Dr Dignan’s poetry, her care, and her enthusiasm should be lauded. There are also many other non-medical pursuits that may make us better doctors. But it is difficult to know which of these are effective or practicable.

We investigated genetic and environmental correlations and gene by environment interactions (GxE) between depressive symptoms measured by the Beck Depression Inventory (BDI) and quantity smoked measured by number of cigarettes smoked per day (CPD) using quantitative genetic modeling. The population-based sample consisted of 12,063 twin individuals from the Finnish Twin Cohort Study. Bivariate Cholesky decomposition revealed that the phenotypic correlation (r = 0.09) between BDI and CPD was explained by shared genetic (r g = 0.18) and environmental (r e = 0.08) factors. GxE models incorporating moderator effects were built by using CPD as trait and BDI as moderator and vice versa. The importance of the genetic variance component increased with increasing moderator value in both models. Thus, the influence of genetic effects on variance of smoking quantity was enhanced in individuals with elevated depression score and vice versa; the genetic effects on depression variance were potentiated among heavy smokers. In conclusion, shared genetic and environmental factors as well as GxE underlie the association of smoking with depression.

This Presidential Address takes place at a time of great change for the Actuarial Profession, not least the review of the Actuarial Profession by Sir Derek Morris and his team. The Address concentrates on the changes that the Actuarial Profession, like many other professions, needs to address from a professional perspective in the 21st century. Key aspects such as peer review, monitoring of compliance with standards, CPD and revalidation of a member's competence are considered and the changes that need to be made in these areas outlined. A review of the complicated area of Conflicts of Interest as it impacts on the work of actuaries, especially in today's business environment and the high expectations of clients, points towards the need for additional professional guidance in this area. The need for an Independent Actuarial Standards Board with a significant non-actuarial membership to take responsibility for the standard setting process of the Actuarial Profession is a necessity going forward.

Against a background of globalisation, regulatory change and the prospect of a merger with the Faculty of Actuaries, the profession is in a state of renewal. Traditional areas of actuarial expertise are likely to see employment reductions. However, our skills in risk and finance should be in demand. To ensure this we need to maintain the relevance of our examination system, develop the appropriate research resources and CPD offerings, give members the support that they need throughout their careers whilst working with employers to produce the skilled professionals that they require.

This Presidential Address considers what needs to be done to enable the United Kingdom actuarial profession to flourish in a more competitive environment. It addresses the need for continued modernisation of the actuarial skill-set, and the need to pay greater attention to the way we communicate our findings. The Address briefly reviews some of the recent changes to the regulation of life assurance in the U.K. before considering the role and structure of the professional body in the post-Morris era. It ends with some thoughts on developments in education and CPD.

The General Insurance Premium Rating Issues Working Party (GRIP) was established by the General Insurance Board of the Faculty and Institute of Actuaries in 2005 to review actuarial involvement in premium rating issues, pricing being one of the key areas in which actuaries work.

GRIP published a full report in January 2007, which is available at www.actuaries.org.uk/grip. This short paper summarises the recommendations of that full report. Further background, discussion and the rationale for these recommendations are set out in more detail in the full report.

Continuous professional development (CPD) is regarded as an essential component of working life for radiation therapists and is increasingly being used by professional associations to ’prove’ the competence of their members. In the past, CPD activities have primarily been viewed as an individual responsibility, and have focused on maintaining a professional knowledge base and, subsequently, hands-on competency through didactic learning. However, there are drawbacks associated with this model; and concentrating on only one facet of learning ignores other theoretical areas of knowledge acquisition. This article explores several areas of social and organisational theories of learning including social networks, communities of practice, learning organisations, knowledge management, knowledge translation and research utilisation. It is concluded that maintenance of competence after graduation is multilayered and should be viewed in a holistic manner to incorporate some of the relevant elements of the concepts discussed. This article also offers some suggestions for the individual wanting to maximise their educational opportunities beyond traditional models of CPD.

Therapy radiographers may be empowered to contribute more freely to the multi-disciplinary professional team if they critically reflect on their inherent clinical knowledge and perspectives. Critical reflection may help radiographers articulate the rationale behind professional decisions and proposed evidence-based treatment planning and delivery protocols, and reveal knowledge embedded in practice. Documentation of professional reflection may yet become a cornerstone for continuing professional development. Despite a paucity of rigorous empirical investigation, ‘reflective practice’ has become focal in nursing education. Three concepts appear confused, ill defined or interchangeable in the literature: ‘reflective practice’, ‘reflection’ and the ‘reflective practitioner’. Debate continues into the value of ‘reflective practice’ as a system: it remains problematic, it is difficult to conceptualise, it appears to have no clear or universal definition and no certain framework or guidelines for its implementation. In reflecting on action there may be strong hindsight bias which may invalidate conclusions reached. There are doubts raised about the benefits of structured models to implement reflective practice. Belonging to such an empirically based profession, it may be that educators and clinical therapy radiographers incorporate only those elements of systematised ‘reflective practice’ that can be empirically demonstrated to be beneficial to the profession, and will result in improved patient outcomes. There is no compelling evidence yet that any systematised ‘reflective practice’ is inherently more beneficial to therapy radiographers than radiographers continuing to reflect as they do now, with or without documentation.

The rapid growth in web technologies illustrates how global attitudes to paper are changing. The world of radiotherapy is responding to this by steadily replacing paper-based systems with digital equivalents. In this time when the world is swapping thousands of years of dependence on ink and paper for pixels and screens, representing professional development in a large file of paper may soon seem incongruous.

This paper aims to introduce the concept of a “virtual portfolio” along with the rationale for using it. In the context of radiotherapy professional practice, the virtual portfolio's function mirrors that of a conventional portfolio, but uses electronic media to collate and present the evidence. Potential advantages and disadvantages of the virtual portfolio are presented, along with a brief overview of the software tools that can assist with the transition away from paper.

Since a portfolio is ultimately a very individual expression of personal and professional development, it is obvious that the virtual portfolio will not be suitable for everyone. It can be seen that electronic media offer some useful tools to the portfolio developer, but ultimately it is the content and use of the portfolio rather than the format that is of importance.