The impact of a religious opera on a secular audience: the existential and religious importance of art

Abstract

Although there is a voluminous literature on the use of traditional healers by ethnic minorities, their use by psychiatric patients has been little studied. This study looks at the use of traditional healers by Asian psychiatric patients. Five of the sample of 14 patients had consulted a traditional healer at some time during their psychiatric illness. Three case histories are presented.     

旋律语调疗法及其对失语症的临床应用

失语症是当今人类面临的一个重要的健康问题。旋律语调疗法被认为是治疗失语症的有效手段之一。传统旋律语调疗法强调严格的程序和材料,改编版本则依据患者情况进行调整,二者均能提高失语症者的自发言语产生、言语复述以及命名等能力。研究还表明,旋律语调疗法不仅能提高失语症者相关脑区的激活水平,而且也能通过影响失语症者的相关神经结构改善其言语功能。未来研究需要进一步确定该疗法的干预机制及其对汉语失语症的适用性。     

Assessing resource demands during sentence processing in Parkinson's disease

Patients with Parkinson's disease (PD) have sentence comprehension difficulty, but it is unclear whether this is due to a deficit in grammatical processing or to an executive resource limitation. To assess grammatical processing in PD while minimizing task-related demands, PD patients and healthy control subjects performed a word detection procedure that assesses sensitivity to grammatical agreements in sentences in an "on-line" fashion. With this technique, we found that control subjects and PD patients are equally sensitive to grammatical agreement violations in sentences. A traditional, resource-demanding measure of sentence comprehension was also administered to the same PD patients. In comparison to healthy controls, PD patients were significantly impaired in their relative comprehension of sentences containing object-gap subordinate clauses compared to subject-gap subordinate clauses. Performance on several executive resource measures was also impaired in PD, and this correlated with their comprehension performance. Sensitivity to grammatical agreements with the word detection procedure, in the context of sentence comprehension difficulty on a traditional measure, suggests that PD patients' executive resource limitations contribute to their sentence comprehension difficulty.     

Working with patients with disruptions in symbolic capacity1

This article focuses on understanding and working with patients who have poorly developed symbolic capacity, or for whom symbolic capacity has been disrupted due to trauma, particularly as it pertains to the use of reverie and interpretation in the analytic process. Many patients who present for Jungian analysis will initially present with deficits in symbolic functioning. This situation results in necessary limitations or modifications in utilizing traditional Jungian techniques such as dream analysis, active imagination, sand tray and other expressive art techniques. The initial phase of analytic work with these patients requires a focus on developing their symbolic capacity before traditional Jungian techniques can be utilized effectively. During the paper Jung's concept of ‘the symbolic attitude’ will be examined as well as the conceptual models of Wilfred Bion and other post-Bionians who outline theories and method for cultivating symbolic capacity and reflective functioning in patients for whom these capacities are impaired or poorly developed.     

The real problem with equipoise

The equipoise requirement in clinical research demands that, if patients are to be randomly assigned to one of two interventions in a clinical trial, there must be genuine doubt about which is better. This reflects the traditional view that physicians must never knowingly compromise the care of their patients, even for the sake of future patients. Equipoise has proven to be deeply problematic, especially in the Third World. Some recent critics have argued against equipoise on the grounds that clinical research is fundamentally distinct from clinical care, and thus should be governed by different norms. I argue against this "difference position," and instead take issue with the traditional, exclusively patient-centered account of physicians' obligations that equipoise presupposes. In place of this traditional view, I propose a Kantian test for the reasonable partiality that physicians should show their patients, focusing on its application in clinical research and medical education.     

Reasonable People,Double Jeopardy,and Justice

The equipoise requirement in clinical research demands that, if patients are to be randomly assigned to one of two interventions in a clinical trial, there must be genuine doubt about which is better. This reflects the traditional view that physicians must never knowingly compromise the care of their patients, even for the sake of future patients. Equipoise has proven to be deeply problematic, especially in the Third World. Some recent critics have argued against equipoise on the grounds that clinical research is fundamentally distinct from clinical care, and thus should be governed by different norms. I argue against this “difference position,” and instead take issue with the traditional, exclusively patient-centered account of physicians' obligations that equipoise presupposes. In place of this traditional view, I propose a Kantian test for the reasonable partiality that physicians should show their patients, focusing on its application in clinical research and medical education.     

Validation of a Behavioral Approach for Measuring Saccades in Parkinson's Disease

Speed and control of saccades are related to disease progression and cognitive functioning in Parkinson's disease (PD). Traditional eye-tracking complexities encumber application for individual evaluations and clinical trials. The authors examined psychometric properties of standalone tasks for reflexive prosaccade latency, volitional saccade initiation, and saccade inhibition (antisaccade) in a heterogeneous sample of 65 PD patients. Demographics had minimal impact on task performance. Thirty-day test–retest reliability estimates for behavioral tasks were acceptable and similar to traditional eye tracking. Behavioral tasks demonstrated concurrent validity with traditional eye-tracking measures; discriminant validity was less clear. Saccade initiation and inhibition discriminated PD patients with cognitive impairment. The present findings support further development and use of the behavioral tasks for assessing latency and control of saccades in PD.     

The sociocultural conceptualisations of schizophrenia and patterns of help seeking in south-east Nigeria

Socioculturally influenced interpretations of mental illness play decisive roles on the time and choice of treatment. These often result in significant delays before patients present at the psychiatric services, with consequent worsening of the prognosis. The aim was to assess the association between sociocultural factors, choice of treatment and treatment delay among patients with schizophrenia. A cross-sectional study of 360 patients with schizophrenia, without previous contact with any statutory psychiatric services, was done. Of this, 75.8% of the participants had visited traditional/faith healers as the first treatment option and have attributed schizophrenia to magico-supernatural causation, despite 70.0% of the participants being educated, while 24.2% of them believed in the natural causation of the illness and presented early to psychiatric hospital. There is a need for community-based psychiatric services that would have mental health education as one of their core mandates; and collaborations with traditional and faith-based healers aimed to reduce delay in their facilities.     

Recognition of familiar and unfamiliar melodies in normal aging and Alzheimer’s disease

We tested normal young and elderly adults and elderly Alzheimer’s disease (AD) patients on recognition memory for tunes. In Experiment 1, AD patients and age-matched controls received a study list and an old/new recognition test of highly familiar, traditional tunes, followed by a study list and test of novel tunes. The controls performed better than did the AD patients. The controls showed the “mirror effect” of increased hits and reduced false alarms for traditional versus novel tunes, whereas the patients false-alarmed as often to traditional tunes as to novel tunes. Experiment 2 compared young adults and healthy elderly persons using a similar design. Performance was lower in the elderly group, but both younger and older subjects showed the mirror effect. Experiment 3 produced confusion between preexperimental familiarity and intraexperimental familiarity by mixing traditional and novel tunes in the study lists and tests. Here, the subjects in both age groups resembled the patients of Experiment 1 in failing to show the mirror effect. Older subjects again performed more poorly, and they differed qualitatively from younger subjects in setting stricter criteria for more nameable tunes. Distinguishing different sources of global familiarity is a factor in tune recognition, and the data suggest that this type of source monitoring is impaired in AD and involves different strategies in younger and older adults.     

生存质量在晚期肿瘤疗效评价中的思考

传统的肿瘤疗效评价方法多采用治愈率、生存率等指标来衡量。随着传统医学模式向生物一心理一社会医学模式转变,生存质量越来越受到重视。生存质量从一个新的角度评价治疗效果,更重视患者的主观感受,而不是仅将临床客观指标作为评价标准,能更客观地指导治疗方案的选择。     

论现代传染病防治中医患关系的特点

现代传染病防治中传统的医患关系的内涵和外延都发生了一定的变化,无论是医方还是患方都体现出强烈超医学性和社会性,在社会大防治的概念下医患之间出现一定的界限模糊甚至角色重叠。现代传染病的发展给我们提供了审视医患关系的新视角,引发人们关于医学发展、社会道德的深层次的思考。     

光学相干断层扫描观察白内障术后黄斑区病变

通过光学相干断层扫描(optical coherence tomography,OCT)技术来早期明确白内障超声乳化术后视网膜黄斑区病变.采集我院白内障超声乳化术及人工晶状体植入术后视力改善不良的老年性白内障患者,进行OCT检查,观察其图象特征.结果提示术眼黄斑区OCT图像表现为:黄斑区视网膜水肿,视网膜厚度增加;黄斑区增生膜形成,部分伴有黄斑区视网膜水肿;黄斑区神经上皮层变薄;黄斑裂孔形成;老年黄斑变性(萎缩性),表现为视网膜色素上皮层断裂、厚薄不均;部分病例视网膜色素上皮层增殖、断裂,表现为色素上皮损害.OCT由于其独特的横截面成像技术,通过精确测量视网膜厚度及观察视网膜反射性的改变,可以在白内障超声乳化术后早期发现黄斑区视网膜的病变,定量地了解病情的变化,是一种比较理想的检测手段.     

图式治疗理论与实践

由于传统认知行为疗法治疗人格障碍面临许多问题和挑战,Young在认知行为疗法的基础上创建了图式治疗。图式治疗关注患者的早期适应不良图式和适应不良的应对方式,并通过一系列治疗策略,帮助患者改变早期适应不良图式,形成更健康的行为方式。图式治疗是在传统认知行为疗法的基础上,结合依恋理论、客体关系理论、格式塔理论和建构主义理论的整合治疗模型,其整合的优势为今后的发展带来很大空间     

The Influence of Christian Conversion in Mapuche Traditional Medicine in Temuco, Chile: Toward a Cultural Syncretism or a form of Ideological Assimilation?

The Mapuche communities living in the urban areas of Chile have undergone radical cultural changes due to Christian conversion. This article analyzes the influence of these changes on the Mapuche ideas and practices of the traditional healers (machi) and patients in Temuco (IX Region), Chile, and the changes and adaptations in the perceptions of healing practices and rituals by the patients. The paper shows how, despite some evident challenges, the encounter with the religion of Christianity can create a process of cultural and spiritual syncretism and push traditional medicine toward an increased specialization in the therapeutic practices.     

The Class Method in the treatment of Psychotic Patients

Contrary to traditional thinking, a review of the recent literature has suggested that bipolar patients can be treated in homogeneous therapy groups in conjunction with concomitant lithium management. Important psychodynamic and interpersonal features are reviewed that have received empirical support and have enhanced our understanding of these patients. Goals for bipolar groups include educating patients on the nature of the disease, helping them learn ways of coping with its symptoms, and encouraging them to discuss relevant psychodynamic and interpersonal issues. To achieve these goals, therapists have used techniques involving education, support, and facilitation of group discussions. Further clinical and empirical work needs to be done to evaluate the effectiveness and process of these bipolar groups, particularly in the inpatient setting.     

Licensed Practical Nurses' Sex Role Stereotypes

Thirty-two licensed practical nurses rated the concepts "an adult male patient" and "an adult female patient" on a set of semantic differential scales prior to listening to and rating one of four simulated patients. The simulated patients were two males and two females, with the characteristics of the females matched exactly to the males. Within each sex, the simulated patients differed according to emotional style ("calm" vs. "excited"); the diagnosis ascribed to the patients also was manipulated. The results suggest that not only were there significant traditional sex-role differences in the perceptions and evaluations of typical adult male and adult female patients, but these stereotypical attitudes were reflected in ratings of specific patients. Although the female simulated patients were exact matches of the males, the latter were consistently evaluated more positively and were more likely to be seen as possessing traditional male traits. These sex-role stereotypes were not attenuated by individual patient characteristics (emotionality or diagnosis) nor by the subjects' own attitudes toward women.     

Experiences at a neurologico-psychiatric department in Ethiopia

On three separate occasions, the authors taught at Gondar School of Medicine, attached to the University of Addis Ababa. They found that the neurological group of patients was determined by geographical rather than specifically tropical conditions, and that the psychiatric syndromes resembled those here, considerably influenced, however, by traditional rural medicine. The paper makes observations on comparative psychopathology.     

The influence of contralesional targets on the cancellation of ipsilesional targets in unilateral neglect

Neglect of contralesional stimuli and perseverative behavior on ipsilesional stimuli may co-occur on a target cancellation task. Our aim was to investigate whether the presence vs. absence of contralesional targets can modify perseveration on ipsilesional targets. We studied four right brain-damaged patients with left neglect and perseverative behavior on screening cancellation tasks. We compared their cancellation performance in two conditions: (i) targets equally distributed on both sides of space and (ii) targets confined to the right side. One patient showed no significant difference in perseveration between these two conditions; in contrast, three patients perseverated significantly more in condition (i) than in condition (ii). These results suggest that, at least in some patients, information from the 'neglected' targets is not completely lost, but rather it affects behavior in the ipsilesional side. The traditional dichotomy 'bad space-good space' would not apply here.     

Mindfulness-based psychotherapy in patients with obsessive-compulsive disorder: A meta-analytical Study

Background/ObjectiveObsessive compulsive disorder is a disorder of special relevance in mental health, however, not all patients respond adequately to traditional intervention systems. The present work aims to study the usefulness of mindfulness-based interventions in patients with obsessive compulsive disorder.MethodAn exhaustive search of the literature between 1996 and 2021 allowed us to locate 11 published articles. The effect size was the pretest-posttest standardized mean change calculated for obsession-compulsion, as well as depression symptoms and conscious coping.Resultshe results showed mean effect sizes for mindfulness in the reduction of obsessive-compulsive symptoms (d + = 0.648) and, to a lesser extent, depression (d + = 0.417) and the improvement in Mindfull coping (d + = 0.509). There was no significant decrease in effect size when mindfulness was applied in patients with residual symptoms from previous treatments.ConclusionsThese results are promising regarding the usefulness of the application of intervention programs based on mindfulness in people with obsessive compulsive disorder, both as an alternative option and as a complementary treatment to more traditional intervention formats.