AbstractWhen considering the manner of death, two categories can be distinguished, namely natural death and unnatural death. Though most physicians think that the distinction between the two is evident, this is not the case.When comparing the Netherlands, Belgium, England and Germany it is noticed that the terms natural and unnatural might be used in law but are not defined by law. In practice, the term unnatural death is used when there is an external cause of death, but even that turns (...) out to not be sufficient in making an obvious difference between the two terms. Different countries may even label the same death differently. A, at times philosophical and semantic, discussion shows that when it comes to causes of death a very large grey area exists between natural and unnatural causes of death. The Netherlands, Belgium and Germany even have the possibility to label a death as natural without actually knowing the cause of death.In conclusion, we recommend a new system in which the circumstances surrounding a death are properly investigated. This should lead to a report to an independent legal expert, who is able to decide if and what conclusion can be drawn, from a judicial and a public point of view, thereby, making the distinction and the use of the terms natural and unnatural/nonnatural obsolete. (shrink)

Mental models influence how individuals think and act in relation to their external environment and have been identified as leverage points to address sustainability challenges. Given the importance of mental models, a new tool to assess mental models has been developed: the Mental Model Mapping Tool. M-Tool was designed to have a standardized format and to be user-friendly for low literacy populations, using pictograms and audio instructions. In this paper, we evaluate M-Tool’s application in two studies with Tanzanian fishers. In (...) Study 1, we investigated M-tool’s convergent validity compared to standard interviewing methods. Study 2 investigated M-Tool’s construct validity by relating mental model complexity to participants’ education level, a relationship that has been well established. The findings show that mental models produced with M-Tool are more complex than mental models obtained through interviewing techniques; model composition is similar across the two methods; and participants with higher levels of education tend to produce more complex mental models with M-Tool than participants with lower levels of education, in line with previous research. These findings suggest that M-Tool can successfully capture mental models among diverse participants. This tool offers researchers and practitioners an instrument to map and compare perceptions of challenges across groups. (shrink)

Research skills are important for university graduates, but little is known about undergraduates’ motivation for research. In this study, self-efficacy beliefs and intrinsic motivation for several research activities were measured three times during an undergraduate research project. In order to promote self-efficacy for writing and collaboration, a collaboration script was developed and tested on half of the students. Twelve students were interviewed three times to gather in-depth information about motivational and self-efficacy beliefs. All measures except intrinsic motivation for research increased (...) significantly during the project. Interview results suggest that enactive mastery and positive social interdependence promoted self-efficacy. Feelings of relatedness seemed to promote intrinsic motivation for writing. Lack of autonomy and low perceived relevance may explain why motivation for research remained stable. The script had no impact on self-efficacy beliefs. Relatedness,... (shrink)

Este artículo sostiene que Platón constituye un interlocutor fructífero para la Teoría crítica. Desde un diálogo con Axel Honneth, argumentaremos primero que la metodología de crítica social desarrollada en la República posee elementos constructivo-racionales y reconstructivo-hermenéuticos. Luego, enfatizaremos dos conceptos prefigurados en dicha obra que, mediante Hegel, yacen en el trasfondo de la Teoría crítica, a saber: holismo y patología social. Ello nos permitirá articular, como conclusión, una “dialéctica de la justicia” que, en el sentido de Adorno & Horkheimer, recorre (...) la obra de Honneth. (shrink)

Protests that target firms’ socially irresponsible behavior are increasingly organized via digital media. This study uses two methods to investigate the effects that online protests and mitigating firm responses have on shareholders’ and consumers’ evaluation. The first method is a financial analysis that includes an event study which measures the effect of online protests on the target firm’s share price, as well as an investigation of the boundary effects of protest characteristics. The second method is an online experiment that assesses (...) the effect of an online protest campaign on consumers’ perception and purchase intention, as well as any mitigating effects that a firm’s response may have. Contrary to recent studies suggesting that participation in online protests is only token support without any substantive effects, our results show that online protests do hurt. Firms can expect to suffer financial, reputational, and sales damage when an online protest campaign mobilizes consumers successfully. We also show that online protests are more likely to take firms by surprise than offline protests. Firms can exacerbate or reduce the damage by their response. We find that although firms may repair the damage to consumers’ purchase intentions, the negative effects on a brand’s image are harder to rectify. The results have valuable implications for protest organizers and managers faced with the task of responding. (shrink)

Eco-anxiety increasingly weighs on (young) people’s mental health and impacts their life choices. This commentary zooms in on socio-ecological reproductive concerns with the aim to provide room for collective doubts on this individual choice, and to normalize emotions of anxiety, fear, grief, guilt, and regret, among many others, because of it.

Text interpretation – the main interest of discourse analysts – is a central component of the text understanding process. In this article we introduce the Landscape Model, which describes the cognitive processes underlying reading comprehension in a detailed and precise manner. Moreover, this model captures the interpretative processes in which the human mind engages during reading. Within the context of the Landscape Model, we describe the relation between discourse understanding and discourse interpretation, and explain some of the phenomena that are (...) central to the field of discourse analysis as seen from a cognitive perspective. In the first section we describe the basic cognitive processes that underlie discourse understanding, as captured by the Landscape Model. In the following section we illustrate the way that the Landscape Model can be applied to the work of discourse analysts. We conclude by discussing the usefulness of the cognitive Landscape Model for the field of discourse analysis. (shrink)

Over recent decades, developments in network governance have seen governments around the world cede considerable authority and responsibility to commercial migration intermediaries for recruiting and managing temporary migrant labour. Correspondingly, a by-product of network governance has been the emergence of soft employment regulation in which voluntary codes of conduct supplement hard legal employment standards. This paper explores these developments in the context of temporary migrant workers employed in Australian horticulture. First the paper analyses the growing use of temporary migrant labour (...) in this industry. It then describes how different types of intermediaries interact with this workforce. The paper then outlines both hard and soft employment regulations, and contrasts them with actual employment conditions, questioning how a network governance approach has affected this vulnerable workforce. The paper concludes that changes in network governance of migration and employment relations have emasculated formal legal regulation, leaving market forces to operate without effective or ethical constraints at the expense of the public good. (shrink)

OBJECTIVES: Cognitive and sensory difficulties frequently jeopardize informed consent of frail elderly patients This study is the first to test whether preliminary research experience could enhance geriatric patients' capacity to consent. DESIGN/SETTING: A step-wise consent procedure was introduced in a study on fluid balance in geriatric patients. Eligible patients providing verbal consent participated in a try-out of a week, during which bioelectrical impedance and weight measurements were performed daily. Afterwards, written informed consent was requested. Comprehension, risk and inconvenience scores (ranges: (...) 0-10) were obtained before and after the try-out by asking ten questions about the study's essentials and by asking for a risk and inconvenience assessment on a ten-points rating scale. SUBJECTS AND RESULTS: Seventy of the 78 eligible subjects started the try-out and 53 (68%) provided written consent. The comprehension score increased from 5.0 (+/- 2.3) to 7.0 (+/- 1.9) following the try-out (P < 0.001). The number of subjects capable of weighing risks and inconveniences increased from 32 to 48 (P < 0.001). CONCLUSIONS: Research experience improved the capacity to consent, still enabling an acceptable participation rate. Therefore, experienced consent seems a promising tool to optimize informed consent in frail elderly subjects. (shrink)

Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of (...) the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

There are many ways to assess face perception skills. In this study, we describe a novel task battery FEAST (Facial Expression Action Stimulus Test) developed to test recognition of identity and expressions of human faces as well as stimulus control categories. The FEAST consists of a neutral and emotional face memory task, a face and object identity matching task, a face and house part-to-whole matching task, and a human and animal facial expression matching task. The identity and part-to-whole matching tasks (...) contain both upright and inverted conditions. The results provide reference data of a healthy sample of controls in two age groups for future users of the FEAST. (shrink)

In order to contain public care expenditure, policymakers in the Netherlands have over the last decades formulated in ever more stringent ways what ought to be expected from spouses, partners, and family members with regard to care for dependent relatives. The current Dutch coalition cabinet plans to shift the principal responsibility for nonmedical care, including demanding forms of care such as long-term personal care, to individuals and families. I argue that these policy developments imply cost redistribution rather than cost containment (...) and that this redistribution is disadvantageous for women. (shrink)

Vaccination programmes against infectious diseases aim to protect individuals from serious illness but also offer collective protection once a sufficient number of people have been immunized. This so-called ‘herd immunity’ is important for individuals who, for health reasons, cannot be immunized or who respond less well to vaccines. For these individuals, it is pivotal that others establish group protection. However, herd immunity can be compromised when people deliberately decide not to be immunized and benefit from the herd’s protection. These agents (...) are often referred to as free riders: their omissions are deemed to be unfair to those who do contribute to the collective’s health. This article addresses the unfairness of such ‘free riding’. An argument by Garett Cullity is examined, which asserts that the unfairness of moral free riding lies neither in one’s intentions, nor in one’s reluctance to embrace a public good. This argument offers a strong basis for justifiably arguing that free riding is unfair. However, it is then argued that other considerations also need to be taken into account before simply holding free riding against non-compliers. (shrink)

PurposeThe purpose of this study is to describe the implementation and outcomes of an Eye Movement and Desensitization Reprocessing treatment-program for women with posttraumatic stress disorder after childbirth.MethodsA prospective cohort-study with pre- and post-measurements was carried out in the setting of an academic hospital in the Netherland. Included were women who gave birth to a living child at least 4 weeks ago, with a diagnosis of PTSD, or severe symptoms of PTSD combined with another psychiatric diagnosis. All received up to (...) 8 sessions of EMDR-therapy. The posttraumatic stress disorder Checklist for DSM-5 was administered before and after treatment. Trauma history was assessed before treatment with the Life Events Checklist for the DSM-5, the Childhood Trauma Questionnaire and the Childbirth Perception Scale. Descriptive statistics were used.ResultsForty-four women were referred, 26 met the inclusion criteria. After treatment, none of the women met the criteria for diagnosis of PTSD after on average 5 weekly sessions of EMDR- therapy. These outcomes are promising, as they were achieved in women with relatively high levels of psychiatric comorbidity and high rates of previous mental health treatment.ConclusionImplementing an EMDR-treatment program for women with PTSD after childbirth in the setting of an academic hospital is feasible and effective. Key factors for success include a close collaboration between the relevant hospital departments and a thorough case conceptualization addressing the etiology of the PTSD. (shrink)

A theory of the joint measurement of quantum mechanical observables is generalized in order to make it applicable to the measurement of the local observables of field theory. Subsequently, the property of local commutativity, which is usually introduced as a postulate, is derived by means of the theory of measurement from a requirement of mutual nondisturbance, which, for local observables performed at a spacelike distance from each other, is interpreted as a requirement of macrocausality. Alternative attempts at establishing a deductive (...) relationship between relativistic causality and local commutativity are reviewed, but found wanting, either because of the assumption of an unwarranted objectivity of the object system (algebraic approach) or because of the use of a projection postulate (operational approach). Finally, the quantum mechanical nonobjectivity is related to certain features of nonlocality which are present in the formalism of quantum mechanics. (shrink)

Objectives: Efficient procedures for obtaining informed (proxy) consent may contribute to high influenza vaccination rates in nursing homes. Yet are such procedures justified? This study’s objective was to gain insight in informed consent policies in Dutch nursing homes; to assess how these may affect influenza vaccination rates and to answer the question whether deviating from standard informed consent procedures could be morally justified. Design: A survey among nursing home physicians. Setting & Participants: We sent a questionnaire to all (356) nursing (...) homes in the Netherlands, to be completed by one of the physicians. Results: We received 245 completed questionnaires. As 21 institutions appeared to be closed or merged into other institutions, the response was 73.1% (245/335). Of all respondents 81.9% reported a vaccination rate above 80%. Almost 50% reported a vaccination rate above 90%. Most respondents considered herd immunity to be an important consideration for institutional policy. Freedom of choice for residents was considered important by almost all. Nevertheless, 106 out of 245 respondents follow a tacit consent procedure, according to which vaccination will be administered unless the resident or her proxy refuses. These institutions show significantly higher vaccination rates (p < 0.03). Conclusions: In our discussion we focus on the question whether tacit consent procedures can be morally justifiable. Such procedures assume that vaccination is good for residents either as individuals or as a group. Even though this assumption may be true for most residents, there are good reasons for preferring express consent procedures. (shrink)

Aneuploidy, an aberrant number of chromosomes in a cell, is a feature of several syndromes associated with cognitive and developmental defects. In addition, aneuploidy is considered a hallmark of cancer cells and has been suggested to play a role in neurodegenerative disease. To better understand the relationship between aneuploidy and disease, various methods to measure the chromosome numbers in cells have been developed, each with their own advantages and limitations. While some methods rely on dividing cells and thus bias aneuploidy (...) rates to that population, other, more unbiased methods can only detect the average aneuploidy rates in a cell population, cloaking cell‐to‐cell heterogeneity. Furthermore, some techniques are more prone to technical artefacts, which can result in over‐ or underestimation of aneuploidy rates. In this review, we provide an overview of several “traditional” karyotyping methods as well as the latest high throughput next generation sequencing karyotyping protocols with their respective advantages and disadvantages. (shrink)

The COVID-19 pandemic has forced developmental researchers to rethink their traditional research practices. The growing need to study infant development at a distance has shifted our research paradigm to online and digital monitoring of infants and families, using electronic devices, such as smartphones. In this practical guide, we introduce the Experience Sampling Method – a research method to collect data, in the moment, on multiple occasions over time – for examining infant development at a distance. ESM is highly suited for (...) assessing dynamic processes of infant development and family dynamics, such as parent-infant interactions and parenting practices. It can also be used to track highly fluctuating family dynamics and routines. The aim of the current paper was to provide an overview by explaining what ESM is and for what types of research ESM is best suited. Next, we provide a brief step-by-step guide on how to start and run an ESM study, including preregistration, development of a questionnaire, using wearables and other hardware, planning and design considerations, and examples of possible analysis techniques. Finally, we discuss common pitfalls of ESM research and how to avoid them. (shrink)

Theurgy, the ritual practice intended to free the descended soul from the body, has been considered an irrational and hence uninteresting part of late Neoplatonism. In this chapter, the author vindicates theurgy by showing that for Proclus there is an intimate relation between philosophy and theurgy. More specifically, he discusses the relevance of theurgy in Proclus’ metaphysics of causation, psychology, theology, and ethics. Theurgical symbols work because they are in fact low immanent forms. We need them, because our souls are (...) entirely descended, and theurgical excellence is the highest virtue. After a discussion of the role of theurgy in Proclus’ reading of the myth of the winged charioteer, the limits of theurgy, and the theurgical practices of purifying the soul from the body and of contemplation, the author ends with a short discussion of hymns as ‘theurgy in action’. (shrink)

This paper studies moral education in Proclus and Iamblichus. The first section analyses Proclus’ theory of moral education and its psychological underpinnings. Especially important in this context is the identification of the faculty of choice with the passive or teachable intellect. The second section investigates the implementation of this theory into practice with the help of Iamblichus’ Letter to Sopater: On Bringing up Children. The final section demonstrates how Proclus’ famous tripartite division of poetry should be understood in the context (...) of his program of moral education. (shrink)

Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)