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Cognitive–behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therapists. This study explored a combination of these responses by investigating a brief, CBT-informed intervention targeted at distressing voices (the GiVE intervention) administered by a briefly trained workforce of assistant psychologists.
To explore the feasibility of conducting a randomised controlled trial to evaluate the clinical and cost-effectiveness of the GiVE intervention when delivered by assistant psychologists to patients with psychosis.
This was a three-arm, feasibility, randomised controlled trial comparing the GiVE intervention, a supportive counselling intervention and treatment as usual, recruiting across two sites, with 1:1:1 allocation and blind post-treatment and follow-up assessments.
Feasibility outcomes were favourable with regard to the recruitment and retention of participants and the adherence of assistant psychologists to therapy and supervision protocols. For the candidate primary outcomes, estimated effects were in favour of GiVE compared with supportive counselling and treatment as usual at post-treatment. At follow-up, estimated effects were in favour of supportive counselling compared with GiVE and treatment as usual, and GiVE compared with treatment as usual.
A definitive trial of the GiVE intervention, delivered by assistant psychologists, is feasible. Adaptations to the GiVE intervention and the design of any future trials may be necessary.
The Subglacial Antarctic Lakes Scientific Access (SALSA) Project accessed Mercer Subglacial Lake using environmentally clean hot-water drilling to examine interactions among ice, water, sediment, rock, microbes and carbon reservoirs within the lake water column and underlying sediments. A ~0.4 m diameter borehole was melted through 1087 m of ice and maintained over ~10 days, allowing observation of ice properties and collection of water and sediment with various tools. Over this period, SALSA collected: 60 L of lake water and 10 L of deep borehole water; microbes >0.2 μm in diameter from in situ filtration of ~100 L of lake water; 10 multicores 0.32–0.49 m long; 1.0 and 1.76 m long gravity cores; three conductivity–temperature–depth profiles of borehole and lake water; five discrete depth current meter measurements in the lake and images of ice, the lake water–ice interface and lake sediments. Temperature and conductivity data showed the hydrodynamic character of water mixing between the borehole and lake after entry. Models simulating melting of the ~6 m thick basal accreted ice layer imply that debris fall-out through the ~15 m water column to the lake sediments from borehole melting had little effect on the stratigraphy of surficial sediment cores.
The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors.
This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n = 128) were compared to a control group without a medical condition (n = 128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27 March 2020–8 June 2020).
Individuals with existing medical conditions reported significantly higher levels of anxiety (p < .01) and felt less gratitude (p ≤ .001). Exploratory analysis indicated that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post hoc analysis revealed that psychological well-being was not significantly related to condition type (e.g. respiratory disorders).
This research supports individualised supports for people with ongoing medical conditions during the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.
This article considers Frank Castorf's Bayreuth Festival production of Wagner's Ring (2013–17) and its relationship to postdramatic theatre, including the latter's fraught relationship to conceptions of the political. Framework and context are provided by Castorf's theatrical practice, both prior to and following German reunification; by Wagner's nineteenth-century revolutionary and post-revolutionary experience, both historical and as dramatised in the Ring; and by Hans-Thies Lehmann's theoretical writing on postdramatic theatre. The production was a story of fascinating collisions: on the one hand, between different, often opposing, conceptions of drama and theatre; on the other, between different, yet in some ways complementary, political experiences. Interpretation proceeds by means of detailed description and analysis of the staging and a broader theoretical discussion. Compelled to reconcile themselves, at least in part, with ideas of musical drama and the work concept, Castorf's postdramatic aesthetics underwent significant challenge. In the wake of this production, ideas of Wagner staging and, more broadly, staging of opera in general have similarly undergone transformation.
The men and women we meet in the Ring, via words, music, and stage gesture, span two generations, various rungs in the cosmic hierarchy (god to human, or vice versa), and four dramas. Every character appearing onstage – and most mentioned in the text – receives attention in this chapter. Opening with roots in the natural world, from which each character in one way or another emerges, context, personality, relationships, motivations, and acts are examined, always bearing in mind that, in the Ring, such issues are explored musically as much as verbally, one sometimes in contradiction with the other, and that Wagner’s broader intellectual framework – philosophical, literary, musical, political, religious – also has much to tell us. We must start and end somewhere, of course, but what becomes quickly apparent is that it is the connections between characters – how their deeds, their words, their music shape and affect one another – that propel Wagner’s drama. As we progress, in Wagner’s conception, from Wotan to Brünnhilde; from male patriarch to female rebel; from power politics, through revolution, to renunciation; from Das Rheingold to Götterdämmerung, none of those categories, none of those characters, remains unchanged.
Comprehensive and quite lengthy introduction to Wagner and the Ring. Covers concept of the volume as well as basic biographical details and intellectual and cultural influences for Wagner. Explains the significance of the Ring in musical, literary, and cultural terms. Sections include mythological sources, musical structure, compositional process, discussion of overall “meaning,” approaches to interpretation, performance history and impact.
The Companion is an essential, interdisciplinary tool for those both familiar and unfamiliar with Wagner's Ring. It opens with a concise introduction to both the composer and the Ring, introducing Wagner as a cultural figure, and giving a comprehensive overview of the work. Subsequent chapters, written by leading Wagner experts, focus on musical topics such as 'leitmotif', and structure, and provide a comprehensive set of character portraits, including leading players like Wotan, Brünnhilde, and Siegfried. Further chapters look to the mythological background of the work and the idea of the Bayreuth Festival, as well as critical reception of the Ring, its relationship to Nazism, and its impact on literature and popular culture, in turn offering new approaches to interpretation including gender, race and environmentalism. The volume ends with a history of notable stage productions from the world premiere in 1876 to the most recent stagings in Bayreuth and elsewhere.