Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management

Objectives: To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners. Methods: An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements. Results: Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users. Conclusion: The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance. Practice Implications: The GRiST web-based DSS (www.egrist.org) links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.

A Modified Model of Risk Business

2000 Mathematics Subject Classification: 60K10, 62P05

Compound Compound Poisson Risk Model

2000 Mathematics Subject Classification: 60K10, 62P05.

The development and analysis of a field project model curriculum and its impact on achievement and attitude toward science and the environment with at-risk eleventh and twelfth grade students

This study was an evaluation of a Field Project Model Curriculum and its impact on achievement, attitude toward science, attitude toward the environment, self-concept, and academic self-concept with at-risk eleventh and twelfth grade students. One hundred eight students were pretested and posttested on the Piers-Harris Children's Self-Concept Scale, PHCSC (1985); the Self-Concept as a Learner Scale, SCAL (1978); the Marine Science Test, MST (1987); the Science Attitude Inventory, SAI (1970); and the Environmental Attitude Scale, EAS (1972). Using a stratified random design, three groups of students were randomly assigned according to sex and stanine level, to three treatment groups. Group one received the field project method, group two received the field study method, and group three received the field trip method. All three groups followed the marine biology course content as specified by Florida Student Performance Objectives and Frameworks. The intervention occurred for ten months with each group participating in outside-of-classroom activities on a trimonthly basis. Analysis of covariance procedures were used to determine treatment effects. F-ratios, p-levels and t-tests at p $<$.0062 (.05/8) indicated that a significant difference existed among the three treatment groups. Findings indicated that groups one and two were significantly different from group three with group one displaying significantly higher results than group two. There were no significant differences between males and females in performance on the five dependent variables. The tenets underlying environmental education are congruent with the recommendations toward the reform of science education. These include a value analysis approach, inquiry methods, and critical thinking strategies that are applied to environmental issues. ^

A developmental education program model for high -risk minority baccalaureate nursing students

The purpose of this study was to define and describe a Developmental Education Program Model for high-risk minority baccalaureate nursing students based upon perceived needs determined by nursing students and nursing faculty. The research examined differences between Black and Non-Black nursing students in level of importance of concerns and issues related to academic, financial, psycho-social and personal areas of student life; faculty perceptions of the differences between Black and Non-Black nursing students in the level of importance of concerns and issues related to academic, financial, psycho-social and personal areas of student life; and the difference between Black and Non-Black nursing faculty perceptions of level of importance of issues and concerns of academic, financial, psycho-social, and personal areas for Black nursing students. In this study two data collection methods were used, questionnaire and interview. The questionnaire was completed by all students and faculty. Black baccalaureate nursing students and nursing faculty were interviewed. The most significant differences were seen in the category of Personal Issues. Student identified concerns and issues related to both academic and health problems. Faculty identified the greatest differences in Academic Issues. The framework for the model which evolved out of the data uses needs from: (1) a whole person perspective (outcome oriented needs); (2) a programmatic perspective (input oriented needs); and (3) learning domain perspective (process oriented needs). ^

Prediction of traffic-induced vibration using 3D bridge model and consideration of influence of bridge structural properties on response

Peer reviewed

Is socioeconomic position early in life associated with physical activity during adulthood following the accumulation of risk model with additive effects?

L'activité physique améliore la santé, mais seulement 4.8% des Canadiens atteignent le niveau recommandé. La position socio-économique est un des déterminants de l'activité physique les plus importants. Elle est associée à l’activité physique de manière transversale à l’adolescence et à l’âge adulte. Cette thèse a tenté de déterminer s'il y a une association à long terme entre la position socio-économique au début du parcours de vie et l’activité physique à l’âge adulte. S'il y en avait une, un deuxième objectif était de déterminer quel modèle théorique en épidémiologie des parcours de vie décrivait le mieux sa forme. Cette thèse comprend trois articles: une recension systématique et deux recherches originales. Dans la recension systématique, des recherches ont été faites dans Medline et EMBASE pour trouver les études ayant mesuré la position socio-économique avant l'âge de 18 ans et l'activité physique à ≥18 ans. Dans les deux recherches originales, la modélisation par équations structurelles a été utilisée pour comparer trois modèles alternatifs en épidémiologie des parcours de vie: le modèle d’accumulation de risque avec effets additifs, le modèle d’accumulation de risque avec effet déclenché et le modèle de période critique. Ces modèles ont été comparés dans deux cohortes prospectives représentatives à l'échelle nationale: la 1970 British birth cohort (n=16,571; première recherche) et l’Enquête longitudinale nationale sur les enfants et les jeunes (n=16,903; deuxième recherche). Dans la recension systématique, 10 619 articles ont été passés en revue par deux chercheurs indépendants et 42 ont été retenus. Pour le résultat «activité physique» (tous types et mesures confondus), une association significative avec la position socio-économique durant l’enfance fut trouvée dans 26/42 études (61,9%). Quand seulement l’activité physique durant les loisirs a été considérée, une association significative fut trouvée dans 21/31 études (67,7%). Dans un sous-échantillon de 21 études ayant une méthodologie plus forte, les proportions d’études ayant trouvé une association furent plus hautes : 15/21 (71,4%) pour tous les types et toutes les mesures d’activité physique et 12/15 (80%) pour l’activité physique de loisir seulement. Dans notre première recherche originale sur les données de la British birth cohort, pour la classe sociale, nous avons trouvé que le modèle d’accumulation de risque avec effets additifs s’est ajusté le mieux chez les hommes et les femmes pour l’activité physique de loisir, au travail et durant les transports. Dans notre deuxième recherche originale sur les données canadiennes sur l'activité physique de loisir, nous avons trouvé que chez les hommes, le modèle de période critique s’est ajusté le mieux aux données pour le niveau d’éducation et le revenu, alors que chez les femmes, le modèle d’accumulation de risque avec effets additifs s’est ajusté le mieux pour le revenu, tandis que le niveau d’éducation ne s’est ajusté à aucun des modèles testés. En conclusion, notre recension systématique indique que la position socio-économique au début du parcours de vie est associée à la pratique d'activité physique à l'âge adulte. Les résultats de nos deux recherches originales suggèrent un patron d’associations le mieux représenté par le modèle d’accumulation de risque avec effets additifs.

Towards convection-resolving, global atmospheric simulations with the Model for Prediction Across Scales (MPAS) v3.1: an extreme scaling experiment, links to sourcecode of model and grides

The Model for Prediction Across Scales (MPAS) is a novel set of Earth system simulation components and consists of an atmospheric model, an ocean model and a land-ice model. Its distinct features are the use of unstructured Voronoi meshes and C-grid discretisation to address shortcomings of global models on regular grids and the use of limited area models nested in a forcing data set, with respect to parallel scalability, numerical accuracy and physical consistency. This concept allows one to include the feedback of regional land use information on weather and climate at local and global scales in a consistent way, which is impossible to achieve with traditional limited area modelling approaches. Here, we present an in-depth evaluation of MPAS with regards to technical aspects of performing model runs and scalability for three medium-size meshes on four different high-performance computing (HPC) sites with different architectures and compilers. We uncover model limitations and identify new aspects for the model optimisation that are introduced by the use of unstructured Voronoi meshes. We further demonstrate the model performance of MPAS in terms of its capability to reproduce the dynamics of the West African monsoon (WAM) and its associated precipitation in a pilot study. Constrained by available computational resources, we compare 11-month runs for two meshes with observations and a reference simulation from the Weather Research and Forecasting (WRF) model. We show that MPAS can reproduce the atmospheric dynamics on global and local scales in this experiment, but identify a precipitation excess for the West African region. Finally, we conduct extreme scaling tests on a global 3?km mesh with more than 65 million horizontal grid cells on up to half a million cores. We discuss necessary modifications of the model code to improve its parallel performance in general and specific to the HPC environment. We confirm good scaling (70?% parallel efficiency or better) of the MPAS model and provide numbers on the computational requirements for experiments with the 3?km mesh. In doing so, we show that global, convection-resolving atmospheric simulations with MPAS are within reach of current and next generations of high-end computing facilities.

Predictive Risk Modelling for Integrated Care: a Structured Review

If patients at risk of admission or readmission to hospital or other forms of care could be identified and offered suitable early interventions then their lives and long-term health may be improved by reducing the chances of future admission or readmission to care, and hopefully, their cost of care reduced. Considerable work has been carried out in this subject area especially in the USA and the UK. This has led for instance to the development of tools such as PARR, PARR-30, and the Combined Predictive Model for prediction of emergency readmission or admission to acute care. Here we perform a structured review the academic and grey literature on predictive risk tools for social care utilisation, as well as admission and readmission to general hospitals and psychiatric hospitals. This is the first phase of a project in partnership with Docobo Ltd and funded by Innovate UK,in which we seek to develop novel predictive risk tools and dashboards to assist commissioners in Clinical Commissioning Groups with the triangulation of the intelligence available from routinely collected data to optimise integrated care and better understand the complex needs of individuals.

Simplified model for prediction of compressive strength of alkali-activated natural pozzolans

The assessment of pozzolanic activity is essential for estimating the reaction of a material as pozzolan. Natural pozzolans can be activated and condensed with sodium silicate in an alkaline environment to synthesize high performance cementitious construction materials with low environmental impact. In this paper, the pozzolanic activities of five natural pozzolans are studied. The correlation between type and chemical composition of natural pozzolan, which affects the formation of the geopolymer gel phase, both for the calcined and untreated natural pozzolans, have been reviewed. The improvement in pozzolanic properties was studied following heat treatment including calcinations and/or elevated curing temperature by using alkali solubility, and compressive strength tests. A model was developed to allow prediction of the alkali-activated pozzolan strength versus their chemical compositions, alkali solubility, and crystallinity.

Comparison of excess radiological risk of building materials and industrial by-products according to I-index (EU-BSS) and revised room model (IAEA SSG-32)

To get a better insight into the radiological features of industrial by-products that can be reused in building materials a review of the reported scientific data can be very useful. The current study is based on the continuously growing database of the By-BM (H2020-MSCA-IF-2015) project (By-products for Building Materials). Currently, the By-BM database contains individual data of about 431 by-products and 1095 building and raw materials. It was found that in case of the building materials the natural radionuclide content varied widely (Ra-226: <DL-27851 Bq/kg; Th-232: <DL-906 Bq/kg, K-40: <DL-17922 Bq/kg), more so than for the by-products (Ra-226: 7-3152 Bq/kg; Th-232: <DL-1350 Bq/kg, K-40: <DL-3001 Bq/kg). The average Ra-226, Th-232 and K-40 contents of the reported by-products were respectively 2.52, 2.35 and 0.39 times higher than the building materials. The gamma exposure of bulk building products was calculated according to IAEA Specific Safety Guide No. SSG-32 and the European Commission Radiation Protection 112 based I-index (EU BSS). It was found that in most cases the I-index without density consideration provides a significant overestimation in excess effective dose.

Self-harm, suicide and risk: helping people who self-harm. Final report of a working group.

The focus of this report is to enquire into and report on why people harm and kill themselves and to consider the role (including the limits of the role) that psychiatrists and other mental healthcare professionals play in their care and treatment. The experiences and views of people who harm themselves as well as those of their carers, health professionals and third-sector workers are central to this enquiry. As there is much policy and guidance on self-harm and suicide prevention, the report does not attempt to retrace this same ground but rather examines the evidence of practice on the ground, including the implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines on self-harm (National Collaborating Centre for Mental Health, 2004). This report is the second in the Royal College of Psychiatristsââ,¬â"¢ programme of work on the broad issue of risk. The College report Rethinking Risk to Others was published in July 2008 (Royal College of Psychiatrists, 2008a) and a new Working Group was set up under the chairmanship of John, Lord Alderdice, to examine risk, self-harm and suicide. This clinical issue is an integral part of the role of the psychiatrist in ensuring the good care and treatment of patients. Our central theme is that the needs, care, well-being and individual human dilemma of the person who harms themselves should be at the heart of what we as clinicians do. Public health policy has a vital role to play and psychiatrists must be involved and not leave these crucial political and managerial decisions to those who are not professionally equipped to appreciate the complexities of self-harm and suicide. But we must never forget that we are not just dealing with social phenomena but with people who are often at, and beyond the limit of what they can emotionally endure. Their aggressive acts towards themselves can be difficult to understand and frustrating to address, but this is precisely why psychiatrists need to be involved to bring clarity to the differing causes for the self-destructive ways in which people act and to assist in managing the problems for the people concerned, including family, friends and professional carers, who sometimes find themselves at the end of their tether in the face of such puzzling and destructive behaviour.

Evaluating statistical and machine learning methods to predict risk of in-hospital child mortality in Uganda

Thesis (Master's)--University of Washington, 2016-08

Estimating the effect of state-level gun purchasing policy on county-level firearm suicide mortality

Thesis (Master's)--University of Washington, 2016-08