Portrait of the therapist as a shaman

What follows will show that an understanding of the nature and purpose of shamanism contains a number of insights that bring to light some important, but often obfuscated, aspects of Western therapeutic practices. the point of departure of the argument is the theory of shamanism developed by the inventor of structural anthropology: Claude Lévi-Strauss. It will be argued, in particular, that his theory of shamanism provides a key to the therapeutic action of symbols upon the body as well as to the broader social function of therapy in general.     

保守治疗与切开减压疗法治疗骨筋膜间室综合征的费用比较

比较针刺加外敷祛风消肿酊保守疗法与切开减压治疗四肢骨筋膜间室综合征治疗费用.采用回顾性研究,将符合 ＆lt;中医骨伤科病证诊断疗效标准 ＆gt;（ZY/T001.9-94）诊断标准要求的患者分为试验组10例,对照组10例.试验组采用针刺加外敷祛风消肿酊保守治疗.对照组采用手术切开减压疗法治疗.采用自拟的疗效评定标准在治疗2周后评定2组的治疗费用.结果治疗2周后,试验组和对照组患者全部愈合.试验组平均费用361.7元;对照组平均费用2 058.1元.保守疗法在其他条件相同的情况下,少用1 694.00元,即少用82.3%.因此,治疗四肢骨筋膜间室综合征在保证疗效的前提下,解决看病贵的首选方法是保守疗法.     

早期乳腺癌患者术后心理状况研究

早期乳腺癌的检出率越来越高,关注治愈率同时,人们越来越关心患者术后的心理状态及生活质量.本文对保乳术及根治术后5年患者进行心理调查.保乳组患者术后心理障碍发生率明显低于根治组.保乳组患者术后心理状况影响因素主要为术后美容效果,而根治组患者心理障碍发生率与年龄、职业、家庭收入相关.两种手术方式对患者5年生存率及无病生存率的影响无明显差异,所以对于早期乳腺癌患者,在符合保乳原则的前提下,保乳手术是一种既安全又能提高生活质量的手术方式.     

心力衰竭的药物及非药物治疗

神经内分泌激活、心室重构是收缩性心力衰竭进展的关键机制,针对上述机制的生物学治疗包括血管紧张素转换酶抑制剂、β受体阻滞剂、盐皮质激素受体拮抗剂等可显著改善心力衰竭患者预后,利尿剂、洋地黄等常规药物治疗可改善心力衰竭症状、降低心力衰竭住院风险,为神经内分泌拮抗剂的应用奠定基础;近年来,从阻断心力衰竭发生机制方面研发了很多新药,但尚没有一种能对长期生存率有显著改善.器械治疗(植入型心脏复律除颤器、心室再同步和心室再同步心脏复律除颤器)可降低特定心力衰竭患者病死风险,预防猝死发生,显著改善预后;心室辅助装置及干细胞治疗则为心力衰竭治疗带来新的曙光.     

Erratum

Abstract

Recent research has highlighted the central role of disgust in the etiology and maintenance of contamination aversion (CA). Data would also suggest that, although amendable to the treatment of choice for CA (exposure and response prevention [ERP]), disgust is resistant to habituation. However, with regard to CA, it is not yet known if disgust's resistance to habituation is an artifact of the emotion or the disorder. Specifically, research has not yet indicated if severity of CA moderates the effect of ERP on disgust. Utilizing an undergraduate convenience sample (n=33), the present study compared emotional responding (disgust and fear) with repeated exposure to a disgusting contamination-relevant stimulus between participants who are high in contamination aversion (HCA; n=17) and low in contamination aversion (LCA; n=16). Results indicated that, habituation of disgust was slower than fear within the HCA group but not the LCA group. Contrasts revealed that the decay of fear across trials was faster for HCA participants when compared with LCA participants, although decay of disgust was similar between groups. These results indicate that habituation of disgust is slower than fear when elevated CA is present.     

Strength Training Effects on Muscle Forces and Contributions to Whole-Body Movement in Cerebral Palsy

Strength training is often prescribed for children with cerebral palsy (CP); however, links between strength gains and mobility are unclear. Nine children (age 14?±?3?years; GMFCS I-III) with spastic CP completed a 6-week strength-training program. Musculoskeletal gait simulations were generated for four children to assess training effects on muscle forces and function. There were increases in isometric joint strength, but no statistical changes in fast-as-possible walking speed or endurance after training. The walking simulations revealed changes in muscle forces and contributions to body center of mass acceleration, with greater forces from the hip muscles during walking most commonly observed. A progressive strength-training program can result in isometric and dynamic strength gains in children with CP, associated with variable mobility outcomes.     

The Theory-Practice Gap in Cognitive Behavioral Therapy: Reflections and a Modest Proposal to Bridge the Gap

This paper examines the issues related to the gap between theory and practice in the area of cognitive-behavioral therapy. The article begins with a review of the evidence for such a gap, and having demonstrated that the gap exists, provides a discussion of some of the factors that are likely important in its genesis and maintenance. The article then focuses on potential strategies to reduce the theory-practice gap that go beyond the common recommendation for both efficacy and effectiveness research. In particular, we provide recommendations for protocol planning and design, training and competency maintenance, dissemination research, and implementation and policy change. We conclude with the proposition that theory and research should not only inform practice, but that practice should have a reciprocal benefit on theory and research.     

The Role of Theory and Research in the Practice of Cognitive-Behavioral Couple Therapy: If You Build It,They Will Come

Cognitive-behavioral couple therapy (CBCT), while empirically validated and highly efficacious, does not always have positive results for couples. One factor that may limit the efficacy of this intervention is the way in which therapists are trained to provide this type of therapy. More specifically, there is a need for therapists to gain a solid foundation in CBCT theory in order to maximize treatment results. This paper presents an argument for why an understanding of theory is necessary for therapists in treating couples. Then, this paper presents our training model and how we integrate theory into our training of both graduate student therapists and more experienced clinicians. We take the stance that “if you build it, they will come.”