"Waking up" the sleeping metaphor of normality in connection to intersex or DSD: a scoping review of medical literature

The aim of the study is to encourage a critical debate on the use of normality in the medical literature on DSD or intersex. For this purpose, a scoping review was conducted to identify and map the various ways in which "normal" is used in the medical literature on DSD between 2016 and 2020. We identified 75 studies, many of which were case studies highlighting rare cases of DSD, others, mainly retrospective observational studies, focused on improving diagnosis or treatment. The most common use of the adjective normal was in association with phenotypic sex. Overall, appearance was the most commonly cited criteria to evaluate the normality of sex organs. More than 1/3 of the studies included also medical photographs of sex organs. This persistent use of normality in reference to phenotypic sex is worrisome given the long-term medicalization of intersex bodies in the name of a "normal" appearance or leading a "normal" life. Healthcare professionals should be more careful about the ethical implications of using photographs in publications given that many intersex persons describe their experience with medical photography as dehumanizing. Keywords: DSD; Ethics; Intersex; Normality; Phenotyp

Jugend und Freizeit: Forschungsbericht über eine Studie zum Freizeitverhalten ; Kurzfassung

Die Studie untersucht das Freizeitverhalten Jugendlicher in einer Kleinstadt in der DDR. Ihr Ziel ist es, den für die Führung der Jugendpolitik verantwortlichen Führungskräften wissenschaftlich fundierte Angaben über den Inhalt der Freizeit Jugendlicher zur Verfügung zu stellen. Im Unterschied zu ähnlichen Studien aus der DDR werden hier Jugendliche aus einer typischen Kleinstadt (Grimma, 17000 Einwohner) untersucht, von denen es etwa 200 ähnlicher Größenordnung gibt und in denen etwa 25 Prozent der Gesamtbevölkerung lebt (1967). Neben der allgemeinen Analyse der Freizeitinteressen, der Freizeitwünsche und des realen Freizeitverhaltens ist die Studie auf die Erforschung der folgenden drei Fragenkomplexe gerichtet: (1) Einfluß des sozialistischen Jugendverbandes auf das Freizeitverhalten (2) Soziale Kontaktformen (Freizeitpartner) (3) Einfluß der Massenkommunikationsmittel auf das Freizeitverhalten. (zä2

Forschungsbericht über eine schriftliche Befragung von Jugendlichen zum Zirkel Junger Sozialisten und eine Gruppenexploration mit bewährten Propagandisten: (FDJ-Studie 15/1968)

In der Studie wird die ideologische Wirksamkeit von grundlegender theoretischer Schulung und Weiterbildung von Jugendlichen in der FDJ untersucht. Dabei kommt es den Autoren darauf an, "in der schriftlichen Befragung über das Meinungsbild der Jugendlichen auf bestimmte Grundeinstellungen zu schließen, die unter der Thematik des Zirkels eine besondere Entwicklung hätten erfahren müssen". Von den 576 befragten Jugendlichen aus Halle und Leipzig hatten 375 im vorausgehenden Jahr am Zirkel Junger Sozialisten teilgenommen. In der Gruppenexploration, einem Erkundungsgespräch mit 16 "bewährten Propagandisten" wurden Fragen zur Persönlichkeit des Propagandisten und zur Methodik der Zirkeldurchführung thematisiert und Anregungen zur Weiterentwicklung gegeben.(HS

Ausgewählte Ergebnisse der Jugendforschung: Zuarbeit für Genossen Werner Lamberz

Die vorliegende Studie referiert die Ergebnisse einer Befragung von Jugendlichen in der DDR (keine Angaben zur Stichprobe und zum Erhebungszeitraum) zu folgenden Themenkomplexen: (1) Entwicklung der politisch-ideologischen Grundeinstellung; (2) Arbeit der FDJ mit der Jugend; (3) Nutzung und Wirkung der Massenmedien bei der Jugend. Der dritte (und umfangreichste) Teil kommt zu folgendem Schluß: "Wir sehen eine Gefahr darin, daß durch Westsendereinflüsse die bürgerliche Ideologie und Lebensweise infiltriert wird bzw. Reste kleinbürgerlichen Denkens verstärkt werden. Dieser Einflußbereich ist eventuell sogar wirksamer als der der unmittelbaren politischen Einflußnahme." (pmb

Human threat circuits: Threats of pain, aggressive conspecific, and predator elicit distinct BOLD activations in the amygdala and hypothalamus

IntroductionThreat processing, enabled by threat circuits, is supported by a remarkably conserved neural architecture across mammals. Threatening stimuli relevant for most species include the threat of being attacked by a predator or an aggressive conspecific and the threat of pain. Extensive studies in rodents have associated the threats of pain, predator attack and aggressive conspecific attack with distinct neural circuits in subregions of the amygdala, the hypothalamus and the periaqueductal gray. Bearing in mind the considerable conservation of both the anatomy of these regions and defensive behaviors across mammalian species, we hypothesized that distinct brain activity corresponding to the threats of pain, predator attack and aggressive conspecific attack would also exist in human subcortical brain regions.MethodsForty healthy female subjects underwent fMRI scanning during aversive classical conditioning. In close analogy to rodent studies, threat stimuli consisted of painful electric shocks, a short video clip of an attacking bear and a short video clip of an attacking man. Threat processing was conceptualized as the expectation of the aversive stimulus during the presentation of the conditioned stimulus.ResultsOur results demonstrate differential brain activations in the left and right amygdala as well as in the left hypothalamus for the threats of pain, predator attack and aggressive conspecific attack, for the first time showing distinct threat-related brain activity within the human subcortical brain. Specifically, the threat of pain showed an increase of activity in the left and right amygdala and the left hypothalamus compared to the threat of conspecific attack (pain > conspecific), and increased activity in the left amygdala compared to the threat of predator attack (pain > predator). Threat of conspecific attack revealed heightened activity in the right amygdala, both in comparison to threat of pain (conspecific > pain) and threat of predator attack (conspecific > predator). Finally, for the condition threat of predator attack we found increased activity in the bilateral amygdala and the hypothalamus when compared to threat of conspecific attack (predator > conspecific). No significant clusters were found for the contrast predator attack > pain.ConclusionResults suggest that threat type-specific circuits identified in rodents might be conserved in the human brain

Lohnleistungen in mittelbar von Arbeitskaempfen betroffenen Betrieben

Available from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, Duesternbrook Weg 120, D-24105 Kiel A 200571 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Trusting Black-Box Algorithms? Ethical Challenges for Biomedical Machine Learning

Based at the intersection of AI ethics and bioethics, this cumulative doctoral thesis investigates the question if and under which conditions we can and should trust black box algorithms used for medical purposes, with a specific focus on psychiatry. To do so, it sheds light on epistemic and ethical questions arising from opaque machine learning techniques in eight independent, peer-reviewed papers that form the core of this thesis and reflect its two-pronged approach: the first four chapters investigate general ethical questions of trust and trustworthiness of medical machine learning, driven by considerations from philosophy and science and technology studies (chapters 3-6), while the remaining four chapters relate abstract theoretical considerations to particular applications of machine learning in psychiatry, drawing also on empirical methods (chapters 7-10). The stage is set in chapter 1, providing a brief introduction to the topic, and chapter 2, which introduces the theoretical and methodological framework of the thesis, embracing an integrated approach to empirically informed bioethical deliberation. The general part of the thesis starts with chapter 3, which defends the notion of trust in medical machine learning against recent criticism and suggests a novel, dimensional model of trust in the spirit of Daniel Dennett. The following three chapters (4-6) investigate properties of machine learning-based appliances that make them trustworthy. Chapter 4 scrutinizes algorithmic fairness through the lens of William James’ pragmatist theory of truth. Chapter 5 investigates the possibility of explaining and understanding medical machine learning, drawing on Karl Jaspers’ Psychopathology. Chapter 6 argues with Onora O’Neill why transparency as mere disclosure it too little to generate trust in medical machine learning and suggests embracing an approach of intelligent openness instead. The following four chapters aim to root these conceptual considerations in practice, by looking at specific applications of ML in psychiatry and neuroscience, and by engaging with relevant stakeholders through semi-structured interviews. To provide an insight into the challenges posed by machine learning in mental health, chapter 7 systematizes ethical questions that arise from computational methods employed to diagnose, treat, and predict schizophrenia, following the principlist framework of Tom Beauchamp and James Childress. Checking these considerations against the attitudes of researchers in the field, chapter 8 provides a unique contribution to the existing literature insofar as it is the first article that examines attitudes and expectations of experts on psychiatric machine learning towards ethical questions, drawing on a sample from Germany and Switzerland. Chapter 9 examines these empirical findings further, exploring the impact of machine learning on psychiatric nosology. Finally, chapter 10 gives an outlook to the future by addressing necessary changes in the training of junior doctors, arguing for the ongoing importance of an education informed by historical reflection. Chapter 11 completes the dissertation, summarizing and discussing the different findings in light of each other. It also acknowledges its limitations and provides suggestions for further research

Personal responsibility for health: the impact of digitalisation

Fostering the personal responsibility of patients is often considered a potential remedy for the problem of resource allocation in health care systems. In political and ethical debates, systems of rewards and punishments based on personal responsibility have proved very divisive. However, regardless of the controversies it has sparked, the implementation of personal responsibility in concrete policies has always encountered the problem of practical enforceability, i.e.how causally relevant behaviour can be tracked, allowing policies of this kind to be applied in a fine-grained, economically viable and accurate fashion. In this paper, we show how this hurdle can be seemingly overcome with the advent of digitalisation in health and delineate the potential impact of digitalisation on personal responsibility for health. We discuss how digitalisation - by datafying health and making patients transparent - promises to close the loophole of practical enforceability by allowing to trace health-related lifestyle choices of individuals as well as their exposure to avoidable risk factors. Digitalisation in health care thereby reinforces what Gerald Dworkin has called the causal aspect of personal responsibility and strengthens the implicit syllogism that - since exposure to risk factors happens at the individual level - responsibility for health should be ascribed to the individual. We conclude by addressing the limitations of this approach and suggest that there are other ways in which the potential of digitalisation can help with the allocation of resources in health care

Veränderungen von Flora und Fauna in Frankfurt am Main in den letzten 200 Jahren

Großstädte in Mitteleuropa sind aufgrund ihrer Lebensraumvielfalt in der Regel artenreicher als vergleich- bare Gebiete im ländlichen Raum. Flora und Fauna unterliegen ganz besonders in den Städten einer ständigen Veränderung: Arten verschwinden, andere kommen hinzu. Die Einwanderung oder Einschleppung von neuen Arten geschieht meist durch die Tätigkeit des Menschen bzw. wird erst durch diese ermöglicht. In Städten wie Frankfurt besteht ein erheblicher Teil der Pflanzenarten aus solchen „Neubürgern“. Viele eingewanderte oder eingeschleppte Pflanzen- und besonders Insektenarten stammen aus wärmeren Regionen. Trotz der neu eingewanderten Arten hat die Gesamtartenzahl in den letzten 200 Jahren abgenommen. Bei den in Frankfurt erloschenen Pflanzen lässt sich kein eindeutiger Bezug zur Erwärmung herstellen, entscheidend dafür waren bisher die unmittelbaren Eingriffe des Menschen, insbesondere Veränderungen in der Landnutzung. Changes in the Flora and Fauna of the City Frankfurt/Main in the last 200 years: Due to their diversity of biotopes, large cities in Central Europe usually house a higher species diversity than rural areas of comparable size. Flora and fauna are highly dynamic, with species disappearing or being introduced continuously. Appearance of new species in an area is in almost all of the cases due to the impact of man. In cities like Frankfurt/Main, a substantial part of the plant species growing outside cultivation is formed by these introduced or alien species. Many alien plant or animal species, especially insects, originate from regions with a warmer climate. In spite of many introduced species, the total plant species diversity has substantially decreased in the last 200 years in Frankfurt. Considering the plants, that have disappeared in Frankfurt in the last centuries, there is no case that can unequivocally be attributed to warmer climate. The basic causes are changes in agriculture and forestry