Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder

Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effectiveness and optimal delivery of CBT, emphasizing cognitive interventions. Methods: A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. Clinical Trial registration: http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580. Results: There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later. Conclusions: The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.

Big data: a normal accident waiting to happen?

Widespread commercial use of the internet has significantly increased the volume and scope of data being collected by organisations. ‘Big data’ has emerged as a term to encapsulate both the technical and commercial aspects of this growing data collection activity. To date, much of the discussion of big data has centred upon its transformational potential for innovation and efficiency, yet there has been less reflection on its wider implications beyond commercial value creation. This paper builds upon normal accident theory (NAT) to analyse the broader ethical implications of big data. It argues that the strategies behind big data require organisational systems that leave them vulnerable to normal accidents, that is to say some form of accident or disaster that is both unanticipated and inevitable. Whilst NAT has previously focused on the consequences of physical accidents, this paper suggests a new form of system accident that we label data accidents. These have distinct, less tangible and more complex characteristics and raise significant questions over the role of individual privacy in a ‘data society’. The paper concludes by considering the ways in which the risks of such data accidents might be managed or mitigated.

Creating a non-word list to match 226 of the Snodgrass standardised picture set

Creating non-word lists is a necessary but time consuming exercise often needed when conducting behavioural language tasks involving lexical decision-making or non-word reading. The following article describes the process whereby we created a list of 226 non-words matching 226 of the Snodgrass picture set (Snodgrass & Vanderwart, 1980).The non-words were matched for number of syllables, stress pattern, number of phonemes, bigram count and presence and location of the target sound when relevant.

Vasectomy within the public health services in Campinas, Sao Paulo, Brazil

Objective: To describe some of the characteristics of men who underwent a vasectomy in the public health network of Campinas, Sao Paulo, Brazil. Methods: A descriptive study including 202 men randomly selected from a list of all the men vasectomized between 1998 and 2004 in the public health network. Results: Most of the men were 30 years of age or older when vasectomized, had completed elementary school and had two or more children of both sexes. Most of the men came from the lowest income segment of the population: 47.6% in 1998-1999 and 61.3% in 2003-2004. Although the men knew various contraceptive methods, 51.2% reported that their partners were using combined oral contraceptives at the time of surgery. Most men initially sought information on vasectomy at health-care clinics where care was provided by a multidisciplinary team; most received counselling, however, 47.9% of the men waited more than 4 months for the vasectomy. Conclusions: The profile of the vasectomized men in this study appears to indicate that the low-income population from Campinas, Sao Paulo, Brazil has access to vasectomy; however, the waiting time for vasectomy reveals that difficulties exist in obtaining this contraceptive method in the public health service.

A Psychoanalytic Reading of Vladimir and Estragon in Samuel Beckett’s Waiting for Godot

Much has been written about Samuel Beckett’s Waiting for Godot, but as far as I am aware no one has compared the two characters of Vladimir and Estragon in order to analyse what makes Vladimir more willing to wait than Estragon. This essay claims that Vladimir is more willing to wait because he cannot deal with the fact that they might be waiting in vain and he involves himself more in his surrounding than Estragon. It is Vladimir who waits for Godot, not Estragon, and Vladimir believes that Godot will have all the answers. This will be explored by examining four topics, all of which will be dealt with from a psychoanalytical point of view and in relation to waiting. Consciousness in relation to the decision to wait; Uncertainty in relation to the unknown outcome of waiting; Coping mechanisms in relation to ways of dealing with waiting; Ways of waiting in relation to waiting-time and two kinds of waiting-characters.