The case for veridical out-of-body experiences (OBEs) reported in near-death experiences might be strengthened by accounts of well-documented veridical OBEs not occurring near death. However, such accounts are not easily found in the literature, particularly accounts involving events seen at great distances from the percipient. In this article, I seek to mitigate this paucity of literature using my collection of dream journal OBE cases. Out of 3,395 records contained in the database as of June 15, 2012, 226 had demonstrated veridicality. This group divides into examples of precognition, after-death communications, and OBEs. Of the OBEs, 92 are veridical. The documentation involved is stronger than is normally encountered in spontaneous cases, because it is made prior to confirmation attempts, all confirmations are contemporaneous, and the number of verified records is large relative to the total number of similar cases in the literature. This database shows that NDE-related veridical OBEs share important characteristics of veridical OBEs that are not part of an NDE. Because the OBEs are similar, but the conditions are not, skeptical arguments that depend on specific physical characteristics of the NDE-such as the use of drugs and extreme physical distress-are weakened. Other arguments against purported psi elements found in veridical OBEs are substantially weakened by the cases presented in this article.
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Emotions embody the value in tourism experiences and drive essential outcomes such as intent to recommend. Current models do not explain how the ebb and flow of emotional arousal during an experience relate to outcomes, however. We analyzed 15 participants’ experiences at the Vincentre museum and guided village tour in Nuenen, the Netherlands. This Vincent van Gogh-themed experience led to a wide range of intent to recommend and emotional arousal, measured as continuous phasic skin conductance, across participants and exhibits. Mixed-effects analyses modeled emotional arousal as a function of proximity to exhibits and intent to recommend. Experiences with the best outcomes featured moments of both high and low emotional arousal, not one continuous “high,” with more emotion during the middle of the experience. Tourist experience models should account for a complex relationship between emotions experienced and outcomes such as intent to recommend. Simply put, more emotion is not always better.
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Background The caesarean delivery (CD) rate has risen in most countries over the last decades, but it remains relatively low in the Netherlands. Our objective was to analyse the trends of CD rates in various subgroups of women between 2000 and 2010, and identify the practice pattern that is attributable to the relative stability of the Dutch CD rate. Methods A total of 1,935,959 women from the nationwide Perinatal Registry of the Netherlands were included. Women were categorized into ten groups based on the modified CD classification scheme. Trends of CD rates in each group were described. Results The overall CD rate increased slightly from 14.0% in 2000–2001 to 16.7% in 2010. Fetal, early and late neonatal mortality rates decreased by 40–50% from 0.53%, 0.21%, 0.04% in 2000–2001 to 0.29%, 0.12%, 0.02% in 2010, respectively. During this period, the prevalence of non-vertex presentation decreased from 6.7% to 5.3%, even though the CD rate in this group was high. The nulliparous women with spontaneous onset of labor at term and a singleton child in vertex presentation had a CD rate of 9.9%, and 64.7% of multiparouswomen with at least one previous uterine scar and a singleton child in vertex presentation had a trial of labor and the success rate of vaginal delivery was 45.9%. Conclusions The Dutch experience indicates that external cephalic version for breech presentation, keeping the CD rate low in nulliparous women and encouraging a trial of labor in multiparous women with a previous scar, could help to keep the overall CD rate steady
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This paper is about Grūtas, a Lithuanian park museum near Druskininkai featuring recovered Soviet-era artifacts. This study fills the gap in literature on people's emotions and reactions dealing with an unwanted past, and an undesirable heritage. Visits to sites associated with occupation, death and suffering are considered emotionally laden. Data were collected from visitor comment books employing a qualitative content analysis as well as quantitative data analysis techniques such as word frequency and semantic network analysis. Few studies empirically investigated visitor emotions to “unwanted” heritage sites. This research provides insights into the interpretive complex by discussing the content of visitor comment books. Three hundred and seventy-nine visitor comments from Lithuanians to the Grūtas park museum were examined. Results reveal that visitors experience both negative and positive emotions after visiting the site, such as unpleasantness, discomfort, surprise, admiration and delight. This is the first study to examine visitor's emotions and reactions to the Grūtas park museum, a site related to difficult heritage.
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Control methods are applied worldwide to reduce predation on livestock by European red foxes (Vulpes vulpes). Lethal methods can inflict suffering; however, moral debate about their use is lacking. Non-lethal methods can also inflict suffering and can unintentionally lead to death, and yet both the welfare consequences and ethical perspectives regarding their use are rarely discussed. The aim of this study was to investigate the animal welfare consequences, the level of humaneness, the ethical considerations and the moral implications of the global use of fox control methods according to Tom Regan’s animal rights view and Peter Singer’s utilitarian view. According to Regan, foxes ought not to be controlled by either lethal or potentially harmful non-lethal methods because this violates the right of foxes not to be harmed or killed. According to Singer, if an action maximises happiness or the satisfaction of preferences over unhappiness or suffering, then the action is justified. Therefore, if and only if the use of fox control methods can prevent suffering and death in livestock in a manner that outweighs comparable suffering and death in foxes is one morally obligated t
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We need mental and physical reference points. We need physical reference points such as signposts to show us which way to go, for example to the airport or the hospital, and we need reference points to show us where we are. Why? If you don’t know where you are, it’s quite a difficult job to find your way, thus landmarks and “lieux de memoire” play an important role in our lives.
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Ethnographic fieldwork is a balancing act between distancing and immersing. Fieldworkers need to come close to meaningfully grasp the sense-making efforts of the researched. In methodological textbooks on ethnography, immersion tends to be emphasized at the expense of its counterpart. In fact, ‘distancing’ is often ignored as a central tenet of good ethnographic conduct. In this article we redirect attention away from familiarization and towards ‘defamiliarization’ by suggesting six estrangement strategies (three theoretical and three methodological) that allow the researcher to develop a more detached viewpoint from which to interpret data. We demonstrate the workings of these strategies by giving illustrations from Machteld de Jong’s field- and text-work, conducted among Moroccan-Dutch students in an institution of higher vocational education.
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Abstract Background: Frail older adults who are hospitalized, are more likely to experience missed nursing care (MNC) due to high care needs, communication problems, and complexity of nursing care. We conducted a qualitative study to examine the factors affecting MNC among hospitalized frail older adults in the medical units. Methods: This qualitative study was carried using the conventional content analysis approach in three teaching hospitals. Semi-structured interviews were conducted with 17 nurses through purposive and snowball sampling. The inclusion criteria for the nurses were: at least two years of clinical work experience on a medical ward, caring for frail older people in hospital and willingness to participate. Data were analyzed in accordance with the process described by Graneheim and Lundman. In addition, trustworthiness of the study was assessed using the criteria proposed by Lincoln and Guba. Results: In general, 20 interviews were conducted with nurses. A total of 1320 primary codes were extracted, which were classified into two main categories: MNC aggravating and moderating factors. Factors such as “age-unfriendly structure,” “inefficient care,” and “frailty of older adults” could increase the risk of MNC. In addition, factors such as “support capabilities” and “ethical and legal requirements” will moderate MNC. Conclusions: Hospitalized frail older adults are more at risk of MNC due to high care needs, communication problems, and nursing care complexity. Nursing managers can take practical steps to improve the quality of care by addressing the aggravating and moderating factors of MNC. In addition, nurses with a humanistic perspective who understand the multidimensional problems of frail older adults and pay attention to their weakness in expressing needs, can create a better experience for them in the hospital and improve patient safety.
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Background Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth. Methodology In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth. Findings The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care. Conclusion By listening to women’s experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers’ wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.
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Detecting practical problems of persons with dementia (PwD) experience at home, and advising them on solutions to facilitate aging in place are complex and challenging tasks for nurses and case managers. In this two group randomized, controlled laboratory experiment, the efficacy of a decision support application aiming to increase nurses' and case managers' confidence in clinical judgment and decision-making was tested. The participants (N = 67) assessed a case of a PwD within the problem domains: self-reliance, safety and informal care, and provided suggestions for possible solutions. Participants used either their regular procedure with (intervention group) or without the App (control group) to conduct these tasks. No statistically significant difference was found on the primary outcome measure, the overall level of confidence. However, nurses and case managers highly recommended use of the App in practice. To explain these results, more research on the potential added value of the App is needed.
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