Search results for: community-based flood risk management

Authors: Bansal Ashwani

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Cartographic depiction and visualization of wetland changes is an important tool to map spatial-temporal information about the wetland dynamics effectively and to comprehend the response of these water bodies in maintaining the groundwater and surrounding ecosystem. This is true for the states of North Western India, i.e., J&K, Himachal, Punjab, and Haryana that are bestowed upon with several natural wetlands in the flood plains or on the courses of its rivers. Thus, the present study documents, analyses and reconstructs the lost wetlands, which existed in the flood plains of the major river basins of these states, i.e., Chenab, Jhelum, Satluj, Beas, Ravi, and Ghagar, in the beginning of the 20th century. To achieve the objective, the study has used multi-temporal datasets since the 1960s using high to medium resolution satellite datasets, e.g., Corona (1960s/70s), Landsat (1990s-2017) and Sentinel (2017). The Sentinel (2017) satellite image has been used for making the wetland inventory owing to its comparatively higher spatial resolution with multi-spectral bands. In addition, historical records, repeated photographs, historical maps, field observations including geomorphological evidence were also used. The water index techniques, i.e., band rationing, normalized difference water index (NDWI), modified NDWI (MNDWI) have been compared and used to map the wetlands. The wetland types found in the north-western states have been categorized under 19 classes suggested by Space Application Centre, India. These enable the researcher to provide with the wetlands inventory and a series of cartographic representation that includes overlaying multiple temporal wetlands extent vectors. A preliminary result shows the general state of wetland shrinkage since the 1960s with varying area shrinkage rate from one wetland to another. In addition, it is observed that majority of wetlands have not been documented so far and even do not have names. Moreover, the purpose is to emphasize their elimination in addition to establishing a baseline dataset that can be a tool for wetland planning and management. Finally, the applicability of cartographic depiction and visualization, historical map sources, repeated photographs and remote sensing data for reconstruction of long term wetlands fluctuations, especially in the northern part of India, will be addressed.

Keywords: cartographic depiction and visualization, wetland changes, NDWI/MDWI, geomorphological evidence and remote sensing

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Authors: Farhad Reyazat, Richard Werner

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This paper contributes to the existent literature by developing a framework that explains how to monitor potential threats to banking sector stability. The study explores structural vulnerabilities at the country level, but also look at bilateral exposures within a network context. The study contributes in analysing of the European banking systemic risk at aggregated level, which integrates the characteristics of bank size, and interconnectedness relative to the size of the economy which ultimate risk belong to, taking to account the concentration ratio of the banking industry within the whole economy. The nature of the systemic risk depends on the interplay of the network topology with the nature of financial transactions over the network, assets and buffer stemming from bank size, correlations, and the nature of the shocks to the financial system. The study’s results illustrate the contribution of banks’ size, size of economy and concentration of counterparty exposures to a given country’s banks in explaining its systemic importance, how much the banking network depends on a few traditional hubs activities and the changes of this dependencies over the last 9 years. The role of few of traditional hubs such as Swiss banks and British Banks and also Irish banks- where the financial sector is fairly new and grew strongly between 1990s till 2008- take the fourth position on 2014 reducing the relative size since 2006 where they had the first position. In-degree concentration index analysis in the study shows concentration index of banking network was not changed since financial crisis 2007-8. In-degree concentration index on first quarter of 2014 indicates that US, UK and Germany together, getting over 70% of the network exposures. The result of comparing the in-degree concentration index with 2007-4Q, shows the same group having over 70% of the network exposure, however the UK getting more important role in the hub and the market share of US and Germany are slightly diminished.

Keywords: systemic risk, counterparty risk, financial stability, interconnectedness, banking concentration, european banks risk, network effect on systemic risk, concentration risk

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Authors: Ali Saeed Alghamdi, Basel Mazen Alsolami, Basel Saeed Alghamdi, Muhanad Saleh Alzahrani Alamri, Salman Anwar Thabet, Abdulhalim J. Kinsara

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Objectives: This study measures the knowledge of the cardiovascular disease among the general population in western regions of Saudi Arabia, and it aimed to increase the level of awareness about cardiovascular diseases among the general population by providing an awareness lecture that included information about the risk factors, major symptoms, and prevention of cardiovascular diseases. The lecture has been attached at the end of the questionnaire. Setting: This study was conducted through an online questionnaire that included our aim and main objectives that targeted the general population in the Western regions of Saudi Arabia (Makkah and Madinah regions). Participants: This study participants were 460 collected through an online questionnaire. Methods: All Saudi citizens and residents who live in the western region of Saudi Arabia aged 18 years and above will be invited to participate voluntarily. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart diseases, with cardiac symptoms and risk factors sections. Results: The majority of respondents were females (74.8%) and Saudis. The knowledge about cardiovascular disease risk factors was weak. Only (18.5%) scores an excellent response regarding risk factors awareness. Lack of exercise, stress, and obesity were the most known risk factors. Regarding cardiovascular disease symptoms, chest pain scores the highest symptom (87.6%) among other symptoms like dyspnea, syncope, and excessive sweating. Participants revealed a poor awareness regarding cardiovascular disease symptoms also (0.9%). However, preventable factors for cardiovascular diseases were more knowledgeable than others categories in this study (60% fall into excellent knowledge). Smoking cessation, normal cholesterol level, and normal blood pressure score the highest preventable methods (92.2%), (88.6%), and (78.7%) respectively. 83.7% of the participant have attended the awareness lecture, and 99 of the attendees reported that the lecture increased their knowledge about cardiovascular disease. Conclusion: This study discussed the level of community awareness of cardiovascular disease in terms of symptoms, risk factors, and protective factors. We found a huge lack of the participant's level of knowledge about the disease and how to prevent it. Moreover, we measure the prevalence of the comorbidities among our participants (diabetes, hypertension, hypercholesterolemia/ hypertriglyceridemia) and their extent of adherence to their medication. In conclusion, this study not only demonstrates awareness of cardiovascular disease risk factors, symptoms, management, and the association between each domain but also provides educational material. Further educational material and campaigns are required to increase awareness and knowledge about cardiovascular diseases.

Keywords: awareness, cardiovascular diseases, education, prevention, risk factors

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Authors: Suvorov Vasyl, Filipchuk Viktor

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Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).

Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy

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Authors: Abhijit Trailokya, Kamlesh Patel

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Background: Hypertension is a common disease seen in clinical practice and is associated with high morbidity and mortality. Many patients require combination therapy for the management of hypertension. Objective: To evaluate co-morbidities, risk factors and management practices of hypertension in Indian population. Material and methods: A total of 1596 hypertensive adult patients received anti-hypertensive medications were studied in a cross-sectional, multi-centric, non-interventional, observational registry. Statistical analysis: Categories or nominal data was expressed as numbers with percentages. Continuous variables were analyzed by descriptive statistics using mean, SD, and range Chi square test was used for in between group comparison. Results: The study included 73.50% males and 26.50% females. Overweight (50.50%) and obesity (30.01%) was common in the hypertensive patients (n=903). A total of 54.76% patients had history of smoking. Alcohol use (33.08%), sedentary life style (32.96%) and history of tobacco chewing (17.92%) were the other lifestyle habits of hypertensive patients. Diabetes (36.03%) and dyslipidemia (39.79%) history was common in these patients. Family history of hypertension and diabetes was seen in 82.21% and 45.99% patients respectively. Most (89.16%) patients were treated with combination of antihypertensive agents. ARBs were the by far most commonly used agents (91.98%) followed by calcium channel blockers (68.23%) and diuretics (60.21%). ARB was the most (80.35%) preferred agent as monotherapy. ARB was also the most common agent as a component of dual therapy, four drug and five drug combinations. Conclusion: Most of the hypertensive patients need combination treatment with antihypertensive agents. ARBs are the most preferred agents as monotherapy for the management of hypertension. ARBs are also very commonly used as a component of combination therapy during hypertension management.

Keywords: antihypertensive, hypertension, management, ARB

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Authors: Hachmi Ben Ameur, Jean Luc Prigent

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We propose an extension of the CPPI method, which is based on conditional floors. In this framework, we examine in particular the TIPP and margin based strategies. These methods allow keeping part of the past gains and protecting the portfolio value against future high drawdowns of the financial market. However, as for the standard CPPI method, the investor can benefit from potential market rises. To control the risk of such strategies, we introduce both Value-at-Risk (VaR) and Expected Shortfall (ES) risk measures. For each of these criteria, we show that the conditional floor must be higher than a lower bound. We illustrate these results, for a quite general ARCH type model, including the EGARCH (1,1) as a special case.

Keywords: CPPI, conditional floor, ARCH, VaR, expected ehortfall

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Authors: Qiang Fu, Abu Saleh

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Research studies are highly fragmented when an innovation management framework is being discussed. With the aim to identify an innovation management framework/assessment tool suitable for small & medium enterprises (SMEs) in the service industry, this researcher critically reviewed existing innovation management frameworks and assessment models/tools and discovered a number of literature gaps. It is established that existing literature lacks generally agreed innovation management dimensions, commonly accepted knowledge creation through empirical studies on innovation management in SMEs, effective innovation management performance measurements, and studies on innovation management in the service industry, in particular in retail SMEs. As such, there is a dire need to develop an appropriate firm-level innovation management framework suitable for SMEs in the service industry for a future research project and further study. In addition, this researcher also discussed the significance of establishing such an innovation management framework.

Keywords: innovation management, innovation management framework, innovation management assessment tools, SMEs, service industry

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Authors: Ya-Ching Wang, Yi-Maun Subeq

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Background: There is a lack of evidence to understand differences in risk for developing breast cancer between sexual minority women and heterosexual women in Taiwan. The purpose of this study is to compare differences in risk for developing breast cancer between the two groups of Taiwanese women. Methods: An online cross-sectional survey was used to collect data. A total of 238 Taiwanese women (mean age 30.69 years old, SD=8.231, range 20-60) were recruited between December 2016 and February 2017, including 115 heterosexual women and 123 sexual minority women. Results: There were no significant differences between heterosexual women and sexual minority women in body mass index, history of non-malignant breast disease, age at menarche and menopause, use of hormone replacement therapy, use of hormone replacement therapy, nor the prevalence of breast cancer. The sexual minority women had higher rates of current drinking, smoking and using breast-bindings and also reported exercise more a week; the heterosexual women had higher rates of pregnancy, children, breastfeed, miscarriages, abortion and use of birth control pills. Discussion/Conclusion: There were significant differences between heterosexual women and sexual minority women in reproductive factors and behavioral risk factors for the development of breast cancer. In particular, the finding that the sexual minority women had higher rate of using breast-bindings (56.6%) than the heterosexual women (4.7%) should be further explore, in order to understand whether long-term breast compression is associated with the development of breast cancer.

Keywords: breast cancer, risk, sexual orientation, Taiwan

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Authors: Ellis Kofi Akwaa-Sekyi, Jordi Moreno Gené

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Managerial actions which negatively profile banks and impair corporate reputation are addressed through effective internal control systems. Disregard for acceptable standards and procedures for granting credit have affected bank loan portfolios and could be cited for the crises in some European countries. The study intends to determine the effectiveness of internal control systems, investigate whether perceived agency problems exist on the part of board members and to establish the relationship between internal controls and credit risk among listed banks in the European Union. Drawing theoretical support from the behavioural compliance and agency theories, about seventeen internal control variables (drawn from the revised COSO framework), bank-specific, country, stock market and macro-economic variables will be involved in the study. A purely quantitative approach will be employed to model internal control variables covering the control environment, risk management, control activities, information and communication and monitoring. Panel data from 2005-2014 on listed banks from 28 European Union countries will be used for the study. Hypotheses will be tested and the Generalized Least Squares (GLS) regression will be run to establish the relationship between dependent and independent variables. The Hausman test will be used to select whether random or fixed effect model will be used. It is expected that listed banks will have sound internal control systems but their effectiveness cannot be confirmed. A perceived agency problem on the part of the board of directors is expected to be confirmed. The study expects significant effect of internal controls on credit risk. The study will uncover another perspective of internal controls as not only an operational risk issue but credit risk too. Banks will be cautious that observing effective internal control systems is an ethical and socially responsible act since the collapse (crisis) of financial institutions as a result of excessive default is a major contagion. This study deviates from the usual primary data approach to measuring internal control variables and rather models internal control variables in a quantitative approach for the panel data. Thus a grey area in approaching the revised COSO framework for internal controls is opened for further research. Most bank failures and crises could be averted if effective internal control systems are religiously adhered to.

Keywords: agency theory, credit risk, internal controls, revised COSO framework

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Authors: Y. Y. Babanyara, B. A. Gana, T. Garba, M. A. Batari

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Proper management of dental waste is a crucial issue for maintaining human health and the environment. The waste generated in the dental clinics has the potential for spreading infections and causing diseases, so improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist, waste handlers, general public and the environment through production of toxins or as by-products of the destruction process. Staff that provide dental healthcare ought to be aware of the proper handling and the system of management of dental waste used by different dental hospitals. The method of investigation adopted in the paper involved a desk study in which documents and records relating to dental waste handling were studied to obtain background information on existing dental waste management in Nigeria other countries of the world are also mentioned as examples. Additionally, information on generation, handling, segregation, risk associated during handling and treatment of dental medical waste were sought in order to determine the best method for safe disposal. This article provides dentists with the information they need to properly dispose of mercury and amalgam waste, and provides suggestions for managing the other wastes that result from the day-to-day activities of a dental office such as: used X-ray fixers and developers; cleaners for X-ray developer systems; lead foils, shields and aprons; chemiclave/chemical sterilant solutions; disinfectants, cleaners, and other chemicals; and, general office waste. Additionally, this study may be beneficial for authorities and researchers of developing countries to work towards improving their present dental waste management system.

Keywords: clinic, dental, disposal, environment, waste management

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Authors: Irfan Khan, Chiemeka David Ekene Arize, Hilly Swami, Suprabha Jha

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Background: The rise of myocardial infarction (MI) among young adults, especially those with psychiatric conditions on antipsychotic medications, highlights the need to explore non-traditional cardiovascular risk factors. Case Presentation: We discuss a 24-year-old male with acute MI, diagnosed with an acute anxiety disorder, treated with risperidone and quetiapine, and with a history of occasional smoking. Despite no significant medical history, his presentation underscores the complex interactions between psychiatric conditions, antipsychotic medication, and lifestyle choices in the etiology of MI. Discussion: This case sheds light on the intricate relationship between minimal smoking habits, the use of atypical antipsychotics, and psychiatric illness as contributory factors to cardiovascular risk in young patients. It suggests a synergistic effect, amplifying the risk of MI, which is not adequately captured by traditional risk models. Conclusion: The case emphasizes the importance of an integrated care appro ach for young MI patients with psychiatric conditions and highlights the urgent need for further research to understand the compounded cardiovascular risk posed by psychiatric medications and lifestyle factors. It advocates for comprehensive risk assessments that consider these non-traditional factors to improve outcomes for this vulnerable patient population.

Keywords: myocardial infarction, young adults, psychiatric illness, antipsychotic medications, smoking

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Authors: M. Jafari Toosy, A. Zamani

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This article, considering the result of pandemics at the international level and all activities and projects performed virtually and the need for resource management and virtual teams in this period identifies the components of virtual management after searching the available resources. Exploration of virtual management in the pandemic era is explored in 10 international articles. The results of research with this method and according to the tasks and topics related to management knowledge and definition of virtual teams can be divided into topics such as planning, decision making, control, organization, leadership, attention to growth and capability, resources and facilities, Communication, creativity, innovation and security. In order to explain the nature of virtual management, a definition of virtual management was provided.

Keywords: management, virtual, virtual team management, pandemic, team

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Authors: Londeka Ntuli, Frasia Oosthuizen

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Background: Tenefovir disiproxil fumarate (TDF) is a nephrotoxic drug and has been proven to contribute to renal insufficiency necessitating intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. TDF is one of the preferred first-line drugs used in combination therapy in most regions. There are estimated 300 000 patients being initiated on the Efavirenz/TDF/Emtricitabine first-line regimen annually in South Africa. It is against this background that this study aims to investigate the effects of TDF on renal sufficiency of HIV positive patients. Methodology: A retrospective quantitative study was conducted, analysing clinical charts of HIV positive patient’s older than 18 years of age and on a TDF-containing regimen for more than 1 year. Data were obtained from the analysis of patient files and was transcribed into Microsoft® Excel® spreadsheet. Extracted data were coded, categorised and analysed using STATA®. Results: A total of 275 patient files were included in this study. Renal function started decreasing after 3 months of treatment (with 93.5% patients having a normal EGFR), and kept on decreasing as time progressed with only 39.6% normal renal function at year 4. Additional risk factors for renal insufficiency included age below 25, female gender, and additional medication. Conclusion: It is clear from this study that the use of TDF necessitates intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. The findings from this study generated pertinent information on the safety profile of the drug TDF in a resource-limited setting of a public health institution. The appropriate management is of tremendous importance in the South African context where the majority of HIV positive individuals are on the TDF containing regimen; thus it is beneficial to ascertain the possible level of toxicities these patients may be experiencing.

Keywords: renal insufficiency, tenefovir, HIV, risk factors

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Authors: Keiko Tamura, Munenari Inoguchi, Michiyo Tsuji

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When disasters occur, in order to raise the speed of each decision making and response, it is common that delegation of authority is carried out. This tendency is particularly evident when the department or branch of the organization are separated by the physical distance from the main body; however, there are some issues to think about. If the department or branch is too dependent on the head office in the usual condition, they might feel lost in the disaster response operation when they are face to the situation. Avoiding this problem, an organization should decide how to delegate the authority and also who accept the responsibility for what before the disaster. This paper will discuss about the method which presents an approach for executing the delegation of authority process, implementing authorities, management by objectives, and preparedness plans and agreement. The paper will introduce the examples of efforts for the three research centers of Niigata University, Japan to arrange organizations capable of taking necessary actions for disaster response. Each center has a quality all its own. One is the center for carrying out the research in order to conserve the crested ibis (or Toki birds in Japanese), the endangered species. The another is the marine biological laboratory. The third one is very unique because of the old growth forests maintained as the experimental field. Those research centers are in the Sado Island, located off the coast of Niigata Prefecture, is Japan's second largest island after Okinawa and is known for possessing a rich history and culture. It takes 65 minutes jetfoil (high-speed ferry) ride to get to Sado Island from the mainland. The three centers are expected to be easily isolated at the time of a disaster. A sense of urgency encourages 3 centers in the process of organizational restructuring for enhancing resilience. The research team from the risk management headquarters offer those procedures; Step 1: Offer the hazard scenario based on the scientific evidence, Step 2: Design a risk management organization for disaster response function, Step 3: Conduct the participatory approach to make consensus about the overarching objectives, Step 4: Construct the unified operational action plan for 3 centers, Step 5: Simulate how to respond in each phase based on the understanding the various phases of the timeline of a disaster. Step 6: Document results to measure performance and facilitate corrective action. This paper shows the result of verifying the output and effects.

Keywords: delegation of authority, disaster response, risk management, unified command

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Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: M. Mokhber, J. Hedayati

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From the managerial perspective, it is important to devise an operational plan based on top priorities due to limited resources, diversity of measures and high costs needed to improve safety in infrastructure. Dealing with the high-risk corridors across Iran, this study prioritized the corridors according to statistical data on accidents involving fatalities, injury or damage over three consecutive years. In collaboration with the Iranian Police Department, data were collected and modified. Then, the prioritization criteria were specified based on the expertise opinions and international standards. In this study, the prioritization criteria included accident severity and accident density. Finally, the criteria were standardized and weighted (equal weights) to score each high-risk corridor. The prioritization phase involved the scoring and weighting procedure. The high-risk corridors were divided into twelve groups out of 50. The results of data analysis for a three-year span suggested that the first three groups (150 corridors) along with a quarter of Iranian road network length account for nearly 60% of traffic accidents. In the next step, according to variables including weather conditions particular roads for the purpose of winter safety measures were extracted from the abovementioned categories. According to the results ranking, ‎‏9‏‎ roads with the overall ‎length of about ‎‎‏1000‏‎ Km of high-risk corridors are considered as preferences of ‎safety measures‎.

Keywords: high-risk corridors, HRCs, road safety rating, road scoring, winter safety measures

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Authors: Rajender Dahiya

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Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.

Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention

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Authors: Muhammad Sheraz, Vasile Preda, Silvia Dedu

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Concepts of econophysics are usually used to solve problems related to uncertainty and nonlinear dynamics. In the theory of option pricing the risk neutral probabilities play very important role. The application of entropy in finance can be regarded as the extension of both information entropy and the probability entropy. It can be an important tool in various financial methods such as measure of risk, portfolio selection, option pricing and asset pricing. Gulko applied Entropy Pricing Theory (EPT) for pricing stock options and introduced an alternative framework of Black-Scholes model for pricing European stock option. In this article, we present solutions to maximum entropy problems based on Tsallis, Weighted-Tsallis, Kaniadakis, Weighted-Kaniadakies entropies, to obtain risk-neutral densities. We have also obtained the value of European call and put in this framework.

Keywords: option pricing, Black-Scholes model, Tsallis entropy, Kaniadakis entropy, weighted entropy, risk-neutral density

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Authors: Dana Cassandra Winkler, Delia Leiding, Rene Bergs, Franziska Kaiser, Ramona Kirchhart, Ute Habel

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Background: Violence is a multidimensional phenomenon, affecting people of every age, socio-economic status and gender. Nevertheless, most studies primarily focus on men perpetrating women. Aim of the present study is to identify the likelihood of mental and somatic disorders and risk-taking behavior in male violence affected. In addition, the relationship between age of violence experience and the risk for health-related problems was analyzed. Method: On the basis of current evidence, a questionnaire was developed focusing on demographic background, health status, risk-taking behavior, and active and passive violence exposure. In total, 5221 males (Mean: 56,1 years, SD: 17,6) were consulted. To account for the time of violence experience in an efficient way, age clusters ‘0-12 years’, ‘13-20 years’, ‘21-35 years’, ‘36-65 years’ and ‘over 65 years’ were defined. A binary logistic regression was calculated to reveal differences in violence-affected and non-violence affected males regarding health and risk-taking factors. Males who experienced violence on a daily/ almost daily basis vs. males who reported violence occurrence once/ several times a month/ year were compared with respect to health factors and risk-taking behavior. Data of males, who indicated active and passive violence exposure, were analyzed by a chi²-analysis, to investigate a possible relation between the age of victimization and violence perpetration. Findings: Results imply that general violence experience, independent of active and passive violence exposure increases the likelihood in favor of somatic-, psychosomatic- and mental disorders as well as risk-taking behavior in males. Experiencing violence on a daily or almost daily basis in childhood and adolescence may serve as a predictor for increased health problems and risk-taking behavior. Furthermore, the violence experience and perpetration occur significantly within the same age cluster. This underlines the importance of a near-term intervention to minimize the risk, that victims become perpetrators later. Conclusion: The present study reveals predictors concerning health risk factors as well as risk-taking behavior in males with violence exposure. The results of this study may underscore the benefit of intervention and regular health care approaches in violence-affected males and underline the importance of acknowledging the overlap of violence experience and perpetration for further research.

Keywords: health disease, male, mental health, prevalence, risk-taking behavior, violence

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Authors: Alon Cohen, Jeffrey Kantor, Shalom Levy

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The use of the audit risk model in auditing has faced limitations and difficulties, leading auditors to rely on a conceptual level of its application. The qualitative approach to assessing risks has resulted in different risk assessments, affecting the quality of audits and decision-making on the adoption of CAATTs. This study aims to investigate risk factors impacting the implementation of the audit risk model and propose a complementary risk-based instrument (KRIs) to form substance risk judgments and mitigate against heightened risk of material misstatement (RMM). The study addresses the question of how risk factors impact the implementation of the audit risk model, improve risk judgments, and aid in the adoption of CAATTs. The study uses a three-stage scale development procedure involving a pretest and subsequent study with two independent samples. The pretest involves an exploratory factor analysis, while the subsequent study employs confirmatory factor analysis for construct validation. Additionally, the authors test the ability of the KRIs to predict audit efforts needed to mitigate against heightened RMM. Data was collected through two independent samples involving 767 participants. The collected data was analyzed using exploratory factor analysis and confirmatory factor analysis to assess scale validity and construct validation. The suggested KRIs, comprising two risk components and seventeen risk items, are found to have high predictive power in determining audit efforts needed to reduce RMM. The study validates the suggested KRIs as an effective instrument for risk assessment and decision-making on the adoption of CAATTs. This study contributes to the existing literature by implementing a holistic approach to risk assessment and providing a quantitative expression of assessed risks. It bridges the gap between intuitive risk evaluation and the theoretical domain, clarifying the mechanism of risk assessments. It also helps improve the uniformity and quality of risk assessments, aiding audit standard-setters in issuing updated guidelines on CAATT adoption. A few limitations and recommendations for future research should be mentioned. First, the process of developing the scale was conducted in the Israeli auditing market, which follows the International Standards on Auditing (ISAs). Although ISAs are adopted in European countries, for greater generalization, future studies could focus on other countries that adopt additional or local auditing standards. Second, this study revealed risk factors that have a material impact on the assessed risk. However, there could be additional risk factors that influence the assessment of the RMM. Therefore, future research could investigate other risk segments, such as operational and financial risks, to bring a broader generalizability to our results. Third, although the sample size in this study fits acceptable scale development procedures and enables drawing conclusions from the body of research, future research may develop standardized measures based on larger samples to reduce the generation of equivocal results and suggest an extended risk model.

Keywords: audit risk model, audit efforts, CAATTs adoption, key risk indicators, sustainability

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Authors: Mozhgan Aliakbari, Sara Moridpour

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In recent years, much attention has been given to truck drivers’ fatigue management. Long working hours negatively influence truck drivers’ physiology, health, and safety. However, there is little empirical research in the heavy vehicle transport sector in Australia to identify the influence of working hours’ management on drivers’ fatigue and consequently, on the risk of crashes and injuries. There is no national legislation regulating the number of hours or kilometres travelled by truck drivers. Consequently, it is almost impossible to define a standard number of hours or kilometres for truck drivers in a safety management system. This paper reviews the existing studies concerning safe system interventions such as tachographs in relation to fatigue caused by long working hours. This paper also reviews the literature to identify the influence of frequency of rest breaks on the reduction of work-related road transport accidents involving trucks. A framework is presented to manage truck drivers’ fatigue, which may result in the reduction of injuries and fatalities involving heavy vehicles.

Keywords: fatigue, time management, trucks, traffic safety

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Saeed Pourhassan, Nastaran Maghbouli

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Statement of the problem: The relationship between obesity and cardiovascular diseases has been studied widely(1). The distribution of fat tissue gained attention in relation to cardiovascular risk factors during lang-time research (2). American College of Cardiology/American Heart Association (ACC/AHA) is widely and the most reliable tool to be used as a cardiovascular risk (CVR) assessment tool(3). This study aimed to determine which anthropometric index is better in discrimination of high CVR patients from low risks using ACC/AHA score in addition to finding the best index as a CVR predictor among both genders in different races and countries. Methodology & theoretical orientation: The literature in PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched by two independent investigators using the keywords "anthropometric indices," "cardiovascular risk," and "obesity." The search strategy was limited to studies published prior to Jan 2022 as full-texts in the English language. Studies using ACC/AHA risk assessment tool as CVR and those consisted at least 2 anthropometric indices (ancient ones and novel ones) are included. Study characteristics and data were extracted. The relative risks were pooled with the use of the random-effect model. Analysis was repeated in subgroups. Findings: Pooled relative risk for 7 studies with 16,348 participants were 1.56 (1.35-1.72) for BMI, 1.67(1.36-1.83) for WC [waist circumference], 1.72 (1.54-1.89) for WHR [waist-to-hip ratio], 1.60 (1.44-1.78) for WHtR [waist-to-height ratio], 1.61 (1.37-1.82) for ABSI [A body shape index] and 1.63 (1.32-1.89) for CI [Conicity index]. Considering gender, WC among females and WHR among men gained the highest RR. The heterogeneity of studies was moderate (α²: 56%), which was not decreased by subgroup analysis. Some indices such as VAI and LAP were evaluated just in one study. Conclusion & significance: This meta-analysis showed WHR could predict CVR better in comparison to BMI or WHtR. Some new indices like CI and ABSI are less accurate than WHR and WC. Among women, WC seems to be a better choice to predict cardiovascular disease risk.

Keywords: obesity, cardiovascular disease, risk assessment, anthropometric indices

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Authors: I. Szer, J. Szer, M. Pieńko, A. Robak, P. Jamińska-Gadomska

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Work at height, such as construction works on scaffoldings, is associated with a considerable risk. Scaffolding workers are usually exposed to changing weather conditions what can additionally increase the risk of dangerous situations. Therefore, it is very important to foresee the risk of adverse conditions to which the worker may be exposed. The data from meteorological stations may be used to asses this risk. However, the dependency between weather conditions on a scaffolding and in the vicinity of meteorological station, should be determined. The paper presents an analysis of two selected environmental parameters which have influence on the behavior of workers – air temperature and wind speed. Measurements of these parameters were made between April and November of 2016 on ten scaffoldings located in different parts of Poland. They were compared with the results taken from the meteorological stations located closest to the studied scaffolding. The results gathered from the construction sites and meteorological stations were not the same, but statistical analyses have shown that they were correlated.

Keywords: scaffolding, health and safety at work, temperature, wind velocity

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Authors: Krzysztof J. Czarnocki, F. Silveira, E. Czarnocka, K. Szaniawska

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Research background: Problems related to the occupational health and decreasing level of safety occur commonly in the construction industry. Important factor in the occupational safety in construction industry is scaffold use. All scaffolds used in construction, renovation, and demolition shall be erected, dismantled and maintained in accordance with safety procedure. Increasing demand for new construction projects unfortunately still is linked to high level of occupational accidents. Therefore, it is crucial to implement concrete actions while dealing with scaffolds and risk assessment in construction industry, the way on doing assessment and liability of assessment is critical for both construction workers and regulatory framework. Unfortunately, professionals, who tend to rely heavily on their own experience and knowledge when taking decisions regarding risk assessment, may show lack of reliability in checking the results of decisions taken. Purpose of the article: The aim was to indicate crucial parameters that could be modeling with Risk Assessment Model (RAM) use for improving both building enterprise productivity and/or developing potential and safety climate. The developed RAM could be a benefit for predicting high-risk construction activities and thus preventing accidents occurred based on a set of historical accident data. Methodology/Methods: A RAM has been developed for assessing risk levels as various construction process stages with various work trades impacting different spheres of enterprise activity. This project includes research carried out by teams of researchers on over 60 construction sites in Poland and Portugal, under which over 450 individual research cycles were carried out. The conducted research trials included variable conditions of employee exposure to harmful physical and chemical factors, variable levels of stress of employees and differences in behaviors and habits of staff. Genetic modeling tool has been used for developing the RAM. Findings and value added: Common types of trades, accidents, and accident causes have been explored, in addition to suitable risk assessment methods and criteria. We have found that the initial worker stress level is more direct predictor for developing the unsafe chain leading to the accident rather than the workload, or concentration of harmful factors at the workplace or even training frequency and management involvement.

Keywords: safety climate, occupational health, civil engineering, productivity

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Authors: Abeer Mohammed, Nevein Mustafa Elashery, Mona Hassan Abdel Aal, Ereny Wilson Nagib

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The Aim of the current study is to investigate nutrition role in the management of psychiatric disorders. Research Design: A quasi- experimental research design was utilized for this study. Setting The study was conducted at outpatient clinic at Institute of Psychiatry affiliated to Ain Shams University hospitals, using a convenient sample of 50 psychiatric patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. Tools: data were collected through; first, an interview questionnaire covering socio-demographic characteristics, second, nutrition assessment tools Third, nutrition risk assessment. Fourth, nutrition management program Results showed that there were highly statistically significant improvements in modified nutritional supplements for patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders' patients after conducting the nutrition management program. Regarding psychiatric patients’ knowledge about healthy food, healthy nutritional habits, and patients’ awareness & readiness for change, there were highly statistically significant improvements. Concerning signs and symptoms of psychiatric disorders, there were highly statistically significant improvements for depression, schizophrenia, bipolar disorders, and obsessive-compulsive patients after conducting the management program. In conclusion, the nutrition management program was effective in improving symptoms associated with, depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. The study recommended that nurses should have more contribution in counseling psychiatric patients, and their families about healthy diet and healthy habits. Further research should recommend studying the effectiveness of herbs on enhancing mental health for psychiatric patients.

Keywords: nutrition, role, management, psychiatric disorders

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Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

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Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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Authors: Jerry Szatko, Edan L. Jorgensen, Stacia Jorgensen

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A crucial component to the success of any financial advising relationship is for the financial professional to understand the perceptions, preferences and thought-processes carried by the financial clients they serve. Armed with this information, financial professionals are more quickly able to understand how they can tailor their approach to best match the individual preferences and needs of each personal investor. Our research explores the use of a quantitative assessment tool in the financial services industry to assist in the identification of the personal investor’s consumer behaviors, especially in terms of financial risk tolerance, as it relates to their financial decision making. Through this process, the Unitifi Consumer Insight Tool (UCIT) was created and refined to capture and categorize personal investor financial behavioral categories and the financial personality tendencies of individuals prior to the initiation of a financial advisement relationship. This paper discusses the use of this tool to place individuals in one of four behavior-based financial risk tolerance categories. Our discoveries and research were aided through administration of a web-based survey to a group of over 1,000 individuals. Our findings indicate that it is possible to use a quantitative assessment tool to assist in predicting the behavioral tendencies of personal consumers when faced with consumer financial risk and decisions.

Keywords: behavior-based advising, financial relationship building, risk capacity based on behavior, risk tolerance, systematic way to assist in financial relationship building

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Authors: Jasna Prester, Ivana Rašić Bakarić, Božidar Matijević

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Various prominent scholars and substantial practitioner-oriented literature on innovation orientation have shown positive effects on firm performance. There is a myriad of factors that influence and enhance innovation but it has been found in the literature that new product innovations accounted for an average of 14 percent of sales revenues for all firms. If there is one thing that has changed in innovation management during the last decade, it is the growing reliance on external partners. As a consequence, a new task for purchasing arises, as firms need to understand which suppliers actually do have high potential contributing to the innovativeness of the firm and which do not. Purchasing function in an organization is extremely important as it deals on an average of 50% or more of a firm's expenditures. In the nineties the purchasing department was largely seen as a transaction-oriented, clerical function but today purchasing integration provides a formal interface mechanism between purchasing and other firm functions that services other functions within the company. Purchasing function has to be organized differently to enable firm innovation potential. However, innovations are inherently risky. There are behavioral risk (that some partner will take advantage of the other party), technological risk in terms of complexity of products and processes of manufacturing and incoming materials and finally market risks, which in fact judge the value of the innovation. These risks are investigated in this work since it has been found in the literature that the higher the technological risk, higher will be the centralization of the purchasing function as an interface with other supply chain members. Most researches on organization of purchasing function were done by case study analysis of innovative firms. This work actually tends to prove or discard results found in the literature based on case study method. A large data set of 1493 companies, from 25 countries collected in the GMRG 4 survey served as a basis for analysis.

Keywords: purchasing function organization, innovation, technological risk, GMRG 4 survey

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Authors: A. Bhatt, C. Bassi, H. Farragher, J. Musk

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Background: All medicines placed on the EU market are legally required to be accompanied by labeling and package leaflet, which provide comprehensive information, enabling its safe and appropriate use. Mock-ups with results of assessments using a target patient group must be submitted for a marketing authorisation application. Consumers need confidence in non-prescription, OTC medicines in order to manage their minor ailments and umbrella brands assist purchasing decisions by assisting easy identification within a particular therapeutic area. A number of regulatory agencies have risk management tools and guidelines to assist in developing umbrella brands for OTC medicines, however assessment and decision making is subjective and inconsistent. This study presents an evaluation in the UK following the US FDA warning concerning methaemoglobinaemia following 21 reported cases (11 children under 2 years) caused by OTC oral analgesics containing benzocaine. METHODS: A standard face to face, 25 structured task based user interview testing methodology using a standard questionnaire and rating scale in consumers aged 15-91 years, was conducted independently between June and October 2015 in their homes. Whether individuals could discriminate between the labelling, safety information and warnings on cartons and PILs between 3 different OTC medicines packs with the same umbrella name was evaluated. Each pack was presented with differing information hierarchy using, different coloured cartons, containing the 3 different active ingredients, benzocaine (oromucosal spray) and two lozenges containing 2, 4, dichlorobenzyl alcohol, amylmetacresol and hexylresorcinol respectively (for the symptomatic relief of sore throat pain). The test was designed to determine whether warnings on the carton and leaflet were prominent, accessible to alert users that one product contained benzocaine, risk of methaemoglobinaemia, and refer to the leaflet for the signs of the condition and what to do should this occur. Results: Two consumers did not locate the warnings on the side of the pack, eventually found them on the back and two suggestions to further improve accessibility of the methaemoglobinaemia warning. Using a gold pack design for the oromucosal spray, all consumers could differentiate between the 3 drugs, minimum age particulars, pharmaceutical form and the risk factor methaemoglobinaemia. The warnings for benzocaine were deemed to be clear or very clear; appearance of the 3 packs were either very well differentiated or quite well differentiated. The PIL test passed on all criteria. All consumers could use the product correctly, identify risk factors ensuring the critical information necessary for the safe use was legible and easily accessible so that confusion and errors were minimised. Conclusion: Patients with known methaemoglobinaemia are likely to be vigilant in checking for benzocaine containing products, despite similar umbrella brand names across a range of active ingredients. Despite these findings, the package design and spray format were not deemed to be sufficient to mitigate potential safety risks associated with differences in target populations and contraindications when submitted to the Regulatory Agency. Although risk management tools are increasingly being used by agencies to assist in providing objective assurance of package safety, further transparency, reduction in subjectivity and proportionate risk should be demonstrated.

Keywords: labelling, OTC, risk, user testing

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