, Valentina; Frolova, Nina

    2016-04-01

    EM-DAT statistical data on human impact and economic damages in the 1st semester 2015 are the highest since 2011: 41% of disasters were floods, responsible for 39% of economic damage and 7% of events were earthquakes responsible for 59% of total death toll. This suggests that disaster risk assessment and management still need to be improved and stay the principle issue in national and international related programs. The paper investigates the risk assessment and management practice in the Russian Federation at different levels. The method is proposed to identify the territories characterized by integrated natural-technological hazard. The maps of the Russian Federation zoning according to the integrated natural-technological hazard level are presented, as well as the procedure of updating the integrated hazard level taking into account the activity of separate processes. Special attention is paid to data bases on past natural and technological processes consequences, which are used for verification of current hazard estimation. The examples of natural-technological risk zoning for the country and some regions territory are presented. Different output risk indexes: both social and economic, are estimated taking into account requirements of end-users. In order to increase the safety of population of the Russian Federation the trans-boundaries hazards are also taken into account.

  6. Bisphenol A and risk management ethics.

    PubMed

    Resnik, David B; Elliott, Kevin C

    2015-03-01

    It is widely recognized that endocrine disrupting compounds, such as Bisphenol A, pose challenges for traditional paradigms in toxicology, insofar as these substances appear to have a wider range of low-dose effects than previously recognized. These compounds also pose challenges for ethics and policymaking. When a chemical does not have significant low-dose effects, regulators can allow it to be introduced into commerce or the environment, provided that procedures and rules are in place to keep exposures below an acceptable level. This option allows society to maximize the benefits from the use of the chemical while minimizing risks to human health or the environment, and it represents a compromise between competing values. When it is not possible to establish acceptable exposure levels for chemicals that pose significant health or environmental risks, the most reasonable options for risk management may be to enact either partial or complete bans on their use. These options create greater moral conflict than other risk management strategies, leaving policymakers difficult choices between competing values.

  7. Ecological risk assessment benefits environmental management

    SciTech Connect

    Fairbrother, A.; Kapustka, L.A.; Williams, B.A.; Glicken, J.

    1994-12-31

    The ecological risk assessment process in its ideal form is an unbiased approach for assessing the probability of harm to the environment as a consequence of a given action. This information can then be combined with other societal values and biases in the management of such risks. However, as the process currently is understood, decision makers often are accused of manipulating information in order to generate decisions or achieve buy in from the public in support of a particular political agenda. A clear understanding of the nature of the risk management process can help define areas where information should be free from social or personal bias, and areas where values and judgments are critical. The authors do not propose to discuss the individual`s decision-making process, but rather to address the social process of risk communication and environmentally-related decision-making, identifying which parts of that process require bias-free, scientifically generated information about the consequences of various actions and which parts need an understanding of the social values which underlie the informed choices among those possible actions.

  8. Bisphenol A and Risk Management Ethics

    PubMed Central

    Resnik, David B.; Elliot, Kevin C.

    2013-01-01

    It is widely recognized that endocrine disrupting compounds, such as Bisphenol A, pose challenges for traditional paradigms in toxicology, insofar as these substances appear to have a wider range of low-dose effects than previously recognized. These compounds also pose challenges for ethics and policymaking. When a chemical does not have significant low-dose effects, regulators can allow it to be introduced into commerce or the environment, provided that procedures and rules are in place to keep exposures below an acceptable level. This option allows society to maximize the benefits from the use of the chemical while minimizing risks to human health or the environment, and it represents a compromise between competing values. When it is not possible to establish acceptable exposure levels for chemicals that pose significant health or environmental risks, the most reasonable options for risk management may be to enact either partial or complete bans on their use. These options create greater moral conflict than other risk management strategies, leaving policymakers difficult choices between competing values. PMID:24471646

  9. RISK MANAGEMENT EVALUATION FOR CONCENTRATED ANIMAL FEEDING OPERATIONS

    EPA Science Inventory

    The National Risk Management Research Laboratory (NRMRL) developed a Risk Management Evaluation (RME) to provide information needed to help plan future research in the Laboratory dealing with the environmental impact of concentrated animal feeding operations (CAFOs). Agriculture...

  10. Improving flood risk management through risk communication strategies

    NASA Astrophysics Data System (ADS)

    Bodoque, Jose Maria; Diez Herrero, Andres; Amerigo, Maria; Garcia, Juan Antonio; Olcina, Jorge; Cortes, Beatriz

    2016-04-01

    A suitable level of social perception about flood risk and awareness of Civil Protection Plans are critical to minimize disasters and damages due to flash floods. In order to improve risk perception, awareness and, as a result, the effectiveness of Civil Protection Plans, it is often required the implementation of communication plans. This research proposes a guide recommendation framework to enhance local population preparedness, prevention and response when a flash flood occurs. The research setting was a village (Navaluenga) located in Central Spain with 2,027 inhabitants. It is crossed by the Alberche river and Chorreron stream (both tributaries of the Tagus river), which are prone to flash floods. In a first phase, we assessed citizens' flash-flood risk perception and level of awareness regarding some key variables of the Civil Protection Plan. To this end, a questionnaire survey was designed and 254 adults, a sample representing roughly 12% of the population census, were interviewed. Responses were analysed, comparing awareness regarding preparedness and response actions with those previously defined in the Civil Protection Plan. In addition, we carried out a latent class cluster analysis aimed at identifying the different groups present among the respondents. Next, a risk communication plan was designed and implemented. It aimed to improve the understanding of flood risk among local people; and it comprises briefings, quiz-answers, contests of stories and flood images and intergenerational workshops. Finally, participants in the first phase were reached again and a new survey was performed. The results derived from these second questionnaires were statistically treated using the same approach of the first phase. Additionally, a t-test for paired samples and Pearson Chi-Square test was implemented in order to detect possible improvements in the perception and awareness. Preliminary results indicate that in Navaluenga there is a low social perception of flood

  11. [Recent prevention strategies and occupational risk analysis: Control Banding and Sobane].

    PubMed

    Ghittori, S; Ferrari, M; Negri, S; Serranti, P; Sacco, P; Biffi, R; Imbriani, M

    2006-01-01

    according to volatility. A simple graph that uses the boiling point of the chemical and the process operating temperature assigns the chemical a high, medium or low volatility rating. The user now has enough information to identify the control approach required to adequately reduce exposures to the chemical Occupational hygienists agreed on three broad control approaches: General Ventilation; Engineering Control; Containment. However it is recognised that in some cases specialist advice will be needed. The user takes the hazard group, quantity and level of dustiness/volatility and matches them to a control approach using a simple table. The controls are described in control guidance sheets, which comprise both general information and, for commonly performed tasks, more specific advice. The second section of the document describes a risk-prevention strategy, called SOBANE, in four levels. These four levels are: screening, where the risk factors are detected by the workers and their management, and obvious solutions are implemented; observation, where the remaining problems are studied in more detail, one by one, and the reasons and the solutions are discussed in detail; analysis, where, when necessary, an occupational health (OH) practitioner is called upon to carry out appropriate measurements to develop specific solutions; expertise, where, in very sophisticated and rare cases, the assistance of an expert is called upon to solve a particular problem. The method for the participatory screening of the risks, Deparis, is proposed for the first level screening of the SOBANE strategy. The aim of Sobane strategy is to make risk prevention faster, more cost effective, and more effective in coordinating the contributions of the workers themselves, their management, the internal and external OH practitioners and the experts.

  12. The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for adults.

    PubMed

    Evans, R W; Pakdaman, A; Dennison, P J; Howe, E L C

    2008-03-01

    In the absence of effective caries preventive methods, operative care became established as the means for caries control in general practice. Water fluoridation resulted in a declining caries incidence which decreased further following the advent of fluoridated toothpaste. The challenge today is to develop a non-invasive model of practice that will sustain a low level of primary caries experience in the younger generation and reduce risk of caries experience in the older generations. The Caries Management System is a ten step non-invasive strategy to arrest and remineralize early lesions. The governing principle of this system is that caries management must include consideration of the patient at risk, the status of each lesion, patient management, clinical management and monitoring. Both dental caries risk and treatment are managed according to a set of protocols that are applied at various steps throughout patient consultation and treatment. The anticipated outcome of implementing the Caries Management System in general dental practice is reduction in caries incidence and increased patient satisfaction. Since the attainment and maintenance of oral health is determined mainly by controlling both caries and periodontal disease, the implementation of the Caries Management System in general practice will promote both outcomes.

  13. Electrostatic risks to reticles and damage prevention methodology

    NASA Astrophysics Data System (ADS)

    Rider, Gavin C.

    2016-03-01

    In recent years a great deal of effort has been expended to try and reduce the reticle ESD damage problem. Methods are almost all based on the standard principles developed for the protection of ESD sensitive electronic devices - but reticles are not the same as electronic devices. Reticles are predominantly damaged by electric field rather than the conductive transfer of static charge, and the physical mechanisms that damage reticles are different from those that damage electronic devices. This paper explains why some of the established methods for ESD prevention are not the best way to protect reticles and in some cases actually increase the risk of reticle damage. Measurements are presented showing that, contrary to the widely held opinion and current practice in semiconductor manufacturing, static dissipative plastic is not the best material to use for the construction of reticle pods. An appropriate combination of insulating material and metallic shielding is shown to provide the best electrostatic protection for reticles.

  14. Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species

    PubMed Central

    Davidson, Alisha D.; Hewitt, Chad L.; Kashian, Donna R.

    2015-01-01

    Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources. PMID:26536244

  15. The Role of Pest Control Advisers in Preventative Management of Grapevine Trunk Diseases.

    PubMed

    Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Doll, David; Baumgartner, Kendra

    2016-04-01

    Vineyards with trunk diseases (Botryosphaeria dieback, Esca, Eutypa dieback, and Phomopsis dieback) can have negative returns in the long run. Minimizing economic impacts depends on effective management, but adopting a preventative practice after infection occurs may not improve yields. Pest control advisers may reduce grower uncertainty about the efficacy of and need for prevention, which often entails future and unobservable benefits. Here, we surveyed advisers in California to examine their influence over grower decision-making, in the context of trunk diseases, which significantly limit grape production and for which curative practices are unavailable. Our online survey revealed adviser awareness of high disease incidence, and reduced yields and vineyard lifespan. Advisers rated both preventative and postinfection practices positively. Despite higher cost estimates given to postinfection practices, advisers did not recommend preventative practices at higher rates. High recommendation rates were instead correlated with high disease incidence for both preventative and postinfection practices. Recommendation rates declined with increasing cost for preventative, but not for postinfection, practices. Our findings suggest that even when advisers acknowledge the risks of trunk diseases, they may not recommend preventative practices before infection occurs. This underscores the importance of clear outreach, emphasizing both the need for prevention and its long-term cost efficacy. PMID:26645645

  16. Prevention in Child and Adolescent Psychiatry: The Reduction of Risk for Mental Disorders.

    ERIC Educational Resources Information Center

    Shaffer, David, Ed.; And Others

    The book describes Project Prevention, an interdisciplinary project developed by the American Academy of Child and Adolescent Psychiatry, to identify risk factors for mental disorders and preventive interventions. After an introductory chapter, the following eight chapters cover: the scope of Project Prevention; children at high risk (e.g.,…

  17. [The management of the risk due to the manual lifting of patients in a hospital risk-management program].

    PubMed

    Margonari, M; Nava, C; Basilico, S; Petri, A

    1999-01-01

    Application of Law 626/94 in the health care area is still only partial and in many respects practically in the initial stages. This is due to a number of causes, including the special features of this sector and the extreme variability and diffusion of the risk factors involved. Assessment of risk, especially the newest ones (from manual patient handling to biological agents) involves considerable difficulties, also because the usual methods cannot be applied. The process of assessment and especially the management of risks in this sector is an extremely complex problem, and to address it requires the creation of an organized structure within the hospital consisting of a general manager, or a person delegated by the same, the medical director, the administrative director, the certified occupational physician, the director of prevention and protection. This management team must be flexible in character, draw up strategic plans according to priority criteria, periodically assess the state of advancement of the plans that will be carried out in phases. It is also necessary to ensure the active cooperation of worker safety representatives and of other experts who may be involved in the various topics addressed from time to time. The authors propose a method used in a three-year project, still under way, for the assessment of risk due to manual patient handling in a major Italian hospital; the data obtained from an assessment made in 58 wards were the following: about 60% of the wards showed a medium-high exposure level, 24% negligible exposure levels and 13.8% zero exposure due to the absence of disabled patients. On the basis of the initial data obtained from health surveillance programmes on a group of 431 exposed subjects, about 10% were judged fit with limitations due to spinal disorders. The main problems that have arisen (management, organisation, training, transfer of workers with limited job fitness, accreditation) are discussed. The method proposed for

  18. Geophysical Hazards and Preventive Disaster Management of Extreme Natural Events

    NASA Astrophysics Data System (ADS)

    Ismail-Zadeh, A.; Takeuchi, K.

    2007-12-01

    Geophysical hazard is potentially damaging natural event and/or phenomenon, which may cause the loss of life or injury, property damage, social and economic disruption, or environmental degradation. Extreme natural hazards are a key manifestation of the complex hierarchical nonlinear Earth system. An understanding, accurate modeling and forecasting of the extreme hazards are most important scientific challenges. Several recent extreme natural events (e.g., 2004 Great Indian Ocean Earthquake and Tsunami and the 2005 violent Katrina hurricane) demonstrated strong coupling between solid Earth and ocean, and ocean and atmosphere. These events resulted in great humanitarian tragedies because of a weak preventive disaster management. The less often natural events occur (and the extreme events are rare by definition), the more often the disaster managers postpone the preparedness to the events. The tendency to reduce the funding for preventive disaster management of natural catastrophes is seldom follows the rules of responsible stewardship for future generations neither in developing countries nor in highly developed economies where it must be considered next to malfeasance. Protecting human life and property against earthquake disasters requires an uninterrupted chain of tasks: from (i) understanding of physics of the events, analysis and monitoring, through (ii) interpretation, modeling, hazard assessment, and prediction, to (iii) public awareness, preparedness, and preventive disaster management.

  19. Epidemiology, prenatal management, and prevention of neural tube defects

    PubMed Central

    Salih, Mustafa A.; Murshid, Waleed R.; Seidahmed, Mohammed Z.

    2014-01-01

    This review article discusses the epidemiology, risk factors, prenatal screening, diagnosis, prevention potentials, and epidemiologic impact of neural tube defects (NTDs). The average incidence of NTDs is 1/1000 births, with a marked geographic variation. In the developed countries, the incidence of NTDs has fallen over recent decades. However, it still remains high in the less-developed countries in Latin America, Africa, the Middle East, Asia, and the Far East (>1 to 11/1000 births). Recognized NTDs risks include maternal diabetes, obesity, lower socioeconomic status, hyperthermia, and exposure to certain teratogens during the periconceptional period. Periconceptional folic acid supplementation decreased the prevalence of NTDs by 50-70%, and an obligatory folic acid fortification of food was adopted in several countries to reach women with unplanned pregnancies and those facing social deprivation. Prevention of NTDs can be accelerated if more, especially low income countries, adopted fortification of the staple food in their communities. PMID:25551106

  20. Management and Prevention of Surgical and Nutritional Complications After Bariatric Surgery.

    PubMed

    Marcotte, Eric; Chand, Bipan

    2016-08-01

    Bariatric surgery is well-recognized for its effects on health, beyond weight-loss. It underwent a revolution recently with the growing performance of laparoscopic procedures, leading to enhanced recovery and a reduction in procedural risk. However, surgical complications, although rare, do develop. It is important to recognize the complications, and ideally prevent them from happening. This article reviews the risks of the four most commonly performed bariatric procedures, with an emphasis on technique and management in the intraoperative and postoperative period. The nutritional aspect of bariatric surgery is of the utmost importance, because catastrophic consequences have been linked to malnutrition and vitamin deficiencies. PMID:27473805

  1. Managing others like you were managed: how prevention focus motivates copying interpersonal norms.

    PubMed

    Zhang, Shu; Higgins, E Tory; Chen, Guoquan

    2011-04-01

    In 5 studies, we investigated the relation between regulatory focus and the tendency to copy a role model's managing behavior after one experiences this behavior as its recipient and later takes on the same managing role. Because enacting role-related behaviors fulfills interpersonal norms that fit prevention concerns, we predicted a stronger tendency to copy among individuals with a stronger prevention focus on duties and obligations ("oughts") but not among those with a stronger promotion focus on aspirations and advancements (ideals). We also predicted that individuals with a stronger prevention focus would tend to copy a managing behavior regardless of their earlier hedonic experience with this behavior as its recipient. These predictions were first supported in 2 experimental studies, where a stronger prevention focus was measured as a chronic disposition (Study 1) and experimentally induced as a temporary state (Study 2). Further, we tested the mechanism underlying the relation between stronger prevention and stronger copying and found that concerns about the normativeness, but not the effectiveness, of a managing behavior motivated copying for individuals with a strong prevention focus (Studies 3 and 4). We generalized these experimental results to the field by surveying a sample of superior-subordinate dyads in real world organizations (Study 5). Across all studies, we found that individuals with a stronger prevention focus tend to copy more a role model's managing behavior--independent of their hedonic satisfaction with the behavior as its recipient and their perception of its effectiveness. PMID:21142377

  2. Conscious sedation for dentistry: risk management and patient selection.

    PubMed

    Jackson, Douglass L; Johnson, Barton S

    2002-10-01

    though conscious sedation is safe when all precautions are followed, being prepared to manage unexpected sedation-related emergencies is necessary. The principles of risk management covered in this article are applicable to other articles in this issue, in which N2O/O2 inhalational sedation and enteral sedation in adults and children are discussed. The remaining article in this section that reviews the prevention of medical emergencies and the pharmacologic agents necessary to treat emergency events that are likely to occur in dental settings further enhances the level of preparedness necessary when administering conscious sedation to adults and children. PMID:12436831

  3. 7 CFR 760.104 - Risk management purchase requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under...

  4. 12 CFR 615.5135 - Management of interest rate risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Management of interest rate risk. 615.5135... agricultural credit bank shall develop and implement an interest rate risk management program as set forth in subpart G of this part. The board of directors shall adopt an interest rate risk management section of...

  5. 7 CFR 760.104 - Risk management purchase requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under...

  6. 12 CFR 615.5135 - Management of interest rate risk.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Management of interest rate risk. 615.5135... agricultural credit bank shall develop and implement an interest rate risk management program as set forth in subpart G of this part. The board of directors shall adopt an interest rate risk management section of...

  7. 12 CFR 615.5135 - Management of interest rate risk.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Management of interest rate risk. 615.5135... agricultural credit bank shall develop and implement an interest rate risk management program as set forth in subpart G of this part. The board of directors shall adopt an interest rate risk management section of...

  8. 14 CFR 117.7 - Fatigue risk management system.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Fatigue risk management system. 117.7... LIMITATIONS AND REST REQUIREMENTS: FLIGHTCREW MEMBERS (EFF. 1-4-14) § 117.7 Fatigue risk management system. (a... Fatigue Risk Management System that provides at least an equivalent level of safety against...

  9. 12 CFR 704.21 - Enterprise risk management.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Enterprise risk management. 704.21 Section 704... CORPORATE CREDIT UNIONS § 704.21 Enterprise risk management. (a) A corporate credit union must develop and follow an enterprise risk management policy. (b) The board of directors of a corporate credit union...

  10. 12 CFR 615.5135 - Management of interest rate risk.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Management of interest rate risk. 615.5135... agricultural credit bank shall develop and implement an interest rate risk management program as set forth in subpart G of this part. The board of directors shall adopt an interest rate risk management section of...

  11. 7 CFR 760.104 - Risk management purchase requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under...

  12. 12 CFR 704.21 - Enterprise risk management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Enterprise risk management. 704.21 Section 704... CORPORATE CREDIT UNIONS § 704.21 Enterprise risk management. (a) A corporate credit union must develop and follow an enterprise risk management policy. (b) The board of directors of a corporate credit union...

  13. 7 CFR 760.104 - Risk management purchase requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under...

  14. 12 CFR 704.21 - Enterprise risk management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Enterprise risk management. 704.21 Section 704... CORPORATE CREDIT UNIONS § 704.21 Enterprise risk management. (a) A corporate credit union must develop and follow an enterprise risk management policy. (b) The board of directors of a corporate credit union...

  15. 7 CFR 760.104 - Risk management purchase requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 7 2013-01-01 2013-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under...

  16. Risk assessment and risk management of noncriteria pollutants.

    PubMed

    Lee, S D

    1990-10-01

    Noncriteria air pollutants are synonymous with hazardous air pollutants (HAPs), air toxics or toxic air pollutants (TAPs). The term noncriteria pollutants refers to all air pollutants except for the criteria pollutants (SOx, PM, NOx, CO, O3, and Pb). Air toxics are pervasive in our environment worldwide in varying degrees. Uses of these chemicals are varied and numerous; their emissions are ubiquitous, and they include organic compounds such as chlorinated hydrocarbons, dioxins, aldehydes, polynuclear aromatic hydrocarbons, and heavy metals such as chromium, nickel, cadmium, and mercury. There are more than 70,000 chemicals that are in use commercially in the United States, and we know relatively little about their ambient concentrations, persistence, transport and transformation as well as their effects on health and the environment, many of which take decades to emerge. The United States Environmental Protection Agency, under the authority of Section 112 of the Clean Air Act, is mandated to regulate any air pollutant which, in the Administrator's judgment, "causes, or contributes to, air pollution which may reasonably be anticipated to result in an increase in serious irreversible or incapacitating reversible illness." For such regulatory decision-making, EPA's Office of Health and Environmental Assessment (OHEA) provides scientific assessment of health effects for potentially hazardous air pollutants. In accordance with risk assessment guidelines developed by OHEA over the years, Health Assessment Documents (HADs) containing risk assessment information were prepared and were subjected to critical review and careful revision to produce Final Draft HADs which serve as scientific databases for regulatory decision-making by the Office of Air Quality Planning and Standards (OAQPS) in its risk management process. EPA developed databases such as the Integrated Risk Information System (IRIS) and the National Air Toxics Information Clearinghouse (NATICH) and a technical

  17. Symposium: Update on prediction and management of OHSS. Prevention of OHSS.

    PubMed

    Aboulghar, Mohamed

    2009-07-01

    Ovarian hyperstimulation syndrome (OHSS) is a major complication of ovulation induction. As the treatment of the syndrome is currently empirical, prevention is the most important aspect of its management. Identification of patients vulnerable to developing OHSS by taking a history of previous OHSS and polycystic ovarian syndrome is the first step in prevention. The use of mild stimulation protocols with small doses of gonadotrophin is also important. As gonadotrophin-releasing hormone (GnRH) antagonist protocol is associated with a lower risk of OHSS, antagonist could be the protocol of choice in high-risk patients. Withholding human chorionic gonadotrophin (HCG) and continuation of GnRH agonist will abort the syndrome but at the expense of loss of the cycle. Coasting, which involves stoppage of gonadotrophins until oestradiol drops to a low concentration before HCG injection, is an effective technique but it does not completely prevent OHSS. Intravenous albumin is useful in the prevention when given at time of oocyte retrieval. Cryopreservation of all embryos will reduce late-onset OHSS but not early-onset OHSS. In-vitro maturation of oocytes will avoid ovarian stimulation and totally prevent OHSS. Triggering ovulation with a lower dose of HCG is effective in reducing the incidence of OHSS. There are possible roles for metformin and dopamine agonist for prevention of OHSS. PMID:19573288

  18. Managing total corporate electricity/energy market risks

    SciTech Connect

    Henney, A.; Keers, G.

    1998-10-01

    The banking industry has developed a tool kit of very useful value at risk techniques for hedging risk, but these techniques must be adapted to the special complexities of the electricity market. This paper starts with a short history of the use of value-at-risk (VAR) techniques in banking risk management and then examines the specific and, in many instances, complex risk management challenges faced by electric companies from the behavior of prices in electricity markets and from the character of generation and electric retailing risks. The third section describes the main methods for making VAR calculations along with an analysis of their suitability for analyzing the risks of electricity portfolios and the case for using profit at risk and downside risk as measures of risk. The final section draws the threads together and explains how to look at managing total corporate electricity market risk, which is a big step toward managing total corporate energy market risk.

  19. RMP*Submit{trademark}: Risk Management Plans Submit software

    SciTech Connect

    1999-03-01

    RMP*Submit is the official EPA personal computer software for RCRA facilities to use in submitting Risk Management Plans (RMP) required under the Risk Management Program. Portions of RMPs submitted to EPA will be publicly available on the Internet via RMP*Info. The information is intended to stimulate the dialogue between industry, state and local officials, and the public to improve accident prevention and emergency response practices. RMP*Submit has all the data elements identified in the RMP regulations; helps avoid common reporting errors by verifying all required data elements have been completed using the same completeness check that will be used at the RMP Reporting Center; allows errors to be corrected before submission of the RMP; and provides on-line help. RMP*Submit is based on the requirements of PART 68, Chemical Accident Prevention Provisions, of the Code of Federal Regulations, and the RMP amendments proposed on April 17, 1998 which were published in the Federal Register on January 6, 1999.

  20. HIV-prevention science at a crossroads: advances in reducing sexual risk

    PubMed Central

    Vermund, Sten H.; Allen, Katherine L.; Karim, Quarraisha Abdool

    2010-01-01

    Purpose of review We review the current state of evidence-based prevention strategies for reducing sexual transmission of HIV. The combined programmatic and scientific efforts through 2008 to reduce sexual transmission of HIV have failed to reduce substantially the global pandemic. Recent findings Prevention interventions to reduce HIV infection target behavioral, biomedical, and structural risk factors. Some of these prevention strategies have been evaluated in randomized clinical trials (RCTs) with HIV seroincidence endpoints. When RCTs are not feasible, a variety of observational and quasiexperimental research approaches can provide insight as to program effectiveness of specific strategies. Only five RCTs have demonstrated a notable decrease in sexually acquired HIV incidence. These include the Mwanza study of syndromic management of sexually transmitted diseases and three male circumcision trials in East Africa; a microbicide trial reported in 2009 shows substantial promise for the efficacy of PRO 2000 (0.5% gel). Summary The combined programmatic and scientific efforts to reduce sexual transmission of HIV have made incremental progress. New prevention tools are needed to stem the continued spread of HIV, though microbicides and vaccines will take many more years to develop, test, and deploy. Combination strategies of existing modalities should be tested to evaluate the potential for more proximate prevention benefits. PMID:19532063

  1. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies

    PubMed Central

    Hendrani, Aditya D; Adesiyun, Tolulope; Quispe, Renato; Jones, Steven R; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

    2016-01-01

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk. PMID:26981215

  2. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies.

    PubMed

    Hendrani, Aditya D; Adesiyun, Tolulope; Quispe, Renato; Jones, Steven R; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

    2016-02-26

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

  3. The relationship of perceived risk and biases in perceived risk to fracture prevention behavior in older women

    PubMed Central

    Jones, Salene M. W.; Gell, Nancy M.; Roth, Joshua A.; Scholes, Delia; LaCroix, Andrea Z.

    2015-01-01

    Background A bias in perceived risk for health outcomes, including fracture, exists. Purpose We compared perceived risk and biases in perceived risk for fracture to fracture preventive behavior. Methods Women over age 55 (n=2874) completed a survey five times over five years and data was pulled from the medical record. Perceived risk was measured by asking women to rate their risk of fracture compared to similar women. Actual risk was measured using FRAX score. Bias was measured using an interaction between perceived and actual risk. Results Higher perceived risk was related to lower quality of life and self-reported health, more medication and calcium use, increased bone density scan use and less walking. Bias was only associated with less medication use. Neither perceived risk nor bias predicted medication adherence. Conclusions Perceived risk, but not bias, may predict different fracture prevention behaviors. Clinicians may need to base interventions on risk perceptions. PMID:25837697

  4. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    PubMed

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable. PMID:26322307

  5. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    PubMed Central

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a “gold standard” for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable. PMID:26322307

  6. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    PubMed

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  7. Research on R&D Project Risk Management Model

    NASA Astrophysics Data System (ADS)

    Gu, Xiaoyan; Cai, Chen; Song, Hao; Song, Juan

    R&D project is an exploratory high-risk investment activity and has potential management flexibility. In R&D project risk management process, it is hard to quantify risk with very little past information available. This paper introduces quality function deployment and real option in traditional project risk management process. Through waterfall decomposition mode, R&D project risk management process is constructed step by step; through real option, the managerial flexibility inherent in R&D project can be modeled. In the paper, first of all, according to the relation matrix between R&D project success factors and risk indexes, risk priority list can be obtained. Then, risk features of various stages are analyzed. Finally, real options are embedded into various stages of R&D project by the risk features. In order to effectively manage R&D risk in a dynamic cycle, the steps above should be carried out repeatedly.

  8. Design of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial

    PubMed Central

    Chimowitz, Marc I.; Lynn, Michael J.; Turan, Tanya N.; Fiorella, David; Lane, Bethany F.; Janis, Scott; Derdeyn, Colin P.

    2011-01-01

    Background Patients with recent transient ischemic attack or stroke caused by 70–99% stenosis of a major intracranial artery are at high risk of recurrent stroke on usual medical management, suggesting the need for alternative therapies for this disease. Methods The Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis trial is an ongoing, randomized, multicenter, two-arm trial that will determine whether intracranial angioplasty and stenting adds benefit to aggressive medical management alone for preventing the primary endpoint (any stroke or death within 30 days after enrollment or after any revascularization procedure of the qualifying lesion during follow-up, or stroke in the territory of the symptomatic intracranial artery beyond 30 days) during a mean follow-up of 2 years in patients with recent TIA or stroke caused by 70–99% stenosis of a major intracranial artery. Aggressive medical management in both arms consists of aspirin 325 mg per day, clopidogrel 75mg per day for 90 days after enrollment, intensive risk factor management primarily targeting systolic blood pressure < 140 mm Hg (< 130 mm Hg in diabetics) and low density cholesterol < 70 mg / dl, and a lifetsyle modification program. The sample size required todetect a 35% reduction in the rate of the primary endpoint from angioplasty and stenting based on the log-rank test with an alpha of 0.05, 80% power, and adjusting for a 2% loss to follow-up and 5% crossover from the medical to the stenting arm is 382 patients per group. Conclusion This is the first randomized trial to compare intracranial angioplasty and stenting with medical therapy and to incorporate intensive management of multiple risk factors and a lifestyle modification program in the study design. Hopefully, the results of the trial will lead to more effective therapy for this high-risk disease. PMID:21729789

  9. Gender, Race, and Risk: Intersectional Risk Management in the Sale of Sex Online.

    PubMed

    Moorman, Jessica D; Harrison, Kristen

    2016-09-01

    Sex worker experience of risk (e.g., physical violence or rape) is shaped by race, gender, and context. For web-based sex workers, experience of risk is comparatively minimal; what is unclear is how web-based sex workers manage risk and if online advertising plays a role in risk management. Building on intersectionality theory and research exploring risk management in sex work, we content-analyzed 600 escort advertisements from Backpage.com ( http://www.backpage.com ) to explore risk management in web-based sex work. To guide our research we asked: Do advertisements contain risk management messages? Does the use of risk management messaging differ by sex worker race or gender? Which groups have the highest overall use of risk management messages? Through a multivariate analysis of covariance (MANCOVA) we found that advertisements contained risk management messages and that uses of these phrases varied by race and gender. Blacks, women, and transgender women drove the use of risk management messages. Black and White transgender women had the highest overall use of these phrases. We conclude that risk management is an intersectional practice and that the use of risk management messages is a venue-specific manifestation of broader risk management priorities found in all venues where sex is sold. PMID:26488687

  10. Gender, Race, and Risk: Intersectional Risk Management in the Sale of Sex Online.

    PubMed

    Moorman, Jessica D; Harrison, Kristen

    2016-09-01

    Sex worker experience of risk (e.g., physical violence or rape) is shaped by race, gender, and context. For web-based sex workers, experience of risk is comparatively minimal; what is unclear is how web-based sex workers manage risk and if online advertising plays a role in risk management. Building on intersectionality theory and research exploring risk management in sex work, we content-analyzed 600 escort advertisements from Backpage.com ( http://www.backpage.com ) to explore risk management in web-based sex work. To guide our research we asked: Do advertisements contain risk management messages? Does the use of risk management messaging differ by sex worker race or gender? Which groups have the highest overall use of risk management messages? Through a multivariate analysis of covariance (MANCOVA) we found that advertisements contained risk management messages and that uses of these phrases varied by race and gender. Blacks, women, and transgender women drove the use of risk management messages. Black and White transgender women had the highest overall use of these phrases. We conclude that risk management is an intersectional practice and that the use of risk management messages is a venue-specific manifestation of broader risk management priorities found in all venues where sex is sold.

  11. Promoting successful aging through effective prevention and management of osteoporosis.

    PubMed

    Cavalieri, Thomas A; Noll, Donald R

    2013-02-01

    Successful aging has been described as having 3 components: a low probability of disease and disease-related disability, a capacity for high cognitive and physical function, and active engagement with social and productive activities. Osteopathic physicians play a critical role in the promotion of successful aging through the prevention, early detection, and management of osteoporosis. Not many years ago, osteoporosis was viewed as an age-related disorder for which there was a lack of effective approaches for early intervention and management. Now, that view has changed.

  12. Prevention and management of complications in body contouring surgery.

    PubMed

    Gusenoff, Jeffrey A

    2014-10-01

    This patient safety article discusses strategies to prevent, diagnose, and manage complications from body contouring surgery. Preoperative, intraoperative, and postoperative approaches to avoiding, identifying, and treating complications are addressed. Individual complications, such as hematoma, seroma, infection, dehiscence, suture extrusion, deep venous thrombosis, and pulmonary embolism are discussed and a review of complication rates in the body contouring literature is provided. The article addresses procedure-specific complications and pearls to avoiding complications in these cases. Difficult problems such as skin relaxation and management of the disappointed patient are also discussed.

  13. Percutaneous pulmonary valve endocarditis: incidence, prevention and management.

    PubMed

    Patel, Mehul; Malekzadeh-Milani, Sophie; Ladouceur, Magalie; Iserin, Laurence; Boudjemline, Younes

    2014-11-01

    The epidemiology of infective endocarditis is changing rapidly due to the emergence of resistant microorganisms, the indiscriminate use of antibiotics, and an increase in the implantation of cardiovascular devices including percutaneous valves. Percutaneous pulmonary valve implantation has achieved standard of care for the management of certain patients with right ventricular outflow tract dysfunction. With its expanding use, several cases of early and delayed infective endocarditis with higher morbidity and mortality rates have been reported. This review summarizes the trends in percutaneous pulmonary valve infective endocarditis, postulates proposed mechanisms, and elaborates on the prevention and management of this unique and potentially fatal complication.

  14. Taekwondo coaches knowledge about prevention and management of dental trauma.

    PubMed

    Vidović, Dina; Gorseta, Kristina; Bursac, Danijel; Glavina, Domagoj; Skrinjarić, Tomislav

    2014-06-01

    The aim of this study was to assess level of knowledge about prevention and dental trauma management among taekwondo coaches in Croatia. The questionnaire submitted to the taekwondo coaches contained 16 items about dental trauma prevention and management. The questionnaires were filled in by 131 taekwondo coaches; 28 females and 103 males. Descriptive statistics was used to describe and analyze the obtained data. The coaches were familiar with dental injuries in high percentage: 41 (31.3%) have observed dental injury and 36 (27.5%) have experienced a dental injury themselves. Eight of them had tooth avulsion, fourteen crown fracture, and eight had tooth luxation. About half of all interviewed coaches 68 (52.7%) were aware of the possibility of replanting avulsed teeth. Twenty six (19.8%) were familiar with the tooth rescue kit. Only 99 out of 131 coaches (75.6%) have used a mouthguard. The obtained results show low knowledge about possibilities for prevention of dental trauma. Insufficient use of mouthguards in this contact sport requires more attention of dentists and coaches education about dental trauma prevention.

  15. Developing eLearning for pressure ulcer prevention and management.

    PubMed

    Cameron, Rosie; Rodgers, Angela; Welsh, Lynn; McGown, Katrina

    2014-08-12

    The impact of pressure ulcers is psychologically, physically and clinically challenging for both patients and NHS staff. NHS Greater Glasgow and Clyde (NHS GGC), in line with the Scottish Best Practice Statement for the Prevention and Management of Pressure Ulcers ( Quality Improvement Scotland, 2009 ), and the NHS Health Improvement Scotland (2011) Preventing Pressure Ulcers Change Package, launched an awareness campaign throughout the organisation in April 2012 and has more recently adopted a 'zero-tolerance' approach to pressure damage. The tissue viability service in NHS GGC recognised that in order to achieve this aim, education of front-line staff is essential. An educational framework for pressure ulcer prevention was developed for all levels of healthcare staff involved in the delivery of patient care. As a means to support the framework, an initiative to develop web-based eLearning modules has been taken forward. This has resulted in the creation of an accessible, cost-effective, stimulating, relevant, and evidence-based education programme designed around the educational needs of all healthcare staff. In conjunction with the organisation's 'top ten tools' for pressure ulcer prevention and management, the modular online education programme addresses the aims of quality improvement and zero tolerance by supporting the provision of safe and effective person-centered care. PMID:25117595

  16. Current approaches to cyanotoxin risk assessment and risk management around the globe

    PubMed Central

    Ibelings, Bas W.; Backer, Lorraine C.; Kardinaal, W. Edwin A.; Chorus, Ingrid

    2015-01-01

    assumptions such as bloom duration, average body size and the amount of water consumed while swimming vary according to local circumstances. Furthermore, for toxins with incomplete toxicological data elements of expert judgment become more relevant and this also leads to a larger degree of variation between countries’ thresholds triggering certain actions. Cyanobacterial blooms and their cyanotoxin content are a highly variable phenomenon, largely depending on local conditions, and likely concentrations can be assessed and managed best if the specific conditions of the locality are known and their impact on bloom occurrence are understood. Risk Management Frameworks, such as for example the Water Safety Plan concept of the WHO and the ‘bathing water profile’ of the European Union are suggested to be effective approaches for preventing human exposure by managing toxic cyanobacteria from catchment to consumer for drinking water and at recreational sites. PMID:26435706

  17. Managing physician lipid management: a population wide, risk-based decision support approach.

    PubMed

    Rubenstein, Lisa V

    2015-01-01

    Successful implementation of clinical guidelines for preventing complications of dyslipidemias has been an ongoing challenge. The article by Vinker and colleagues in this journal investigates the results of implementing risk-based guidelines for LDL (Low Density Lipoprotein) management in comparison to the prior approach of using the same LDL cutoff for patients at all levels of risk. Results show LDL levels dropped across the primary care population using the new risk-based approach, suggesting that clinical decision aids that link to individual patient characteristics, rather than promoting a universal target for all, may provide a particularly strong stimulus for changing provider and patient behavior. Results also challenge healthcare organizations, providers and patients to learn more about the pathway from guidelines to clinical reminders and from reminders to lower LDL levels and better population health. PMID:26175893

  18. Software risk estimation and management techniques at JPL

    NASA Technical Reports Server (NTRS)

    Hihn, J.; Lum, K.

    2002-01-01

    In this talk we will discuss how uncertainty has been incorporated into the JPL software model, probabilistic-based estimates, and how risk is addressed, how cost risk is currently being explored via a variety of approaches, from traditional risk lists, to detailed WBS-based risk estimates to the Defect Detection and Prevention (DDP) tool.

  19. Risk management model in road transport systems

    NASA Astrophysics Data System (ADS)

    Sakhapov, R. L.; Nikolaeva, R. V.; Gatiyatullin, M. H.; Makhmutov, M. M.

    2016-08-01

    The article presents the results of a study of road safety indicators that influence the development and operation of the transport system. Road safety is considered as a continuous process of risk management. Authors constructed a model that relates the social risks of a major road safety indicator - the level of motorization. The model gives a fairly accurate assessment of the level of social risk for any given level of motorization. Authors calculated the dependence of the level of socio-economic costs of accidents and injured people in them. The applicability of the concept of socio-economic damage is caused by the presence of a linear relationship between the natural and economic indicators damage from accidents. The optimization of social risk is reduced to finding the extremum of the objective function that characterizes the economic effect of the implementation of measures to improve safety. The calculations make it possible to maximize the net present value, depending on the costs of improving road safety, taking into account socio-economic damage caused by accidents. The proposed econometric models make it possible to quantify the efficiency of the transportation system, allow to simulate the change in road safety indicators.

  20. Management of Environmental Risks in Coastal Areas

    NASA Astrophysics Data System (ADS)

    Caprioli, M.; Trizzino, R.; Pagliarulo, R.; Scarano, M.; Mazzone, F.; Scognamiglio, A.

    2015-08-01

    The present work deals with the assessment and management of environmental risk conditions in a typical costal area of Southern Italy. This area, located in the Salento peninsula, is subject to recurrent widespread instability phenomena due to the presence of steep rocky cliffs. Along the coast there are numerous beach resorts that are very crowded in the summer season. The environmental hazard deriving from the possible rock falls is unacceptably high for the people safety. Moreover, the land-based mapping of the dangerous natural structures is very difficult and time and resources expending. In this context, we carried out an UAV survey along about 1 km of coast, near the towns of San Foca, Torre dell'Orso and Sant' Andrea ( Lecce, Southern Italy). The UAV platform was equipped with a photogrammetric measurement system that allowed us to obtain a mobile mapping of the fractured fronts of dangerous rocky cliffs. UAV-images data have been processed using dedicated software (Agisoft Photoscan). The total error obtained was of centimeter-order that is a very satisfactory result. The environmental information has been arranged in an ArcGIS platform in order to assess the risk levels. The possibility to repeat the survey at time intervals more or less close together depending on the measured levels of risk and to compare the output allows following the trend of the dangerous phenomena. In conclusion, for inaccessible locations of dangerous rocky bodies the UAV survey coupled with a GIS methodology proved to be a key engineering tool for the management of environmental risks.