Caring for ageing migrants in nursing homes: 'doing diversity' while 'doing death'

The proposed paper will present first results of a research project investigating how nursing homes in Switzerland deal with migrant elders who are in intensive need of care. Focusing on the end-of-life in institutional care settings, the intention is to explore the dimensions of ‘doing death’ in Swiss nursing homes when the elderly involved are of migrant background. The focus is laid on the co-construction of end of life in interactions between residents of migrant background and professional carers involved (often of migrant background themselves), and will thereby focus on processes of ‘doing diversity’ while ‘doing death’. To do so, we chose an ethnographic approach focusing on the participant observation of everyday practices of ‘doing death’ and ‘death work’ and on interviewing staff, residents and their relatives. Caring for ageing migrants at the end of their lives is studied in different types of assisted living at the end of life: The field of research was entered by studying a group specific department for residents of so-called ‘Mediterranean’ background. It was contrasted by a department stressing the individuality of each resident but including a considerable number of residents with migrant background. We are interested in how (and if at all) specific forms of ‘doing community’ within different types of departments may also lead to specific ways of ‘doing death’, which aim at a stronger embeddedness of dying trajectories in social relations of reciprocity and exchange. Furthermore, migrant ‘doing death’ is expected to be particularly negotiable since the potential diversities of symbolic reference systems and daily practices are widened. If the respective resident is limited in his/her capacities to play an active part in negotiating about ‘good care’ and ‘good dying’ – either due to language competences, which would be migrant specific, or due to degenerative diseases, which is not migrant specific – the field of negotiations will be left up to the professionals within the organization (and to the relatives, which are, however, not constantly present). Strategies of stereotyping the ‘other’ as well as driving nurses, caring aides and other professionals of migrant background into roles of ‘cultural experts’ or ‘transcultural translators’ are expected to be common in such situations. However, the task of negotiating what would be a ‘good dying’ and what measures are appropriate is always at stake in contemporary heterogeneous societies. Therefore we would argue that studying dying processes involving migrant residents is looking at paradigmatic manifestations of doing death in recent contexts of reflexive modernity.

Antiretrovirale Therapie

Antiretroviral therapy to treat HIV, as we know it today, is nothing less than a huge success story in modern medical history. What used to be an almost certain death-sentence was transformed into a very manageable chronic disease by means of highly efficient und mostly well tolerated drugs. Today, HIV-infected patients treated according to international recommendations have a very good chance to outgo the negative effects of HIV-1 and are therefore able to reach an almost normal life expectancy. Furthermore, patients successfully treated with antiretroviral drugs are no longer infectious, which is an essential aspect of global strategies to overcome the pandemic. Nevertheless, due to the complexity of HIV, physicians treating patients with antiretroviral therapy require profound knowledge of aspects such as viral resistance mechanisms and immune reconstitution, as well as drug-toxicity und drug-drug-interactions. Many other aspects such as long-term side-effects of antiretroviral drugs are still unknown. Strict adherence to treatment is of utmost importance.

Doing House and Neighbourhood

The paper will focus on basic ways of communication between the actors in the house and home and their direct social environments (esp. neighbourhood) during the early modern period. Such ways of communication were established in and through work relations, sociability, social control and certain liminal rites. So far underestimated, the neighbourhood was both helpful and inevitable to keep house and household running. A typical aspect of the practice of communication was the importance of repetitive performative events in everyday life. In order to establish and maintain social relations, the honour of the ‘house’ as such and fundamental roles like housefather and housemother had to be performed under the eyes of neighbours and other actors. Thus, empirical evidence reveals the house and home as a specific kind of stage. In contrast to the outdated concept of ‘das ganze Haus’ (the whole house) by Otto Brunner and also a reduced socioeconomic understanding of household, the openness of the house proves to be a highly relevant feature of early modern society. This openness refers to accessibility, visibility and control. The paper will explain the proposed concept and analyse concrete examples from work and wedding.

Doing House and Family in der Sattelzeit

Vorstellung des Programms des Sinergiaprojekts

Nazis by Kraut: A playful application of moral self-licensing

Doing something moral gives one a license to do something immoral. This form of moral compen-sation is called “moral self-licensing”. Interestingly, the moral behavior can take place in another domain than the subsequent immoral behavior. For example, buying eco-friendly products gives one a license to steal. This article is based on the idea that a healthy diet has a moral dimension. As a consequence, consuming a healthy product should give one a license for immoral behavior. This research supports this hypothesis on a playful study. This study shows that drinking sauerkraut juice contributes to a stronger support of Nazi-esque right wing ideology than drinking either nothing or a less-healthy beverage (Nestea).

The Almost Person: Myth, Narrative and The Doctor

Paul Ricœur describes selfhood as the product of a communal narrative. Communal narratives structured as symbolic myths provide a narrative identity and an ethic of selfhood. The psychologist Jerome Bruner, for instance, places the source of such a narrative identity in the family, where ‘canonical stories’ are formed. ‘Home’ becomes a mode of discourse, a way of recognizing ourselves in the narratives given to us by others. This paper will draw on these concepts of narrative identity in order to investigate the problems to selfhood which face the character of The Doctor in the BBC series Doctor Who. I will identify The Doctor as a character who acts within a self-constructed narrative vacuum, reading the character by contrasting two types of personal myth-making, one ‘real’, as in a lived narrative, and one ‘counterfeit’; a conjured myth to replace and obscure the lived self. The paper will pay particular attention to the twenty-first century reincarnations of Doctor Who. I will argue that the writing of Russell T. Davis and later Steven Moffat in particular directly address this tension of myth and selfhood, as The Doctor struggles between his self-imposed role as a modern Prometheus and the insistent haunting and return of his own story. In these incarnations, his companions become mirrors to The Doctor, bringing with them their own narrative and ethical identities. In turn, it is through his companions that The Doctor is able to build his own lived narrative of sorts, which challenges his self-created ‘mythology’. In contrast to the weeping angels, whose horrific agency manifests only when not apprehended, the Doctor’s story continues to become more real the more he is ‘perceived’, both by the human race and by the viewer.

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients.

BACKGROUND Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. METHODS Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. RESULTS One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still TOL. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. CONCLUSIONS In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.