Evaluating cognitive rehabilitation in multiple sclerosis: on the bumpy road to establishing evidence

There is marked enfeeblement of the memory; conceptions are formed slowly; the intellectual and emotional faculties are blunted in their totality,” Charcot (1877) reportedly noted about people with multiple sclerosis (MS) [1]. Despite these early observations of what we now refer to as ‘cognitive deficits’ and ‘mood disorders’, the magnitude and severity of these problems in MS were not considered seriously until over 100 years later. By the early 1990s, studies had begun to consistently demonstrate that people with MS reported cognitive problems

Editorial – Using sexual identity labels to move beyond them

This is the first issue of the Psychology of Sexualities Review. As mentioned in my previous Editorial, this change in name reflects the change made to the Section’s name, following a ballot of the Section’s membership. I trust that the papers in this issue are a testament to the Editorial Team’s promise to continue the legacy of the Lesbian & Gay Psychology Review’s of publishing high quality papers. In this Editorial I focus on the idea of using sexual identity labels, which have served us well and continue to do so, to move beyond them. I must clarify that by suggesting movement beyond these labels, I am in no way implying that we discard them, but permit a flexibility to incorporate other labelled identities and label-less identities to the fold. This plurality and inclusivity, I believe, forms the spirit of the Psychology of Sexualities Review. When thinking about plurality and inclusivity related to sexuality, two landmark judicial judgments in the recent past come to mind, perhaps because of their personal relevance to me, both from my own subject-ship and from those of some of my clients I see in therapy. The first, the Delhi High Court’s reading down of Section 377 of the Indian Penal Code, a section which criminalises private consensual sex between adults of the same sex (reported in the papers as ‘India decriminalises gay sex’, Mitta & Singh, 2009); and the second, the UK Supreme Court ruling related to ‘gay asylum seekers’ (‘Gay asylum seekers’, 2010). There is no question about the importance, the worthiness, the triumph, and the desperate need for both these judgments. A close reading, however, examining the language used in the official judgments and the English language newspaper reporting of these, exposes a certain conservative economy of terms that both reports employ. This is particularly pertinent as both judgments are related to minorities from India, and ‘gay asylum seekers’ from Cameroon and Iran, countries where some sexual minorities2 do not identity as ‘gay’ or even ‘homosexual’. The collapsing of sexual identities (and associated labels) into seemingly ‘neutral’ terminology employing behavioural categories of ‘men who have sex with men’ (MSM) and ‘women who have sex with women’ (WSW) is also problematic. While such usage has almost become the mainstay of epidemiological and public health studies (since the 1990s), social constructionists have highlighted the limits of such terms, but have also critiqued the use of identity labels such as ‘gay’, instead arguing for a ‘more textured understandings of sexuality that do not assume alignments among identity, behaviour, and desire’ (Young & Meyer, 2005, p.1144). My argument is that just as terms such as MSM and WSW tend to obliterate self-determination regarding sexual identities, terms such as ‘gay’ and ‘lesbian’, when applied indiscriminately or as global categories, can be as alienating; obfuscating text and subtext of sexual identities, desires, and practices. These terms then have the potential to become essentialist concepts

Outcome measurement in cognitive neurorehabilitation

Introduction: The aim of this chapter is to consider the criteria for selecting outcome measures for evaluating the effects of cognitive neurorehabilitation. The International Classification of Function, Disability and Health (ICF) (World Health Organization, 2001) is used as a framework for deciding what to measure. The properties of the ideal outcome measure are discussed. Examples of outcome measures commonly used in clinical studies are provided and their strengths and limitations considered. The focus is on self-report measures rather than neuropsychological tests as these reflect the effect of cognitive rehabilitation on daily life

The psychological impact of the unpredictability of multiple sclerosis: a qualitative literature meta-synthesis

Background: Multiple sclerosis (MS) is a neurological conditioncharacterised by an unpredictable nature. This characteristic is reported to be the largest challenge for individuals with the condition. Chronic illness literature highlights the psychological impact of unpredictability, but there is a paucity of research examining this concept in MS. Objectives: This systematic review aimed to explore the psychological impact of unpredictability in MS. Methods: A meta-synthesis was conducted. A total of 6 studies with 59 participants were reviewed and critically appraised. Themes relating to the psychological impact of unpredictability were extracted and synthesised. Results: A preliminary model of the unpredictability of MS was developed highlighting the different psychological impacts of diagnosis, remission and relapse. Conclusions: The psychological impact of unpredictability alters through diagnosis, remission and relapse. Further research is required to explore the experience of unpredictability in MS

The expansion of regional supermarket chains / canging models of retailing and the implications for local supplier capabilities in South Africa, Botswana, Zambia, and Zimbabwe

Over the past two decades, southern African countries have experienced rapid growth in the number and spread of supermarkets. Several factors have been attributed to this growth, including increasing urbanization, increased per capita income, the rise of the middle class, economies of scale and scope, and transport economies. The format and location of supermarkets have also evolved over the years, moving away from serving the traditional high-end affluent consumers in urban areas to successfully penetrating new markets in low-income rural communities, including through more efficient procurement and distribution systems. This spread into rural areas and the rapid proliferation of supermarkets generally has given rise to some important consequences for competitive rivalry between grocery retail outlets, as well as for local suppliers who want to participate in supermarket value chains in the southern African region

Editorial – Using sexual identity labels to move beyond them

This is the first issue of the Psychology of Sexualities Review. As mentioned in my previous Editorial, this change in name reflects the change made to the Section’s name, following a ballot of the Section’s membership. I trust that the papers in this issue are a testament to the Editorial Team’s promise to continue the legacy of the Lesbian & Gay Psychology Review’s of publishing high quality papers. In this Editorial I focus on the idea of using sexual identity labels, which have served us well and continue to do so, to move beyond them. I must clarify that by suggesting movement beyond these labels, I am in no way implying that we discard them, but permit a flexibility to incorporate other labelled identities and label-less identities to the fold. This plurality and inclusivity, I believe, forms the spirit of the Psychology of Sexualities Review. When thinking about plurality and inclusivity related to sexuality, two landmark judicial judgments in the recent past come to mind, perhaps because of their personal relevance to me, both from my own subject-ship and from those of some of my clients I see in therapy. The first, the Delhi High Court’s reading down of Section 377 of the Indian Penal Code, a section which criminalises private consensual sex between adults of the same sex (reported in the papers as ‘India decriminalises gay sex’, Mitta & Singh, 2009); and the second, the UK Supreme Court ruling related to ‘gay asylum seekers’ (‘Gay asylum seekers’, 2010). There is no question about the importance, the worthiness, the triumph, and the desperate need for both these judgments. A close reading, however, examining the language used in the official judgments and the English language newspaper reporting of these, exposes a certain conservative economy of terms that both reports employ. This is particularly pertinent as both judgments are related to minorities from India, and ‘gay asylum seekers’ from Cameroon and Iran, countries where some sexual minorities2 do not identity as ‘gay’ or even ‘homosexual’. The collapsing of sexual identities (and associated labels) into seemingly ‘neutral’ terminology employing behavioural categories of ‘men who have sex with men’ (MSM) and ‘women who have sex with women’ (WSW) is also problematic. While such usage has almost become the mainstay of epidemiological and public health studies (since the 1990s), social constructionists have highlighted the limits of such terms, but have also critiqued the use of identity labels such as ‘gay’, instead arguing for a ‘more textured understandings of sexuality that do not assume alignments among identity, behaviour, and desire’ (Young & Meyer, 2005, p.1144). My argument is that just as terms such as MSM and WSW tend to obliterate self-determination regarding sexual identities, terms such as ‘gay’ and ‘lesbian’, when applied indiscriminately or as global categories, can be as alienating; obfuscating text and subtext of sexual identities, desires, and practices. These terms then have the potential to become essentialist concepts