In this study, we examined the learning of new grapheme-phoneme correspondences in individuals with and without dyslexia. Additionally, we investigated the relation between grapheme-phoneme learning and measures of phonological awareness, orthographic knowledge and rapid automatized naming, with a focus on the unique joint variance of grapheme-phoneme learning to word and non-word reading achievement. Training of grapheme-phoneme associations consisted of a 20-min training program in which eight novel letters (Hebrew) needed to be paired with speech sounds taken from the participant's native (...) language (Dutch). Eighty-four third grade students, of whom 20 were diagnosed with dyslexia, participated in the training and testing. Our results indicate a reduced ability of dyslexic readers in applying newly learned grapheme-phoneme correspondences while reading words which consist of these novel letters. However, we did not observe a significant independent contribution of grapheme-phoneme learning to reading outcomes. Alternatively, results from the regression analysis indicate that failure to read may be due to differences in phonological and/or orthographic knowledge but not to differences in the grapheme-phoneme-conversion process itself. (shrink)

Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

Research has shown the importance of engaging in networking behaviors for employees’ career success. Networking behaviors can be seen as a proactive way of creating access to career-related social resources and we argue that this type of proactive career behaviors might be particularly relevant for freelancers who cannot depend on an organizational career system supporting their further development, yet whose careers are characterized by high levels of uncertainty and unpredictability. To date, however, our understanding of how freelancers, being a category (...) of workers that are deprived of an organizational context of support for career development, can safeguard their employability, is limited. Therefore, this study addresses this gap and investigates whether freelancers’ networking behaviors are positively associated with career outcomes, through the mediating role of the need for relatedness fulfillment and employability-enhancing competencies. Hypotheses are tested via Structural Equation Modelling using a sample of 1,874 freelancers from Belgium, France, Germany, the Netherlands and the United Kingdom. The results generally support our hypotheses, providing evidence for a significant association between networking behaviors and need for relatedness fulfillment, and between networking behaviors and employability-enhancing competencies. Moreover, we found a significant association between need for relatedness fulfillment and employability-enhancing competencies, being the mediators in our research model and the outcomes of career satisfaction and future career opportunities. Implications for career development in the contemporary workplace are discussed, with particular attention for need for relatedness fulfillment, employability, and sustainable careers of freelance workers. (shrink)

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

The blackbody radiation field is studied from different points of view. The existence of zero-point fluctuations is shown to be crucial in determining the form of the thermal part of the spectrum. The notion of a continuous field is seen to be compatible with a discrete structure for its interaction: The description normally used in the quantum context does not refer to the field but to its interaction with atomic systems, which involves statistically independent elementary acts of absorption and emission. (...) The same classical field has different effects on absorption and on emission, and these are conveniently, but not necessarily, described in terms of non-commuting operators. (shrink)

A comparison is made between the scientific receptions of three proposed new members of the hominin phylogenetic tree: the first finds of Neanderthal Man, those of Homo erectus, and those of Homo floresiensis. In each case, the leading scientists of the moment of discovery heavily debated the finds and neglected the meaning of those finds. At least it took/will take one generation before the meaning of those finds were/will be accepted.

Background: Moral case deliberation is a form of clinical ethics support to help healthcare professionals in dealing with ethically difficult situations. There is a lack of evidence about what outcomes healthcare professionals experience in daily practice after moral case deliberations. The Euro-MCD Instrument was developed to measure outcomes, based on the literature, a Delphi panel, and content validity testing. To examine relevance of items and adequateness of domains, a field study is needed. Aim: To describe experienced outcomes after participating in (...) a series of moral case deliberations, both during sessions and in daily practice, and to explore correlations between items to further validate the Euro-MCD Instrument. Methods: In Sweden, the Netherlands, and Norway, healthcare institutions that planned a series of moral case deliberations were invited. Closed responses were quantitatively analyzed. The factor structure of the instrument was tested using exploratory factor analyses. Ethical considerations: The study was approved in Sweden by a review board. In Norway and the Netherlands, data services and review boards were informed about the study. Results: The Euro-MCD Instrument was completed by 443 and 247 healthcare professionals after four and eight moral case deliberations, respectively. They experienced especially outcomes related to a better collaboration with co-workers and outcomes about individual moral reflexivity and attitude, both during sessions and in daily practice. Outcomes were experienced to a higher extent during sessions than in daily practice. The factor structure revealed four domains of outcomes, which did not confirm the six Euro-MCD domains. Conclusion: Field-testing the Euro-MCD Instrument showed the most frequently experienced outcomes and which outcomes correlated with each other. When revising the instrument, domains should be reconsidered, combined with theory about underlying concepts. In the future, a feasible and valid instrument will be presented to get insight into how moral case deliberation supports and improves healthcare. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

In recent years, functional connectivity in the developmental science received increasing attention. Although it has been reported that the anatomical connectivity in the preterm brain develops dramatically during the last months of pregnancy, little is known about how functional and effective connectivity change with maturation. The present study investigated how effective connectivity in premature infants evolves. To assess it, we use EEG measurements and graph-theory methodologies. We recorded data from 25 preterm babies, who underwent long-EEG monitoring at least twice during (...) their stay in the NICU. The recordings took place from 27 weeks postmenstrual age until 42 weeks PMA. Results showed that the EEG-connectivity, assessed using graph-theory indices, moved from a small-world network to a random one, since the clustering coefficient increases and the path length decreases. This shift can be due to the development of the thalamocortical connections and long-range cortical connections. Based on the network indices, we developed different age-prediction models. The best result showed that it is possible to predict the age of the infant with a root mean-squared error equal to 2.11 weeks. These results are similar to the ones reported in the literature for age prediction in preterm babies. (shrink)

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

The practices of Galenic pharmacy that dominated the Western pharmaceutical tradition throughout the medieval and early modern periods generally eschewed methods of alchemical processing and the use of high heat. A unique 10th-century Arabic pharmaceutical treatise, the Kitab al Tasrif by al-Zahrāwī/Abulcasis, however, discussed thermo-chemical techniques of distillation, calcination, and sublimation at length and would go on to have a major impact on Galenic pharmacy. It included recipes, for example, for two highly important distilled substances – rosewater and Philosophers' Oil (...) – that were copied and revised in Latin texts from the later Middle Ages and early modern Spanish formularies. By the end of the 16th century, these recipes had formed the basis for two new categories of distilled medicines – distilled waters and distilled oils – in Galenic pharmacy. Their inclusion in the Galenic formulary indicates that apothecaries in the Latin West were familiar with and indeed practicing thermo-chemical operations during the medieval and early modern periods. (shrink)

To ensure their survival in natural habitats, plants must recognize and respond to a wide variety of insect herbivores. Aphids and other Hemiptera pose a particular challenge, because they cause relatively little direct tissue damage when inserting their slender stylets intercellularly to feed from the phloem sieve elements. Plant responses to this unusual feeding strategy almost certainly include recognition of aphid salivary components and the induction of phloem‐specific defenses. Due to the excellent genetic and genomic resources that are available for (...) Arabidopsis thaliana (Arabidopsis), this plant was chosen as a model system to study the metabolic and transcriptional responses to infestation by two aphids, Myzus persicae (green peach aphid, a broad generalist) and Brevicoryne brassicae (cabbage aphid, a crucifer‐feeding specialist). Future research on Arabidopsis–aphid interactions will lead to the identification of aphid‐specific elicitors, components of the defense‐signaling pathway, and additional metabolic responses that are induced by aphid infestation. BioEssays 29:871–883, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Ethics support services like Moral Case Deliberation intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to describe how participants’ perceive the importance of MCD outcomes after MCD; compare these perceptions with those before MCD participation; and test the factor structure of these outcomes. Swedish, (...) Norwegian and Dutch healthcare professionals rated the importance of outcomes in the Euro-MCD Instrument after four and eight MCDs. Ratings were compared with those before MCD participation using paired and independent samples t-tests. The factor structure was tested using exploratory factor analyses. After 4 and 8 MCDs, 443 respectively 247 respondents completed the instrument. More than 69% rated all MCD outcomes as ‘quite’ or ‘very’ important, especially outcomes from Enhanced Collaboration, Improved Moral Reflexivity and Improved Moral Attitude. Significant differences for 16 outcomes regarding ratings before and after MCD participation were not considered meaningful. Factor analyses suggested three categories, which seemingly resemble the domains Improved Moral Reflexivity, Enhanced Collaboration and a combination of Improved Moral Attitude and Enhanced Emotional Support. After participation in MCDs, respondents confirmed the importance of outcomes in the Euro-MCD Instrument. The question on perceived importance and the categorization of outcomes need reconsideration. The revised instrument will be presented elsewhere, based on all field studies and theoretical reflections. (shrink)

The transition towards sustainable and just food systems is ongoing, illustrated by an increasing number of initiatives that try to address unsustainable practices and social injustices. Insights are needed into what a just transition entails in order to critically engage with plural and potentially conflicting justice conceptualisations. Researchers play an active role in food system transitions, but it is unclear which conceptualisations and principles of justice they enact when writing about food system initiatives. To fill this gap this paper investigates: (...) Which conceptualisations of justice emerge from the literature related to food system initiatives and which principles of justice do authors use? We developed an initial framework for which we drew on political philosophy literature. We then undertook an extensive review of the food system transitions literature using this framework and were able to identify a range of recognition, distributive, and procedural justice conceptualisations and associated principles of justice. Recognised as subjects of justice were those with a particular role in the food system, people who are marginalised, Indigenous communities, those with experiences of negative consequences of the food system, future generations, and nonhumans. The identified conceptualisations and the developed framework can be used by those involved in food system initiatives to reflect on how they conceptualise justice. We challenge them to be more explicit about who they do and do not recognise as subjects of justice and which principles of justice they use. Such clarity is needed to reflexively enact a just transition towards sustainable and just food systems. (shrink)

In prevention and health promotion interventions, screening methods and risk profile assessments are often used as tools for establishing the interventions’ effectiveness, for the selection and determination of the health status of participants. The role these instruments fulfil in the creation of effectiveness and the effects these instruments have themselves remain unexplored. In this paper, we have analysed the role screening methods and risk profile assessments fulfil as part of prevention and health promotion programmes in the selection, enrolment and participation (...) of participants. Our analysis showed, that screening methods and health risk assessments create effects as they objectify health risks and/or the health status of individuals, i.e., they select the individuals ‘at risk’ and indicate the lifestyle modifications these people are required to make in order to improve their health. Yet, these instruments also reduce the group of participants thereby decreasing the possible effect of interventions, as they provide the legitimisation for people to make choices to whether they enrol or not and what lifestyle changes they incorporate into their lives. In other words, they present a space of interaction, in which agency is distributed across the practice nurses, the participants and the instruments. Decisions were not just made upon the projection of the outcomes of these instruments; decisions that were made by both the patients and practice nurses were the resultant of their opinions on these outcomes that were formed in interaction with the instruments. (shrink)

The monumental Florilegium Coislinianum can be dated in the 9th-10th century and originally contained all the letters up to Omega, but now the most complete manuscript, Parisinus gr. 923 , ends at Psi. Hitherto only the third book has been made available in a critical edition, while the rest of the anthology is still not accessible in a printed version. This article presents the critical edition of the second book , containing some interesting fragments attributed e.g. to a certain Leontius (...) the Damascene, to Athanasius of Alexandria and to John Chrysostom. (shrink)

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in different (...) healthcare organisations throughout the Netherlands were included. After completion of the programme, participants feel sufficiently confident and equipped to facilitate an MCD session. Feeling competent does not mean that participants have no doubts or questions left. Rather, they are aware of their limitations and see the need for continuous learning. According to the respondents, the actual exercise of facilitating MCD during and in between the training sessions contributed most to the development of competences necessary for being an MCD facilitator. Respondents without prior experience of participating in MCD sessions felt less competent after the training than those who had participated in MCD sessions before. Self-attributed competence varied between participants with different professional backgrounds. (shrink)

We show that the electromagnetic radiation field, conventionally introduced as a perturbation in quantum mechanics, is actually at the basis of the operator formalism. We first analyze the linear resonant response of the (continuous) variables x(t), p(t) of a harmonic oscillator to the full radiation field, i.e. the zero-point field plus an applied field playing the role of the driving force, and then extend the analysis to the response of a charged particle bound by a non-linear force, typically an atomic (...) electron. This leads to the establishment of a one-to-one correspondence between the response functions and the respective quantum operators, and to the identification of the quantum commutator with the Poisson bracket of the response functions with respect to the normalized variables of the driving field. To complete the quantum description, a similar procedure is used to obtain the field operators as the response functions to the same normalized variables. The results allow us to draw important conclusions about the physical content of the quantum formalism, in particular about the meaning of the quantum expectation values and the coarse-grained nature of the quantum-mechanical description. (shrink)

In spoken interactions, interlocutors carefully plan and time their utterances, minimising gaps and overlaps between consecutive turns. Cross-linguistic comparison has indicated that spoken languages vary only minimally in terms of turn-timing, and language acquisition research has shown pre-linguistic vocal turn-taking in the first half year of life. These observations suggest that the turn-taking system may provide a fundamental basis for our linguistic capacities. The question remains however to what extent our capacity for rapid turn-taking is determined by modality constraints. The (...) avoidance of overlapping turns could be motivated by the difficulty of hearing and speaking at the same time. If so, turn-taking in sign might show greater toleration for overlap. Alternatively, signed conversations may show a similar distribution of turn-timing as spoken languages, thus avoiding both gaps and overlaps. To address this question we look at turn-timing in question-answer sequences in spontaneous conversations of Sign Language of the Netherlands. The findings indicate that although there is considerable overlap in two or more signers' articulators in conversation, when proper allowance is made for onset preparation, post-utterance retraction and the intentional holding of signs for response, turn-taking latencies in sign look remarkably like those reported for spoken language. This is consistent with the possibility that, at least with regard to responses to questions, speakers and signers follow similar time courses in planning and producing their utterances in on-going conversation. This suggests that turn-taking systems may well be a shared cognitive infrastructure underlying all modern human languages, both spoken and signed. (shrink)

A rapidly emerging hegemonic neuro-culture and a booming neural subjectivity signal the entry point for an inquiry into the status of the signifier neuro as a universal passe-partout. The wager of this paper is that the various appropriations of the neurosciences in the media and in academia itself point to something essential, if not structural, in connection with both the discipline of the neurosciences and the current socio-cultural and ideological climate. Starting from the case of neuroeducation, the genealogy of the (...) neurological turn is linked to the history of psychology and its inextricable bond with processes of psychologisation. If the neurological turn risks not merely neglecting the dimension of critique, but also obviating its possibility, then revivifying a psy-critique might be necessary in order to understand today’s neural subjectivity and its place within current biopolitics. (shrink)

La méthode musicale d'improvisation collective exprime une conception du jeu dont l'attitude de base démocratique et émancipatrice suggère des comparaisons avec le concept de la situation idéale du discours formulé par Jürgen Habermas. Cette présomption est expliquée plus en détail dans le cadre d'une approche introductive de l'improvisation collective comme processus de relation caractérisé par l'interactivité et la synchronicité. Après une discussion sur l'action d'improvisation en musique sous ses aspects théoriques, historiques et psychologiques, les différents stades de développement de l'improvisation (...) libre ou collective issus du free jazz dans les années 1960 seront présentés. La sublimation des formes d'expression idiomatiques et culturelles exigées par des musiciens comme Derek Bailey s'expliquera par le développement individuel d'un langage sonore caractéristique sur l'instrument en tant qu'égalisation pour les formes de dialogue asymétriques de cette situation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:L’esthétique de StaceA. M. KeithAnne-Marie Taisne. L’esthétique de Stace. Paris: Les Belles Lettres, 1994. 433 pp. Paper, 280 FF. (Collection d’Etudes Anciennes 122)Anne-Marie Taisne is the author of numerous articles concerning the literary history and artistic context that inform single poems in Statius’ Silvae and self-contained passages in his Thebaid and unfinished Achilleid, papers which lay the groundwork for her comprehensive new study of the literary aesthetic on (...) display in the extant poetic oeuvre of P. Papinius Statius. In this ambitious monograph, she undertakes to explore two facets of Statius’ technical artistry, his spatial and temporal imagery, within the theoretical framework provided by ancient literary criticism. She is particularly concerned to articulate the poet’s dynamic reuse of the weighty literary tradition to which he is heir, and accordingly proposes, in her introduction, to structure her discussion around such central ancient critical issues as imitatio (mimesis) along with its close relatives aemulatio and contaminatio, and doctrina with its associated critical vocabulary of ingenium, ratio, and ars (6–10). Throughout the volume, she explicates these techniques in detailed analysis of Statian imagines, which she defines generally in the sense of “imagery” following S. Viarre (“L’image et le symbole dans la poésie d’Ovide: Recherches sur l’imaginaire,” REL 62 [1974] 263–80), and particularly by reference to individual usages of the term as they are discussed in the article on imago in the Thesaurus Linguae Latinae (11).Part 1, “Correspondances dans l’espace,” examines the spatial imagery of Thebaid, Achilleid, and Silvae in three chapters which treat (1) echo and reflection (17–52), (2) metamorphosis, multiplication, and contagion (53–119), and (3) simile (120–76). Part 2, “Correspondances dans le temps,” investigates the poems’ use of time as a structural principle, again in three chapters which discuss (1) prophecies and portents (177–236), (2) digressive elements such as ecphrases and embedded narratives (237–303), and (3) leitmotifs, or repeated patterns of imagery, such as divine and human interventions and the role of nature in the poems. The material Taisne analyzes in part 1 coheres more convincingly with her overarching theme of spatial imagery than that which she discusses in part 2 under the rubric of temporal imagery. I did not understand, for example, why nature, well discussed in connection with Statius’ use of the simile in part 1 (137–62), reappears in part 2 (331–58) with no explanation of its relevance to temporal imagery.Taisne persuasively documents the wide range of literary models on which Statius draws in all his poetry, and shows that the Thebaid makes particular use of epic and tragic models (166–68, 170, 373–75), the Achilleid of tragic and lyric models (168–71, 374–78). Her discussion of the literary echoes and wider symbolic relevance of individual passages is often very interesting, and the sheer accumulation of literary parallels is extremely impressive. I was reminded of and newly alerted to significant literary resonances on almost every page, and noticed only one incomplete assemblage of literary parallels (in her discussion of Hylas [End Page 159] in Silvae 1.2.199 [27–28], there is no mention of Theocr. Id. 13, Ap. Rhod. Arg. 1.1207–72, or Nicander apud Ant. Lib. Met. 26). The service to which this material is put, however, is not as exciting as the length of the study might lead one to hope. Throughout, Taisne argues that Statius’ deployment of imagery is consistent with the overarching thematic framework of each poem, defined as furor and horror in the Thebaid (23 and passim), an ambiguous and deceptive calm in the Achilleid (353–54 and passim), and serenity and harmony in the Silvae (28 and passim), but she does not press her analysis beyond the accumulation of imagery in the service of these themes as evidence of Statian amplificatio. This is particularly disappointing in an author so well placed to discuss the material culture of the Flavian epoch and the interrelations between Statius’ poetry (especially the Silvae) and the culture of display in Domitian’s Rome. Nevertheless, scholars will be grateful to Taisne for the material she has collected... (shrink)