Psychotherapy as an eductional process

Clients in psychotherapy with social workers, psychiatrists and psychologists learn things that they did not know previously. This learning modifies their view of reality and themselves. Clients learn that their problems are, to an extent universal, interpersonal—both out from themselves and to themselves from others, due to experiences in their past in their families, perhaps solvable by identifying with successful others, often due to unrealistic expectations about themselves, others and existence in general. Successful therapy is marked by culture-building interaction by the client and the therapist with the client's subjective understanding modified to enable greater autonomous action.     

Intra-rater reliability of hip abductor isometric strength testing in a standing position in older fallers and non-fallers

Background

Reduced hip muscle strength has been shown to be a major factor related to falls in older persons. However, comprehensive assessment of hip abduction strength in the clinical setting is challenging. The aim of this study was to investigate the feasibility and intra-rater reliability of a quick and simple hip abductor strength test in a functional standing position.

Methods

Individuals over 65 years of age were recruited from the geriatric department of a university hospital and an outpatient clinic. Thirty-two older subjects, including 16 fallers (≥1 fall during the last 12 months) and 16 non-fallers were included. Maximum voluntary isometric strength (MVIS) and rate of force generation (RFG) of the hip abductors of the right leg were evaluated in a standing position using a hand-held dynamometer. Two test-sessions were carried out. All hip strength values were normalized to participants’ weight. Reliability was determined using the intra-class correlation coefficient agreement (ICC_agreement), the standard error of measurement (SEM) and a Bland and Altman analysis (BA).

Results

All participants completed the strength tests, which took a mean 2.47?±?0.49 min (one limb). Intra-rater reliability was higher for MVIS (0.98_{[0.95–0.99]}) than RFG (ICC?=?0.93_{[0.87–0.97]}) for the entire sample. In the non-fallers, ICC was 0.98_{[0.95–1.00]} (SEM?=?0.08 N.kg^??1) for MVIS and 0.88_{[0.75–0.96]} for RFG (SEM?=?1.34 N.kg^-1.s^-1). In the fallers, ICC was 0.94_{[0.89–0.98]} (SEM?=?0.11 N.kg^??1) for MVIS and 0.93_{[0.84–0.98]} (SEM?=?1.12 N.kg^??1.s^??1) for RFG. The BA plot showed that the MVIS and RFG values did not differ across test-sessions, showing that no learning effect occurred (no systematic effect). The mean differences between test-sessions were larger and the LOA smaller in the fallers than in the non-fallers.

Conclusion

Assessment of hip strength in a standing position is feasible, rapid and reliable. We therefore recommend this position for clinical practice. Future studies should investigate the diagnostic value of hip abductor strength in standing to discriminate between fallers and non-fallers, and to determine if change in strength following a falls prevention program reduces the risk of falls.

     

Multi‐Family Therapy with a Reflecting Team: A Preliminary Study on Efficacy among Opiate Addicts in Methadone Maintenance Treatment

In this study, we evaluate the efficacy of multi‐family therapy at reducing the addiction severity and at improving the psychological and family dynamics of opiate addicts receiving methadone treatment at a public treatment center. The study compares multi‐family therapy with a reflecting team (MFT‐RT) and a standard treatment following a methadone maintenance treatment program. The results show that multi‐family therapy with a reflecting team effectively reduces the addiction severity in several of the areas evaluated and noted that this effect is superior to standard treatment. The psychotherapy patients showed improvement in the areas of employment and social support; their drug use diminished and their psychiatric condition improved. At the same time, they needed a lower daily dose of methadone. In addition, the group undergoing standard treatment showed a noteworthy deterioration in their medical condition. Both groups showed a significant increase in their alcohol use. When applied to family treatments, the systemic‐constructivist approach by the reflecting team offers combined techniques that can help improve care for the families of patients with addiction problems.     

The Vernacular Life of the Street: Ratsitatanina and Indian Ocean Créolité1

The record of an alleged conspiracy of Madagascar-born slaves and apprentices in Mauritius during 1822 offers a useful vantage onto the vernacular life of the street in the colonial Mascarene islands of the western Indian Ocean. This article examines details of the alleged conspiracy to propose that Ratsitatanina, the accused ringleader, neither planned nor participated in a servile revolt. A close reading of the trial record, however, suggests that the Malagasy language was widely spoken in Mauritius in 1822 and that Malagasy speakers maintained communities in Mascarene diaspora through frequent encounters and vernacular exchanges along urban byways. Together with colonial censuses, these documents challenge scholars to rethink the timing and nature of creolisation in the French slave islands of the western Indian Ocean. Multilingualism and cultural heterogeneity were more salient features of colonial human landscapes during the eighteenth and nineteenth centuries than commonly admitted in prevalent models of Indian Ocean créolité. This article proposes a dynamic model of creolisation for the Indian Ocean islands that emphasises the cultural and linguistic agility of subaltern colonial populations.     

Bootstrap approximations for Bayesian analysis of Geo/G/1 discrete-time queueing models

In this paper we consider a Bayesian nonparametric approach to the analysis of discrete-time queueing models. The main motivation consists in applications to telecommunications, and in particular to asynchronous transfer mode (ATM) systems. Attention is focused on the posterior distribution of the overflow rate. Since the exact distribution of such a quantity is not available in a closed form, an approximation based on “proper” Bayesian bootstrap is proposed, and its properties are studied. Some possible alternatives to proper Bayesian bootstrap are also discussed. Finally, an application to real data is provided.     

Response improvement in complex experiments by co-information composite likelihood optimization

We propose an adaptive procedure for improving the response outcomes of complex combinatorial experiments. New experiment batches are chosen by minimizing the co-information composite likelihood (COIL) objective function, which is derived by coupling importance sampling and composite likelihood principles. We show convergence of the best experiment within each batch to the globally optimal experiment in finite time, and carry out simulations to assess the convergence behavior as the design space size increases. The procedure is tested as a new enzyme engineering protocol in an experiment with a design space size of order 10⁷.     

Unpaid labour and territorial extraction in digital value networks

Production in knowledge and data-intensive industries is powered by work that can, in theory, be done from anywhere, via cloudwork platforms. Cloudwork platforms govern data value chains in distinct ways to concentrate power and extract value at the global scale. We argue that unpaid labour is a systemic mechanism of accumulation in these digital value networks. In this paper we demonstrate how it is tied to platform business models and facilitated by elements of platform governance including monopsony power, a high degree of spatial flexibility in sourcing labour, regulatory unaccountability and digital enclosure. We draw on a survey of 699 workers on 14 platforms in 74 countries to show that unpaid labour is an engine of South–North value extraction, and workers in the global South perform more unpaid labour than counterparts in the global North. Our findings have important ramifications our understanding of the changing international division of labour and platform capitalism.