A longitudinal, epidemiological study was carried out in a rural area of Kenya with a population of about 28,000 between 1974 and 1980. Population registration during this time showed that population growth was very high between 1974 and 1978 (4·4% per year) and much lower in 1979 and 1980 (1·1%). Natural increase was nearly as high as in Kenya as a whole (3·7%) in this period. Fertility was somewhat lower than in all Kenya (the crude birth rate was 46 per (...) 1000) while mortality was substantially lower (7 per 1000). Evidence is presented supporting the argument that these low mortality rates are genuine. Levels of temporary and permanent migration are high and probably characteristic for many parts of Kenya. The change in population growth in 1979 and 1980 is probably due to changes in economic conditions leading in particular to less in-migration and to more out-migration. (shrink)

BACKGROUND: Delusions in schizophrenia are commonly approached as empirical false beliefs about everyday reality. Phenomenological accounts, by contrast, have suggested that delusions are more adequately understood as pertaining to a different kind of reality experience. How this alteration of reality experience should be characterised, which dimensions of experiential life are involved, and whether delusional reality might differ from standard reality in various ways is unclear and little is known about how patients with delusions value and relate to these experiential alterations. (...) This study aimed to investigate the nature of delusional reality experience, and its subjective apprehension, in individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis. METHODS: In this qualitative phenomenological study, we recruited individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis from two psychiatric-hospital services in Belgium using homogenous sampling. Criteria for participation were having undergone at least one psychotic episode with occurring delusional symptoms, present at least 1 year before participation, on the basis of clinical notes assessed by the attending psychiatrist; a schizophrenia-spectrum diagnosis, ascertained through clinical interview by the attending psychiatrist upon admission; being aged between 18 years and 65 years; and having the capacity to give informed consent. Exclusion criteria included worries concerning capacity to consent and risk of distress caused by participation. We did phenomenologically driven semi-structured interviews with the participants to explore the nature of delusional reality experience and their subjective valuation of these experiences. We used interpretative phenomenological analysis, a qualitative method tailored to the in-depth exploration of participants’ first-person perspective, to analyse their accounts. FINDINGS: Between March 2, 2020, and Sept 30, 2020, 18 adults participated in the interview study. The findings suggest that delusions are often embedded in wide-ranging alterations of basic reality experience, involving quasi-ineffable atmospheric and ontological qualities that undermine participants’ sense of the world as unambiguously real, fully present, and shared with others. We also found that delusional reality experience can differ from standard reality in various ways, across multiple dimensions, and that participants are often implicitly or explicitly aware of the distinction between delusional and standard reality. Delusional experience can have an enduring value and meaning that is not fully captured by a strictly medical perspective. INTERPRETATION: Increased awareness and recognition of the distinctive nature of delusional reality experience, in both clinical and research settings, can improve diagnostic accuracy, explanatory models, and therapeutic support for individuals with delusions whose lived realities are not always evident from an everyday perspective. FUNDING: FWO Flanders. TRANSLATION: For the Dutch translation of the abstract see Supplementary Materials section. (shrink)

This paper examines mortality by cause of death in a rural area of Machakos district in Kenya. The cause-of-death data collected between 1975 and 1978 were likely to be of fairly good quality. The number of deaths was higher among infants and children. Infectious diseases and diseases of the respiratory system were the leading causes of death among children below 5 years of age. Next in prominence were the causes ascribed to congenital anomalies and perinatal conditions.Among adolescents and young adults, (...) injury and poisoning, together with tuberculosis and other infectious and parasitic diseases, were the leading causes of death. Degenerative diseases, especially diseases of the circulatory system and neoplasms and respiratory illness, were responsible for the majority of deaths among the older population. (shrink)

Background: The Declaration of Helsinki, the World Medical Association’s statement of ethical guidelines regarding medical research, is published in the three official languages of the WMA: English, French and Spanish.Methods: A detailed comparison of the three official language versions was carried out to determine ways in which they differed and ways in which the wording of the three versions might illuminate the interpretation of the document.Results: There were many minor linguistic differences between the three versions. However, in paragraphs 1, 6, (...) 29, 30 and in the note of clarification to paragraph 29, there were differences that could be considered potentially significant in their ethical relevance.Interpretation: Given the global status of the Declaration of Helsinki and the fact that it is translated from its official versions into many other languages for application to the ethical conduct of research, the differences identified are of concern. It would be best if such differences could be eliminated but, at the very least, a commentary to explain any differences that are unavoidable on the basis of language or culture should accompany the Declaration of Helsinki. This evidence further strengthens the case for international surveillance of medical research ethics as has been proposed by the WMA. (shrink)

Artificial intelligence (AI) and machine learning (ML) are increasingly integrated into the functioning of physical and digital products, creating unprecedented opportunities for interaction and functionality. However, there is a challenge for designers to ideate within this creative landscape, balancing the possibilities of technology with human interactional concerns. We investigate techniques for exploring and reflecting on the interactional affordances, the unique relational possibilities, and the wider social implications of AI systems. We introduced into an interaction design course (_n_ = 100) nine (...) ‘AI exercises’ that draw on more than human design, responsible AI, and speculative enactment to create experiential engagements around AI interaction design. We find that exercises around metaphors and enactments make questions of training and learning, privacy and consent, autonomy and agency more tangible, and thereby help students be more reflective and responsible on how to design with AI and its complex properties in both their design process and outcomes. (shrink)

AimsThis preliminary study aimed to investigate therapy-induced electrophysiological changes in persons with primary progressive aphasia. The investigated event-related potential components associated with language processing were the mismatch negativity, P300, N400, and P600.MethodsA linguistic ERP test battery and standardized language assessment were administered in four patients with PPA of which two received speech-language therapy and two did not receive therapy. The battery was administered twice with approximately 6 months in between in each patient. The results of the follow-up assessments were compared (...) to the results of the initial assessments.ResultsAlthough the results of the behavioral language assessment remained relatively stable between the initial and follow-up assessments, changes in the mean amplitudes, onset latencies, and duration of the ERP components were found in the four patients. In the two patients that did not receive SLT, an increased delay in 50% and a decreased mean amplitude in 25% of the measured ERP components were found. The electrophysiological changes found in the patients that received SLT were variable. Interestingly, the mismatch negativity and the N400 effect elicited by the categorical priming paradigm were less delayed and had an increased mean amplitude at the follow-up assessment in the patient with the non-fluent variant who received SLT. In this patient, the P600 component was absent at the initial assessment but present at the follow-up assessment.ConclusionAlthough no clear patterns in electrophysiological changes between patients who received SLT and patients who did not receive SLT were found by our preliminary study, it seems like the SLT induced improvements or compensation mechanisms in some specific language comprehension processes in the patient with the NFV. The results of this study are still preliminary because only four heterogeneous patients were included. Future studies should include larger patient groups of the three clinical variants because the therapy-induced electrophysiological changes might differ depending on the clinical variant and the underlying pathology. (shrink)

Wouter Van Haaften; The Justification of Conceptual Development Claims, Journal of Philosophy of Education, Volume 24, Issue 1, 30 May 2006, Pages 51–70, https.

Lysophosphatidic acid (LPA) is a lipid mediator with a wide variety of biological actions, particularly as an inducer of cell proliferation, migration and survival. LPA binds to specific G‐protein‐coupled receptors and thereby activates multiple signal transduction pathways, including those initiated by the small GTPases Ras, Rho, and Rac. LPA signaling has been implicated in such diverse processes as wound healing, brain development, vascular remodeling and tumor progression. Knowledge of precisely how and where LPA is produced has long proved elusive. Excitingly, (...) it has recently been discovered that LPA is generated from precursors by ‘autotaxin’, a once enigmatic exo‐phosphodiesterase implicated in tumor cell motility. Exogenous phospholipases D can also produce LPA, which may contribute to their toxicity. Here we review recent progress in our understanding of LPA bioactivity, signaling and synthesis. BioEssays 26:870–881, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

I defend that the development of children may include foundational change, such that stages can be reconstructed representing different views of (the relevant aspect of) reality and involving different forms of judgement in that domain. This implies fundamental stage-relativism. Claims that such stages are better than their forerunners can be justified, if at all, only on stage-bound criteria. This does not preclude the possibility of justibing them, however, except to persons in lower stages. The development produces the possibility of its (...) justijcation. Education cannot, therefore, be conceived as commuunication between equals. Reality is different for children, not simply defective or wrong. (shrink)

An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease, involving dialysis or conservative care. Shared decision-making is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift (...) from a biomedical to a person-centered conception might help to make the process more shared. Shared should, therefore, be interpreted as two persons bringing two perspectives to the table, that both need to be explored during the decision-making process. Starting from the patient’s perspective will enable to determine the mutual goals of care first and, subsequently, determine the best way for achieving those goals. To perform such SDM, the healthcare professional needs to become a skilled companion, being part of the patient’s relational context, and start asking the right questions about what matters to the patient as person. In this article, we describe the need for a person-centered conception of SDM for the setting of older patients with advanced CKD. (shrink)

The aim of this empirical study is to understand how bachelor students at universities of applied sciences (UAS) use their ethical compasses during internships. Semi-structured interviews were held with 36 fourth-year bachelor students across four UAS and three different programs in the Netherlands: Initial Teacher Education, Business Services, and Information and Communication Technology. To our knowledge, no studies appear to have investigated and compared students from multiple professional fields, nor identified the dynamics and the sequence of the strategies in the (...) decision-making process that students use when faced with ethical dilemmas during internships. We found that students’ ethical dilemmas stemmed from: mentors’ or managers’ behaviours/requests, colleagues’ behaviours, organisations’ morally questionable incentives, pupils’ home situations, and pupils’ behaviours/personal stories. The majority of students used multiple strategies and first investigated the ethical dilemmas they encountered and then avoided, intervened, delegated responsibilities, or adjusted to their environments. Students’ values played an important role in experiencing an ethical dilemma, however, these values were not always acted upon. We identified that rather students’ beliefs about having influence and/or ownership (or not), personal interest(s) and power relations influenced the way how they used their ethical compasses. Thus, instead of navigating on moral standards (of their profession), students reacted on beliefs which reflected the ways in which they constructed their internship contexts, social relationships and their own (and others) needs. As a result, half of the mentioned dilemmas were resolved in a prudent-strategic manner (e.g., by prioritising personal interests), instead of morally. This indicates that students did not always convert (moral) values into moral action and did not use their ethical compasses in the way UAS aspires. Finally, this study found that the ways in which students used their ethical compasses were strongly influenced by their environments. (shrink)

Adolescence is a period of life during which peers play a pivotal role in decision-making. The narrative of social influence during adolescence often revolves around risky and maladaptive decisions, like driving under the influence, and using illegal substances. However, research has also shown that social influence can lead to increased prosocial behaviors and a reduction in risk-taking. While many studies support the notion that adolescents are more sensitive to peer influence than children or adults, the developmental processes that underlie this (...) sensitivity remain poorly understood. We argue that one important reason for this lack of understanding is the absence of precisely formulated models. To make a first step toward formal models of social influence during adolescence, we first identify three prominent verbal models of social influence in the literature: social motivation, reward sensitivity, and distraction. We then illustrate how these can be translated into formal models, and how such formal models can inform experimental design and help identify developmental processes. Finally, by applying our formal models to existing datasets, we demonstrate the usefulness of formalization by synthesizing different studies with seemingly disparate results. We conclude with a discussion on how formal modeling can be utilized to better investigate the development of peer influence in adolescence. (shrink)

Both the concept of a Darwinian tree of life (TOL) and the possibility of its accurate reconstruction have been much criticized. Criticisms mostly revolve around the extensive occurrence of lateral gene transfer (LGT), instances of uptake of complete organisms to become organelles (with the associated subsequent gene transfer to the nucleus), as well as the implications of more subtle aspects of the biological species concept. Here we argue that none of these criticisms are sufficient to abandon the valuable TOL concept (...) and the biological realities it captures. Especially important is the need to conceptually distinguish between organismal trees and gene trees, which necessitates incorporating insights of widely occurring LGT into modern evolutionary theory. We demonstrate that all criticisms, while based on important new findings, do not invalidate the TOL. After considering the implications of these new insights, we find that the contours of evolution are best represented by a TOL. (shrink)

Psychological safety is important for the well-being and productivity of people in the workplace. Psychological safety becomes even more important and even more difficult to maintain in times of uncertainty. Previous research mainly focused on the influence of and on interpersonal relationships. This study applies an individual perspective by investigating what is needed on an individual level in order to build psychological safety. The expectation was that self-compassion induces an individual to experience higher positive affect, and this advances the development (...) of positive relations and social acceptance. Moreover, we assumed that the mediation of the relationship between self-compassion and positive relations and social acceptance by positive affect is moderated by the level of basic need satisfaction. Participants from the Netherlands and Belgium completed an online questionnaire about their level of self-compassion, basic need satisfaction, positive affect and positive relations and social acceptance. Using hierarchical regression analyses for moderated mediation analysis, results showed that self-compassion and positive affect had a significant positive effect on positive relations and social acceptance. Positive affect significantly mediated the relationship between self-compassion and positive relations and social acceptance, when basic need satisfaction was low, but not when basic need satisfaction was high. Our research showed that individuals need either their basic needs satisfied or self-compassion so they can build the high-quality relations needed to stimulate psychological safety. This finding shifts attention from the dyadic relationship to the individual and highlights important factors at the individual level which advance the development of high-quality relationships with others. (shrink)

I defend that the development of children may include foundational change, such that stages can be reconstructed representing different views of (the relevant aspect of) reality and involving different forms of judgement in that domain. This implies fundamental stage-relativism. Claims that such stages are better than their forerunners can be justified, if at all, only on stage-bound criteria. This does not preclude the possibility of justibing them, however, except to persons in lower stages. The development produces the possibility of its (...) justijcation. Education cannot, therefore, be conceived as commuunication between equals. Reality is different for children, not simply defective or wrong. (shrink)

Traditional theory of mind (ToM) accounts for social cognition have been at the basis of most studies in the social cognitive neurosciences. However, in recent years, the need to go beyond traditional ToM accounts for understanding real life social interactions has become all the more pressing. At the same time it remains unclear whether alternative accounts, such as interactionism, can yield a sufficient description and explanation of social interactions. We argue that instead of considering ToM and interactionism as mutually exclusive (...) opponents, they should be integrated into a more comprehensive account of social cognition. We draw on dual process models of social cognition that contrast two different types of social cognitive processing. The first type (labeled Type 1) refers to process es that are fast, efficient, stimulus-driven, and relatively inflexible. The second type (labeled Type 2) refers to processes that are relatively slow, cognitively laborious, flexible, and may involve conscious control. We argue that while interactionism captures aspects of social cognition mostly related to Type 1 processes, ToM is more focused on those based on Type 2 processes. We suggest that real life social interactions are rarely based on either Type 1 or Type 2 processes alone. On the contrary, we propose that in most cases both types of processes are simultaneously involved and that social behavior may be sustained by the interplay between these two types of processes. Finally, we discuss how the new integrative framework can guide experimental research on social interaction. (shrink)

The contribution that Professor Pieter M. Venter has made to the study of the Old Testament during his academic and ecclesiastic career is reviewed. After a brief biographical introduction, the article surveys the development of his research interests, focusing specifically on his contributions to the study of wisdom literature, narratives and narratology, second temple literature, the formation of the canon, and Old Testament Theology. The review concludes with reference to his way of practising critical theology, taking full cognisance of research (...) into the linguistic, historical critical, narratological and ideological aspects of Old Testament texts, but always with a sensitivity for the needs of the church as interpretive community. (shrink)

Religion can affect public support for the European Union. However, specifying the circumstances under which religion may become a stronger predictor of EU-support has so far been neglected. This article shows that the media play a role in this process and it is investigated to what extent the presence or absence of references to religious issues in EU news coverage primes people's religious attitudes to contribute to their evaluation of the EU. For this purpose, a content analysis of the amount (...) of religious news items in EU coverage in German and Dutch newspapers between 1997 and 2007 was conducted. Two points in time were chosen — 1998, when only a small amount of religious news items appeared in EU coverage, and 2005, when religious items reached a peak. Eurobarometer data were used to test the media priming proposition. The findings show that an increasing religious dimension in media coverage about the EU primes a linkage between religious and political considerations and thus influences the strength of the impact of religion on attitudes towards the EU. (shrink)

The expression that professionals should be led by their moral or ethical compass is increasingly used by academics, policy makers, professionals, and educational institutes. Dutch universities of applied sciences (UAS), for example, explicitly aim to educate their students to become professionals equipped with a moral compass. This moral or ethical compass is a metaphor of which people intuitively grasp its meaning, but our literature review also shows that various interpretations are possible. We found three clusters of proposed ethical compasses expressing (...) its a) content, b) form, or c) use, which we present in this article. Thereafter, we evaluate which compass can meaningfully assist (young) professionals and, therefore, should be part of the aims and content of education provided by UAS. Based on this evaluation, we describe the possibilities and boundaries of UAS’ contribution to the development of their students’ ethical compass. (shrink)

This article introduces the methodology of the ‘Ontology Explorer’, a semantic method and JavaScript-based open-source tool to analyse data models underpinning information systems. The Ontology Explorer has been devised and developed by the authors, who recognized a need to compare data models collected in different formats and used by diverse systems. The Ontology Explorer is distinctive firstly because it supports analyses of information systems that are not immediately comparable and, secondly, because it systematically and quantitatively supports discursive analysis of ‘thin’ (...) data models – also by detecting differences and absences through comparison. When applied to data models underpinning systems for population management, the Ontology Explorer enables the apprehension of how people are ‘inscribed’ in information systems: which assumptions are made about them, and which possibilities are excluded by design. The Ontology Explorer thus constitutes a methodology to capture authorities’ own imaginaries of populations and the ‘scripts’ through which they enact actual people. Furthermore, the method allows the comparison of scripts from diverse authorities. This is exemplified by illustrating its functioning with information systems for population management deployed at the European border. Our approach integrates a number of insights from early infrastructure studies and extends their methods and analytical depth to account for contemporary data infrastructures. By doing so, we hope to trigger a systematic discussion on how to extend those early methodical innovations at the semantic level to contemporary developments in digital methods. (shrink)

ObjectiveInformed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers’ beliefs and experiences related to principles and practice of informed consent.MethodsQualitative study conducted between January and June 2018 in a rural 150-bed mission hospital in Southern Malawi. Clinical observations, semi-structured interviews and a focus group (...) discussion were used to collect data. Participants were 22 clinical officers, nurse-midwives and midwifery students involved in maternity care. Data were analysed to identify themes and construct an analytical framework.ResultsDefinition and purpose of informed consent revolved around providing information, respecting women’s autonomy and achieving legal protection. Due to fear of blame and litigation, health workers preferred written consent. Written consent requires active participation by the consenting individual and was perceived to transfer liability to that person. A woman’s refusal to provide written informed consent may pose a dilemma for the health worker between doing good and respecting autonomy. To prevent such refusal, health workers said to only partially disclose surgical risks in order to minimize women's anxiety. Commonly perceived barriers to obtain a fully informed consent were labour pains, language barriers, women’s lack of education and their dependency on others to make decisions.ConclusionsHealth workers are familiar with the principles around informed consent and aware of its advantages, but fear of blame and litigation, partial disclosure of risks and barriers to communication hamper the process of obtaining informed consent. Findings can be used to develop interventions to improve the informed consent process. (shrink)

This paper makes a small point concerning the contraposition of relativism and absolutism. Relativism need not be vulnerable to the self‐refutation argument; as for internal consistency both positions can be equally right. They are asymmetric, however, in that according to the absolutist only one of the two positions can be right, whereas from the relativist's viewpoint they can both be right.

In this empirical study, we investigate _what_ and _how_ teachers in Dutch universities of applied sciences (UAS) think they contribute to the development of students’ ethical compasses. Six focus groups were conducted with teachers across three programmes: Initial Teaching Education, Business Services, and Information and Communication Technology. This study revealed that teachers across the three different professional disciplines shared similar ideas about what should be addressed in the development of students’ ethical compasses. Their contributions were grouped into three core themes: (...) creating students’ moral awareness, developing students’ moral skills and promoting students’ moral professional behaviour. The majority of the teachers used a wide range of planned and unplanned pedagogic–didactic actions (reflecting individual learning and cooperative and group learning) to enhance the development of students’ ethical compasses. However, teachers’ strategies were mostly unstructured and unreflective and depended on the individual teacher’s ability and knowledge to address moral themes. Furthermore, the study revealed two incompatible ideals: as role models, the teachers aimed to exemplify explicitly how to be a professional with an ethical compass. However, they also wanted to adopt a neutral stance because they were afraid to manipulate the students’ ethical compasses. Therefore, they avoided promoting _the_ ethical compass that they believed to be the best. (shrink)

Wouter Van Haaften; The Justification of Conceptual Development Claims, Journal of Philosophy of Education, Volume 24, Issue 1, 30 May 2006, Pages 51–70, https.