Witnessing and bearing witness. On offering systemic consultations and practices of solidarity at the Uyghur Tribunal

The experience of offering therapeutic support to the Uyghur Tribunal held in London in June and September 2021 powerfully brought home the critical variations in the meanings of witnessing and bearing witness and what they entail. In this paper, we explore the role of witnessing through offering systemic consultation to those who have experienced human rights violations and those who have witnessed these accounts and discuss our observations about the healing power of acts of resistance/activism. We are four systemic psychotherapists, with a particular interest in narrative practices, and approaches that foreground social justice. With a concern not to become “failed witnesses” which Jessica Benjamin (2014) describes as “a failure of those not involved in the acts of injury to serve the function of acknowledging and actively countering or repairing the suffering and injury that they encounter as observers in the social world”, we attempt here to communicate our experience of witnessing and joining with, through practices of solidarity, those bearing witness at the People's Tribunal held to hear evidence about China's alleged genocide and crimes against humanity against Uyghur, Kazakh and other Turkic Muslim populations

Propensity score-based analysis of 30-day survival in cardiogenic shock patients supported with different microaxial left ventricular assist devices

Background and methods Microaxial left ventricular assist devices are used increasingly for treating cardiogenic shock. We compared the short-term outcome of patients supported with different microaxial devices for cardiogenic shock. A retrospective propensity score-adjusted analysis was performed in cardiogenic shock patients treated with either the Impella CP (n = 64) or the Impella 5.0/5.5 (n = 62) at two tertiary cardiac care centers between 1/14 and 12/19. Results Patients in the Impella CP group were significantly older (69.6 ± 10.7 vs. 58.7 ± 11.9 years, p = .001), more likely in INTERMACS profile 1 (76.6% vs. 50%, p = .003) and post-C-reactive protein (CPR) (36% vs. 13%, p = .006). The median support time was 2.0 days [0.0, 5.3] in the CP group vs. 8.5 days [4.3, 15.8] in the 5.0/5.5 group (p < .001). The unadjusted 30-day survival was significantly higher in the Impella 5.0/5.5 group (58% vs. 36%, p = .021, odds ratio [OR] for 30-day survival on Impella 5.0/5.5 was 3.68 [95% confidence interval [CI]: [1.46–9.90]], p = .0072). After adjustment, the 30-day survival was similar for both devices (OR: 1.23, 95% CI: [0.34–4.18], p = .744). Lactate levels above 8 mmol/L and preoperative CPR were associated with a significant mortality increase in both cohorts (OR: 10.7, 95% CI: [3.45–47.34], p < .001; OR: 13.2, 95% CI: [4.28–57.89], p < .001, respectively). Conclusion Both Impella devices offer a similar effect with regard to survival in cardiogenic shock patients. Preoperative CPR or lactate levels exceeding 8 mmol/L immediately before implantation have a poor prognosis on Impella CP and Impella 5.0/5.5.ISSN:0886-0440ISSN:1540-819