715 resultados para Hospitals -- Australia -- Risk management
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Market risk exposure plays a key role for nancial institutions risk management. A possible measure for this exposure is to evaluate losses likely to incurwhen the price of the portfolio's assets declines using Value-at-Risk (VaR) estimates, one of the most prominent measure of nancial downside market risk. This paper suggests an evolving possibilistic fuzzy modeling approach for VaR estimation. The approach is based on an extension of the possibilistic fuzzy c-means clustering and functional fuzzy rule-based modeling, which employs memberships and typicalities to update clusters and creates new clusters based on a statistical control distance-based criteria. ePFM also uses an utility measure to evaluate the quality of the current cluster structure. Computational experiments consider data of the main global equity market indexes of United States, London, Germany, Spain and Brazil from January 2000 to December 2012 for VaR estimation using ePFM, traditional VaR benchmarks such as Historical Simulation, GARCH, EWMA, and Extreme Value Theory and state of the art evolving approaches. The results show that ePFM is a potential candidate for VaR modeling, with better performance than alternative approaches.
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O estudo teve como objetivo avaliar a capacidade preditiva dos modelos de estimação do risco de mercado em momentos de crises financeiras. Para isso, foram testados modelos de estimação do Value-at-Risk (VaR) aplicados aos retornos diários de carteiras compostas por índices de ações de países desenvolvidos e emergentes. Foram testados o modelo VaR de Simulação Histórica, modelos ARCH multivariados (Bekk, Vech e CCC), Redes Neurais Artificiais e funções Cópulas. A amostra de dados refere-se aos períodos de duas crises financeiras internacionais, Crise Asiática, de 1997, e Crise do Sub Prime dos EUA, de 2008. Os resultados apontaram que os modelos ARCH multivariados (Vech e Bekk) e Cópula - Clayton tiveram desempenho semelhantes, com bons ajustes em 100% dos testes. Diferentemente do que era esperado, não foi possível perceber diferenças significativas entre os ajustes para países desenvolvidos e emergentes e os momentos de crise e normal.
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The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. Purpose: To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate recommendations (RECs) for prophylaxis that can be implemented into practice. Data sources: A multidisciplinary group of experts from 12 Brazilian Medical Societies searched MEDLINE, Cochrane, and LILACS. Study selection: Two experts independently classified the evidence for each RF by its scientific quality in a standardized manner. A risk-assessment algorithm was created based on the results of the review. Data synthesis: Several VTE RFs have enough evidence to support RECs for prophylaxis in hospitalized medical patients (eg, increasing age, heart failure, and stroke). Other factors are considered adjuncts of risk (eg, varices, obesity, and infections). According to the algorithm, hospitalized medical patients ≥40 years-old with decreased mobility, and ≥1 RFs should receive chemoprophylaxis with heparin, provided they don't have contraindications. High prophylactic doses of unfractionated heparin or low-molecular-weight-heparin must be administered and maintained for 6-14 days. Conclusions: A multidisciplinary group generated evidence-based RECs and an easy-to-use algorithm to facilitate VTE prophylaxis in medical patients. © 2007 Rocha et al, publisher and licensee Dove Medical Press Ltd.
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Includes bibliography
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death. Study Design: Prospective cohort of 484 infants with 23(0/7) to 26(6/7) weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of >= 1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life. Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions. Conclusion: In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. Journal of Perinatology (2012) 32, 913-919; doi:10.1038/jp.2012.28; published online 29 March 2012
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Un problema comune agli Ingegneri Gestionali è quello legato alla necessità di dover sempre spiegare in cosa consista veramente il proprio campo di studi. Amici, conoscenti e parenti non dimostrano mai, infatti, familiarità con il termine. Chi scrive è costretto addirittura ad ammettere di avere una madre che, a pochi giorni dalla discussione dalla Tesi Magistrale, continui ad affermare di non aver ancora capito quale lavoro andrà poi a fare il figlio. Medicina, Giurisprudenza ed Economia sono concetti facili da comprendere; “studiare con approccio quantitativo l'organizzazione e i processi produttivi delle imprese costruendo e applicando modelli per la soluzione dei loro problemi” in effetti lo è un po’ meno. Accade così che si debbano quindi aggiungere altri termini, spiegando l’ingegneria gestionale come insieme di altre discipline: produzione, logistica, marketing, economia aziendale, risorse umane, gestione, progetti... Si dà il caso che questo insieme di altre discipline coincida in larga parte con una branca ancora più oscura ai più: l’event management. Questo lavoro di Tesi è incentrato proprio sulla gestione di un evento: gli FPA Worlds 2012, i Mondiali di Frisbee Freestyle 2012 tenutisi a Riccione dal 2 al 5 agosto. L’autore, nell’ambito del suo percorso di Tirocinio, ne è stato l’event manager, ovvero il massimo responsabile e organizzatore, andando a far confluire esperienze, conoscenze e passioni personali con la coronazione degli studi universitari. L’intero progetto lo ha coinvolto dal luglio 2010 al settembre 2012, all’interno di un’azienda riminese con cui già collaborava dal 2009. La Tesi, di carattere prettamente sperimentale, va quindi ad esporre i processi gestionali “nascosti” dietro ad un evento che ha riscosso successo di pubblico e mediatico, affiancando in ognuno dei capitoli tematici modelli teorici e risultati pratici. La vastità di conoscenze, competenze e strumenti utilizzati ha reso quest’esperienza altamente stimolante, così come le numerose sfide che si sono succedute nel difficile percorso per organizzare il miglior Mondiale di Frisbee Freestyle di sempre.
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This PhD Thesis is composed of three chapters, each discussing a specific type of risk that banks face. The first chapter talks about Systemic Risk and how banks get exposed to it through the Interbank Funding Market. Exposures in the said market have Systemic Risk implications because the market creates linkages, where the failure of one party can affect the others in the market. By showing that CDS Spreads, as bank risk indicators, are positively related to their Net Interbank Funding Market Exposures, this chapter establishes the above Systemic Risk Implications of Interbank Funding. Meanwhile, the second chapter discusses how banks may handle Illiquidity Risk, defined as the possibility of having sudden funding needs. Illiquidity Risk is embodied in this chapter through Loan Commitments as they oblige banks to lend to its clients, up to a certain amount of funds at any time. This chapter points out that using Securitization as funding facility, could allow the banks to manage this Illiquidity Risk. To make this case, this chapter demonstrates empirically that banks having an increase in Loan Commitments, may experience an increase in risk profile but such can be offset by an accompanying increase in Securitization Activity. Lastly, the third chapter focuses on how banks manage Credit Risk also through Securitization. Securitization has a Credit Risk management property by allowing the offloading of risk. This chapter investigates how banks use such property by looking at the effect of securitization on the banks’ loan portfolios and overall risk and returns. The findings are that securitization is positively related to loan portfolio size and the portfolio share of risky loans, which translates to higher risk and returns. Thus, this chapter points out that Credit Risk management through Securitization may be have been done towards higher risk taking for high returns.
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Negli ultimi anni l’attenzione di legislatori e degli Organi di Vigilanza, in base alle riforme regolamentari attivate in risposta alla crisi economica, si sono focalizzate sulle pratiche di risk management delle Banche, sottolineando l’importanza dei sistemi di controllo e gestione dei rischi. Il presente lavoro nasce con l’intento di analizzare e valutare le caratteristiche salienti del processo di assunzione e gestione dei rischi nel sistema economico finanziario attuale. Numerosi e autorevoli esperti, come gli operatori del Financial Stability Board , Institute of International Finance e Senior Supervisory Group, si sono espressi sulle cause della crisi finanziaria ed hanno sollevato dubbi circa la qualità delle azioni intraprese da alcuni manager, sulle loro politiche gestionali e sulla comprensione delle reali condizioni in cui versavano le loro Banche (in termini di esposizione ai rischi, report da aggregazione dati su performance aziendali e qualità dei dati aggregati) , si è ritenuto giusto dal punto di vista teorico approfondire in particolare i temi del Risk Appetite e Risk Tolerance, novità introdotte nelle diverse direttive e normative in risposta alle citate ed ambigue politiche di gestione ed assunzione rischi. I concetti, qui introdotti, di appetito e tolleranza al rischio conducono ad una ampia sfera di riferimento che guarda alla necessità di fissare degli obiettivi di rischio e loro limiti per poter meglio controllare e valutare la stabilità economica/finanziaria e stimare gli effetti di condizioni peggiorative (reali o soltanto teoriche, come gli stress test) sulla solvibilità e profittabilità delle Banche nazionali ed internazionali. Inoltre, ad integrazione di quanto precedentemente esposto sarà illustrata una survey sulla disclosure delle principali Banche europee in relazione alle informazioni sul Risk Appetite e sul Risk Tolerance.
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OBJECTIVES: To briefly inform on the conclusions from a conference on the next 10 years in the management of peripheral artery disease (PAD). DESIGN OF THE CONFERENCE: International participation, invited presentations and open discussion were based on the following issues: Why is PAD under-recognised? Health economic impact of PAD; funding of PAD research; changes of treatment options? Aspects on clinical trials and regulatory views; and the role of guidelines. RESULTS AND CONCLUSIONS: A relative lack of knowledge about cardiovascular risk and optimal management of PAD patients exists not only among the public, but also in parts of the health-care system. Specialists are required to act for improved information. More specific PAD research is needed for risk management and to apply the best possible evaluation of evidence for treatment strategies. Better strategies for funding are required based on, for example, public/private initiatives. The proportion of endovascular treatments is steadily increasing, more frequently based on observational studies than on randomised controlled trials. The role of guidelines is therefore important to guide the profession in the assessment of most relevant treatment.
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With the publication of the quality guideline ICH Q9 "Quality Risk Management" by the International Conference on Harmonization, risk management has already become a standard requirement during the life cycle of a pharmaceutical product. Failure mode and effect analysis (FMEA) is a powerful risk analysis tool that has been used for decades in mechanical and electrical industries. However, the adaptation of the FMEA methodology to biopharmaceutical processes brings about some difficulties. The proposal presented here is intended to serve as a brief but nevertheless comprehensive and detailed guideline on how to conduct a biopharmaceutical process FMEA. It includes a detailed 1-to-10-scale FMEA rating table for occurrence, severity, and detectability of failures that has been especially designed for typical biopharmaceutical processes. The application for such a biopharmaceutical process FMEA is widespread. It can be useful whenever a biopharmaceutical manufacturing process is developed or scaled-up, or when it is transferred to a different manufacturing site. It may also be conducted during substantial optimization of an existing process or the development of a second-generation process. According to their resulting risk ratings, process parameters can be ranked for importance and important variables for process development, characterization, or validation can be identified. LAY ABSTRACT: Health authorities around the world ask pharmaceutical companies to manage risk during development and manufacturing of pharmaceuticals. The so-called failure mode and effect analysis (FMEA) is an established risk analysis tool that has been used for decades in mechanical and electrical industries. However, the adaptation of the FMEA methodology to pharmaceutical processes that use modern biotechnology (biopharmaceutical processes) brings about some difficulties, because those biopharmaceutical processes differ from processes in mechanical and electrical industries. The proposal presented here explains how a biopharmaceutical process FMEA can be conducted. It includes a detailed 1-to-10-scale FMEA rating table for occurrence, severity, and detectability of failures that has been especially designed for typical biopharmaceutical processes. With the help of this guideline, different details of the manufacturing process can be ranked according to their potential risks, and this can help pharmaceutical companies to identify aspects with high potential risks and to react accordingly to improve the safety of medicines.
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OBJECTIVES: To validate the Probability of Repeated Admission (Pra) questionnaire, a widely used self-administered tool for predicting future healthcare use in older persons, in three European healthcare systems. DESIGN: Prospective study with 1-year follow-up. SETTING: Hamburg, Germany; London, United Kingdom; Canton of Solothurn, Switzerland. PARTICIPANTS: Nine thousand seven hundred thirteen independently living community-dwelling people aged 65 and older. MEASUREMENTS: Self-administered eight-item Pra questionnaire at baseline. Self-reported number of hospital admissions and physician visits during 1 year of follow-up. RESULTS: In the combined sample, areas under the receiver operating characteristic curves (AUCs) were 0.64 (95% confidence interval (CI)=0.62-0.66) for the prediction of one or more hospital admissions and 0.68 (95% CI=0.66-0.69) for the prediction of more than six physician visits during the following year. AUCs were similar between sites. In comparison, prediction models based on a person's age and sex alone exhibited poor predictive validity (AUC
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This paper surveys the currency risk management practices of Swiss industrial corporations. We find tha industrials do not quantify their currency risk exposure and investigate possible reasons. One possibility is that firms do not think they need to know because they use on-balance-sheet instruments to protect themselves before and after currency rates reach troublesome levels. This is puzzling because a rough estimate of at least cash flow exposure is not a prohibitive task and could be helpful. It is also puzzling that firms use currency derivatives to hedge/insure individual short-term transactions, without apparently trying to estimate aggregate transaction exposure.