Communicative Violence In Psychotherapy

After some theoretical reflections on communicative violence based on the concept of the “double body” (Sybille Krämer) which explains why words can heal or hurt, we show excerpts from therapeutic session using conversation analysis as methodological tool to make subtle forms of violence visible. The problem of violence is not one-sided from therapist to patient but the inverse direction should be included, too. We detect that it is sometimes the “good will” of therapists to help a patient “overcome” a (supposed) “inhibition” to continue talk that contributes to symmetrical escalations in conversation causing trouble in turn-taking. Sometimes it is an up-to-now undescribed practice of patients, which we call “empathy blinder”. A mild and a more complex form of this pattern are described. Further examples are analyzed hoping to direct some attention to the problem of communicative violence. In general, we do not yet present solutions, more expositions of a problem widely under taboo.

Comparison of musculoskeletal disorder health claims between construction floor layers and a general working population

OBJECTIVES: Compare rates of medical insurance claims for musculoskeletal disorders (MSD) between workers in a construction trade and a general worker population to determine if higher physical exposures in construction lead to higher rates of claims on personal medical insurance. METHODS: Health insurance claims between 2006 and 2010 from floor layers were frequency matched by age, gender, eligibility time, and geographic location to claims from insured workers in general industry obtained from MarketScan. We extracted MSD claims and dates of service from six regions of the body: neck, low back, knee, lower extremity, shoulder, and distal arm, and evaluated differences in claim rates. RESULTS: Fifty-one percent of floor layers (n=1,475) experienced musculoskeletal claims compared to 39% of MarketScan members (p<0.001). Claim rates were higher for floor layers across all body regions with nearly double the rate ratios for the knee and neck regions (RR: 2.10 and 2.07). The excess risk was greatest for the neck and low back regions; younger workers had disproportionately higher rates in the knee, neck, low back, and distal arm. A larger proportion of floor layers (22%) filed MSD claims in more than one body region compared to general workers (10%; p<0.001). CONCLUSIONS: Floor layers have markedly higher rates of MSD claims compared to a general worker population, suggesting shifting of medical costs for work-related MSD to personal health insurance. The occurrence of disorders in multiple body regions and among the youngest workers highlights the need for improved work methods and tools for construction workers

Brauchen wir eine Frauenquote?

Das Bundesjustizministerium und das Bundesfamilienministerium wollen einen Gesetzesvorschlag einbringen, der den Unternehmen vorgibt, auf Führungsebene eine eigene Frauenquote festzulegen und zu veröffentlichen. Nach Ansicht von Barbara Steffens, Ministerin für Gesundheit, Emanzipation, Pflege und Alter des Landes Nordrhein-Westfalen, gibt es in Deutschland erhebliche Defizite bei der Gleichstellung von Frauen. Deshalb werde sich die nordrhein-westfälische Landesregierung im Bundesrat für eine Quotierung von Aufsichtsräten in börsennotierten Unternehmen einsetzen. Zudem soll in Nordrhein-Westfalen eine geschlechterparitätische Besetzung von Aufsichts- und Verwaltungsräten in landeseigenen sowie kommunalen Betrieben und Gesellschaften erreicht werden. Nach Gregor Thüsing, Universität Bonn, können gesetzgeberische Maßnahmen sinnvoll sein. Aber die Quote sei immer eine Ungerechtigkeit gegenüber dem Angehörigen des anderen Geschlechts. Christine Bortenlänger, Bayerische Börse AG, ist für ein 100%iges Ja. Die Quote sei derzeit der schnellste Weg, eine Veränderung zu erreichen und gegenüber anderen Ländern aufzuholen, zumal Firmen mit gemischten Führungen bessere Ergebnisse erzielten und auch deutlich innovativer seien. Jana Oehmichen, Universität Karlsruhe, sieht einer gesetzliche Quote mit drei Gefahren verbunden: dem Generalverdacht der »Quotenfrau«, der Delegation wichtiger Entscheidungen in andere Gremien und dem Mangel an potentiellen Kandidatinnen. Marie-Christine Ostermann, Verband DIE JUNGEN UNTERNEHMER, ist der Meinung, dass man keine Quote brauche: »Denn man tut den Frauen in unserem Land keinen Gefallen, wenn man sie per Gesetz zu Quotenfrauen abstempelt…. Bei der Stellenbesetzung sollte allein die Qualifikation maßgeblich sein.« Und Günter Buchholz, Fachhochschule Hannover, sieht keinen Bedarf, da seiner Ansicht nach die Gleichberechtigung so gut wie erreicht sei.Weibliche Führungskräfte, Unternehmen, Gleichberechtigung, Aufsichtsrat, Geschlecht, Deutschland

Exploring physical exposures and identifying high-risk work tasks within the floor layer trade

INTRODUCTION: Floor layers have high rates of musculoskeletal disorders yet few studies have examined their work exposures. This study used observational methods to describe physical exposures within floor laying tasks. METHODS: We analyzed 45 videos from 32 floor layers using Multimedia-Video Task Analysis software to determine the time in task, forces, postures, and repetitive hand movements for installation of four common flooring materials. We used the WISHA checklists to define exposure thresholds. RESULTS: Most workers (91%) met the caution threshold for one or more exposures. Workers showed high exposures in multiple body parts with variability in exposures across tasks and for different materials. Prolonged exposures were seen for kneeling, poor neck and low back postures, and intermittent but frequent hand grip forces. CONCLUSIONS: Floor layers experience prolonged awkward postures and high force physical exposures in multiple body parts, which probably contribute to their high rates of musculoskeletal disorders

The Building of Empathy: Conceptual “Pillars” and Conversational Practices in Psychotherapy

Empathy can be considered a special type of cooperation between therapist and patient. This exploratory study compares psychoanalytical, depth-psychological and behavioural therapy, in each case using transcriptions of audio recordings of initial, mid-term and late sessions. For each school of therapy, five treatments are included, creating a database of 45 sessions. We describe the project and the method of conversation analysis using examples of these transcripts and hypothesise that while all three schools of therapy are faced with common fundamental problems concerning the realisation of empathy, one can observe empathy profiles specific to each school. Here, we introduce theoretical groundwork and the terminology of conversation analysis. The topic may be of particular interest to clinicians, since everyday problems are examined through the prism of microanalysis

Astrocyte mediated modulation of blood-brain barrier permeability does not correlate with a loss of tight junction proteins from the cellular contacts

In the central nervous system (CNS) complex endothelial tight junctions (TJs) form a restrictive paracellular diffusion barrier, the blood-brain barrier (BBB). Pathogenic changes within the CNS are frequently accompanied by the loss of BBB properties, resulting in brain edema. In order to investigate whether BBB leakiness can be monitored by a loss of TJ proteins from cellular borders, we used an in vitro BBB model where brain endothelial cells in co-culture with astrocytes form a tight permeability barrier for 3H-inulin and 14C-sucrose. Removal of astrocytes from the co-culture resulted in an increased permeability to small tracers across the brain endothelial cell monolayer and an opening of the TJs to horseradish peroxidase as detected by electron microscopy. Strikingly, opening of the endothelial TJs was not accompanied by any visible change in the molecular composition of endothelial TJs as junctional localization of the TJ-associated proteins claudin-3, claudin-5, occludin, ZO-1 or ZO-2 or the adherens junction-associated proteins β-catenin or p120cas did not change. Thus, opening of BBB TJs is not readily accompanied by the complete loss of the junctional localization of TJ protein

I-MOVE multicentre case–control study 2010/11 to 2014/15 : is there within-season waning of influenza type/subtype vaccine effectiveness with increasing time since vaccination?

Influenza vaccines are currently the best method available to prevent seasonal influenza infection. In most European countries one dose (or two doses for children) of seasonal vaccine is given from September to December to the elderly and other target groups for vaccination. In Europe, influenza seasons can last until mid-May (1), and it is expected that vaccination conveys protection on the individual for the duration of the season. In 13/15 reviewed studies on the length of vaccine-induced protection among the elderly, using anti-haemagglutination antibody titres as a proxy for seroprotection levels, seroprotection rates lasted at least >4 months after vaccination (2). However in the 2011-12 influenza season various studies in Europe reported a decrease in influenza vaccine effectiveness (VE) against A(H3N2) over time within the season (3–5). In the United States, a decrease in VE against A(H3N2) with time since vaccination was suggested in the 2007-8 influenza season (6). The observed decrease of VE over time can be explained by viral change (notably antigenic drift) occurring in the season. Drift in B viruses may be slower than in A viruses (7), and A(H3N2) viruses undergo antigenic drift more frequently than A(H1N1)pdm09 viruses (8). The decrease of VE over time can also be explained by a waning of the immunity conferred by the vaccine independently from viral changes. If vaccine-induced protection wanes more rapidly during the season, then depending on the start and duration of the influenza season, the decline of VE may cause increases in overall incidence, hospitalisations and deaths. Changes to vaccination strategies (timing and boosters) may be needed. As anti-haemagglutination antibody titres are not well defined as a correlate of protection (9,10), vaccine efficacy (as measured in trials) or vaccine effectiveness observational studies may be one way to measure vaccine-induced protection. These studies require a large sample size to model VE by time since vaccination and currently, most of the seasonal observational studies lack the precision required to provide evidence for waning immunity. In this study we pooled data across five post-pandemic seasons (2010/11-2014/15) from the I-MOVE (Influenza - Monitoring Vaccine Effectiveness) multicentre case control studies (1,3,11,12), to obtain a greater sample size to study the effects of time since vaccination on influenza type/subtype-specific VE. We measure influenza type/subtype-specific VE by time since vaccination for the overall season, but also in the early influenza phase; under the hypothesis that virological changes are fewer in the early season, but waning of the vaccine effect should be present regardless of time within the influenza phase

SARS-CoV-2 Transmissibility Within Day Care Centers—Study Protocol of a Prospective Analysis of Outbreaks in Germany

Introduction: Until today, the role of children in the transmission dynamics of SARS-CoV-2 and the development of the COVID-19 pandemic seems to be dynamic and is not finally resolved. The primary aim of this study is to investigate the transmission dynamics of SARS-CoV-2 in child day care centers and connected households as well as transmission-related indicators and clinical symptoms among children and adults. Methods and Analysis: COALA (“Corona outbreak-related examinations in day care centers”) is a day care center- and household-based study with a case-ascertained study design. Based on day care centers with at least one reported case of SARS-CoV-2, we include one- to six-year-old children and staff of the affected group in the day care center as well as their respective households. We visit each child's and adult's household. During the home visit we take from each household member a combined mouth and nose swab as well as a saliva sample for analysis of SARS-CoV-2-RNA by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and a capillary blood sample for a retrospective assessment of an earlier SARS-CoV-2 infection. Furthermore, information on health status, socio-demographics and COVID-19 protective measures are collected via a short telephone interview in the subsequent days. In the following 12 days, household members (or parents for their children) self-collect the same respiratory samples as described above every 3 days and a stool sample for children once. COVID-19 symptoms are documented daily in a symptom diary. Approximately 35 days after testing the index case, every participant who tested positive for SARS-CoV-2 during the study is re-visited at home for another capillary blood sample and a standardized interview. The analysis includes secondary attack rates, by age of primary case, both in the day care center and in households, as well as viral shedding dynamics, including the beginning of shedding relative to symptom onset and viral clearance. Discussion: The results contribute to a better understanding of the epidemiological and virological transmission-related indicators of SARS-CoV-2 among young children, as compared to adults and the interplay between day care and households.Peer Reviewe