Prevalence of problematic use of opioids in chronic noncancer pain: a systematic review with meta-analysis

Introdução e objetivo: A prescrição de opioides para dor crónica não oncológica está associada a uso problemático. O nosso objetivo foi rever e resumir as evidências sobre a prevalência do uso problemático de opioides em adultos com dor crónica não oncológica. Bases de dados e tratamento de dados: Foi realizada uma revisão sistemática da literatura, seguindo os principais itens para revisões sistemáticas e meta-análises. A meta-análise foi realizada para estimar as taxas de prevalência combinadas usando um modelo de efeitos aleatórios, tendo sido realizada também análise de subgrupos. Resultados: A pesquisa identificou um total de 784 estudos potencialmente relevantes. Após uma avaliação completa, 19 artigos, principalmente dos EUA, foram incluídos na síntese qualitativa e quantitativa. A prevalência estimada de uso problemático de opioides em adultos com dor crónica não oncológica foi de 36,3% (intervalo de confiança de 95%: 27,4% - 45,2%; I2 = 99,64%). O método utilizado para identificar o uso problemático de opioides foi principalmente o questionário. Treze estudos (68%) apresentaram baixo risco de viés. Conclusões: Embora se verifique heterogeneidade significativa, o estudo apresenta uma estimativa alarmante sobre a prevalência do uso problemático de opioides em pacientes com dor não oncológica, que merece atenção especial dos profissionais e autoridades de saúde.Background and objective: Opioid prescription for chronic noncancer pain is associated with problematic use. We aimed to review and summarize the evidence about the prevalence of problematic use of opioids in adults with chronic noncancer pain. Databases and Data Treatment: A systematic review of the literature was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analysis was performed to estimate the pooled prevalence rates using a random-effects model and sub-analysis was conducted. Results: Our search identified a total of 784 potentially relevant studies. After a thorough evaluation, 19 papers were included in our qualitative and quantitative synthesis, mostly from the USA. The estimated prevalence of problematic use of opioids in adults with chronic noncancer pain was 36.3% (95% confidence interval: 27.4% - 45.2%; I2 = 99.64%). The method used to identify problematic opioid use was mostly questionnaire. Thirteen studies (68%) presented a low risk of bias. Conclusions: Although significant heterogeneity was present, our study presents an alarming estimate regarding the prevalence of problematic use of opioids among patients with noncancer pain, which deserves special attention from health care professionals and health authorities

How to deal with extreme observations in empirical finance: an application to capital markets

In the last few years, Extreme Value Theory (EVT) has gained increased importance in modeling extreme observations in all social sciences. This is especially true in finance, since EVT is a tool used to consider probabilities associated with extreme and rare events with catastrophic consequences, as happened in the Sub-prime crisis in 2007. To model extreme observations, we use two different statistical distribution families in this thesis: Generalized Extreme Value (GEV) and Generalized Pareto Distribution (GPD). In this thesis, EVT methods were used to investigate and fit the empirical distribution of the monthly maximum and minimum return series of the FTSE 100, NIKKEI 225 and S&P500 indices to the theoretical GEV and GPD distributions. We have applied two approaches of extreme value theory, the Block Maxima and the Peaks Over Threshold (POT) approach, as well as the parametric approach of the Maximum Likelihood Estimate Method (MLE) for the distribution parameter estimation and the non-parametric approach of the Hill estimator. As a result of the application, we have seen that in the GEV distribution application, our data was well represented by the Fréchet and Weibull distributions. On the other hand, in the GPD distribution, using the parametric approach MLE, our data was mostly well represented by the Exponential and Beta distributions. However, applying the GPD using the non-parametric approach of the Hill estimator for the tail index, we have seen that the monthly maximum returns of our indices are well represented by the Pareto distribution.Nos últimos anos, a Teoria de Valores Extremos (TVE) tem ganho uma importância crescente no estudo de observações extremas em todas as ciências. Isto é especialemente verdade em finanças, uma vez que a TVE é uma ferramenta utilizada para analisar as probabilidades associadas a eventos extremos e raros com consequências catastróficas, como a crise do Sub-Prime em 2007. Para modelar observações extremas, usamos duas famílias de distribuição estatísticas: Distribuição Generalizada de Valores Extremos (GEV) e a Distribuição Generalizada de Pareto (GPD). Nesta tese, a TVE foi utilizada para investigar e ajustar a distribuição empírica dos retornos maximos e minimos mensais dos índices bolsistas FTSE 100, NIKKEI 225 e do S&P500 às ditribuições teóricas da GEV e GPD. Aplicamos duas abordagens na aplicação da TVE, o método do Block Maxima e o método dos excessos de nível (POT), onde para a estimação dos parâmetros da distribuição recorremos ao método paramétrico da Máxima Verosimilhança, bem como ao método não-paramétrico através do estimador Hill. Como resultado do estudo empírico na aplicação da GEV, verificamos que as séries são bem representadas pela distribuição de Fréchet e Weibull. Por outro lado, na aplicação da GPD, utilizando a abordagem paramétrica para o cálculo dos parâmetros da distribuição, as séries são bem representadas pelas distribuições exponencial e Beta. No entanto, a aplicação do GPD utilizando a abordagem não-paramétrica, verificou-se que a série dos retornos máximos mensais dos índices são bem representados pela distribuição de Pareto

De-Americanizing Viet Nam: The Representation of the “Vietnam War” in Viet Thanh Nguyen’s The Sympathizer

[Abstract] Since the end of the war in Viet Nam in 1975, we, as a society, have been exposed to an American narrative that has manipulated our view of the conflict. We have been led to believe that the Vietnamese conflict was an American tragedy rather than a devastating war with a colonial background and fought on Southeast Asian soil. The purpose of this undergraduate thesis is first, to analyze the succession of events that resulted in the war in Viet Nam and the American participation in the same, and second, to examine how, after their non-defeat, Americans began controlling the story behind the war, releasing literary and cinematographic representations that placed Americans as the rightful victims of the war. In an attempt to redress such manipulation, I will employ Viet Thanh Nguyen’s novel The Sympathizer, published 40 years after the end of the conflict, as an example of a de-Americanized version of the war in Viet Nam, that is, a fictional version that portrays the war as, first and foremost, a Vietnamese conflict and tragedy. The aim of this analysis is to demonstrate how susceptible society is to believe the version of the story publicized by the country with more power and how influential America has been in creating misconceptions about Viet Nam and its war.Traballo fin de grao (UDC.FIL). Inglés: estudios lingüísticos y literarios. Curso 2017/201

Estado actual da pescaria de camarāo no Banco de Sofala

A summary of the shrimp fishery history as well as the most important recommendations for the period 1977-1990 is presented. During the last years the catch rates have decreased. Although many possible causes can be appointed, such as, weather conditions and increase of effort, there is no clear explanation for it. A relationship between catch rates in the main period of recruitment (January to March) and the level of recruitment of the same year was established. Based on this relationship, the total annual catch is predicted for the level of fishing mortality chosen. Fishing mortality is estimated as 2.28 yearˉ¹ and a gradual reduction of fishing effort is recommended until 2.17 yearˉ¹ calculated as F(sub)0.1

Wireless High Sustainable Growth

This is an equity research on Verizon Communications. Verizon is a telecommunication company that operates mainly in the US, being one of the leaders of this market. Moreover, the company’s revenue is primarily driven by its wireless service, which represents around 70% of its total revenues.Moreover, we are also presenting an overview of the company’s business, the industry of telecommunications, the financial performance of the company and the risks our valuation may face