What GPs need to know about palliative-care drugs : methadone

This is the second in a short series of articles that focus on what GPs should consider when monitoring and prescribing specialist‐initiated palliative‐care drugs. Here, the authors summarise the key issues around the use of methadone for pain management.

Determinants of pollution: what do we really know?

The recent literature proposes many variables as significant determinants of pollution. This paper gives an overview of this literature and asks which of these factors have an empirically robust impact on water and air pollution. We apply Extreme Bound Analysis (EBA) on a panel of up to 120 countries covering the period 1960–2001. We find supportive evidence of the existence of the environmental Kuznets curve for water pollution. Furthermore, mainly variables capturing the economic structure of a country affect air and water pollution.

How do I know if my forecasts are better? Using benchmarks in Hydrological ensemble prediction

The skill of a forecast can be assessed by comparing the relative proximity of both the forecast and a benchmark to the observations. Example benchmarks include climatology or a naïve forecast. Hydrological ensemble prediction systems (HEPS) are currently transforming the hydrological forecasting environment but in this new field there is little information to guide researchers and operational forecasters on how benchmarks can be best used to evaluate their probabilistic forecasts. In this study, it is identified that the forecast skill calculated can vary depending on the benchmark selected and that the selection of a benchmark for determining forecasting system skill is sensitive to a number of hydrological and system factors. A benchmark intercomparison experiment is then undertaken using the continuous ranked probability score (CRPS), a reference forecasting system and a suite of 23 different methods to derive benchmarks. The benchmarks are assessed within the operational set-up of the European Flood Awareness System (EFAS) to determine those that are ‘toughest to beat’ and so give the most robust discrimination of forecast skill, particularly for the spatial average fields that EFAS relies upon. Evaluating against an observed discharge proxy the benchmark that has most utility for EFAS and avoids the most naïve skill across different hydrological situations is found to be meteorological persistency. This benchmark uses the latest meteorological observations of precipitation and temperature to drive the hydrological model. Hydrological long term average benchmarks, which are currently used in EFAS, are very easily beaten by the forecasting system and the use of these produces much naïve skill. When decomposed into seasons, the advanced meteorological benchmarks, which make use of meteorological observations from the past 20 years at the same calendar date, have the most skill discrimination. They are also good at discriminating skill in low flows and for all catchment sizes. Simpler meteorological benchmarks are particularly useful for high flows. Recommendations for EFAS are to move to routine use of meteorological persistency, an advanced meteorological benchmark and a simple meteorological benchmark in order to provide a robust evaluation of forecast skill. This work provides the first comprehensive evidence on how benchmarks can be used in evaluation of skill in probabilistic hydrological forecasts and which benchmarks are most useful for skill discrimination and avoidance of naïve skill in a large scale HEPS. It is recommended that all HEPS use the evidence and methodology provided here to evaluate which benchmarks to employ; so forecasters can have trust in their skill evaluation and will have confidence that their forecasts are indeed better.

Typographic layout and first impressions: testing how changes in text layout influence reader's judgments of documents

This study explores how the typographic layout of information influences readers' impressions of magazine contents pages. Thirteen descriptors were used in a paired comparison procedure that assessed whether participants' rhetorical impressions of a set of six controlled documents change in relation to variations in layout. The combinations of layout attributes tested were derived from the structural attributes associated with three patterns of typographic differentiation (high, moderate, and low) described in a previous study (see Moys, 2014). The content and the range of stylistic attributes applied to the test material were controlled in order to focus on layout attributes. Triangulation of the quantitative and qualitative data indicates that, even within the experimental confines of limited stylistic differentiation, the layout attributes associated with patterns of high, moderate, and low typographic differentiation do influence readers' rhetorical judgments. In addition, the findings emphasize the importance of considering inter-relationships between clusters of typographic attributes rather than testing isolated variables.

Recover it from the facts as we know them

In Andrea Sangiovanni’s words, practice-dependent theorists hold that “[t]he content, scope, and justification of a conception of [a given value] depends on the structure and form of the practices that the conception is intended to govern”. They have tended to present this as methodologically innovative, but here I point to the similarities between the methodological commitments of contemporary practice-dependent theorists and others, particularly P. F. Strawson in his Freedom and Resentment and Bernard Williams in general. I suggest that by looking at what Strawson and Williams did, we can add to the reasons for adopting one form or another of practice-dependence. The internal complexity of the practices we hope our principles will govern may require it. However, this defence of practice-dependence also puts pressure on self-identified practice-dependence theorists, suggesting that they need to do more work to justify the interpretations of the practices their theories rely on.

You know how I know you're gay? : masculinity and homophobia in mainstream comedy

You Know How I Know You're Gay?: Masculinity and Homophobia in Contemporary Mainstream Comedy is a three-part senior scholars project that consists of a critical analysis of homophobic humor in contemporary mainstream comedy, an original feature-length comedy script entitled Don 't Be that Freshman, and a DVD of selected scenes from Don't Be that Freshman. The critical analysis first establishes the existence of homophobic humor in mainstream comedy and then links this homophobia to masculine anxiety, applying the ideas set forth in Michael Kimmel's essay, "Masculinity as Homophobia," to contemporary, mainstream, homosocial comedies. The paper goes on to examine audience reactions to this homophobic humor, focusing on audience members who enjoy these movies, yet consider themselves to be accepting of homosexuality and against homophobia. I discuss ways of resistance and the importance of opposing homophobic humor, and finally, I look at comedy as a potentially transgressive medium that could be used to fight homophobia and social inequality. The critical analysis, therefore, leads into Don't Be that Freshman, a film that uses progressive humor to oppose homophobia and expose the potential dangers and pitfalls of conforming to social constructions of gender. Don't Be that Freshman is a film about three pairs of college roommates in their first semester at college who become each other's first friends on campus. It is a character-driven comedy that attempts to normalize non-heterosexual sexual orientation and gender non-conformity, to advocate a type of living that does not conform to problematic social constructions and cultural ideologies, and at the same time to appeal to a mainstream audience. The film version is twenty-five minutes long and consists of ten scenes from the script.

Reading Is, Like, You Know, Sooooo Gross!

“Huge Decline in Book Reading” ran one headline. “Cultural Atrophy!” read another. “Study Links Drop in Test Scores to a Decline Spent in Reading” ran one for the “Duh!” award. “Americans are Closing the Book on Reading” said one, vying for the pun-acious trophy.

O psicólogo e os serviços de acolhimento institucional para crianças e adolescentes

The Shelters are responsible for caring for children and adolescents whose families or guardians are temporarily unable to fulfill his role as care and protection. The activities to be developed by psychologists in these services are greatly important for the elaboration and development of political- pedagogical project of the same, and for reasons pertaining to the present and future of children and adolescents received judgments. The psychologist puts up the challenge of contributing to a better care of children, also cooperating with the implementation of the new care standards of childcare. The aim of this study was to investigate the role of the professional psychologist in assistance to children and adolescents in 13 Shelters in the Metropolitan Region of Natal/RN. For both set out to make visits to the institutions to know how it is organized the field work of the psychologist, his routine work and activities developed. Nine psychologists interviewed according to a semi-structured interview script. The data analysis is supported by the theoretical aspects of dialectical materialism historical and theme content analysis was used. Results were presented from three angles: psychologists and institutional framework; activities, resources and methods of work; psychologists and legal frameworks of the Institutional Hospitality. The study points out the recent entry of the psychologist in Shelters, combined with considerable turnover of these professionals. This work has been organized through the Individualized Service Plan, prioritizing the return to family of origin. Moreover, in general, perform joints with the service network, reporting, individual consultations and follow-adoption processes . Staff members, however, feel a lack of specific and continuing training on special protection, including due to the distance between the proposed theory and practice. It was thus observed a movement of psychologists distance themselves from welfare or repressive practices, however the structural difficulties of services and lack of continuing education appear to limit the development of a performance focused on the transformation of the reality of children and adolescents treated and their families

Takayasu's arteritis: What should the dentist know?

Takayasu's arteritis is a chronic inflammatory disease that affects large blood vessels, especially the aorta and/or its major branches. The condition presents with segmental lesions adjacent to normal, apparently unaffected, areas. The lesions include stenosis, occlusion, dilatations or aneurysm formations along the path of the affected artery. Because of the severity of the disease and the possibility of cardiovascular complications, patients with Takayasu's arteritis require medical treatment based on immunosuppressive and antihypertensive drugs, as well as regular follow up and surgical intervention in many instances. The aim of this paper was to describe the characteristics of Takayasu's arteritis, to report dental treatment carried out on an affected patient, and to discuss the main implications and care required during routine treatment for children in the dental office. © 2005 BSPD and IAPD.

Migration in the Caribbean: what do we know? an overview of data, policies and programmes at the international and regional levels to address critical issues

Includes bibliography