Risk Reduction Benefits Research Articles

Maintenance grouping optimization for the management of risk in offshore riser system

Riser system failure in relation to major accidents is one of the potential undesirable events in the offshore petroleum industry. It has the potential for high consequence such as several fatalities/injuries, severe environmental impact or gross economic loss. Besides, it may be related to maintenance being insufficient, incorrect, a new hazard source or a triggering event for an accident scenario.Furthermore, there has been a paradigm shift in the design of unmanned platforms following the Piper Alpha disaster in 1988. Firefighting systems are usually not installed anymore based on the reason that the risk reduction benefit they offer to maintenance personnel is not commensurate with their frequency of visits unlike in manned facilities, i.e. a negative risk balance. In manned facilities, where such safety systems are installed, maintenance personnel are subject to major hazard exposure due to the visits required of them. Hence, there is the need to reduce the risk to personnel as much as reasonable. Maintenance grouping optimization can serve as an alternative contributor to the reduction of maintenance frequencies which should reduce the risk, but on the other hand, as the human error opportunities increase, the likelihood of making errors increases which increases risk.The main objective of this paper is to investigate how maintenance grouping optimization and the potential human error can be balanced in relation to reducing the major accident risk. The paper builds on a review of literature on maintenance optimization, human reliability and risk.

Statins and diabetes risk: how real is it and what are the mechanisms?

In randomized trials and many observational studies, statins are associated with a modest excess of type 2 diabetes mellitus. High-intensity statins, such as atorvastatin 80 mg and rosuvastatin 20 mg, are associated with a higher excess risk of diabetes than moderate-intensity statins, such as atorvastatin 10 mg, simvastatin 20-40 mg, or pravastatin 40 mg. Multiple mechanisms have been proposed for statin-associated diabetes risk, primarily related to increased insulin resistance or impaired insulin secretion. Genetic polymorphisms with reduced HMG CoA reductase function are associated with weight gain, insulin resistance, and diabetes. Animal models have shown that HMG CoA inhibition has multiple downstream effects that may increase diabetes risk. Statin impairment of insulin signaling, decreased adipocyte differentiation, decreased pancreatic β-cell insulin secretion, and other effects have also been found. The excess risk of diabetes appears to be confined to those who are already at risk for developing diabetes. Diabetes is diagnosed only 2-4 months earlier in statin-treated patients and therefore is unlikely to have no long-term adverse consequences. The clinical impact of statin-associated diabetes is likely unimportant. The cardiovascular risk reduction benefit from statin far outweighs the potential for adverse effects in all but the very lowest risk individuals.

Consumer behavior and perspectives concerning spent household battery collection and recycling in China: a case study

Currently, the majority of spent batteries are not recycled but become part of the household waste in many countries, especially in China which is the largest producer and consumer of batteries. This is due to many reasons, including the lack of governmental policies to encourage and facilitate battery return and recycling. In that context this research was designed to investigate the attitudes and behaviors of Chinese consumers with regard to collection and recycling of spent batteries.The survey results were based upon the analyses of 1874 valid questionnaires. The key reason for the failure of return of spent batteries for recycling was the lack of conveniently located spent battery collection sites. Low awareness of battery management policies revealed that the residents did not have adequate information. The consumers were convinced that government is responsible for and should play a vital role in the proper management of spent batteries. The respondents favored using curbside recycling bins for depositing their spent batteries. The questionnaire results revealed that residents would pay a deposit to be 15.6% and 13.6% of the sale price of a battery respectively for deposit refund system and subsidy for spent battery collection and recycling respectively.In conclusion, policies on spent battery collection and recycling should be developed and implemented in China. The respondents provided the following insights for ways to dramatically increase spent battery collection and recycling by underscoring that governments: a. Are responsible for developing the policies, strategies to encourage all residents to return their spent batteries; b. Are responsible for ensuring that conveniently located collection facilities are widely available for citizen deposits of spent batteries; c. Should provide expanded information and education about risk reduction benefits of proper spent battery collection and recycling; d. Should support research on the production of new battery recycling technologies.

Impact of the global financial crisis on Islamic and conventional stocks and bonds

AbstractThis study explores the impact of the global financial crisis (GFC) on Islamic and conventional stock and bond indices in 11 Islamic and eight non‐Islamic countries. We find that there are benefits of Islamic stocks during the GFC, particularly during the early stage of the crisis because Islamic institutions are prohibited from holding sub‐prime mortgage securities and derivatives. The strongest benefits of Islamic stocks are in the UK and USA. We conclude that there are benefits of risk reduction and stability for Islamic stocks during a financial crisis, although not necessarily during a global recession.

Abstract P1-15-19: Effects of statin use on skin toxicity during breast radiation therapy

Abstract Background: Recent San Antonio Breast Cancer Symposium abstracts have suggested that statin use confers a significant benefit in breast cancer risk reduction and specifically in the subset of inflammatory breast cancer. Additional studies evaluating the combination of statin use with various breast cancer treatments are currently on-going. The primary objective of this study was to determine the effects of statin use on acute skin toxicity during breast radiation therapy (RT). Methods: We performed a retrospective chart review of 325 patients diagnosed with breast cancer who underwent RT between 2004 and 2012. Of these, 227 patients were considered evaluable. Patients were excluded if the course of RT was fewer than 16 treatments. Patients were also excluded if follow-up at the end of RT was not obtainable. Of the evaluable patients, 46 were on statins at time of RT, while 181 were not. Patients were evaluated at two time points - midway through RT and at completion of RT. Skin reactions were measured using the RTOG grading system for acute radiation morbidity. Grade 1 reactions were erythema and slight skin atrophy. Grade 2 indicated follicular, faint or dull erythema/ epilation/dry desquamation/ decreased sweating. Grade 3 was tender or bright erythema, patchy moist desquamation/moderate edema. Lastly, Grade 4 was ulceration, hemorrhage, necrosis. Results: Our results showed a statistically significant increase in acute radiation skin toxicity in patients on statins at the time of radiation therapy. By the midway point of RT, 67% of the statin group had developed Grade 1-3 skin toxicity vs. only 42% of the control group. Odds ratio midway through RT was 2.75. By the completion of RT, 94% of the statin group compared with 67% of the control group had Grade 1-3 skin toxicity (p=0.005). Odds Ratio at completion of RT was 7.29. The statin group also progressed to more advanced stages of toxicity more rapidly than our control group. Grade 1 skin reactions were seen in 62% of our statin group vs. 41% of our control group midway through treatment (p=0.044). Grade 2-3 reactions were seen in almost 5% of patients in the statin group vs. 1% in the non-statin group midway through treatment. At the end of treatment, 48% of patients on statins had developed Grade 2-3 reactions when compared with 29% in the non-statin group (p=0.0199). These results still remained significant when controlled for chemotherapy use. Conclusion: Our study revealed that patients on statins developed acute skin toxicity at higher rates than our control group. These results were statistically significant at both the midway point as well as at the completion of RT. Study limitations include the small sample size and the retrospective nature of the study. Our data also raises the question of what effect statins may have on local recurrence rates as well as the potential effects of radiosensitization in various breast cancer cell lines. These results are hypothesis-generating and require larger retrospective analyses or prospective trials to verify this effect. Citation Format: Scott M Lieberman, Elizabeth Stone, Christopher Chen, Marlow Hernandez, Leah Roberts. Effects of statin use on skin toxicity during breast radiation therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-15-19.

Treatment of hypertension in patients with coronary artery disease: a scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension.

1. Relationship Between Hypertension and CAD e437 2. Prevention of Cardiovascular Events in Patients With Hypertension and CAD e443 3. BP Goals e445 4. Management of Hypertension in Patients With CAD and Stable Angina e449 5. Management of Hypertension in Patients With ACS e451

Further Exploration Of Global Asset GMVPs: Does Risk Reduction Benefit From Weekly Data?

The paper studies the differences in risk reduction among global minimum variance portfolios (GMVPs) derived from the optimization of weekly and monthly return. This research follows the analysis of Zibri and Kukeli (2014) regarding differences in performance which is measured for different revision frequencies and transaction costs. The data used are weekly/monthly returns for stock, bond, gold, oil indices for the period 1996-2013. If more frequently rebalancing is applied, most restrictive weekly GMVPs reduce risk more than returns vis--vis monthly GMVPs.

Perceptions of voluntary medical male circumcision among circumcising and non-circumcising communities in Malawi

Three randomised controlled trials in Africa indicated that voluntary medical male circumcision (VMMC) is an effective method to reduce a man's risk of becoming infected through sex with an HIV-positive female partner. The success of recent public health initiatives to increase numbers of circumcised men in Malawi has been very limited. We conducted in-depth interviews and focus group discussions (FGDs) with men, women and male adolescents from non-circumcising and circumcising communities in southern Malawi to better understand their beliefs about male circumcision and the promotion of VMMC for HIV prevention. Results revealed that beliefs about male circumcision, in general, are strongly mediated by Malawian culture and history. Participants have attempted to develop a new meaning for circumcision in light of the threat of HIV infection and the publicised risk reduction benefits of VMMC. Several study participants found it difficult to distinguish VMMC from traditional circumcision practices (jando and lupanda), despite awareness that the new form of circumcision was an expression of (western) modern medicine performed largely for public health purposes. Greater recognition of background cultural beliefs and practices could inform future efforts to promote medical male circumcision as an HIV prevention strategy in this context.

Treating Atypical Femoral Fractures Related to Bisphosphonates.

Doctors widely prescribe osteoclast-inhibiting bisphosphonate drugs to treat osteoporosis, but long-term bisphosphonate use has been linked to an increased risk of atypical subtrochanteric femoral fractures. According to an updated task force report from the American Society for Bone and Mineral Research, the features that distinguish these atypical subtrochanteric fractures include transverse orientation, general lack of comminution, and localized cortical thickening at the fracture site. In addition, the prolonged healing times of these fractures challenge orthopaedists to obtain strong and stable fixation that outlasts the extended period required for fracture union. Intramedullary nailing is often used to treat these fractures, but related characteristics such as canal narrowing can make this fixation approach unfeasible. This month’s “Case Connections” looks at various techniques for repairing bisphosphonate-associated atypical femoral fractures. In the January 14, 2015, JBJS Case Connecto r , Yuasa et al. reported on the case of a sixty-nine-year-old woman who, one month prior to scheduled right hip arthroplasty to treat osteoarthritis, presented with severe right thigh pain after a low-trauma fall. History-taking revealed four-plus years of treatment with alendronate (Fosamax), and radiographs showed a noncomminuted transverse subtrochanteric fracture below an arthritic hip joint. During a single operation, the patient underwent cementless total hip arthroplasty using a modular stem/neck, followed by fracture reduction and fixation using a cable-and-plate system (Fig. 1). The patient was switched from alendronate to a …

Which financial stocks did short sellers target in the subprime crisis?

Tracing the SEC ban on the short selling of financial stocks in September 2008, this paper investigates whether such selling activity before the 2008 short ban reflected financial companies’ risk exposure in the subprime crisis. Evidence suggests that short sellers sold short stocks that had the greatest asset and insolvency risk exposures, and that the short selling of financial firms’ stocks was not significantly greater than that of non-financial firms after we match them on firm size and insolvency risk. When the short ban was in effect, the market quality of financial stocks without subprime assets exposure had deteriorated to a larger degree than that of financial companies with subprime assets exposure. The findings imply that such a regulation may mute the market disciplining effects of investors and may also be seen as a counterweight to any perceived macro or systemic risk reduction benefits resulting from such a ban.

Which Financial Stocks Did Short Sellers Target in the Subprime Crisis?

​Tracing the SEC ban on the short selling of financial stocks in September 2008, this paper investigates whether such selling activity before the 2008 short ban reflected financial companies’ risk exposures in the subprime crisis. The evidence suggests that short sellers sold short stocks that had the greatest asset and insolvency risk exposures, and that the short selling of financial firms’ stocks was not significantly greater than that of non-financial firms. When the short ban was in effect, the market quality of financial stocks without subprime asset exposure had deteriorated to a larger degree than that of financial companies with subprime asset exposure. The findings imply that such a regulation may mute the market disciplining effects of investors and may also serve as a counterweight to any perceived macro or systemic risk reduction benefits resulting from such a ban.

Preliminary Report on Standards in Global Financial Markets

This paper considers the ‘market failures’ that can block standardisation and recommends actions to overcome these barriers and so ensure greater realisation of the efficiency and risk-reduction benefits of standardisation in global financial markets. It first reviews the economic benefits of standardisation and the ‘market failures’ (lack of co-ordination and vested interests) can prevent these being achieved. It then looks at standard setting institutions in a range of industries (engineering, the global supply chain, the internet) developed to overcome these market failures, comparing these with the relatively underdeveloped institutions of standards development in financial services. It goes on to examine the development of both transaction and data reference standards in financial markets, finding that much remains to be done, especially on data reference standards where the limited progress to date has relied largely on regulatory mandate. Finally it recommends three practical actions to improve standardisation in global financial markets: (i) Promotion of discussion and dialogue across industry; (ii) engagement of senior management in the task of building cross industry support for both standardisation and standards institutions; and (iii) renewed effort, by researchers and practitioners, on identifying specific opportunities for using standardisation to promote business efficiency and improve market transparency.

Oral anticoagulation therapy after radiofrequency ablation of atrial fibrillation and the risk of thromboembolism and serious bleeding: long-term follow-up in nationwide cohort of Denmark.

To investigate the long-term risk of thromboembolism and serious bleeding associated with oral anticoagulation (OAC) therapy beyond 3 months after radiofrequency ablation (RFA) of atrial fibrillation (AF). Linking Danish administrative registries, 4050 patients undergoing first-time RFA (2000-11) were identified. Risk of thromboembolism and serious bleeding according to OAC therapy were analysed by incidence rates (presented per 100 person-years) and Cox proportional-hazard models. The median age was 59.5 years (interquartile range, IQR: 52.8-65.2); 26.5% were females. During a median follow-up of 3.4 years (IQR: 2.0-5.6), 71 (1.8%) thromboembolism cases were identified, where incidence rates with and without OAC were 0.56 (0.40-0.78)95%CI and 0.64 (0.46-0.89)95%CI, respectively. Oral anticoagulation discontinuation remained insignificant [hazard ratio 1.42(0.86-2.35)95%CI] in multivariable analysis. Beyond 3 months after RFA 87 (2.1%) serious bleedings occurred; incidence rates with and without OAC were 0.99 (0.77-1.27)95%CI and 0.44 (0.29-0.65)95%CI, respectively. Oral anticoagulation therapy was significantly associated with serious bleeding risk [hazard ratio 2.05(1.25-3.35)95%CI]. In an age- and gender-matched cohort (1 : 4) of 15 848 non-ablated AF patients receiving rhythm-control therapy, thromboembolic rates with and without OAC were 1.34 (1.21-1.49)95%CI and 2.14 (1.98-2.30)95%CI, respectively. Adjusted incidence rate ratio was 0.53 (0.43-0.65)95%CI favouring RFA cohort. Thromboembolic risk beyond 3 months after RFA was relatively low compared with a matched non-ablated AF cohort. With cautious interpretation due to low number of events, serious bleeding risk associated with OAC seems to outweigh the benefits of thromboembolic risk reduction. Randomized studies are warranted to test our results.

Dependence of stock and commodity futures markets in China: Implications for portfolio investment

We examine the recent trends in dependence structure between the fast-growing commodity markets and the stock markets in China. We address this issue by using copula functions that allow for measuring both average and tail dependence. Our results provide evidence of low and positive correlations between these markets, suggesting that commodity futures are a desirable asset class for portfolio diversification. By comparing the market risks of alternative portfolio strategies, we show that Chinese investors can take advantage of commodity futures during different times to realize risk diversification and downside risk reduction benefits.

Practical Implementation of the 2013 AHA/ACC Blood Cholesterol Guidelines.

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States. Choosing the appropriate patients for whom to initiate statin therapy to reduce the risk of ASCVD is of paramount importance. The new AHA/ACC guidelines on the treatment of cholesterol emphasize a patient-centered approach that shifts away from arbitrary LDL-C goals and recommends targeting statin therapy in patient populations that show ASCVD risk-reduction benefit. In addition, the guidelines emphasize lifestyle modification and the importance of the clinician-patient relationship in discussing ASCVD risk and initiating statin therapy.

Metabolic syndrome and hypertension: regular exercise as part of lifestyle management.

The incorporation of physical activity and exercise represents a clinically important aspect in the management of metabolic syndrome, hypertension, and diabetes. While the benefit of exercise and active lifestyles is well documented for prevention and risk reduction of cardiovascular and stroke outcomes, the detailed regiment and recommendations are less clear. The components of a prescribed physical activity include consideration of activity type, frequency of an activity, activity duration, and intensity of a specific physical movement. The exercise parameters prescribed as part of the management of metabolic syndrome, diabetes, and elevated blood pressure are most often proposed as separate documents while the general recommendations are similar. The evidence is strong such that physical activity and exercise recommendations in disease management guidelines are considered high quality. The general recommendations for both blood pressure and glycemic management include a regiment of physical activity with moderate- to high-intensity exercise of 30-min bouts on multiple days with a desired goal of a total of 150 min of exercise per week. While additional research is needed to identify the specific exercise/activity mode, frequencies for exercise training, intensity levels, and duration of exercise that achieve maximal blood pressure and glycemic lowering, this general recommendation showed a consistent and significant benefit in risk reduction. Similarly, the current available evidence also indicates that aerobic exercise, dynamic resistance exercise, and isometric exercises can lower blood pressure and improve glycemic control.

493PD - A Survey of Genetic Counsellors About the Needs of 18-25 Year Olds from Families with Hereditary Breast and Ovarian Cancer Syndrome

ABSTRACT Aim: Despite evidence supporting the benefits of risk reduction, protocols for early detection and prevention among women from families affected by hereditary breast and ovarian cancer (HBOC) are not yet proven, and clinical trials have not been undertaken for patients aged 18 to 25. The absence of psychosocial data may leave genetic counsellors without uniform guidance on how to manage the care of these patients. This project sought to investigate how best to work with HBOC patients aged 18-25 given their unique developmental, familial, and medical challenges. Methods: Certified genetic counselors were recruited through the NSGC's Cancer Genetics Special Interest Group listserv. Researchers constructed an online survey which included 41 items and elicited information about: counsellor demographics, training, and practice settings; approaches to cancer risk assessment; and common challenges in work with 18- to -25-year-old patients. The survey was also informed by previous work by researchers with 18 to 25-year-olds with BRCA gene mutations. Researchers used a combination of grounded theory and content analysis on open-ended responses, supported and triangulated with statistical analysis. Results: Respondents experienced 18-25-year-old patients presenting for cancer risk assessment differently than older patients, and some reported adapting their counseling style to address these differences. Respondents differed in the extent to which they felt familiar with the developmental needs of patients in this age group. Respondents aged 39 and under reported familiarity with this stage in life, having more recently completed it; respondents aged 40 and over reported less familiarity with, and more interest in learning about, this age group. A primary challenge, reported primarily by counsellors aged 39 and under, is navigating family dynamics in the counselling room and addressing the developmentally labile young adult. Conclusions: With respect to BRCA-related cancer risk, where penetrance is incomplete and onset in early adulthood is rare, optimal screening and prevention protocols now exist. This shifts the risk management landscape from one of choice to one of adherence. A rich understanding of the trajectories of human growth over time might enhance the counsellor's capacity to assess patients and their family members. Disclosure: All authors have declared no conflicts of interest.

Does mitigation save? Reviewing cost-benefit analyses of disaster risk reduction

The benefit-cost-ratio (BCR), used in cost-benefit analysis (CBA), is an indicator that attempts to summarize the overall value for money of a project. Disaster costs continue to rise and the demand has increased to demonstrate the economic benefit of disaster risk reduction (DRR) to policy makers. This study compiles and compares original CBA case studies reporting DRR BCRs, without restrictions as to hazard type, location, scale, or other parameters. Many results were identified supporting the economic effectiveness of DRR, however, key limitations were identified, including a lack of: sensitivity analyses, meta-analyses which critique the literature, consideration of climate change, evaluation of the duration of benefits, broader consideration of the process of vulnerability, and potential disbenefits of DRR measures. The studies demonstrate the importance of context for each BCR result. Recommendations are made regarding minimum criteria to consider when conducting DRR CBAs.

Identifying safe haven assets for equity investors through an analysis of the stability of shock transmission

Our analysis takes the perspective of an equity fund manager who seeks a potential safe haven asset to protect her portfolio during market downturns. We employ a regime-switching framework, within which we separate common and idiosyncratic shocks, to assess the suitability of gold, 10-year and 1-year U.S. Treasury bonds. We find evidence in favour of choosing either gold or the longer-dated bond as our safe haven asset. Both deliver risk reduction benefits as equity markets plunge. In contrast, the 1-year bond is not suitable as its vulnerability to contagious idiosyncratic shocks more than offsets its ability to hedge against common risk factors.

Practical Applications of The Tortoise and the Hare: Risk Premium versus Alternative Asset Portfolios

While alternative investments reduce portfolio risk, implementing risk premia strategies using liquid futures, ETFs and/or other low-cost products can offer superior diversification. The authors of this research compare the risk-reduction benefits of alternative investments and risk premia strategies. In <b><i>The Tortoise and the Hare: Risk Premium versus Alternative Asset Portfolios</i></b>, co-authors <b>Ron Bird</b>, <b>Harry Liem</b> and <b>Susan Thorp</b> (from the research team at the <b>Paul Woolley Centre at the University of Technology, Sydney</b>) examine whether risk premia (the tortoise) actually offer improved diversification benefits versus alternative investments (the hare), using equal-weighted and least-risk-optimized portfolios. “We know that alternative investments are a hot product for institutional investors,… but are they as good as a lot of people would have us believe?” asks Bird. The analysis shows the tortoise has the advantage. The study constructs efficient frontiers for the two types of portfolios and finds that, overall, risk premia portfolios outperformed pure alternative investments. Some risk-premia strategies generate lower returns, but with much lower standard deviations, offering higher Sharpe ratios in most cases. <b>TOPICS:</b>Portfolio theory, analysis of individual factors/risk premia, tail risks