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.

Developing a probabilistic graphical structure from a model of mental-health clinical risk expertise

This paper explores the process of developing a principled approach for translating a model of mental-health risk expertise into a probabilistic graphical structure. The Galatean Risk Screening Tool [1] is a psychological model for mental health risk assessment based on fuzzy sets. This paper details how the knowledge encapsulated in the psychological model was used to develop the structure of the probability graph by exploiting the semantics of the clinical expertise. These semantics are formalised by a detailed specification for an XML structure used to represent the expertise. The component parts were then mapped to equivalent probabilistic graphical structures such as Bayesian Belief Nets and Markov Random Fields to produce a composite chain graph that provides a probabilistic classification of risk expertise to complement the expert clinical judgements. © Springer-Verlag 2010.

Using XML and XSLT for flexible elicitation of mental-health risk knowledge

Current tools for assessing risks associated with mental-health problems require assessors to make high-level judgements based on clinical experience. This paper describes how new technologies can enhance qualitative research methods to identify lower-level cues underlying these judgements, which can be collected by people without a specialist mental-health background. Content analysis of interviews with 46 multidisciplinary mental-health experts exposed the cues and their interrelationships, which were represented by a mind map using software that stores maps as XML. All 46 mind maps were integrated into a single XML knowledge structure and analysed by a Lisp program to generate quantitative information about the numbers of experts associated with each part of it. The knowledge was refined by the experts, using software developed in Flash to record their collective views within the XML itself. These views specified how the XML should be transformed by XSLT, a technology for rendering XML, which resulted in a validated hierarchical knowledge structure associating patient cues with risks. Changing knowledge elicitation requirements were accommodated by flexible transformations of XML data using XSLT, which also facilitated generation of multiple data-gathering tools suiting different assessment circumstances and levels of mental-health knowledge. © 2007 Informa UK Ltd All rights reserved.

Utilising Intranet technologies in construction sector SMEs:building up knowledge bases for extreme weather event risk management

Intranet technologies accessible through a web based platform are used to share and build knowledge bases in many industries. Previous research suggests that intranets are capable of providing a useful means to share, collaborate and transact information within an organization. To compete and survive successfully, business organisations are required to effectively manage various risks affecting their businesses. In the construction industry too this is increasingly becoming an important element in business planning. The ability of businesses, especially of SMEs which represent a significant portion in most economies, to manage various risks is often hindered by fragmented knowledge across a large number of businesses. As a solution, this paper argues that Intranet technologies can be used as an effective means of building and sharing knowledge and building up effective knowledge bases for risk management in SMEs, by specifically considering the risks of extreme weather events. The paper discusses and evaluates relevant literature in this regard and identifies the potential for further research to explore this concept.

Resilience and adaptation of small and medium-sized enterprises to flood risk

Purpose – The UK has experienced a number of flood events in recent years, and the intensity and frequency of such events are forecast to further increase in future due to changing climatic conditions. Accordingly, enhancing the resilience of small and medium-sized enterprises (SMEs) – which form an important segment in a society – to flood risk, has emerged as an important issue. However, SMEs often tend to underestimate the risk of flooding which tends to have a low priority in their business agenda. The purpose of this paper is to undertake an investigation of adaptation to the risk of flooding considering community-level measures, individual-level property protection, and business continuity and resilience measures. Design/methodology/approach – A total of four short case studies were conducted among SMEs to identify their response to flood risk, and what measures have been undertaken to manage the risk of flooding. Findings – It was observed that SMEs have implemented different property-level protection measures and generic business continuity/risk management measures, based on their requirements, to achieve a desired level of protection. Practical implications – SMEs are likely to positively respond to property-level adaptation following a post-flood situation. It is important that information such as costs/benefits of such measures and different options available are made accessible to SMEs affected by a flood event. Social implications – Implementation of property-level adaptation measures will contribute towards the long term adaptation of the existing building stock to changing climatic conditions. Originality/value – The paper contributes towards policy making on flood risk adaptation and SME decision making, and informs policy makers and practitioners.

Information and communication technology adoption in the Italian road freight haulage industry

Despite the importance of information and communication technology (ICT) in the management of transport and logistics systems, there is a shortage of studies in the road freight haulage sector. This paper is aimed at filling this void through an exploratory survey on ICT adoption and the influencing factors carried out in the Italian road transport market. The paper provides a review of the previous research on this topic that allows the identification of research gaps that have been addressed through a questionnaire survey. The findings provide evidence of a passive stance on ICT usage characterised by the adoption of isolated applications. The financial risk associated with technology investment and human resources are the main barriers to ICT adoption, while the improvement of service level and the reliability of transport operations emerge as stimulating factors. The results suggest that the potential benefits of technology have not been fully exploited and a risk-sensitive stance on ICT is evident preventing the full incorporation of ICT into business processes.

Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST

Aim: To explore current risk assessment processes in general practice and Improving Access to Psychological Therapies (IAPT) services, and to consider whether the Galatean Risk and Safety Tool (GRiST) can help support improved patient care. Background: Much has been written about risk assessment practice in secondary mental health care, but little is known about how it is undertaken at the beginning of patients' care pathways, within general practice and IAPT services. Methods: Interviews with eight general practice and eight IAPT clinicians from two primary care trusts in the West Midlands, UK, and eight service users from the same region. Interviews explored current practice and participants' views and experiences of mental health risk assessment. Two focus groups were also carried out, one with general practice and one with IAPT clinicians, to review interview findings and to elicit views about GRiST from a demonstration of its functionality. Data were analysed using thematic analysis. Findings Variable approaches to mental health risk assessment were observed. Clinicians were anxious that important risk information was being missed, and risk communication was undermined. Patients felt uninvolved in the process, and both clinicians and patients expressed anxiety about risk assessment skills. Clinicians were positive about the potential for GRiST to provide solutions to these problems. Conclusions: A more structured and systematic approach to risk assessment in general practice and IAPT services is needed, to ensure important risk information is captured and communicated across the care pathway. GRiST has the functionality to support this aspect of practice.

Application of Methods of Multi-criteria Evaluation in Choosing a Method of Compression as a Means of Heightening the Information Security of System and Applied Objects

In this paper is proposed a model for researching the capability to influence, by selected methods’ groups of compression, to the co-efficient of information security of selected objects’ groups, exposed to selected attacks’ groups. With the help of methods for multi-criteria evaluation are chosen the methods’ groups with the lowest risk with respect to the information security. Recommendations for future investigations are proposed.

Information Supply of Geo-information Systems for the Forecasting Problem of the Avalanche Danger

This article is dedicated to the vital problem of the creation of GIS-systems for the monitoring, prognostication and control of technogenic natural catastrophes. The decrease of risks, the protection of economic objects, averting the human victims, caused by the dynamism of avalanche centers, depends on the effectiveness of the prognostication procedures of avalanche danger used. In the article the structure of a prognostication subsystem information input is developed and the technology for the complex forecast of avalanche-prone situations is proposed.

Study of the Information Security of File Objects under Information Attacks with a Record of Effect of the Methods of Compression

This report examines important issues pertaining to the different ways of affecting the information security of file objects under information attacks through methods of compression. Accordingly, the report analyzes the three-way relationships which may exist among a selected set of attacks, methods and objects. Thus, a methodology is proposed for evaluation of information security, and a coefficient of information security is created. With respects to this coefficient, using different criteria and methods for evaluation and selection of alternatives, the lowest-risk methods of compression are selected.

Evaluating Misclassification Probability Using Empirical Risk

* The work is supported by RFBR, grant 04-01-00858-a

The effect of timeliness and credit ratings on the information content of earnings announcements

Abstract: This paper investigates the impact of timeliness and credit ratings on the information content of the earnings announcements of Greek listed firms from 2001 to 2008. Using the classical event study methodology and regression analysis, we find that firms tend to release good news on time and are inclined to delay the release of bad news. We also provide evidence that the level of corporate risk differentiates the information content of earnings according to the credit rating category. Specifically, firms displaying high creditworthiness enjoy positive excess returns on earnings announcement dates. In contrast, firms with low creditworthiness undergo significant share price erosions on earnings announcement days. We also observe a substitution effect between timeliness and credit ratings in relation to the information content of earnings announcements. Specifically, we find that as the credit category of earnings-announcing firms improves, the informational role of timeliness is mitigated.

Sensitivity Analysis of the Risk of Forecasting for Autoregressive Time Series with Missing Values

2000 Mathematics Subject Classification: 62M20, 62M10, 62-07.

Balancing push and pull information management within the supply chain

The aim of this paper is to explore the management of information in an aerospace manufacturer's supply chain by analysing supply chain disruption risks. The social network perspective will be used to examine the flows of information in the supply chain. The examination of information flows will also be explored in terms of push and pull information management. The supply chain risk management (SCRM) strategy is to assess the management of information that allows companies to gather information which will allow them to mitigate that risk before any disruption to the supply chain occurs. There is a shortage of models in analysing the supply chain risk associated with information flows, possibly due to the omission of appropriate modelling techniques in this area (Tang and Nurmaya, 2011). This paper uses an exploratory case study consisting of a multi method qualitative approach using fifteen interviews and four focus groups.

Retinal arteriolar diameter response to flicker light provocation - A useful marker for risk stratification in cardiovascular disease?

Purpose: To to evaluate the benefit of bilinear and linear fitting to characterize the retinal vessel dilation to flicker light stimulation for the purpose of risk stratification in cardiovascular disease. Methods: Forty-five patients (15 with coronary artery disease (CAD), 15 with Diabetes Mellitus (DM) and 15 with CAD and DM) all underwent contact tonometry, digital blood pressure measurement, fundus photography, retinal vessel oximetry, static retinal vessel analysis and continous retinal diameter assessment using the retinal vessel analyser (and flicker light provocation). In addition we measured blood glucose (HbA1c) and keratinin levels in DM patients. Results: With increased severity of cardiovascular disease a more linear reaction profile of retinal arteriolar diameter to flicker light provocation can be observed. Conclusion: Absolute values of vessel dilation provide only limited information on the state of retinal arteriolar dilatory response to flicker light. The approach of bilinear fitting takes into account the immediate response to flicker light provocation as well as the maintained dilatory capacity during prolonged stimulation. Individuals with cardiovascular disease however show a largely linear reaction profile indicating an impairment of the initial rapid dilatory response as usually observed in healty individuals