Developing Clinical Practice Guidelines for violence risk assessment in mental health triage : a systematic review

Background : On a global level, there is a growing trend to utilise mental health triage service systems as a way of providing consumers with access to 24 hour mental health care. At present, violence risk assessment in mental health triage lacks a suitable evidence base and clear guidelines. This presentation provides an overview of a Clinical Practice Guideline for violence risk assessment at point of entry to health services.
Aims : The objective of this study was to develop Clinical Practice Guidelines for violence risk assessment in mental health triage, and to pilot test the Clinical Guidelines in two major hospitals in Melbourne.
Method : The method employed in the study was a systematic review, as per the Australian National Health and Medical Research Council’s methodology for developing Clinical Guidelines. Research was conducted at the Royal Melbourne Hospital and the Alfred Hospital to establish the utility of the Guideline in practice.
Results : The systematic review established the highest level of evidence for violence risk assessment. Clinical Practice Guidelines for mental health triage were developed from these findings.
Conclusions : Evidence based Clinical Guidelines maximise the potential for creating safer outcomes for consumers, families/carers, and health care workers.

Comparison of different maximum safe levels in fortified foods and supplements using a probabilistic risk assessment approach

Different European institutions have developed mathematical models to propose maximum safe levels either for fortified foods or for dietary supplements. The objective of the present study was to compare and check the safety of these different maximum safe levels (MSL) by using a probabilistic risk assessment approach. The potential maximum nutritional intakes were estimated by taking into account all sources of intakes (base diet, fortified foods and dietary supplements) and compared with the tolerable upper intake levels for vitamins and minerals. This approach simulated the consequences of both food fortification and supplementation in terms of food safety. Different scenarios were tested. They are the result of the combination of several MSL obtained using the previous models. The study was based on the second French Individual and National Study on Food Consumption performed in 2006–7, matched with the French food nutritional composition database. The analyses were based on a sample of 1918 adults aged 18–79 years. Some MSL in fortified foods and dietary supplements obtained independently were protective enough, although some others could lead to nutritional intakes above the tolerable upper intake levels. The simulation showed that it is crucial to consider the inter-individual variability of fortified food intakes when setting MSL for foods and supplements. The risk assessment approach developed here by integrating the MSL for fortified foods and dietary supplements is useful for ensuring consumer protection. It may be subsequently used to test any other MSL for vitamins and minerals proposed in the future.

An agile IT security model for project risk assessment

There are two fundamental challenges in effectively performing security risk assessment in today's IT projects.The first is the project manager's need to know what IT security risks face the project before the project begins. At this stage IT security staff are unable to answer this question without first knowing the system requirements for the project which are yet to be defined. Second organisations that deal with a large project throughput each year find the current IT security risk assessment process to be tedious and expensive, especially when the same process has to be repeated for each individual project. This also makes it difficult for an organisation to prioritise which projects require more investment in IT security in order to fit within budget constraints. This paper presents a conceptual model that is based on an agile approach to alleviate these challenges. We do this by first analysing two online database resources of vulnerabilities by comparing them to each other, and then compare them to the agile criteria of the conceptual model which we define. The conceptual model is then presented and an example is given of how it can be applied to an actual project. We then briefly discuss what further work needs to be done to implement the conceptual model and validate it against an existing IT project.

Does traditional security risk assessment have a future in information security?

The current information security standards still advocate the use of risk assessment in the prioritisation of security investments. However, prior research on the use of risk assessment methodologies in organisational security has shown that the use of the traditional monolithic risk assessment process described in the current risk management standard is simply not practical at the organisational level. This paper first examines the problems in performing a systematic risk assessment and then discusses the limitations of a traditional risk assessment. To address these limitations, this paper proposes splitting up the current monolithic risk assessment process. The result is an information security assessment framework that puts greater emphasis on situational awareness and allows for better decision making on the prioritization of security investments.

Assessing risk post intervention for an acute coronary syndrome: a review of the risk assessment tools and their development

Considerable variability in survival rate after an acute myocardial infarction exists and accurate risk stratification is of significant importance. The American College of Cardiology and the American Heart Association has recommended early risk stratification using several clinical risk scoring instruments to identify high risk patients. The aim of this paper is to identify secondary cardiovascular risk scoring instruments that could be utilized at the time of intervention for acute coronary syndromes and compare their psychometric properties as they were developed. A search using Medline, Cumulative Index to Nursing and Allied Health Literature and the Psychology and Behavioral Sciences Collection data-bases identified studies published between January 1990 and January 2010 used to measure risk after intervention for acute coronary syndrome. Four validated secondary risk prediction scoring instruments were identified for comparison.Secondary risk prediction scoring instruments for the acute coronary syndrome patient population are evidence based, valid and reliable. Use of the instruments by cardiac focused clinicians will aid in the determination of treatment strategies, and estimation of short and long term events and mortality.