Cognitive-behaviour therapy for chronic fatigue syndrome: comparison of outcomes within and outside the confines of a randomised controlled trial

Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N=30) and patients who received CBT as part of everyday clinical practice (N=384). The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up. Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended.     

"八荣八耻"的道德哲学

“八荣八耻”的社会主义荣辱观,把社会主义道德的要求聚焦到荣辱观,集中点击人的良心,可谓四两拨千斤;“八荣八耻”督促人们作出善恶选择,启迪了个人的道德自觉、自主和自律,同时也强调了公民的道德权利和义务;“八荣八耻”的落实重在修养和践行,为社会主义道德建设与和谐社会的构建创造了精神条件。     

关于医疗、科研的一点认识

临床医疗是医院的根本使命,在权重上医疗自然重于科研.医疗实践是科研的出发点与归宿,决定了科研的基本走向.当前,科研工作受到前所未有的重视,科研作为医疗人员绩效考核的权重过大,偏离了医院的根本使命,会对科研、医疗、医护人员乃至整个社会造成伤害.SCI论文与临床关系不密切,不宜用来评价临床医师的水准.应该建立科学的考评机制,考核标准应细化、全面,对科研的奖励应适度.对于医护人员的考核应以医疗为主、科研为辅.     

Making space for India in post-apartheid South Africa: Narrating diasporic subjectivities through classical song and dance

Background/purposeDiasporic associations and hometown groups fuel transnational exchanges and circulations. Their role has mostly been understood in terms of broader calculative agendas related to ethnic and national cultural politics. In South Africa, classical Indian singers, dancers and instrumentalists are an important part of these transnational landscapes. This paper focuses on the individual actors giving shape to these flows, and explores how a range of subjectivities is entangled with the materialities and forces present in classical performance spaces.Methods and resultsDrawing on fieldwork in Durban, South Africa, it explores how, and why organising actors assemble the matter of classical performance spaces. The paper also explores interconnections to Bollywood as another emergent diasporic site both in tension and accord with classical Indian performances.ConclusionDrawing from a feminist social practice approach, this paper argues that diaspora associational life is assembled through agents negotiating different gaps and discrepancies arising from the material and affective inhabitation of diasporic worlds.     

Does testing with feedback help grade-school children learn key concepts in science?

Testing effects have been well-established across a variety of studies involving school-age children. Specifically, children's test performance improves when they are given the opportunity to practice retrieval prior to the final test as compared to when practice involves only study. The current investigation focused on the influence of testing with feedback on fifth graders’ learning of science concepts. Across two experiments, 65 students studied twenty key concept definitions. After study, the definitions were randomly assigned to one of four conditions: control, test only, study only, and test plus feedback. Concepts assigned to the latter three conditions were presented again (either for test only, study only, or test plus feedback) during two separate sessions, and a final test was administered during a separate session. At the final test, students were asked to provide the definition for each of the twenty key concepts. Final test performance was best for definitions that had been tested with feedback, followed by recall for those that had only been tested or only restudied, with lowest performance for those that did not receive additional practice. Despite multiple sessions spaced across several days, however, performance for all conditions was low, which may have resulted from the ineffective use of feedback. In summary, testing followed by feedback can boost younger students learning of science concepts, but mastery will require the use of other strategies as well.     

Computer-Assisted Therapies: Examination of Therapist-Level Barriers to Their Use

Despite enthusiasm in the field for their potential ease of dissemination, little work has examined whether practicing clinicians are willing and able to use computer-assisted therapies (i.e., computerized treatments designed to be administered with therapist support). For therapists to use these tools, they require access to computer equipment, the skills needed to use the equipment, and willingness to adopt the technology in treatment. This study examined these three factors using survey data from a national sample of mental health clinicians (N = 1,067). Respondents reported on their access to technology and computer fluency, in addition to completing the Computer-Assisted Therapy Attitudes Scale (CATAS), a measure of therapist attitudes designed for this study. Overall, the majority of therapists (90.7%) reported access to at least one computer at work and self-reported computer fluency levels were high. On average, therapists held positive attitudes towards computer-assisted therapies, although expressed concern that these technologies might damage rapport and did not feel that these technologies would improve treatment outcomes. Predictors of positive attitudes included greater general openness toward new treatments, greater comfort with computers, and easier access to technology at work (all ps < .01). Results suggested that, on the whole, therapists may be likely to integrate computer-assisted therapies into their clinical practice. However, therapists vary both in their ability and willingness to use these tools. Implications for the dissemination of computer-assisted therapies are discussed.     

A life without a plan? Freelance musicians in pandemic limbo

The Covid-19 pandemic has exacerbated the already precarious conditions of freelance workers. The aim of this study is to understand what it means for freelance musicians to be in pandemic limbo. Thirteen Swedish professional freelance musicians in the classical genre were interviewed about their experiences in the midst of the pandemic. A theoretical frame of reference is offered with concepts from Bourdieu, sociology of emotions and emotional geographies. This enables an understanding of what it means as a freelancer to be dislocated and disrupted in relation to places and spaces of work and investments in time and emotions. The conclusions are about the ambivalent emotions and processes of emotional management that are caused by the pandemic. For freelance musicians, depending on their access to the live-settings of gigs, auditions and social venues, it is like being thrown back in time and place (back to where careers were slowly built). However, while at a distance from the normal run of careers, constructive processes of critical reflection and re-orientation have been initiated.