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Background: The incidence of non-alcoholic fatty liver disease (NAFLD) is rising in parallel with increasing bodyweight and loss of glucose control, implicating a high risk of hepatic and extra-hepatic complications. Subjects / Methods: This longitudinal observational study analysed several indicators for NAFLD in 240 overweight subjects (body mass index (BMI) > 28 kg/m²) at 2 visits within in average 16 months. Subjects were categorised according to their insulin sensitivity (HOMAIR) and diabetic status. Methods: Liver fat and liver stiffness were measured with sonographic elastography (FibroScan®), and by calculation of Fatty Liver Index (FLI), and NAFLD Fibrosis Score (NFS). Results: Parameters indicative for liver steatosis, i.e., the controlled attenuation parameter (CAP) and the FLI, were significantly higher in the T2DM group compared to the normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) groups (p

Background: The incidence of metabolic dysfunction- associated fatty liver disease (MAFLD) is rising in parallel with increasing bodyweight and loss of glucose control, implicating a high risk of hepatic and extra-hepatic complications. Subjects / Methods: This longitudinal observational study analysed several indicators for MAFLD in 240 overweight subjects (body mass index (BMI) > 28 kg/m²) at 2 visits within in average 16 months. Subjects were categorised according to their insulin sensitivity (HOMAIR) and diabetic status. Methods: Liver fat and liver stiffness were measured with sonographic elastography (FibroScan®), and by calculation of Fatty Liver Index (FLI), and NAFLD Fibrosis Score (NFS). Results: Parameters indicative for liver steatosis, i.e., the controlled attenuation parameter (CAP) and the FLI, were significantly higher in the T2DM group compared to the normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) groups (pIRsignificantly correlated with sonographic liver fat content (CAP) (r=0.53, pIRscore increased mainly driven by the group of obese subjects with T2DM. No significant change in liver fat or stiffness was observed that period. Conclusions: In subjects with a BMI ≥ 28kg/m², the prevalence of MAFLD increases in line with increasing insulin resistance and loss of glucose control. Despite some further deterioration in insulin sensitivity, liver fat content appeared relatively unchanged over 16 months.

Though work is important for people’s self-esteem and recognition, the sociology of work pays little attention to the meaning of work. This reflects that work in capitalist societies tends to be alienated. But empirical findings show that employees nevertheless try to appropriate their work by asking for its meaning. They claim for a meaningful work and for the possibility to execute work in a meaningful way. If they have to carry out work they feel to be meaningless they can suffer psychological strain. Meaning has not only an individual dimension but it refers to the meaning for society and other people and there are social institutionalizations of recognized meanings of work. Fordism and flexible capitalism are connected to different forms of alienation and difficulties to appropriate work as meaningful. Therefore, meaningful work is embedded in relations of collegiality and cooperation and can be damaged by the fragmentation of work.

Mental illnesses constitute an ever-growing share of factors relating to incapacity to work, and their importance in company health policy is increasing. The article analyses the possibilities and challenges of reintegration into work for those employees who had been diagnosed with mental disorders and had received treatment. It is based on a qualitative study of employees who had undergone therapy in psychosomatic clinics and of expert interviews with participants in Company Integration Management (BEM). It can be shown that a particular challenge, especially in the case of mental illnesses, is the fear of stigmatisation. It can hold back the affected individuals from participating in the BEM or from openly discussing their experiences of psychological burdens. The logics of actions of the different actors lead to a tendency to individualise BEM. On the one hand this enables appropriate action for each and every individual case, but on the other hand it implies that BEM loses sight of the psychological burden stemming from the general structure of the work situation itself. The BEM does, however, offer the potential to act as an instrument of situational prevention, if it is linked with other institutions of company health policy, especially risk assessment.

We investigated the effect of sequential treatment escalation with dapagliflozin and saxagliptin on beta cell function in patients with T2DM insufficiently controlled on metformin monotherapy during a hyperglycaemic clamp investigation. Twenty-six patients (19 males, age 63.5±7.0 years; duration of diabetes 8.8±4.7 years; HbA1c 63.9±15.8 mmol/mol; mean±SD) were enrolled in the study. During a first treatment period (TP1) all patients received 10 mg dapagliflozin for one month, followed by the addition of 5 mg saxagliptin or placebo for another month (TP2). At baseline and at the end of each treatment period, fasting glucose and insulin levels were analysed, and a hyperglycaemic clamp with the measurement of plasma C-peptide, insulin, proinsulin, and glucagon was performed. Treatment with dapagliflozin reduced fasting glucose levels and insulin resistance (TP1). Within the hyperglycaemic clamp, C-peptide and insulin concentrations increased after the addition of dapagliflozin in TP1 (0.48±0.45 nmol*h/l; 6.24±17.9 mU*h/l) and further improved after the addition of saxagliptin in TP2 (0.38±0.34 nmol*h/l; 6.59±10.15 mU*h/l). Acute insulin response did not change after the addition of dapagliflozin (TP1), but significantly improved after the addition of saxagliptin in TP2 (0.89±0.76 mU*h/l). Both drugs improved the C-peptide/proinsulin ratio. After the addition of saxagliptin, the glucagon/insulin ratio significantly declined (TP2). Treatment escalation with dapagliflozin and saxagliptin exhibit additive effects on beta cell capacity, and improves alpha and beta cell integrity.

We dedicate this article to Werner Fricke for his coherent and persevering work on concepts of action research and we want to thank him for his collegial interest in our research. Abstract Workers are not determined by their social conditions, and they are no simple object of dominant (neoliberal) discourses. The article shows that, contrarily to widespread beliefs about working people as individualistic “entrepreneurial selves”, workers strongly hold on to ideas about the social character of their life and their world of work, the need for humanity in both work and life, and the basic idea that work, even when it is waged labour, should be meaningful and have a sense for others in society. This is the result of our empirical investigation about expectations on work articulated by “normal” employees (mid-career, medium-level qualification, in relative stable employment). We explored how expectations on work are affected by precarisation, but also by a general rising social insecurity due to permanent corporate restructuring, changes in the social system etc. The findings show, overall, that normative expectations on work have not been given up. However, not all expectations have the otential to serve as basis for self-empowerment and (collective) action. Here, our distinction between “claims” and “desires” is very important. Claims are expectations which are normatively justified. We identified three modes to legitimise claims of work: the concept of performance as meaningful, ocietal work; the concept of human rights, seeing oneself as a bodily and mental human being; and the onception of a balanced life, seeing oneself as a social being within diverse needs and social mbeddings. Desires, by contrast, are expectations with no legitimization in normative terms. Here, expectations are fulfilled by chance or even by individualistic recklessness. Both “claims” and “desires” go along with different perception of society as a whole: firstly as (still) normatively tructured and thus shapeable by the workers: or, secondly, as a terrain of fortune and mere struggle. So, whereas expectations on work in general are not given up, we see a shift from claims to desires. Workers are not sure anymore whether their claims: seen as normal and legitimate, can still rely on the normative normality in today’s society. Biographically, claims and desires are embedded in life rientations, i.e. implicit perspectives on the world, their options and modes to act and influence their life. In all, the article insists on the need to analyse workers as subjects with highly complex and self-confident resources of action and resistance: to avoid worker’s objectivation as a pure appendix to (neoliberal) discourses. Keywords: claims on work, life orientations, meaningful work, normality, social actor ----- ?Normalidad no normal? Reinvindicaciones sobre el trabajo y la vida en el mundo contingente del trabajo Resumen Los trabajadores no estan determinados por sus condiciones sociales, y no son un simple objeto de discursos (neoliberales) dominantes. Este articulo muestra que, contrariamente a las creencias eneralizadas sobre los trabajadores como “emprendedores” individuales, los trabajadores se aferran fuertemente a ideas sobre el caracter social de su vida y su mundo del trabajo; a la necesidad de la humanidad tanto en el trabajo como en la vida; y a la idea basica de que el trabajo, incluso cuando es una labor asalariada, debe ser significativo y tener un sentido para los demas en la sociedad. Este es el resultado de nuestra investigacion empirica sobre las expectativas en el trabajo articuladas por los empleados "normales" (carrera media, calificacion de nivel medio, en un empleo relativamente estable). Exploramos como las expectativas sobre el trabajo se ven afectadas por la precarizacion, pero tambien por el aumento general de la inseguridad social debido a la reestructuracion corporativa permanente, cambios en el sistema social, etc. Los resultados muestran, en general, que las expectativas normativas sobre el trabajo no han sido abandonadas. Sin embargo, no todas las expectativas tienen el potencial de servir como base para el auto-empoderamiento y la accion (colectiva). Aqui, nuestra distincion entre "reivindicaciones" y "deseos" es muy importante. Las reivindicaciones son expectativas que estan justificadas ormativamente. Identificamos tres modos para legitimar las reivindicaciones de trabajo: el concepto de desempeno como trabajo social significativo; el concepto de derechos humanos, viendose a si mismo como un ser humano corporal y mental; y la concepcion de una vida equilibrada, viendose a si mismo como un ser social dentro de diversas necesidades e inserciones sociales. Por el contrario, los deseos son expectativas sin legitimidad en terminos normativos. Aqui, las expectativas se cumplen por asualidad o incluso por imprudencia individualista. Tanto las « reivindicaciones » como los « deseos » acompanan la percepcion diferente de la sociedad en su conjunto: en primer lugar como (todavia) normativamente estructurada y, por tanto, moldeable por los trabajadores: o, en Segundo lugar, como erreno de fortuna y mera lucha. Asi, mientras las expectativas sobre el trabajo en general no son abandonadas, vemos un cambio de las reivindicaciones para los deseos. Los trabajadores ya no estan seguros si sus reivindicaciones: vistas como normales y legitimas, todavia pueden depender de la normalidad normativa en la sociedad actual. Biograficamente, las reivindicaciones y los deseos estan incorporados en las orientaciones de vida, es decir, las perspectivas implicitas en el mundo, sus opciones y modos de actuar e influir en su vida. En suma, el articulo insiste en la necesidad de analizar a los trabajadores como sujetos con recursos de accion y resistencia altamente complejos y seguros de si mismos: para evitar la objetivacion del trabajador como un apendice puro de los discursos neoliberales). Palabras clave: Reinvindicaciones de trabajo, orientaciones de vida, trabajo significativo, normalidad, actor social. ----- Bibliography: Hurtgen, Stefanie/Voswinkel, Stephan: Non-Normal Normality? Claims on Work and Life in a Contingent World of Work, IJAR, 2-2017, pp. 112-128. https://doi.org/10.3224/ijar.v13i2.03

Kann man heute weiterhin – oder vielleicht erst Recht – von entfremdeter Arbeit sprechen? Oder bleibt diese Diagnose der Zeit tayloristischer Arbeit vorbehalten, ist also fur neuere Arbeitsformen nicht mehr zeitgemas? Dieser Aufsatz vertritt die These, dass der Entfremdungsbegriff neu gefasst werden muss und sich dann zeigt, wie angemessen diese Diagnose auch heute – erst recht – ist.

Zusammenfassung „Sinnvolle“ Arbeit ist zum einen Ergebnis einer gesellschaftlichen oder professionellen Definition ihres Gebrauchswerts. Auf diese institutionalisierten Sinnzuschreibungen beziehen sich Menschen, wenn sie versuchen, sich die Arbeit unter Bezug auf ihren Sinn anzueignen. Oft überblenden sie die Funktion der jeweiligen Arbeit durch sinnbezogene Rahmungen. Zum andern soll Arbeit sinnvoll geleistet werden können, so dass Organisation und Rahmenbedingungen der Arbeit wichtig sind für das Sinnerleben der Arbeitenden. Schließlich ist Arbeit eine Dimension der Aneignung des Lebens, dessen Vielfalt sie durch übermäßige Sinnzuschreibungen an die Arbeit beeinträchtigen kann.

Do employees want to have good working conditions – or do they demand them? The article argues that this makes a fundamental conceptual difference in the analysis of the orientation of employees and their self-constitution as social actors. Thus, we start with the distinction of “wishes” for and “expectations” of good working conditions. It is shown then that expectations made of work cannot be analysed without taking into account the biographical and social life; which are always and necessarily part of the demands made on work and life. At present, however, the self-confidence to make demands for good work has to be regarded as fundamentally unsettled, amongst those “normally” employed, i.e. in relatively stable employment. Yet, this uncertainty is not to be confused with the widely assumed internalisation of neoliberal invocations. It is precisely such internalisation that we do not find in the expectations of employees towards their work.

Der Sinn ihrer Arbeit ist von groser Bedeutung fur die Identifikation von Beschaftigten mit ihrer Arbeit. Allerdings sind verschiedene Dimensionen sinnvoller Arbeit zu unterscheiden. Zunachst arbeiten die Menschen auch deshalb, weil sie hiermit ihren Lebensunterhalt verdienen mussen, in dieser Hinsicht hat die Arbeit also eine instrumentelle Bedeutung. Aber nur selten reduziert sich die Arbeitsorientierung der Beschaftigten hierauf. Wenn sie den Anspruch haben, dass ihre Arbeit sinnvoll ist, dann beziehen sie sich oft auf deren sozialen oder gesellschaftlichen Nutzen und darauf, ob die Arbeit sinnvoll, also effizient und ihre Fahigkeiten nutzend, auszufuhren ist. Gegenwartig wird der Sinn von Arbeit verbreitet darin gesehen, dass sie „Spas mache“ und Selbstverwirklichung ermogliche; ihr Sinn liegt dann in der Arbeitsausfuhrung selbst. Zwischen diesen Dimensionen sinnvoller Arbeit gibt es vielfaltige Wechselbeziehungen, die im Aufsatz skizziert werden. Beschaftigte rahmen auch Arbeit, die nicht sinnvoll erscheint, oft so, dass sie ihr Sinn zuschreiben konnen. Nicht nur die Erfahrung von Sinnlosigkeit in der Arbeit, sondern auch eine mit Sinnerleben verbundene (Uber-)Identifikation mit der Arbeit kann – im Lebenszusammenhang betrachtet – mit psychischen Belastungen verbunden sein. Dies wird an Beispielen aus einer empirischen Untersuchung verdeutlicht.

Welche Arbeitssituationen sind psychisch belastend? Wie gehen Organisationen mit psychischen Erkrankungen um? Und wie wird die Erwerbsarbeit in Therapien thematisiert? Die Autor_innen analysieren Fälle psychisch erkrankter Beschäftigter interdisziplinär und zeigen auf, welche Verbesserungsmöglichkeiten es an den Schnittstellen von Gesundheitssystem und betrieblicher Wiedereingliederung gibt. Which work situations are emotionally challenging? How do organizations deal with mental disorders? And how is work made a subject of discussion in therapy? The authors analyze the cases of employees suffering from mental disorders interdisciplinarily and show what options for improvement there are at the interfaces of the health system and the reintegration to the work place.

Gegen einen Trend aktueller sozialwissenschaftlicher Analysen, von den derzeitigen Veranderungen in den Arbeits- und Lebensverhaltnissen auf entsprechende Entwicklungen sozial-psychischer Dispositionen zu schliesen, entwickelt der vorliegende Artikel theoretisch und empirisch die These, dass Menschen auch selbst Anforderungen an sich definieren und ihre Ressourcen und Handlungsmoglichkeiten strukturieren, indem sie sich mit ihren strukturellen Bedingungen auseinandersetzen. Zum Verstandnis der Art und Weise, dies zu tun, entwickelt der Aufsatz das Konzept der „Lebensorientierungen“. Anhand von vier beispielhaften Typisierungen von Lebensorientierungen aus einem Forschungsprojekt zu Anspruchen an Arbeit von „NormalarbeitnehmerInnen“ wird gezeigt, dass gangige Vorstellungen von Subjektformen korrekturbedurftig sind.

Aims The aim of the study was to investigate the effect of sequential treatment escalation with empagliflozin and linagliptin on laboratory markers of alpha- and beta cell function in patients with type 2 diabetes mellitus (T2DM) insufficiently controlled on metformin monotherapy. Methods Forty-four patients with T2DM received 25 mg empagliflozin for a duration of one month in an open-label fashion (treatment period (TP 1). Thereafter, patients were randomised to a double-blind add-on therapy with linagliptin 5 mg or placebo (TP 2) for one additional month. Alpha- and beta cell function were assessed with a standardised liquid meal test (LMT) and an intravenous (iv.) glucose challenge. Efficacy parameters comprised of the area under the curve (AUC) for glucose, insulin, proinsulin and glucagon after the LMT and the assessment of fast- and late-phase insulin release after an intravenous glucose load with a subsequent hyperglycaemic clamp. Results Empagliflozin reduced fasting and postprandial plasma glucose levels associated with a significant reduction in postprandial insulin levels, and an improvement in the conversion rate of proinsulin (TP 1). Addition of linagliptin during TP 2 further improved postprandial glucose levels most probably due to a marked reduction in postprandial glucagon concentrations (TP 2). The insulin response to an intravenous glucose load increased during treatment with empagliflozin (TP 1), and further improved after the addition of linagliptin (TP 2). Conclusion After metformin failure, sequential treatment escalation with empagliflozin and linagliptin is an attractive treatment option due to additive effects on postprandial glucose control, most probably mediated by complementary effects on alpha- and beta cell function.

For decades, the German sociology of work had been dominated by a Marxism-inspired paradigm of interest. More recently, however, a paradigm of identity and recognition has gained prominence. This change is closely linked to a shift in the socio-theoretical, socio-political, and normative discourse as well as to a shift in labor relations, where identity, subjectivity, and recognition claims have become more important. The paradigm of recognition meets the requirements of these changes better than the old concept of interest. At the same time, however, the use of the concept of interest has become increasingly vague and has lost much of its explanatory power. Against this backdrop, the article argues for a multidimensional reconceptualization of ‘interest’ and ‘recognition’, which is necessary in order to save the concept of recognition from becoming a catch-all category. Based on the recognition theory of Axel Honneth and the contributions of Heinrich Popitz and Pierre Bourdieu, ‘interest’ is being concep...

In dem Beitrag beleuchten wir einen Aspekt der Krise der Kritik, den wir als „Sprachlosigkeit der Kritik“ bezeichnen. Die heterogenen Kritiken lassen sich nicht mehr zu einer kritischen Erzahlung bundeln. Es fehlt an einer gemeinsamen Sprache mit erklarenden Bildern und Grammatiken.

Neuronal and glial glutamate transporters play a central role in the termination of synaptic transmission and in extracellular glutamate homeostasis in the mammalian central nervous system. They are known to be multimers; however, the number of subunits forming a functional transporter is controversial. We studied the subunit stoichiometry of two distantly related glutamate transporters, the human glial glutamate transporter hEAAT2 and a bacterial glutamate transporter from Escherichia coli, ecgltP. Using blue native polyacrylamide gel electrophoresis, analysis of concatenated transporters, and chemical cross-linking, we demonstrated that human and prokaryotic glutamate transporters expressed in Xenopus laevis oocytes or in mammalian cells are assembled as trimers composed of three identical subunits. In an inducible mammalian cell line expressing hEAAT2 the glutamate uptake currents correlate to the amount of trimeric transporters. Overexpression and purification of ecgltP in E. coli resulted in a homogenous population of trimeric transporters that were functional after reconstitution in lipid vesicles. Our results indicate that an evolutionarily conserved trimeric quaternary structure represents the sole native and functional state of glutamate transporters.