Risk Management Recommendations Research Articles

Reappraisal of the Concept and Implications of Pulmonary Hypertension in Degenerative Mitral Regurgitation

BackgroundEuropean and U.S. clinical guidelines diverge regarding pulmonary hypertension (PHTN) in degenerative mitral regurgitation (DMR). Gaps in knowledge underpinning these divergences affect risk assessment and management recommendations attached to systolic pulmonary pressure (SPAP) in DMR. ObjectivesThis study sought to define PHTN links to DMR severity, prognostic thresholds, and independent outcome impact in a large quantitative DMR registry. MethodsThis study gathered a large multicentric registry of consecutive patients with isolated moderate-to-severe DMR, with DMR and SPAP quantified prospectively at diagnosis. ResultsIn 3,712 patients (67 ± 15 years, 36% women) with ≥ moderate-to-severe DMR, effective regurgitant orifice (ERO) was 0.42 ± 0.19 cm2, regurgitant volume 66 ± 327 mL/beat and SPAP 41 ± 16 mm Hg. Spline-curve analysis showed excess mortality under medical management emerging around SPAP 35 mm Hg and doubling around SPAP 50 mm Hg. Accordingly, severe pulmonary hypertension (sPHTN) (SPAP ≥50 mm Hg) was detected in 916 patients, moderate pulmonary hypertension (mPHTN) (SPAP 35-49 mm Hg) in 1,128, and no-PHTN (SPAP <35 mm Hg) in 1,668. Whereas SPAP was strongly associated with DMR-ERO, nevertheless excess mortality with sPHTN (adjusted HR: 1.65; 95% CI: 1.24-2.20) and mPHTN (adjusted HR: 1.44; 95% CI: 1.11-1.85; both P ≤ 0.005) was observed independently of ERO and all baseline characteristics and in all patient subsets. Nested models demonstrated incremental prognostic value of mPHTN and sPHTN (all P < 0.0001). Despite higher operative risk with mPHTN and sPHTN, DMR surgical correction was followed by higher survival in all PHTN ranges with strong survival benefit of early surgery (<3 months). Postoperatively, excess mortality was abolished (P ≥ 0.30) in mPHTN, but only abated in sPHTN. ConclusionsThis large international registry, with prospectively quantified DMR and SPAP, demonstrates a Doppler-defined PHTN impact on mortality, independent of DMR severity. Crucially, it defines objectively the new and frequent mPHTN range, independently linked to excess mortality under medical management, which is abolished by DMR correction. Thus, at DMR diagnosis, Doppler-SPAP measurement defining these new PHTN ranges, is crucial to guiding DMR management.

Evaluation of psychological occupational health constraints according to the Karasek model among female sewing machine operators in Tunisia

Evaluation of psychological occupational health constraints according to the Karasek model among female sewing machine operators in Tunisia

Theoretical and methodological approaches to the management of cyber security risks at critical infrastructure objects: response to cyber incidents and crisis managemen

The research is devoted to analyzing and developing theoretical and methodological recommendations for cybersecurity risk management at critical infrastructure facilities. The paper defines and describes the cyber risk management process, identifies cyber challenges, and considers the cyber risk management system. Recommendations include expanding cooperation, improving monitoring systems, staff training, legal regulation, and participation in international initiatives. These measures are aimed at improving the effectiveness of cyber risk management to ensure national security.

Cost-Effectiveness of Gene-Specific Prevention Strategies for Ovarian and Breast Cancer

Pathogenic variants (PVs) in BRCA1, BRCA2, PALB2, RAD51C, RAD51D, and BRIP1 cancer susceptibility genes (CSGs) confer an increased ovarian cancer (OC) risk, with BRCA1, BRCA2, PALB2, RAD51C, and RAD51D PVs also conferring an elevated breast cancer (BC) risk. Risk-reducing surgery, medical prevention, and BC surveillance offer the opportunity to prevent cancers and deaths, but their cost-effectiveness for individual CSGs remains poorly addressed. To estimate the cost-effectiveness of prevention strategies for OC and BC among individuals carrying PVs in the previously listed CSGs. In this economic evaluation, a decision-analytic Markov model evaluated the cost-effectiveness of risk-reducing salpingo-oophorectomy (RRSO) and, where relevant, risk-reducing mastectomy (RRM) compared with nonsurgical interventions (including BC surveillance and medical prevention for increased BC risk) from December 1, 2022, to August 31, 2023. The analysis took a UK payer perspective with a lifetime horizon. The simulated cohort consisted of women aged 30 years who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. Appropriate sensitivity and scenario analyses were performed. CSG-specific interventions, including RRSO at age 35 to 50 years with or without BC surveillance and medical prevention (ie, tamoxifen or anastrozole) from age 30 or 40 years, RRM at age 30 to 40 years, both RRSO and RRM, BC surveillance and medical prevention, or no intervention. The incremental cost-effectiveness ratio (ICER) was calculated as incremental cost per quality-adjusted life-year (QALY) gained. OC and BC cases and deaths were estimated. In the simulated cohort of women aged 30 years with no cancer, undergoing both RRSO and RRM was most cost-effective for individuals carrying BRCA1 (RRM at age 30 years; RRSO at age 35 years), BRCA2 (RRM at age 35 years; RRSO at age 40 years), and PALB2 (RRM at age 40 years; RRSO at age 45 years) PVs. The corresponding ICERs were -£1942/QALY (-$2680/QALY), -£89/QALY (-$123/QALY), and £2381/QALY ($3286/QALY), respectively. RRSO at age 45 years was cost-effective for RAD51C, RAD51D, and BRIP1 PV carriers compared with nonsurgical strategies. The corresponding ICERs were £962/QALY ($1328/QALY), £771/QALY ($1064/QALY), and £2355/QALY ($3250/QALY), respectively. The most cost-effective preventive strategy per 1000 PV carriers could prevent 923 OC and BC cases and 302 deaths among those carrying BRCA1; 686 OC and BC cases and 170 deaths for BRCA2; 464 OC and BC cases and 130 deaths for PALB2; 102 OC cases and 64 deaths for RAD51C; 118 OC cases and 76 deaths for RAD51D; and 55 OC cases and 37 deaths for BRIP1. Probabilistic sensitivity analysis indicated both RRSO and RRM were most cost-effective in 96.5%, 89.2%, and 84.8% of simulations for BRCA1, BRCA2, and PALB2 PVs, respectively, while RRSO was cost-effective in approximately 100% of simulations for RAD51C, RAD51D, and BRIP1 PVs. In this cost-effectiveness study, RRSO with or without RRM at varying optimal ages was cost-effective compared with nonsurgical strategies for individuals who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. These findings support personalizing risk-reducing surgery and guideline recommendations for individual CSG-specific OC and BC risk management.

Deep learning-based chatbot by natural language processing for supportive risk management in river dredging projects

Dredging projects play a vital role in water conservation, especially for flood control, but they often encounter natural and human-induced risks. This study addresses these challenges by creating a comprehensive knowledge base for dredging risks. This knowledge base serves several essential functions: it aids in immediate and thorough risk prevention, provides practical risk management recommendations, and assists dredging personnel in making informed decisions when dealing with risks. Furthermore, the study introduces an advanced deep-learning model that enhances access to critical information. Users can quickly find relevant risk prevention strategies by inputting keywords. The model's distinctive feature is its ability to analyze unforeseen risks through natural language processing, predict the potential impact and frequency of unexpected events, and propose appropriate risk response measures. This empowers dredging personnel to conduct preliminary risk assessments confidently. The deep learning model seamlessly integrates into LINE's communication platform, creating a river dredging project risk knowledge chatbot. This user-friendly chatbot is accessible to personnel at all project stages, enabling real-time interaction. It offers a practical way to develop and implement risk prevention plans and response measures. In summary, this research presents an innovative approach that enhances the efficiency and safety of dredging projects. By merging a knowledge base with cutting-edge technology and real-time communication, it equips dredging personnel to manage known and unforeseen risks proficiently, ultimately contributing to the success of water conservancy and flood control projects.

Ризик: сутність поняття та класифікація в туристичній індустрії

Nowadays one of the characteristic features of society's functioning is high uncertainty. This is manifested in the impossibility of predicting future events, which creates fear and apprehension to perform some activity in order to protect oneself from undesirable consequences. Uncertainty is the prerequisite for the risks emergence. The purpose of the study is to define the essence of "risk" concept, its classification and sys-tematization, which will allow a better understanding which factors affect tourism activity in the world for the further risk management programs formation. Despite the large number of studies, the authors mostly consider the risks of the tourism in-dustry which affect a separate tourist enterprise activities. The decisive factor for risk management at the micro (enterprise) level is the ability to respond quickly and flexibly, the presence of risk management programs and measures to eliminate consequences. Each group of risks has a different effect on a separate industry or enterprise, and mostly they have a negative character. The tourism industry suffers significantly from conditions caused by natural, climatic, eco-nomic, political, foreign economic and other factors. The most devastating event in recent years that caused a significant drop in tourism industry was the COVID-19 pandemic, with an average of 70% drop in international tourist arrivals for 2020-2022. Due to the existing risks, the tourism industry bears significant financial losses, bankruptcies or structural changes. Different risks require appro-priate solutions and support measures. To carry out the research, general scientific and special methods were used, in particular the-oretical generalization - to highlight the theoretical aspects of risks in tourism; synthesis, compari-son and systematization; statistical analysis method - for analyzing statistical data of tourist flows. The information base is scientific publications of Ukrainian and foreign scientists, as well as data from the World Tourism Organization (WTO). The conducted study of the tourism industry and the risks impact on it gives reason to con-clude that it is very sensitive to the risks that arise in society, even one adverse event can leave a negative impression on the destination or the tourist attraction of the country. The results of this re-search can be useful to develop practical recommendations for risk management at the level of en-terprises and the industry as a whole. The article proposes a classification of risks in tourism with information about countries that are most vulnerable to such phenomena as natural disasters, terrorism, environmental and political dangers, etc., thanks to which it is possible to assess the safety of individual destinations. Examples of the various factors influence on the tourism industry of the countries and regions are also given.

Assessment of Potential Risks of Current ESG Investment

This paper addresses the critical need for a systematic examination of risks in the field of Environmental, Social, and Governance (ESG) investment. By categorizing these risks into three main dimensions - consumer side, corporate side, and regulatory side - this study presents a refined analysis of the distinct risks faced by each stakeholder. The identified risks include costs, limitations of investment models, environmental risks, and risks associated with inconsistent standards. Importantly, this research bridges the gap in previous literature by providing a comprehensive and systematic investigation of ESG investment risks. To mitigate these risks, this paper integrates cutting-edge theories and models to propose practical recommendations for risk management and control. By doing so, it offers valuable insights for investors, corporations, and regulatory bodies seeking to strengthen their understanding of and ability to navigate ESG investment risks effectively. Furthermore, this study forecasts future trends, allowing for reasonable considerations of potential policy changes and the evolution of investment models. By providing such insights, the paper offers a perspective that is forward-looking and adaptable to emerging developments. In summary, this research contributes to the understanding of ESG investment risks by presenting a comprehensive analysis and proposing actionable measures to mitigate these risks. It fills the gap in the existing literature and offers practical significance for stakeholders involved in ESG investment. Additionally, the study presents a forward-looking perspective by offering reasonable projections for future trends.

Sea-Level Rise in Pakistan: Recommendations for Strengthening Evidence-Based Coastal Decision-Making

Pakistan is vulnerable to a range of climate hazards, including sea-level rise. The Indus Delta region, situated in the coastal Sindh province, is particularly at risk of sea-level rise due to low-lying land and fragile ecosystems. In this article, expertise is drawn together from the newly established Pakistan Sea-Level Working Group, consisting of policy experts, scientists, and practitioners, to provide recommendations for future research, investment, and coastal risk management. An assessment of the current scientific understanding of sea-level change and coastal climate risks in Pakistan highlights an urgent need to improve the availability and access to sea-level data and other coastal measurements. In addition, reflecting on the policy environment and the enablers needed to facilitate effective responses to future sea-level change, recommendations are made to integrate coastal climate services into the National Adaptation Plan and develop a National Framework for Climate Services. Such a framework, alongside collaboration, co-production, and capacity development, could help support required improvements in coastal observations and monitoring and continuously deliver useful, usable, and accessible sea-level information for use by practitioners and decision-makers.

A survey of performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China

Objective: To understand the performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China, and provide suggestions for the improvement of public health risk assessment. Methods: A self-administered survey was conducted in professionals involved in public health risk assessment in emergencies from national institution, provincial institutions and some prefectural institutions for disease control and prevention (1-2 prefectural institutions were selected using convenience sampling in each province) between March and April in 2021. Results: A total of 79 institutions for disease control and prevention were investigated, including 1 national institution, 32 provincial institutions and 46 prefectural institutions. By April 2021, all the 79 institutions surveyed had conducted risk assessment of public health emergencies, in which 61 (77.2%) had established departments responsible for the public health risk assessment, i.e. emergency management office or communicable disease prevention and control office (section), and regular risk assessment mechanisms. The main sources of information for public health risk assessment were public health surveillance systems, including the National Notifiable Diseases Reporting System (100.0%) and Public Health Emergencies Management Information System (97.5%). Compared with the provincial institutions, the prefectural institutions were more likely to use specific disease surveillance systems (84.8% vs. 62.5%; χ2=5.09, P=0.024). The risk management recommendations made by 43 institutions for disease control and prevention (54.4%) after the risk assessment were accepted by the superior health administrative departments and used in epidemic prevention and control. Conclusions: Public health risk assessment in emergencies has been widely carried out by national, provincial and prefectural institutions for disease control and prevention in China. Specialized departments and mechanisms have been established, but the information sources are still confined to public health surveillance systems and the application of the risk assessment results still needs to be further improved.

Risk management actions following genetic testing in the Cancer Health Assessments Reaching Many (CHARM) Study: A prospective cohort study.

Genetic testing can identify cancer risk early, enabling prevention and early detection. We describe use of risk management interventions following genetic testing in the Cancer Health Assessment Reaching Many (CHARM) study. CHARM assessed risk and provided genetic testing to low income, low literacy, and other underserved populations that historically face barriers to accessing cancer genetic services. CHARM was implemented in Kaiser Permanente Northwest (KPNW) and Denver Health (DH) between 2018 and 2020. We identified post-testing screening (mammography, breast MRI, colonoscopy) and surgical (mastectomy, oophorectomy) procedures using electronic health records. We examined utilization in participants who did and did not receive actionable risk management recommendations from study genetic counselors following national guidelines. CHARM participants were followed for an average of 15.4 months (range: 0.4-27.8 months) after results disclosure. Less than 2% (11/680) received actionable risk management recommendations (i.e., could be completed in the initial years following testing) based on their test result. Among those who received actionable recommendations, risk management utilization was moderate (54.5%, 6/11 completed any procedure) and varied by procedure (mammogram: 0/3; MRI: 2/4; colonoscopy: 4/5; mastectomy: 1/5; oophorectomy: 0/3). Cancer screening and surgery procedures were rare in participants without actionable recommendations. Though the number of participants who received actionable risk management recommendations was small, our results suggest that implementing CHARM's risk assessment and testing model increased access to evidence-based genetic services and provided opportunities for patients to engage in recommended preventive care, without encouraging risk management overuse.

Multi-Hazard Population Exposure in Low-Elevation Coastal Zones of China from 1990 to 2020

China’s low-elevation coastal zone (LECZ) is characterized by multiple hazards and high impacts. How to quantitatively portray the spatiotemporal characteristics of the exposed population to multi-hazards in the LECZ is an important subject of risk reduction. In this study, the overall characteristics, spatial patterns, and main impact hazard in the LECZ from 1990 to 2020 were investigated using a multi-hazard population exposure model, spatial autocorrelation method, and principal component analysis (PCA) method. The results show that among the four hazards (earthquake, tropical cyclones (TCs), flood, and storm surge), TCs cover the largest area, accounting for 90.1% of the total LECZ area. TCs were also the hazard with the largest average annual growth rate of the exposed population (2.36%). The central region of China’s LECZ is the cluster of exposed populations and the main distribution area with the largest increase in exposed populations. Therefore, the central region is a hotspot for multi-hazard risk management. Additionally, flood contributes the most to the multi-hazard population exposure index; thus, flood is a key hazard of concern in the LECZ. This study identifies the hotspot areas and priority hazards of multi-hazard exposed populations in the LECZ and provides important policy recommendations for multi-hazard risk management in the LECZ, which is important for LECZ to enhance the resilience of hazards.

Longitudinal adherence to breast cancer surveillance following cancer genetic testing in an integrated health care system.

Screening with mammography and breast magnetic resonance imaging (MRI) is an important risk management strategy for individuals with inherited pathogenic variants (PVs) in genes associated with increased breast cancer risk. We describe longitudinal screening adherence in individuals who underwent cancer genetic testing as part of usual care in a vertically integrated health system. We determined the proportion time covered (PTC) by annual mammography and breast MRI for individuals with PVs in TP53, BRCA1, BRCA2, PALB2, NF1, CHEK2, and ATM. We determined time covered by biennial mammography beginning at age 50years for individuals who received negative results, uncertain results, or with PVs in genes without specific breast cancer screening recommendations. One hundred and forty individuals had PVs in TP53, BRCA1, BRCA2, PALB2, NF1, CHEK2, or ATM. Among these individuals, average PTC was 48% (range 0-99%) for annual screening mammography and 34% (range 0-100%) for annual breast MRI. Average PTC was highest for individuals with PVs in CHEK2 (N = 14) and lowest for individuals with PVs in TP53 (N = 3). Average PTC for biennial mammography (N = 1,027) was 49% (0-100%). Longitudinal screening adherence in individuals with PVs in breast cancer associated genes, as measured by the proportion of time covered, is low; adherence to annual breast MRI falls below that of annual mammography. Additional research should examine screening behavior in individuals with PVs in breast cancer associated genes with a goal of developing interventions to improve adherence to recommended risk management.

Chronic kidney disease: the missing concept in the 2019 EULAR/ERA-EDTA recommendations for lupus nephritis.

Chronic kidney disease (CKD) is diagnosed when glomerular filtration rate (GFR) falls below 60ml/min/1.73m2 or urinary albumin:creatinine ratio (UACR) reaches ≥30mg/g, as these two thresholds indicate a higher risk of adverse health outcomes, including cardiovascular mortality. CKD is classified as mild, moderate or severe, based on GFR and UACR values, and the latter two classifications convey a high or very high cardiovascular risk, respectively. Additionally, CKD can be diagnosed based on abnormalities detected by histology or imaging. Lupus nephritis (LN) is a cause of CKD. Despite the high cardiovascular mortality of patients with LN, neither albuminuria nor CKD are discussed in the 2019 European League Against Rheumatism (EULAR)/European Renal Association-European Dialysis and Transplant Association recommendations for the management of LN or the more recent 2022 EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases. Indeed, the proteinuria target values discussed in the recommendations may be present in patients with severe CKD and a very high cardiovascular risk who may benefit from guidance detailed in the 2021 European Society of Cardiology guidelines on cardiovascular disease prevention in clinical practice. We propose that the recommendations should move from a conceptual framework of LN as an entity separate from CKD to a framework in which LN is considered a cause of CKD and evidence generated from large CKD trials applies unless demonstrated otherwise.

Анализ и оценка кадровых рисков научно-педагогических работников в образовательной организации высшего образования

The article deals with the challenges of building of HR capacity in higher education institutions aimed at minimizing HR risks in conditions of uncertainty of regulations for HEIs scientific and pedagogical staff. Assessment of staffing for the educational programs implemented at Samara National Research University named after Academician S.P. Korolev (Samara University) by university schools and integrated training areas allowed to identify inconsistencies between the qualification of permanent scientific and pedagogical staff (SPS) and the requirements of regulatory legal acts as well as to offer recommendations for elimination of such inconsistencies. The analysis of the identified discrepancies served as the basis for the identification and classification of substantial and potential HR risks that come with scientific and pedagogical staff. Using the expert assessment method, the significance and probability of occurrence of such risks have been assessed. At the final stage of the study, we provided methodological recommendations for HR risk management with due regard to the Unified Code of Ethics in force and absence of professional standards “Teacher Professional Training, Vocational Education and Continuing Professional Education”. Measures to prevent and minimize HR risks in higher education include, in particular, the development of advanced training and retraining programs, annual monitoring of staffing, development of intra-university regulations governing the work of higher-education teaching personnel by position.

Towards identifying challenges in business analysis on IT projects – a practical study

The subject matter of this article is business analysis and requirement engineering (BA/RE) in software projects. The goal is to identify the challenges faced by Ukrainian business analysts and requirement engineers in software development projects and investigate the possible reasons and negative consequences of these issues. The tasks to be solved are: create and conduct a survey on the practices of BA/RE in IT projects, define the most critical problems in BA/RE, their causes and implications, and define how project context influences problems in business analysis and requirement engineering. The methods used are: a survey (N = 324) was performed among business analysts and requirement engineers in Ukraine regarding problems in BA/RE and the context of IT projects in which they manifest. The Chi-Square test of independence and Cramer's V effect size measure were applied to define statistically significant dependencies between project context and BA/RE problems. The following results were obtained: the most critical problems in BA/RE, their causes, and their implications were defined and compared with other comprehensive studies. Twelve statistically significant associations for pairs "project context – BA/RE problem" were found (based on the p-value and Cramer's V effect size measure). Conclusion: 1) A comparison of the results of this study with similar studies conducted in other contexts has shown that the issues identified by Ukrainian BA/RE professionals are similar to those found by other researchers in other countries; 2) it is concluded that project context influences particular BA/RE problems, and these dependencies allow us to develop recommendations for risk management for particular problems depending on the project context.

Narrowing the Horizon: Using Known Invasives and Propagule Pressure to Focus Risk Screening Efforts on Potential Invasives

About 11 million marine ornamental fish of ca 1800 non-native species are imported into the USA each year. Selecting species for risk assessment is daunting for such a diverse pathway. Herein, we discuss a focused method for species selection: choosing important taxa related to known invaders in high-volume pathways and narrowing prospective species lists to manageable groups of potential hazards. We provide an example using 11 damselfishes, a family with high volume in trade and one of the species established in USA waters. We used a specialized literature review and a risk screening tool (Aquatic Species Invasiveness Screening Kit) to provide an estimate of risk of invasiveness of marine waters of Florida. The established species was identified as a hazard and potential invasive. All other species scored well below the threshold for invasiveness and future climate had little effect on estimates of invasiveness. The analysis revealed little need for additional risk assessment or prohibitions on damselfishes in trade. Education, monitoring, and early detection and rapid response were the main risk management recommendations. The focused species selection process employed herein provided hazard identification and preliminary risk estimates for just 11 species, but collectively, they represent 40% by volume of fishes imported in the marine ornamental trade.

The impact of traditional cardiovascular risk factor control on 7-year follow-up atherosclerosis progression in systemic lupus erythematosus.

The 2022 EULAR recommendations for cardiovascular risk management in patients with rheumatic disorders, including SLE, call for rigorous management of cardiovascular risk factors (CVRF). The impact of CVRF target attainment on atherosclerotic plaque progression hasn't been previously evaluated in prospective ultrasound studies. A total of 115 patients with SLE and 1:1 age and sex-matched healthy controls who had a baseline carotid and femoral ultrasound examination in our cardiovascular research unit were invited for a 7-year follow-up assessment of new plaque development. We aimed to compare the incidence of plaque progression between SLE patients and controls and reveal the extent to which it is affected by the attainment of European Society of Cardiology (ESC) targets for modifiable CVRFs (blood pressure, smoking status, body weight, lipids and physical activity), and disease-related features (disease duration, disease activity, autoantibodies, treatments). Eighty-six SLE patients and 42 controls had a 7-year follow-up carotid and femoral plaque examination. New plaque development was observed in 32/86 patients vs 8/42 controls (P = 0.037). Patients with SLE had a 4-fold higher risk for plaque progression than controls (OR: 4.16, CI: 1.22, 14.19, P = 0.023), adjusting for potential confounders. Multivariate regression analyses showed a 50% decrease in plaque progression for every modifiable CVRF fulfilling ESC targets (OR: 0.56, CI: 0.34, 0.93, P = 0.026). Patients with SLE develop a rapid progression of atherosclerotic plaques which may be drastically reduced by CVRF target attainment according to ESC guidelines.

Asset Portfolio Risk Management Study-Empirical Analysis Based on VaR Model

This research paper is based on an empirical analysis of portfolio risk management using the value-at-risk (VaR) model. First, the theoretical foundations of portfolio management are introduced, including portfolio theory, asset pricing models, risk management theory and methods, and VaR models. Then the research methodology is described, including data sources and processing, VaR model construction, and risk metric calculation and interpretation. The empirical results section shows the risk analysis and source identification of asset portfolios, the estimation of VaR model parameters and confidence intervals, and the results of VaR calculations and risk measures at different confidence levels. Finally, the results are discussed and analyzed, including the interpretation and comparison of the risk measure results and the advantages and disadvantages of the VaR model. The paper also provides practical risk management recommendations and decision support for investors based on the results of the study. Limitations of the study and future research directions are also discussed. Overall, insights into portfolio risk management using VaR models are provided and a useful reference for researchers and investors interested in this area.

GEDEFO-SEFH management of antineoplastic extravasations survey results.

Extravasation is a potentially severe complication of intravenous administration of antineoplastic drugs. The limited data makes it difficult to develop an optimal management scheme. The objective of this study is to describe the clinical practice in the extravasation management of antineoplastic agents in Spanish centers. An online survey was distributed to oncology pharmacists using the email distribution list of the Spanish Society of Hospital Pharmacists. Respondents were surveyed on the standard operational protocol (SOP) of extravasation, tissue damage risk classification, and specific measures of extravasation management. A total of 68 surveys were completed. A specific extravasation SOP was available in 82.4% centers. The pharmacist participates in the authorship (100%) and actively collaborates in extravasation management (76.5%). A tissue damage risk classification based on the three categories was mostly adopted (48.2%) and 73.2% applied specific criteria based on concentration and/or extravasated volume. Extravasation management was mainly performed with the application of physical measures and/or antidotes (91.2%). High variability in the choices of pharmacological and/or physical measures recommended is outstanding. The results of this study highlight the involvement of Spanish pharmacists in extravasation management, the application of physical measures and/or pharmacological measures as the method of choice in extravasation management, as well as the existing discrepancies in tissue damage risk classification and management recommendations.

РИЗИК-МЕНЕДЖМЕНТ ВОЛОНТЕРСЬКИХ ПРОЄКТІВ

The question of the organization of charitable activities in Ukraine was considered, the specifics of volunteering in modern conditions were determined. The need for risk management in volunteer projects is emphasized. The purpose of the article is to review the theoretical foundations and develop practical recommendations for risk management of volunteer projects. The methodological basis of the research was logical methods of information processing, methods of analysis for identifying project risks, an abstract-logical method for formulating recommendations and conclusions. Presenting main material. The theoretical and methodological principles of charitable activities in Ukraine are considered. The specifics of implementing volunteer projects were analyzed and their risks were identified. It was determined that they are characterized by external risks associated with legislation, the search for donors, communication links, etc., and internal risks, which can include motivational risks, risks associated with compliance with the requirements of the "project triangle", and the risks of project participants. The risks of volunteer projects have been identified. Project risk management measures are proposed, the implementation of which will make it possible to prevent the occurrence of a risky situation or reduce its negative impact on the achievement of project goals. The originality and practical significance of the research is confirmed by the possibility of using the proposed measures as a practical risk management tool for planning volunteer projects. Conclusions and prospects for further research. The proposed identification of project risks and recommendations for their management can be used to further improve the risk management processes of volunteer projects by creating simulation models for evaluating the quantitative characteristics of adverse events.