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)

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

In science policy, it is generally acknowledged that science-based problem-solving requires interdisciplinary research. For example, policy makers invest in funding programs such as Horizon 2020 that aim to stimulate interdisciplinary research. Yet the epistemological processes that lead to effective interdisciplinary research are poorly understood. This article aims at an epistemology for interdisciplinary research, in particular, IDR for solving ‘real-world’ problems. Focus is on the question why researchers experience cognitive and epistemic difficulties in conducting IDR. Based on a study of educational (...) literature it is concluded that higher-education is missing clear ideas on the epistemology of IDR, and as a consequence, on how to teach it. It is conjectured that the lack of philosophical interest in the epistemology of IDR is due to a philosophical paradigm of science, which prevents recognizing severe epistemological challenges of IDR, both in the philosophy of science as well as in science education and research. The proposed alternative philosophical paradigm entails alternative philosophical presuppositions regarding aspects such as the aim of science, the character of knowledge, the epistemic and pragmatic criteria for accepting knowledge, and the role of technological instruments. This alternative philosophical paradigm assume the production of knowledge for epistemic functions as the aim of science, and interprets ‘knowledge’ as epistemic tools that must allow for conducting epistemic tasks by epistemic agents, rather than interpreting knowledge as representations that objectively represent aspects of the world independent of the way in which it was constructed. The engineering paradigm of science involves that knowledge is indelibly shaped by how it is constructed. Additionally, the way in which scientific disciplines construct knowledge is guided by the specificities of the discipline, which can be analyzed in terms of disciplinary perspectives. This implies that knowledge and the epistemic uses of knowledge cannot be understood without at least some understanding of how the knowledge is constructed. Accordingly, scientific researchers need so-called metacognitive scaffolds to assist in analyzing and reconstructing how ‘knowledge’ is constructed and how different disciplines do this differently. In an engineering paradigm of science, these metacognitive scaffolds can also be interpreted as epistemic tools, but in this case as tools that guide, enable and constrain analyzing and articulating how knowledge is produced. In interdisciplinary research, metacognitive scaffolds assist interdisciplinary communication aiming to analyze and articulate how the discipline constructs knowledge. (shrink)

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)

Recently, research into gender differences in achievement has mainly concentrated on the underperformance of boys in comparison with girls. Qualitative research in particular points to the importance of the gender-specific cultures adolescents experience. The purpose of this article is to test quantitatively the explanatory value of academic culture with respect to the stated gender differences in achievement. Use is made of data of 3760 pupils in the third and the fourth year of secondary education in a sample of 34 schools (...) in Flanders (Belgium). A distinction is made between general schools preparing students for higher education and schools offering technical and vocational education. It is demonstrated that boys' culture is less study oriented than girls' culture and that this difference can be held responsible for the gender differences in achievement, at least in general schools. In technical/vocational schools, boys seem to oppose the study culture. (shrink)

Using an ethical approach to the study of employability, we question the mainstream approach to career self-direction. We focus on a specific category of employees that has been neglected in past research, namely vulnerable workers who have been unemployed for several years and who have faced multiple psychosocial problems. Building on the Ability-Motivation-Opportunity model, we examine how establishing clear expectations, developmental inducements, and social organizational goals can foster employability competences of vulnerable workers. Our study took place in the particularly relevant (...) context of social enterprises, which have a primary goal to enhance the employability competences of vulnerable workers. Multilevel analysis of data from 38 CEOs of social enterprises, 121 leaders and 594 workers, demonstrated that establishing clear expectations and developmental inducements enable vulnerable workers to anticipate and optimize their employability competences. Furthermore, a positive association was found between establishing clear expectations and the balance dimension of employability, yet only in social enterprises that prioritize social organizational goals, suggesting the need to recognize the extent organizational goals shape opportunities for vulnerable workers. Establishing clear expectations and developmental inducements can therefore enhance vulnerable workers’ employability competences in supportive contexts; however, there may be detrimental side effects to drifting away from social organizational goals. (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)

According to the standards of public law, municipal polls have only a local scope : the election of a common council. Do politicians make deductions concerning the formal political power-constellation on national level either from the approach of municipal elections or from their results? Can these elections lead to changes in or of the government and eventually to anticipated legislative elections?After the first world-war, the electorate was called eight times to vote for new common councillors. Half of these elections had (...) no influence on the national power-constellation :they hardly stirred the national political life. In 1958 any possible influence of the municipal elections was even a priori ruled out. A remarkable point is that all municipal elections which took place undergovernments of national union, were only of local importance.Since the first world-war not a single municipal election has led to changes within the government : there was never a redistribution of ministerial portfolios amongst the coalitionpartners, nor did any electioncause the dismissal of an individual minister.It is traditional in Belgian politics that the national opposition, when the results of municipal elections are in its favour and prejudicial to the party in office, tries to call in question the legitimacy of the government in the opinion of the public by the way of motions or interpellations in parliament, claiming dismissal of the government or anticipated legislative elections. At these occasions it appeared unimportant whether the parliamental majority were confortable or not. But never did the governments give in to these attempts.The elections of 1857, 1884 and 1932 constitute an element of power - although of subsidiary importance - in the discharge of the then governments. The governmental crisis of 1884 however can only be explained if the constitutional position of Leopold II is taken into account. With all other factors alike, such a crisis wouldn't arise any more in the context of to-day. The municipal elections of 1932 have moreover led to anticipated legislative elections whose date was an element of power in the election-process. At that time, these elections played the part of an indicator of the electorial condition, comparable to that of the by elections in Great-Britain. And an unreliable indicator too, in view of the difference between national and local electionstatures. (shrink)

This article deals with the differences that exist between the profile of Flemish male and female political candidates placed on election-lists. The survey, held amongst all female and male political candidates, shows that male candidates find themselves in a more favourable position due to the accumulation of small gender differences in education, professional and domestic life.Male candidates more often have university degrees and leading functions resulting in more important relations. They are better represented both in the party structure and in (...) corporate life.Child care and domestic tasks seem to be their partner's responsability. Female political underrepresentation is a result of a generally weaker position of women in society. Notwithstanding the enormous progress made over the last five decades, the problem of female underrepresentation in politics remains a structural one. Hence, the question is wether a solution should ask for structural measures by the government. (shrink)

The major changes in the Belgian partysystem occurred within the context of the rise of the welfare state. Most welfare provisions were subcontracted to the different «zuil» organisations, with their political parties functioning as masterorganisation.The contrasts between «catholic» Flanders and «red» Wallonia dominated the political agenda, and led up to the fractionalisation of the party-system. The political positions of the parties remained unchanged : ascendancy of the catholics, challenged by the socialists, with the liberals holding the balance, and communists and (...) «federalist» parties beingback in opposition after a short period of governmental participation.Although party identification has shifted from ideological towards clientelist motives, the party preference of the electorate did not alter. The functions of parties did change : the power of mandatories decreased and parties increasingly control and even formulate public policy.Television has personalized political propaganda, which is, in between elections, professionally made by highly subsidized cultural masterorganisations. The costs of electoral propaganda, nowadays runned by commercial - advertising bureaus, have increased substantially. All this led to the decline of the propaganda by volunteers. (shrink)

The essays in this volume demonstrate how the performance of sincerity is culturally specific and is enacted in different ways in different media and disciplines, including law and the arts.

In 1990, Vermeerbergen started the first larger-scale corpus study with spontaneous language data from adult signers on the morpho-syntactic aspects of Flemish Sign Language. After this, a number of lexicographic projects, including the collection of a 90-h corpus, led to the launch of the first online bilingual Dutch/VGT—VGT/Dutch dictionary in 2004. Since then, researchers have developed several corpora of variable sizes, with the greatest realization being the VGT Corpus. The main focus of this chapter is twofold. On the one hand (...) the run-up to, the development and the use of the VGT Corpus will be discussed, while on the other hand smaller specific research corpora will be highlighted such as the corpus on early parent-child interaction and the multifocal eye-tracking corpus. The current chapter will discuss the research and community value of the corpora and future directions. Finally, it will elaborate on the need for corpus research, the associated advantages and disadvantages, and the obstacles faced in smaller deaf communities. (shrink)

Rational public decision-making is nearly impossible for two reasons : the organisational complexity of public services and the existence of two circuits, a political one, and an administrativeone.Moreover, public decisions are made by different pressure groups, and from different decision centres. In Belgium the impact of political parties is steadily increasing, up to the point where they function as master-organisations that have set up their own institutions to carry out public tasks. In thesocio-economie field the government acts more often as (...) an arbitrator and money-supplier than as a decision-maker.In the welfare state the government's position in the whole field of decision-making amounts to delegating decisions to private organisations and pressure groups, which in due course leads to corporatism andirrationality. Finally, the organisation structure of the civil service itself stimulates irrationality because it was set up as a pyramid hierarchy in a time when the government did not have many tasks. (shrink)

The aim of the present study was to investigate how saccadic selection relates to people’s awareness of the saliency and identity of a saccade goal. Observers were instructed to make an eye movement to either the most salient line segment or the only right-tilted element in a visual search display. The display was masked contingent on the first eye movement and after each trial observers indicated whether or not they had correctly selected the target. Whereas people’s awareness concerning the saliency (...) of the saccade goal was generally low, their awareness concerning the identity was high. Observers’ awareness of the saccade goal was not related to saccadic performance. Whereas saccadic selection consistently varied as a function of saccade latency, people’s awareness concerning the saliency or identity of the saccade goal did not. The results suggest that saccadic selection is primarily driven by subconscious processes. (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)

‘Aha! Zo zit het in elkaar! Nu begrijp ik het! Waarom heb ik dat niet eerder gezien?’ ‘Kwantummechanica is niet te begrijpen, het is onvoorstelbaar, maar je kunt er wel goed mee rekenen.’ Twee even herkenbare als spiegelbeeldige uitspraken over begrijpen in de wetenschap. Begrijpen lijkt een psychologische toestand te zijn die wordt opgeroepen als we door de dingen kunnen heen kijken. De metafoor van zien verwijst naar een invloedrijke Platonistische notie: het schouwen van een diepere, echtere realiteit. Wetenschappelijk begrijpen (...) is dan het ‘voor ogen krijgen’ van de wereld achter de verschijnselen. Deze voorstelling van zaken heeft verwantschap met gewone intuïties, maar er zitten toch een aantal haken en ogen aan. (shrink)

At the genera! elections in Belgium, the voter bas the possibility to bring out a vote for a party or a vote for a candidate of the party. At the general elections of October 13, 1985, for the House of Representatives, the voters have voted for 48 % by preference, whereas, for the Senate 38 % of them have done so. The use of preferential votes is varying from one electoral district to another: from 66 % in the district of (...) Oudenaarde to 34 % in Mechelen.There is also a difference from one politica! party to another. The highest percentage is obtained by the christian-democratic parties : 58 % ; the lowest by the ecologists: 22 %.The preferential votes individual candidates obtain differ widely, pointing out not only their popularity but also to a certain extend their political power. (shrink)