Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses’ attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better (...) not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units. (shrink)

Despite societal concerns about the welfare of commercial laying hens, little attention has been paid to the welfare implications of the choices made by the genetics companies involved with their breeding. These choices regarding trait selection and other aspects of breeding significantly affect living conditions for the more than 7 billion laying hens in the world. However, these companies must consider a number of different commercial and societal interests, beyond animal welfare concerns. In this article we map some of the (...) relevant dilemmas faced by genetics companies in order to outline the scope of opportunities to improve welfare under current market conditions. This includes identifying cases where different animal welfare concerns conflict. We discuss the moral responsibility of laying hen genetics companies and the welfare implications that derive from the choices they make and the policies they follow. In addition to evaluating a selection of predominant current practices and breeding goals, we outline different angles from where to assess the moral legitimacy of various industry practices and policies. We discuss specific issues such as injurious pecking, bone health, induced moulting, chick culling and the circumstances of breeding stock. (shrink)

A diagnosis of dementia often comes with difficulties in understanding a conversational context and expressing how one feels. So far, research on how to facilitate advance care planning for people with dementia focused on defining relevant themes and topics for conversations, or on how to formalize decisions made by surrogate decision makers, e.g., family members. The aim of this review is to provide a better scope of the existing research on practical communication aspects related to dementia in ACP conversations. In (...) November 2020, seven databases were searched to select papers for inclusion. This search was updated in December 2021. The search strategy consisted of three tiers, intersected by using the Boolean term “AND,” and resulted in 787 studies. Two researchers followed explicit criteria for two sequential levels of screening, based on titles and abstracts and full papers. A total of 22 studies were included for data analysis. Seven topics emerged clustered around two themes. This scoping review provides practical suggestions for healthcare professionals to improve ACP communication and uncovered gaps in research on communication aspects related to dementia in ACP conversations, such as non-verbal behavior, timing and implementation, and personal preferences. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

Background The European Union aims to optimize patient protection and efficiency of health-care research by harmonizing procedures across Member States. Nonetheless, further improvements are required to increase multicenter research efficiency. We investigated IRB procedures in a large prospective European multicenter study on traumatic brain injury, aiming to inform and stimulate initiatives to improve efficiency. Methods We reviewed relevant documents regarding IRB submission and IRB approval from European neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury. (...) Documents included detailed information on IRB procedures and the duration from IRB submission until approval. They were translated and analyzed to determine the level of harmonization of IRB procedures within Europe. Results From 18 countries, 66 centers provided the requested documents. The primary IRB review was conducted centrally or locally and primary IRB approval was obtained after one, two or three review rounds with a median duration of respectively 50 and 98 days until primary IRB approval. Additional IRB approval was required in 55% of countries and could increase duration to 535 days. Total duration from submission until required IRB approval was obtained was 114 days and appeared to be shorter after submission to local IRBs compared to central IRBs. Conclusion We found variation in IRB procedures between and within European countries. There were differences in submission and approval requirements, number of review rounds and total duration. Research collaborations could benefit from the implementation of more uniform legislation and regulation while acknowledging local cultural habits and moral values between countries. (shrink)

continent. 1.4 (2011): 242—252. Introduction The following two works were produced by visual artist Jonas Staal and writer Vincent W.J. van Gerven Oei during a visit as artists in residence at The Bag Factory, Johannesburg, South Africa during the summer of 2010. Both works were produced in situ and comprised in both cases a public intervention conceived by Staal and a textual work conceived by Van Gerven Oei. It was their aim, in both cases, to produce complementary works that could (...) be read “through each other,” in which the movement of artistic construction would be imitated by textual deconstruction and vice versa. Both works deal with the way in which capital, apartheid, and monumentality are interwoven in South-African society. The Missing Link addresses a monument for democracy, erected on the premises of a private corporation running both an amusement park and the Apartheid Museum franchise. The textual intervention accompanying this public intervention investigates the limits of the inclusiveness of the anti-discrimination section in the South-African constitution, itself a monumental work of democracy. The Monument for the Distribution of Wealth deals with the history and eventual dissolution of a monumental square, commemorating the Soweto Uprising, in one of the poorest townships of Johannesburg. The history accompanying this public dismemberment of memory is equally fragmented, which is expressed by the many voices recounting uncertain and perhaps even irrelevant “facts” about the genius loci, the way in which the memorial space has actually entered into the memory of the inhabitants surrounding it. Next to their individual practices, Staal and Van Gerven Oei have worked together on a number of projects ever since 2007, including several art residencies. Their work involves an investigation of the different interfaces between art, politics, and public space in media ranging from theater and public interventions, to video installations and (co-authored) textual works. The Missing Link Missing Link (1) Missing Link (2) Missing Link (3) Intervention on the monument entitled The Seven Pillars of the Constitution , part of the Apartheid Museum in Johannesburg, South Africa. The Seven Pillars represent the constitutional values propagated in South Africa since the abolition of the apartheid regime. The monument and museum were built by the Gold Reef Resorts corporation, which is also responsible for the theme park and casino next to it. By placing the word “capitalism” on the wall surrounding the museum, the capitalist system and the constant social divisions that it implies are interpreted as sophistic continuations of apartheid politics. Through the capitalist system, apartheid is still operational within South African society. Whereas during the apartheid regime, the separation clearly ran along race divisions, in the current, “democratic” system, the same actual separation is sustained without it being an explicit element of the foundations of the country, i.e. the constitution. This intervention foregrounds the constant role of capitalism is both periods. At the same time the intervention acknowledges that contemporary Western artisthood is a mirror of the privileges that are offered by the capitalist system, and the type of artist that it produces. The intervention initiates a critical discourse concerning the capitalist system situated within the disaster of capitalism itself, in other words: through the desire to break with the presumption that art would be able to operate outside the capitalist system and to confirm that art—and the artist himself—is in fact modeled on this system. The public intervention by Staal was supplemented by a textual intervention by Van Gerven Oei: a proposition to alter the seventeenth amendment of the South African constitution. Even though the anti-discrimination legislation in South-Africa is one of the most stringent and inclusive in the world, one factor—wealth—remains outside its scope, thus continuing the schisms along racial lines produced during the apartheid regime: §9.3. The state may not unfairly discriminate directly or indirectly against anyone on one or more grounds, including race, gender, sex, pregnancy, marital status, ethnic or social origin, colour, sexual orientation, age, disability, religion, conscience, belief, culture, language, birth, and wealth. Monument for the Distribution of Wealth Intervention concerning the June 16 Memorial Acre in Central Western Jabavu, one of the poorest townships of Johannesburg. The monument comprises a park on which different are placed recalling an important protest the black population against the former apartheid regime. In 1976, from a school adjacent to the park, they started a massive protest against the introduction of Afrikaans in the school curriculum. The police reacted violently, and shot several hundreds of students. The construction of the June 16 Memorial Acre was started in 2005, and from the start was the paragon of corruption. Coordinated by local politicians, some family members of the protest leader from 1976 gained control of the realization of the monument, outside the regulation through external institutions. The available budget of 41 million rand (at that time well over 5 million euro) was largely embezzled. In the meantime, the monument has become fully dilapidated and defaced. The park has become overgrown with weeds and covered in a layer of dirt, and the local population is slowly plundering the square to use the material for the construction and decoration of their own houses. The Monument for the Distribution of Wealth develops the dynamics already existent around the June 16 Memorial Acre. Without obtaining official permission in advance, several local inhabitants were hired to break down the monument, sort the materials, and offer it to the neighborhood. Thus, the redistribution of wealth after the fall of the apartheid regime is finally taking place, albeit from the mere remains of the capital that was once invested in the community. The words “monument” and “for free” are spray-painted on the stacks of material, both in English and Zulu, as these are locally the most common languages. Van Gerven Oei supplemented Staal’s public intervention with an account of the history of the monument based on a series of interviews. The account clarifies how the different interests within the protest 1976 are reflected in the exceeding decay of the park, and how in the end those interests were represented by the June 16 Memorial Acre. Monument for the Distribution of Wealth 1: Removing stones Monument for the Distribution of Wealth 3: Pulling down statues Monument for the Distribution of Wealth 4: Offering the material Monument for the Distribution of Wealth 5: Offering the material Monument for the Distribution of Wealth 6 The next day A Fragmentary History of the Monument for the Distribution of Wealth, Formerly Known as the June 16 Memorial Acre in Central Western Jabavu, Soweto Vincent W.J. van Gerven Oei The following text, based on interviews and online research aims to provide parts of a history of the park in front of Morris Isaacson High School in Central Western Jabavu, Soweto. The idea for the transformation of the park into a memorial site has its source in the events of June 16, 1976: the start of the the student uprising in Soweto. The development of the park was started in the early 1980s, and the actual transformation into a memorial site, the June 16 Memorial Acre, was initiated in 2005. Over the last few years, several monumental additions have been made to the park: A marble monument with three pillars was revealed on June 16, 2006. A sculpture of a book and several billboards on June 16, 2008. A sculpture of student leader Tsietsi Mashinini on June 16, 2010. The park was transformed into the Monument for the Distribution of Wealth on August 3, 2010. According to the entry “Youth Struggle” on the website South African History Online, the Bantu Education Act was introduced in 1953 . In 1954 , Dr Verwoerd, Minister of Native Affairs, stated: “What is the use of teaching the Bantu child mathematics when it cannot use it in practice? That is quite absurd.” According to the entry “Soweto uprising” on Wikipedia, the Afrikaans Medium Decree was issued in 1974 , forcing all black schools to use Afrikaans and English in a 50-50 mix as languages of instruction. The Regional Director of Bantu Education (Northern Transvaal Region), J.G. Erasmus, told Circuit Inspectors and Principals of Schools that from January 1, 1975 , Afrikaans had to be used for mathematics, arithmetic, and social studies from standard five (7th grade). English would be the medium for general science and practical subjects. Indigenous languages would be used for religion instruction, music, and physical culture. According the entry “Soweto uprising” on Wikipedia, on April 30, 1976 , students from the Orlando West Junior School in Soweto went on strike, refusing to go to school. Their example was followed by other schools in Soweto. A student from Morris Isaacson High School, Toboho “Tsietsi” Mashinini, proposed a meeting on June 13, 1976 to discuss further action. According to Weizmann Hamilton’s article “The Soweto Uprising 1976,” which appeared in the September 1986 edition of Inqaba Ya Basebenzi (Fortress of the Revolution), on June 13, 1976 , the South African Students’ Movement called a meeting at the Donaldson Community Center in Orlando. 300-400 Students representing 55 schools decided to hold a mass demonstration on June 16. According to Brian Mokhele, member of the Joint Community Safety Forum, Dr Edelstein was the first victim of the Soweto uprising and killed the day before the march on June 15, 1976 . Edelstein was an administrator at the pass office in Jabavu and gave golf courses to the local community. Edelstein was put in a garbage bin and pierced by pickaxes. The garbage bin was left at the very spot of the murder for many years. A few years ago, a child was beheaded at the same spot, and the basketball court next to it has been abandoned since. According to Marcus Neustetter, founder of the Trinity Session, this story is untrue. According the entry “Soweto uprising” on Wikipedia, on June 16 , Tsietsi Mashinini led students from Morris Isaacson High School to join up with others who walked from Naledi High School. A crowd of between 3,000 and 10,000 eventually ended up near Orlando High School. According to Raymond Marlowe, a local photographer, Tsietsi Mashinini was heading the march. According to the entry “Hector Pieterson” on Wikipedia, Dr Edelstein died on June 16, 1976 , stoned to death by mob and left with a sign around his neck proclaiming “Beware Afrikaaners.” The first child to die that day was called Hastings Ndlovu. According to Pat Motsiri, Orlando West is claiming struggle heritage through the Hector Pieterson Museum, while Hector Pieterson was from Jabavu. According to Pat Motsiri, his generation effectively struggled between 1980 and 1991, forcing the release of Nelson Mandela and negotiations with the apartheid regime while the 1976-generation was safely in exile. Nevertheless, this has not been recognized in any monument. After the abolition of apartheid, the generation from 1976 returned from exile, occupied important government and ANC positions, creating an abundance of 1976 memorials and refusing to acknowledge that this was only possible because of the younger generation’s struggle. He calls this a generational conflict. According to Archibald Dlamini, the park officer responsible for the Memorial Acre, he started working for the municipality in 1978. In 1981/82 , Isaac Makhele from Pimville, who used to work in the cemetery business, was the first developer of the park. It used to be just a normal park until City Parks decided to develop the Memorial Acre in 2006. In 2007 the work was stopped by the community. According to Brian Mokhele, he left the country in 1989 after he participated in the riots of 1986. But when he returned in 1999 he found that nothing had changed. He says that they were promised to be protected by the Constitution, but that reality is different. The police uses fear to suppress them so that they don’t come out to talk openly. He has been arrested twice, both times harassed and tortured by the police, but in the end always released without indictment. He says that this is their way to threaten communities to back off from politics. According to Moses, who is sitting outside rolling a joint, Brian knows everything. He tells Brian to tell me everything he knows. According to Brian Mokhele, Tsietsi Mashinini was possibly murdered in 1990 during his exile in New York. Two weeks before he was supposed to return to South Africa, his papers in order, he was found dead under mysterious circumstances. His coffin was sealed when he was buried. According to Pat Motsiri, he came up with the idea for the Memorial Acre in 2003 . He submitted the documents for the proposal to the council, which sidelined him as soon as the budget came out in 2005 . According to Brian Mokhele, there was on estimation R 41,000,000 spent to redesign the park and turn it into the Memorial Acre. The millions were divided by Amos Masondo, the mayor of Soweto, the local councilor Bongani D. Zondi, and the director of the city of Johannesburg, Pat Lephunya. They were dividing the money between several contractors: Tsietsi Mashinini’s brothers were involved in the development of the park, they got the tender to do the green areas, the landscaping. Construction was done by other companies, some did the paving, the toilets, etc. EMBA, a private company appointed by the municipality was in control of the money flow, but the money was quickly gone. According to Raymond Marlowe, the contractor bought a BMW with the money. According to Archibald Dlamini, the Mashinini brothers got the tender, so the space would look more like the other places around in Soweto. It was agreed that after they were done, they would return the property to the municipality. They did whatever they could do. According to Mafaisa, a member of the Jabavu business community, he was one of the contractors for the landscaping and the pavement under Mpho Mashinini, one of the brothers. He says that I should contact Mavi for information on Mpho. According to Poi Stuurman, a local youth worker, Mafaisa is one of the guys who ran away with the money. According to Mavi, Mpho Mashinini was never a contractor. The contracts were organized by Sbu Butelezi, the former head of the Gauteng Department for Public Works. The June 16 Foundation and the Mashinini brothers will be the beneficiaries of the park when it is finished. According to Brian Mokhele, City Parks did not accept the Memorial Acre because it was not finished. The rest of the year, the unfinished park is not maintained, as should have happened. This was done deliberately so that in the end they can just clean the whole thing up and have a reason to redo the whole park. According to Brian Mokhele, the Mashinini brothers now work for the government. People that manipulate for money purposes always come from the government’s side. Because the park was left unfinished, the people from the neighborhood are taking away the stones to decorate their own homes with. According to Archibald Dlamini, because City Parks doesn’t accept responsibility of the park, he officially has nothing the guard, except for his cottage, which is municipal property. The thieves come at night and destroy the park, but he cannot do anything because he is sleeping. According to the website of the Thanda Foundation on June 16, 2006 a bronze statue of Hector Pieterson, the first child to die in the 1976 protests, made by Kobus Hattingh and Jacob Maponyane was unveiled in the Maponya Mall in Soweto. The statue is sculpted after the famous image shot by Sam Nzima of Mbuyisa Makhubo carrying the dead body of the boy. The sculpture was sponsored by the Thanda Foundation, founded by the Swedish entrepreneur Dan Olofsson and South-African entrepreneur Matthews Phosa. According to the official website of the City of Johannesburg, the Memorial Acre and Artwork were unveiled in 2006. According to a blog post on sowetouprisings.com, the Memorial Acre was still under development on July 24, 2006. According to Archibald Dlamini, City Parks only cleans up the park once a year just before the June 16 celebrations. Everybody is waiting for the Mashinini brothers to finish their job. The last time he talked with them was in 2007 . According to a sign on the school grounds of the Morris Isaacson High School, the June 16 Trail will be finished in 2008 . According to a blog post on sowetouprisings.com, the Memorial Acre contains another monument erected in Tsietsi’s honor. The monument was created as part of the Sunday Times Heritage Public Art program. Its physical form resembles a giant book which symbolizes the crisis in education experienced in 1976. On the face of the book is the map of the route taken by the students from Morris Isaacson High School in Central Western Jabavu to Phefeni Junior Secondary in Orlando West (currently the site of the Hector Pieterson Museum), while the back cover of the ‘book’ is inscribed with a tribute to Tsietsi Mashinini. The monument was revealed on June 16, 2008 . According to Marcus Neustetter, the billboards on the Memorial Acre were part of a school project realized in 2008. Following several workshops, the students from different high schools along the June 16 Trail were invited to work with artists on the billboards, while the neighborhood community was invited to watch the process during the festivities on June 15 and 16, 2008 . The billboards were supposed to be removed because of construction works on the Memorial Acre, which never ended up happening. According to Brian Mokhele, the former toilet facilities were converted into a house for the park officer. This park officer has been working for city parks for more than 12-15 years, but does nothing here, because the park, including the new toilet buildings, is not finished. The government is now moving around looking for people to take this job because they stopped it. They confronted everybody who was going in and chased them away. According to John, in 2009 , some girls, around 16 or 17 years old, were raped by four men who had been drinking in a local shebeen. When the bar quit they said that they would go home by car, but instead raped the girls on the Memorial Acre nearby. This happened in the unfinished toilets, because the doors couldn’t be closed. According to Brian Mokhele, there used to be some fences around the park because of the construction work that was eventually stopped, but these were also stolen. According to Archibald Dlamini, people from the neighborhood started about two and a half years ago, and the last piece was stolen near the end of 2009 . Sometimes he would catch someone with a roll of fence, and then use it for his own cottage. According to the official website of the City of Johannesburg, a statue of Tsietsi Mashinini by Johannes Pokhela was revealed on June 16, 2010 , “Youth Day.” According to Shirley Makutoane, deputy principal of Isaac Morrison High School, the statue of Tsietsi Mashinini, funded by the June 16 Foundation, has temporarily been placed within the school perimeter. The statue will be moved to the Memorial Acre when it will be finished, in 2011 . According to Brian Mokhele, beside the June 16 Foundation, there is also a June 16 Memorial Acre Foundation. Both foundations are quarreling about the money involved in the Memorial Acre project. Nobody knows who’s involved in them. According to Marcus Neustetter, the June 16 Foundation consists of people that were part of 1976 protest movement, local government officials, representatives of the Hector Pieterson Museum, and the council. According to students from the Isaac Morrison High School, the statue of Tsietsi Mashinini is on the school ground because on the Memorial Acre it would be vandalized by youths from White City, an adjacent neighborhood. Accorcing to Brian Mokhele, the statue of Tsietsi should eventually be mounted on the Memorial Acre. It is wrong that the statue is in the school at the moment, because it is not a public school. He wants the statues to depict the massiveness of the force that was coming into Soweto after the protests. According to Brian Mokhele, City Parks, City of Jo’burg, City Lights, and SAPS are making some sort of plan to take the plan back. They want to remove the trees from the Memorial Acre, and redesign the Memorial Acre into a relaxing park, without political content. They want to depoliticize the square. In doing so,they will have their own employment and not use local workforces. According to Brian Mokhele, the community wants to remove the monuments, amphitheater, and sculptures from the Memorial Acre because they do not resemble anything. The sculptures should be depicting the truth of what happened, because the Memorial Acre is a political heritage site. He wants to involve the people that actually participated in the struggle to make the monument so that everyone can enjoy it and get a better understanding of the struggle heritage. Therefore, he proposes collective ideology in which everyone has a say. This would prevent future vandalization of the monument. According to Pat Motsiri, the sculptures must depict the event around June 16, 1976. Like the story of Dr Edelstein, who was pierced by pickaxes, forced into a garbage bin and burned alive. According to Jonas Staal, the Memorial Acre should be destroyed, its elements stacked on pallets, thus forming the Monument for the Distribution of Wealth . According to Mafaisa, his men can do the work quickly. He has about twenty men working under him. (shrink)

continent. 1.2 (2011): 129-135. Introduction Vincent W.J. van Gerven Oei Successions of words are so agreeable. It is about this. —Gertrude Stein Nachoem Wijnberg (1961) is a Dutch poet and novelist. He also a professor of cultural entrepreneurship and management at the Business School of the University of Amsterdam. Since 1989, he has published thirteen volumes of poetry and four novels, which, in my opinion mark a high point in Dutch contemporary literature. His novels even more than his poetry are (...) criticized for being inaccessible, which I generally take to be a compliment. It would be like saying that Fernando Pessoa is inaccessible, which he is not. Neither is Wijnberg. When we think of the combination economist-poet we are immediately reminded of the American poet Wallace Stevens, who, as the story goes, had two stacks of paper on his desk, one for contracts, one for poems. We also know that Stevens wrote on the economy and that questions of economy and insurance surface at multiple points in his poems. The following text is a very preliminary attempt to point at the intersections between poems, novels, business, and poetry in Wijnberg’s work. On the back cover of his novel De opvolging ( The Succession , 2005), Wijnberg states the following: “[This is] a novel for whomever is interested in the workings of a company as much as in the workings of a poem.” Wijnberg thus claims that the way in which a company “works” may be similar to the way in which a poem “works.” The question is the obvious one, what does this similarity consist in? De opvolging tells the story of company in which bosses and company doctors, secretaries, children, clowns, and beggars have tons of meetings, recite poems, perform plays, tell jokes, and succeed each other, climbing up and down in the company’s hierarchy. De opvolging is a novel in which the career of people follows the career of words. It resonates with Gertrude Stein's sentences, "Grammar. What is it. Who was it" (1975, 50). The words in Wijnberg's poems are like he characters in his novel. And if we keep in mind this allegorical reading of De opvolging , which is obviously only one of the possible readings, we may be able to understand some aspects of Wijnberg’s poetry. A repetition is already a pun. Look, that word is trying it again, as if it is afraid that by not doing it it would give up the hope that it will ever be able to do something. A pun is the opposite of the first word coming to the mind of someone who shouts it when he suddenly discovers something. (104) The repetition, the succession of the same word, is already a pun, a joke. The succession of the father by the son after the revolution is a joke. "Look he's trying it again!" The essence of a joke is a repetition. Archimedes’ “Eureka!” is its opposite. Poems can easily become jokes, depending on the way the words follow and repeat each other. In De opvolging , the careers of the bosses, good and bad secretaries, and company doctors easily become jokes, as they are “afraid that by not doing it [they] would give up the hope that [they] will ever be able to do something.” Not only the repetition, but also the distance and difference between the words in a poem, their cause and effect relations can be read as company relations. This becomes clear when we, for example, read the first lines of the poem “Cause, sign” from Het leven van ( The Life Of , 2009). A sign lets know what is going to happen, a cause lets it happen. If the sign also lets happen there is no reason to isolate it, because then I would isolate some- thing only because it’s different for me. If I didn’t have to write this myself, but would have secretaries to whom I could dictate it, I would be able to say more about it. (49) Upon reading the first two lines we can already conclude that any word may be cause or sign or both. If a sign is also a cause there is no reason to discriminate it, yet to the poet they are still different. This difference only becomes expressible the moment he would have a secretary. Just like in De opvolging , the secretary introduces a distance; not in a company but in a poem. Hence the difference between “good” and “bad” secretaries in a company, where the good secretary of one boss may be the bad secretary of another one. The more we can say about the bosses of the company, or signifiers of the poem, the greater the distance we introduce between them and us. We should take serious the relation between Wijnberg’s novels and poems. Although they operate on different scales, they explain and converse with each other. Another example may be the novel Politiek en liefde ( Politics and Love , 2002), which deals with the relation, precisely, between politics and love. In the novel, Nicolai, a lieutenant in the Dutch army, is sent to Africa on a military mission. Upon leaving a receives a letter from his father. Dear son, Don’t do anything stupid before your father has advised you to do so. Your mother asked me to write a wise letter. I have been looking for wisdom for half a day and haven’t found much. If you borrow a small amount from a bank you become the bank’s slave, but if you borrow a couple of millions and spend them as quickly as possible the bank becomes your slave. What I want to say is that you have to return from Africa in good health, and before you know it the world will be your slave [....] Signed with a kiss from your father. (88) The line, “If you borrow a small amount from a bank you become the bank’s slave, but if you borrow a couple of millions and spend them as quickly as possible the bank becomes your slave,” returns as the title of poem in Het leven van: “If I borrow enough money the bank becomes my slave” (12-3), which elaborates this theme. So both in the way that these poems are structured and in their subject matter, they refer to the structures of our economy, to the ever-continuing line of CEOs succeeding each other like words, to the distance between them introduced by bureaucracy, and giving and receiving as economical and poetical acts. Poem and economy map onto each other, as in another episode from De opvolging : Edward reads two of the beggar’s poems about presents. Of a holiday nothing remains, except for memories, and if some of them are bad I’d rather forget them all; if I get a present I’d rather get something that’s useful to me for a long time. If I may choose, I choose what I can use longest, long enough to partially forget that this was the present, because it feels bad when nothing is left of it. […] Giving away becomes destruction in the stock destruction economy [ voorraadvernie -tigings-economie ], that is a gift economy [ geschenkeneconomie ], encountering for the first time an economy in which there’s selling and buying on markets. Instead of destroying supplies someone can also quickly say that they aren’t worth anything anymore; if someone wants to take them I’d gladly give him something extra. In a stock destruction economy he is someone who each day wants to work more hours than his colleagues. If around a company there is a gift economy in which someone’s rank is determined and made visible by the gifts someone can give someone else, a company will be more often character- ized by an invisible or unclear system of ranks. (152) Two poems about gifts present two different economical models, described by Wijnberg with the terms “stock destruction economy” and “gift economy.” Here we immediately recall the opposition introduced by George Bataille’s work on the concept of expenditure in The Accursed Share , where a “general economy” would surpass the stock destruction economy based on scarcity (capitalism) and become a gift economy (potlatch) and an egalitarian (communist) society. These claims are made both on the level of the poems and in their discursive explanation. They follow each other and on each other. I would like to finish this introduction to Wijnberg’s writing with a translation from his novel De joden ( The Jews , 1999), which develops the story of Hitler abdicating as chancellor of the Third Reich, appointing philosopher Martin Heidegger as his successor. In a conversation with two Russian actor-spies, sent by Stalin to figure out the situation, philosopher Walter Benjamin describes the abdication scene. Maimon: You were there when Hitler resigned? Benjamin: In the room we’re right now. The desk and the chairs are new. After his resignation Hitler would like to take his furniture to his new house. Martin naturally agrees. It is a sunny day. Martin is very nervous and complains about the heat. Martin is wearing his best dark blue suit, not his professor’s robe. Hitler is wearing his uniform. We enter the room and Hitler gets up and embraces Martin. Martin is not very good at embracing. Hitler shakes his hand. Hitler’s cap is on the desk. The cap has a metal lining. Hitler has strong neck muscles. Hitler says: A man is unclean. He takes a bath. Does he make the bath water unclean? I say: a man is unclean. He steps into a river. A little further a man steps into the river; does he become unclean? Hitler nods. I say: a man is standing in music. Another man hears the music but also sees the first man moving on the beat of the music in a way that he is certain that the music would excite different feelings in him if he wouldn’t to see the first man. Hitler says: a man is clean, listens to music, is suddenly touched and he doesn’t know by what. The conversation ends in the way you know it ends. Hitler picks up his cap from the desk and puts it on Martin’s head. (73-4) Aware of the never ending debate on the question of Heidegger’s involvement in the Nazi regime, Wijnberg has the audacity to present the arguments of complicity in the religious terminology of cleanliness and uncleanliness, while at the same time recalling overtones of Hitler’s supposed love for Wagner, suggesting a relation between Benjamin and Hitler, and so on. The space of this introduction is to small to treat a novel like De joden , a reading of which together with passages from Philippe Lacoue-Labarthe's Heidegger, Art, and Politics: The Fiction of the Political , Jacques Derrida's Of Spirit , Christopher Fynsk's Heidegger: Thought and Historicity , and Avital Ronell's The Telephone Book would be extremely elucidating and potentially open new avenues in thinking Heidegger's emphasis on poetry after the fall of the Nazi empire. But at this point we will have to curb our curiosity and follow the poet himself. The themes of the relation between business and poetry, but also Chinese landscape painting, love, Indian and Japanese poetry, and Western philosophy are analyzed and assimilated in Wijnberg’s work without ever losing the clarity of expression. It may be that, according to Alain Badiou, the “Age of the Poets” is over, but its end (Paul Celan) has exactly brought a new balance between philosophy and poetry, and it is this playful, but nonetheless serious balance that makes one hope that one day Wijnberg’s complete oeuvre might become available to readers across the planet. Tiranë, Albania February 15, 2011 English translations (all of them translated by David Colmer, who is preparing an English collection of Wijnberg’s poems entitled Advanced Payment ): Poetry International Words Without Borders Green Integer Review from Het leven van ( The Life of ) THE LIFE OF KANT, OF HEGEL As if every day he takes a decision that is as good as when he’d been able to think about it all his life. The life of Kant, of Hegel, the days of the life of, select three or four of them. Tell what he has discovered during those days as if he were the last one who knew so little. Give me something that I can cancel against then I can prepare myself for it. The reward is that I may continue with what I’m doing, it doesn’t matter how long it takes. This has nothing to do with everything remaining the same if I say that I no longer want anything else. I wouldn’t be able to say in which one and the other occur in a way that I if I knew something to cancel that one against it wouldn’t be possible now. The stars above my head and being able to say what belongs to what if I’ve let them in. FOLLOWING MY HEART WITHOUT BREAKING THE RULES Observing the rules without observing the rules by going where the rules no longer apply. I could also observe the rules there by applying them to what at great distance may resemble what the rules are about. But why would I do that, not to confuse someone who is seeing me from a great distance? Behind this morning the morning prepares itself when the rules are everything I have. IF I BORROW ENOUGH MONEY THE BANK BECOMES MY SLAVE A bank lends me money, if I don’t pay it back they tell my boss that he has to pay them my salary. But they have to leave me enough to eat and sleep and an umbrella when it’s raining. They can also empty my house, the furniture isn’t worth a lot, but every little helps. Each morning I leave for work, if I don’t start early they’ll soon get someone else, no bank will lend me money when the sun is shining. My boss has given me a cat to raise as a dog. Of course I know that it won’t work out, but I’ve asked for a week—maybe the cat gets lucky, maybe I get lucky. My hands around a cup of coffee, before I leave for work, warm-empty, cold-empty, as if hidden in the mist over a lawn. What I make when there’s no work left for me, I’m ashamed to say how little it is. Once I’m outside I check it, if they watch out of the window they can see me doing it. Suppose it is so much that I’d stay counting for hours, it’s getting dark and I’m still there. They stay watching for a while once they’ve finished their work, but have to go home, I get that, sure, I could also go home and continue counting there. If it’s too little running back immediately won’t help, because nobody’s there anymore, and if I come back tomorrow I may have spent what’s missing tonight. Going somewhere where it’s warm enough to walk around without clothes during daytime, it helps me to know that something’s more there than here. For someone like me there’s work anywhere, it shouldn’t take a week to find work for me there. Three times work and a home close to work, I may choose one and try for a week whether I want to stay there. If at the end of the week I don’t want to stay I’m back on the next day, then it was a week’s holiday. RULES If that’s against a rule, it’s yet another one that I cannot observe, or only so briefly that I cannot re- member it later. Anyways the rules are only there to help me remember what I need in order to do better what I do. In that respect there’s no difference between the rules that I find in a book and the rules that I think of early in the morning. I know that because I’ve made a rule just now nothing has yet to observe it. CAUSE, SIGN A sign lets know what is going to happen, a cause lets it happen. If the sign also lets happen there is no reason to isolate it, because then I would isolate something only because it’s different for me. If I didn’t have to write this down myself, but would have secretaries to whom I could dictate it, I could to say more about it. If something is taken away from me I consider how it would be if the opposite had been taken from me. That is what causes or signifies what is farthest away from what is caused or signified by what has been taken away from me. note: For the translations of “The life of Kant, of Hegel” and “If I borrow enough money the bank becomes my slave” I was able to consult David Colmer’s wonderful translations. (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)

Facial electromyography research shows that corrugator supercilii ('frowning muscle') activity tracks the emotional valence of linguistic stimuli. Grounded or embodied accounts of language processing take such activity to reflect the simulation or ‘reenactment’ of emotion, as part of the retrieval of word meaning (e.g., of “furious”) and/or of building a situation model (e.g., for “Mark is furious”). However, the same muscle also expresses our primary emotional evaluation of things we encounter. Language-driven affective simulation can easily be at odds with the (...) reader’s affective evaluation of what language describes (e.g., when we like Mark being furious). To examine what happens in such cases, we independently manipulated simulation valence and moral evaluative valence in short narratives. Participants first read about characters behaving in a morally laudable or objectionable fashion: this immediately led to corrugator activity reflecting positive or negative affect. Next, and critically, a positive or negative event befell these same characters. Here, the corrugator response did not track the valence of the event, but reflected both simulation and moral evaluation. This highlights the importance of unpacking coarse notions of affective meaning in language processing research into components that reflect simulation and evaluation. Our results also call for a re-evaluation of the interpretation of corrugator EMG, as well as other affect-related facial muscles and other peripheral physiological measures, as unequivocal indicators of simulation. Research should explore how such measures behave in richer and more ecologically valid language processing, such as narrative; refining our understanding of simulation within a framework of grounded language comprehension. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Various tests have been proposed as helps to identify intrinsic properties. This paper compares three prominent tests and shows that they fail to pass adequate verdicts on a set of three properties. The paper examines whether improved versions of the tests can reduce or remove these negative outcomes. We reach the sceptical conclusion that whereas some of the tests must be discarded as inadequate because they don’t yield definite results, the remaining tests depend for their application on the details of (...) fundamental particle physics so much so that they cannot be relied upon. (shrink)

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder, and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient’s autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical (...) practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient’s and the therapist’s perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist’s approach, who used motivational interventions with a view to appealing to the patient’s responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions. (shrink)

Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...) confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: ‘resident’s behavior’, ‘divergent perspectives on good care’ and ‘organizational context’. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical ‘blind spots’. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)