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Risk is part of every human endeavor. From the moment we get up in the morning, drive or take
public transportation to get to school or to work until we get back into our beds and perhaps even
afterwards, we are exposed to risks of different degrees.
A Very Short History of Risk
For much of human history, risk and survival have gone hand in hand. Prehistoric humans lived
short and brutal lives, as the search for food and shelter exposed them to physical danger from
preying animals and poor weather. Even as more established communities developed in Sumeria,
Babylon and Greece, other risks such as war and disease continued to ravage humanity. For
much of early history, though, physical risk the risk-averse one starved to death.
Economic activities until the industrial age often exposed those involved in it to physical risk
with economic rewards.
Defining Risk

Risk refers to uncertain future conditions or circumstances that may adversely impact a project if
they occur. A risk represents the possibility, not the certainty, of a future event affecting the
success of a project.
Risk and Reward

The “no free lunch” mantra has a logical extension. Those who desire large rewards have to be
willing to expose themselves to considerable risk. The link between risk and return is most
visible when making investment choices; stocks are riskier than bonds, but generate higher
returns over long periods. It is less visible but just as important when making career choices; a
job in sales and trading at an investment bank may be more lucrative than a corporate finance job
at a corporation but it does come with a greater likelihood that you will be laid off if you don’t
produce results.
Risk and Innovation

The other aspect of risk that needs examination is the role that risk taking plays in creating
innovation. Over history, many of our most durable and valuable inventions have come from a
desire to either remove risk or expose ourselves to it. Consider again the example of the spice

trade. The risks at sea and from hostile forces created a need for more seaworthy crafts and
powerful weapons, innovations designed to exploit risk.
Kinds of Risk
The distinction draws between “hazard” and “outrage.” In a nutshell, “hazard” is the technical
component of risk, the product of probability and magnitude. “Outrage” is the nontechnical
component, an amalgam of voluntariness, control, responsiveness, trust, dread, etc. They are
connected by the fact that outrage is the principal determinant of perceived hazard. When people
are upset, they tend to think they are endangered; when they’re not upset, they tend to think
they’re not endangered.
Following are the four major kinds of Risk.
Public Relations: High Hazard, Low Outrage

Low outrage by definition means an apathetic audience. Getting and holding this audience’s
attention will be extremely difficult, so there is a premium on figuring out your key message,
honing it down to as few words as possible, and finding a way to make it interesting. Since the
hazard is high, or at least higher than the outrage, the task is often to provoke more outrage.
I call these paradigm public relations because the essence of PR is talking to people who aren’t
interested. But this is also the domain of health education, safety training, and environmental
activism. Urging people to take some risk more seriously is the kinds of risk communication
industrial hygienists do most often.
The uninterested public is a huge group, so high-hazard low-outrage risk communication is likely
to make heavy use of mass media. The barriers to be surmounted include audience inattention,
audience size, media resistance, the need to package everything into short sound bites, and the
policy implications of trying to provoke outrage.
Stakeholder Relations: Moderate Hazard, Moderate Outrage

Unlike publics, stakeholders are an attentive audience neither too apathetic nor too upset to
listen. So the task of stakeholder relations is to discuss the issues openly and rationally,
explaining your views and responding to audience questions and concerns.
Instead of the mass media, stakeholder relations rely on interpersonal dialogue, supplemented by
such specialized media as newsletters and web sites. There are no real barriers to overcome, but

one-on-one dialogue can be painfully inefficient. And you have to be prepared to explain the
technical details; this is the only audience that really wants to hear them.
Outrage Management: Low Hazard, High Outrage

Now the audience is outraged, largely at you. And while the outrage may be justified in some
nontechnical sense for example, you may have been less than honest or less than courteous, it
isn’t technically justified; the hazard is low. A core group of “fanatics” is usually accompanied
by a larger, less outraged constituency watching to see how the controversy evolves. The task is
to reduce audience outrage by listening, acknowledging, apologizing, sharing control and credit,
etc. The controversy ends when the “fanatics” declare victory or their constituency thinks they
have won enough.
In outrage management the medium is in-person dialogue … though this time the “audience”
does most of the talking. Barriers include the audience’s outrage at you, your own outrage at the
audience, coming to grips with the need to focus on outrage when you’d really rather talk about
substance, and sometimes the complicating presence of the media. The silver lining: At least you
have their attention, though it is hostile or at least highly skeptical attention.
Crisis Communication: High Hazard, High Outrage

This is a relatively rare but enormously important sort of risk communication. The audience is
huge and very upset. The outrage is even greater than in outrage management. It’s also different
more fear and misery than anger. If either is unbearable, it may flip into denial or escalate into
terror or depression. The task, therefore, is to help the audience bear its fear and misery. Key
strategies include avoiding over-reassurance, sharing dilemmas, being human and empathic,
providing things to do, and acknowledging uncertainty.
As in public relations, crisis communication makes heavy use of mass media. But finely honed
sound bites aren’t needed. There is no “public” in a crisis; everyone’s a stakeholder, glued to the
television screen for hours. Missing the difference between crisis communication and routine
public relations is the biggest barrier which is why people who are good at PR politicians, for
example, but also many industrial hygienists may do poor crisis communication unless they

Sources of Risk

1. Was the method of randomization adequate?
A random unpredictable assignment sequences. Examples of adequate methods are coin toss (for
studies with two groups), rolling a dice (for studies with two or more groups), drawing of balls of
different colours, drawing of ballots with the study group labels from a dark bag, computer-
generated random sequence, pre-ordered sealed envelopes, sequentially-ordered vials, telephone
call to a central office, and pre-ordered list of treatment assignments
Examples of inadequate methods are: alternation, birth date, social insurance/security number,
date in which they are invited to participate in the study, and hospital registration number
2. Was the treatment allocation concealed?
Assignment generated by an independent person not responsible for determining the eligibility of
the patients. This person has no information about the persons included in the trial and has no
influence on the assignment sequence or on the decision about eligibility of the patient.
Was knowledge of the allocated interventions adequately prevented during the study?
3. Was the patient blinded to the intervention?
This item should be scored “yes” if the index and control groups are indistinguishable for the
patients or if the success of blinding was tested among the patients and it was successful.
4. Was the care provider blinded to the intervention?
This item should be scored “yes” if the index and control groups are indistinguishable for the
care providers or if the success of blinding was tested among the care providers and it was
5. Was the outcome assessor blinded to the intervention?
Adequacy of blinding should be assessed for the primary outcomes. This item should be scored
“yes” if the success of blinding was tested among the outcome assessors and it was successful or:
   For outcome criteria assessed during scheduled visit and that supposes a contact
    between participants and outcome assessors (e.g., clinical examination): the blinding
    procedure is adequate if patients are blinded, and the treatment or adverse effects of the
    treatment cannot be noticed during clinical examination.

6. Was the drop-out rate described and acceptable?
The number of participants who were included in the study but did not complete the observation
period or were not included in the analysis must be described and reasons given. If the
percentage of withdrawals and drop-outs does not exceed 20% for short-term follow-up and 30%
for long-term follow-up and does not lead to substantial bias a 'yes' is scored. (N.B. these
percentages are arbitrary, not supported by literature).
7. Were all randomized participants analyzed in the group to which they were allocated?
All randomized patients are reported/analyzed in the group they were allocated to by
randomization for the most important moments of effect measurement (minus missing values)
irrespective of non-compliance and co-interventions.

Other sources of potential bias:
8. Were the groups similar at baseline regarding the most important prognostic indicators?
In order to receive a “yes”, groups have to be similar at baseline regarding demographic factors,
duration and severity of complaints, percentage of patients with neurological symptoms, and
value of main outcome measure(s).
9. Were co-interventions avoided or similar?
This item should be scored “yes” if there were no co-interventions or they were similar between
the index and control groups.
10. Was the compliance acceptable in all groups?
The reviewer determines if the compliance with the interventions is acceptable, based on the
reported intensity, duration, number and frequency of sessions for both the index intervention
and control intervention. For example, physiotherapy treatment is usually administered over
several sessions; therefore it is necessary to assess how many sessions each patient attended. For
single-session interventions (for ex: surgery), this item is irrelevant.
11. Was the timing of the outcome assessment similar in all groups?
Timing of outcome assessment should be identical for all intervention groups and for all
important outcome assessments.

What is GDR?
The Global Depositary Receipts GDR represented by this certificate are each issued in respect of
one ordinary share of par value GEL 1.00 each "Shares" in Joint Stock Company Bank of
Georgia the Company pursuant to and subject to an agreement dated 24 November 2006, and
made between the Company and The Bank of New York in its capacity as depositary the
"Depositary" for the "Regulation S Facility" and for the "Rule 144A Facility" such agreement,
as amended from time to time, being hereinafter referred to as the "Deposit Agreement".
The Offering will consist of Regulation S GDRs only. However, a depositary receipt facility for
the issuance of Rule 144A GDRs is being established concurrently. No Rule 144A GDRs will be
sold in the Offering. The GDRs will upon issue be represented by interests in a Regulation S
Master GDR, evidencing Regulation S GDRs, and by interests in a Rule 144A Master GDR,
evidencing Rule 144A GDRs (as each such term is defined in the Deposit Agreement). The
GDRs are exchangeable in the circumstances set out in “Summary of Provisions Relating to the
GDRs while in Master Form” for a certificate in definitive registered form in respect of GDRs
representing all or part of the interest of the holder in the Master GDR.
Pakistan to finalize GDR issue

Pakistan is looking to raise funds overseas by selling shares of one of its state firms and the
details should be finalized.
Following are the Pakistani Companies that issue the GDR.
   1. MCB become the first Pakistani company to list on the London Stock Exchange. MCB
       Bank Ltd. generated $150 million in October by issuing GDRs, also on the London Stock
   2. The country's largest listed firm, the Oil and Gas Development Co. Ltd. (OGDC.KA)
       raised $813 million. The Company list on the London Stock Exchange.
   3. Pakistan sold a 25 percent stake in the country's third largest bank, United Bank Ltd.
       (UBL.KA), to raise $650.3 million through the GDR issue on the London Stock
   4. National Bank of Pakistan issued GDR in London Stock Exchange. NBP's GDR issue
       will be the fourth such offering by a Pakistani firm.


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