BackgroundThe interpretation of clinical gait data in children with cerebral palsy (CP) is time-consuming, requires extensive expertise and often lacks transparency. Here we aimed to develop a set of look-up tables to support this process, linking typical gait features as present in CP to their potential underlying impairments.MethodsWe developed an initial core set of gait features and their potential underlying impairments based on biomechanical reasoning, literature and clinical experience. This core set was further specified through a Delphi process in a (...) multidisciplinary group of experts in gait analysis of children with CP and evaluated on 20 patient cases. The likelihood of the listed gait feature–impairment relationships was scored by the expert panel on a five-point scale.ResultsThe final core set included 120 relevant gait feature–impairment relations including likelihood scores. This set was presented in the form of look-up tables in both directions, i.e., sorted by gait features with potential underlying impairment, and sorted by impairments with potential related gait features. The average likelihood score for the relations was 3.5 ± 0.6 (range 2.1–4.6).ConclusionThe developed set of look-up tables linking gait features and impairments, can assist gait analysts and clinicians in standardized biomechanical reasoning, to support treatment decision-making for gait impairments in children with CP. (shrink)

The target article's evolutionary approach provides an excellent framework for understanding when and why people retaliate or forgive. We argue that recent findings on the basic processes in forgiveness can further refine the authors' proposed model. Specifically, the lack of executive control may restrict the explanatory power of relationship value and exploitation risk.

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)

Workplace aggression has been established as a prevalent and detrimental issue in organizations. While numerous studies have documented the important role of leaders in inhibiting or accelerating workplace aggression, a systematic overview of the associations between different leadership styles and workplace aggression as well as its boundary conditions is still lacking. This study reports a meta-analysis investigating the associations between leadership and workplace aggression. Drawing on data from 165 samples, our results revealed that change-oriented, relational-oriented, and values-based and moral leadership (...) were associated with reduced workplace aggression. In contrast, passive and destructive leadership were associated with increased workplace aggression. Importantly, relative weights analyses revealed that ethical leadership was most strongly negatively associated with workplace aggression. Additionally, moderation analyses revealed that the associations between leadership and workplace aggression were, in some cases, moderated by power distance and rating sources, but independent of measurement time lag. Overall, the findings of this meta-analysis highlight the important associations between leadership and workplace aggression. Implications for future research and policy recommendations aiming to reduce workplace aggression are discussed. (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)

Les décisions politiques sur les risques environnementaux complexes font fréquemment intervenir des éléments scientifiques contestés. Il n’y a généralement pas de « faits » qui conduisent à une politique correcte unique. Les éléments de preuve qui sont intégrés dans les avis scientifiques destinés à une décision politique nécessitent une évaluation de leur qualité. En 2003, l’Agence néerlandaise d’évaluation environnementale a adopté une méthode standardisée, désignée sous le nom de « guide », dans le cadre de laquelle les principaux aspects de (...) la production et de l’utilisation des connaissances sont présentés grâce à une liste de contrôle visant à l’évaluation et à la communication des incertitudes. Dans cet article, nous présentons des résultats de l’application de ce guide à la controverse sur les risques des particules en suspension. La délibération active sur l’incertitude dans un contexte d’expertise entraîne un processus d’apprentissage commun entre les experts et les décideurs politiques, ce qui conduit à une meilleure prise de conscience du phénomène d’incertitude et de ses implications politiques.Policy decisions on complex environmental risks often involve disputed science. Typically, there are no “ facts” to support a single unequivocally correct policy. The evidence provided in scientific studies for policy-making decisions requires high-quality assessment. In 2003, the Netherlands Environmental Assessment Agency adopted a standardized method, referred to as “guidelines”, whereby key quality aspects of knowledge production and use are presented in the form of a checklist for uncertainty assessments and communication. In this article, we present the outcomes of applying the guidelines in controversies on the risks of ambient particulate matter. In the policy–advisory context, active deliberation on uncertainty produces a common learning process for advisors and policy makers, which leads to a deeper understanding and increased awareness of the phenomenon of uncertainty and its policy implications. (shrink)

In this article the authors seek to conceptualize a dynamic and inclusive understanding of personal identity within multicultural democracies such as South Africa, which will draw on both the liberal and communitarian traditions' respect for the project of self. A preliminary lay out for such a project emerges from a literature survey of recent, primarily South African publications on identity and culture, and it suggests that selfhood depends on: a) virtues, cultivated within cooperative communities which allow for effective freedom; b) (...) a venture into existential uncertainty, which alleviates that fear of loss of identity that is supposedly central to many multicultural conflicts; c) the hermeneutic construction of identity through narratives that allow for a plurality of voices; and d) the creative transcending and re- interpretation of values and traditions. The authors contend that such an under standing of identity goes some way towards addressing the question of the way that diverse personal and group identities are to be accommodated in South Africa's multicultural democracy, and to re thinking the unity which underlies diversity without resorting to liberalism's reduction of personal identity to rational autonomy. S. Afr. J. Philos. Vol.20(3) 2001: 35-54. (shrink)

In academic research, many attempts have been undertaken to legitimize corporate community involvement by showing a business case for it. However, much less attention has been devoted to building understanding about the actual dynamics and challenges of managing CCI in the business context. As an alternative to existing predominantly static and top-down approaches, this paper introduces a social movement framework for analyzing CCI management. Based on the analysis of qualitative case study data, we argue that the active role of employees (...) pressuring for CCI policies and practices, as well as the organization audience responses to their efforts, are at the core of the challenges involved in managing CCI. These challenges also pose limits to how far CCI can be extended to a “business as usual” activity. (shrink)

Family carers of individual’s living with Huntington’s Disease (HD) manage a distinct and unique series of difficulties arising from the complex nature of HD. This paper presents the validation of the definitive measure of quality of life for this group. The Huntington’s Disease Quality of Life Battery for carers (HDQoL-C) was expanded and then administered to an international sample of 1716 partners and family carers from 13 countries. In terms of the psychometric properties of the tool, exploratory analysis of half (...) of the sample, demonstrated good internal consistency and reliability. Some items on the full version did not meet psychometric thresholds and a short version (HDQoL-Cs) was developed based on more stringent criteria. Confirmatory Factor Analysis of the model structure showed a good fit for all Factors and, indicated that the HDQoL-C and HDQoL-Cs are psychometrically robust measures of quality of life. We found that carers who lived with and looked after their spouse/partner had reduced sense of coping, hope for the future and overall quality of life. Carers with children who were at risk, carried the gene or were symptomatic also had poorer quality of life outcomes. Findings indicated the HDQoL-C and HDQoL-Cs are valid in multiple languages and across varied cultures as measures of self-reported quality of life in family carers of individual’s living with HD. These psychometrically validated tools can aid and guide the implementation of therapeutic interventions to improve life quality in this population. (shrink)

In this article the perspective shifts to the “upstream” end of the agricultural knowledge and information system (AKIS). Because knowledge policy and strategic decision-making are not the prerogative of the public sector, organizations such as cooperative unions and multinational companies are included. After considering the influence of the changing environment on the nature of the AKIS, the role of knowledge management and policy in the emerging knowledge and information market is examined. Special attention is given to public and private R&D. (...) The article then looks where information technology (IT) fits in and what considerations determine strategic investment in IT projects and sustained services. Some of the European experiences with this strategic investment are evaluated. (shrink)

Society’s relationship with modern animal farming is an ambivalent one: on the one hand there is rising criticism about modern animal farming; on the other hand people appreciate certain aspects of it, such as increased food safety and low food prices. This ambivalence reflects the two faces of modernity: the negative (exploitation of nature and loss of traditions) and the positive (progress, convenience, and efficiency). This article draws on a national survey carried out in the Netherlands that aimed at gaining (...) a deeper understanding about the acceptance of modern dairy farming in Dutch society. People take two dimensions into account when evaluating different aspects of modern dairy farming: (1) the way living beings are used for production and (2) the way a dairy farm functions as a business. In both these dimensions people appeared to adopt cautious opinions: most people preferred relatively traditional and natural farms and were concerned about the use of nature and treatment of animals in modern production—although this did not imply an outright rejection of modern animal farming. The study also looked for (and sought to explain) differences of opinion between social groups. Besides socio-demographic factors such as age and gender, farming experience and value-orientation (such as socially minded and professional) appeared to be important variables. The values and convictions within modern society can help to explain why some people are greatly concerned about animal welfare while some show less concern. This diversity also helps to explain why general information campaigns are quite ineffective in allaying concerns about modern animal farming. (shrink)

As we owe the division of ecology into autecology and synecology to botanists, the arguments for this subdivision and also the definitions and contents of both subsciences as given bySchröter, Flahault &Schröter, Gams andDu Rietz are communicated in full. The same is the case with the division of ecology given by the zoologistsAdams andChapman. Moreover the opinions of these authors in this respect are critisized in detail as well as in their general aspects. This critique is connected with the author's (...) own positive opinion, which is given at the end of the paper, where also the remarks covered by the first two papers of this series are summarised.In ecology as a biological science either the individual or the complex of individuals has to occupy a central position. Therefore science about the environment, especially the abiotic one, as well as science about a definite region or spot of the earth ought not to be incorporated in biology.In autecology the individual occupies a central position, it is one of the subsciences of idiobiology, it is a science about the relations to environment, taken in the broadest sense. Dependent upon the contents of this we have many definitions of ecology, the most important ones being: 1) ecology is a biogeographical subscience; 2) ecology is taken in the sense of ethology; 3) ecology is taken as a science of the teleological relations of the individual to its environment and the objects in it, thus of the non-causal relations, the causal ones being assigned to physiology. These non-causal relations appear under four aspects, all called teleological, i.e. the true purpose-notion, relation in the sense of requirement, that in the sense of wholeness, and of adaptation and the degree of adaptation. Adaptation is taken in a broad sense, covering as well the degree of adaptation , as the latitude of the possibility of adaptation and the degree of variability of the individual to adapt itself. The proposal is made to confine the term autecology to this teleological aspect of the relations of the individual, i.e. of all its characters, not of the epharmonic ones only, to environment.In synecology the complex of individuals, showing direct real connections during individual life, occupies a central position, with equal scientific interest for all members of the complex. Synecology contains all biological scientific contents about this matter. The application ofTschulok's system of subsciences to synecology is critisized and the development of the system of these subsciences is left to its developmental fate in time. Considering the importance of the knowledge of the tendencies of thought for the development of synecology an attempt is made to state those already applied in synecology; author distinguishes the systematical, the mathematical, the causal, the historical, the teleological and the essential tendency of thought. Also the difference in the tendencies of thought shows that autecology and synecology are to be separated in a logical system of biological subsciences.Puisque c'est aux botanistes que nous devons la division de l'écologie en autécologie et synécologie, l'auteur passe en revue tous les arguments qui ont amené les biologistes à faire cette subdivision, ainsi que les définitions de ces deux subsciences et les matières qu'elles comprennent, comme elles sont données parSchröter, Flahault &Schröter, Gams etdu Rietz. Il en fait de même pour la division de l'écologie faite par les zoologistesAdams etChapman. En outre il discute les opinions de ces auteurs sous ce rapport, dans leurs détails aussi bien que dans leurs aspects généraux. Cette discussion est en rapport avec l'opinion positive de l'auteur, qu'il expose à la fin de l'article, où se trouvent résumées également les remarques qui se trouvaient déjà dans les deux premiers articles de cette série.Dans l'écologie, en tant que science biologique, l'individu — ou bien l'ensemble des individus — doit occuper une position centrale. C'est pourquoi ni la science qui concerne le milieu, en particulier le milieu abiotique, ni la science qui se rapporte à une région ou un endroit défini de la terre, ne devrait être incorporée dans la biologie.Dans l'autécologie l'individu occupe une position centrale. Cette science est une des subsciences de l'idiobiologie; elle se rapporte aux relations entre le sujet et son milieu — „milieu” pris dans le sens le plus large du mot. Selon les significations diverses qu'on peut attacher aux termes „relations” et „milieu”, nous avons plusieurs définitions de l'écologie, parmi lesquelles les plus importantes suivent ci-dessous:1)L'écologie est une subscience biogéographique; 2) le terme „écologie” est pris dans le sens d'éthologie; 3) l'écologie est considérée comme la science des relations téléologiques entre l'individu et son milieu et les objets se trouvant dans ce milieu; elle est donc considérée comme la science des relations non-causales, les relations causales étant conférées à la physiologie. Ces relations non-causales se présentent sous quatre aspects, tous appelés téléologiques, c. à. d. la vraie notion de but, les relations dans le sens de besoins, les relations dans le sens de „tout” et les relations dans le sens d'adaptation et de degré d'adaptation.Le mot „adaptation” est pris dans un sens étendu, comprenant aussi bien le degré d'adaptation que l'amplitude de la possibilité d'adaptation et le degré de variabilité dans l'adaptation de l'individu à son milieu. L'auteur propose de restreindre le terme „autécologie” à cet aspect téléologique des relations entre l'individu et son milieu; il s'agit ici, bien entendu, de toutes les qualités de l'individu et non seulement des qualités epharmoniques.Dans la synécologie l'ensemble des individus montrant des rapports directs et réels durant la vie individuelle occupe une position centrale et offre un intérêt scientifique pareil pour tous les membres de l'ensemble. La synécologie comprend tout ce qu'il y a à dire sur cette matière par rapport à la science biologique. L'application du système des subsciences deTschulok à la synécologie est critiquée par l'auteur, qui juge prématuré de s'occuper déjà d'un tel système de subsciences: l'avenir seul nous apprendra quel système se développera ici. Vu l'importance d'une connaissance exacte des différentes tendances de penser pour le développement de la synécologie, l'auteur s'efforce de rassembler celles qui ont déjà été appliquées dans la synécologie; il distingue les tendances de penser systématique, mathématique, causale, historique, téléologique et essentielle . En outre les différences entre ces tendances de penser démontrent, que l'autécologie et la synécologie doivent être séparées dans un système logique de subsciences biologiques. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

OBJECTIVES: To identify the factors that influence the assessment of reported cases of physician-assisted death by members of the public prosecution. DESIGN/SETTING: At the beginning of 1996, during verbal interviews, 12 short case-descriptions were presented to a representative group of 47 members of the public prosecution in the Netherlands. RESULTS: Assessment varied considerably between respondents. Some respondents made more "lenient" assessments than others. Characteristics of the respondents, such as function, personal-life philosophy and age, were not related to the assessment. Case (...) characteristics, i.e. the presence of an explicit request, life expectancy and the type of suffering, strongly influenced the assessment. Of these characteristics, the presence or absence of an explicit request was the most important determinant of the decision whether or not to hold an inquest. CONCLUSIONS: Although the presence of an explicit request, life expectancy and the type of suffering each influenced the assessment, each individual assessment was dependent on the assessor. The resulting danger of legal inequality and legal uncertainty, particularly in complicated cases, should be kept to a minimum by the introduction of some form of protocol and consultation in doubtful or boundary cases. The notification procedure already promotes a certain degree of uniformity in the prosecution policy. (shrink)

About a decade ago, the Netherlands Environmental Assessment Agency unwittingly embarked on a transition from a technocratic model of science advising to the paradigm of ‘‘post-normal science’’. In response to a scandal around uncertainty management in 1999, a Guidance for ‘‘Uncertainty Assessment and Communication’’ was developed with advice from the initiators of the PNS concept and was introduced in 2003. This was followed in 2007 by a ‘‘Stakeholder Participation’’ Guidance. In this article, the authors provide a combined insider/outsider perspective on (...) the transition process. The authors assess the extent to which the PNS paradigm has delivered new approaches in the agency’s practice and analyze two projects—on long-term options for Dutch sustainable development policy and for urban development policy—the latter in somewhat more detail. The authors identify several paradoxes PBL encounters when putting the PNS concept into practice. It is concluded that an openness to other styles of work than the technocratic model has become visible, but that the introduction of the PNS paradigm is still in its early stage. (shrink)

We identify two aspects of the problem of maintaining perceptual stability despite an observer's eye movements. The first, visual direction constancy, is the (egocentric) stability of apparent positions of objects in the visual world relative to the perceiver. The second, visual position constancy, is the (exocentric) stability of positions of objects relative to each other. We analyze the constancy of visual direction despite saccadic eye movements.Three information sources have been proposed to enable the visual system to achieve stability: the structure (...) of the visual field, proprioceptive inflow, and a copy of neural efference or outflow to the extraocular muscles. None of these sources by itself provides adequate information to achieve visual direction constancy; present evidence indicates that all three are used.Our final question concerns how information processing operations result in a stable world. The three traditionally suggested means have been elimination, translation, or evaluation. All are rejected. From a review of the physiological and psychological evidence we conclude that no subtraction, compensation, or evaluation need take place. The problem for which these solutions were developed turns out to be a false one. We propose a “calibration” solution: correct spatiotopic positions are calculated anew for each fixation. Inflow, outflow, and retinal sources are used in this calculation: saccadic suppression of displacement bridges the errors between these sources and the actual extent of movement. (shrink)

The phenomena referred to by the term attention were not discovered by scientific psychology. They were discovered and described within philosophy and gently handed over to the emerging academic psychology of the nineteenth century. The main contributors and contributions to the delineation and construction of attention as an empirical phenomenon and a topic for theorizing were Aristotle, who noticed that not all that reaches the senses is clearly perceived; Augustine, who interpreted attention as an effort of the soul; Descartes, who (...) distinguished active attention from passive attention; and Leibniz, who discussed the relation between attention, perception, and consciousness. (For further information on attention's philosophical past the reader is referred to Neumann's (in press) brief history of this philosophical past that is badly in need of an English translation.). (shrink)