Displaying publications 21 - 40 of 54 in total

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  1. Usin MF, Ramesh P, Lopez CG
    Malays J Pathol, 2004 Jun;26(1):43-8.
    PMID: 16190106
    Event reporting can provide data to study the failure points of an organization's work process. As part of the ongoing efforts to improve transfusion safety, a Medical Event Reporting System Transfusion Medicine, (MERS - TM) as designed by Kaplan et al was implemented in the Transfusion Medicine Unit of the University Malaya Medical Centre to provide a standardized means of organized data collection and analysis of transfusion errors, adverse events and near misses. An event reporting form was designed to detect, identify, classify and study the frequency and pattern of events occurring in the unit. Events detected were classified according to Eihdhoven Classification model (ECM) adopted for MERS - TM. Since our system reported all events, we called it Event Reporting System - Transfusion Medicine (ERS-TM). Data was collected and analyzed from the reporting forms for a period of five months from January 15th to June 15th 2002. The initial half of the period was a process of evaluation during which 118 events were reported, coded, analyzed and corrective measures adopted to prevent the recurrence of the same event. The latter half saw the reporting of 122 events following the adoption of corrective measures. There was a reduction in the occurrence of some events and an increase in others, which were mainly beyond the organization's control. A longer period of evaluation is necessary to identify the underlying contributory causes that can be useful to develop plans for corrective and preventive action and thereby reduce the rate of recurrence of errors through proper training and adoption of just culture.
    Matched MeSH terms: Risk Management/methods*; Risk Management/statistics & numerical data
  2. de la Rosette J, Laguna P, Álvarez-Maestro M, Eto M, Mochtar CA, Albayrak S, et al.
    Int J Urol, 2020 11;27(11):981-989.
    PMID: 32772434 DOI: 10.1111/iju.14340
    OBJECTIVES: To determine the well-being of urologists worldwide during the coronavirus disease 2019 pandemic, and whether they have adequate personal protective equipment knowledge and supplies appropriate to their clinical setting.

    METHODS: Urologists worldwide completed a Société Internationale d'Urologie online survey from 16 April 2020 until 1 May 2020. Analysis was carried out to evaluate their knowledge about protecting themselves and others in the workplace, including their confidence in their ability to remain safe at work, and any regional differences.

    RESULTS: There were 3488 respondents from 109 countries. Urologists who stated they were moderately comfortable that their work environment offers good protection against coronavirus disease 2019 showed a total mean satisfaction level of 5.99 (on a "0 = not at all" to "10 = very" scale). A large majority (86.33%) were confident about protecting themselves from coronavirus disease 2019 at work. However, only about one-third reported their institution provided the required personal protective equipment (35.78%), and nearly half indicated their hospital has or had limited personal protective equipment availability (48.08%). Worldwide, a large majority of respondents answered affirmatively for testing the healthcare team (83.09%). Approximately half of the respondents (52.85%) across all regions indicated that all surgical team members face an equal risk of contracting coronavirus disease 2019 (52.85%). Nearly one-third of respondents reported that they had experienced social avoidance (28.97%).

    CONCLUSIONS: Our results show that urologists lack up-to-date knowledge of preferred protocols for personal protective equipment selection and use, social distancing, and coronavirus disease 2019 testing. These data can provide insights into functional domains from which other specialties could also benefit.

    Matched MeSH terms: Risk Management/methods; Risk Management/standards
  3. Shawal FNS, Guan NY, Mohd Suadi Nata DH, How V, Tamrin SBM
    Work, 2018;60(1):153-162.
    PMID: 29733040 DOI: 10.3233/WOR-182725
    BACKGROUND: People who work with the steam boilers in palm oil mills are vulnerable to accidents, notably to explosions, whenever failures of any kind occur during their operation.

    OBJECTIVE: This cross-sectional study was conducted in palm oil mills to determine the knowledge, attitude, and perception (KAP) concerning the risk management of steam boilers among workers in palm oil mills.

    METHODS: A total of 50 workers who were working with steam boilers and/or involved in managing the operation of steam boilers with at least three years of working experience in the palm oil industry were purposively sampled. A self-administrated questionnaire consisting of four main parts - socio-demographic and occupational information, knowledge, attitude, and perception of the risk management of steam boilers was distributed. The knowledge, attitude, and perception were calculated based on a Likert-type scale.

    RESULTS: This study found that 56% of boiler workers had a good level of knowledge (mean score = 77.22±19.6), 72% had a good attitude toward risk (mean score = 83.17±5.85), and 64% had a good perception of risk (mean score = 79.50±11.22). The prevalence of accidents was 16%, and, for near misses, it was 24%. The cause of the reported accidents was largely attributed to carelessness, specifically at 80%. Apart from that, there was a positive association (χ2 = 6.56; p = 0.010) between attitude and accidents.

    CONCLUSION: This study found that the workers had good KAP levels of risk management of steam boilers in palm oil mills. However, there is a need for the employers to revise the training of workers and ensure its effectiveness in heightening the awareness of risks and accidents despite the high level of KAP.

    Matched MeSH terms: Risk Management/methods; Risk Management/standards*
  4. Di Simone E, Di Muzio M, Dionisi S, Giannetta N, Di Muzio F, De Gennaro L, et al.
    Eur Rev Med Pharmacol Sci, 2019 Jun;23(12):5522-5529.
    PMID: 31298407 DOI: 10.26355/eurrev_201906_18224
    INTRODUCTION: Western world health care systems have been trying to improve their efficiency and effectiveness in order to respond properly to population aging and non-communicable diseases epidemic. Treatment of the elderly population is becoming complex due to the high number of prescribed drugs because of multimorbidity. Errors in drugs administration in different health care related settings are an actual important issue due to different causes. Aim of this observational study is to measure the online interest in seeking medication errors information related to risk management and shift work.

    MATERIALS AND METHODS: We investigated Google Trends® for popular search relating to medication errors, risk management and shift work. Relative search volumes (RSVs) were evaluated from 2008 to 2018. A comparison between RSV curves related to medication errors, risk management and shift work was carried out. Then, we compared the world to Italian search.

    RESULTS: RSVs were persistently higher for risk management than for medication errors (mean RSVs 069 vs. 48%) and RSVs were stably higher for medication errors than shift work (mean RSVs 48 vs. 22%). In Italy, RSVs were much lower compared to the rest of the world, and RSVs for medication errors during the study period were negligible. Mean RSVs for risk management and shift work were 3 and 25%, respectively. RSVs related to medication errors and clinical risk management were correlated (r=0.520, p<0.0001).

    CONCLUSIONS: Google Trends® search query volumes related to medication errors, risk management and shift work are different. RSVs for risk management are higher, and they are correlated with medication errors. Also, shift work search appears to be lower. These results should be interpreted in order to correctly evaluate how to decrease the number of medication errors in different health care related setting.

    Matched MeSH terms: Risk Management/methods; Risk Management/trends; Risk Management/statistics & numerical data*
  5. Anuar, I., Zahedi, F., Kadir, A., Mokhtar, A.B.
    MyJurnal
    Background : Risk management strategy at the workplace needs two way interactions between employee and employer. Therefore, study on risk perception among workers based on scientific analysis is needed to gain knowledge and understanding on how workers perceived risk at the workplace in order to design risk management strategies more effectively.
    Methodology : A cross sectional study was carried out among 628 respondents from 36 medical laboratories in the public and private sector in Klang Valley. Using a self administered questionnaire, respondents were required to perceive risk on 30 hazards which have been identified in the medical laboratory. Each hazard was encoded by using Likert scale 1= not risky, 2= risky but low, 3= moderate risk, 4= high risk and 5= very high risk.
    Result : Overall, the study showed that working in the medical laboratory was perceived to of moderate risk. When comparing among ethic groups, the Malays had the highest perception of risk (3.07±0.88) as compared with Indians (3.03±0.88) and the Chinese (2.78±0.90). Employee with higher education and position level perceived low level of risk compared to those with lower education and position level. For those working in different types of laboratories, there are significant difference on risk perception, (p=0.001). Employees who work in government sector perceived higher (3.12±0.93) risk compared to workers in private sector (2.85±0.88). In terms of OSH based knowledge, those with higher level of education and position have a high score knowledge on OSH compared to those have lower education and position level.
    Conclusion : This study showed that risk perception among workers in medical laboratory is influenced by socio-demography factor such race, education level, job position and the laboratory where the respondents are working.
    Matched MeSH terms: Risk Management
  6. Aziz Basiran, Ismail Bahari
    MyJurnal
    Various types of Occupational Safety and Health Management Systems (OSH-MS) exist in the market. Basically, these systems have similar basic principles and even elements. However, the importance of these elements in terms of successful management of OSH differs according to the end-user. OSH Practitioners with different roles and responsibilities have different views on which element or elements contribute significantly to the overall success of OSH management. There are no standardization in terms quantifying the elements that qualifies an OSH-MS. A study was carried out to quantify the implementation of an OSH-MS through the determination of weighing factors for the different elements in an OSH-MS. Respondents for this study comprised of top safety and health management, safety and health officers (SHO) / radiation protection officers (RPO), DOSH officers, auditors and consultants who are very familiar with OSH-MS. Sample of this study was based on purposive sampling due to strict criteria and prerequisites to be met. Questionnaires were distributed to the identified organizations and personnel. Results from this study established that, auditor has the highest level of understanding of OSH-MS compared with top safety and health management, SHO / RPO, DOSH officers and OSH consultants. Among all the elements in the OSH-MS studied for their levels of importance in terms of the overall success of implementing an OSH-MS, OSH policy is the most critical element, followed by hazard identification, risk assessment and control, employee participation, responsibility and accountability and competence and training. The weighing factor for these top 5 elements are OSH policy (0.36); hazard identification, risk assessment and risk control (0.25); employee participation (0.15); responsibility and accountability (0.14); and competence and training (0.10). Application of the weighing factors of these elements allows the quantification of audit status (Audit Score) based on the equation: audit score = 0.36 [OSH Policy] + 0.25 [Hazard Identification, Risk Assessment and Risk Control] + 0.15 [Employee Participation] + 0.14 [Responsibility and Accountability] + 0.10 [Competence and Training]. Minimum tolerable target for each element of an OSH-MS was also determined. The minimum tolerable frequency of OSH policy is reviewed by top management is yearly; the minimum tolerable frequency of risk management is reviewed is yearly; the minimum tolerable percentage of employees who should be made known on relevant legal and other requirements is ≥90%; the minimum tolerable percentage of OSH objectives and programme(s) achieved / implemented is between 80 – 89%; the minimum tolerable percentage of money budgeted for OSH in a year compared to organization revenue is between 1 – 5%; the minimum tolerable number of hours for each employee needed to be trained on OSH per year is between 30 – 39 hours; the minimum tolerable percentage of employees who should be communicated on matters related to OSH is ≥90%; the minimum tolerable percentage of employees participation and involvement in hazard identification, risk assessment and determining controls is ≥90%; the minimum tolerable percentage of employees who should be involved in establishing OSH documents is
    Matched MeSH terms: Risk Management
  7. Adeleke AQ, Bahaudin AY, Kamaruddeen AM, Bamgbade JA, Salimon MG, Khan MWA, et al.
    Saf Health Work, 2018 Mar;9(1):115-124.
    PMID: 30363069 DOI: 10.1016/j.shaw.2017.05.004
    Background: Substantial empirical research has shown conflicting results regarding the influence of organizational external factors on construction risk management, suggesting the necessity to introduce a moderator into the study. The present research confirmed whether rules and regulations matter on the relationships between organizational external factors and construction risk management.

    Methods: Based on discouragement and organizational control theory, this research examined the effects of organizational external factors and rules and regulations on construction risk management among 238 employees operating in construction companies in Abuja and Lagos, Nigeria. A personally administered questionnaire was used to acquire the data. The data were analyzed using partial least squares structural equation modeling.

    Results: A significant positive relationship between organizational external factors and construction risk management was asserted. This study also found a significant positive relationship between rules and regulations and construction risk management. As anticipated, rules and regulations were found to moderate the relationship between organizational external factors and construction risk management, with a significant positive result. Similarly, a significant interaction effect was also found between rules and regulations and organizational external factors. Implications of the research from a Nigerian point of view have also been discussed.

    Conclusion: Political, economy, and technology factors helped the construction companies to reduce the chance of risk occurrence during the construction activities. Rules and regulations also helped to lessen the rate of accidents involving construction workers as well as the duration of the projects. Similarly, the influence of the organizational external factors with rules and regulations on construction risk management has proven that most of the construction companies that implement the aforementioned factors have the chance to deliver their projects within the stipulated time, cost, and qualities, which can be used as a yardstick to measure a good project.

    Matched MeSH terms: Risk Management
  8. Choy CY
    Curr Opin Anaesthesiol, 2008 Apr;21(2):183-6.
    PMID: 18443485 DOI: 10.1097/ACO.0b013e3282f33592
    PURPOSE OF REVIEW: Updates on developments in critical incident monitoring in anaesthesia, and assesses its role in improving patient safety.
    RECENT FINDINGS: Critical incident reporting has become more widely accepted as an effective way to improve anaesthetic safety, and has continued to highlight the importance of human errors and system failures. The establishment of an international database also improves critical incident reporting. Experiences from the national reporting and learning system in the UK have provided some solutions to the many problems and criticisms faced by the critical incident reporting technique. Direct observations to detect errors are more accurate than voluntary reporting of critical incidents, and may be a promising new approach.
    SUMMARY: Critical incident monitoring is a valuable tool in ensuring patient safety due to its low cost and the ability to provide a comprehensive body of detailed qualitative information. The qualitative information gathered can be used to develop strategies to prevent and manage existing problems, as well as to plan further initiatives for patient safety. Novel approaches should complement existing methods to achieve better results. The development of a culture which emphasises safety should go hand in hand with current audit activities.
    Matched MeSH terms: Risk Management/methods*
  9. Choy YC, Lee CY, Inbasegaran K
    Med J Malaysia, 1999 Mar;54(1):4-10.
    PMID: 10971998
    Critical incident reporting is a useful quality improvement technique for reducing morbidity and mortality in anaesthesia. This study analyses 93 cases in Kuala Lumpur Hospital from July 1995 to January 1997. The main incidents during anaesthesia in this study were airway incidents. While human error was identified as the main factor contributing to the occurrence of adverse incidents. Critical incident monitoring plays an important role in identifying potential problems, which may lead to disaster. The findings from this report of the anaesthesia incident monitoring study continued to indicate the occurrence of similar problems seen in an earlier report. The identification of common incidents can be used to identify risk factors and minimise repetition of such incidents.
    Matched MeSH terms: Risk Management*
  10. Wee SY, Aris AZ, Yusoff FM, Praveena SM
    Sci Total Environ, 2019 Jun 25;671:431-442.
    PMID: 30933799 DOI: 10.1016/j.scitotenv.2019.03.243
    Endocrine disrupting compounds (EDCs) are an emerging environmental concern and commonly occur as a mixture of compounds. The EDC mixture can be more toxic than any single compound. The present study analyses EDCs in surface water in the case of an urban tropical river, the Langat River, using the multiresidue analytical method of solid phase extraction and liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS). The Langat River is used as a drinking water source and is treated for Malaysian drinking water supply. A total of 14 EDCs i.e. five hormones, seven pharmaceuticals, one pesticide, and one plasticizer were detected. Caffeine was observed to be highest at 19.33 ng/L, followed by bisphenol A and diclofenac at 8.24 ng/L and 6.15 ng/L, respectively. Using a conservative risk quotient (RQ) method, EDCs were estimated for having negligible risks under acute and chronic exposure (RQ risk related to these compounds in the Langat River riverine ecosystem. However, the presence of EDCs in surface water raises concerns about potential human exposure to EDCs via dietary intake i.e. food and drinking water supply. Although the ecological risks are considered negligible, these risks should not be neglected in terms of future prioritization and risk management. Improvements in water quality monitoring and risk assessment in water source protection are required to support a multibarrier approach to managing drinking water supply systems for safe water supply. The present study proposes a risk management and monitoring framework for EDCs to support the aforementioned multibarrier approach.
    Matched MeSH terms: Risk Management/methods*
  11. Jairaman J, Sakiman Z, Li LS
    Clin. Lab. Med., 2017 Mar;37(1):163-176.
    PMID: 28153364 DOI: 10.1016/j.cll.2016.09.013
    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory.
    Matched MeSH terms: Risk Management*
  12. Tingle J
    Br J Nurs, 2017 May 25;26(10):572-573.
    PMID: 28541112 DOI: 10.12968/bjon.2017.26.10.572
    John Tingle, Reader in Health Law at Nottingham Trent University, and Jen Minford, Junior Doctor Co-ordinator, Nottingham University Hospitals NHS Trust, discuss initiatives presented at a global summit on patient safety.
    Matched MeSH terms: Risk Management*
  13. Chong VC, Lee PK, Lau CM
    J Fish Biol, 2010 Jun;76(9):2009-66.
    PMID: 20557654 DOI: 10.1111/j.1095-8649.2010.02685.x
    A total of 1951 species of freshwater and marine fishes belonging to 704 genera and 186 families are recorded in Malaysia. Almost half (48%) are currently threatened to some degree, while nearly one third (27%) mostly from the marine and coral habitats require urgent scientific studies to evaluate their status. Freshwater habitats encompass the highest percentage of threatened fish species (87%) followed by estuarine habitats (66%). Of the 32 species of highly threatened (HT) species, 16 are freshwater and 16 are largely marine-euryhaline species. Fish extinctions in Malaysia are confined to two freshwater species, but both freshwater and marine species are being increasingly threatened by largely habitat loss or modification (76%), overfishing (27%) and by-catch (23%). The most important threat to freshwater fishes is habitat modification and overfishing, while 35 species are threatened due to their endemism. Brackish-water, euryhaline and marine fishes are threatened mainly by overfishing, by-catch and habitat modification. Sedimentation (pollution) additionally threatens coral-reef fishes. The study provides recommendations to governments, fish managers, scientists and stakeholders to address the increasing and unabated extinction risks faced by the Malaysian fish fauna.
    Matched MeSH terms: Risk Management
  14. Purmal K, Nambiar P
    Int Dent J, 2009 Jun;59(3):155-60.
    PMID: 19637524
    To study the success and failures of the mediation process of complaints from 2004-2007 by the Complaints Bureau Steering Committee and the Public Complaints Bureau Committee of the Malaysian Dental Association (MDA).
    Matched MeSH terms: Risk Management
  15. Maakip I, Keegel T, Oakman J
    Appl Ergon, 2016 Mar;53 Pt A:252-7.
    PMID: 26499952 DOI: 10.1016/j.apergo.2015.10.008
    Musculoskeletal disorders (MSDs) are a major occupational health issue for workers in developed and developing countries, including Malaysia. Most research related to MSDs has been undertaken in developed countries; given the different regulatory and cultural practices it is plausible that contributions of hazard and risk factors may be different. A population of Malaysian public service office workers were surveyed (N = 417, 65.5% response rate) to determine prevalence and associated predictors of MSD discomfort. The 6-month period prevalence of MSD discomfort was 92.8% (95%CI = 90.2-95.2%). Akaike's Information Criterion (AIC) analyses was used to compare a range of models and determine a model of best fit. Contributions associated with MSD discomfort in the final model consisted of physical demands (61%), workload (14%), gender (13%), work-home balance (9%) and psychosocial factors (3%). Factors associated with MSD discomfort were similar in developed and developing countries but the relative contribution of factors was different, providing insight into future development of risk management strategies.
    Matched MeSH terms: Risk Management
  16. Somboonsook B, Wakerman J, Hattch CT, Collison M, Barnes A, Kyi W, et al.
    Med J Malaysia, 1995 Sep;50(3):212-20.
    PMID: 8926897
    This study was the first assessment of a nationwide risk approach system to antenatal management introduced to Malaysia in 1989. Three rapid, record-based surveys on three different study groups were conducted to determine risk factor prevalence, accuracy of risk assignment, action after risk assignment and the relationship of risk level and place of delivery. The most frequent risk factors were short birth interval, high parity and first pregnancy. Accuracy of risk assignment was highest at the lowest levels of risk and poorest at the highest levels. Women at the lowest levels of risk were more likely to be seen by a doctor than women at highest risk. These was a trend to deliver in hospital, rather than at home, as level of risk increased; but many women at high risk still delivered at home. Recommendations are made on modifications to the system prior to future evaluation.
    Matched MeSH terms: Risk Management
  17. Dikshit A, Pradhan B, Alamri AM
    Sci Total Environ, 2021 Feb 10;755(Pt 2):142638.
    PMID: 33049536 DOI: 10.1016/j.scitotenv.2020.142638
    Drought forecasting with a long lead time is essential for early warning systems and risk management strategies. The use of machine learning algorithms has been proven to be beneficial in forecasting droughts. However, forecasting at long lead times remains a challenge due to the effects of climate change and the complexities involved in drought assessment. The rise of deep learning techniques can solve this issue, and the present work aims to use a stacked long short-term memory (LSTM) architecture to forecast a commonly used drought measure, namely, the Standard Precipitation Evaporation Index. The model was then applied to the New South Wales region of Australia, with hydrometeorological and climatic variables as predictors. The multivariate interpolated grid of the Climatic Research Unit was used to compute the index at monthly scales, with meteorological variables as predictors. The architecture was trained using data from the period of 1901-2000 and tested on data from the period of 2001-2018. The results were then forecasted at lead times ranging from 1 month to 12 months. The forecasted results were analysed in terms of drought characteristics, such as drought intensity, drought onset, spatial extent and number of drought months, to elucidate how these characteristics improve the understanding of drought forecasting. The drought intensity forecasting capability of the model used two statistical metrics, namely, the coefficient of determination (R2) and root-mean-square error. The variation in the number of drought months was examined using the threat score technique. The results of this study showed that the stacked LSTM model can forecast effectively at short-term and long-term lead times. Such findings will be essential for government agencies and can be further tested to understand the forecasting capability of the presented architecture at shorter temporal scales, which can range from days to weeks.
    Matched MeSH terms: Risk Management
  18. Zheyuan C, Rahman MA, Tao H, Liu Y, Pengxuan D, Yaseen ZM
    Work, 2021;68(3):825-834.
    PMID: 33612525 DOI: 10.3233/WOR-203416
    BACKGROUND: The increasing use of robotics in the work of co-workers poses some new problems in terms of occupational safety and health. In the workplace, industrial robots are being used increasingly. During operations such as repairs, unmanageable, adjustment, and set-up, robots can cause serious and fatal injuries to workers. Collaborative robotics recently plays a rising role in the manufacturing filed, warehouses, mining agriculture, and much more in modern industrial environments. This development advances with many benefits, like higher efficiency, increased productivity, and new challenges like new hazards and risks from the elimination of human and robotic barriers.

    OBJECTIVES: In this paper, the Advanced Human-Robot Collaboration Model (AHRCM) approach is to enhance the risk assessment and to make the workplace involving security robots. The robots use perception cameras and generate scene diagrams for semantic depictions of their environment. Furthermore, Artificial Intelligence (AI) and Information and Communication Technology (ICT) have utilized to develop a highly protected security robot based risk management system in the workplace.

    RESULTS: The experimental results show that the proposed AHRCM method achieves high performance in human-robot mutual adaption and reduce the risk.

    CONCLUSION: Through an experiment in the field of human subjects, demonstrated that policies based on the proposed model improved the efficiency of the human-robot team significantly compared with policies assuming complete human-robot adaptation.

    Matched MeSH terms: Risk Management
  19. Hasan H, Parker A, Pollard SJT
    Sci Total Environ, 2021 Feb 10;755(Pt 1):142868.
    PMID: 33348485 DOI: 10.1016/j.scitotenv.2020.142868
    We explore the interplay between preventative risk management and regulatory style for the implementation of water safety plans in Malaysia and in England and Wales, two jurisdictions with distinct philosophies of approach. Semi-structured interviews were conducted with 32 water safety professionals in Malaysia, 23 in England and Wales, supported by 6 Focus Group Discussions (n = 53 participants). A grounded theory approach produced insights on the transition from drinking water quality surveillance to preventative risk management. Themes familiar to this type of regulatory transition emerged, including concerns about compliance policy; overseeing the risk management controls of regulatees with varied competencies and funds available to drive change; and the portfolio of interventions suited to a more facilitative regulatory style. Because the potential harm from waterborne illness is high where pathogen exposures occur, the transition to risk-informed regulation demands mature organisational cultures among water utilities and regulators, and a laser-like focus on ensuring risk management controls are delivered within water supply systems.
    Matched MeSH terms: Risk Management
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