D. D. Martin

In this paper, we explore psychosis and schizophrenia as prototype disturbances, where mentalizing failures are widely seen. We attempt to describe how the process of rekindling mentalizing within attachment relationships (here, the patient-therapist relationship) can have a protective effect not just on the onset of the disturbance, but also when psychosis is already actively installed. We start by discussing mentalizing in training, practice and supervision. We also try to understand it contextually, as a relational concept, within the history of psychological therapies.

Zusammenfassung In ihrem Bestreben, die Funktionsweise totalitärer Systeme zu verstehen, insbesondere, die von Nazi-Deutschland begangenen Verbrechen zu begreifen, spricht Hannah Arendt von der Banalität des Bösen. Dabei geht sie über Kants Auffassung des radikal Bösen hinaus, ohne dessen moralische Bedeutung zu verwerfen, um angesichts der Erschütterung des traditionellen Verständnisses von Humanität durch den Eichmann-Prozess den Begriff der persönlichen Verantwortung zu retten. Insofern sie sich an der antiken griechischen Philosophie von Sokrates und Platon sowie an den Quellen des Judentums orientiert, wird in Umrissen eine konzeptuelle Nähe zu Hermann Cohen sichtbar. Der dialogische und dialektische Charakter des Denkens, auf dem Arendts Widerstand gegen den Totalitarismus beruht, ist in Cohens Philosophie, die Arendt kaum wird gelesen haben, vorgeformt. Das von Cohen in seiner Auseinandersetzung mit Kant für Arendt herausgearbeitete radikal Gute lässt sich jedoch nur durch zwei regulativen Prinzipien annäherungsweise bestimmen: durch das Sokratische Prinzip des inneren Selbstgesprächs und den auf die moralische Sphäre angewandten Urteilsbegriff Kants.

This article aims to describe the main features of Kurt Goldstein’s philosophical anthropology, also showing how the project of such an anthropology found its form in the rereading of clinical material. We underline the originality of an anthropology rooted in the description of pathology and care, following a critical method which refuses other possible ways of drawing the figure of man from clinical experience. We thus attempt to show how a renewed reading of Goldstein is possible that is less dependent on the Canguilhemian and Merleau-Pontian readings which were fundamental for French-speaking readers.

Background: In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient’s advance directives and implement them. Objectives: To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services. Research design, participants, and context: This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency Medical Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis. Ethical considerations: This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients’ anonymity and willingness to participate in the study were guaranteed. Findings: There were four types of barriers that hindered the proper management of patients’ advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals’ decision-making. Discussion: These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals’ beliefs and the opinions of colleagues and family members, can also influence the professionals’ final decisions. Conclusion: The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated.

Background: Although convolutional neural networks (CNNs) achieve high diagnostic accuracy for detecting Alzheimer’s disease (AD) dementia based on magnetic resonance imaging (MRI) scans, they are not yet applied in clinical routine. One important reason for this is a lack of model comprehensibility. Recently developed visualization methods for deriving CNN relevance maps may help to fill this gap as they allow the visualization of key input image features that drive the decision of the model. We investigated whether models with higher accuracy also rely more on discriminative brain regions predefined by prior knowledge. Methods: We trained a CNN for the detection of AD in N = 663 T1-weighted MRI scans of patients with dementia and amnestic mild cognitive impairment (MCI) and verified the accuracy of the models via cross-validation and in three independent samples including in total N = 1655 cases. We evaluated the association of relevance scores and hippocampus volume to validate the clinical utility of this approach. To improve model comprehensibility, we implemented an interactive visualization of 3D CNN relevance maps, thereby allowing intuitive model inspection. Results: Across the three independent datasets, group separation showed high accuracy for AD dementia versus controls (AUC ≥ 0.91) and moderate accuracy for amnestic MCI versus controls (AUC ≈ 0.74). Relevance maps indicated that hippocampal atrophy was considered the most informative factor for AD detection, with additional contributions from atrophy in other cortical and subcortical regions. Relevance scores within the hippocampus were highly correlated with hippocampal volumes (Pearson’s r ≈ −0.86, p < 0.001). Conclusion: The relevance maps highlighted atrophy in regions that we had hypothesized a priori. This strengthens the comprehensibility of the CNN models, which were trained in a purely data-driven manner based on the scans and diagnosis labels. The high hippocampus relevance scores as well as the high performance achieved in independent samples support the validity of the CNN models in the detection of AD-related MRI abnormalities. The presented data-driven and hypothesis-free CNN modeling approach might provide a useful tool to automatically derive discriminative features for complex diagnostic tasks where clear clinical criteria are still missing, for instance for the differential diagnosis between various types of dementia.

Fractal fluctuations are a core concept for inquiries into human behavior and cognition from a dynamic systems perspective. Here, we present a generalized variance method for multivariate detrended fluctuation analysis (mvDFA). The advantage of this extension is that it can be applied to multivariate time series and considers intercorrelation between these time series when estimating fractal properties. First, we briefly describe how fractal fluctuations have advanced a dynamic system understanding of cognition. Then, we describe mvDFA in detail and highlight some of the advantages of the approach for simulated data. Furthermore, we show how mvDFA can be used to investigate empirical multivariate data using electroencephalographic recordings during a time-estimation task. We discuss this methodological development within the framework of interaction-dominant dynamics. Moreover, we outline how the availability of multivariate analyses can inform theoretical developments in the area of dynamic systems in human behavior.

El presente artículo contiene una lectura cruzada del Fedro y el Crátilo en la que se aclaran algunos de sus ejes temáticos centrales con el fin de sacar a relucir las constantes del pensamiento platónico que ambos diálogos comparten. La descripción de la dialéctica presente en el Fedro encaja con una definición socrática del Crátilo que explicita que el nombre es un instrumento al servicio del dialéctico. Todo ello nos lleva a concluir que la técnica dialéctica, además de constituir el principal mecanismo regulador de la oratoria, se postula en los diálogos platónicos como un procedimiento de corrección que permite validar cualquier tipo de proposición y aproximar a la verdad los más variados discursos y representaciones de la realidad. Abstract: The current paper contains a comparative reading of the Phaedrus and the Cratylus. Some of their central topics are here contrasted in order to highlight the characteristic traits of Platonic thought present in both dialogues. The description of dialectic in the Phaedrus fits well with a Socratic definition in the Cratylus which clearly specifies that names are tools at the service of the dialectician. This evidence leads us to the conclusion that -besides being the main mechanism to control and judge rhetoric- dialectical technic appears in the dialogues as the only correcting procedure that makes it possible to verify any sort of proposition and bring speeches and depictions of reality closer to the truth.

„Sinn und Recht jeder Zeit, […] liegt […] allein darin, dass sie dem Geist […] die Existenzmöglichkeit bietet.“Dieser 1930 geschriebene Satz stammt von einem der bekanntesten Architekten der Architektur-Moderne: Ludwig Mies van der Rohe. Sein im Zitat angedeutetes Menschenbild könnte man in Anlehnung an Max Scheler als,Leben + Geist‘ charakterisieren. Es bildet die Grundlage für die 1930 vollendete Villa Tugendhat und scheint darin auf.Der Beitrag analysiert die Villa Tugendhat im Hinblick auf das ihr zugrundliegende Menschenbild.

""A Monument to Saint Augustine, now happily reprinted by Wipf and Stock, gathers many diverse strands of the early twentieth century Catholic thought within its pages: the creative transformation of neo-scholasticism through a kind of ressourcement, the Catholic literary intellectual renaissance in Europe and Britain, the focus upon the renewal of Christian humanism in the face of modernity's proliferating dangers, and the Augustinian turn as a resource for the theology of crisis. Were it to do nothing else, this volume would be of extraordinary historical importance insofar as it makes clear how central the legacy of St. Augustine was to the interwar renaissance in Catholic thought and culture, not only to Burns, Dawson, and the British Catholics but also to the great figures of the Continent: Blondel, Gilson, Maritain, and Przywara. But the volume does much more. The contributions themselves are of real, substantive, and lasting value. The essays contained in this volume are not in theology per se--though theology, especially the doctrine of creation and theological anthropology, lies ever just beneath the surface. Rather, they treat Augustine from the perspective of philosophy, history, religious studies, and the humanities more generally."" -- From the New Introduction by Jacob Sherman ""A remarkable tribute."" -- The New Statesman ""No more appropriate monument could have been devised."" -- Observer ""Admirable... attractive... brilliant."" -- Spectator.

Inheritance is normally distributed to the heirs, but during the 20th century the state claimed a share of the estate through inheritance taxation. The purpose of this article is to examine how the successively increased importance of inheritance taxation in Scandinavia was justified in political debate between 1890 and 1935. The results shows that the tax was mainly motivated by the state’s increased revenue needs. The tax was not controversial in Denmark or Sweden, but caused strong conflicts in the Norwegian debate.