Q and A with Professor Diane Enns on thinking through loneliness

13-17 June 2022 is Loneliness Awareness Week in the UK. We speak to Professor Diane Enns about her new book, Thinking Through Loneliness, touching on topics such as the need to consider the social structures that produce loneliness, the importance of weaving personal experiences into scholarly discussions of loneliness and how COVID-19 impacted the writing of the work. Q&A with Professor Diane Enns on Thinking Through Loneliness. Bloomsbury. 2022

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

What Would Arendt Say? Inaugural conference of the Society for Women of Ideas, November 19-20, 2021

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Just Rage: Politics Without Consensus

One has such rage, one would drink any blood, drought drives one mad. The victim of unjust political rule rightly craves relief from the suffering and dehumanization of tyranny and demands the right to speak and act as a political subject. The longer this right is refused, the greater the victim’s righteous indignation and fury; it festers, and the call for justice may turn into a call for blood, moral outrage and political dissent may turn into bloodlust. Emancipatory politics slides easily ..

Organized Loneliness

The point of departure in this essay is Hannah Arendt’s intriguing reference to “organized loneliness” at the end of The Origins of Totalitarianism. If loneliness is a unique experience of psychological suffering fundamental to human life, organized loneliness threatens our very existence for it systematizes the isolation produced by totalitarianism to suppress solidarity and action. I will argue that the concept of organized loneliness has never been more relevant, though its conditions have changed, and no one elaborates these conditions as effectively and urgently as Franco Berardi. Loneliness under “high–tech capitalism” is one of many psychosocial symptoms resulting from the erosion of empathy and sensitivity, social media–fed mass conformity, and the severe isolation caused by our competitive, precarious and flexible work environments. Bringing together the insights of these two remarkable thinkers will help us understand the danger — at once psychological, social and political — of our contemporary loneliness

De la terreur à l’extrême violence

La violence, dans l'unification de son signifiant et dans la distribution de ses manifestations, dans la communication de ses mécanismes ou la différenciation de ses effets, demeure au centre des préoccupations de la pensée politique. La philosophie politique moderne l'a posée comme l'état premier à partir duquel, et face auquel devaient être déterminées les conditions de la vie collective sous une institution civile ; la violence devenait un moment paradoxalement constitutif, toujours déjà présupposé comme cela même qu'il fallait refouler, tenir à distance, ou civiliser, pour rendre possible son autre, État, Société, ou Liberté. La philosophie contemporaine ne cesse d'être convoquée par des situations et des conjonctures qui nous obligent à réinterroger les significations politiques de la violence à partir de ses seuils « impolitiques », et à réexaminer les partages topiques que l'on supposait permettre de fixer des bornes à la violence en en différenciant les économies, ou de garantir sa consistance politique en dialectisant les oppositions des contre-violences, et les transformations institutionnelles et subjectives correspondantes : les partages du privé et du public, du physique et du symbolique, du social et de l'étatique, du droit et de la police, du national et de l'international, du religieux et du laïc, etc. En revenant aussi bien sur les textes de nos différentes traditions philosophiques que sur les conjonctures passées et présente qui en convoquent le réexamen critique, ce sont ces zones impolitiques, d'indiscernabilité ou d'indécidabilité, que les contributions ici rassemblées proposent de soumettre à nouveau à la réflexion, lorsque l'institution de la violence (sa codification, sa symbolisation, sa régulation) se heurte à de l'in-instituable, ou lorsque la politisation de la violence bascule dans son contraire et tend à « libérer » une violence intraitable

Exploring the Relationship Between Attention and Awareness. Neurophenomenology of the Centroencephalic Space of Functional Integration

Although there is a no established theory, there is no longer any doubt about the multiplicity of the structures involved in the attentional processes. Attention is involved, in fact, in several fundamental functions: Consciousness, perception, motor action, memory and so on. For several decades, the hypothesis that attention is highly variable (for extension and clarity) in terms of consciousness has been quite influential, which would range within itself in relation to its changes of state: From sleep to wakefulness, from drowsiness to twilight state of consciousness, from confusion to hyperlucidity, from dreamlike to oneiric states. More recently, other fields of considerable theoretical importance have linked attention to emotion, to affectivity or primary autonomous psychic energy or to social determinants. In this paper, we shall demonstrate how paying attention to something does not mean becoming aware of it. A series of experiments has shown that these are two distinct mental states. This decoupling could represent a useful mechanism for the ability to survive that has developed during the course of evolution. © Springer Nature Singapore Pte Ltd. 2020