Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. (...) Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress. (shrink)

I discuss two types of evidential problems with the most widely touted experiments in evolutionary psychology, those performed by Leda Cosmides and interpreted by Cosmides and John Tooby. First, and despite Cosmides and Tooby's claims to the contrary, these experiments don't fulfil the standards of evidence of evolutionary biology. Second Cosmides and Tooby claim to have performed a crucial experiment, and to have eliminated rival approaches. Though they claim that their results are consistent with their theory but contradictory to the (...) leading non-evolutionary alternative, Pragmatic Reasoning Schemas theory, I argue that this claim is unsupported. In addition, some of Cosmides and Tooby's interpretations arise from misguided and simplistic understandings of evolutionary biology. While I endorse the incorporation of evolutionary approaches into psychology, I reject the claims of Cosmides and Tooby that a modular approach is the only one supported by evolutionary biology. Lewontin's critical examinations of the applications of adaptationist thinking provide a background of evidentiary standards against which to view the currently fashionable claims of evolutionary psychology. (shrink)

" De quoi demain sera-t-il fait? " interroge Victor Hugo. Un philosophe, une historienne répondent au long d'un dialogue serré, exigeant. Pourquoi ont-ils choisi de faire ce livre ensemble? En raison d'une longue amitié, au nom d'une histoire commune, en vertu de la qualité d'un débat qui n'a jamais cessé entre eux depuis qu'à la fin des années soixante la jeune étudiante découvrit l'importance de ce penseur de quinze ans son aîné qui, avec d'autres, réveillait l'esprit critique de toute une (...) génération. Si les points de vue sont différents, l'héritage intellectuel est commun. Et c'est cet héritage qu'ils s'attachent à inventorier avant de circonscrire des enjeux majeurs de notre temps : comment penser la différence dans l'universel? La famille a-t-elle encore un avenir? La liberté se réduira-t-elle demain pour l'homme à l'intelligibilité des contraintes qui pèsent sur lui, ou le désir et l'imprévisible auront-ils encore leur place? Que nous dit la souffrance des animaux que nous massacrons? La page de la révolution est-elle définitivement tournée après l'échec du communisme? Est-il envisageable d'en finir une fois pour toutes avec la peine de mort? Quelles seront demain les formes nouvelles de l'antisémitisme et comment les combattre? L'échange s'achève sur un éloge de la psychanalyse, référence commune tout au long du dialogue. (shrink)

(2005). Freedom in Responsibility: On the Relevance of “Sin” As a Hermeneutic Guiding Principle in Bioethical Decision Making. Christian Bioethics: Vol. 11, No. 2, pp. 147-165.

Climate change assessments rely upon scenarios of socioeconomic developments to conceptualize alternative outcomes for global greenhouse gas emissions. These are used in conjunction with climate models to make projections of future climate. Specifically, the estimations of greenhouse gas emissions based on socioeconomic scenarios constrain climate models in their outcomes of temperatures, precipitation, etc. Traditionally, the fundamental logic of the socioeconomic scenarios—that is, the logic that makes them plausible—is developed and prioritized using methods that are very subjective. This introduces a fundamental (...) challenge for climate change assessment: The veracity of projections of future climate currently rests on subjective ground. We elaborate on these subjective aspects of scenarios in climate change research. We then consider an alternative method for developing scenarios, a systems dynamics approach called ‘Cross-Impact Balance’ (CIB) analysis. We discuss notions of ‘objective’ and ‘objectivity’ as criteria for distinguishing appropriate scenario methods for climate change research. We distinguish seven distinct meanings of ‘objective,’ and demonstrate that CIB analysis is more objective than traditional subjective approaches. However, we also consider criticisms concerning which of the seven meanings of ‘objective’ are appropriate for scenario work. Finally, we arrive at conclusions regarding which meanings of ‘objective’ and ‘objectivity’ are relevant for climate change research. Because scientific assessments uncover knowledge relevant to the responses of a real, independently existing climate system, this requires scenario methodologies employed in such studies to also uphold the seven meanings of ‘objective’ and ‘objectivity.’. (shrink)

Cognitive enhancement is the use of drugs, biotechnological strategies or other means by healthy individuals aiming at the improvement of cognitive functions such as vigilance, concentration or memory without any medical need. In particular, the use of pharmacological substances has received considerable attention during the last few years. Currently, however, little is known concerning the use of cognitive enhancers, their effects in healthy individuals and the place and function of cognitive enhancement in everyday life. The purpose of the book is (...) to give an overview of the current research on cognitive enhancement and to provide in-depth insights into the interdisciplinary debate on cognitive enhancement. (shrink)

Since the fundamental challenge that I laid at the doorstep of the pluralists was to defend, with nonderivative models, a strong notion of genic cause, it is fatal that Waters has failed to meet that challenge. Waters agrees with me that there is only a single cause operating in these models, but he argues for a notion of causal ‘parsing’ to sustain the viability of some form of pluralism. Waters and his colleagues have some very interesting and important ideas about (...) the sciences, involving pluralism and parsing or partitioning causes, but they are ideas in search of an example. He thinks he has found an example in the case of hierarchical and genic selection. I think he has not. (shrink)

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

De senere år har pleie- og omsorgstjenesten i mange norske kommuner startet med ulike former for etikkarbeid, oftest initiert av KS’ prosjekt “Samarbeid om etisk kompetanseheving”. Hensikten med vår studie var å evaluere innsatsen i de kommunene som deltok i prosjektet fra starten av, med vekt på hvilke tiltak som var iverksatt, hvilke virksomheter dette omfattet, og om tiltakene har fortsatt utover prosjektperioden. Studien har et kvalitativt design. Materialet er hovedsakelig basert på telefonintervjuer med kontaktpersoner for etikksatsingen i 34 kommuner. (...) Det transkriberte materialet er analysert ved kvalitativ innholdsanalyse. Med unntak av fem kommuner som aldri kom i gang med etikkarbeidet, hadde de fleste startet etikkrefleksjon innenfor flere tjenester, oftest i sykehjem og hjemmetjenester. Noen kommuner hadde imidlertid ikke klart å videreføre etikkarbeidet utover en prosjektperiode. Det var stor variasjon både i etikkarbeidets forankring i kommunen, omfang, hyppighet og metoder. Et gjennomgående funn er vektlegging av behovet for etikkkompetanse og oppfølging av dem som skal lede etikkarbeidet. Flertallet av kommunene som fortsatt gjennomfører etikkrefleksjon, tar utgangspunkt i egen praksis, men et mindretall anvender strukturerte metoder. Dersom etikkarbeidet i kommunen skal være levedyktig over tid, bør arbeidet forankres på flere nivåer i organisasjonen, og de som skal lede dette arbeidet, bør få styrket sin kompetanse i etikk og etikkrefleksjon.Nøkkelord: etikk, evaluering, kommunehelsetjenestenEnglish summary: Building ethical competence in Norwegian municipalities: What has been done and what has been sustainable?“Cooperation for building ethics competence” is a national project aimed to stimulate moral reflection and build competence in ethics in community health services in Norway. This article is based on an evaluation of the activities implemented by the first 34 participating municipalities, exploring which measures were implemented, which services and employees were involved, and if the measures are sustainable. The study has a qualitative design, and the data mainly consists of telephone interviews with “key” persons in 34 municipalities. With the exception of five municipalities that never really started ethics work, the majority had implemented ethical reflection in several areas, most often in nursing homes and home care services. There was great variation with regard to the implementation. Many had tried a variety of reflection models, and only a minority of the municipalities were using a structured method of ethical reflection. A consistent finding is the need for more competence; many of those who run ethical reflection are reported to need more competence both in ethics and methods for systematic reflection. There were also great variations in how well the ethics projects were anchored within the municipality. To make ethical interventions sustainable, this study indicates the importance of strong anchoring within the municipality, the need for ethical competence, as well as good methods for structuring ethical reflection. (shrink)

BackgroundThe significant increase of digital collaboration, driven by the current COVID-19 pandemic, is resulting in changes in working conditions and associated changes in the stress-strain perception of employees. Due to the evident leadership influence on employees' health and well-being in traditional work settings, there is a need to investigate leadership in virtual remote work contexts as well. The objective of this scoping review was to assess the extent and type of evidence concerning virtual leadership in relation to employees' mental health, (...) job satisfaction and perceptions of isolation.MethodA search was undertaken in five databases, PubMed, Cochrane Library, PsycINFO, PSYNDEX and Web of Science, as well as reference lists of included articles on 9th February 2021 and an update on 28th September 2021. The search strategy was limited to English, German and French language, peer reviewed journal articles published from January 2000 onwards. This scoping review was conducted in accordance with the JBI methodology for scoping reviews. The methodological quality of the included studies was assessed using the JBI critical appraisal tools. A narrative synthesis was conducted.ResultsNineteen studies met the eligibility criteria for this review. Overarching review findings suggested a positive link between virtual leadership and well-being, job satisfaction, and a negative link to psychological strain, stress and perceptions of isolation of digitally collaborating employees.ConclusionsBy mapping the available evidence on virtual leadership in relation to health and work-related employee outcomes, the review identified many research gaps in terms of content and methodology. Due to limited data, causal relationships were not derived. Future research is needed to examine the complex cause-and-effect relationships of virtual leadership in more detail. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Thomas Aquinas’s Two Approaches to Female RationalityElisabeth Uffenheimer-LippensAlthough the female human being was never at the center of his daily and intellectual attention, Thomas Aquinas as a religious thinker had no choice but to consider her in a wide range of different contexts. She is found in theoretical-speculative discussions (about creation, original sin and its punishment, resurrection) and in more practical ones (about marriage, reproduction, ordination of women, (...) women as teachers, as witnesses). Thomas’s ideas about the female human being have been investigated by theologians, philosophers, and historians. Often, but not always, the research has been inspired and even distorted by one form or another of feminism.In this article I shall not discuss all the different aspects of the topic “woman” as they can be found in Thomas’s works, but limit myself to one of them, namely, his understanding of female rationality. I have become intrigued by the fact that he thought about the rationality of woman in two different ways which he never integrated or explicitly connected. In the majority of his texts Thomas describes woman’s rationality as “inferior” in comparison to the “superior” male rationality. This justifies her subordination to the male human being and is expressed in her inability to control her passions. There are, however, other texts in which Thomas discusses the human mind in general, without specifying whether he means the mind of the male or the female human being. He recognizes in the human mind two aspects or functions of rationality, namely, a ratio superior which he labels symbolically “masculine” and a ratio inferior which he calls “feminine.” The meaning of this is [End Page 191] that woman’s rationality is not of an inferior kind, but includes both aspects of rationality.The thesis underlying this article is that not enough attention has been paid to the fact that two fundamentally different ways of understanding female rationality can be found in the work of Thomas Aquinas. His symbolic use of male and female has too often been confused with what one could call the “real” relationship between man and woman. The aim of this article is to present these two different understandings in Thomas, without making any detailed attempt to trace their historical origins. In addition, I want to show the new perspectives that are opened up by his second approach.The first part of this article will focus on the “inferior rationality” of women and try to understand what is meant by inferiority. The discussion will develop around an analysis of the words mollis and mollities. This will lead me to the relationship between inferior rationality and bodily weakness on the one hand, and between inferior rationality and the passions on the other hand. The practical consequences of woman’s inferior rationality shall also be treated. The second part of this article will focus on the human mind, and on the difference between ratio inferior and ratio superior. The definition of these two functions of human rationality will be followed by an analysis of texts where Thomas describes original sin as a paradigm for concrete sin, and where he connects ratio inferior to woman/feminine and ratio superior to man/male. The discussion will be completed by a study of the relationship between the ratio inferior and the vis cogitativa. This will allow me to bring out the importance of this second understanding of female rationality.I. Woman’s Inferior RationalityWoman’s intellectual capacity is repeatedly described by Thomas with the unflattering comparatives debilior (debilis meaning, among other things, “disabled, infirm, feeble, frail, [End Page 192] weak”)1 and inferior. Almost every woman does not have a “firm judgment of reason”; she is “unstable of reason.”2 She does not possess “sufficient strength of mind” (to resist concupiscence).3 There is clearly a “deficiency of reason”4 because she has an overall “weakness of nature.”5These descriptions of female rationality can only be understood insofar as they stand over and against the male rationality which is described in almost bodily comparatives as fortior, firmior, robustior. The male has more “strength of soul.”6 In him “the discretion... (shrink)

La référence à la norme spontanément admise et reconnue par tous, à l'idéal implicitement partagé, à la hiérarchie véhiculée par la tradition que les générations se donnent la charge de transmettre, autrement dit au Tiers, est aujourd'hui remise en cause. Nous voulons être une société pluraliste, évoquant des références diverses, prenant en compte différents modèles culturels et donnant place aux singularités. La coordination de l'action collective en est rendue d'autant plus complexe. Il faut désormais arriver à construire des normes à (...) plusieurs, en fonction des situations, avec les protagonistes eux-mêmes, au cas par cas. Dans le même mouvement, nous entendons de plus en plus qu'" il manque du tiers ", qu'" il faudrait davantage faire tiers ", qu'" il y a moyen de faire tiers autrement qu'en se référant au grand Tiers d'hier "! Mais en un mot comme en cent, la question se pose avec acuité : qu'est-ce encore que le Tiers, qu'un tiers? C'est cette interrogation qu'ont soutenue, pendant cinq ans, des psychanalystes, philosophes, sociologues..., au sein d'un groupe de travail dans le cadre du Département de communication de l'Université de Louvain. Ils font ici le point sur leurs débats. (shrink)

Backgrounds Most countries are facing increased pressure on healthcare resources. A better understanding of how healthcare providers respond to new demands is relevant for future pandemics and other crises. Objectives This study aimed to explore what nurses and doctors in Norway reported as their main ethical challenges during two periods of the COVID-19 pandemic: February 2021 and February 2022. Research design A longitudinal repeated cross-sectional study was conducted in the Western health region of Norway. The survey included an open-ended question (...) about ethical challenges among doctors and nurses in hospital departments. Free-text comments were analysed using Systematic Text Condensation and also presented in a frequency table. Ethical considerations Ethical approval was granted by the Regional Research Ethics Committee in Western Norway (131,421). All participants provided consent when participating in the study. Results In 2021, 249 and in 2022, 163 healthcare professionals responded to the open-ended question. Nurses and doctors reported three main categories of ethical challenges related to the COVID-19 pandemic: (1) barriers that hindered them in acting as they ethically would have wanted to do; (2) priority-setting dilemmas linked to overtreatment, transfer of resources and ranking patient needs; and (3) workload expansion threatening work–life balance and employees’ health. Category one comprised of resource barriers, regulatory barriers, system barriers, and personal barriers. Regulatory barriers, especially visitor restrictions for next-of-kin, were the most frequently reported in 2021. Resource barriers, related to the increased scarcity of qualified staff, were most frequently reported in 2022. Clinicians stretched themselves thin to avoid compromising on care, diagnostics, or treatment. Conclusions Developing clinicians’ ability to handle and cope with limited healthcare resources is necessary. To foster resilience and sustainability, healthcare leaders, in collaboration with their staff, should ensure fair priority-setting and initiate reflections among doctors and nurses on what it implies to provide ‘good enough’ care. (shrink)

Background: Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses. Aim: The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour. Research design, participants and research context: A phenomenological (...) and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses’ homes or at the hospital. Ethical consideration: Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained. Findings: The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner’s life had changed considerably. The main theme that emerged therefore was ‘oscillating in a changing relationship’. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: ‘doing the right thing in unpredictable daily situations’; ‘torn between patience and guilt’; and ‘living in a time of uncertainty, hope and despair’. Conclusion: Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses’ married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners’ well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners’ progressing illness. (shrink)

Denunciations of child sexual abuse in the sport context have been increasing in the last decades. Studies estimate that between 14 and 29% of athletes have been victim of at least one form of sexual violence in sport before the age of 18. However, studies suggest that many do not disclose their experience of CSA during childhood. This finding is alarming since studies have shown that the healing process usually starts with disclosure. Moreover, little is known about the healing process (...) of CSA experienced in the sport context. The aim of the study is to present a single case study of a CSA in sport to better understand the global experience over time from the perspective of the athlete. A narrative inquiry approach was adopted. Three non-structured interviews were conducted with the participant. Three pathways in the survivor journey have been identified through inductive thematic analysis: pathway to understanding, pathway to disclosure, and pathway to healing. These pathways represent distinct processes but are intertwined as they are dynamic and iterative. Indeed, the survivor explained how she had been, and is still, going back and forth between them. Results are consistent with those found in the literature on CSA in the general population. It suggests that theoretical models of CSA in the general population could be applied to CSA in sport. Practical implications include a need for education and clearer boundaries in the coach-athlete relationship. Sport stakeholders also need to be better equipped to recognize the signs of sexual violence in sport. Our results indicate that qualitative research could be a potential avenue to help victims heal from CSA. It gives them the chance to talk about and make sense of their abuse in a safe space. Finally, our results demonstrate the importance of reviewing the current justice system for victims. It should be based on a trauma-informed approach that places the victim at the center of the judicial process. (shrink)

RESUMENLas clases naturales tienen un importante valor heurístico que no ha sido explorado a nivel epistémico. Una revisión crítica del concepto de “clase natural” sugerido por la teoría del Cúmulo de Propiedades Homeostáticas (HPC), desde la complejidad y la causalidad, muestra que es incompatible con las prácticas científicas, en especial las de la biología. Debido a los múltiples problemas que presenta en ese ámbito científico el concepto de ‘clase natural’ debería ser reconfigurado con el fin de estar acorde con las (...) inferencias explicativas y predictivas de la biología. Esto tendría como consecuencia un mejor entendimiento filosófico de los procesos y entidades naturales a la vez que ayudaría a resolver algunos problemas filosóficos y científicos.PALABRAS CLAVECLASE NATURAL, CAUSALIDAD, COMPLEJIDAD, PRACTICAS CIENTÍFICAS, ESPACIOS DE POSIBILIDAD EPISTÉMICOSABSTRACTNatural kinds have an important epistemic value that has not been studied due to the fact that the philosophical research has been focused on both semantics and logical aspects. I propose a critical review from causality and complexity to the concept of «natural kind» advanced by Homeostatic Properties Cluster Theory (HPC) in order to demonstrate that the kinds in the HPC style s are not supported by scientific practices such as biology. I think that a different concept of “natural kind” should be based on scientific practices in order to obtain a better philosophical understanding compared to HPC of both, natural processes and obtaining successful inferences. I hold that this epistemic approach provides us a new characterization of “natural kind” that will be useful as a unifying concept of natural phenomena, as well as for generating new spaces of epistemic possibilityKEY WORDSNATURAL KINDS, CAUSALITY, COMPLEXITY, SCIENTIFIC PRACTICES, EPISTEMIC POSSIBILITY SPACES. (shrink)

Bezeichnet man im deutschsprachigen Raum eine kulturelle Veranstaltung als 'Spektakel', geht damit oft eine negative Wertung einher. Im Gegensatz dazu zeigt der Band die vielfältigen Begriffsdimensionen, medialen Charakteristika und Funktionen dieser zentralen ästhetischen Kategorie in künstlerischen, epistemischen und politischen Kontexten auf. Beiträge aus Kunstgeschichte, Philosophie, Film-, Literatur-, Medien-, Tanz- und Theaterwissenschaft setzen sich mit ästhetischen Theorien und Praktiken des Spektakels von der Antike bis zur Gegenwart auseinander. Die behandelten Beispiele reichen von der christlichen Liturgie bis zur Barockoper, von Paulinus von (...) Nola bis Christoph Schlingensief, vom populären Wissenschaftstheater des 19. Jahrhunderts bis zu politischen Funktionen des Spektakulären im südkoreanischen Kino oder dem italienischen Roman, in Alltag und Kunst des Sozialismus sowie der globalen Medienkultur. Mit Beiträgen von: Micha Braun, Simon Frisch, Elisabeth Fritz, Antje Géra, Nicola Gess, Martin Hähnel, Sarah Hegenbart, Teresa Hiergeist, Carsten Juwig, Katherina Keller-Grein, Kirsten Maar, Astrid Matron, Kassandra Nakas, Ulf Otto, Rita Rieger, Ivo Ritzer, Tanja Schwan und Christiane Voss"--Back cover. (shrink)

ObjectiveThe aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety.BackgroundOSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, daytime sleepiness, poor cognitive function, and sudden death during sleep. Both excessive sleepiness, fatigue, and symptoms of depression are frequently reported.Method5,464 patients referred to a university hospital for obstructive sleep apnea underwent standard respiratory polygraphy. The (...) severity of OSA was defined as either mild, moderate, or severe, using the apnea–hypopnea index. Validated questionnaires were used to assess excessive sleepiness, pathological fatigue, depression, and anxiety.ResultsNearly 70% of the patients were men, and median age was 50 years. One in three had moderate-to-severe OSA. Excessive sleepiness and pathological fatigue were present in 43 and 39%, respectively. The prevalence of possible depression and anxiety was 19 and 28%, respectively. The proportion of patients with male sex, obesity, and excessive sleepiness increased with the severity of OSA. In contrast, the proportion of patients with pathological fatigue did not increase with OSA severity, and there was a decrease in depression and anxiety with increasing OSA severity.ConclusionOur study reports that pathological fatigue, as well as anxiety and depression, did not increase with OSA severity, whereas excessive sleepiness did. Knowledge concerning conditions related to OSA severity may be indicative of pretest probability of OSA and thus change the priority for polygraphy. Furthermore, the high prevalence rates of fatigue, anxiety, and depression among these patients warrant further investigations. (shrink)

Name der Zeitschrift: Byzantinische Zeitschrift Jahrgang: 109 Heft: 2 Seiten: 703-738.

Knochen waren im 19. und frühen 20. Jahrhundert ein unverzichtbarer, größtenteils importabhängiger Rohstoff der chemischen Industrie, die daraus Düngemittel, Tierfutter, Leim, Gelatine, Seife und andere Produkte herstellte. Das Thema Knochenverwertung wurde im Schulunterricht der NS-Zeit genutzt, um Jugendlichen die Relevanz des Vierjahresplans und der deutschen Autarkiepolitik zu verdeutlichen und sie zu motivieren, sich im Rahmen der Altstoffsammlungen an der heimischen Erfassung dieses Rohmaterials zu beteiligen. Diverse NS-Instanzen hatten ein differenziertes Spektrum von Lehrmitteln erarbeitet, um die Behandlung dieses Themas in der (...) Schule zu unterstützen. Der Artikel untersucht, welche Botschaften diese damals hochmodernen Unterrichtsmedien vermittelten und zeigt, wie auch weniger ideologieanfällig scheinende Fächer, etwa der Chemieunterricht, politisch instrumentalisiert wurden. (shrink)