870 resultados para Integrated risk management


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Five years after the 2005 Pakistan earthquake that triggered multiple mass movements, landslides continue to pose a threat to the population of Azad Kashmir, especially during heavy monsoon rains. The thousands of landslides that were triggered by the 7.6 magnitude earthquake in 2005 were not just due to a natural phenomenon but largely induced by human activities, namely, road building, grazing, and deforestation. The damage caused by the landslides in the study area (381 km2) is estimated at 3.6 times the annual public works budget of Azad Kashmir for 2005 of US$ 1 million. In addition to human suffering, this cost constitutes a significant economic setback to the region that could have been reduced through improved land use and risk management. This article describes interdisciplinary research conducted 18 months after the earthquake to provide a more systemic approach to understanding risks posed by landslides, including the physical, environmental, and human contexts. The goal of this research is twofold: to present empirical data on the social, geological, and environmental contexts in which widespread landslides occurred following the 2005 earthquake; and, second, to describe straightforward methods that can be used for integrated landslide risk assessments in data-poor environments. The article analyzes limitations of the methodologies and challenges for conducting interdisciplinary research that integrates both social and physical data. This research concludes that reducing landslide risk is ultimately a management issue, based in land use decisions and governance.

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The progress in prenatal medicine raises complex questions with respect to the physician-patient relationship. The physician needs to reconcile medical aspects, ethical principles as well as judicial norms. Already, during the first trimester, the physician has to put into practice the schedule combining for each individual pregnancy physical, laboratory and other appropriate exams. Physicians are under the obligation to inform in a clear and comprehensive way without creating unnecessary anxiety for their patients. Legal requirements include informed consent, the respect for the patient's right to self-determination, and compliance with the Swiss federal law on genetic testing, especially with its articles on prenatal screening and diagnosis. This article discusses the complexity of obstetrical practice when it comes to delivering adequate information within the scope of ethical and legal requirements in Switzerland. L'évolution de la médecine prénatale soulève des enjeux complexes dans la relation médecin-patient. Il s'agit de concilier à la fois les aspects médicaux, les principes éthiques et les normes juridiques. Dès le premier trimestre de la grossesse le médecin doit poser le cadre du suivi et des examens appropriés pour chaque grossesse. Son devoir est d'informer de manière claire et précise sans inquiéter inutilement, en respectant l'exigence légale d'un consentement éclairé et plus largement le droit de la patiente à l'autodétermination ainsi que le cadre de la loi fédérale suisse sur l'analyse génétique humaine dans le domaine du dépistage et du diagnostic prénatal. Cet article discute de la complexité de l'information et de l'application des principes éthiques et légaux dans la pratique obstétricale en Suisse.

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Background: There may be a considerable gap between LDL cholesterol (LDL-C) and blood pressure (BP) goal values recommended by the guidelines and results achieved in daily practice. Design Prospective cross-sectional survey of cardiovascular disease risk profiles and management with focus on lipid lowering and BP lowering in clinical practice. Methods: In phase 1, the cardiovascular risk of patients with known lipid profile visiting their general practitioner was anonymously assessed in accordance to the PROCAM-score. In phase 2, high-risk patients who did not achieve LDL-C goal less than 2.6 mmol/l in phase 1 could be further documented. Results: Six hundred thirty-five general practitioners collected the data of 23 892 patients with known lipid profile. Forty percent were high-risk patients (diabetes mellitus or coronary heart disease or PROCAM-score >20%), compared with 27% estimated by the physicians. Goal attainment rate was almost double for BP than for LDL-C in high-risk patients (62 vs. 37%). Both goals were attained by 25%. LDL-C values in phase 1 and 2 were available for 3097 high-risk patients not at LDL-C goal in phase 1; 32% of patients achieved LDL-C goal of less than 2.6 mmol/l after a mean of 17 weeks. The most successful strategies for LDL-C reduction were implemented in only 22% of the high-risk patients. Conclusion: Although patients at high cardiovascular risk were treated more intensively than low or medium risk patients, the majority remained insufficiently controlled, which is an incentive for intensified medical education. Adequate implementation of Swiss and International guidelines would expectedly contribute to improved achievement of LDL-C and BP goal values in daily practice.

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Tutkielman tavoitteena on määritellä projektikontrolloinnin ja - riskijohtamisen roolit ja toiminnot saksalaisissa kone- ja tehdassuunnitteluteollisuusyrityksissä. Tämä on kvalitatiivinen tutkielma, jossa käytetään voimakkaasti kuvailevia metodeita. Materiaali tutkimuksen empiiriseen osaan kerättiin kyselykaavakkeen avulla. Kyselykaavakkeiden tulokset käsiteltiin Microsoft Office Access- ohjelmalla ja analysoitiin Microsoft Office Excel- ohjelmalla ja Pivot table- työkalun avulla. Tutkimustulokset osoittavat, että asianmukaisessa projektikontrollointi- ja riskijohtamismetodien käytössä ja käyttötiheydessä esiintyy puutteita saksalaisissa kone- ja tehdassuunnitteluteollisuusyrityksissä. Tehostamalla ja keskittymällä enemmän projektikontrollointi- ja riskijohtamismetodeihin ja prosesseihin sekä projektien että yritysten suorituskyky paranisi.

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This article draws on empirical material to reflect on what drives rapid change in flood risk management practice, reflecting wider interest in the way that scientific practices make risk landscapes and a specific focus on extreme events as drivers of rapid change. Such events are commonly referred to as a form of creative destruction, ones that reveal both the composition of socioenvironmental assemblages and provide a creative opportunity to remake those assemblages in alternate ways, therefore rapidly changing policy and practice. Drawing on wider thinking in complexity theory, we argue that what happens between events might be as, if not more, important than the events themselves. We use two empirical examples concerned with flood risk management practice: a rapid shift in the dominant technologies used to map flood risk in the United Kingdom and an experimental approach to public participation tested in two different locations, with dramatically different consequences. Both show that the state of the socioenvironmental assemblage in which the events take place matters as much as the magnitude of the events themselves. The periods between rapid changes are not simply periods of discursive consolidation but involve the ongoing mutation of such assemblages, which could either sensitize or desensitize them to rapid change. Understanding these intervening periods matters as much as the events themselves. If events matter, it is because of the ways in which they might bring into sharp focus the coding or framing of a socioenvironmental assemblage in policy or scientific practice irrespective of whether or not those events evolve the assemblage in subtle or more radical ways.

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Työ käsittelee energian tuotannossa esiintyviä tärkeimpiä taloudellisia ja teknisiä riskejä sekä niiden hallitsemista energian tuottajan näkökulmasta. Ensiksi käsitellään yleisesti riskienhallintaa, eri riskityyppejä ja esitetään periaatteellinen riskienhallintaprosessi. Sen jälkeen tarkastellaan energiamarkkinoiden nykytilannetta lähinnä Pohjoismaiden tasolla ja verrataan sitä aikaisempaan tilanteeseen energian tuottajan kannalta. Tämä siksi, että energiamarkkinoiden vapautuminen on muuttanut merkittävästi energian tuotantoon liittyviä taloudellisia riskejä, käytännössä lisännyt niitä. Pääpaino on energian tuotannossa esiintyvien olennaisten riskien tarkastelussa ja niiden hallitsemisessa. Ensin esitellään työn kannalta olennaiset riskit ja tekijät joista ne aiheutuvat. Jokainen riski ja sen aiheuttamat haitat liiketoiminnalle kuvataan lyhyesti. Sen jälkeen kiinnitetään huomiota asioihin, jotka ovat tyypillisiä energian tuotannolle ja aiheuttavat samalla erikoisvaatimuksia riskienhallinnalle. Sitten käydään läpi sopivat riskienhallinnan menetelmät, jotka ovat yleisesti käytössä energian tuotannossa, aiemmin esitetyille olennaisille riskeille. Esitetyistä riskienhallinta menetelmistä useimpia ei ole kohdistettu millekään yksittäiselle riskille, vaan monia niistä voidaan käyttää useammankin riskin hallintaan.

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Euroopan energiamarkkinat ovat olleet viimeisen kymmenen vuoden aikana suurten muutosten alla. Markkinoiden kehitys on ollut huomattavaa myös Iso-Britanniassa, jossa sähkö- ja kaasumarkkinat ovat olleet avoinna kilpailulle jo muutamia vuosia. Ennen markkinoiden avautumista energiyhtiöt pystyivät siirtämään kaikki riskit suoraan asiakkaan kannettaviksi. Markkinoiden avautumisen myötä lisääntynyt kilpailu on kuitenkin pakottanut energiayhtiöitä ajanmukaistamaan näkemyksiään riskeistä. Riskitekijät, joista ei aiemmin tarvinnut välittää, on nyt pystyttävä tunnistamaan ja hallitsemaan. Tämä työ keskittyy hinta- ja volyymiriskien hallintaan. Rahoitusmarkkinoilla pitkään käytettyjä riskienhallintatyökaluja on otettu käyttöön myös energiamarkkinoilla. Energiamarkkinoiden piirteet poikkeavat kuitenkin rahoitusmarkkinoista, eikä näitä työkaluja voida ottaa käyttöön muutoksitta. Silti, jopa muutosten jälkeen rahoitusmarkkinoiden riskienhallitavälineet aliarvioivat energiamarkkinoiden hinta- ja volyymiriskejä. Tässä yhteydessä työssä esitetään Profit at Risk, PaR. PaR on skenaariopohjainen riskienhallinnan työkalu, joka on kehitetty erityisesti energiamarkkinoille ja täten huomioi niiden erikoispiirteet. Työn rungon muodostavat energiamarkkinoiden käyttäytyminen, hinta- ja volyymiriskitekijät sekä pohdinta miten hinta- ja volyymiriskeiltä voidaan suojautua ja miten niitä voidaan hallita. PaR-metodologiaa verrataan perinteisiin riskienhallintamenetelmiin ja työn tavoitteena on tuoda esiin ne tekijät, joiden ansiosta PaR on sopivampi työkalu energiamarkkinoiden riskienhallintaan kuin perinteiset menetelmät. Käytännön esimerkkinä työssä toimii Fortum Energy plus’n PaR –malli. Koska PaR on kehitetty erityisesti energiamarkkinoille, se huomioi täysin markkinoiden aiheuttamat hinta- ja volyymiriskit. Käytännön esimerkki kuitenkin osoittaa, että PaR menetelmästä ei ole riskienhallinnallista hyötyä ellei työkalun käyttäjällä ole täydellistä tietämystä niin energiamarkkinoista kuin markkinoiden muutoksiin vaikuttavien tekijöiden käyttäytymisestä.

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This paper presents the current state and development of a prototype web-GIS (Geographic Information System) decision support platform intended for application in natural hazards and risk management, mainly for floods and landslides. This web platform uses open-source geospatial software and technologies, particularly the Boundless (formerly OpenGeo) framework and its client side software development kit (SDK). The main purpose of the platform is to assist the experts and stakeholders in the decision-making process for evaluation and selection of different risk management strategies through an interactive participation approach, integrating web-GIS interface with decision support tool based on a compromise programming approach. The access rights and functionality of the platform are varied depending on the roles and responsibilities of stakeholders in managing the risk. The application of the prototype platform is demonstrated based on an example case study site: Malborghetto Valbruna municipality of North-Eastern Italy where flash floods and landslides are frequent with major events having occurred in 2003. The preliminary feedback collected from the stakeholders in the region is discussed to understand the perspectives of stakeholders on the proposed prototype platform.

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

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Fast development in the operating environment and fierce competition have driven companies to pursue efficiency and success through lean and global supply chains. At the same time overall uncertainty has increased in the business environment and supply chains have become a priority in risk management since their vulnerability may endanger business continuity. Although risk management should start at procurement strategy development phase, proactive contingency planning is also essential because it enables correct reaction and fast changes in process execution in the case of risk realization. This thesis is a case study conducted in the pharmaceutical industry where purchasing and materials management organizations face a number of challenges and limitations that have to be considered in supply risk management. The goal of the study was to discuss the operating environment, and identify and analyze supply risks and potential risk management practices. The study was concluded with suggestions for purchasing strategy development that take risk management considerations into account. This copy is the public version of the thesis.