Search results for: background risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9463

Search results for: background risk

9283 Proposal of a Model Supporting Decision-Making on Information Security Risk Treatment

Authors: Ritsuko Kawasaki, Takeshi Hiromatsu

Abstract:

Management is required to understand all information security risks within an organization, and to make decisions on which information security risks should be treated in what level by allocating how much amount of cost. However, such decision-making is not usually easy, because various measures for risk treatment must be selected with the suitable application levels. In addition, some measures may have objectives conflicting with each other. It also makes the selection difficult. Therefore, this paper provides a model which supports the selection of measures by applying multi-objective analysis to find an optimal solution. Additionally, a list of measures is also provided to make the selection easier and more effective without any leakage of measures.

Keywords: information security risk treatment, selection of risk measures, risk acceptance, multi-objective optimization

Procedia PDF Downloads 363
9282 A Financial Analysis of the Current State of IKEA: A Case Study

Authors: Isabela Vieira, Leonor Carvalho Garcez, Adalmiro Pereira, Tânia Teixeira

Abstract:

In the present work, we aim to analyse IKEA as a company, by focusing on its development, financial analysis and future benchmarks, as well as applying some of the knowledge learned in class, namely hedging and other financial risk mitigation solutions, to understand how IKEA navigates and protects itself from risk. The decision that led us to choose IKEA for our casework has to do with the long history of the company since the 1940s and its high internationalization in 63 different markets. The company also has clear financial reports which aided us in the making of the present essay and naturally, was a factor that contributed to our decision.

Keywords: Ikea, financial risk, risk management, hedge

Procedia PDF Downloads 23
9281 Higher Consumption of White Rice Increase the Risk of Metabolic Syndrome in Adults with Abdominal Obesity

Authors: Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi

Abstract:

Background: Higher consumption of white rice has been suggested as a risk factor for development of metabolic abnormalities. In this study we investigated the association between consumption of white rice and the 3-year occurrence of metabolic syndrome (MetS) in adults with and without abdominal obesity. Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 years. Dietary intakes were measured, using a 168-food items validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were evaluated at both baseline (2006-2008) and after 3-year follow-up (2009-2011). MetS and its components were defined according to the diagnostic criteria proposed by NCEP ATP III, and the new cutoff points of waist circumference for Iranian adults. Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of white rice consumption. Results: The mean age of participants was 37.8±12.3 y, and mean BMI was 26.0±4.5 kg/m2 at baseline. The prevalence of MetS in subjects with abdominal obesity was significantly higher (40.9 vs. 16.2%, P<0.01). There was no significant difference in white rice consumption between the two groups. Mean daily intake of white rice was 93±59, 209±58, 262±60 and 432±224 g/d, in the first to fourth quartiles of white rice, respectively. Stratified analysis by categories of waist circumference showed that higher consumption of white rice was more strongly related to the risk of metabolic syndrome in participants who had abdominal obesity (OR: 2.34, 95% CI:1.14-4.41 vs. OR:0.99, 95% CI:0.60-1.65) Conclusion: We demonstrated that higher consumption of white rice may be a risk for development of metabolic syndrome in adults with abdominal obesity.

Keywords: white rice, abdominal obesity, metabolic syndrome, food science, triglycerides

Procedia PDF Downloads 431
9280 Intellectual Property Risk Assessment in Planning Market Entry to China

Authors: Qing Cao

Abstract:

Generally speaking, China has a relatively high level of intellectual property (IP) infringement. Risk assessment is indispensable in the strategic planning process. To complement the current literature in international business, the paper sheds the light on how to assess IP risk for foreign companies in planning market entry to China. Evaluating internal and external IP environment, proposed in the paper, consists of external analysis, internal analysis and further internal analysis. Through position the company’s IP environment, the risk assessment approach enables the foreign companies to either build the corresponding IP strategies or abort the entry plan beforehand to minimize the IP risks.

Keywords: intellectual property, IP environment, risk assessment

Procedia PDF Downloads 540
9279 Sex Education Training Program Effect on Junior Secondary School Students Knowledge and Practice of Sexual Risk Behavior

Authors: Diyaolu Babajide Olufemi, Oyerinde Oyewole Olusesan

Abstract:

This study examined the effect of sex education training programs on the knowledge and practice of sexual risk behavior among secondary school adolescents in Ibadan North Local Government area of Oyo State. A total of 105 students were sampled from two schools in the Local Government area. Seventy students (70) constituted the experimental group while thirty-five (35) constituted the control group. Pretest-Posttest control group quasi-experimental design was adopted. A self-developed questionnaire was used to test participants’ knowledge and practice of sexual risk behavior before and after the training (α=.62, .82 and .74). Analysis indicated a significant effect of sex education training on participants’ knowledge and practice of sexual risk behavior, a significant gender difference in knowledge of sexual risk behavior but no significant age and gender difference in the practice of sexual risk behavior. It was thus concluded that sex education should be taught in schools and emphasized at homes with no age or gender restrictions.

Keywords: early adolescent, health risk, sexual risk behavior, sex education

Procedia PDF Downloads 120
9278 Environmental Governance and Opportunities for Disaster Risk Reduction in Nigeria

Authors: Willie Eselebor

Abstract:

Environmental governance is not new, but may consist of a series of actions taken to establish sanity and ensure sustainable environment. While there is a growing accord linking disaster risk reduction with the management of environment and natural resources, little is known about failure to act which constitute vulnerability and how improved governance reduces risk globally. The paper reviews emerging trends in the field of application of governance tools and approaches for reducing disaster risk. The Hyogo Framework for Action (HFA) enjoin all stakeholders to stimulate the sustainable use and management of ecosystems, which promote the implementation of integrated environmental and natural resource planning that incorporate disaster risk reduction, including structural and non-structural measures, such as integrated management of fragile ecosystems. The methodology adopted is a case study of disaster-prone sites, prompting guided analysis on which hazards are traceable to environmental degradation, why a degraded environment reduces community resilience; how healthy ecosystems provide natural defense, and which opportunities exist to address gaps in reduction of disasters in Nigeria. The paper further analyses the interaction between disaster risk and environmental change. It is established that environmental governance remains a challenge; which implies that there is the need for a shift in traditional approaches to disaster risk management; exploring new initiatives and allowing environmental managers to be docketed as disaster risk managers in context, potentially opening up a window of dialogue on disaster risk management.

Keywords: disaster, ecosystem, environment, risk

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9277 A Structural Equation Model of Risk Perception of Rockfall for Revisit Intention

Authors: Ya-Fen Lee, Yun-Yao Chi

Abstract:

The study aims to explore the relationship between risk perceptions of rockfall and revisit intention using a Structural Equation Modelling (SEM) analysis. A total of 573 valid questionnaires are collected from travelers to Taroko National Park, Taiwan. The findings show the majority of travellers have the medium perception of rockfall risk, and are willing to revisit the Taroko National Park. The revisit intention to Taroko National Park is influenced by hazardous preferences, willingness-to-pay, obstruction and attraction. The risk perception has an indirect effect on revisit intention through influencing willingness-to-pay. The study results can be a reference for mitigation the rockfall disaster.

Keywords: risk perception, rockfall, revisit intention, structural equation modelling

Procedia PDF Downloads 411
9276 Transparency Obligations under the AI Act Proposal: A Critical Legal Analysis

Authors: Michael Lognoul

Abstract:

In April 2021, the European Commission released its AI Act Proposal, which is the first policy proposal at the European Union level to target AI systems comprehensively, in a horizontal manner. This Proposal notably aims to achieve an ecosystem of trust in the European Union, based on the respect of fundamental rights, regarding AI. Among many other requirements, the AI Act Proposal aims to impose several generic transparency obligationson all AI systems to the benefit of natural persons facing those systems (e.g. information on the AI nature of systems, in case of an interaction with a human). The Proposal also provides for more stringent transparency obligations, specific to AI systems that qualify as high-risk, to the benefit of their users, notably on the characteristics, capabilities, and limitations of the AI systems they use. Against that background, this research firstly presents all such transparency requirements in turn, as well as related obligations, such asthe proposed obligations on record keeping. Secondly, it focuses on a legal analysis of their scope of application, of the content of the obligations, and on their practical implications. On the scope of transparency obligations tailored for high-risk AI systems, the research notably notes that it seems relatively narrow, given the proposed legal definition of the notion of users of AI systems. Hence, where end-users do not qualify as users, they may only receive very limited information. This element might potentially raise concern regarding the objective of the Proposal. On the content of the transparency obligations, the research highlights that the information that should benefit users of high-risk AI systems is both very broad and specific, from a technical perspective. Therefore, the information required under those obligations seems to create, prima facie, an adequate framework to ensure trust for users of high-risk AI systems. However, on the practical implications of these transparency obligations, the research notes that concern arises due to potential illiteracy of high-risk AI systems users. They might not benefit from sufficient technical expertise to fully understand the information provided to them, despite the wording of the Proposal, which requires that information should be comprehensible to its recipients (i.e. users).On this matter, the research points that there could be, more broadly, an important divergence between the level of detail of the information required by the Proposal and the level of expertise of users of high-risk AI systems. As a conclusion, the research provides policy recommendations to tackle (part of) the issues highlighted. It notably recommends to broaden the scope of transparency requirements for high-risk AI systems to encompass end-users. It also suggests that principles of explanation, as they were put forward in the Guidelines for Trustworthy AI of the High Level Expert Group, should be included in the Proposal in addition to transparency obligations.

Keywords: aI act proposal, explainability of aI, high-risk aI systems, transparency requirements

Procedia PDF Downloads 272
9275 Comparing Performance of Neural Network and Decision Tree in Prediction of Myocardial Infarction

Authors: Reza Safdari, Goli Arji, Robab Abdolkhani Maryam zahmatkeshan

Abstract:

Background and purpose: Cardiovascular diseases are among the most common diseases in all societies. The most important step in minimizing myocardial infarction and its complications is to minimize its risk factors. The amount of medical data is increasingly growing. Medical data mining has a great potential for transforming these data into information. Using data mining techniques to generate predictive models for identifying those at risk for reducing the effects of the disease is very helpful. The present study aimed to collect data related to risk factors of heart infarction from patients’ medical record and developed predicting models using data mining algorithm. Methods: The present work was an analytical study conducted on a database containing 350 records. Data were related to patients admitted to Shahid Rajaei specialized cardiovascular hospital, Iran, in 2011. Data were collected using a four-sectioned data collection form. Data analysis was performed using SPSS and Clementine version 12. Seven predictive algorithms and one algorithm-based model for predicting association rules were applied to the data. Accuracy, precision, sensitivity, specificity, as well as positive and negative predictive values were determined and the final model was obtained. Results: five parameters, including hypertension, DLP, tobacco smoking, diabetes, and A+ blood group, were the most critical risk factors of myocardial infarction. Among the models, the neural network model was found to have the highest sensitivity, indicating its ability to successfully diagnose the disease. Conclusion: Risk prediction models have great potentials in facilitating the management of a patient with a specific disease. Therefore, health interventions or change in their life style can be conducted based on these models for improving the health conditions of the individuals at risk.

Keywords: decision trees, neural network, myocardial infarction, Data Mining

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9274 Dietary Pattern derived by Reduced Rank Regression is Associated with Reduced Cognitive Impairment Risk in Singaporean Older Adults

Authors: Kaisy Xinhong Ye, Su Lin Lim, Jialiang Li, Lei Feng

Abstract:

background: Multiple healthful dietary patterns have been linked with dementia, but limited studies have looked at the role of diet in cognitive health in Asians whose eating habits are very different from their counterparts in the west. This study aimed to derive a dietary pattern that is associated with the risk of cognitive impairment (CI) in the Singaporean population. Method: The analysis was based on 719 community older adults aged 60 and above. Dietary intake was measured using a validated semi-quantitative food-frequency questionnaire (FFQ). Reduced rank regression (RRR) was used to extract dietary pattern from 45 food groups, specifying sugar, dietary fiber, vitamin A, calcium, and the ratio of polyunsaturated fat to saturated fat intake (P:S ratio) as response variables. The RRR-derived dietary patterns were subsequently investigated using multivariate logistic regression models to look for associations with the risk of CI. Results: A dietary pattern characterized by greater intakes of green leafy vegetables, red-orange vegetables, wholegrains, tofu, nuts, and lower intakes of biscuits, pastries, local sweets, coffee, poultry with skin, sugar added to beverages, malt beverages, roti, butter, and fast food was associated with reduced risk of CI [multivariable-adjusted OR comparing extreme quintiles, 0.29 (95% CI: 0.11, 0.77); P-trend =0.03]. This pattern was positively correlated with P:S ratio, vitamin A, and dietary fiber and negatively correlated with sugar. Conclusion: A dietary pattern providing high P:S ratio, vitamin A and dietary fiber, and a low level of sugar may reduce the risk of cognitive impairment in old age. The findings have significance in guiding local Singaporeans to dementia prevention through food-based dietary approaches.

Keywords: dementia, cognitive impairment, diet, nutrient, elderly

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9273 Implementation of Risk Management System to Improve the Quality of Higher Education Institutes

Authors: Muhammad Wasif, Asif Ahmed Shaikh, Sarosh Hashmat Lodi, Muhammad Aslam Bhutto, Riazuddin

Abstract:

Risk Management System is quite popular in profit- based organizations, health and safety and project management fields since the last few decades. But due to rapidly changing environment and requirement of ISO 9001:2015 standards, public-sector institution, especially higher education institutes are also performing risk assessment to monitor the performance of the institution and aligning it with the latest benchmark. In this context, NED University of Engineering and Technology performed research and developed a Standard Operating Procedure (SOP) for the risk assessment, its monitoring and control. In this research, risks are broken into the four sources, namely; Internal Academics Risks, External Academics Risks, Internal Non-academic Risks, External Non-academic Risks. Risks are identified by the management at all levels. Severity and likelihood of the risks are assigned based on the previous audit results and the customer complains. Risk Ratings are calculated to orderly arrange the risk according to the Risk Rating, and controls for the risks are designed, which are assigned to the responsible person. At the end of the article, result and analysis on the different sources of risk are discussed in details and the conclusion is drawn. Discussion on few sample risks are presented in this article. Hence it is presented in the research that the Risk Management System can be applied in a Higher Education Institute to effectively control the risks which might affect the scope and Quality Management System of an organization.

Keywords: higher education, quality management system, risk assessment, risk management

Procedia PDF Downloads 289
9272 Analysis of Factors Used by Farmers to Manage Risk: A Case Study on Italian Farms

Authors: A. Pontrandolfi, G. Enjolras, F. Capitanio

Abstract:

The study analyses the strategies Italian farmers use to cope with the risks that face their production. We specifically explore the potential and the limitations of the economic tools for climatic risk management in agriculture of the Common Agricultural Policy 2014-2020, that foresees contributions for economic tools for risk management, in relation to farms’ needs, exposure and vulnerability of agricultural areas to climatic risk. We consider at the farm level approaches to hedge risks in terms of the use of technical tools (agricultural practices, pesticides, fertilizers, irrigation) and economic/financial instruments (insurances, etc.). We develop cross-sectional and longitudinal analyses as well as analyses of correlation that underline the main differences between the way farms adapt their structure and management towards risk. The results show a preference for technical tools, despite the presence of important public aids on economic tools such as insurances. Therefore, there is a strong need for a more effective and integrated risk management policy scheme. Synergies between economic tools and risk reduction actions of a more technical, structural and management nature (production diversification, irrigation infrastructures, technological and management innovations and formation-information-consultancy, etc.) are emphasized.

Keywords: agriculture and climate change, climatic risk management, insurance schemes, farmers' approaches to risk management

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9271 Hybrid Risk Assessment Model for Construction Based on Multicriteria Decision Making Methods

Authors: J. Tamosaitiene

Abstract:

The article focuses on the identification and classification of key risk management criteria that represent the most important sustainability aspects of the construction industry. The construction sector is one of the most important sectors in Lithuania. Nowadays, the assessment of the risk level of a construction project is especially important for the quality of construction projects, the growth of enterprises and the sector. To establish the most important criteria for successful growth of the sector, a questionnaire for experts was developed. The analytic hierarchy process (AHP), the expert judgement method and other multicriteria decision making (MCDM) methods were used to develop the hybrid model. The results were used to develop an integrated knowledge system for the measurement of a risk level particular to construction projects. The article presents a practical case that details the developed system, sustainable aspects, and risk assessment.

Keywords: risk, system, model, construction

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9270 Risk Management and Security Practice in Customs Supply Chain: Application of Cross ABC Method to the Moroccan Customs

Authors: Lamia Hammadi, Abdellah Ait Ouhman, Aomar Ibourk

Abstract:

It is widely assumed that the case of Customs Supply Chain is classified as a complex system, due to not only the variety and large number of actors, but also their complex structural links, and the interactions between these actors, that’s why this system is subject to various types of Risks. The economic, political and social impacts of those risks are highly detrimental to countries, businesses and the public, for this reason, Risk management in the customs supply chain is becoming a crucial issue to ensure the sustainability, security and safety. The main characteristic of customs risk management approach is determining which goods and means of transport should be examined? To what extend? And where future compliance resources should be directed? The purposes of this article are, firstly to deal with the concept of customs supply chain, secondly present our risk management approach based on Cross Activity Based Costing (ABC) Method as an interactive tool to support decision making in customs risk management. Finally, analysis of case study of Moroccan customs to putting theory into practice and will thus draw together the various elements of a structured and efficient risk management approach.

Keywords: cross ABC method, customs supply chain, risk, risk management

Procedia PDF Downloads 359
9269 A Comparative Study of Substance Abusers and Non-Abusers on Peer Pressure, Tendency to Risk Taking Behavior and Anxiety

Authors: Musarrat Jabeen Khan, Uzma Azam, Kainat Umar, Jazba Amber Satti, Aiman Shehzadi, Nimo Omer

Abstract:

This study aimed to examine the comparison between substance abusers and non-abusers on anxiety, peer pressure, and risk-taking behavior among young adults. The sample consisted of 138 individuals including 64 female and 71 males, age range from 17-35 years, drawn from non-clinical population through convenient sampling. Questionnaire technique was used for the information assortment and the scales were susceptibility to peer pressure (Dieman, Pamella, Shope & Butchart, 1987), Zung self-rating anxiety scale (Zung, 1971), and risk-taking questionnaire (Gullone, Moore, Moss & Boyd, 2000) having alpha reliability of .54, .88, and .80 respectively. Results showed that anxiety negatively correlates with the risk-taking behavior. High level of anxiety stops an individual to involve himself in risk taking activities. Peer pressure have positive correlation with risk-taking behavior. Females are more susceptible to peer pressure irrespective of being abusers or non-abusers as compared to male abusers and non-abusers. Substance abusers have less anxiety as compared to non-abusers but are more susceptible to peer pressure and risk-taking behaviors.

Keywords: substance, substance abuse, anxiety, peer pressure, risk-taking behavior

Procedia PDF Downloads 139
9268 Measuring Banking Risk

Authors: Mike Tsionas

Abstract:

The paper develops new indices of financial stability based on an explicit model of expected utility maximization by financial institutions subject to the classical technology restrictions of neoclassical production theory. The model can be estimated using standard econometric techniques, like GMM for dynamic panel data and latent factor analysis for the estimation of co-variance matrices. An explicit functional form for the utility function is not needed and we show how measures of risk aversion and prudence (downside risk aversion) can be derived and estimated from the model. The model is estimated using data for Eurozone countries and we focus particularly on (i) the use of the modeling approach as an “early warning mechanism”, (ii) the bank- and country-specific estimates of risk aversion and prudence (downside risk aversion), and (iii) the derivation of a generalized measure of risk that relies on loan-price uncertainty.

Keywords: financial stability, banking, expected utility maximization, sub-prime crisis, financial crisis, eurozone, PIIGS

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9267 Sensitivity of Credit Default Swaps Premium to Global Risk Factor: Evidence from Emerging Markets

Authors: Oguzhan Cepni, Doruk Kucuksarac, M. Hasan Yilmaz

Abstract:

Risk premium of emerging markets are moving altogether depending on the momentum and shifts in the global risk appetite. However, the magnitudes of these changes in the risk premium of emerging market economies might vary. In this paper, we focus on how global risk factor affects credit default swaps (CDS) premiums of emerging markets using principal component analysis (PCA) and rolling regressions. PCA results indicate that the first common component accounts for almost 76% of common variation in CDS premiums of emerging markets. Additionally, the explanatory power of the first factor seems to be high over sample period. However, the sensitivity to the global risk factor tends to change over time and across countries. In this regard, fixed effects panel regressions are employed to identify the macroeconomic factors driving the heterogeneity across emerging markets. There are two main macroeconomic variables that affect the sensitivity; government debt to GDP and international reserves to GDP. The countries with lower government debt and higher reserves tend to be less subject to the variations in the global risk appetite.

Keywords: emerging markets, principal component analysis, credit default swaps, sovereign risk

Procedia PDF Downloads 365
9266 A Bayesian Classification System for Facilitating an Institutional Risk Profile Definition

Authors: Roman Graf, Sergiu Gordea, Heather M. Ryan

Abstract:

This paper presents an approach for easy creation and classification of institutional risk profiles supporting endangerment analysis of file formats. The main contribution of this work is the employment of data mining techniques to support set up of the most important risk factors. Subsequently, risk profiles employ risk factors classifier and associated configurations to support digital preservation experts with a semi-automatic estimation of endangerment group for file format risk profiles. Our goal is to make use of an expert knowledge base, accuired through a digital preservation survey in order to detect preservation risks for a particular institution. Another contribution is support for visualisation of risk factors for a requried dimension for analysis. Using the naive Bayes method, the decision support system recommends to an expert the matching risk profile group for the previously selected institutional risk profile. The proposed methods improve the visibility of risk factor values and the quality of a digital preservation process. The presented approach is designed to facilitate decision making for the preservation of digital content in libraries and archives using domain expert knowledge and values of file format risk profiles. To facilitate decision-making, the aggregated information about the risk factors is presented as a multidimensional vector. The goal is to visualise particular dimensions of this vector for analysis by an expert and to define its profile group. The sample risk profile calculation and the visualisation of some risk factor dimensions is presented in the evaluation section.

Keywords: linked open data, information integration, digital libraries, data mining

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9265 Development of Pediatric Medical Trauma Stress (PMTS) Among Children at Risk

Authors: Amichai Ben ari, Daniella Margalit

Abstract:

Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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9264 Application Potential of Selected Tools in Context of Critical Infrastructure Protection and Risk Analysis

Authors: Hromada Martin

Abstract:

Risk analysis is considered as a fundamental aspect relevant for ensuring the level of critical infrastructure protection, where the critical infrastructure is seen as system, asset or its part which is important for maintaining the vital societal functions. Article actually discusses and analyzes the potential application of selected tools of information support for the implementation and within the framework of risk analysis and critical infrastructure protection. Use of the information in relation to their risk analysis can be viewed as a form of simplifying the analytical process. It is clear that these instruments (information support) for these purposes are countless, so they were selected representatives who have already been applied in the selected area of critical infrastructure, or they can be used. All presented fact were the basis for critical infrastructure resilience evaluation methodology development.

Keywords: critical infrastructure, protection, resilience, risk analysis

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9263 Reducing the Risk of Alcohol Relapse after Liver-Transplantation

Authors: Rebeca V. Tholen, Elaine Bundy

Abstract:

Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

Procedia PDF Downloads 100
9262 Production Structures of Energy Based on Water Force, Its Infrastructure Protection, and Possible Causes of Failure

Authors: Gabriela-Andreea Despescu, Mădălina-Elena Mavrodin, Gheorghe Lăzăroiu, Florin Adrian Grădinaru

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The purpose of this paper is to contribute to the enhancement of a hydroelectric plant protection by coordinating protection measures and existing security and introducing new measures under a risk management process. Also, the plan identifies key critical elements of a hydroelectric plant, from its level vulnerabilities and threats it is subjected to in order to achieve the necessary protection measures to reduce the level of risk.

Keywords: critical infrastructure, risk analysis, critical infrastructure protection, vulnerability, risk management, turbine, impact analysis

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9261 Board Regulation and Its Impact on Composition and Effects: Evidence from German Cooperative Banks

Authors: Markus Stralla

Abstract:

This study employs a GMM framework to examine the impact of potential regulatory intervention regarding the occupations of supervisory board members in cooperative banking. To achieve insights, the study proceeds in two different ways. First, it investigates the changes in board structure prior and following to the German Act to Strengthen Financial Market and Insurance Supervision (FinVAG). Second, the study estimates the influence of Ph.D.Share, professional concentration and supervisory power on bank-risk changes in consideration of the implementation of FinVAG. Therefore, the study is based on a sample of 246 German cooperative banks from 2006-2011 while applying four different measures of bank risk, namely credit-, equity-, liquidity-risk, and Z-Score, with the former three also being addressed in FinVAG. Results indicate that the implementation of FinVAG results in (most likely unintentional) structural changes, especially at the expense of farmers, and affects all risk measures and relations between risk measures and supervisory board characteristics in a risk-reducing and therefore intended way. To disentangle the complex relationship between board characteristics and risk measures, the study utilizes two-step system GMM estimator to account for unobserved heterogeneity and simultaneity in order to reduce endogeneity problems. The findings may be especially relevant for stakeholders, regulators, supervisors and managers.

Keywords: bank governance, bank risk-taking, board of directors, regulation

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9260 Tools and Techniques in Risk Assessment in Public Risk Management Organisations

Authors: Atousa Khodadadyan, Gabe Mythen, Hirbod Assa, Beverley Bishop

Abstract:

Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.

Keywords: decision-making, public risk management organisations, risk assessment, tools and techniques

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9259 Characterizing Multivariate Thresholds in Industrial Engineering

Authors: Ali E. Abbas

Abstract:

This paper highlights some of the normative issues that might result by setting independent thresholds in risk analyses and particularly with safety regions. A second objective is to explain how such regions can be specified appropriately in a meaningful way. We start with a review of the importance of setting deterministic trade-offs among target requirements. We then show how to determine safety regions for risk analysis appropriately using utility functions.

Keywords: decision analysis, thresholds, risk, reliability

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9258 Links between Landscape Management and Environmental Risk Assessment: Considerations from the Italian Context

Authors: Mara Balestrieri, Clara Pusceddu

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Issues relating to the destructive phenomena that can damage people and goods have returned to the centre of debate in Italy with the increase in catastrophic episodes in recent years in a country which is highly vulnerable to hydrological risk. Environmental factors and geological and geomorphological territorial characteristics play an important role in determining the level of vulnerability and the natural tendency to risk. However, a territory has also been subjected to the requirements of and transformations of society, and this brings other relevant factors. The reasons for the increase in destructive phenomena are often to be found in the territorial development models adopted. Stewardship of the landscape and management of risk are related issues. This study aims to summarize the most relevant elements about this connection and at the same time to clarify the role of environmental risk assessment as a tool to aid in the sustainable management of landscape. How planners relate to this problem and which aspects should be monitored in order to prepare responsible and useful interventions?

Keywords: assessment, landscape, risk, planning

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9257 Risk Factors for Diabetic Foot: Upper Egypt Experience

Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

Abstract:

Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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9256 Risk Assessment Tools Applied to Deep Vein Thrombosis Patients Treated with Warfarin

Authors: Kylie Mueller, Nijole Bernaitis, Shailendra Anoopkumar-Dukie

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Background: Vitamin K antagonists particularly warfarin is the most frequently used oral medication for deep vein thrombosis (DVT) treatment and prophylaxis. Time in therapeutic range (TITR) of the international normalised ratio (INR) is widely accepted as a measure to assess the quality of warfarin therapy. Multiple factors can affect warfarin control and the subsequent adverse outcomes including thromboembolic and bleeding events. Predictor models have been developed to assess potential contributing factors and measure the individual risk of these adverse events. These predictive models have been validated in atrial fibrillation (AF) patients, however, there is a lack of literature on whether these can be successfully applied to other warfarin users including DVT patients. Therefore, the aim of the study was to assess the ability of these risk models (HAS BLED and CHADS2) to predict haemorrhagic and ischaemic incidences in DVT patients treated with warfarin. Methods: A retrospective analysis of DVT patients receiving warfarin management by a private pathology clinic was conducted. Data was collected from November 2007 to September 2014 and included demographics, medical and drug history, INR targets and test results. Patients receiving continuous warfarin therapy with an INR reference range between 2.0 and 3.0 were included in the study with mean TITR calculated using the Rosendaal method. Bleeding and thromboembolic events were recorded and reported as incidences per patient. The haemorrhagic risk model HAS BLED and ischaemic risk model CHADS2 were applied to the data. Patients were then stratified into either the low, moderate, or high-risk categories. The analysis was conducted to determine if a correlation existed between risk assessment tool and patient outcomes. Data was analysed using GraphPad Instat Version 3 with a p value of <0.05 considered to be statistically significant. Patient characteristics were reported as mean and standard deviation for continuous data and categorical data reported as number and percentage. Results: Of the 533 patients included in the study, there were 268 (50.2%) female and 265 (49.8%) male patients with a mean age of 62.5 years (±16.4). The overall mean TITR was 78.3% (±12.7) with an overall haemorrhagic incidence of 0.41 events per patient. For the HAS BLED model, there was a haemorrhagic incidence of 0.08, 0.53, and 0.54 per patient in the low, moderate and high-risk categories respectively showing a statistically significant increase in incidence with increasing risk category. The CHADS2 model showed an increase in ischaemic events according to risk category with no ischaemic events in the low category, and an ischaemic incidence of 0.03 in the moderate category and 0.47 high-risk categories. Conclusion: An increasing haemorrhagic incidence correlated to an increase in the HAS BLED risk score in DVT patients treated with warfarin. Furthermore, a greater incidence of ischaemic events occurred in patients with an increase in CHADS2 category. In an Australian population of DVT patients, the HAS BLED and CHADS2 accurately predicts incidences of haemorrhage and ischaemic events respectively.

Keywords: anticoagulant agent, deep vein thrombosis, risk assessment, warfarin

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9255 Analysis of Risk-Based Disaster Planning in Local Communities

Authors: R. A. Temah, L. A. Nkengla-Asi

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Planning for future disasters sets the stage for a variety of activities that may trigger multiple recurring operations and expose the community to opportunities to minimize risks. Local communities are increasingly embracing the necessity for planning based on local risks, but are also significantly challenged to effectively plan and response to disasters. This research examines basic risk-based disaster planning model and compares it with advanced risk-based planning that introduces the identification and alignment of varieties of local capabilities within and out of the local community that can be pivotal to facilitate the management of local risks and cascading effects prior to a disaster. A critical review shows that the identification and alignment of capabilities can potentially enhance risk-based disaster planning. A tailored holistic approach to risk based disaster planning is pivotal to enhance collective action and a reduction in disaster collective cost.

Keywords: capabilities, disaster planning, hazards, local community, risk-based

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9254 Automated Manual Handling Risk Assessments: Practitioner Experienced Determinants of Automated Risk Analysis and Reporting Being a Benefit or Distraction

Authors: S. Cowley, M. Lawrance, D. Bick, R. McCord

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Technology that automates manual handling (musculoskeletal disorder or MSD) risk assessments is increasingly available to ergonomists, engineers, generalist health and safety practitioners alike. The risk assessment process is generally based on the use of wearable motion sensors that capture information about worker movements for real-time or for posthoc analysis. Traditionally, MSD risk assessment is undertaken with the assistance of a checklist such as that from the SafeWork Australia code of practice, the expert assessor observing the task and ideally engaging with the worker in a discussion about the detail. Automation enables the non-expert to complete assessments and does not always require the assessor to be there. This clearly has cost and time benefits for the practitioner but is it an improvement on the assessment by the human. Human risk assessments draw on the knowledge and expertise of the assessor but, like all risk assessments, are highly subjective. The complexity of the checklists and models used in the process can be off-putting and sometimes will lead to the assessment becoming the focus and the end rather than a means to an end; the focus on risk control is lost. Automated risk assessment handles the complexity of the assessment for the assessor and delivers a simple risk score that enables decision-making regarding risk control. Being machine-based, they are objective and will deliver the same each time they assess an identical task. However, the WHS professional needs to know that this emergent technology asks the right questions and delivers the right answers. Whether it improves the risk assessment process and results or simply distances the professional from the task and the worker. They need clarity as to whether automation of manual task risk analysis and reporting leads to risk control or to a focus on the worker. Critically, they need evidence as to whether automation in this area of hazard management leads to better risk control or just a bigger collection of assessments. Practitioner experienced determinants of this automated manual task risk analysis and reporting being a benefit or distraction will address an understanding of emergent risk assessment technology, its use and things to consider when making decisions about adopting and applying these technologies.

Keywords: automated, manual-handling, risk-assessment, machine-based

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