Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial

Background Up to 70% of adolescents with moderate to severe unipolar major depression respond to psychological treatment plus Fluoxetine (20-50 mg) with symptom reduction and improved social function reported by 24 weeks after beginning treatment. Around 20% of non responders appear treatment resistant and 30% of responders relapse within 2 years. The specific efficacy of different psychological therapies and the moderators and mediators that influence risk for relapse are unclear. The cost-effectiveness and safety of psychological treatments remain poorly evaluated. Methods/Design Improving Mood with Psychoanalytic and Cognitive Therapies, the IMPACT Study, will determine whether Cognitive Behavioural Therapy or Short Term Psychoanalytic Therapy is superior in reducing relapse compared with Specialist Clinical Care. The study is a multicentre pragmatic effectiveness superiority randomised clinical trial: Cognitive Behavioural Therapy consists of 20 sessions over 30 weeks, Short Term Psychoanalytic Psychotherapy 30 sessions over 30 weeks and Specialist Clinical Care 12 sessions over 20 weeks. We will recruit 540 patients with 180 randomised to each arm. Patients will be reassessed at 6, 12, 36, 52 and 86 weeks. Methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, research assessors independent of treatment team and blind to randomization, analysis by intention to treat, data management using remote data entry, measures of quality assurance, advanced statistical analysis, manualised treatment protocols, checks of adherence and competence of therapists and assessment of cost-effectiveness. We will also determine whether time to recovery and/or relapse are moderated by variations in brain structure and function and selected genetic and hormone biomarkers taken at entry. Discussion The objective of this clinical trial is to determine whether there are specific effects of specialist psychotherapy that reduce relapse in unipolar major depression in adolescents and thereby costs of treatment to society. We also anticipate being able to utilise psychotherapy experience, neuroimaging, genetic and hormone measures to reveal what techniques and their protocols may work best for which patients.

Mediating culture in the Italian literary field, 1940s-1950s: an introduction

This introduction lays out the scholarly and methodological context where to situate the contributions to this special issue. By combining a rigorous scrutiny of hitherto untapped archival sources with a re-examined application of Pierre Bourdieu’s sociology of culture within the field of periodical studies and publishing history in Italy (1940s-1950s), the studies illuminate the complex ways in which journals, periodical editors, and the connected publishing houses negotiate cultural practice in a literary field increasingly dominated by the polarization of political discourse.

Il realismo di un nuovissimo medio evo: Boccaccio in the age of neorealism

After the war Italian artists and intellectuals saw a significant and necessary confluence between their political desire to create a "new." Italy and their cultural ambition to re-invigorate the study of medieval Italy. This tendency is particularly evident, I argue, in the post-war scholarly and critical focus on Boccaccio, and especially Boccaccio’s Decameron. Not only within the academy but also in the popular press, Boccaccio was granted pride of place in the canon, venerated as the pioneer of socially conscious vernacular literary realism, the archetype for the pursuit of artistic truth in the face of social upheaval. As a result, I wish to suggest, Italian neorealism, which rose to prominence in the first years after the Second World War, was in a significant sense imbued with and realised through a profound engagement with the work of Boccaccio. In turn, the cultural currents affiliated with neorealism influenced Boccaccio studies, whose operative notions of medieval «realism» were to a perhaps surprising degree stimulated by approaches to the neo-realist poetics at work in the Italian films, novels, and criticism of the 1940s and ’50s. Situating the critical discourse surrounding Boccaccio within the post-war Italian context can therefore serve to shed unexpected light on both the cultural affirmation of neorealism and the disciplinary configuration of Italian medieval studies.

Language networks, literary translation and the friars in late medieval ireland

Dublin, Trinity College MS 667 (olim F 5 3) is something of a meeting point of languages and traditions, representing one of the most significant witnesses to Latin exemplars for vernacular translations to survive from medieval Ireland. What is more, the translated texts appear to travel in groups, with several Irish-language manuscripts bearing close comparison to Trinity 667 in the texts and versions of texts they contain. Examining these texts and the contexts in which they circulated in Irish can give us a sense of the sorts of historical and cultural currents to which such translation work appears to have been responding.