Substances hazardous to health:the nature of the expertise associated with competent risk assessment

This research investigated expertise in hazardous substance risk assessment (HSRA). Competent pro-active risk assessment is needed to prevent occupational ill-health caused by hazardous substance exposure occurring in the future. In recent years there has been a strong demand for HSRA expertise and a shortage of expert practitioners. The discipline of Occupational Hygiene was identified as the key repository of knowledge and skills for HSRA and one objective of this research was to develop a method to elicit this expertise from experienced occupational hygienists. In the study of generic expertise, many methods of knowledge elicitation (KE) have been investigated, since this has been relevant to the development of 'expert systems' (thinking computers). Here, knowledge needed to be elicited from human experts, and this stage was often a bottleneck in system development, since experts could not explain the basis of their expertise. At an intermediate stage, information collected was used to structure a basic model of hazardous substance risk assessment activity (HSRA Model B) and this formed the basis of tape transcript analysis in the main study with derivation of a 'classification' and a 'performance matrix'. The study aimed to elicit the expertise of occupational hygienists and compare their performance with other health and safety professionals (occupational health physicians, occupational health nurses, health and safety practitioners and trainee health and safety inspectors), as evaluated using the matrix. As a group, the hygienists performed best in the exercise, and this group were particularly good at process elicitation and at recommending specific control measures, although the other groups also performed well in selected aspects of the matrix and the work provided useful findings and insights. From the research, two models of HSRA have been derived, an HSRA aid, together with a novel videotape KE technique and interesting research findings. The implications of this are discussed with respect to future training of HS professionals and wider application of the videotape KE method.

Review of progress in implementing the recommendations of Sir Gareth Roberts regarding employability and career development of PhD students and research staff:A report for Research Councils UK by an independent review panel October 2010

The need for improvement in the development of research careers and researchers’ training in transferable skills was highlighted in two particular recommendations (numbers 4.2 and 5.3) in the 2002 report ‘SET for success: the report of Sir Gareth Roberts’ Review - the supply of people with science, technology, engineering and mathematics skills’ (Roberts, 2002). As a consequence of that review, Research Councils UK (RCUK)1 have invested about £120 million, usually referred to as ’Roberts’ Money’, in research organisations to address this concern in all research disciplines. The last ‘Roberts’ Money’ payment will be for the period up to March 2011; it was therefore proposed to assess the progress made with taking forward these specific recommendations. An independent panel was formed by RCUK to undertake this review in 2010. The terms of reference for the panel are in Annex A. In summary, the panel was asked to review progress made and to advise RCUK and the higher education (HE) sector about future requirements for the development and training of researchers. In the course of their review, the panel considered a wide range of existing reports, interviewed key stakeholders in the HE sector and elsewhere, as well as drawing on their own knowledge and expertise. This report presents the findings of the panel’s review.

Medication error in mental health:implications for primary care

Medication errors are associated with significant morbidity and people with mental health problems may be particularly susceptible to medication errors due to various factors. Primary care has a key role in improving medication safety in this vulnerable population. The complexity of services, involving primary and secondary care and social services, and potential training issues may increase error rates, with physical medicines representing a particular risk. Service users may be cognitively impaired and fail to identify an error placing additional responsibilities on clinicians. The potential role of carers in error prevention and medication safety requires further elaboration. A potential lack of trust between service users and clinicians may impair honest communication about medication issues leading to errors. There is a need for detailed research within this field.

Management of allergic conjunctivitis and dry eye

Ocular allergy is a common eye condition encountered in clinical practice. However, little is known how seasonal allergic conjunctivitis (SAC), the most common subtype, is managed in clinical practice. Further, dry eye, another common eye condition, may be misdiagnosed as SAC and vice-versa as they share similar signs and symptoms. In addition, despite the frequent recommendation of non-pharmacological treatments for SAC, evidenceto support their use has not been identified in the scientific literature. The aim of this thesis was therefore to determine the actual diagnosis and management of SAC and dry eye in clinical practice and investigate the efficacy of non-pharmacological treatments for these conditions. The diagnostic and management strategies for SAC and dry eye employed by pharmacy staff are found to be inconsistent with current guidelines and scientific evidence based upon a mystery shopper design. Cluster analysis of tear film metrics in normal and dry eye patients identified several clinically relevant groups of patients that may allow for targeted treatment recommendations. Using a novel environmental chamber model of SAC, the use of artificial tears and cold compresses, either alone or combined is an effective treatment modality for acute and symptomatic SAC, on a par with topical anti-allergic medication, and has been demonstrated for the first time. In addition, eyelid warming therapy with a simple, readily available, seed filled device is an effective method of treating meibomian gland dysfunction (MGD) related evaporative dry eye, perhaps the most common dry eye subtype. A greater focus on ophthalmology must be implemented as part of the formal education and training of pharmacy staff, while greater professional communication between community pharmacists, optometrists and the population they serve is required. Artificial tears and cold compresses may be considered as front line agents for acute SAC by pharmacy staff and optometrists, to whom pharmacological treatment options are limited.

Semi-supervised learning of statistical models for natural language understanding

Natural language understanding is to specify a computational model that maps sentences to their semantic mean representation. In this paper, we propose a novel framework to train the statistical models without using expensive fully annotated data. In particular, the input of our framework is a set of sentences labeled with abstract semantic annotations. These annotations encode the underlying embedded semantic structural relations without explicit word/semantic tag alignment. The proposed framework can automatically induce derivation rules that map sentences to their semantic meaning representations. The learning framework is applied on two statistical models, the conditional random fields (CRFs) and the hidden Markov support vector machines (HM-SVMs). Our experimental results on the DARPA communicator data show that both CRFs and HM-SVMs outperform the baseline approach, previously proposed hidden vector state (HVS) model which is also trained on abstract semantic annotations. In addition, the proposed framework shows superior performance than two other baseline approaches, a hybrid framework combining HVS and HM-SVMs and discriminative training of HVS, with a relative error reduction rate of about 25% and 15% being achieved in F-measure.