Psychotherapy in historical perspective

This article will briefly explore some of the ways in which the past has been used as a means to talk about psychotherapy as a practice and as a profession, its impact on individuals and society, and the ethical debates at stake. It will show how, despite the multiple and competing claims about psychotherapy’s history and its meanings, historians themselves have, to a large degree, not attended to the intellectual and cultural development of many therapeutic approaches. This absence has the potential consequence of implying that therapies have emerged as value-free techniques, outside of a social, economic and political context. The relative neglect of psychotherapy, by contrast with the attention historians have paid to other professions, particularly psychiatry, has also underplayed its societal impact. This article will foreground some of the instances where psychotherapy has become an object of emerging historical interest, including the new research that forms the substance of this special issue of History of the Human Sciences

Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse

<p>Abstract</p> <p>Background</p> <p>Weight change during chemotherapy is reported to be associated with a worse prognosis in breast cancer patients, both with weight gain and weight loss. However, most studies were conducted prior to the common use of anthracycline-base chemotherapy and on North American populations with a mean BMI classified as overweight. Our study was aimed to evaluate the prognostic value of weight change during anthracycline-based chemotherapy on non metastatic breast cancer (European population) with a long term follow-up.</p> <p>Methods</p> <p>Patients included 111 women diagnosed with early stage breast cancer and locally advanced breast cancer who have been treated by anthracycline-based chemotherapy regimen between 1976 and 1989. The relative percent weight variation (WV) between baseline and postchemotherapy treatment was calculated and categorized into either weight change (WV > 5%) or stable (WV < 5%). The median follow-up was 20.4 years [19.4 - 27.6]. Cox proportional hazard models were used to evaluate any potential association of weight change and known prognostic factors with the time to recurrence and overall survival.</p> <p>Results</p> <p>Baseline BMI was 24.4 kg/m2 [17.1 - 40.5]. During chemotherapy treatment, 31% of patients presented a notable weight variation which was greater than 5% of their initial weight.</p> <p>In multivariate analyses, weight change (> 5%) was positively associated with an increased risk of both recurrence (RR 2.28; 95% CI: 1.29-4.03) and death (RR 2.11; 95% CI: 1.21-3.66).</p> <p>Conclusions</p> <p>Our results suggest that weight change during breast-cancer chemotherapy treatment may be related to poorer prognosis with higher reccurence and higher mortality in comparison to women who maintained their weight.</p

Management of hydrocele in adolescent patients

Hydrocele is defined as an abnormal collection of serous fluid in the potential space between the parietal and visceral layers of the tunica vaginalis. In the majority of affected adolescents, hydrocele is acquired and is idiopathic in origin. The pathogenesis of idiopathic hydrocele is thought to be an imbalance in the normal process of fluid production and reabsorption. The diagnosis is usually clinical. Taking a thorough history is essential to rule out any fluctuation in size, which is an indication of a patent processus vaginalis. Scrotal ultrasonography is mandatory in nonpalpable testicles to rule out a subtending testicular solid mass requiring inguinal exploration. Otherwise, open hydrocelectomy via a scrotal incision is the standard treatment of idiopathic hydroceles. The second most common cause of hydrocele in adolescents is varicocelectomy. The risk of hydrocele formation is higher with non-artery-sparing procedures or those performed without microsurgical aid, and in surgery requiring cord dissection. If hydrocele occurs after varicocelectomy, initial management should include observation with or without hydrocele aspiration. Large persistent hydroceles are best served by open hydrocelectomy

Introduction : narcissism, melancholia and the subject of community.

Sigmund Freud’s twin papers, ‘On Narcissism: An Introduction’ (1914) and ‘Mourning and Melancholia’ (1917 [1915]), take as their formative concern the difficulty of setting apart the ‘inner’ and the ‘outer’ worlds, and of preserving a stable image of a boundaried self. Whilst it is true that the term narcissism especially has come to be deployed in ways that seem foreign to the complexities of Freud’s 1914 paper (by its reduction to a personality disorder or its use as a broad-brush cultural diagnosis), we suggest in this introductory chapter that neither narcissism nor melancholia can be thought about today without expressing some debt to Freudian metapsychology. However, whereas Freud was most evidently concerned to describe the structure of ego-formation, subsequent commentators have preferred to emphasize the cultural and normative dimensions of these terms. Accordingly, we consider the respective discursive histories of narcissism and melancholia and find that although they have been put to work in very different ways they remain grounded by a shared concern with mechanisms of relation and identification. Indeed, this shared concern is the basis upon which they’ve been most productively reanimated in recent years: the rise of melancholia as a critical aid to the study of cultural displacement and dispossession, and the determined redemption of narcissism from its pejorative characterization as fundamentally anti-social. We argue that what is most noteworthy in this post-Freudian literature is the increasing relevance of metapsychology to social and political theory. The language of psychoanalysis, extrapolated from the clinic, permits a detailed examination of the boundaries which construct and challenge the terms of social solidarity. Specifically, this takes place though careful reading of the complex practices of (dis)identification at the heart of ego-formation (at both individual and group levels), and the associated mechanisms of defence, for example: introjection, incorporation, projective-identification, and splitting. By recognising the complexity of how communities get made, and connecting this with recent literature on counter publics and the commons, we demonstrate that Freud’s frameworks of narcissism and melancholia remain essential for any contemporary understanding of political association

The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial

BackgroundBreast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women.MethodsOverweight or obese (n?=?243) and normal weight (n?=?166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes.ResultsForty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight ?2.3 (?3.5, ?1.0) kg, body fat ?1.6 (?2.6, ?0.7) kg, community vs. control; weight ?2.4 (?3.6, ?1.1) kg, body fat ?1.4 (?2.4, ?0.5) kg (all p?&#x3c;?0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective.ConclusionsThe programmes were equally effective for weight control, but the community programme had additional benefits.Clinical trial registrationISRCTN6857614

A Study On The Results Of Competing Sentence Test In Patients With Cerebrovascucular Accident

Background: Cerebrovasular diseases (CVD) are one of the most common anomalies which may affect on auditory cortex. In this research we have tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA) patients without hearing problem by using Persian version of C.S.T. Materials and Methods: This cross-sectional analytic study was established at Loghman-e-Hakim Hospital on a group of 30 normal subject (15 male, 14 female) and a group of 40 patients with CVA including 30 patients (16 male, 14 female) with abnormal CT scan and 10 patients with normal CT scan. Results: Routine audiologic test including: Pure tone audiometry, Immitance audiometry and speech audiometry were nearly normal in all cases. There were significant differences between mean scores of CST in the patients with CVA and control group (P 0.05). In spite of nearly normal hearing and high scores in the simple speech tests such as SDS, there were significant differences in mean scores of CST in both ears of CVA patients (P&lt; 0.05). Another important point is that in some of patients with CVA. Conclusion: Although common radiologic evaluations such as CT scan showed no anatomic or structural anomaly but central auditory assessments such as CST can show dysfunctions of CANS. Therefore, CST might be a valuable test in CANS batteries for the cerebrovascular diseases

PHYTOCHEMICAL ANALYSIS AND ANTIMICROBIAL ACTIVITY OF ARTOCARPUS HIRSUTUS: AN IN VITRO STUDY

published quarterly. The aim of IJPBS is to publish. peer reviewed research and review articles rapidly without delay in the developing field of pharmaceutical and biological science