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People get bored even with things they like and get tired of repetition and sameness. Economists have to take account of this tendency when studying how people choose to spend their money. If you love your pizza, and you haven t had any pizza in a long time, you get a great big rush of utility from eating a slice. The melted cheese, the basil and garlic in the sauce, and the familiar warmth in your mouth all make you very, very happy. But eating that first slice dampens the thrill of pizza, and so if you eat a second slice, it may taste good, but not as good as the first. And if you

def num explanatory variables(self): return 2 def call (self, t, fill, state, requestor, env): # harvest active flows all flows = self. leg.flows() flows = [] for flow in all flows: accrual start days = env.relative date( flow.accrual start date()) if accrual start days >= t*365.0: flows.append(flow) if len(flows) < 1: raise RuntimeError, "no active flows remaining" # explanatory variables num sims = state.shape[0] evs = numpy.zeros((num sims, self.num explanatory variables())) pv01 = numpy.zeros(num sims) notl exchange = numpy.zeros(num sims) cnt = 0 for flow in flows: Ts = env.relative date(flow.accrual start date())/365.0 Te = env.relative date(flow.accrual end date())/365.0 Tp = env.relative date(flow.pay date())/365.0 dfp = fill.numeraire rebased bond(t, Tp, flow.pay currency()\ , env, requestor, state) pv01 += flow.year fraction()*dfp if cnt == 0: dfs = fill.numeraire rebased bond(t, Ts, flow.pay currency()\ , env, requestor, state) notl exchange = dfs dfe = fill.numeraire rebased bond(t, Te, flow.pay currency()\ , env, requestor, state) evs[:, 0] = (dfs/dfe-1.0)/flow.year fraction() elif cnt == len(flows)-1: notl exchange -= fill.numeraire rebased bond(t, Te, flow.pay currency(), env, requestor, state) cnt = cnt+1 evs[:, 1] = notl exchange/pv01 return evs

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It is almost Christmas, and the ward is plastered with tinsel, greeting cards and plastic images of Santa Claus. Christmas has a reassuring continuity which Louise thinks is nice. She feels surrounded by other Christmases. Images of her late husband, and a house full of excited children expecting carloads of friends and relatives, pass through her mind. Louise feels in a daze. She is often confused, and fully lucid only intermittently. When she can make sense she seems to talk more as a little girl than a woman. But this is some sort of defence, helped by her pain-killing drugs. She knows she is dying, and feels indescribably tired, though when she becomes more alert she seems to come back to life. Then she expresses regret at her passivity, she doesn t know what came over her , and reasserts her determination to ght, to get better soon. Louise is a chaos of emotions, a cocktail of denial, resistance and acceptance. When she accepts she can think only of a single wish, which she has not the strength to ful l. She simply wishes she could tell Daniel she loves him.

Adversities are usually classi ed as acute and chronic. The former usually have a rapid onset and are of short duration, while the latter, such as chronic parental ill-health, exert their in uence over time. While acute life events may result in depressive reactions or in extreme cases post-traumatic stress disorder, chronic stressors are thought to have a more lasting effect on psychological health (Compas, 1989). The impact of negative events varies between individuals depending on the resources at their disposal, generally referred to as resilience factors. These include personal factors such as intelligence, high self-esteem, internal locus of control and having problem-focused coping skills. Environmental factors such as having a close, supportive family and good friendships have an additive effect in conferring resilience. Clearly, both personal and environmental factors are unlikely to be independent of attachment relationships. Severe adverse life events are not especially common as immediate precipitants of anorexia nervosa compared to other adolescent psychiatric disorders and where they have occurred, they confer a relatively good prognosis (North et al., 1997).

Connecting information about the best evidence to a speci c patient s problem is no easy matter. The patient s problems have to be clearly de ned and placed within the context of a clinical risk assessment. This needs to include an assessment both of the acute risk and the longer term prognosis, taking into account physical, psychological, psychosocial, developmental and family variables. Elsewhere we discuss the best approach to foster the exchange of necessary information between the person with the eating disorder and the professional.

As far as you can, list the main issues as they occur to you. Dr Wilson has at least four options available: 1 2 3 4 To To To To do nothing further. change Paul s medication and continue to monitor him at home. persuade him to admit himself to a psychiatric hospital. admit him, without his agreement, to a psychiatric hospital.

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