Oxycodone or oxycodone plus paracetamol for acute postoperative pain in adults

In this short communication we wanted to find out what is the analgesic effect of single dose oral oxycodone, with or without the addition of paracetamol, for adults with postoperative pain? Oxycodone at doses of 5mg and above is an effective analgesia for patients with moderate to severe postoperative pain. The efficacy of oxycodone is increased with the addition of paracetamol. The use of oxycodone 10mg plus paracetamol 625mg can be considered for use in the pain relief protocol in post-operative settings. Clinicians should consider a range of factors before prescribing or administering oxycodone for acute post-operative pain, including but not limited to, individual patient clinical profile, adverse effects, cost and patient preference.

Damage localisation in beams and plates using vibration characteristics

Dynamic computer simulation techniques are used to develop and apply a multi-criteria procedure, incorporating changes in natural frequencies, modal flexibility and the modal strain energy, for damage localisation in beams and plates. Numerically simulated modal data obtained through finite element analyses are used to develop algorithms based on changes of modal flexibility and modal strain energy before and after damage and used as the indices for assessment of the state of structural health. The proposed procedure is illustrated through its application to flexural members under different damage scenarios and the results confirm its feasibility for damage assessment.

Collaborative digital media performance with generative music systems

Music is inherently active and interactive. Like technologies before them, digital systems provide a range of enhanced music performance opportunities. In this paper we outline the educational advantages of ensemble performance in which generative media systems are integrated. As a concrete example, we focus on our work with the jam2jam system which uses generative music processes to enhance collaborative music making. We suggest that our research points toward a new class of activities that maintain the well established benefits of ensemble performance while adding cultural and pedagogical value by leveraging the capabilities and cachet of digital media practices.

Sex, drugs, and deterrence : applying Stafford and Warr’s reconceptualization of deterrence theory to drug driving across the genders

A consistent finding in the literature is that males report greater usage of drugs and subsequently greater amounts of drug driving. Research also suggests that vicarious influences may be more pertinent to males than to females. Utilising Stafford and Warr’s (1993) reconceptualization of deterrence theory, this study sought to determine if the relative deterrent impact of zero-tolerance drug driving laws is disparate between genders. A sample of motorists’ (N = 899) completed a self-report questionnaire assessing participants frequency of drug driving and personal and vicarious experiences with punishment and punishment avoidance. Results show that males were significantly more likely to report future intentions of drug driving. Additionally, vicarious experiences of punishment avoidance was a more influential predictor of future drug driving instances for males with personal experiences of punishment avoidance a more influential predictor for females. These findings can inform gender sensitive media campaigns and interventions for convicted drug drivers.

Towards a comprehensive model of driver aggression : a review of the literature and directions for the future

Driver aggression is a road safety issue of growing concern throughout most highly motorised countries, yet to date there is no comprehensive model that deals with this issue in the road safety area. This paper sets out to examine the current state of research and theory on aggressive driving with a view to incorporating useful developments in the area of human aggression from mainstream psychological research. As a first step, evidence regarding the prevalence and incidence of driver aggression, including the impact of the phenomenon on crash rates is reviewed. Inconsistencies in the definition and operationalisation of driver aggression that have hampered research in the area are noted. Existing models of driver aggression are then identified and the need to distinguish and address the role of intentionality as well as the purpose of perpetrating behaviours within both these and research efforts is highlighted. Drawing on recent findings from psychological research into general aggression, it is argued that progress in understanding driver aggression requires models that acknowledge not only the person-related and situational factors, but the cognitive and emotional appraisal processes involved in driver aggression. An effective model is expected to allow the explanation of not only the likelihood and severity of driver aggression behaviours, but also the escalation of incidents within the context of the road environment.

Case study of collaborative learning in two contexts : what do students gain?

This book presents important research advances in the study of teaching and teacher research as well as a review of motivation in education; mentoring; an evaluation of online learning; educational change and computer-assisted teaching.

Source of concern for IT purchasing decisions

The open source juggernaut seems to be gaining pace. The open source model certainly has appeal - cutting costs, while at the same time potentially increasing staff and system efficiencies. However, open source poses a number of significant legal challenges and risks for those that incorporate it. Clients need to look carefully before leaping.

User-created content and everyday cultural practice : lessons from YouTube

This chapter sets out the debates about the changing role of audiences in relation to user-created content as they appear in New Media and Cultural Studies. The discussion moves beyond the simple dichotomies between active producers and passive audiences, and draws on empirical evidence, in order to examine those practices that are most ordinary and widespread. Building on the knowledge of television’s role in facilitating public life, and the everyday, affective practices through which it is experienced and used, I focus on the way in which YouTube operates as a site of community, creativity and cultural citizenship; and as an archive of popular cultural memory.

Low intensity CBT by mail

Introduction: There are many low intensity (LI) cognitive behavoural therapy (CBT) solutions to the problem of limited service access. In this chapter, we aim to discuss a relatively low-technology approach to access using standard postal services-CBT by mail, or M-CBT. Bibliotherapies including M-CBT teach key concepts and self-management techniques, together with screening tools and forms to structure home practice. M-CBT differs from other bibliotherapies by segmenting interventions and mailing them at regular intervals. Most involve participants returning copies of monitoring forms or completed handouts. Therapist feedback is provided, often in personal letters that accompany the printed materials. Participants may also be given access to telephone or email support. ----- ----- M-CBT clearly fulfills criteria for an LI CBT (see Bennett-Levy et al., Chapter 1, for a definition of LI interventions). Once written, they involve little therapist time and rely heavily on self-management. However, content and overall treatment duration need not be compromised. Long-term interventions with multiple components can be delivered via this method, provided their content can be communicated in letters and engagement is maintained.

Implementing low intensity CBT in case management of clients with severe mental illness

In a previous chapter (Dean and Kavanagh, Chapter 37), the authors made a case for applying low intensity (LI) cognitive behaviour therapy (CBT) to people with serious mental illness (SMI). As in other populations, LI CBT interventions typically deal with circumscribed problems or behaviours. LI CBT retains an emphasis on self-management, has restricted content and segment length, and does not necessarily require extensive CBT training. In applying these interventions to SMI, adjustments may be needed to address cognitive and symptomatic difficulties often faced by these groups. What may take a single session in a less affected population may require several sessions or a thematic application of the strategy within case management. In some cases, the LI CBT may begin to appear more like a high-intensity (HI) intervention, albeit simple and with many LI CBT characteristics still retained. So, if goal setting were introduced in one or two sessions, it could clearly be seen as an LI intervention. When applied to several different situations and across many sessions, it may be indistinguishable from a simple HI treatment, even if it retains the same format and is effectively applied by a practitioner with limited CBT training. ----- ----- In some ways, LI CBT should be well suited to case management of patients with SMI. treating staff typically have heavy workloads, and find it difficult to apply time-consuming treatments (Singh et al. 2003). LI CBT may allow provision of support to greater numbers of service users, and allow staff to spend more time on those who need intensive and sustained support. However, the introduction of any change in practice has to address significant challenges, and LI CBT is no exception. ----- ----- Many of the issues that we face in applying LI CBT to routine case management in a mnetal health service and their potential solutions are essentially the same as in a range of other problem domains (Turner and Sanders 2006)- and, indeed, are similar to those in any adoption of innovation (Rogers 2003). Over the last 20 years, several commentators have described barriers to implementing evidence-based innovations in mental health services (Corrigan et al. 1992; Deane et al. 2006; Kavanagh et al. 1993). The aim of the current chapter is to present a cognitive behavioural conceptualisation of problems and potential solutions for dissemination of LI CBT.

Adapting low intensity CBT interventions for clients with severe mental illness

Many people with severe mental illness (SMI) such as schizophrenia, whose psychotic symptoms are effectively managed, continue to experience significant functional problems. This chapter argues that low intensity (LI) cognitive behaviour therapy (CBT; e.g. for depression, anxiety, or other issues) is applicable to these clients, and that LI CBT can be consistent with long-term case management. However, adjustments to LI CBT strategies are often necessary and boundaries between LI CBT and high intensity (HI) CBT (with more extensive practitioner contact and complexity) may become blurred. Our focus is on LI CBT's self-management emphasis, its restricted content and segment length, and potential use after limited training. In addition to exploring these issues, it draws on the authors' Collaborative Recovery (CR; Oades et al. 2005) and 'Start Over and Survive' programs (Kavanagh et al. 2004) as examples. ----- ----- Evidence for the effectiveness of LI CBT with severe mental illness is often embedded within multicomponent programs. For example, goal setting and therapeutic homework are common components of such programs, but they can also be used as discrete LI CBT interventions. A review of 40 randomised controlled trials involving recipients with schizophrenia or other sever mental illnesses has identified key components of illness management programs (Mueser et al. 2002). However, it is relatively rare for specific components of these complex interventions to be assessed in isolation. Given these constraints, the evidence for specific LI CBT interventions with severe mental ilnness is relatively limited.

Brief motivational interviewing for depression and anxiety

Motivational interviewing (MI)can be applied as a brief, low intensity (LI) intervention of 1-4 individualised sessions (typically 45-60 minutes in duration), including screening, assessment feedback, and psycho-education. MI is a client-centred, directive therapeutic style that enhances readiness for change by helping clients explore and resolve ambivalence (Miller and Rollnick 2002). A summary of the key components of brief MI interventions is provided in Table 16.1. There is a well-established evidence base for MI in the treatment of substance misuse (particularly alcohol misuse; Moyer et al. 2002), as well as a growing evidence for the use of MI in the treatment of other mental disorders (e.g. depression, PTSD, OCD), as well as suicidality and physical health problems (Hettema et al. 2005). Brief MI intervention can be delivered as a standalone treatment or as a motivational prelude to pharmacological and/or other psychological treatments (Hettema et al. 2005). MI has been used as an accompaniment to cognitive behavioural therapy (CBT) in the treatment of both depression and anxiety for resolving ambivalence about change and developing strategies for responding to resistance (e.g. treatment attendance, homework/medication compliance; Arkowitz et al. 2008a, 2008b). This chapter will describe how to apply brief MI interventions to the treatment of depression and anxiety as applied to the case of Megan (see Box 16.1) along with some of the challenges and potential solutions to applying MI in practice.

Recent advances in cancer therapy targeting proteins involved in DNA double-strand break repair

Damage to genetic material represents a persistent and ubiquitous threat to genomic stability. Once DNA damage is detected, a multifaceted signaling network is activated that halts the cell cycle, initiates repair, and in some instances induces apoptotic cell death. In this article, we will review DNA damage surveillance networks, which maintain the stability of our genome, and discuss the efforts underway to identify chemotherapeutic compounds targeting the core components of DNA double-strand breaks (DSB) response pathway. The majority of tumor cells have defects in maintaining genomic stability owing to the loss of an appropriate response to DNA damage. New anticancer agents are exploiting this vulnerability of cancer cells to enhance therapeutic indexes, with limited normal tissue toxicity. Recently inhibitors of the checkpoint kinases Chk1 and Chk2 have been shown to sensitize tumor cells to DNA damaging agents. In addition, the treatment of BRCA1- or BRCA2-deficient tumor cells with poly(ADP-ribose) polymerase (PARP) inhibitors also leads to specific tumor killing. Due to the numerous roles of p53 in genomic stability and its defects in many human cancers, therapeutic agents that restore p53 activity in tumors are the subject of multiple clinical trials. In this article we highlight the proteins mentioned above and catalog several additional players in the DNA damage response pathway, including ATM, DNA-PK, and the MRN complex, which might be amenable to pharmacological interventions and lead to new approaches to sensitize cancer cells to radio- and chemotherapy. The challenge is how to identify those patients most receptive to these treatments.