Aan de praat, over moreel beraad. Responsief evaluatie onderzoek naar moreel beraad binnen GGZ-instelling Reinier van Arkel

In 2004 is met behulp van dr. Bert Molewijk (VUmc) en dr. Margreet Stolper (VUmc) het moreel beraad binnen een van de divisies van GGZ-instelling Reinier van Arkel geïmplementeerd. Nu, twaalf jaar later, wordt moreel beraad nog steeds gevoerd en ligt het plan er om het moreel beraad ook in andere eenheden van de organisatie in te voeren. In opdracht van VUmc wordt in deze responsieve evaluatie de ervaringen van betrokkenen geëvalueerd. Het doel van deze responsieve evaluatie is om te leren van alle ervaringen. De hoofdvraag is als volgt: “Hoe wordt moreel beraad binnen Reinier van Arkel ervaren door verschillende betrokkenen en wat kunnen we hiervan leren voor de zorgethiek en de praktijk?”. Op dialogische wijze worden de ervaringen van zes verschillende belanghebbenden verzameld en geanalyseerd. Uit de bevindingen blijkt dat de ervaringen met moreel beraad vooral positief zijn. Het moreel beraad binnen Reinier van Arkel wordt door alle betrokkenen als belangrijk ervaren voor de kwaliteit van zorg, professionele ontwikkeling en teambuilding. Vanuit de zorgethiek kan geleerd worden dat het tijdens een moreel beraad belangrijk is dat er oog is voor critical insights als praktijken, lichamelijkheid en emoties, afhankelijkheid en kwetsbaarheid, macht en positie. Vanuit de bevindingen worden de critical insights tegelijkertijd verrijkt en rijzen nieuwe discussiepunten op die vragen voor nadere reflectie. Uit de bevindingen blijkt tot slot dat de betrokkenen het belangrijk vinden dat moreel beraad organisatiebreed ingevoerd en georganiseerd wordt. Er zijn verschillende visies over de wijze waarop dat het beste kan gebeuren. Alle betrokkenen vinden het belangrijk om op dialogische wijze met elkaar daarover in gesprek te gaan. Aangeraden wordt om deze dialoog in een focusgroepbijeenkomst aan te gaan

The invention of knowing : a study of Nietzsche's casual-genetic enquiries into knowledge

A typically Nietzschean reflection on our cognitive capacities assumes the form of an investigation into the genesis of these capacities. Nietzsche is in fact remarkably consistent in his use of this approach. It is first on display in the unpublished essay On Truth and Lies, and it recurs with some frequency throughout the middle- and late-period. In this thesis, I am interested in understanding what Nietzsche aims to accomplish by reflecting on our cognitive capacities in this manner. On a standard interpretation, Nietzsche resorts to this approach in the hope of accomplishing traditional epistemic aims. On this view, Nietzsche is looking to determine whether knowledge is possible at all; and if it is possible, under what conditions, and within which limits. Although the standard view currently appears as doxa in the scholarship, I believe that there is little to no textual evidence in support of it. In this thesis, I therefore propose an alternative. In my view, Nietzsche’s enquiries into the origins of our cognitive capacities stand in the service of his interest in the value of knowledge, and not in the service of knowledge’s possibility. To make this point I defend two claims. First, I argue that the mature Nietzsche is actually quite hostile to the idea that we can theoretically substantiate either the possibility of knowledge, or a sceptical stance regarding this possibility. If this is true, then certainly the mature Nietzsche could not possibly have intended for his genetic enquiries to contribute to that aim. Second, I offer a novel interpretation of Nietzsche’s third essay in The Genealogy to substantiate my claim that, in fact, the aim of these enquiries is to help us reflect on the value of knowledge. This interpretation, coupled with considerable circumstantial evidence, shows my interpretation to be more plausible than the standard view

Low antimicrobial resistance in general practice patients in Rotterdam, the city with the largest proportion of immigrants in the Netherlands

Antimicrobial resistance (AMR) is an increasing problem. The prevalence of antimicrobial resistance in general practice patients is expected to be relatively high in Rotterdam, the Dutch city with the largest proportion non-Western immigrants. The aim of this study was to assess the prevalence of antibiotic-resistant uropathogens (Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis) in general practices in Rotterdam, and to find a possible association between the prevalence of antibiotic-resistant E. coli and age, gender, and socioeconomic status (SES). A retrospective analysis was performed of urine samples from general practice patients in 2016. The prevalence of AMR in uropathogens was compared with national resistance data, as was the prevalence of highly and multidrug resistant and extended spectrum β-lactamase (ESBL) producing E. coli and K. pneumoniae. Univariate logistic regression was used to study associations between antibiotic-resistant E. coli and age, gender, and SES area score. No clinically relevant differences were observed in the prevalence of antibiotic-resistant uropathogens in Rotterdam compared with the national prevalence. For E. coli and K. pneumoniae, the prevalence was 3.6% for ESBL production (both pathogens together), while the prevalence ranged between 4.2%–5.0% for high resistance and between 1.2%–3.3% for multidrug resistance. Ciprofloxacin-resistant E. coli was significantly associated with higher age. Although Rotterdam has a high percentage of non-western immigrants and a low SES, AMR is low among general practice patients. This indicates that adherence to national guidelines in general practice enables maintenance of low AMR, even in high-risk populations

Perception and cognition of cues Used in synchronous Brain–computer interfaces Modify electroencephalographic Patterns of control Tasks

A motor imagery (MI)-based brain–computer interface (BCI) is a system that enables humans to interact with their environment by translating their brain signals into control commands for a target device. In particular, synchronous BCI systems make use of cues to trigger the motor activity of interest. So far, it has been shown that electroencephalographic (EEG) patterns before and after cue onset can reveal the user cognitive state and enhance the discrimination of MI-related control tasks. However, there has been no detailed investigation of the nature of those EEG patterns. We, therefore, propose to study the cue effects on MI-related control tasks by selecting EEG patterns that best discriminate such control tasks, and analyzing where those patterns are coming from. The study was carried out using two methods: standard and all-embracing. The standard method was based on sources (recording sites, frequency bands, and time windows), where the modulation of EEG signals due to motor activity is typically detected. The all-embracing method included a wider variety of sources, where not only motor activity is reflected. The findings of this study showed that the classification accuracy (CA) of MI-related control tasks did not depend on the type of cue in use. However, EEG patterns that best differentiated those control tasks emerged from sources well defined by the perception and cognition of the cue in use. An implication of this study is the possibility of obtaining different control commands that could be detected with the same accuracy. Since different cues trigger control tasks that yield similar CAs, and those control tasks produce EEG patterns differentiated by the cue nature, this leads to accelerate the brain–computer communication by having a wider variety of detectable control commands. This is an important issue for Neuroergonomics research because neural activity could not only be used to monitor the human mental state as is typically done, but this activity might be also employed to control the system of interest

Denesting certain nested radicals of depth two

Contains fulltext : 18722.pdf ( ) (Open Access)Report No. 991614 p

Radical extensions and Galois groups

Contains fulltext : 32897.pdf (publisher's version ) (Open Access)The use of symbolic computing is one of the characteristics of a computer algebra package. For example, the number square root of 2 is represented as a symbol with the property that its square is 2. This enables us to do exact calculations. However, the computer algebra package often give complicated expressions although there is a simpler expression for the number that we are interested in. The simplification of nested radicals was an important motivation for the research in this thesis. Given a nested radical alpha we can build a chain of field extensions, such that the largest field in this chain is a Galois extension containing alpha and such that all subextensions in the chain are generated by a radical. Galois theory gives a powerfull tool to study field extensions. In the article `Simplifications of nested radicals' Susan Landau uses Galois theory to provide an algorithm that calculates a simple expression for alpha. In all publications about nested radicals roots of unity play an important role. In Landau's algorithm roots of unity cause problems in proving that the algorithm gives the simplest possible representation as a nested radical. In chapter 1 of this thesis we study Galois extensions generated by nested radicals where the ground field does not necessarely contain the roots of unity to apply Kummer theory. We give a description of the Galois group of extensions over a field K generated by the n-th roots of all elements of K. In chapter 2 we consider field extensions generated by one radical alpha over the ground field Q. We give necessary and sufficient conditions on alpha to generate a field with no other subfields than those generated by a power of alpha. In chapter 3 and 4 we return to the simplification of nested radicals and study nested radicals of special forms. Chapter 5 is an article written together with Alice Gee. We study the Rogers-Ramanujan continued fraction. In 1913 Ramanujan astonished Hardy by giving an identity between a continued fraction and a nested radical. He found this by computing the value of the Rogers-Ramanujan continued fraction at i. In this chapter we give a method to compute nested radicals for singular values of the Rogers-Ramanujan continued fraction.RU, Computeralgebra, 17 mei 2005Promotor : Keune, F.J. Co-promotores : Bosma, W., Smit, B.105 p

Singular values of the Rogers-Ramanujan continued fraction

Let z\in\C be imaginary quadratic in the upper half plane.Then the Rogers-Ramanujan continued fraction evaluated at $q=e^{2\pi i z}$ is contained in a class field of \Q(z). Ramanujan showed that for certain values of $z$, one can write these continued fractions as nested radicals. We use the Shimura reciprocity law to obtain such nested radicals whenever $z$ is imaginary quadratic