In recent years, experts in geriatric care have increasingly promoted the use of reminiscence museums, collections of period objects that are used to help senior citizens draw on old memories in order to recall and talk about their past. Hands Off Not an Option is a practical guide to making and using such collections, showing how to establish and fill out a museum and illustrating the ways it can be used within senior care facilities and within individual homes. The book (...) will thus be of value both to those practicing in geriatric medical and social care and to individual families working with aged relatives. The book includes 1 DVD. (shrink)

This article gives a practice-based and theoretical overview of the transformation from a traditional hierarchical organization in the care and cure sector towards a so-called Community-driven organization providing human happiness to 6000 elderly people. The actual case study is intertwined with conceptual information for better understanding of the innovative transition which took place at Humanitas. The case description includes its initial situation, its new core values, mission and objectives and shows the sequence of emerging policies and interventions that resulted in (...) a stakeholder oriented business model for the care sector. The selected concepts are Graves'' Emerging Cyclical Level of Existence Theory (or Spiral Dynamics), Ken Wilber''s Four Quadrant Model, Roberts Simons'' Four Levers of Control and various elements from the European Corporate Sustainability Framework sponsored by the European Commission. The conclusion marks the match between theory and practice in transforming Humanitas Rotterdam into providing cure, care, housing and well-being to elderly people. (shrink)

This article gives a practice-based and theoretical overview of the transformation from a traditional hierarchical organization in the care and cure sector towards a so-called Community-driven organization providing human happiness to 6000 elderly people. The actual case study is intertwined with conceptual information for better understanding of the innovative transition which took place at Humanitas. The case description includes its initial situation, its new core values, mission and objectives and shows the sequence of emerging policies and interventions that resulted in (...) a stakeholder oriented business model for the care sector. The selected concepts are Graves' Emerging Cyclical Level of Existence Theory (or Spiral Dynamics), Ken Wilber's Four Quadrant Model, Roberts Simons' Four Levers of Control and various elements from the European Corporate Sustainability Framework sponsored by the European Commission. The conclusion marks the match between theory and practice in transforming Humanitas Rotterdam into providing cure, care, housing and well-being to elderly people. (shrink)

Stuart, Jennie Review(s) of: Hands off not an option! The reminiscence museum mirror of a humanistic care philosophy, by Professor Dr Hans Marcel Becker assisted by Inez van den Dobbelsteen- Becker and Topsy Ros. Eburon Academic Publishers, Delft, 2011 272 pp.

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction and negative interpretation bias in a student sample screened for high and low social anxiety. Results support the hypothesis that group differences in negative interpretations (...) of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing. (shrink)

The aim of this volume is to examine this claim, and to place it in the wider context of recent epistemological debates about the role of sociality in knowledge acquisition.

This paper takes as a starting point a recent development in privacy-debates: the emphasis on social and institutional environments in the definition and the defence of privacy. Recognizing the merits of this approach I supplement it in two respects. First, an analysis of the relation between privacy and autonomy teaches that in the digital age more than ever individual autonomy is threatened. The striking contrast between on the one hand offline vocabulary, where autonomy and individual decision making prevail, and on (...) the other online practices is a challenge that cannot be met in a social approach. Secondly, I elucidate the background of the social approach. Its importance is not exclusively related to the digital age. In public life we regularly face privacy-moments, when in a small distinguished social domain few people are commonly involved in common experiences. In the digital age the contextual integrity model of Helen Nissenbaum has become very influential. However this model has some problems. Nissenbaum refers to a variety of sources and uses several terms to explain the normativity in her model. The notion ‘context’ is not specific and faces the reproach of conservatism. We elaborate on the most promising suggestion: an elaboration on the notion ‘goods’ as it can be found in the works of Michael Walzer and Alisdair Macintyre. Developing criteria for defining a normative framework requires making explicit the substantive goods that are at stake in a context, and take them as the starting point for decisions about the flow of information. Doing so delivers stronger and more specific orientations that are indispensible in discussions about digital privacy. (shrink)

Environmental pollution and greenhouse gas emissions that contribute to climate change have adverse impacts on global health. Somewhat paradoxically, health care systems that aim to prevent and cure disease are themselves major emitters and polluters. In this paper we develop a justification for the claim that solidaristic health care systems should include sustainability as one of the criteria for determining which health interventions are made available or reimbursed – and which not. There is however a complication: most adverse health effects (...) due to climate change do occur elsewhere in the world. If solidarity would commit us to take care of everyone’s health, worldwide, it might imply that solidaristic health system cannot justifiably restrict universal access to their own national populations. In response we explain health solidarity is to be considered as a moral ideal. Such an ideal does not specify what societies owe to whom, but it does have moral implications. We argue that ignoring sustainability in political decision making about what health care is to be offered, would amount to betrayal of the ideal of solidarity. (shrink)

In evaluating the merits and shortcomings of virtue ethics I focus on some central differences between virtue ethics and rival theories such as deontology and utilitarianism. Virtue ethics does not prescribe strict rules of conduct. Instead, the virtue ethical approach can be understood as an invitation to search for standards, as opposed to strict rules, that ought to guide the conduct of our individual lives. This requires a particular method. The importance of this approach in present times will become clear (...) when we investigate the relation between virtue ethics and postmodernity. In our postmodern age moral concepts are no longer perceived as deriving their meaning from larger frameworks. Instead, their meanings are perceived as being de rived from the contingencies that define our particular existences. Thus ongoing grass roots moral engagement is required, and virtue ethics is the appropriate moral framework for doing this. This results in a broadening of rationality insofar as the full richness of our situated lives are factored into our accounts of rationality. At the same time virtue ethics prevents relativism, mainly because it does justice to the social embeddedness of human activities. In order to illustrate the virtue ethical approach I will discuss two key concepts in our moral vocabulary: responsibility and integrity. We will see how these basic concepts can be properly understood only if one takes into consideration the contingencies, inherent paradoxes and tensions in human life. S. Afr. J. Philos. Vol.23(3) 2004: 267-281. (shrink)

Tolerance for blood transfusion risks is very low, as evidenced by the implementation of expensive blood tests and the rejection of gay men as blood donors. Is this low risk tolerance supported by the precautionary principle, as defenders of such policies claim? We discuss three constraints on applying the precautionary principle and show that respecting these implies tolerating certain risks. Consistency means that the precautionary principle cannot prescribe precautions that it must simultaneously forbid taking, considering the harms they might cause. (...) Avoiding counterproductivity requires rejecting precautions that cause more harm than they prevent. Proportionality forbids taking precautions that are more harmful than adequate alternatives. When applying these constraints, we argue, attention should not be restricted to harms that are human caused or that affect human health or the environment. Tolerating transfusion risks can be justified if available precautions have serious side effects, such as high social or economic costs. (shrink)

Recently, ethical guidelines for clinical practice have gained increased popularity, but in order to become useful they require more pioneer’s work. Clinical-ethical guidelines need to be based on a scientific foundation and their practicability must be improved. We present and put to discussion the initial steps of the METAP Project about the development and practical implementation of a clinical-ethical guideline dedicated to a fair resource-allocation at the bedside. -/- With its methodological orientation, the project represents a guideline which is based (...) on both research and consensus-building, undergoing systematic evaluation and modification. In addition to the guideline, the project comes with a manual (a tool kit) including a procedural instrument for making decisions supporting deliberative aspects. It focuses on issues of micro-allocation; furthermore, it provides empirical, ethical and legal basics for making fair treatment decisions that should help to prevent overtreatment, undertreatment or discrimination in patient care. We propose an Escalation Model with various instruments serving as problem solving strategies that correspond to the respective needs; these instruments include a pocket-summary (“Leporello”) with the most important facts; further reading material; normative and procedural recommendations; ward-specific strategies, and also the option of clinical ethics consultation. -/- Clinical partners have been actively involved in the developmental process from the beginning and contributed to the practical applicability, acceptance and a valid need-orientation of the whole tool kit. This partnership and the participatory approach seem to have helped METAP to gain a foothold in the clinic. (shrink)

BACKGROUND: The availability of costly safety measures against transfusion-transmissible infections forces Western countries to confront difficult ethical questions. How to decide about implementing such measures? When are such decisions justified? As a preliminary to addressing these questions, we assessed which concerns shape actual donor blood safety policymaking in five Western countries. STUDY DESIGN AND METHODS: Our qualitative study involved determining which issues had been discussed in advisory committee meetings and capturing these issues in general categories. Appropriate documents were identified in (...) collaboration with local decision-making experts in Canada, Germany, the Netherlands, the United States, and the United Kingdom. The introduction of hepatitis B virus nucleic acid testing and selected measures against variant Creutzfeldt-Jakob disease, West Nile virus, and Q-fever were chosen as cases representing decision-making on safety measures with high costs and low or uncertain added safety. RESULTS: A broad inventory of concerns was established, including: 1) nine categories of advantages and disadvantages of candidate safety policies; 2) six kinds of difficulties in assessing risks and forecasting the effects of safety policies; 3) 13 decision-making principles; and 4) six kinds of practical barriers hampering the translation of candidate policies into decisions. CONCLUSION: Blood safety policymaking involves a wide variety of competing concerns, and approaches to reconcile these considerations are themselves contested. Developing a systematic decision-making approach requires ethical reflection on, among others, reasonable costs of safety and the value of transparency in public policy. (shrink)

Ethische Leitlinien für die klinische Praxis erfreuen sich zunehmender Beliebtheit. Damit klinisch-ethische Leitlinien aber überhaupt erfolgreich wirksam werden können, ist noch Pionierarbeit zu leisten. Solche Leitlinien müssen wissenschaftlich stärker fundiert und ihre praktische Anwendbarkeit muss verbessert werden. In dieser Arbeit werden die ersten Schritte des Projekts METAP zur methodischen Entwicklung und praktischen Implementierung einer Leitlinie für eine patientengerechte Versorgung am Krankenbett beschrieben und zur Diskussion gestellt. Das Projekt orientiert sich methodisch an der Entwicklung medizinischer Leitlinien und generiert damit eine forschungs- (...) und konsensgestützte Leitlinie, die systematischer Evaluation und Modifikation unterliegt und Rechenschaft über ihre wissenschaftliche Fundierung gibt. Zusätzlich zur Leitlinie bietet das Projekt in der Form eines Handbuchs ein Entscheidungsfindungsverfahren an, welches unter anderem deliberative Aspekte unterstützt. Das Handbuch konzentriert sich auf ethische Fragen der Mikroallokation und liefert darüber hinaus Informationen über empirische, ethische und rechtliche Grundlagen für Therapieentscheidungen. Anhand eines Eskalationsmodells können unterschiedliche Instrumente nach Bedarf als ethische Lösungsstrategien eingesetzt werden, von der Kurzfassung im Kitteltaschenformat („Leporello“) mit den wichtigsten Fakten, weiterführenden Texten und Empfehlungen mit normativen und prozeduralen Hinweisen, über stationsinterne Lösungsversuche bis hin zum Ethikkonsil. Klinische Partner sind von Beginn an aktiv in den Entwicklungsprozess eingebunden und verbessern so die Praxistauglichkeit und Akzeptanz sowie die Ausrichtung des Instrumentariums an den tatsächlichen Bedürfnissen. Dieses partnerschaftliche, partizipative Vorgehen scheint eine wichtige Voraussetzung dafür zu sein, dass METAP in der Klinik Fuß fassen konnte. (shrink)

Research on dyscalculia in neurodegenerative diseases is still scarce, despite high impact on patients’ independence and activities of daily living function. Most studies address Alzheimer’s Disease; however, patients with Parkinson’s Disease also have a higher risk for cognitive impairment while the relation to arithmetic deficits in financial contexts has rarely been studied. Therefore, the current exploratory study investigates deficits in two simple arithmetic tasks in financial contexts administered within the Clinical Dementia Rating in a sample of 100 PD patients. Patients (...) were classified as cognitively normal or mildly impaired according to Level I consensus criteria, and assessed using a comprehensive neuropsychological test battery, neurological motor examination, and sociodemographic and clinical questionnaires. In total, 18% showed arithmetic deficits: they were predominately female, had longer disease duration, more impaired global cognition, but minor signs of depression compared to PD patients without arithmetic deficits. When correcting for clinical and sociodemographic confounders, greater impairments in attention and visuo-spatial/constructional domains predicted occurrence of arithmetic deficits. The type of deficit did not seem to be arbitrary but seemed to involve impaired place × value processing frequently. Our results argue for the importance of further systematic investigations of arithmetic deficits in PD with sensitive tests to confirm the results of our exploratory study that a specific subgroup of PD patients present themselves with dyscalculia. (shrink)

In der Antisemitismuskritik insbesondere nach dem Zweiten Weltkrieg wird Fichte vielfach eine zentrale Rolle zugedacht: nämlich als dem Angelpunkt des Umschlags vom religiösen Antijudaismus zur politischen Judenfeindlichkeit. Diese Sicht, die sich im Wesentlichen auf eine Äußerung in einer Frühschrift des Philosophen von 1793 stützt, hat — so die These des Buches — dessen weitere Entwicklung, wenn überhaupt, dann nur völlig unzureichend zur Kenntnis genommen. Für überraschend viele jüdische Zeitgenossen, seine jüdischen Studenten voran, ist Fichte der wegweisende Philosoph der Epoche gewesen. (...) Die weitere, gerade jüdische Rezeptionsgeschichte seines Werkes belegt bis ins Dritte Reich hinein eine erstaunliche, bislang in diesem Umfang nicht zur Kenntnis genommene Affinität des Judentums zu Fichte. Dabei erweisen sich Fichtes Reden an die deutsche Nation — für viele sicherlich überraschend — gerade für den Zionismus als beispielhaft für jedes Volk im Werden und für das jüdische allemal. Auch die französische Fichte-Rezeption — ebenfals dort ist die jüdische prominent vertreten — hat, die Zeit des Grande Guerre ausgenommen, bis zu Beginn des Zweiten Weltkrieges in Fichte vor allem den Erben der Freiheitsversprechen von Aufklärung und Revolution in Frankreich gesehen. (shrink)

Denjenigen, die mit der im Titel angesprochenen Thematik und Problematik auch nur halbwegs vertraut sind, fällt in der Regel sofort das Verdikt Fichtes über das Judentum aus dem Beitrag zur Berichtigung der Urtheile des Publicums über die französische Revolution von 1793 ein. Es gilt als eines der frühesten Dokumente eines Übergangs vom religiösen Antijudaismus zum politischen Antisemitismus avant la lettre. Nimmt man nun noch die Tatsache hinzu, daß derselbe Philosoph nach verbreitetem Verständnis mit seinen Reden an die deutsche Nation von (...) 1807/8 auch als einer der frühesten Begründer des Nationalismus in Deutschland gilt, so sehen viele Interpreten den weiteren Weg, der schließlich im chauvinistschen Rassenantisemitismus der NS-Zeit endete, geradezu zwanghaft vorgezeichnet. Ein Beispiel für viele andere, die man in der Einleitung meines Buches Fichtes Idee der Nation und das Judentum, das im Oktober 2000 bei Rodopi/amsterdam erschienen ist, zu Hauf finden kann, ist Léon Poliakov: Im 5. Band seiner großen Antisemitismusstudie versteigt er sich zu einer Aussage wie: Fichtes »nationalsozialistische Ausleger hatten es nicht nötig, diese Texte [= der Reden an die deutsche Nation] allzu sehr umzubilden, um den Nachweis erbringen zu können, daß er der erste Prophet der nationalsozialistischen Gottgläubigkeit und des ›arischen Glaubens‹, jenen Eckpfeilern der nebulösen Metaphysik Hitlers gewesen ist.« Nebenbei gesagt: Weder diese beiden Begriffe, noch was immer sie bezeichnen mögen, kommen auch nur entfernt bei Fichte vor, aber das hat weder Poliakov noch andere Fichte-Kritiker, die im Tenor ähnlich geurteilt haben, je gestört. (shrink)

Denjenigen, die mit der im Titel angesprochenen Thematik und Problematik auch nur halbwegs vertraut sind, fällt in der Regel sofort das Verdikt Fichtes über das Judentum aus dem Beitrag zur Berichtigung der Urtheile des Publicums über die französische Revolution von 1793 ein. Es gilt als eines der frühesten Dokumente eines Übergangs vom religiösen Antijudaismus zum politischen Antisemitismus avant la lettre. Nimmt man nun noch die Tatsache hinzu, daß derselbe Philosoph nach verbreitetem Verständnis mit seinen Reden an die deutsche Nation von (...) 1807/8 auch als einer der frühesten Begründer des Nationalismus in Deutschland gilt, so sehen viele Interpreten den weiteren Weg, der schließlich im chauvinistschen Rassenantisemitismus der NS-Zeit endete, geradezu zwanghaft vorgezeichnet. Ein Beispiel für viele andere, die man in der Einleitung meines Buches Fichtes Idee der Nation und das Judentum, das im Oktober 2000 bei Rodopi/amsterdam erschienen ist, zu Hauf finden kann, ist Léon Poliakov: Im 5. Band seiner großen Antisemitismusstudie versteigt er sich zu einer Aussage wie: Fichtes »nationalsozialistische Ausleger hatten es nicht nötig, diese Texte [= der Reden an die deutsche Nation] allzu sehr umzubilden, um den Nachweis erbringen zu können, daß er der erste Prophet der nationalsozialistischen Gottgläubigkeit und des ›arischen Glaubens‹, jenen Eckpfeilern der nebulösen Metaphysik Hitlers gewesen ist.« Nebenbei gesagt: Weder diese beiden Begriffe, noch was immer sie bezeichnen mögen, kommen auch nur entfernt bei Fichte vor, aber das hat weder Poliakov noch andere Fichte-Kritiker, die im Tenor ähnlich geurteilt haben, je gestört. (shrink)

Blood service organizations employ various ways to ensure transfusion blood safety, including the testing of all donations for transfusion-transmissible infections (TTI) and the exclusion of donors who are at increased risk of a recent infection. As some TTIs are more common among men who have sex with men (MSM), many jurisdictions (temporarily) defer the donation of blood by sexually active MSM. This boils down to a categorical exclusion of a large group solely on the basis of their sexual orientation, which (...) is seen as unduly discriminatory and stigmatizing. Blood service organizations in the U.K. and the Netherlands have recently changed their deferral policies for MSM. The problem of the MSM deferral involves a conflict between fundamental rights: the right of MSM to equal treatment and the right to health of the recipients of blood and blood products. We distinguish and discuss three broad alternative options to the current categorical deferral of MSM donations: (1) completely abandoning donor selection on the basis of sexual behavior, (2) individual risk assessment of the sexual activities of each potential donor, and (3) individual risk assessment of the sexual activities of MSM only. The new U.K. policy falls within the second category, and the new Dutch policy is in the third category. We argue that each approach comes with moral costs but that the most reasonable option is different from the policies of both the U.K. and the Netherlands. (shrink)

Blood service organizations employ various ways to ensure transfusion blood safety, including the testing of all donations for transfusion-transmissible infections (TTI) and the exclusion of donors who are at increased risk of a recent infection. As some TTIs are more common among men who have sex with men (MSM), many jurisdictions (temporarily) defer the donation of blood by sexually active MSM. This boils down to a categorical exclusion of a large group solely on the basis of their sexual orientation, which (...) is seen as unduly discriminatory and stigmatizing. Blood service organizations in the U.K. and the Netherlands have recently changed their deferral policies for MSM. The problem of the MSM deferral involves a conflict between fundamental rights: the right of MSM to equal treatment and the right to health of the recipients of blood and blood products. We distinguish and discuss three broad alternative options to the current categorical deferral of MSM donations: (1) completely abandoning donor selection on the basis of sexual behavior, (2) individual risk assessment of the sexual activities of each potential donor, and (3) individual risk assessment of the sexual activities of MSM only. The new U.K. policy falls within the second category, and the new Dutch policy is in the third category. We argue that each approach comes with moral costs but that the most reasonable option is different from the policies of both the U.K. and the Netherlands. (shrink)

Increasing complexity of projects is mentioned as one of the reasons for project failure—still. This paper presents a comparative research to investigate how project complexity was perceived by project practitioners in different industry sectors. Five sectors were included: process industry, construction industry, ICT, high-tech product development, and food processing industry. In total, more than 140 projects were included in the research, hence providing a broad view on Dutch project practice. From the complexity assessments, it is concluded that only one complexity (...) element was present in the top complexity elements of projects across the five sectors: the high project schedule drive. The variety of external stakeholders’ perspectives, a lack of resources and skills availability, and interference with existing site were found in the top lists of three sectors. It was concluded that a framework to grasp project complexity could support the management of complex projects by creating awareness for the complexities. Further research could be focused on the subjective character of complexity as well as on the application of cross-sector learning, since this research does show similarities between large technical projects in different sectors. (shrink)

Ich rekonstruiere und kritisiere Hans Drieschs Argumentation für die Behauptung, daß biologischen Prozessen nur eine substanzdualistische Ontologie der belebten Materie (Vitalismus) gerecht werden kann. Meine Diagnose lautet, daß Drieschs Argumentation zwar logisch schlüssig ist bzw. durch leichte Modifikationen in eine logisch gültige Form gebracht werden kann, aber von empirisch unbegründeten, metaphysischen Prämissen über die Möglichkeiten eines energieumwandelnden Mechanismus ausgeht.

The coefficients of internal consistency and retest reliability had been rarely investigated within the methodology of dream content analysis. Analyzing a dream series of elderly, healthy persons obtained from weekly telephone interviews, the internal consistency of a series of 20 dreams and retests after 4 or 22 weeks, respectively, had been computed. The findings indicate that dream recall and dream length are quite stable, but dream characteristics such as bizarreness and emotional tone underlie large intraindividual fluctuations. In order to obtain (...) reliable measures for these variables which will be important for correlational studies, including waking-life trait measures, one has to obtain as many dreams as possible in a very short time period. Further research is needed to extend the present findings to diary dreams and laboratory dreams. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

For Bernard Williams, philosophy and history are importantly connected. His work exploits this connection in a number of directions: he believes that philosophy cannot ignore its own history the way science can; that even when engaging with philosophy’s history primarily to produce history, one needs to draw on philosophy; and that when doing the history of philosophy primarily to produce philosophy, one still needs a sense of how historically distant past philosophers are, because the point of reading them is to (...) confront something different from the present. But Williams also holds that systematic philosophy itself needs to be done historically, engaging not just with its own history, but with that of the concepts it seeks to understand. To explore these different ways in which philosophy and history intertwine, this volume assembles specially commissioned contributions by A. W. Moore, Terence Irwin, Sophie-Grace Chappell, Catherine Rowett, Marcel van Ackeren, John Cottingham, Gerald Lang, Lorenzo Greco, Paul Russell, Carla Bagnoli, Peter Kail, David Owen, Giuseppina D’Oro, James Connelly, Matthieu Queloz, Nikhil Krishnan, John Marenbon, Ralph Wedgwood, Garrett Cullity, Hans-Johann Glock, Geraldine Ng, Ilaria Cozzaglio, Amanda R. Greene, and Miranda Fricker. They critically appraise Williams’s work in and on the history of philosophy as well as his historicist turn and his use of genealogy. The resulting collection uniquely combines substantive discussions of historical figures from Homer to Wittgenstein with methodological discussions of how and why the history of philosophy should be done, and how and why philosophy should draw on history. (shrink)