Examining the relationship between risk assessment and risk management in mental health

Risk assessment is crucial for developing risk management plans to prevent or minimize mental health patients' risks that will impede their recovery. Risk assessments and risk management plans should be closely linked. Their content and the extent to which they are linked within one Trust is explored. There is a great deal of variability in the amount and detail of risk information collected by nurses and how this is used to develop risk management plans. Keeping risk assessment information in one place rather than scattered throughout patient records is important for ensuring it can be accessed easily and linked properly to risk management plans. Strengthening the link between risk assessment and management will help ensure interventions and care is tailored to the specific needs of individual patients, thus promoting their safety and well-being. Thorough risk assessment helps in developing risk management plans that minimize risks that can impede mental health patients' recovery. Department of Health policy states that risk assessments and risk management plans should be inextricably linked. This paper examines their content and linkage within one Trust. Four inpatient wards for working age adults (18-65 years) in a large mental health Trust in England were included in the study. Completed risk assessment forms, for all patients in each inpatient ward were examined (n= 43), followed by an examination of notes for the same patients. Semi-structured interviews took place with ward nurses (n= 17). Findings show much variability in the amount and detail of risk information collected by nurses, which may be distributed in several places. Gaps in the risk assessment and risk management process are evident, and a disassociation between risk information and risk management plans is often present. Risk information should have a single location so that it can be easily found and updated. Overall, a more integrated approach to risk assessment and management is required, to help patients receive timely and appropriate interventions that can reduce risks such as suicide or harm to others. © 2011 Blackwell Publishing.

Latency and variability of the visual evoked magnetic response: a comparison of two single channel magnetometers

The latency variation of the P100M from minute to minute, between morning and afternoon and from day to day was investigated in an unshielded environment using two single channel magnetometers. Latency variation was greatest from minute to minute with relatively little longer term variation. The two magnetometers differed both in mean latency and in the degree of variation. This may be attributed to variation in the performance of the filters which were set a narrow bandwidth for recording in an unshielded environment.

Direct real-time cavity mode assessment and optimization technique for fiber lasers

A simple technique for direct real-time assessment of a fiber laser cavity-mode condition during operation is demonstrated. Mode stabilization and optimization with this cavity-mode monitoring and conditioning feedback scheme shows significant improvements to the output performance.

Direct cavity assessment and mode optimisation technique for DFB fibre laser

A technique for direct real-time assessment of a distributed feedback fibre laser cavity conditions during operation is demonstrated and used to provide a cavity mode conditioning feedback mechanism to optimise output performance. Negligible wavelength drift is demonstrated over a 52 mW pump power range.

e-CAF: flexible marking schemes for electronic coursework assessment and feedback

Recent surveys reveal that many university students in the U.K. are not satisfied with the timeliness and usefulness of the feedback given by their tutors. Ensuring timeliness in marking can result in a reduction in the quality of feedback. Though suitable use of Information and Communication Technology should alleviate this problem, existing Virtual Learning Environments are inadequate to support detailed marking scheme creation and they provide little support for giving detailed feedback. This paper describes a unique new web-based tool called e-CAF for facilitating coursework assessment and feedback management directed by marking schemes. Using e-CAF, tutors can create or reuse detailed marking schemes efficiently without sacrificing the accuracy or thoroughness in marking. The flexibility in marking scheme design also makes it possible for tutors to modify a marking scheme during the marking process without having to reassess the students’ submissions. The resulting marking process will become more transparent to students.

Developments in assessment and teaching methodologies in modern languages in England and France in response to educational reform (1975-1985)

This comparative study considers the main causative factors for change in recent years in the teaching of modern languages in England and France and seeks to contribute, in a general sense, to the understanding of change in comparable institutions. In England by 1975 the teaching of modern languages in the comprehensive schools was seen to be inappropriate to the needs of children of the whole ability-range. A combination of the external factor of the Council of Europe initiative in devising a needs-based learning approach for adult learners, and the internal factor of teacher-based initiatives in developing a graded-objectives learning approach for the less-able, has reversed this situation to some extent. The study examines and evaluates this reversal, and, in addition, assesses teachers' attitudes towards, and understanding of, the changes involved. In France the imposition of `la reforme Haby' in 1977 and the creation of `le college unique' were the main external factors for change. The subsequent failure of the reform and the socialist government's support of decentralisation policies returning the initiative for renewal to schools are examined and evaluated, as are the internal factors for changes in language-teaching - `groupes de niveau' and the creation of `equipes pedagogiques'. In both countries changes in the function of examinations at 15/16 plus are examined. The final chapter compared the changes in both education systems.

Ability assessment and job structure measures in occupational mobility

Recent and potential changes in technology have resulted in the anticipation of increases in the frequency of job changes. This has led manpower policy makers to investigate the feasibility of incorporating the employment skills of job groups in the general prediction of future job learning and performance with a view to the establishment of "job families" within which transfer might be considered reciprocally high. A structured job analysis instrument (the Position Analysis Questionnaire) is evaluated in terms of two distinct sets of scores; job dimensions and synthetically established attribute/trait profiles. Studies demonstrate that estimates of a job's structure/dimensions and requisite human attributes can be reliably established. Three alternative techniques of statistically assembling profiles of the requisite human attributes for jobs are found to have differential levels of reliability and differential degrees of validity in their estimation of the "actual" ability requirements of jobs. The utility of these two sets of job descriptors to serve as representations of the cognitive structure similarity of job groups is investigated in a study which simulates a job transfer situation. The central role of the index of similarity used to assess the relationship between "target" and "present" job is demonstrated. The relative extents to which job structure similarity and job attribute similariity are associated with positive transfer are investigated. The studies demonstrate that the dimensions of jobs, and more fruitfully their requisite human attributes can serve as bases to predict job transfer learning and performance. The nature of the index of similarity used to optimally formulate predictions of transfer is such that networks of jobs might be establishable to which current job incumbents could be expected to transfer positively. The derivation of "job families" with anticipated reciprocal transfer consequences is considered to be less appropriate.

Knowledge engineering for mental-health risk assessment and decision support

Mental-health risk assessment practice in the UK is mainly paper-based, with little standardisation in the tools that are used across the Services. The tools that are available tend to rely on minimal sets of items and unsophisticated scoring methods to identify at-risk individuals. This means the reasoning by which an outcome has been determined remains uncertain. Consequently, there is little provision for: including the patient as an active party in the assessment process, identifying underlying causes of risk, and eecting shared decision-making. This thesis develops a tool-chain for the formulation and deployment of a computerised clinical decision support system for mental-health risk assessment. The resultant tool, GRiST, will be based on consensual domain expert knowledge that will be validated as part of the research, and will incorporate a proven psychological model of classication for risk computation. GRiST will have an ambitious remit of being a platform that can be used over the Internet, by both the clinician and the layperson, in multiple settings, and in the assessment of patients with varying demographics. Flexibility will therefore be a guiding principle in the development of the platform, to the extent that GRiST will present an assessment environment that is tailored to the circumstances in which it nds itself. XML and XSLT will be the key technologies that help deliver this exibility.

Measuring the assessment and counselling provided with the supply of non-prescription asthma reliever medication: a simulated patient study

BACKGROUND: Over one quarter of asthma reliever medications are provided without prescription by community pharmacies in Australia. Evidence that community pharmacies provide these medications with sufficient patient assessment and medication counseling to ensure compliance with the government's Quality Use of Medicines principles is currently lacking. OBJECTIVE: To assess current practice when asthma reliever medication is provided in the community pharmacy setting and to identify factors that correlate with assessment of asthma control. METHODS: Researchers posing as patients visited a sample of Perth metropolitan community pharmacies in May 2007. During the visit, the simulated patient enacted a standardized scenario of someone with moderately controlled asthma who wished to purchase a salbutamol (albuterol) inhaler without prescription. Results of the encounter were recorded immediately after the visit. Regression analysis was performed, with medication use frequency (a marker of asthma control) as the dependent variable. RESULTS: One hundred sixty community pharmacies in the Perth metropolitan area were visited in May 2007. Pharmacists and/or pharmacy assistants provided some form of assessment in 84% of the visits. Counseling was provided to the simulated patients in 24% of the visits. Only 4 pharmacy staff members asked whether the simulated patient knew how to use the inhaler. Significant correlation was found between assessment and/or counseling of reliever use frequency and 3 independent variables: visit length (p < 0.001), number of assessment questions asked (p < 0.001), and the simulated patient who conducted the visit (p < 0.02). CONCLUSIONS: Both patient assessment and medication counseling were suboptimal compared with recommended practice when nonprescription asthma reliever medication was supplied in the community pharmacy setting. Pharmacy and pharmacist demographic variables do not appear to affect assessment of asthma control. This research indicates the need for substantial improvements in practice in order to provide reliever medication in line with Quality Use of Medication principles of ensuring safe and effective use of medication.

Enhancing student learning experience through a novel electronic coursework assessment and feedback management system

Recent National Student Surveys revealed that many U.K. university students are dissatisfied with the timeliness and usefulness of the feedback received from their tutors. Ensuring timeliness in marking often results in a reduction in the quality of feedback. In Computer Science where learning relies on practising and learning from mistakes, feedback that pin-points errors and explains means of improvement is important to achieve a good student learning experience. Though suitable use of Information and Communication Technology should alleviate this problem, existing Virtual Learning Environments and e-Assessment applications such as Blackboard/WebCT, BOSS, MarkTool and GradeMark are inadequate to support a coursework assessment process that promotes timeliness and usefulness of feedback while maintaining consistency in marking involving multiple tutors. We have developed a novel Internet application, called eCAF, for facilitating an efficient and transparent coursework assessment and feedback process. The eCAF system supports detailed marking scheme editing and enables tutors to use such schemes to pin-point errors in students' work so as to provide helpful feedback efficiently. Tutors can also highlight areas in a submitted work and associate helpful feedback that clearly links to the identified mistakes and the respective marking criteria. In light of the results obtained from a recent trial of eCAF, we discuss how the key features of eCAF may facilitate an effective and efficient coursework assessment and feedback process.

Techno-economic assessment and uncertainty analysis of thermochemical processes for second generation biofuels

Biomass-To-Liquid (BTL) is one of the most promising low carbon processes available to support the expanding transportation sector. This multi-step process produces hydrocarbon fuels from biomass, the so-called “second generation biofuels” that, unlike first generation biofuels, have the ability to make use of a wider range of biomass feedstock than just plant oils and sugar/starch components. A BTL process based on gasification has yet to be commercialized. This work focuses on the techno-economic feasibility of nine BTL plants. The scope was limited to hydrocarbon products as these can be readily incorporated and integrated into conventional markets and supply chains. The evaluated BTL systems were based on pressurised oxygen gasification of wood biomass or bio-oil and they were characterised by different fuel synthesis processes including: Fischer-Tropsch synthesis, the Methanol to Gasoline (MTG) process and the Topsoe Integrated Gasoline (TIGAS) synthesis. This was the first time that these three fuel synthesis technologies were compared in a single, consistent evaluation. The selected process concepts were modelled using the process simulation software IPSEpro to determine mass balances, energy balances and product distributions. For each BTL concept, a cost model was developed in MS Excel to estimate capital, operating and production costs. An uncertainty analysis based on the Monte Carlo statistical method, was also carried out to examine how the uncertainty in the input parameters of the cost model could affect the output (i.e. production cost) of the model. This was the first time that an uncertainty analysis was included in a published techno-economic assessment study of BTL systems. It was found that bio-oil gasification cannot currently compete with solid biomass gasification due to the lower efficiencies and higher costs associated with the additional thermal conversion step of fast pyrolysis. Fischer-Tropsch synthesis was the most promising fuel synthesis technology for commercial production of liquid hydrocarbon fuels since it achieved higher efficiencies and lower costs than TIGAS and MTG. None of the BTL systems were competitive with conventional fossil fuel plants. However, if government tax take was reduced by approximately 33% or a subsidy of £55/t dry biomass was available, transport biofuels could be competitive with conventional fuels. Large scale biofuel production may be possible in the long term through subsidies, fuels price rises and legislation.

Direct cavity assessment and mode optimisation technique for DFB fibre laser

A technique for direct real-time assessment of a distributed feedback fibre laser cavity conditions during operation is demonstrated and used to provide a cavity mode conditioning feedback mechanism to optimise output performance. Negligible wavelength drift is demonstrated over a 52 mW pump power range.

An online assessment and development tool for business incubators:optimising business-incubation management practice, performance and impact, Project Report

This project is focused on exchanging knowledge between ABS, UKBI and managers of business incubators in the UK. The project relates to exploitation of extant knowledge-base on assessing and improving business incubation management practice and performance and builds on two earlier studies. It addresses a pressing need for assessing and benchmarking business incubation input, process and outcome performance and highlighting best practice. The overarching aim of this project was to obtain proof-of-concept for a business incubation performance assessment and benchmarking online tool, fine-tune it and put it in use by nurturing a community of business incubation management practice, aligned by the resultant tool. The purpose was to offer an appropriate set of measures, in areas identified by relevant research on business incubation performance management and impact as critical, against which: 1.The input and process performance of business incubation management practice can be assessed and benchmarked within the auspices of a community of incubator managers concerned with best practice 2.The outcome performance and impact of business incubators can be assessed longitudinally. As such, the developed online assessment framework is geared towards the needs of researchers, policy makers and practitioners concerned with business incubation performance, added value and impact.