Rationale In Belgium, several policies regulating reimbursement of acid suppressant drugs and evidence-based recommendations for clinical practice were issued in a short period of time, creating a unique opportunity to observe their effect on prescribing. Aims and objectives To describe the evolution of prescriptions for acid suppressants and explore the interaction of policies and practice recommendations with prescribing patterns. Method Monthly claims-based data for proton pump inhibitors (PPIs) and H-2-antihistamines by general practitioners, internists and "astroenterologists were obtained from the Belgian (...) national health insurance database (1997-2005). The evolution of reimbursed defined daily doses and expenses after introduction of reimbursement regulations and dissemination of practice recommendations was explored. Results Recommendations had no impact on prescribing. All changes can be related to concomitant policies. Lifting reimbursement restrictions for cheaper products did not control growth or save costs in the Iona term. Only restricting reimbursement of all PPIs managed to curb the growth. We observed an unintended increase of non-omeprazole PPIs by gastroenterologists. Conclusions Reimbursement policies influence prescribing, but their effect can be unintended. A dialogue between policymakers and guideline developers, and evidence-based policies that are linked to clinical guidelines, could be an effective way to pursue both cost-containment and quality of care. (shrink)

Modernity is Apocalyptic in essence. This assertion is stated nowhere in The Triumph of Human Empire by Rosalind Williams, nor in l’Apocalypse Joyeuse by Jean-Baptiste Fressoz. But it is everywhere on the pages of these books, which recount the ambivalence with which the project of Modernity and its technological feats has been received in specific times and places, notably nineteenth century Europe. Essence here is not to be understood as transcendental a-historical necessity, but as unfolding historical ontology. Despite contingencies, the (...) project of Modernity has continued to realise a secular ending of the world by continuing to conquer and destroy it.In The Triumph of Human Empire we encounter ambivalence through the biographies and works of three European writers, who employed the genre of romance to express their uneasiness with modern civilisation and progress: Jules Verne, William Morris and Louis Stevenson. Verne is perhaps the writer which we would least expect to have probl .. (shrink)

Opstellen over de Amerikaanse filosoof (1839-1914), in het bijzonder over de betekenis van zijn pragmatisme voor de semiotiek.

This book raises in a new way a central question of Christology: what is the divine motive for the incarnation? Throughout Christian history a majority of Western theologians have agreed that God's decision to become incarnate in the person of Jesus Christ was made necessary by "the Fall": if humans had not sinned, the incarnation would not have happened. This position is known as "infralapsarian." A minority of theologians however, including some major 19th- and 20th-century theological figures, championed a "supralapsarian" (...) Christology, arguing that God has always intended the incarnation, independent of "the Fall." Edwin Chr. van Driel offers the first scholarly monograph to map and analyze the full range of supralapsarian arguments. He gives a thick description of each argument and its theological consequences, and evaluates the theological gains and losses inherent in each approach. Van Driel shows that each of the three ways in which God is thought to relate to all that is not God -- in creation, in redemption, and in eschatological consummation -- can serve as the basis for a supralapsarian argument. He illustrates this thesis with detailed case studies of the Christologies of Schleiermacher, Dorner, and Barth. He concludes that the most fruitful supralapsarian strategy is rooted in the notion of eschatological consummation, taking interpersonal interaction with God to be the goal of the incarnation. He goes on to develop his own argument along these lines, concluding in an eschatological vision in which God is visually, audibly, and tangibly present in the midst of God's people. (shrink)

In grapheme-color synesthesia, a number or letter can evoke two different and possibly conflicting color sensations at the same time. In this study, we investigate the relationship between synesthesia and executive control functions. First, no general skill differences were obtained between synesthetes and non-synesthetes in classic executive control paradigms. Furthermore, classic executive control effects did not interact with synesthetic behavioral effects. Third, we found support for our hypothesis that inhibition of a synesthetic color takes effort and time. Finally, individual differences (...) analyses showed no relationship between the two skills; performance on a ‘normal’ Stroop task does not predict performance on a synesthetic Stroop task. Across four studies, the current results consistently show no clear relationship between executive control functions and synesthetic behavioral effects. This raises the question of which mechanisms are at play in synesthetic ‘management’ during the presence of two conflicting sensations. (shrink)

In this essay I argue that John Duns Scotus offers two arguments to support his well-known supralapsarian Christological position: a formal argument based on the ordering within God’s will, and a material argument based on the ordering of God’s love. While the latter is constructively more fruitful, its most natural reading, according to which God becomes incarnate so as to be loved not just by Godself but also by another, is also inconsistent with Scotus’s own account of the metaphysics of (...) the incarnation. An alternative reading, according to which God hypostatically unites with the human soul of Christ because God falls in love with it, is equally untenable. I offer therefore an alternative reading that, while not consistent with the letter of Scotus’s argument, I believe nonetheless to be consistent with its spirit. On this reading, the love expressed in the incarnation is directed at creation. In deciding to become incarnate, God decides to give Godself to that what is not God; the embodiment of this decision is Christ. The incarnation is not an expression of divine self-love, or love for one particular soul, but an expression of love for others. (shrink)

While there is an increasing focus on the use of online networks among autistic users, how autistic adults communicate in social networking sites remains underexplored. The article puts forward an argument for combining systematic observation of digital practices with analysis of evaluative language in order to provide a situated account of ‘autistic sociality’ in social media. Drawing on practice-based theories of social media affordances and discourse analysis research on online self-presentation and affiliation we show how autistic Twitter users rely on (...) association, content persistence and editability in order to signal social engagement through different forms of interaction and alignment. We discuss how the proposed framework can provide a new perspective on communicative practices of autistic social media users and advance development of inclusive digital networking platforms. (shrink)

Innovation is a key component of most definitions of culture and intelligence. Additionally, innovations may affect a species' ecology and evolution. Nonetheless, conceptual and empirical work on innovation has only recently begun. In particular, largely because the existing operational definition (first occurrence in a population) requires long-term studies of populations, there has been no systematic study of innovation in wild animals. To facilitate such study, we have produced a new definition of innovation: Innovation is the process that generates in an (...) individual a novel learned behavior that is not simply a consequence of social learning or environmental induction. Using this definition, we propose a new operational approach for distinguishing innovations in the field. The operational criteria employ information from the following sources: (1) the behavior's geographic and local prevalence and individual frequency; (2) properties of the behavior, such as the social role of the behavior, the context in which the behavior is exhibited, and its similarity to other behaviors; (3) changes in the occurrence of the behavior over time; and (4) knowledge of spontaneous or experimentally induced behavior in captivity. These criteria do not require long-term studies at a single site, but information from multiple populations of a species will generally be needed. These criteria are systematized into a dichotomous key that can be used to assess whether a behavior observed in the field is likely to be an innovation. (shrink)

We propose a new approach for tracing value change. Value change may lead to a mismatch between current value priorities in society and the values for which technologies were designed in the past, such as energy technologies based on fossil fuels, which were developed when sustainability was not considered a very important value. Better anticipating value change is essential to avoid a lack of social acceptance and moral acceptability of technologies. While value change can be studied historically and qualitatively, we (...) propose a more quantitative approach that uses large text corpora. It uses probabilistic topic models, which allow us to trace values that are latent. We demonstrate the approach for five types of value change in technology. Our approach is useful for testing hypotheses about value change, such as verifying whether value change has occurred and identifying patterns of value change. The approach can be used to trace value change for various technologies and text corpora, including scientific articles, newspaper articles, and policy documents. (shrink)

Emotional memories are vivid and lasting but not necessarily accurate. Under some conditions, emotion even increases people’s susceptibility to false memories. This review addresses when and why emotion leaves people vulnerable to misremembering events. Recent research suggests that pregoal emotions—those experienced before goal attainment or failure —narrow the scope of people’s attention to information that is central to their goals. This narrow focus can impair memory for peripheral details, leaving people vulnerable to misinformation concerning those details. In contrast, postgoal emotions—those (...) experienced after goal attainment or failure —broaden the scope of attention leaving people more resistant to misinformation. Implications for legal contexts, such as emotion-related errors in eyewitness testimony, are discussed. (shrink)

Entry of new organizations, including multinational enterprises from emerging markets, raises the ethical question of will they benefit society. The concept of legitimacy answers this question because it is the overall assessment of the appropriateness of organizational ends and means. Moreover, gaining legitimacy enables EMNEs to succeed in new host countries. Past work examined collective level indicators of the legitimacy of MNEs, but recent research recognizes the importance of individuals’ perceptions as the micro-foundation of legitimacy. This study first uses new (...) pragmatism, deontology, and utilitarianism to demonstrate that legitimacy is fundamentally an ethical concept—a perspective that has been overlooked in management research. Second, this study uses a seven-step procedure to develop and validate a measure of individuals’ perceptions of the legitimacy of Chinese EMNEs operating in The Netherlands, a developed country. Six dimensions of legitimacy were identified. The study also finds support for this legitimacy judgment process linking the dimensions: validating knowledge → propriety judgments → generalized judgment. This work provides additional micro-foundations to research on legitimacy and contributes to the ongoing process of construct validation. Future research could use the validated measure in other settings and use specific ethical theories in depth to refine the concept of legitimacy. (shrink)

Social robots and their interactions with children are becoming increasingly sophisticated, with the emergence of child-robot relationships as a likely result. However, adequate measurement instruments that tap into concepts associated with child-robot relationship formation are scarce. We aimed to develop three measures that can be used to assess children’s closeness to, trust in, and perceived social support from, a social robot. We established the validity and reliability of these measures among 87 Dutch children aged 7 to 11 years old. Because (...) of their shortness, the measures can efficiently be applied by scholars aiming to gain insight into the general process of child-robot relationship formation and its specific sub-processes, that is, the emergence of closeness, trust, and perceived social support. (shrink)

The commentaries have both drawn out the implications of, and challenged, our definition and operationalization of innovation. In this response, we reply to these concerns, discuss the differences between our operationalization and the preexisting operationalization if innovation, and make suggestions for the advancement of the challenging and exciting field of animal innovation.

Conflict adaptation reflects the increase in cognitive control after previous conflict between task-relevant and task-irrelevant information. Tonic arousal elicited by emotional words e...

Social robots and their interactions with children are becoming increasingly sophisticated, with the emergence of child-robot relationships as a likely result. However, adequate measurement instruments that tap into concepts associated with child-robot relationship formation are scarce. We aimed to develop three measures that can be used to assess children’s closeness to, trust in, and perceived social support from, a social robot. We established the validity and reliability of these measures among 87 Dutch children aged 7 to 11 years old. Because (...) of their shortness, the measures can efficiently be applied by scholars aiming to gain insight into the general process of child-robot relationship formation and its specific sub-processes, that is, the emergence of closeness, trust, and perceived social support. (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)

The Safe-by-Design approach in synthetic biology holds the promise of designing the building blocks of life in an organism guided by the value of safety. This paves a new way for using biotechnologies safely. However, the Safe-by-Design approach moves the bulk of the responsibility for safety to the actors in the research and development phase. Also, it assumes that safety can be defined and understood by all stakeholders in the same way. These assumptions are problematic and might actually undermine safety. (...) This research explores these assumptions through the use of a Group Decision Room. In this set up, anonymous and non-anonymous deliberation methods are used for different stakeholders to exchange views. During the session, a potential synthetic biology application is used as a case for investigation: the Food Warden, a biosensor contained in meat packaging for indicating the freshness of meat. Participants discuss what potential issues might arise, how responsibilities should be distributed in a forward-looking way, who is to blame if something would go wrong. They are also asked what safety and responsibility mean at different phases, and for different stakeholders. The results of the session are not generalizable, but provide valuable insights. Issues of safety cannot all be taken care of in the R&D phase. Also, when things go wrong, there are proximal and distal causes to consider. In addition, capacities of actors play an important role in defining their responsibilities. Last but not least, this research provides a new perspective on the role of instruction manuals in achieving safety. (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)

The value of Plutarch’s perception of physical reality and his attitude towards the natural spectacle Plutarch was very interested in the natural world around him, not only in terms of its elementary composition and physical processes, but also with respect to its providential ordering and marvels. His writings teach us a lot about his perception of physical reality and about his attitude to the natural spectacle. He found his greatest inspiration in the ontological and epistemological framework of Plato’s Timaeus, but (...) a wide range of other authors were also of seminal interest to his project. Moreover, the highly literary value of Plutarch’s natural philosophical writings should not be underrated. It is therefore not surprising that recently scholars have started to reassess the ancient scientific value of Plutarch’s natural philosophical writings. Natural Spectaculars aims to give further impetus to this dynamic by treating several aspects of Plutarch’s natural philosophy which have remained unexplored up to now. (shrink)

Leading social innovation is challenging. Creating enduring social innovation requires navigating the tension of simultaneously engaging top-down and shared leadership. We outline the crux of the challenge and provide key takeaways and practical advice for the tandem deployment of top-down and shared leadership for social innovation success.

The suggestion of seeking specificity in a higher-order array is attractive, but Stoffregen & Bardy fail to provide a compelling empirical basis to their claim that specificity exists solely in the global array. Using the example of relative motion, the alternate hypotheses that must be considered are presented.