The Politics of Pleasure: Promenading on the Corniche and Beachgoing

Can the pleasures of young Palestinian women from refugee camps in promenading on the Beirut seaside Corniche on a warm summer evening be political? Or days spent at women-only beaches? If so, how do we understand such pleasure as everyday practices, as a politics of the present moment, or conversely (or simultaneously) as mechanisms of being co-opted into a broader apparatus of consumerist ideology and capitalist complacency? Drawing on ethnographic research over 2 years I argue that these moments of pleasure are caesuras in the massive apparatus of power – welded from strands of work, neoliberal practice, nationalist certitudes and political exclusion – which binds these women. These acts of pleasure cannot easily be categorised as ‘resistance’ but I argue that they should not facilely be considered reinforcements of hegemonic control either. They are momentary and ephemeral recognitions of ordinary life lived in hard times, attempts at clawing back an instant of joy from the drudgery of the everyday, and a surrender to the enjoyment of conviviality in public and urban spaces. If they are at all political, they are so because such conviviality is ever harder to sustain in the calamity of hopelessness that characterises so much politics today

Characteristics of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy practice: A scoping review of the literature

© 2017 The Author(s). Background: Most conventional treatment for musculoskeletal conditions continue to show moderate effects, prompting calls for ways to increase effectiveness, including drawing from strategies used across other health conditions. Therapeutic alliance refers to the relational processes at play in treatment which can act in combination or independently of specific interventions. Current evidence guiding the use of therapeutic alliance in health care arises largely from psychotherapy and medicine literature. The objective of this review was to map out the available literature on therapeutic alliance conceptual frameworks, themes, measures and determinants in musculoskeletal rehabilitation across physiotherapy and occupational therapy disciplines. Methods: A scoping review of the literature published in English since inception to July 2015 was conducted using Medline, EMBASE, PsychINFO, PEDro, SportDISCUS, AMED, OTSeeker, AMED and the grey literature. A key search term strategy was employed using physiotherapy , occupational therapy , therapeutic alliance , and musculoskeletal to identify relevant studies. All searches were performed between December 2014 and July 2015 with an updated search on January 2017. Two investigators screened article title, abstract and full text review for articles meeting the inclusion criteria and extracted therapeutic alliance data and details of each study. Results: One hundred and thirty articles met the inclusion criteria including quantitative (33%), qualitative (39%), mixed methods (7%) and reviews and discussions (23%) and most data came from the USA (23%). Randomized trials and systematic reviews were 4.6 and 2.3% respectively. Low back pain condition (22%) and primary care (30.7%) were the most reported condition and setting respectively. One theory, 9 frameworks, 26 models, 8 themes and 42 subthemes of therapeutic alliance were identified. Twenty-six measures were identified; the Working Alliance Inventory (WAI) was the most utilized measure (13%). Most of the therapeutic alliance themes extracted were from patient perspectives. The relationship between adherence and therapeutic alliance was examined by 26 articles of which 57% showed some correlation between therapeutic alliance and adherence. Age moderated the relationship between therapeutic alliance and adherence with younger individuals and an autonomy support environment reporting improved adherence. Prioritized goals, autonomy support and motivation were facilitators of therapeutic alliance. Conclusion: Therapeutic Alliance has been studied in a limited extent in the rehabilitation literature with conflicting frameworks and findings. Potential benefits described for enhancing therapeutic alliance might include better exercise adherence. Several knowledge gaps have been identified with a potential for generating future research priorities for therapeutic alliance in musculoskeletal rehabilitation

Cognitive functioning and age at onset in non-affective psychotic disorder

van der Werf M, Köhler S, Verkaaik M, Verhey F, van Os J, GROUP Investigators. Cognitive functioning and age at onset in non-affective psychotic disorder. Objective:  Age at psychosis onset has been related to variability in cognitive functioning, but its effect may be mediated by demographic and clinical factors. The aim of the current study was to study the contribution of age at onset, as well as demographic and illness characteristics, to variation in cognitive functioning in patients with schizophrenia spectrum disorder. Method:  Patients (n = 1053) and healthy controls (n = 631) underwent comprehensive neuropsychological and clinical assessments. The effect of age at onset on age-standardized cognitive test scores was assessed with multiple linear regression analyses. Mediation by illness and demographic factors was tested using a multiple mediation Sobel test. Results:  A diagnosis of schizophrenia, higher antipsychotic dose, and more negative symptoms were associated with earlier onset of illness, while female sex and a more chronic course were associated with later illness onset. Furthermore, earlier onset was associated with worse performance on immediate recall and sustained attention. However, male sex, more negative symptoms, and higher antipsychotic dose mediated the effect of age at onset on memory, while negative symptoms explained its association with attention/vigilance. Conclusion:  Greater impairment in memory and attention in early-onset psychosis may be explained by features indicative of underlying neurodevelopmental vulnerabilit