Study to assess the effect of a structured communication approach on quality of life in secure mental health settings (Comquol): study protocol for a pilot cluster randomized trial

Background Forensic mental health services have largely ignored examining patients’ views on the nature of the service offered to them. A structured communication approach (DIALOG) has been developed with the aim of placing the patient’s perspective of their care at the heart of the discussions between patients and clinicians. The effectiveness of the structured communication approach in community mental health services has been demonstrated but no trial taken place in a secure psychiatric setting. This pilot study is evaluating a six-month intervention combining DIALOG with principles of Solution Focused Therapy (SFT) on quality of life in medium secure settings. Methods/design A cluster randomized controlled trial design is being employed to conduct a 36 months pilot study. Participants are recruited from six medium secure in–patient services with 48 patients in the intervention group and 48 in the control group. The intervention uses a structured communication approach. It comprises of six meetings between patient and nurse over held once a month a six month period. During each meeting patients rate their satisfaction with a range of life and treatment domains with responses displayed on a tablet. The rating is followed by a discussion on how to improve the current situation in those domains identified by the patient. Assessments take place prior to the intervention (baseline), at 6 months (post intervention) and at 12 months (follow-up). The primary outcome is self reported Quality of Life. Discussion: The study aims to a) establish the feasibility of the trial design as the basis for determining the viability of a large full-scale trial, b) determine the variability of the outcomes of interest (quality of life, levels of satisfaction, disturbance, ward climate, and engagement with services) c) estimate the costs of the intervention and d) refine the intervention following the outcome of the study based upon the experiences of the nurses and patients. The intervention allows patients to have a greater say in how they are treated and targets care on areas that patients identify as important to them. It is intended to establish systems that support meaningful patient (and carer) involvement and participation. Trial registration: Current Controlled Trials ISRCTN34145189 Keywords: Comquol, DIALOG, Forensic, Mental Health, Quality of Life, Solution Focused Brief Therapy

Cyber Insurance: recent advances, good practices & challenges

The aim of this ENISA report is to raise awareness for the most impact to market advances, by shortly identifying the most significant cyber insurance developments for the past four years – during 2012 to 2016 – and to capture the good practices and challenges during the early stages of the cyber insurance lifecycle, i.e. before an actual policy is signed, laying the ground for future work in the area

Predictors of moving on from mental health supported accommodation in England: national cohort study

National Institute of Health Research (RP-PG-0610-10097

Design Considerations for Building Credible Security Testbeds: Perspectives from Industrial Control System Use Cases

This paper presents a mapping framework for design factors and an implementation process for building credible Industrial Control Systems (ICS) security testbeds. The security and resilience of ICSs has become a critical concern to operators and governments following widely publicised cyber security events. The inability to apply conventional Information Technology security practice to ICSs further compounds challenges in adequately securing critical systems. To overcome these challenges, and do so without impacting live environments, testbeds are widely used for the exploration, development, and evaluation of security controls. However, how a testbed is designed and its attributes, can directly impact not only its viability but also its credibility. Combining systematic and thematic analysis, and the mapping of identified ICS security testbed design attributes, we propose a novel relationship map of credibility-supporting design factors (and their associated attributes) and a process implementation flow structure for ICS security testbeds. The framework and implementation process highlight the significance of demonstrating some design factors such as user/experimenter expertise, clearly defined testbed design objectives, simulation implementation approach, covered architectural components, core structural and functional characteristics covered, and evaluations to enhance confidence, trustworthiness and acceptance of ICS security testbeds as credible. These can streamline testbed requirement definition, improve design consistency and quality while reducing implementation costs

Timing of Cyber-Physical Attacks on Process Control Systems

Part 1: Control Systems SecurityInternational audienceThis paper introduces a new problem formulation for assessing the vulnerabilities of process control systems. In particular, it considers an adversary who has compromised sensor signals and has to decide on the best time to launch an attack. The task of selecting the best time to attack is formulated as an optimal stopping problem that the adversary has to solve in real time. The theory underlying the best choice problem is used to identify an optimal stopping criterion, and a low-pass filter is subsequently used to identify when the time series of a process variable has reached the state desired by the attacker (i.e., its peak). The complexities associated with the problem are also discussed, along with directions for future research

Two safety patterns

Safety is the avoidance of unacceptable hazards, including threats to human lives, the environment, or to costly facilities. Safety constraints are expressed using assertions that define system states that should not occur because they may lead to mishaps. We present here two safety patterns. The Safety Assertion pattern describes the contents of an assertion that indicates a state of the system that must not happen. The Safety Assertion Enforcer pattern evaluates safety assertions when there is an incoming event that can change the state of the system and prevents the change if it violates an assertion. These patterns can be useful for designing or certifying safe systems