Counselling in primary care : a systematic review of the evidence

Primary objective: To undertake a systematic review which aimed to locate, appraise and synthesise evidence to obtain a reliable overview of the clinical effectiveness, cost-effectiveness and user perspectives regarding counselling in primary care. Main results: Evidence from 26 studies was presented as a narrative synthesis and demonstrated that counselling is effective in the short term, is as effective as CBT with typical heterogeneous primary care populations and more effective than routine primary care for the treatment of non-specific generic psychological problems, anxiety and depression. Counselling may reduce levels of referrals to psychiatric services, but does not appear to reduce medication, the number of GP consultations or overall costs. Patients are highly satisfied with the counselling they have received in primary care and prefer counselling to medication for depression. Conclusions and implications for future research: This review demonstrates the value of counselling as a valid choice for primary care patients and as a broadly effective therapeutic intervention for a wide range of generic psychological conditions presenting in the primary care setting. More rigorous clinical and cost-effectiveness trials are needed together with surveys of more typical users of primary care services

Spatial Graphs with Local Knots

It is shown that for any locally knotted edge of a 3-connected graph in $S^3$, there is a ball that contains all of the local knots of that edge and is unique up to an isotopy setwise fixing the graph. This result is applied to the study of topological symmetry groups of graphs embedded in $S^3$.Comment: 20 pages, 3 figures; in v. 2 the proof of Theorem 1 has been clarified, and other minor revisions have been mad

Feature Neighbourhood Mutual Information for multi-modal image registration: An application to eye fundus imaging

© 2014 Elsevier Ltd. All rights reserved. Multi-modal image registration is becoming an increasingly powerful tool for medical diagnosis and treatment. The combination of different image modalities facilitates much greater understanding of the underlying condition, resulting in improved patient care. Mutual Information is a popular image similarity measure for performing multi-modal image registration. However, it is recognised that there are limitations with the technique that can compromise the accuracy of the registration, such as the lack of spatial information that is accounted for by the similarity measure. In this paper, we present a two-stage non-rigid registration process using a novel similarity measure, Feature Neighbourhood Mutual Information. The similarity measure efficiently incorporates both spatial and structural image properties that are not traditionally considered by MI. By incorporating such features, we find that this method is capable of achieving much greater registration accuracy when compared to existing methods, whilst also achieving efficient computational runtime. To demonstrate our method, we use a challenging medical image data set consisting of paired retinal fundus photographs and confocal scanning laser ophthalmoscope images. Accurate registration of these image pairs facilitates improved clinical diagnosis, and can be used for the early detection and prevention of glaucoma disease

Sociology, Embodiment and Morality: A Durkheimian Perspective

Durkheim is often associated with the ‘old’ sociology of morality but a fresh engagement with the embodied dimensions of his work can bring theoretical clarity to the contemporary field. In undertaking this task, our argument proceeds through three stages. Firstly, we demonstrate how Durkheim’s explanatory homo duplex model insists that biological and social factors combine to constitute morality. Secondly, we analyse how this model provides the basis for a broader explanatory account that resists reductionist ‘substantive’ assessments of diverse moral systems to focus on them as cultural systems. Finally, we explore how his approach facilitates the analysis of competing moral solidarities within as well as across contemporary societies. Having reappraised Durkheim’s account, we suggest that the sociology of morality should be inclusive of insights from other disciplines but also synthetic, resisting various forms of reductionism in favour of a distinctively sociological model reflective of the fact that human beings are, simultaneously, natural and cultural creatures