The pivotal problem of comorbidity research lies in the psychometric foundation it rests on, that is, latent variable theory, in which a mental disorder is viewed as a latent variable that causes a constellation of symptoms. From this perspective, comorbidity is a (bi)directional relationship between multiple latent variables. We argue that such a latent variable perspective encounters serious problems in the study of comorbidity, and offer a radically different conceptualization in terms of a network approach, where comorbidity is hypothesized to (...) arise from direct relations between symptoms of multiple disorders. We propose a method to visualize comorbidity networks and, based on an empirical network for major depression and generalized anxiety, we argue that this approach generates realistic hypotheses about pathways to comorbidity, overlapping symptoms, and diagnostic boundaries, that are not naturally accommodated by latent variable models: Some pathways to comorbidity through the symptom space are more likely than others; those pathways generally have the same direction (i.e., from symptoms of one disorder to symptoms of the other); overlapping symptoms play an important role in comorbidity; and boundaries between diagnostic categories are necessarily fuzzy. (shrink)

Evolutionary psychology is put forward by its defenders as an extension of evolutionary biology, bringing psychology within the integrated causal chain of the hard sciences. It is extolled as a new paradigm for integrating psychology with the rest of science. We argue that such claims misrepresent the methods and explanations of evolutionary biology, and present a distorted view of the consequences that might be drawn from evolutionary biology for views of human nature. General theses about adaptation in biology are (...) empty schemata, not laws of nature allowing the subsumption of mind under biology. Functional thinking is an indispensable tool for psychology, mostly of value in abstractive unification and as a heuristic, but it gains little from association with evolutionary notions of selection. Thus, we argue, the cherished integrative causal model evaporates, and evolutionary phraseology serves no more than rhetorical purposes. Moreover, the universality of human nature and the evolutionary irrelevance of individual variation are presented as biological truths that psychologists should respect in their approach to mind. On closer inspection, this turns out to be rather dubious biology. Psychology might conceivably be better off as a continuation of biology by different means, but evolutionary psychology does not provide the conceptual integration leading to such a happy union. (shrink)

We performed an EEG graph analysis on data from 31 typical readers (22.27 ± 2.53 y/o) and 24 dyslexics (22.99 ± 2.29 y/o), recorded while they were engaged in an audiovisual task and during resting-state. The task simulates reading acquisition as participants learned new letter-sound mappings via feedback. EEG data was filtered for the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), and beta (13–30 Hz) bands. We computed the Phase Lag Index (PLI) to provide an estimate of the (...) functional connectivity between all pairs of electrodes per band. Then, networks were constructed using a Minimum Spanning Tree (MST), a unique sub-graph connecting all nodes (electrodes) without loops, aimed at minimizing bias in between groups and conditions comparisons. Both groups showed a comparable accuracy increase during task blocks, indicating that they correctly learned the new associations. The EEG results revealed lower task-specific theta connectivity, and lower theta degree correlation over both rest and task recordings, indicating less network integration in dyslexics compared to typical readers. This pattern suggests a role of theta oscillations in dyslexia and may reflect differences in task engagement between the groups, although robust correlations between MST metrics and performance indices were lacking. (shrink)

The King Report on Corporate Governance (1994) evoked unprecedented interest in corporate governance in South Africa. This does not mean that corporate governance was not an issue of concern before the release of this historical report. To the contrary, corporate governance in its broader sense has been at stake since the inception of the first publicly owned companies in South Africa. This article intends to give an overview of corporate governance in South Africa. It starts by making a distinction between (...) broad and narrow conceptions of corporate governance. Before applying this distinction to the practice of corporate governance in South Africa, a brief overview of the corporate landscape in South Africa is provided. Then the South African situation with regard to broad and narrow corporate governance respectively is analysed. The article ends with a discussion of the review of corporate governance that currently is in the making in South Africa. Throughout the article both the financial and ethical dimensions of corporate governance is attended to. (shrink)

This article reflects a conversation between Jan G. van der Watt and Stephan Joubert. The article serves as the introduction to the Special Collection: ‘From timely exegesis to contemporary ecclesiology: Relevant hermeneutics and provocative embodiment of faith in a Corona-defined world – Festschrift for Stephan Joubert, sub-edited by Willem Oliver ’. Following a brief bio-statement as introduction, the following issues are discussed: the collection for the Jerusalem church; relevance of theology for society; social-scientific exegesis; the ancient concept of grace; Bible (...) translation in South Africa; public theology on the electronic platform; biblical examples of leadership and electronic media in religious activities and education.Contribution: This Festschrift represents current trends in biblical scholarship and ecclesial leadership. It contributes to the public discourse in church and society, especially the role of the electronic media in current Fourth Industrial Revolution. (shrink)

According to the logic of collective action, mere awareness of the causes of environmental degradation will not motivate rational agents to reduce pollution. Yet some government policies aim to enlist citizens in schemes of voluntary cooperation, drawing on an ethos of collective responsibility. Are such policies doomed to failure? This book provides a novel application of rational choice theory to a large-scale survey of environmental attitudes in The Netherlands. Its main findings are that rational citizens are motivated to cooperate towards (...) a less polluted environment to a large extent, but that their willingness to assume responsibility depends on the social context of the collective action problem they face. This empirical study is an important volume in the development of a more consistent foundation for rational choice theory in policy analysis, which seeks to clarify major theoretical issues concerning the role of moral commitment, self-interest and reciprocity in environmental behaviour. (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)

Research suggests that sedentary behavior is negatively associated with cognitive outcomes. Interrupting prolonged sitting has been shown to improve cognitive functions, including executive functioning, which is important for academic performance. No research has been conducted on the effect of standing on EF in VET students, who make up a large proportion of the adolescent population and who are known to sit more than other students of this age. In this study, we investigated the acute effects of reducing SB by short (...) time standing on EF in vocational education and training students. In a randomized crossover study, 165 VET students were first taught for 15 min in seated position. After this, they performed while seated the Letter Memory Test for updating, and the Color Shape Test for shifting and inhibition. Students were randomly assigned to a sitting or standing condition. All students were taught again for 15 min and then took the same tests in the condition they were allocated to, respectively, standing or seated. After 1 week, the test procedure was repeated, in which students switched conditions. Mixed model analyses showed no significant effect of sitting or standing on updating, shifting, or inhibition. Also, no significant differences were found for the order of condition on updating, shifting, or inhibition. Our results suggest that 40 min of standing does not significantly influence EF among VET students. (shrink)

The paper discusses ten philosophical problems in deontic logic: how to formally represent norms, when a set of norms may be termed ‘coherent’, how to deal with normative conflicts, how contraryto-duty obligations can be appropriately modeled, how dyadic deontic operators may be redefined to relate to sets of norms instead of preference relations between possible worlds, how various concepts of permission can be accommodated, how meaning postulates and counts-as conditionals can be taken into account, and how sets of norms may (...) be revised and merged. The problems are discussed from the viewpoint of input/output logic as developed by van der Torre & Makinson. We argue that norms, not ideality, should take the central position in deontic semantics, and that a semantics that represents norms, as input/output logic does, provides helpful tools for analyzing, clarifying and solving the problems of deontic logic. (shrink)

The ground-state dispersion energy of a pair of axially symmetric molecules is calculated, to arbitrary order in the inverse intermolecular separation, on the basis of London's anisotropic oscillator model.

A study is made of the dominant terms of an earlier model-based formula describing the dispersion energy of axially symmetric interacting molecules. The existence of mixed-pole eighth-order terms is noted.

Lon Fuller, one of the great American jurists of this century, is often remembered only for his stand on the morality of law in the Fuller-Hart debate. Rediscovering Fuller considers the full range of Fuller's writings, from his early engagement with legal fictions and his critique of legal positivism to his later work on implicit law and the art of institutional design. Contributors from the fields of both civil law and common law argue that Fuller's insights are highly relevant to (...) contemporary concerns. The book contains essays by K. Winston, D. Dyzenhaus, P. Cliteur, F. Schauer ("Beyond the Fuller-Hart Debate"), P. Westerman, W. van der Burg, D. Luban ("Moralities of Law"), G. Postema, P. Teachout ("Implicit Law"), R. Macdonald, W. Witteveen, J. Allison, M. Hertogh, K. Soltan ("The Art of Institutional Design"), J. Allan, F. Mootz, J. Vining ("Law's Dialogue"), and a preface by Ph. Selznick. "At some point in the future, when we become more open to the moral relevance of social inquiry, more empirical in our study of philosophical issues, more capable of uniting moral and social theory, Lon Fuller's work will stand as a landmark. This volume will help show the way." —Ph. Selznick. (shrink)

Wim van der Steen charts conceptual foundations of evolutionary biology and, on the basis of this, he evaluates applications of evolutionary theory outside biology. Philosophical analysis shows that key notions of the theory such as fitness, adaptation, selection, and optimality are empty place-holder concepts that call for context-dependent specifications of meaning. For example, as he points out, the notion of optimality is empty without a specification of constraints. Hence, the controversial thesis that animals perform optimal behaviors as a result of (...) natural selection is meaningless rather than true or false. Analysis shows that many other controversies in evolutionary biology are spurious. Thus, the thesis of genic selectionism, which puts genes at center stage in evolutionary theory, is best reconstructed as an arbitrary conceptualization without substance. Disagreements over the thesis are futile. They reflect preferences for different conceptualizations which are ultimately equivalent. As concepts are properly specified, van der Steen asserts evolutionary theory turns out to be a body of interesting natural history at a low level of generality. General laws of evolution do not exist. Hence, evolutionary approaches do not allow sweeping claims about human nature. Unfortunately, in disciplines outside biology such claims are often defended with evolutionary approaches. Evolutionary theory also cannot serve as a foundation for normative views in ethics or epistemology. This is an important and controversial work for scholars and advanced researchers in biology and the philosophy of biology. (shrink)

Does ethics have adequate general theories? Our analysis shows that this question does not have a straightforward answer since the key terms are ambiguous. So we should not concentrate on the answer but on the question itself. “Ethics” stands for many things, but we let that pass. “Adequate” may refer to varied arrays of methodological principles which are seldom fully articulated in ethics. “General” is a notion with at least three meanings. Different kinds of generality may be at cross-purposes, so (...) we must not expect theories to be general in sundry senses. “Theory,” for that matter, is itself ambiguous. Some thinkers say that ethics cannot have theories, while others deny it. We doubt whether opposing parties are talking about the same things.No wonder, then, that controversies in ethics are long-lasting and unproductive. We hope that the methodology we have presented will alleviate some of them. The examples we chose show that this is feasible. Views such as Hare's and Jonsen and Toulmin's which are seemingly wide apart, show convergence if we put them in a methodological perspective.Our analysis also suggests that many alleged differences between science and ethics could fade away if methodology is brought to bear on them. Specifically, the idea that ethics compares poorly with science in view of limited generality, or poor means of justification, is unfounded. Those who defend this view over-rate the powers of science. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

The use of do not resuscitate (DNR) orders in Dutch hospitals was studied as part of a nationwide study on medical decisions concerning the end of life. DNR decisions are made in 6 per cent of all admissions, and 61 per cent of all in-hospital deaths were preceded by a DNR decision. We found that in only 14 per cent of the cases had the patients been involved in the DNR decision (32 per cent of competent patients). The concept of (...) futility is analysed as these findings are discussed. We conclude that determining the effectiveness of resuscitation is a medical judgement whereas determining the proportionality (burden/benefit ratio) of it requires a discussion between doctor and patient (or his or her surrogates). Since the respondents in the cases without patient involvement gave many reasons for their decision that went beyond determining effectiveness, we conclude that more patient involvement would have been desirable. (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)

BackgroundThere is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study.MethodsWe conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands.ResultsThree themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment.ConclusionsHealthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)