Background: Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study of the role of nurses in medical end-of-life decisions in hospitals, home care and nursing homes.Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, (...) home care and nursing homes are described and compared.Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals and nursing homes and less frequently in home care situations . In some cases , nurses administered the euthanatics.Conclusions: The results show substantial differences between the intramural sector and the extramural sector , which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians. (shrink)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)

Background Speech understanding may rely not only on auditory, but also on visual information. Non-invasive functional neuroimaging techniques can expose the neural processes underlying the integration of multisensory processes required for speech understanding in humans. Nevertheless, noise (from fMRI) limits the usefulness in auditory experiments, and electromagnetic artefacts caused by electronic implants worn by subjects can severely distort the scans (EEG, fMRI). Therefore, we assessed audio-visual activation of temporal cortex with a silent, optical neuroimaging technique: functional near-infrared spectroscopy (fNIRS). Methods (...) We studied temporal cortical activation as represented by concentration changes of oxy- and deoxy-hemoglobin in four, easy-to-apply fNIRS optical channels of 33 normal-hearing adult subjects and 5 post-lingually deaf cochlear implant (CI) users in response to supra-threshold unisensory auditory and visual, as well as to congruent auditory-visual speech stimuli. Results Activation effects were not visible from single fNIRS channels. However, by discounting physiological noise through reference channel subtraction, auditory, visual and audiovisual speech stimuli evoked concentration changes for all sensory modalities in both cohorts (p<0.001). Auditory stimulation evoked larger concentration changes than visual stimuli (p<0.001). A saturation effect was observed for the audiovisual condition. Conclusions Physiological, systemic noise can be removed from fNIRS signals by reference channel subtraction. The observed multisensory enhancement of an auditory cortical channel can be plausibly described by a simple addition of the auditory and visual signals with saturation. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

It is gratifying to see that philosophers' continued interest in Words and Objections has been so strong as to motivate a paperback edition. This is gratifying because it vindicates the editors' belief in the permanent im portance of Quine's philosophy and in the value of the papers com menting on it which were collected in our volume. Apart from a couple of small corrections, only one change has been made. The list of Professor Quine's writings has been brought up to (...) date. The editors cannot claim any credit for this improvement, however. We have not tried to imitate the Library of Living Philosophers volumes and to include Professor Quine's autobiography in this volume, but we are fortunate to publish here his brand-new auto bibliography. 1975 THE EDITORS TABLE OF CONTENTS V PREFACE 1 EDITORIAL INTRODUCTION 1. 1. C. SMAR T / Quine's Philosophy of Science 3 GILBERT HARMAN / An Introduction to 'Translation and Meaning', Chapter Two of Word and Object 14 ERIK STENIUS / Beginning with Ordinary Things 27 NOAM CHOMSKY / Quine's Empirical Assumptions 53 1AAKKO HINTIKKA / Behavioral Criteria of Radical Translation 69 BARRY STROUD / Conventionalism and the Indeterminacy of Translation 82 P. F. STRA WSON / Singular Terms and Predication 97 118 H. P. GRICE / Vacuous Names P. T. (shrink)

Reductionism as a scientific methodology has been extraordinarily successful in biology. However, recent developments in molecular biology have shown that reductionism is seriously inadequate in dealing with the mind-boggling complexity of integrated biological systems. This title presents an appropriate balance between science and philosophy and covers traditional philosophical treatments of reductionism as well as the benefits and shortcomings of reductionism in particular areas of science. Discussing the issue of reductionism in the practice of medicine it takes into account the holistic (...) and integrative aspects that require the context of the patient in his biological and psychological entirety. The emerging picture is that what first seems like hopeless disagreements turn out to be differences in emphasis. Although genes play an important role in biology, the focus on genetics and genomics has often been misleading. The consensus view leads to pluralism: both reductionst methods and a more integrative approach to biological complexity are required, depending on the questions that are asked. * An even balance of contributions from scientists and philosophers of science - representing a unique interchange between both communities interested in reductionism. (shrink)

The biological sciences study (bio)complex living systems. Research directed at the mechanistic explanation of the "live" state truly requires a pluralist research program, i.e. BioComplexity research. The program should apply multiple intra-level and inter-level theories and methodologies. We substantiate this thesis with analysis of BioComplexity: metabolic and modular control analysis of metabolic pathways, emergence of oscillations, and the analysis of the functioning of glycolysis.

This article addresses the research question: “How do Dutch highly educated Muslim women of Moroccan descent use prayer in dealing with problems?” The theoretical framework was mainly based on the work of Pargament et al. regarding religious coping. The empirical part of the study consisted of a quantitative and a qualitative part. This article presents results of the quantitative part. For the quantitative part of our research, 177 questionnaires were collected using snowball sampling. We asked respondents about their praying practices (...) and their ways of religious coping, using the Brief RCOPE. The connection and communication in their prayer with a loving, caring, benevolent God is the main religious way in which these Muslim women of Moroccan descent cope with all kinds of problems. This use of prayer as a way of coping can be clarified through the psychological functions of religiosity and prayer that are suggested by Pargament, Koenig, and Perez. Prayer could help them in: finding meaning, being master over their circumstances and controlling their emotions, finding comfort and closeness to God, experiencing intimacy with others and closeness to God, and transforming their way of life. We did find few negative religious coping strategies, such as negative feelings towards God or alienation. This is in line with research results of Abu Raiya and Pargament. As Islam implies surrender to God, it may be difficult for Muslims to admit their religious distress, doubts, and struggles. (shrink)