Littérature scientifique sur le sujet « Risk management – Germany – History »
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Articles de revues sur le sujet "Risk management – Germany – History"
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Geyer, Martin H. « “Gaps” and the (Re-)Invention of the FutureSocial and Demographic Policy in Germany during the 1970s and 1980s ». Social Science History 39, no 1 (2015) : 39–61. http://dx.doi.org/10.1017/ssh.2015.41.
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To argue that the future was (re-)invented in the 1970s and the 1980s might seem especially puzzling in light of arguments that the optimism associated with utilitarian, modernization, and socialist theories withered at the time amidst widespread debate over a variety of “crises.” Nonetheless, it was in this peculiar constellation that ideas of the future became fundamentally renegotiated. “New risks” were juxtaposed with prevailing older ideas of social security that were predicated on individual and collective risk management. Focusing on West Germany, this article examines the various technical and political debates over “gaps” in terms of the finances, demographics, and trust in the system of social policy, which helped to put technical and political diagnoses of “new risks” squarely on the political agenda. This demographic argument is of particular interest, as it dramatized the unintended side effects of older social policy and created new, dystopian future scenarios of total systemic breakdown. At times, however, these discussions about managing the risks associated with Germany's demographic future verged on the utopian. New concepts of governmentality and biopolitics prevailed in this context. Moreover, pragmatic and sometimes technocratic concepts of new “governance” (and thus risk management) were proposed by social scientists and politicians as a means to address anxieties about the demographic future, and new models of risk-taking and risk-managing individuals also flourished at the time. With their descriptive but also prescriptive features, these theories contributed to ongoing academic efforts to explain the present and the future in terms of risk.
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Schlich, Thomas. « Farmer to industrialist : Lister's antisepsis and the making of modern surgery in Germany ». Notes and Records of the Royal Society 67, no 3 (29 mai 2013) : 245–60. http://dx.doi.org/10.1098/rsnr.2013.0032.
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This paper analyses what is possibly the most important long-term impact of Joseph Lister's method of antisepsis on surgery, namely its role in replacing surgery's traditional regime of the management of chance by what can be called a regime of modern risk management. It was a crucial step for the expansion of surgery and thus the formation of modern surgery, as we know it today. It put surgery on a par with contemporary trends in industry, transport technologies and science, and made it a component factor in the formation of a modern technology-oriented society. The paper uses the example of the German-speaking countries, which, because of the rapid and emphatic acceptance of Lister's antisepsis there, is particularly well suited for such an analysis. It shows how, in this context, risk management, as a way of dealing with uncertainty, was an integral part of the new techniques of antisepsis and asepsis.
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Pohle, Monika, et Iain L. Fraser. « Risk, information and noise : risk perception and risk management of French and German banks during the nineteenth century ». Financial History Review 2, no 1 (avril 1995) : 25–39. http://dx.doi.org/10.1017/s0968565000001244.
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Kleinschmidt, Christian. « Comparative Consumer Product Testing in Germany ». Business History Review 84, no 1 (2010) : 105–24. http://dx.doi.org/10.1017/s0007680500001264.
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The introduction of comparative product testing in Germany reflected the rise of a mass consumer society within a rapidly changing market economy. The first proposal to establish a federally supported institute for product testing was made in 1957. Proponents wished to reduce the asymmetries of power and information between producers and consumers. Producers' initial opposition was overcome once federal legislation was passed and they recognized that the institute's work gave them an opportunity to use the test results in their corporate marketing and advertising strategies. By integrating state-regulated consumer protection into the social-market economy, the Stiftung Warentest, Germany's independent product-testing foundation, became an expression of both the emerging modern consumer society and the German corporatist model.
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Berghoff, Hartmut. « Varieties of Financialization ? Evidence from German Industry in the 1990s ». Business History Review 90, no 1 (2016) : 81–108. http://dx.doi.org/10.1017/s0007680516000039.
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Following some general remarks on the impact of financialization on nonfinancial sectors of the economy, this article identifies common misconceptions about the German and American varieties of capitalism. It then outlines the post-1960 U.S. experience with financialization, including the reasons for the rise of financialization and its main consequences. The article will then look at Germany, a country with a very different entry point into the world of financialization, and ask when and to what degree the concept was adopted. Finally, a detailed case study of Siemens—one of Germany's largest industrial concerns—will explore how this icon of Germany Inc. adapted to the demands of financialization and coped with the external changes caused by globalization, deregulation, and digitalization.
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Eberl, W., R. Knöfler, M. Olivieri, K. Kurnik et C. Bidlingmaier. « Haemostatic testing prior to elective surgery in children ? Not always ! » Hämostaseologie 29, no 01 (2009) : 64–67. http://dx.doi.org/10.1055/s-0037-1616942.
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SummaryIn Germany, preoperative coagulation tests are commonly used, based on the belief that these tests should identify patients with an increased bleeding risk. However, published evidence does not longer support this approach for both traditional screening tests and novel techniques of global assessment of haemostasis. Unselected screening yields many false positive results and detects irrelevant disorders. It leads to postponement of surgery, anxiety in parents and patients, and is not cost effective. Even worse, it does not reliably detect relevant bleeding disorders such as the most common coagulopathy, von Willebrand disease. The bleeding history of patients and their relatives is a more effective tool to detect patients at risk. According to international guidelines and a joint statement of different German medical societies, a standardized questionnaire should be mandatory in preoperative screening. A diagnostic pathway should be employed to identify patients in whom specific tests are helpful. Because neither laboratory tests nor questionnaires can infallibly predict or exclude perioperative bleeding, guidelines for the management of these unexpected situations have to be established.
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Painter, James. « Disaster, uncertainty, opportunity or risk ? Key messages from the television coverage of the IPCC’s 2013/2014 reports ». Mètode Revista de difusió de la investigació, no 6 (15 avril 2016) : 81. http://dx.doi.org/10.7203/metode.6.4179.
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This article examines the television coverage of the three 2013 and 2014 reports by the Working Groups of the IPCC in five European countries: Germany, Norway, Poland, Spain and the United Kingdom. The presence, salience and dominance of four frames (disaster, uncertainty, explicit risk and opportunity) were examined in each of the bulletins monitored. The «disaster» frame was the strongest of all the frames, measured by all three metrics. «Opportunity» was the next most present, followed by «uncertainty». Although the IPCC put considerable emphasis on a risk management approach to tackling climate change in its communication of the WG2 report, the «explicit risk» frame was hardly present. The UK stood out for including some coverage of sceptical viewpoints.
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Schmidt, M. E., J. Chang-Claude, T. Slanger, N. Obi, D. Flesch-Janys et K. Steindorf. « Physical Activity and Postmenopausal Breast Cancer ». Methods of Information in Medicine 48, no 05 (2009) : 444–50. http://dx.doi.org/10.3414/me9239.
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Summary Objectives: Epidemiological evidence suggests an inverse association between physical activity (PA) and postmenopausal breast cancer risk. Breast cancer is a heterogeneous disease, influenced by reproductive factors, lifestyle pattern, and predispositions. We investigated whether these risk factors modify the effect of PA on breast cancer risk. Methods: We analyzed data from 2004 hormone-receptor-positive postmenopausal breast cancer cases and 6569 controls from the population-based MARIE study conducted 2002–2005 in Germany. Interaction was statistically tested using adjusted unconditional logistic regression models. Results: The inverse association between leisure-time PA and risk of postmenopausal hormone-receptor-positive breast cancer was not heterogeneous by family history of breast cancer or by hormone therapy. PA showed a significant interaction with benign breast diseases (p = 0.023) and with breastfeeding (p = 0.045) but not with parity (p = 0.94), with clear risk reductions only for women who ever had breastfed or who ever had a benign breast disease (among ever breastfed: odds ratio = 0.63; 95% confidence interval = (0.52, 0.77), highest vs. lowest PA quartile). Interaction with BMI was weak (p = 0.053). Conclusions: Breastfeeding and benign breast diseases modified the effect of PA on postmenopausal breast cancer risk. If other studies find similar modifications, increasing knowledge about these risk factors may contribute to a better understanding of the mode of action of PA on breast cancer risk. For women who are at higher risk for breast cancer due to family history or due to hormone therapy use, it is encouraging that they might lower their risk by being physically active.
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Burhop, Carsten. « Pharmaceutical Research in Wilhelmine Germany : The Case of E. Merck ». Business History Review 83, no 3 (2009) : 475–503. http://dx.doi.org/10.1017/s000768050000297x.
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This paper offers a detailed case study of the emergence, organization, and development of research and development at E. Merck. During the 1890s, revolutionary changes in the scientific knowledge base, especially the rise of bacteriological research and the entry of dyestuff producers into the pharmaceuticals market, combined with the financial distress Merck was undergoing to force the firm to reorganize pharmaceutical research as a corporate strategy. Consequently, between 1895 and 1898, Merck restructured its in-house research, forming closer ties with universities and other outside inven- tors. Merck depended on these sources to generate new products, while relying on in-house scientists to improve productive efficiency. A spate of new products was launched between the late 1890s and 1905, but, in the following years, resource constraints restricted Merck's innovative capacity.
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Vos, Cora, Angélica Jaconi, Anna Jacobs et Axel Don. « Hot regions of labile and stable soil organic carbon in Germany – Spatial variability and driving factors ». SOIL 4, no 2 (6 juin 2018) : 153–67. http://dx.doi.org/10.5194/soil-4-153-2018.
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Abstract. Atmospheric carbon dioxide levels can be mitigated by sequestering carbon in the soil. Sequestration can be facilitated by agricultural management, but its influence is not the same on all soil carbon pools, as labile pools with a high turnover may be accumulated much faster but are also more vulnerable to losses. The aims of this study were to (1) assess how soil organic carbon (SOC) is distributed among SOC fractions on a national scale in Germany, (2) identify factors influencing this distribution and (3) identify regions with high vulnerability to SOC losses. The SOC content and proportion of two different SOC fractions were estimated for more than 2500 mineral topsoils (< 87 g kg−1 SOC) covering Germany, using near-infrared reflectance spectroscopy. Drivers of the spatial variability in SOC fractions were determined using the machine learning algorithm cforest. The SOC content and proportions of fractions were predicted with good accuracy (SOC content: R2 = 0.87–0.90; SOC proportions: R2 = 0.83; ratio of performance to deviation (RPD): 2.4–3.2). The main explanatory variables for the distribution of SOC among the fractions were soil texture, bulk soil C ∕ N ratio, total SOC content and pH. For some regions, the drivers were linked to the land-use history of the sites. Arable topsoils in central and southern Germany were found to contain the highest proportions and contents of stable SOC fractions, and therefore have the lowest vulnerability to SOC losses. North-western Germany contains an area of sandy soils with unusually high SOC contents and high proportions of light SOC fractions, which are commonly regarded as representing a labile carbon pool. This is true for the former peat soils in this area, which have already lost and are at high risk of losing high proportions of their SOC stocks. Those “black sands” can, however, also contain high amounts of stable SOC due to former heathland vegetation and need to be treated and discussed separately from non-black sand agricultural soils. Overall, it was estimated that, in large areas all over Germany, over 30 % of SOC is stored in easily mineralisable forms. Thus, SOC-conserving management of arable soils in these regions is of great importance.
Thèses sur le sujet "Risk management – Germany – History"
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Thieken, Annegret Henriette. « Floods, flood losses and flood risk management in Germany ». Thesis, Universität Potsdam, 2009. http://opus.kobv.de/ubp/volltexte/2009/2916/.
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Die vorliegende Habilitation beschäftigt sich mit verschiedenen Aspekten des Hochwasserrisikos in Deutschland. In zwölf Artikeln werden neue wissenschaftliche Erkenntnisse über Hochwassergefahren, über Faktoren, die Hochwasserschäden beeinflussen, sowie über effektive private Vorsorgemaßnahmen präsentiert.
So wird die jahreszeitliche Verteilung von Hochwasser in ganz Deutschland gezeigt. Weiterhin werden mögliche Auswirkungen des Klimawandels auf Abflussverhältnisse und Häufigkeiten von Hochwasserereignissen am Beispiel des Rhein-Einzugsgebietes abgeschätzt. Ferner wird am Niederrhein simuliert, welche Auswirkungen Deichbrüche haben können.
Hochwasserschäden stehen im zweiten Teil der Arbeit im Fokus: Nach dem August-Hochwasser 2002 wurden ca. 1700 Privathaushalte telefonisch befragt. Damit konnten die Einflüsse verschiedener Faktoren, wie der Überflutungsdauer oder der Verunreinigung des Hochwassers mit Öl, auf die Höhe von finanziellen Schäden quantifiziert werden. Daraus ist zum einen ein neues Modell entstanden, mit dem Hochwasserschäden großräumig berechnet werden können. Zum anderen konnten Hinweise für die Verbesserung der privaten Vorsorge abgeleitet werden. Beispielsweise zeigte sich, dass versicherte Haushalte schneller und besser entschädigt werden als Nicht-Versicherte. Ebenfalls wurde deutlich, dass verschiedene Bevölkerungsgruppen, wie Mieter und Hauseigentümer, unterschiedliche Möglichkeiten haben, Vorsorge zu betreiben. Dies ist zukünftig in der Risikokommunikation zu berücksichtigen.
In den Jahren 2005 und 2006 waren Elbe und Donau wiederum von Hochwasser betroffen. Eine erneute Befragung von Privathaushalten und Behörden ermöglichte, die Verbesserung des Hochwasserrisikomanagement und der Vorsorge am Beispiel der Stadt Dresden zu untersuchen.
Viele Methoden und Erkenntnisse dieser Arbeit sind in der wasserwirtschaftlichen Praxis anwendbar und tragen somit zur Verbesserung der Hochwasserrisikoanalyse und des Risikomanagements in Deutschland bei.This thesis deals with different aspects of flood risk in Germany. In twelve papers new scientific findings about flood hazards, factors that influence flood losses as well as effective private precautionary measures are presented. The seasonal distribution of flooding is shown for the whole of Germany. Furthermore, possible impacts of climate change on discharge and flood frequencies are estimated for the catchment of the river Rhine. Moreover, it is simulated at reaches of the Lower Rhine, which effects may result from levee breaches. Flood losses are the focus of the second part of the thesis: After the flood in August 2002 approximately 1700 households were interviewed by telephone. By this, it was possible to quantify the influence of different factors such as flood duration or the contamination of the flood water with oil on the extent of financial flood damage. On this basis, a new model was derived, by which flood losses can be calculated on a large scale. On the other hand, it was possible to derive recommendations for the improvement of private precaution. For example, the analysis revealed that insured households were compensated more quickly and to a better degree than uninsured. It became also clear that different groups like tenants and homeowners have different capabilities of performing precaution. This is to be considered in future risk communication. In 2005 and 2006, the rivers Elbe and Danube were again affected by flooding. A renewed pool among households and public authorities enabled us to investigate the improvement of flood risk management and the precaution in the City of Dresden. Several methods and finding of this thesis are applicable for water resources management issues and contribute to an improvement of flood risk analysis and management in Germany.
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Volkmann, Abigail J. « River Basin Management and Restoration in Germany and the United States : Two Case Studies ». Scholarship @ Claremont, 2013. http://scholarship.claremont.edu/scripps_theses/165.
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The uses and management of water resources play an important role in the development of a culture and the health of its environment and population. Humans throughout history have consistently exploited rivers, which degrades water quality and leads to water scarcity. This thesis is an examination of two river restoration projects, one on the Oder River in Germany and the other on the Klamath River in the United States, that represent each country's efforts to reverse river exploitation. These cases in Germany and the United States demonstrate the importance of achieving a better understanding of the political instruments and strategies for mitigating environmental issues on a global scale.
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Kosater, Peter. « Application of non-linear time series models to power risk management a case study for Germany / ». [S.l.] : [s.n.], 2007. http://kups.ub.uni-koeln.de/volltexte/2007/2032.
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Töppel, Jannick [Verfasser], et Hans Ulrich [Akademischer Betreuer] Buhl. « Risk and Return Management for the Heat Transition in Germany / Jannick Töppel ; Betreuer : Hans Ulrich Buhl ». Augsburg : Universität Augsburg, 2020. http://d-nb.info/1221524917/34.
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Wang, Lingling. « CEO employment history and risk-taking in firm policies ». unrestricted, 2009. http://etd.gsu.edu/theses/available/etd-04292009-150418/.
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Thesis (Ph. D.)--Georgia State University, 2009.Title from file title page. Harley E. Ryan, committee chair; Conrad Ciccotello, Omesh Kini, Jayant Kale, committee members. Description based on contents viewed July 1, 2009. Includes bibliographical references (p. 72-74).
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Löbler, Helge. « Innovatives Risikoverhalten im Ost-West-Vergleich ». Universitätsbibliothek Leipzig, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-218192.
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Seit Ende der sechziger Jahre wird mit unterschiedlicher Intensität auf die Innovationskrise und auf den Rückgang der Investitionstätigkeit deutscher Unternehmen hingewiesen. Zur Zeit wird dieses Thema vor allem im Zusammenhang mit der abnehmenden Wettbewerbsfähigkeit
der deutschen Unternehmen im internationalen Vergleich wieder intensiv diskutiert. Mangelnde Innovationen und daraus resultierende Investitionslücken führen danach nicht nur zu einem verringerten Wirtschaftswachstum, sondern erschweren darüber hinaus auch den
noch immer nicht vollständig bewältigten Strukturwandel. Dabei scheinen Innovationen und Investitionen auch für die neuen Bundesländer von besonderer Bedeutung zu sein, wenn sie ihren Anschluß an die internationale Wettbewerbssituation bewältigen wollen. Die vorliegende Untersuchung fragt auf der Basis des Risk-/Return-
Paradoxon, ob sich das Innovationsverhalten in den neuen Bundesländern von dem in den alten Bundesländern unterscheidet.
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Begg, Chloe. « Power, responsibility and justice : practices of local stakeholder participation in flood risk management in England and Germany ». Thesis, Lancaster University, 2018. http://eprints.lancs.ac.uk/126315/.
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Over the past few decades there has been an increasing interest in the active involvement of local stakeholders in the management of floods in Europe. Such involvement is seen as necessary as the management of floods becomes more complex. Management approaches now seek to include a range of potential measures to reduce risk in addition to structural defence measures (e.g. spatial planning, emergency management, property-level protection measures, etc.). Local stakeholder involvement is seen to be important because governments lack resources, both human and financial, required to deliver all these measures alone. This thesis draws on a range of literature, concepts, theories as well as qualitative and quantitative data collected in England and Germany to discuss the implications that participative approaches have on the fairness of European flood risk management (FRM). As a result, the studies included in this thesis each provide a specific approach to understanding the role of local stakeholder participation in European FRM but taken together provide a rich and multi-sited contribution to current discussions and debates about environmental justice. Studies of environmental justice are interested in who is included and excluded from decisions related to the distribution of environmental goods (resources) and bads (risks). It is argued that fair decision-making processes arise when power is equally distributed between all (potential) participants (procedural justice). It is also argued that just procedures can lead to fairer distributions in resources and risks (distributional justice). This thesis highlights the difficulties of achieving such justice in practice. I that participation in practice generally focuses on transferring responsibility to the local level at the expense of power at the local level. In addition, resources are distributed in such a way as to create and strengthen vulnerabilities related to flood risk. It is concluded that if European FRM is to become more just, investments need to be made to ensure that those who are made responsible for FRM (who are often also the most vulnerable to flood impact) accept that responsibility and have the resources required to fulfil that responsibility.
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Werner, Stephan D. « Endogenous risk in non-life insurance : evidence from the German insurance sector during the Interwar period ». Thesis, London School of Economics and Political Science (University of London), 2016. http://etheses.lse.ac.uk/3269/.
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Motivated by the recent 2007/2008 Financial Crisis, this dissertation identifies endogenous risk in the German insurance sector during the Interwar sector. In the context of principal agent theory, endogenous risk is the result of a company reacting to shocks that are generated and amplified within the financial system by shifting risk from shareholders to policyholders. This dissertation provides analytical support for this interdependence on the basis of established financial as well as actuarial models and assumptions. The empirical analysis considers the German insurance sector during the Interwar period due to the presence of a pronounced business cycle, the absence of exogenous low-probability high-cost events, a consistent regulatory framework as well as available quantitative data. The econometric analysis is based on four newly compiled datasets that collect the 1924 gold account opening balances, company- as well as line-specific financial information, and stock price quotations for all publicly traded German insurance companies during the Interwar period. The dissertation finds that during the Interwar period in the German insurance sector (Ch.2), the risk of getting discontinued prior to default (3) led companies to cater dividend payout (Ch.4) and reinsurance operations (Ch.5) to an optimistic investor clientele (Ch.6), yet in contrast to the underwriting cycle (Ch.7).
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Morgan, John Francis William. « The natural history of professionalisation and its relevance to differences in valuation methodology and practice in the United Kingdom and Germany ». Thesis, University of Reading, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265178.
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Younas, Zahid Irshad [Verfasser]. « Impact of ownership concentration and corporate governance on sustainability and stakeholder risk : An empirical Analysis of listed firms from USA, UK and Germany / Zahid Irshad Younas ». Kassel : Universitätsbibliothek Kassel, 2017. http://d-nb.info/1154973026/34.
Texte intégralLivres sur le sujet "Risk management – Germany – History"
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Bangert, Michael. Zinsrisiko-Management in Banken. Wiesbaden : Gabler, 1987.
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Taylor, Wayne. The church at risk : [the miraculous story of Adventist Risk Management]. Silver Spring, Md : Adventist Risk Management, 2004.
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Financial risk management : models, history, and institution : Models, history, and institution. Hoboken, N.J : Wiley, 2011.
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Risk management for Islamic banks. Edinburgh : Edinburgh University Press, 2013.
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Ultimate risk. London : Bantam Press, 1994.
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Ultimate risk. London : Corgi, 1995.
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Finanzwirtschaftliches Risikomanagement in Nichtbanken : Eine konzeptionelle Analyse unter Berücksichtigung innovativer Instrumente. Frankfurt am Main : Lang, 1993.
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Fiege, Stefanie. Risikomanagement- und Überwachungssystem nach KonTraG : Prozess, Instrumente, Träger. Wiesbaden : Deutscher Universitäts-Verlag, 2006.
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Dangerous commerce : Insurance and the management of international risk. Ithaca : Cornell University Press, 1997.
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G, Longenecker Julia, dir. Avoiding archaeological disasters : A risk management approach. Walnut Creek, CA : Left Coast Press, 2009.
Trouver le texte intégralChapitres de livres sur le sujet "Risk management – Germany – History"
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Krempel, Stephan. « Medical Law Aspects : Germany ». Dans Risk Management in Medicine, 113–15. Berlin, Heidelberg : Springer Berlin Heidelberg, 2016. http://dx.doi.org/10.1007/978-3-662-47407-5_15.
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Szylar, Christian. « Risk Management History ». Dans Risk Management under UCITS III/IV, 33–62. Hoboken, NJ USA : John Wiley & Sons, Inc., 2013. http://dx.doi.org/10.1002/9781118557709.ch2.
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Becker, Matilda. « Legal geography and flood risk management in Germany ». Dans Flood Risk Management, 17–29. New York, NY : Routledge, 2019. : Routledge, 2019. http://dx.doi.org/10.4324/9781351010009-2.
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Rybak, Christian, et A. Moroder. « Hospital Law in Germany and Europe ». Dans Risk Management in Medicine, 117–23. Berlin, Heidelberg : Springer Berlin Heidelberg, 2016. http://dx.doi.org/10.1007/978-3-662-47407-5_16.
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Weber, Jürgen, et Arnim Liekweg. « Statutory Regulation of the Risk-Management Function in Germany : Implementation Issues for the Non-Financial Sector ». Dans Risk Management, 277–94. Berlin, Heidelberg : Springer Berlin Heidelberg, 2000. http://dx.doi.org/10.1007/978-3-662-04008-9_16.
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Smith, Denis, et Jo McCloskey. « History Repeating Itself ? » Dans Risk Management and Society, 101–24. Dordrecht : Springer Netherlands, 2000. http://dx.doi.org/10.1007/978-94-017-2913-0_5.
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Kloman, H. Felix. « A Brief History of Risk Management ». Dans Enterprise Risk Management, 19–29. Hoboken, NJ, USA : John Wiley & Sons, Inc., 2011. http://dx.doi.org/10.1002/9781118267080.ch2.
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Nestle, Ursula, et Peter Lukas. « Risk Management in Radiation Medicine : Administrative, Legal and Ethical Aspects of Research in Radiation Medicine in Germany ». Dans Sustainable Risk Management, 183–85. Cham : Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-66233-6_16.
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Britzelmaier, Bernd, Susanne Schmidtmeier, Carolin Weidler et Chiara Crovini. « Exploring SMEs’ Risk Management in Southern Germany ». Dans Palgrave Studies in Cross-disciplinary Business Research, In Association with EuroMed Academy of Business, 15–42. Cham : Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-45831-7_2.
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Bauman, Eric H., et Ortwin Renn. « A Comparative Analysis of Air Pollution Standard-Setting and Regulatory Procedures in the United States and West Germany ». Dans Risk Assessment and Management, 727–34. Boston, MA : Springer US, 1987. http://dx.doi.org/10.1007/978-1-4757-6443-7_71.
Texte intégralActes de conférences sur le sujet "Risk management – Germany – History"
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Jakubick, Alexander T., et Manfred Hagen. « Environmental Risk and Costs/Benefits of the WISMUT Remediation ». Dans ASME 2003 9th International Conference on Radioactive Waste Management and Environmental Remediation. ASMEDC, 2003. http://dx.doi.org/10.1115/icem2003-4982.
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The Uranium mining and milling activities in Eastern Germany before reunification produced more than 232 000 t of U. Following reunification, £ 6.6 billion were committed to remediation of the left behind liabilities. The inventory of the liabilities comprises operations areas (37 km2), waste rock dumps (311 M m3), tailings (160 M m3), an open pit (84 M m3) and five large underground mines (1.53 M m3). The specific activities are 0.5 to 1 Bq/g for the waste rock, 10 Bq/g for the tailings, up to 500 Bq/g for the water treatment residues and 0.2 to 1 Bq/g for scrap metal. The remediation of the risk associated with this inventory is carried out by WISMUT GmbH. The legal framework of the remediation is set by the Federal Mining Act, the Atomic Act, the Radiation Protection Ordinance and the Water Resources Management Act. The large number and variety of objects that release contaminants at very different rates require, remedial measures to be planned and optimized in an integral way for each site. The integration is done on the basis of Conceptual Site Models (CSM). The CSM helps to balance among the objects the remedial effort, the allocation of resources and allows to flexibly adapt remedial measures to the site/object-specific conditions while maintaining conceptual consistency and focus on the overall remediation goals without compromising essential details. The remediation necessity of individual objects or areas is investigated, justified and the type of remedial measures selected on the basis of Remedial Investigation/Feasibility Studies (RI/FS). In the RI/FS the calculated individual effective dose to the public caused by the object/area in the nonremediated and remediated state is compared with the reference level of 1 mSv per year. Based on RI/FS contaminated areas are remediated either for unrestricted or for restricted use. Waste rock piles are remediated by covering in situ, by relocation and/or by backfilling into an open pit. Currently, approximately 40,000 tons of waste rock are backfilled into a pit per day. Backfilling follows a geochemically optimized placement procedure. In cases where the remediation object was judged vulnerable, remediation was supported by risk assessment. A probabilistic risk assessment was used to justify the dry remediation of the tailings ponds. Technically, the most challenging part of dry tailings remediation is the stabilization of the soft, under-consolidated slimes having a high excess pore water pressure and very low shear strengths. Because total cleanup and relocation of contaminants are not always feasible, the remediation is commonly done by covering of the contaminated object or area, i.e. by confinement. The covers used are either barrier covers that limit infiltration by having a low permeability layer incorporated or an evaporative cover which maximizes infiltration storage till it is removed by evapotranspiration. The largest sources of contaminant release are the discharges from flooded mines and from dewatering of the tailings ponds. Discharge rates vary from 30 m3/h to 1000 m3/h. Because the contaminants load in the discharging mine water decreases with time causing the conventional water treatment to become uneconomic, various alternative water treatment technologies are tested at WISMUT to identify suitable and cost efficient replacement options. Considerable amounts of contaminated debris and scrap metals arise from decommissioning and demolition of the structures. The aim is to categorize and recycle the uncontaminated portion of the scrap metal. The categorization of the scrap metal into contaminated and uncontaminated is by measuring the beta-count rate in the field. To improve the selectivity of the field monitors, specially prepared standards reflecting the operational history of the metal at the particular site are used to calibrate the instruments. Approximately £ 3.9 billion were invested into the remediation by end of 2002. A rough calculation of the specific costs of WISMUT remediation when using re-assessed total costs turned out to be approximately £ 22.6 per kg of U3O8 produced. Considering that this sum includes the indirect costs, the specific remediation costs appear in an international comparison very reasonable.
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Teetes, George, Matt Koziol et Norman Perez. « Risk Management on Water Infrastructure Tunnel Projects—DC Clean Rivers Project Case History ». Dans Geo-Risk 2017. Reston, VA : American Society of Civil Engineers, 2017. http://dx.doi.org/10.1061/9780784480724.035.
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« REAL ESTATE PORTFOLIO RISK MANAGEMENT PRACTICES OF INSTITUTIONAL INVESTORS IN GERMANY : A SURVEY ». Dans 2006 European Real Estate Society conference in association with the International Real Estate Society : ERES Conference 2006. ERES, 2006. http://dx.doi.org/10.15396/eres2006_309.
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Jiang, Hsinyi, Carl K. Chang, Jinchun Xia et Shuxing Cheng. « A History-Based Automatic Scheduling Model for Personnel Risk Management ». Dans 31st Annual International Computer Software and Applications Conference - Vol. 2 - (COMPSAC 2007). IEEE, 2007. http://dx.doi.org/10.1109/compsac.2007.25.
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Korder, Svenja, Dominik Breuherr et Gunther Reinhart. « Towards a Work-Related Turnover Risk Management in Manufacturing SMEs ». Dans 8th International Conference on Human Interaction and Emerging Technologies. AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1002797.
Texte intégralRésumé :
The shortage of skilled workers in Germany caused by demographic change steadily increases. In the manufacturing sector, this situation leads to difficulties filling vacant positions and thus to extended vacancy periods of jobs in companies. Therefore, the turnover of skilled workers becomes a problem, especially in small and medium-sized manufacturing enterprises, as individual positions are not filled redundantly. High costs due to temporary workers or the rejection of orders can be the consequences. Turnover research has been conducted for a long time, but there is a lack of a standardized method to capture the turnover risk of skilled workers. This paper presents an approach for the systematic assessment of turnover risk in manufacturing work. The method is based on an employee survey. The results are transferred into a risk matrix in order to derive the level of risk for work-related turnover of individual employees. To ensure a cost-, personnel- and time-efficient implementation in the operations of SMEs, the method will be transferred into a software application. In this way, the turnover risk can be made transparent. The user can select specific measures evaluated according to manufacturing-specific performance indicators. These measures should help SMEs prevent the turnover of critical specialists and avoid high costs caused by long vacancy periods of jobs.
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Zevenbergen, C., J. Rijke, S. van, L. Chelleri et P. J. T. M. Bloemen. « Towards an adaptive, flood risk management strategy in The Netherlands : An overview of recent history* ». Dans The International Conference On Fluvial Hydraulics (River Flow 2016). Taylor & Francis Group, 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742 : CRC Press, 2016. http://dx.doi.org/10.1201/9781315644479-310.
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Lange, Jörg, et Thilo Feucht. « 3-D-Printing with Steel : Additive Manufacturing of Connection Elements and Beam Reinforcements ». Dans IABSE Symposium, Guimarães 2019 : Towards a Resilient Built Environment Risk and Asset Management. Zurich, Switzerland : International Association for Bridge and Structural Engineering (IABSE), 2019. http://dx.doi.org/10.2749/guimaraes.2019.1836.
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<p>Automated steel construction manufacturing with robots is no longer just a dream of the future but a reality. The Institute for Steel Structures and Materials Mechanics of the Technical University (TU) of Darmstadt/Germany has two welding robots. These robots are being used to assess various application for Additive Manufacturing. For the construction of steel, Wire + Arc Additive Manufacturing (WAAM) is suitable, which is similar to Gas-Shielded Metal Arc Welding. The wire electrode serves as printing material. With this method we can produce components in layers and achieve deposition rates of 5 kg/h. The components studied in this research project are connection elements such as simply supported girder connections and head plates and reinforcing elements such as stiffeners and beam reinforcements. In this paper topology-optimized structures are presented, which can be printed with the WAAM directly on steel beams.</p>
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Hiemer, Florian, Sylvia Keßler et Christoph Gehlen. « Retrofitted corrosion monitoring in cracked concrete of infrastructure buildings ». Dans IABSE Symposium, Guimarães 2019 : Towards a Resilient Built Environment Risk and Asset Management. Zurich, Switzerland : International Association for Bridge and Structural Engineering (IABSE), 2019. http://dx.doi.org/10.2749/guimaraes.2019.1386.
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<p>Infrastructural buildings are subject to a high risk of reinforcement corrosion resulting from de- icing salts. A lot of effort is put in the design of these buildings in order to minimize this risk and ensure the durability during their service life. However, the evaluation of the effectiveness of these measures as well as the resulting corrosion state is an essential but critical part in the assessment of the structural condition. Therefore a versatile corrosion monitoring system was developed, which can be retrofitted in structures which are subject to a certain corrosion risk. In a first case study this monitoring system was installed in two parking structures in southern Germany which were subject to cracks in the concrete cover, combined with a chloride exposure during winter periods. All basic electrochemical parameters of reinforcement corrosion could be measured allowing for an evaluation of the corrosion development before and after the coating measure. The principle of the monitoring system proved to be an effective tool and can be used in a wide range of structures (bridges, parking garages etc.).</p>
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Chorney, Terris, et Denise Hamsher. « The Evolution of Risk Management at Enbridge Pipelines ». Dans 2000 3rd International Pipeline Conference. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/ipc2000-100.
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1999 marks an important anniversary for Enbridge Pipelines Inc. of Canada and its U.S.-based affiliate, the Lakehead Pipe Line Company Ltd.: for 50 years we have been the primary link between the large oil production areas of western Canada and major market hubs in the U.S. midwest and eastern Canada. In retrospect, this strong history of success is chiefly due to thorough and logical planning and choice selection in all aspects of company endeavors. At Enbridge, as in countless other firms in a wide-range of industries, decision making was often the product of expert consensus and years of solid experience in dealing with similar situations. This approach has worked well for Enbridge and our stakeholders for five decades, as evidenced by the reliability, efficiency, and safety record of our pipeline system. However, as the millenium nears, we are increasingly finding formalized processes that integrate quantitative models and qualitative analysis helpful in planning and execution for both the short- and long-term. Several broad trends at the root of this movement include the heightened pace of change; the increasingly complex web of relevant factors; the growing magnitude of the consequences associated with sub-optimal decisions; the need for thorough documentation; and the apparent benefits of a framework that enables objectivity and consistency. In short, an approach that completely and systematically evaluates the multitude of dynamic factors that affect the ultimate outcome of the matter at issue is necessary. Although the term “risk management” is now often used to describe this process, Enbridge — along with many other responsible firms in the pipeline operating and other industries — has always practiced the underlying principles. This paper addresses the background of “risk management” in both the Canadian and U.S. pipeline industry, as well as accepted theory. It also encompasses the progression of risk management at Enbridge Pipelines, up to and including current initiatives. The usefulness of risk analysis, risk assessment, and risk management tools will be discussed, along with the overriding necessity of a well thought-out process, firm corporate commitment, and qualified expertise. Much of the focus will address the ongoing evolution and maturity of a comprehensive and well-integrated risk management program within the Enbridge North American business units. The criticality of maintaining focus on the core business function — in this case, pipeline operations — will also be addressed. In addition, past learning’s as well as future opportunities and challenges will be reviewed.
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Porter, Michael, Rodolfo Reale, Gabriel Marcuz et K. Wayne Savigny. « Geohazard Risk Management for the Nor Andino Gas Pipeline ». Dans 2006 International Pipeline Conference. ASMEDC, 2006. http://dx.doi.org/10.1115/ipc2006-10208.
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A 1,050 km long 20” pipeline was constructed to transport natural gas from northern Argentina to the coast of Chile. On the Argentine side, significant portions of the route traverse rugged mountainous terrain subject to landslides, debris flows, flash floods, and earthquakes. On the Chilean side (situated up to 5,000 m above sea level), the pipeline crosses active faults and terminates at locations historically subject to tsunami. The pipeline began operation in 1999. An outburst flood in a steep mountain stream caused the pipeline to rupture in 2001. Reactivation of a large rock slide in 2002 caused a second rupture. It appeared that the original design had underestimated the route’s exposure to geohazards, and efforts were required to improve pipeline safety and reliability. A geohazard risk management program was initiated in April 2002. Geohazards were identified and characterized through airphoto interpretation and field inspection. Sites were initially ranked using semi-quantitative risk estimates. Risk cost-benefit analyses were used to select optimal risk control measures at high ranking geohazard sites. These included monitoring programs, reconstruction of stream crossings, reroutes, and in one instance, landslide avoidance using a horizontal directional drill. Risk control measures were implemented between 2002 and 2006, and additional efforts are ongoing. An updated assessment of geohazard exposure was completed in 2005 with the objective of quantifying the level of risk reduction that had been achieved and prioritizing further risk reduction efforts. This paper describes implementation of the geohazard risk management program using a case history format. It highlights the techniques used to control the range of hazard that were identified in 2002 and to quantify the improvements achieved by 2006. The paper concludes with an overview of additional risk reduction initiatives that are in progress or under consideration.
Rapports d'organisations sur le sujet "Risk management – Germany – History"
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Bourrier, Mathilde, Michael Deml et Farnaz Mahdavian. Comparative report of the COVID-19 Pandemic Responses in Norway, Sweden, Germany, Switzerland and the United Kingdom. University of Stavanger, novembre 2022. http://dx.doi.org/10.31265/usps.254.
Texte intégralRésumé :
The purpose of this report is to compare the risk communication strategies and public health mitigation measures implemented by Germany, Norway, Sweden, Switzerland, and the United Kingdom (UK) in 2020 in response to the COVID-19 pandemic based on publicly available documents. The report compares the country responses both in relation to one another and to the recommendations and guidance of the World Health Organization where available. The comparative report is an output of Work Package 1 from the research project PAN-FIGHT (Fighting pandemics with enhanced risk communication: Messages, compliance and vulnerability during the COVID-19 outbreak), which is financially supported by the Norwegian Research Council's extraordinary programme for corona research. PAN-FIGHT adopts a comparative approach which follows a “most different systems” variation as a logic of comparison guiding the research (Przeworski & Teune, 1970). The countries in this study include two EU member States (Sweden, Germany), one which was engaged in an exit process from the EU membership (the UK), and two non-European Union states, but both members of the European Free Trade Association (EFTA): Norway and Switzerland. Furthermore, Germany and Switzerland govern by the Continental European Federal administrative model, with a relatively weak central bureaucracy and strong subnational, decentralised institutions. Norway and Sweden adhere to the Scandinavian model—a unitary but fairly decentralised system with power bestowed to the local authorities. The United Kingdom applies the Anglo-Saxon model, characterized by New Public Management (NPM) and decentralised managerial practices (Einhorn & Logue, 2003; Kuhlmann & Wollmann, 2014; Petridou et al., 2019). In total, PAN-FIGHT is comprised of 5 Work Packages (WPs), which are research-, recommendation-, and practice-oriented. The WPs seek to respond to the following research questions and accomplish the following: WP1: What are the characteristics of governmental and public health authorities’ risk communication strategies in five European countries, both in comparison to each other and in relation to the official strategies proposed by WHO? WP2: To what extent and how does the general public’s understanding, induced by national risk communication, vary across five countries, in relation to factors such as social capital, age, gender, socio-economic status and household composition? WP3: Based on data generated in WP1 and WP2, what is the significance of being male or female in terms of individual susceptibility to risk communication and subsequent vulnerability during the COVID-19 outbreak? WP4: Based on insight and knowledge generated in WPs 1 and 2, what recommendations can we offer national and local governments and health institutions on enhancing their risk communication strategies to curb pandemic outbreaks? WP5: Enhance health risk communication strategies across five European countries based upon the knowledge and recommendations generated by WPs 1-4. Pre-pandemic preparedness characteristics All five countries had pandemic plans developed prior to 2020, which generally were specific to influenza pandemics but not to coronaviruses. All plans had been updated following the H1N1 pandemic (2009-2010). During the SARS (2003) and MERS (2012) outbreaks, both of which are coronaviruses, all five countries experienced few cases, with notably smaller impacts than the H1N1 epidemic (2009-2010). The UK had conducted several exercises (Exercise Cygnet in 2016, Exercise Cygnus in 2016, and Exercise Iris in 2018) to check their preparedness plans; the reports from these exercises concluded that there were gaps in preparedness for epidemic outbreaks. Germany also simulated an influenza pandemic exercise in 2007 called LÜKEX 07, to train cross-state and cross-department crisis management (Bundesanstalt Technisches Hilfswerk, 2007). In 2017 within the context of the G20, Germany ran a health emergency simulation exercise with WHO and World Bank representatives to prepare for potential future pandemics (Federal Ministry of Health et al., 2017). Prior to COVID-19, only the UK had expert groups, notably the Scientific Advisory Group for Emergencies (SAGE), that was tasked with providing advice during emergencies. It had been used in previous emergency events (not exclusively limited to health). In contrast, none of the other countries had a similar expert advisory group in place prior to the pandemic. COVID-19 waves in 2020 All five countries experienced two waves of infection in 2020. The first wave occurred during the first half of the year and peaked after March 2020. The second wave arrived during the final quarter. Norway consistently had the lowest number of SARS-CoV-2 infections per million. Germany’s counts were neither the lowest nor the highest. Sweden, Switzerland and the UK alternated in having the highest numbers per million throughout 2020. Implementation of measures to control the spread of infection In Germany, Switzerland and the UK, health policy is the responsibility of regional states, (Länders, cantons and nations, respectively). However, there was a strong initial centralized response in all five countries to mitigate the spread of infection. Later on, country responses varied in the degree to which they were centralized or decentralized. Risk communication In all countries, a large variety of communication channels were used (press briefings, websites, social media, interviews). Digital communication channels were used extensively. Artificial intelligence was used, for example chatbots and decision support systems. Dashboards were used to provide access to and communicate data.
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Lucas, Brian. Urban Flood Risks, Impacts, and Management in Nigeria. Institute of Development Studies (IDS), janvier 2021. http://dx.doi.org/10.19088/k4d.2021.018.
Texte intégralRésumé :
This summary reviews evidence on the urban flooding impact, risk factors, and management and mitigation measures in Lagos and other cities in Nigeria. Flooding is a common problem every year in many cities across Nigeria, but the impacts of flooding are poorly documented. There is no consistent set of statistics at a national or sub-national level that can be used to compare the impacts of flooding across cities, and reports that focus on particular flood events are often incomplete. The literature notes the principal factors contributing to flood risk including uncontrolled urban growth, inadequate and poorly-maintained drainage systems, solid waste management practices, weakness in institutional capacity and coordination, and warning systems and public awareness. The evidence base for flood impacts, risks, and mitigation efforts at the city level in Nigeria is limited, and much of the information available is low quality, inconsistent, or outdated. Many rely on surveys of city residents rather than objective empirical data, and some of these surveys appear to be poorly designed. A significant number of the academic publications available have been published in non-mainstream journals without the usual level of academic peer review. Recent information is scarce, and a significant amount of the available evidence dates from 2011 and 2012, which coincides with an episode of nationwide flooding that was among the worst in Nigeria’s history.
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Sett, Dominic, Christina Widjaja, Patrick Sanady, Angelica Greco, Neysa Setiadi, Saut Sagala, Cut Sri Rozanna et Simone Sandholz. Hazards, Exposure and Vulnerability in Indonesia : A risk assessment across regions and provinces to inform the development of an Adaptive Social Protection Road Map. United Nations University - Institute for Environment and Human Security, mars 2022. http://dx.doi.org/10.53324/uvrd1447.
Texte intégralRésumé :
Risk induced by natural hazards and climate change has been accelerating worldwide, leading to adverse impacts on communities' well-being. Dealing with this risk is increasingly complex and requires cross-sectoral action. Adaptive Social Protection (ASP) has emerged as a promising approach to strengthen the resilience of communities by integrating Social Protection (SP), Disaster Risk Management (DRM) and Climate Change Adaptation (CCA) efforts. To inform this integration and thereby support the development of a functional ASP approach, the identification and provision of relevant data and information are vital. In this context, risk assessments are crucial as they establish the groundwork for the design of effective ASP interventions. However, despite the importance of risk information for ASP and the abundance of sectoral assessments, there is not yet a comprehensive risk assessment approach, a reality that also applies to Indonesia. Although the country is one of the international pioneers of the concept and has enshrined ASP at the highest national level in its development plans, this emphasis in policy and practice has been hampered by the absence of more unified assessment methods. The Hazard, Exposure and Vulnerability Assessment (HEVA) presented here takes a unique approach to develop such a cross-sectoral risk assessment and apply it throughout Indonesia. The HEVA brings together different risk understandings of key actors both internationally and domestically within SP, DRM and CCA, as well as identifying commonalities across sectors to establish a joint understanding. The HEVA not only considers risk as an overarching outcome but also focuses on its drivers, i.e. hazards, exposure and vulnerability, to identify why specific communities are at risk and thus customize ASP interventions. Subsequently, risks are assessed for Indonesia’s regions and provinces based on this cross-sectoral risk understanding. Secondary data has been acquired from various existing sectoral assessments conducted in Indonesia, and in total, data for 44 indicators has been compiled to calculate hazard, exposure and vulnerability levels for all 34 Indonesian provinces. Findings of the HEVA suggest that overall risk is high in Indonesia and no single province can be characterized as a low-risk area, demonstrating a strong relevance for ASP throughout the whole of the country. Papua, Maluku, and Central Sulawesi were identified as provinces with the highest overall risk in Indonesia. However, even Yogyakarta, which was identified as a comparatively low-risk province, still ranks among the ten most hazard-prone provinces in the country and has a demonstrated history of severe impact events. This also underlines that the composition of risk based on the interplay of hazard, exposure and vulnerability differs significantly among provinces. For example, in Papua and West Papua, vulnerability ranks as the highest in Indonesia, while hazard and exposure levels are comparatively low. In contrast, East Java and Central Java are among the highest hazard-prone provinces, while exposure and vulnerability are comparatively low. The results provide much more comprehensive insight than individual sectoral analyses can offer, facilitating the strategic development and implementation of targeted ASP interventions that address the respective key risk components. Based on lessons learned from the development and application of the HEVA approach, as well as from the retrieved results, the report provides recommendations relevant for policymakers, practitioners and researchers. First, recommendations regarding risk assessments for ASP are given, emphasizing the need to bring together sectoral understandings and to consider the interconnection of hazards, exposure and vulnerability, including their drivers and root causes, to assess current and future risk. It is also recommended to complement national level assessments with more specific local assessments. Secondly, recommendations regarding ASP option development in general are provided, including the importance of considering side effects of interventions, root causes of risks, the potential of nature-based solutions and barriers to implementation due to local capacities when designing ASP interventions. Third, recommendations regarding focal areas for ASP programmes are outlined for the case of Indonesia, such as prioritizing interventions in risk hotspots and areas characterized by high readiness for ASP solutions. At the same time, it is vital to leave no region behind as all provinces face risks that potentially jeopardize communities’ well-being.
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Narvaez, Liliana, Sally Janzen, Caitlyn Eberle et Zita Sebesvari. Technical Report : Taiwan drought. United Nations University - Institute for Environment and Human Security (UNU-EHS), août 2022. http://dx.doi.org/10.53324/ujzw5639.
Texte intégralRésumé :
During the 2020-2021 typhoon season, for the first time in 56 years, no typhoon made landfall on Taiwan, leading to one of the worst droughts in the island’s history. As reservoirs fell below 5% capacity, more than one million households and businesses had to ration water. This water rationing was not without controversy, especially for the island’s most water-intensive industries: rice farming and semiconductor manufacturing. Taiwan’s case exemplifies the challenges of water stress and related risk across value chains that could emerge as a result. It also shows stark choices that governments and authorities may have to face in rationing water resources. Water management in a changing climate is incredibly important to ensure the life, health and prosperity of people and ecosystems on our planet.This technical background report for the 2021/2022 edition of the Interconnected Disaster Risks report analyses the root causes, drivers, impacts and potential solutions for the Taiwan drought through a forensic analysis of academic literature, media articles and expert interviews.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust et Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations : Investigating effectiveness and screening program implementation considerations : An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, octobre 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Dodd, Hope, David Peitz, Gareth Rowell, Janice Hinsey, David Bowles, Lloyd Morrison, Michael DeBacker, Jennifer Haack-Gaynor et Jefrey Williams. Protocol for Monitoring Fish Communities in Small Streams in the Heartland Inventory and Monitoring Network. National Park Service, avril 2021. http://dx.doi.org/10.36967/nrr-2284726.
Texte intégralRésumé :
Fish communities are an important component of aquatic systems and are good bioindicators of ecosystem health. Land use changes in the Midwest have caused sedimentation, erosion, and nutrient loading that degrades and fragments habitat and impairs water quality. Because most small wadeable streams in the Heartland Inventory and Monitoring Network (HTLN) have a relatively small area of their watersheds located within park boundaries, these streams are at risk of degradation due to adjacent land use practices and other anthropogenic disturbances. Shifts in the physical and chemical properties of aquatic systems have a dramatic effect on the biotic community. The federally endangered Topeka shiner (Notropis topeka) and other native fishes have declined in population size due to habitat degradation and fragmentation in Midwest streams. By protecting portions of streams on publicly owned lands, national parks may offer refuges for threatened or endangered species and species of conservation concern, as well as other native species. This protocol describes the background, history, justification, methodology, data analysis and data management for long-term fish community monitoring of wadeable streams within nine HTLN parks: Effigy Mounds National Monument (EFMO), George Washington Carver National Monument (GWCA), Herbert Hoover National Historic Site (HEHO), Homestead National Monument of America (HOME), Hot Springs National Park (HOSP), Pea Ridge National Military Park (PERI), Pipestone National Monument (PIPE), Tallgrass Prairie National Preserve (TAPR), and Wilson's Creek national Battlefield (WICR). The objectives of this protocol are to determine the status and long-term trends in fish richness, diversity, abundance, and community composition in small wadeable streams within these nine parks and correlate the long-term community data to overall water quality and habitat condition (DeBacker et al. 2005).