Recognition, assessment and treatment of social anxiety disorder: summary of NICE guidance

Social anxiety disorder is one of the most persistent and common of the anxiety disorders, with lifetime prevalence rates in Europe of 6.7% (range 3.9-13.7%).1 It often coexists with depression, substance use disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder.2 It can severely impair a person’s daily functioning by impeding the formation of relationships, reducing quality of life, and negatively affecting performance at work or school. Despite this, and the fact that effective treatments exist, only about half of people with this condition seek treatment, many after waiting 10-15 years.3 Although about 40% of those who develop the condition in childhood or adolescence recover before adulthood,4 for many the disorder persists into adulthood, with the chance of spontaneous recovery then limited compared with other mental health problems. This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on recognising, assessing, and treating social anxiety disorder in children, young people, and adults.5

Assessing macro uncertainty in real-time when data are subject to revision

Model-based estimates of future uncertainty are generally based on the in-sample fit of the model, as when Box-Jenkins prediction intervals are calculated. However, this approach will generate biased uncertainty estimates in real time when there are data revisions. A simple remedy is suggested, and used to generate more accurate prediction intervals for 25 macroeconomic variables, in line with the theory. A simulation study based on an empirically-estimated model of data revisions for US output growth is used to investigate small-sample properties.

Global change pressures on soils from land use and management

Soils are subject to varying degrees of direct or indirect human disturbance, constituting a major global change driver. Factoring out natural from direct and indirect human influence is not always straightforward, but some human activities have clear impacts. These include land use change, land management, and land degradation (erosion, compaction, sealing and salinization). The intensity of land use also exerts a great impact on soils, and soils are also subject to indirect impacts arising from human activity, such as acid deposition (sulphur and nitrogen) and heavy metal pollution. In this critical review, we report the state-of-the-art understanding of these global change pressures on soils, identify knowledge gaps and research challenges, and highlight actions and policies to minimise adverse environmental impacts arising from these global change drivers. Soils are central to considerations of what constitutes sustainable intensification. Therefore, ensuring that vulnerable and high environmental value soils are considered when protecting important habitats and ecosystems, will help to reduce the pressure on land from global change drivers. To ensure that soils are protected as part of wider environmental efforts, a global soil resilience programme should be considered, to monitor, recover or sustain soil fertility and function, and to enhance the ecosystem services provided by soils. Soils cannot, and should not, be considered in isolation of the ecosystems that they underpin and vice versa. The role of soils in supporting ecosystems and natural capital needs greater recognition. The lasting legacy of the International Year of Soils in 2015 should be to put soils at the centre of policy supporting environmental protection and sustainable development.

Microbial Recognition Via Toll-Like Receptor-Dependent and -Independent Pathways Determines the Cytokine Response of Murine Dendritic Cell Subsets to CD40 Triggering

Dendritic cells (DC) can produce Th-polarizing cytokines and direct the class of the adaptive immune response. Microbial stimuli, cytokines, chemokines, and T cell-derived signals all have been shown to trigger cytokine synthesis by DC, but it remains unclear whether these signals are functionally equivalent and whether they determine the nature of the cytokine produced or simply initiate a preprogrammed pattern of cytokine production, which may be DC subtype specific. Here, we demonstrate that microbial and T cell-derived stimuli can synergize to induce production of high levels of IL-12 p70 or IL-10 by individual murine DC subsets but that the choice of cytokine is dictated by the microbial pattern recognition receptor engaged. We show that bacterial components such as CpG-containing DNA or extracts from Mycobacterium tuberculosis predispose CD8alpha(+) and CD8alpha(-)CD4(-) DC to make IL-12 p70. In contrast, exposure of CD8alpha(+), CD4(+) and CD8alpha(-)CD4(-) DC to heat-killed yeasts leads to production of IL-10. In both cases, secretion of high levels of cytokine requires a second signal from T cells, which can be replaced by CD40 ligand. Consistent with their differential effects on cytokine production, extracts from M. tuberculosis promote IL-12 production primarily via Toll-like receptor 2 and an MyD88-dependent pathway, whereas heat-killed yeasts activate DC via a Toll-like receptor 2-, MyD88-, and Toll/IL-1R domain containing protein-independent pathway. These results show that T cell feedback amplifies innate signals for cytokine production by DC and suggest that pattern recognition rather than ontogeny determines the production of cytokines by individual DC subsets.

How Pragmatically Odd! Interface Delays and Pronominal Subject Distribution in the L2 Spanish of English Natives

Sorace (2000, 2005) has claimed that while L2 learners can easily acquire properties of L2 narrow syntax they have significant difficulty with regard to interpretation and the discourse distribution of related properties, resulting in so-called residual optionality. However, there is no consensus as to what this difficulty indicates. Is it related to an insurmountable grammatical representational deficit (in the sense of representation deficit approaches; e.g. Beck 1998, Franceschina 2001, Hawkins 2005), is it due to cross-linguistic interference, or is it just a delay due to a greater complexity involved in the acquisition of interface-conditioned properties? In this article, I explore the L2 distribution of null and overt subject pronouns of English speaking learners of L2 Spanish. While intermediate learners clearly have knowledge of the syntax of Spanish null subjects, they do not have target-like pragmatic knowledge of their distribution with overt subjects. The present data demonstrate, however, that this difficulty is overcome at highly advanced stages of L2 development, thus suggesting that properties at the syntax-pragmatics interface are not destined for inevitable fossilization.

On L2 Clustering and Resetting the Null Subject Parameter in L2 Spanish: Implications and Observations.

In this article, along with others, we take the position that the Null-Subject Parameter (NSP) (Chomsky 1981; Rizzi 1982) cluster of properties is narrower in scope than some originally contended. We test for the resetting of the NSP by English L2 learners of Spanish at the intermediate level, including poverty-of-the stimulus knowledge of the Overt Pronoun Constraint (Montalbetti 1984). Our participants are tested before and after five months' residency in Spain in an effort to see if increased amounts of native exposure are particularly beneficial for parameter resetting. Although we demonstrate NSP resetting for some of the L2 learners, our data essentially demonstrate that even with the advent of time/exposure to native input, there is no immediate gainful effect for NSP resetting.

What do effective teachers of literacy do? Subject knowledge and pedagogical choices for literacy

This article explores the fine detail of practice by three teachers, recognised as effective teachers of literacy. All three were observed during nine literacy lessons, working with Year 2 (6/7 year olds) classes of successful inner-city primary schools in the South of England. Data collection took place in 2003, just as their schools were moving away from the early prescription of the National Literacy Strategy (NLS), and follow up visits were made in 2005. My initial interest had been in what these three teachers did with the NLS in order to motivate pupils and ensure high pupil attainment. Following observations, interviews and coding of teacher-pupil interaction, it became clear that The NLS Framework for Teaching (DfES, 2001) was not the driver of their success but a valuable vehicle for subtle and intuitive teacher behaviours that grew from a detailed understanding of how children develop as readers and writers. Implications for training student teachers to marry theoretical understanding with the expectations of a prescribed curriculum for literacy are discussed.

EU free movement law and the legal recognition of same-sex relationships: the case for mutual recognition

This article seeks to examine the cross-border legal recognition of same-sex relationships in the EU. Although the Member States maintain an exclusive competence in the field of family law and, thus, it is up to them to determine whether they will provide a legal status to same-sex couples within their territory, they need to exercise their powers in that field in a way that does not violate EU law. This, it is suggested, requires that Member States mutually recognize the legal status of same-sex couples and do not treat same-sex couples worse than opposite-sex couples, if the basis of the differentiation is, merely, the (homosexual) sexual orientation of the two spouses/partners. Nonetheless, the current legal framework does not make it clear that Member States are under such an obligation. The main argument of the article, therefore, is that the EU must adopt a more hands-on approach towards this issue.

Queering Philip Roth: homosocial discourse in 'An actor’s life for me', 'Letting go', 'Sabbath’s theater' and the 'American trilogy'

Much has been written on Roth’s representation of masculinity, but this critical discourse has tended to be situated within a heteronormative frame of reference, perhaps because of Roth’s popular reputation as an aggressively heterosexual, libidinous, masculinist, in some versions sexist or even misogynist author. In this essay I argue that Roth’s representation of male sexuality is more complex, ambiguous, and ambivalent than has been generally recognized. Tracing a strong thread of what I call homosocial discourse running through Roth’s oeuvre, I suggest that the series of intimate relationships with other men that many of Roth’s protagonists form are conspicuously couched in this discourse and that a recognition of this ought to reconfigure our sense of the sexual politics of Roth’s career, demonstrating in particular that masculinity in his work is too fluid and dynamic to be accommodated by the conventional binaries of heterosexual and homosexual, feminized Jew and hyper-masculine Gentile, the “ordinary sexual man” and the transgressively desiring male subject.

Combining 3D and 2D for less constrained periocular recognition

Periocular recognition has recently become an active topic in biometrics. Typically it uses 2D image data of the periocular region. This paper is the first description of combining 3D shape structure with 2D texture. A simple and effective technique using iterative closest point (ICP) was applied for 3D periocular region matching. It proved its strength for relatively unconstrained eye region capture, and does not require any training. Local binary patterns (LBP) were applied for 2D image based periocular matching. The two modalities were combined at the score-level. This approach was evaluated using the Bosphorus 3D face database, which contains large variations in facial expressions, head poses and occlusions. The rank-1 accuracy achieved from the 3D data (80%) was better than that for 2D (58%), and the best accuracy (83%) was achieved by fusing the two types of data. This suggests that significant improvements to periocular recognition systems could be achieved using the 3D structure information that is now available from small and inexpensive sensors.

University teaching: recognition and reward

Teaching in universities has increased in importance in recent years which, in part, is a consequence of the change in funding of universities from block grants to student tuition fees. Various initiatives have been made which serve to raise the profile of teaching and give it greater recognition. It is also important that teaching is recognised even more fully and widely, and crucially that it is rewarded accordingly. We propose a mechanism for recognising and rewarding university teaching that is based on a review process that is supported by documented evidence whose outcomes can be fed into performance and development reviews, and used to inform decisions about reward and promotion, as well as the review of probationary status where appropriate.

On fusion for multispectral iris recognition

Multispectral iris recognition uses information from multiple bands of the electromagnetic spectrum to better represent certain physiological characteristics of the iris texture and enhance obtained recognition accuracy. This paper addresses the questions of single versus cross spectral performance and compares score-level fusion accuracy for different feature types, combining different wavelengths to overcome limitations in less constrained recording environments. Further it is investigated whether Doddington's “goats” (users who are particularly difficult to recognize) in one spectrum also extend to other spectra. Focusing on the question of feature stability at different wavelengths, this work uses manual ground truth segmentation, avoiding bias by segmentation impact. Experiments on the public UTIRIS multispectral iris dataset using 4 feature extraction techniques reveal a significant enhancement when combining NIR + Red for 2-channel and NIR + Red + Blue for 3-channel fusion, across different feature types. Selective feature-level fusion is investigated and shown to improve overall and especially cross-spectral performance without increasing the overall length of the iris code.

Segmentation-level fusion for iris recognition

This paper investigates the potential of fusion at normalisation/segmentation level prior to feature extraction. While there are several biometric fusion methods at data/feature level, score level and rank/decision level combining raw biometric signals, scores, or ranks/decisions, this type of fusion is still in its infancy. However, the increasing demand to allow for more relaxed and less invasive recording conditions, especially for on-the-move iris recognition, suggests to further investigate fusion at this very low level. This paper focuses on the approach of multi-segmentation fusion for iris biometric systems investigating the benefit of combining the segmentation result of multiple normalisation algorithms, using four methods from two different public iris toolkits (USIT, OSIRIS) on the public CASIA and IITD iris datasets. Evaluations based on recognition accuracy and ground truth segmentation data indicate high sensitivity with regards to the type of errors made by segmentation algorithms.

Designing care bundle documentation to support the recognition and treatment of acute kidney injury: a route to quality improvement

The chapter describes development of care bundle documentation, through an iterative, user-centred design process, to support the recognition and treatment of acute kidney injury (AKI). The chapter details stages of user and stakeholder consultation, employed to develop a design response that was sensitive to user experience and need, culminating in simulation testing of a near final prototype. The development of supplementary awareness-raising materials, relating to the main care bundle tool is also discussed. This information design response to a complex clinical decision-making process is contrasted to other approaches to promoting AKI care. The need for different but related approaches to the working tool itself and the tool’s communication are discussed. More general recommendations are made for the development of communication tools to support complex clinical processes.