ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication (...) strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

We make a brief review of the Kramers escape rate theory for the probabilistic motion of a particle in a potential well U(x), and under the influence of classical fluctuation forces. The Kramers theory is extended in order to take into account the action of the thermal and zero-point random electromagnetic fields on a charged particle. The result is physically relevant because we get a non-null escape rate over the potential barrier at low temperatures (T → 0). It is found (...) that, even if the mean energy is much smaller than the barrier height, the classical particle can escape from the potential well due to the action of the zero-point fluctuating fields. These stochastic effects can be used to give a classical interpretation to some quantum tunneling phenomena. Relevant experimental data are used to illustrate the theoretical results. (shrink)

We present a conceptual framework on the experience of time and provide a coherent basis on which to base further inquiries into qualitative approaches concerning time experience. We propose two Time-Layers and two Time-Formats forming four Time-Domains. Micro-Flow and Micro-Structure represent the implicit phenomenal basis, from which the explicit experiences of Macro-Flow and Macro-Structure emerge. Complementary to this theoretical proposal, we present empirical results from qualitative content analysis obtained from 25 healthy participants. The data essentially corroborate the theoretical proposal. With (...) respect to Flow, the phenomenally accessible time experience appeared as a continuous passage reaching from the past through the present into the future. With respect to Structure, the individual present was embedded in the individual biography, emerging from past experiences and comprising individual plans and goals. New or changing plans and goals were being integrated into the existing present, thus forming a new present. The future appeared as changeable within the present, by means from the past, and therefore as a space of potential opportunities. Exemplarily, we discuss these results in relation to previous empirical findings on deviant experiences of time in Autism Spectrum Disorder that is presumably characterized by a breakdown of Flow and concomitant compensatory repetition resulting in an overly structured time. Finally, we speculate about possible implications of these findings both for psychopathological and neuroscientific research. (shrink)

H. L. A. Hart’s (1907-1992) influence on contemporary philosophy is not restricted to the philosophy of law. As the book’s sub-title suggests and the table of contents confirm, he wrote widely on matters social, political and moral, not just legal. Probably best known for The Concept of Law (1961), Hart also authored a collection of essays on Jeremy Bentham (Essays on Bentham,1982), two books on the morality of criminal law based on his exchange with Lord Patrick Devlin (Law, Liberty and (...) Morality, 1963) and The Morality of the Criminal Law, 1965), one on punishment (Punishment and Responsibility, 1968), a treatise as well as a collection of essays on jurisprudential theory (Definition and Theory in Jurisprudence, 1953, and Essays in Jurisprudence and Philosophy, 1983), and finally a volume on legal causation, co-authored with Tony Honoré (Causation in the Law, 1959). The book under review here, on Hart’s legacy, is divided into six sections: the first is devoted to Hart’s general jurisprudential theory; the second to his writings on criminal law; the third to legal causation; the fourth to concerns of justice; the fifth to legal, political and moral rights; and the sixth and final section to matters of toleration and liberalism. (shrink)

Today’s panel is about the expanding boundary of population health policy, what that expanding boundary has to do with law, and what kinds of challenges and opportunities come out of it. What I want to do for the next few minutes is talk to you about the notion of population health as it exists where law and policy are made, rather than where it exists in a spectacular international theoretical literature. Then I want to introduce our panelists. In the process, (...) I will explain why the Honorable John Nilson, is not with us, which tells you a great deal about not only the real world of the politics of population health, but also about the kind of trouble you can get into if you are a first class lawyer involved in population health. (shrink)

The framework of Findlay & Walker's target article provides a first attempt to model the saccadic system at all levels. Their scheme is based on two main principles. These are “parallel processing of saccade timing and metrics” and “competitive inhibition through winner-take-all strategies.” In our opinion, however, both concepts are in their strictest sense at odds with the current knowledge of the saccadic system, and need to be refined to make the scheme more relevant.