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Objective: to systematize the strengths and challenges of Axel Honneth’s Theory of Recognition, and to reflect on these as support for research in health care. Method: this is a reflection article which considers the potential of incorporating the category of recognition in the Honnethian proposition for research, understanding, exercising of practice and management of health care. Results: the process of recognition promotes the exploration and understanding of relations of power and respect, above all in terms of conflict which are ascribed to these. As a result, it indicates support for diagnoses and structuring nuclei for overcoming oppressive and unequal practices, with consequences for dealing with situations of insecurity, weaknesses in self-esteem and vulnerabilities in the interactions between the subjects, which are configured as contemporary challenges. Conclusion: in the scientific exploration of care, management and public policies in health, this theoretical framework can assist in the visibility of the context and in its critical knots, in order to promote autonomy and human dignity, which are relevant for the interpersonal relations in the processes of care, with fruitful contributions to the qualification of the health care.
Objetivo: sistematizar as potencialidades e desafios da Teoria do Reconhecimento, de Axel Honneth, e refletir sobre eles como subsídio às pesquisas em saúde.
Método: trata-se de artigo de reflexão que toma o potencial da incorporação da categoria reconhecimento na propositura honnethiana para pesquisa, compreensão, exercício e gestão do cuidado em saúde.
Resultados: o processo de reconhecimento favorece a exploração e a compreensão das relações de poder e respeito, sobretudo em termos do conflito a elas circunscrito. Dessa forma, indica subsídios para diagnósticos e núcleos estruturantes para a superação de práticas opressivas e desiguais, com desdobramentos para lidar com situações de insegurança, fragilidades na autoestima e vulnerabilidades nas interações entre os sujeitos, que configuram desafios contemporâneos.
Conclusão: na exploração científica do cuidado, gestão e políticas públicas em saúde, este referencial teórico pode auxiliar na visibilidade do contexto e seus nós críticos, para favorecer a autonomia e a dignidade humana, relevantes para as relações interpessoais nos processos de cuidado, com contribuições profícuas à qualificação da atenção à saúde.
From reciprocal recognition to a society that is properly 'social' : on Axel Honneth's recent work
(2017)
This paper addresses Axel Honneth's recent endeavors to defend his theory of justice, broadly described in Freedom's right (2011) as an analysis of society. The paper begins by exposing Honneth's model as a theory of institutional intersubjectivity rather than a theory of the struggle for recognition. This model, however, was subject to criticism due to its supposed acceptance of the capitalistic market economy as a social order. In order to defend it from such objections, Honneth (2016) exposes the normative core of socialist ideals as a version of social freedom. Finally, he presents a distinction between two forms of political intervention: an internal and an external struggle for recognition – and asserts the advantages of the former.
Este artigo apresenta uma discussão sobre a obra recente de Axel Honneth. Começando por uma exposição de seu projeto teórico mais amplo, descrito em O direito da liberdade (2011) como uma teoria da justiça sociologicamente ancorada, o artigo demonstra como Honneth se move da ideia de uma luta por reconhecimento em direção à ideia de intersubjetividade institucional. Este movimento, porém, é acompanhado por críticas que vêm nesta passagem o abandono das ambições críticas de seu modelo e um compromisso reformista com a ordem capitalista de mercado. A fim de responder a estas objeções, Honneth propõe uma reatualização da ideia do socialismo (2015) a partir da noção de liberdade social, concluindo com uma distinção entre duas formas de luta por reconhecimento, uma interna e outra externa – e defendendo as vantagens da primeira.
Objective: This study examines the interrelations of parenting practices, emotional climate, and household chaos in families with children with and without ADHD. In particular, indirect pathways from children’s ADHD symptomatology to inadequate parenting and negative emotional climate via household chaos were investigated. Method: Parenting, emotional climate, and household chaos were assessed using questionnaires and a speech sample of parents of 31 children with and 53 without ADHD, aged 7 to 13 years. Results: Group differences were found for certain parenting dimensions, the parent–child relationship, critical comments, and household chaos. While we found significant indirect effects between children’s ADHD and certain parenting dimensions through household chaos, no effects were found for any aspect of emotional climate. Conclusion: Children’s ADHD symptoms translate into inadequate parenting through household chaos, which underlines the need for interventions to improve household organization skills in parents of children with ADHD.
O ensaio traz como base a crítica ao capitalismo, no que se refere aos efeitos negativos que ele impõe aos indivíduos, a partir dos estudos da primeira geração da Escola de Frankfurt. Analisar-se-á a história das ideias a partir de Walter Benjamin, Herbert Marcuse, Theodor Adorno e Max Horkheimer. Benjamin afirma que vive-se a perda da aura das obras de arte, já que a sua comercialização faz com que se perca a essência daquelas obras. Ademais, a imposição da novidade às obras e aos produtos consumidos representa uma ferramenta de manipulação do capitalismo, culminando na pobreza da experiência humana. Marcuse afirma que a sociedade vive o princípio do desempenho, que provoca modos de vida uniformizados, baseados numa concepção de trabalho e diversão homogêneos. Adorno propôs que o tempo livre provocava uma sensação de liberdade nos indivíduos, mas, na realidade, tratava-se do exercício de uma não liberdade, já que as formas de diversão seguiam à risca os padrões exigidos pelo capital. A partir do método adotado pela própria Teoria Crítica, afirma-se que a presente discussão teórica só se torna efetiva quando aplicada à prática, à sociedade atual.
This article is written from the perspective of phenomenology. Its potential gain for a critical human geography is discussed in contrast to the paradigmatic frame of basic assumptions in constructivism. The example of atmospheres will illustrate another theoretical conception of space. In phenomenological view there happens not only a reality of things but also a circum-actuality is not spatially extended like a house or another material objective. Atmospheres are vital qualities (Dürckheim) we feel like a cloud in our sense perception in situations of awareness. This implies the necessity to make a difference between a material body (Körper) and a felt body (Leib). This epistemic knowledge will improve our critique of neoliberal societies, tuned by aestheticisation especially in glamour CBDs of postmodern cities. Finally there is a close link to the work of Michel Foucault, topped off in his The Hermeneutics of the Subject. References to the Critical Theory (Frankfurter Schule) are connected.
Anxiety and politics
(2017)
The English version of this article was first published in 1957. The journal tripleC: Communication, Capitalism & Critique republished it 60 years later in 2017. In this essay, Franz L. Neumann discusses the role of anxiety in politics. The article asks: How does it happen that the masses sell their souls to leaders and follow them blindly? On what does the power of attraction of leaders over masses rest? What are the historical situations in which this identification of leader and masses is successful, and what view of history do the men have who accept leaders? For answering these questions, the author suggests a combination of political economy, Freudian political psychology, and ideology critique. He sees anxiety in the context of alienation. Alienation is analysed as a multidimensional phenomenon consisting of economic, political, social and psychological alienation. Neumann introduces the notions of Caesaristic identification, institutionalised anxiety and persecutory anxiety. The essay shows that fascism remains an actual threat in capitalist societies.
Intestinal carriage of multidrug-resistant bacteria among healthcare professionals in Germany
(2017)
Healthcare professionals (HCP) might be at increased risk of acquisition of multidrug-resistant bacteria (MDRB), i.e., methillicin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and multidrug-resistant gram-negative bacteria (MDRGN) and could be an unidentified source of MDRB transmission.
The aim of this study was to determine the prevalence as well as risk factors of MDRB colonization among HCP.
HCP (n=107) taking part in an antibiotic stewardship program, were voluntarily recruited to perform a rectal swab and to fill in a questionnaire to identify risk factors of MDRB carriage, i.e. being physician, gender, travel abroad within the previous 12 months, vegetarianism, regular consumption of raw meat, contact to domestic animals, household members with contact to livestock, work or fellowship abroad, as well as medical treatment abroad and antibiotic therapy within the previous 12 months.
Selective solid media were used to determine the colonization rate with MRSA, VRE and MDRGN. MDRGN were further characterized by molecular analysis of underlying β-lactamases.
None of the participants had an intestinal colonization with MRSA or VRE. 3.7% of the participants were colonized with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, predominantly blaCTX-M type. Neither additional flouroquinolone resistance nor carbapenem resistance was detected in any of these isolates. No risk factors were identified to have a significant impact of MDRB carriage among HCP.
A colonization rate of 3.7% with ESBL-producing Enterobacteriaceae is of interest, but comparing it to previously published data with similar colonization rates in the healthy population in the same geographic area, it is probably less an occupational risk.
Objective: Extracorporeal life support (ECLS) is a life-saving procedure used in the treatment of severe cardiogenic shock. Within this retrospective single centre study, we examined our experience in this critically ill patient cohort to assess outcomes and clinical parameters by comparison of ECLS with or without selective left ventricular decompression.
Methods: Between 2004 and 2014 we evaluated 48 adult patients with INTERMACS level 1 heart failure (age 49.7 ± 19.5 years), who received either central ECLS with (n = 20, 41.7%) or ECLS without (n = 28, 58.3%, including 10 peripheral ECLS) integrated left ventricular vent in our retrospective single centre trial.
Results: Follow up was 100% with a mean of 0.83 ± 1.85 years. Bridge to ventricular assist device was feasible in 29.2% (n = 14), bridge to transplant in 10.4% (n = 5) and bridge to recovery in 8.3% (n = 4). Overall 30-day survival was 37.5%, 6-month survival 27.1% and 1-year survival 25.0%. ECLS support with left ventricular decompression showed favourable 30-day survival compared to ECLS without left ventricular decompression (p = 0.034). Thirty-day as well as long-term survival did not differ between the subgroups (central ECLS with vent, ECLS without vent and peripheral ECLS without vent). Multivariate logistic regression adjusted for age and gender revealed ECLS without vent as independent factor influencing 30-day survival.
Conclusion: ECLS is an established therapy for patients in severe cardiogenic shock. Independent of the ECLS approach, 30-day mortality is still high but with superior 30-day survival for patients with ECLS and left ventricular venting. Moreover, by unloading the ventricle, left ventricular decompression may provide an important time window for recovery or further treatment, such as bridge to bridge or bridge to transplant.
Exposure to community violence through witnessing or being directly victimized has been associated with conduct problems in a range of studies. However, the relationship between community violence exposure (CVE) and conduct problems has never been studied separately in healthy individuals and individuals with conduct disorder (CD). Therefore, it is not clear whether the association between CVE and conduct problems is due to confounding factors, because those with high conduct problems also tend to live in more violent neighborhoods, i.e., an ecological fallacy. Hence, the aim of the present study was: (1) to investigate whether the association between recent CVE and current conduct problems holds true for healthy controls as well as adolescents with a diagnosis of CD; (2) to examine whether the association is stable in both groups when including effects of aggression subtypes (proactive/reactive aggression), age, gender, site and socioeconomic status (SES); and (3) to test whether proactive or reactive aggression mediate the link between CVE and conduct problems. Data from 1178 children and adolescents (62% female; 44% CD) aged between 9 years and 18 years from seven European countries were analyzed. Conduct problems were assessed using the Kiddie-Schedule of Affective Disorders and Schizophrenia diagnostic interview. Information about CVE and aggression subtypes was obtained using self-report questionnaires (Social and Health Assessment and Reactive-Proactive aggression Questionnaire (RPQ), respectively). The association between witnessing community violence and conduct problems was significant in both groups (adolescents with CD and healthy controls). The association was also stable after examining the mediating effects of aggression subtypes while including moderating effects of age, gender and SES and controlling for effects of site in both groups. There were no clear differences between the groups in the strength of the association between witnessing violence and conduct problems. However, we found evidence for a ceiling effect, i.e., individuals with very high levels of conduct problems could not show a further increase if exposed to CVE and vice versa. Results indicate that there was no evidence for an ecological fallacy being the primary cause of the association, i.e., CVE must be considered a valid risk factor in the etiology of CD.
One striking observation in Parkinson’s disease (PD) is the remarkable gender difference in incidence and prevalence of the disease. Data on gender differences with regard to disease onset, motor and non-motor symptoms, and dopaminergic medication are limited. Furthermore, whether estrogen status affects disease onset and progression of PD is controversially discussed. In this retrospective single center study, we extracted clinical data of 226 ambulatory PD patients and compared age of disease onset, disease stage, motor impairment, non-motor symptoms, and dopaminergic medication between genders. We applied a matched-pairs design to adjust for age and disease duration. To determine the effect of estrogen-related reproductive factors including number of children, age at menarche, and menopause on the age of onset, we applied a standardized questionnaire and performed a regression analysis. The male to female ratio in the present PD cohort was 1.9:1 (147 men vs. 79 women). Male patients showed increased motor impairment than female patients. The levodopa equivalent daily dose was increased by 18.9% in male patients compared to female patients. Matched-pairs analysis confirmed the increased dose of dopaminergic medication in male patients. No differences were observed in age of onset, type of medication, and non-motor symptoms between both groups. Female reproductive factors including number of children, age at menarche, and age at menopause were positively associated with a delay of disease onset up to 30 months. The disease-modifying role of estrogen-related outcome measures warrants further clinical and experimental studies targeting gender differences, specifically hormone-dependent pathways in PD.
Callous-unemotional traits are characterized by a lack of empathy, a disregard for others' feelings and shallow or deficient affect, such as a lack of remorse or guilt. Neuroanatomical correlates of callous-unemotional traits have been demonstrated in clinical samples (i.e., adolescents with disruptive behavior disorders). However, it is unknown whether callous-unemotional traits are associated with neuroanatomical correlates within normative populations without clinical levels of aggression or antisocial behavior. Here we investigated the relationship between callous-unemotional traits and gray matter volume using voxel-based morphometry in a large sample of typically-developing boys and girls (N = 189). Whole-brain multiple regression analyses controlling for site, total intracranial volume, and age were conducted in the whole sample and in boys and girls individually. Results revealed that sex and callous-unemotional traits interacted to predict gray matter volume when considering the whole sample. This interaction was driven by a significant positive correlation between callous-unemotional traits and bilateral anterior insula volume in boys, but not girls. Insula gray matter volume explained 19% of the variance in callous-unemotional traits for boys. Our results demonstrate that callous-unemotional traits are related to variations in brain structure beyond psychiatric samples. This association was observed for boys only, underlining the importance of considering sex as a factor in future research designs. Future longitudinal studies should determine whether these findings hold over childhood and adolescence, and whether the neuroanatomical correlates of callous-unemotional traits are predictive of future psychiatric vulnerability.
Solenogastres (Aplacophora) is a small clade of marine, shell-less worm-molluscs with close to 300 valid species. Their distribution ranges across all oceans, and whereas the vast majority of species has been collected and described from the continental shelf and slope, only few species are known from depths below 4,000 m. Following traditional taxonomy, identification of specimens to species level is complex and time-consuming and requires detailed investigations of morphology and anatomy—often resulting in the exclusion of the clade in biodiversity or biogeographic studies. During the KuramBio expedition (Kuril-Kamchatka Biodiversity Studies) to the abyssal plain of the Northwest Pacific and the Kuril-Kamchatka Trench, 33 solenogaster specimens were sampled from 4,830 m to 5,397 m. Within this study we present an efficient workflow to address solenogaster diversity, even when confronted with a high degree of singletons and minute body sizes, hampering the use of single individuals for multiple morphological and molecular approaches. We combine analyses of external characters and scleritome with molecular barcoding based on a self-designed solenogaster specific set of mitochondrial primers. Overall we were able to delineate at least 19 solenogaster lineages and identify 15 species to family level and beyond. Based on our approach we identified three key lineages from the two regionally most species-rich families (Acanthomeniidae and Pruvotinidae) for deeper taxonomic investigations and describe the novel abyssal species Amboherpia abyssokurilensis sp. nov. (Cavibelonia, Acanthomeniidae) using microanatomical 3D-reconstructions. Our study more than doubles the previous records of solenogaster species from the Northwest Pacific and its marginal seas. Almost all lineages are reported for the first time from the region of the (Northwest) Pacific, vastly expanding distribution ranges of the respective clades. Moreover it doubles the number of Solenogastres collected from abyssal depths on a global scale and underlines the lack of exploratory α-diversity work in the abyssal zone for reliable species estimates in marine biodiversity.
"Die Geschichtsforscher haben die Faxen dicke. Sie gehen jetzt zum Kadi. Demnächst wollen einige von ihnen beim Verwaltungsgericht Gießen den Zugang zu den Rentkammerarchiven der Fürsten zu Ysenburg erzwingen. Konkret: den Eintritt ins Bandhaus neben dem Schlosspark in Büdingen. In dem arg baufälligen Sandsteingebäude aus dem Jahre 1572 lagern wahre Informationsschätze, vermutet der Historiker Christian Vogel. […]"
Mit dem Ziel einer Re-Politisierung der Selbstbildung im Sinne einer politischen Ökologie legt Katja Rothe das Spiel als ein Gefüge aus, welches das Subjekt auf eine "umweltliche" Weise herstellt, mit sozialen Formen verbindet und kontextualisiert. Ausgehend von einem Überblick über die Bedeutung des Spiels und der Spieltherapien in der psychologischen Praxis von Hermine Hug-Hellmuth über Anna Freud und Melanie Klein, Margaret Lowenfeld und Dora Kalff und deren Vernachlässigung in der Wissenschaftsgeschichte der Psychologie schlägt Rothe vor, Spiele als Formen und Technologien der "Selbst-Bildung" auszulegen, in denen die Interaktion mit Objekten den Ausgangspunkt von offenen bedeutungsgenerierenden Prozessen bildet. Dabei bezieht sich Rothe, wenn sie von Objekten spricht, auf das Konzept des Übergangsobjekts, das im Zentrum von Winnicotts Theorie des Spiels steht. Das zu einem Ort des Übergangs gewordene Objekt beschreibt sie als jenes Element im Spiel, das es erlaubt, etwas zu finden, was man erfunden habe. Das Spiel wird damit als Versammlungsort beschreibbar, an dem sich Subjekt und Objekt in umweltlicher Weise gegenseitig konstituieren.
Le gouvernement de soi et des autres: Zu Auftrittsverboten für türkische Regierungsmitglieder
(2017)
Die hochproblematische Verfassungsreform in der Türkei führt innerhalb der EU zu ungewöhnlichen Allianzen: In seltener Einmütigkeit wird länderübergreifend von ganz rechts bis weit ins linke politische Spektrum hinein ein Auftrittsverbot für türkische Politiker gefordert. Das gefühlt häufigste Argument bemüht dabei die Souveränität: Man möchte die Kampagne der türkischen Regierung für ihre die Gewaltenteilung gefährdende Verfassungsreform nicht auch noch im eigenen Land haben. In einer pluralistischen Gesellschaft weckt solche Einmütigkeit Zweifel, die sich bei näherem Hinschauen verfestigen – und zwar in juristischer wie politischer Hinsicht.