A problem in spontaneous dream psi studies is validation of purported psi elements. Dreams rarely have enough specifi city to satisfy critics that they point to paranormal knowledge of a specifi c event. This creates evidential hurdles to overcome when evaluating whether a dream contains psi-derived information such as scenes of future events or physically distant locations. In this study, the goal is to arrive at a reasonable method to establish that information derived from spontaneous dream experiences can be established as veridical. To accomplish this, a method for fi nding the equivalent of a target within a spontaneous experience is used to fi x a specifi c locale and time for comparison. Adverse scoring criteria are used to address complaints about confi rmation bias. The result is a psi-adverse method for scoring spontaneous experiences that are anchored to a specifi c locale and time. This method regularly produced signifi cant p-values when used to assess 20 consecutive dream records, comprising 598 individual line items. These records were taken as a sample from a group of 3,305 dream records made over the past 22 years by the author.
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Background: A new selective preventive spinal immobilization (PSI) protocol was introduced in the Netherlands. This may have led to an increase in non-immobilized spinal fractures (NISFs) and consequently adverse patient outcomes. Aim: A pilot study was conducted to describe the adverse patient outcomes in NISF of the PSI protocol change and assess the feasibility of a larger effect study. Methods: Retrospective comparative cohort pilot study including records of trauma patients with a presumed spinal injury who were presented at the emergency department of a level 2 trauma center by the emergency medical service (EMS). The pre-period 2013-2014 (strict PSI protocol), was compared to the post-period 2017-2018 (selective PSI protocol). Primary outcomes were the percentage of records with a NISF who had an adverse patient outcome such as neurological injuries and mortality before and after the protocol change. Secondary outcomes were the sample size calculation for a larger study and the feasibility of data collection. Results: 1,147 records were included; 442 pre-period, and 705 post-period. The NISF-prevalence was 10% (95% CI 7-16, n = 19) and 8% (95% CI 6-11, n = 33), respectively. In both periods, no neurological injuries or mortality due to NISF were found, by which calculating a sample size is impossible. Data collection showed to be feasible. Conclusions: No neurological injuries or mortality due to NISF were found in a strict and a selective PSI protocol. Therefore, a larger study is discouraged. Future studies should focus on which patients really profit from PSI and which patients do not.
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This paper is a response to articles in the literature regarding symbols in dreams. While some neurology-based dream studies reject dream symbols altogether, the preponderance of material available for review accepts that dreams are frequently populated by symbols that require interpretation to be understood. In this study of my own extensive dream journals, the presence of veridical psi dreams makes it possible to rule out symbolic content in some cases. The results of this study show that-at least from the 11,850 dream scenes reviewed here-unambiguous symbolic content is extremely rare. For this paper, it was assumed that no dreams contained any symbolically presented information unless the dreams contained unambiguous indications that symbols were present. Following this method, a distinction may be made between dream content that clearly contains symbols and dreams that are assumed to be symbolic by default. Symbols that met the criteria used here can be shown to be di?erent from conventionally accepted symbols in that they clarify-rather than obfuscate-the communication of complex ideas.
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In this policy brief we recommend that in order to face numerous societal challenges such as migration and climate change, regional governments should create a culture of innovation by opening up themselves and stimulate active citizenship by supporting so called Public Sector Innovation (PSI) labs. These labs bring together different types of stakeholders that will explore new solutions for societalchallenges and come up with new policies to tackle them. This method has been developed and tested in a large EU funded research project.
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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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ObjectiveIn 2016, a selective preventive spinal immobilization protocol for emergency medical service (EMS) nurses was introduced in the Netherlands. This protocol leaves more room for autonomous decision-making in the pre-hospital phase regarding preventive spinal immobilization (PSI), compared to the previous strict protocol. In this study, we explored the experiences and perspectives of EMS nurses on decisionmaking about PSI after the change from a strict to a selective PSI protocol. Methods: We used a qualitative design with semi-structured face-to-face interviews. Thematic analysis was applied. The capability-opportunity-motivation-behavior-model was used to interpret the experiences and perspectives. Results: Thirteen EMS nurses from three emergency medical services were interviewed. Respondents appreciated autonomous decision-making as there was more room for patient-centered informed decision-making. However, autonomous decision-making required optimized knowledge and skills and elicited the need to receive feedback on their decision not to apply PSI. When nurses anticipated resistance to selective PSI from receiving hospitals, they were doubtful to apply it. Conclusion: Nurses appreciate the increased autonomy in decision-making, encouraging them to focus on patient-centered care. Increased autonomy also places higher demands on knowledge and skills, calling for training and feedback. Anticipated resistance to receiving hospitals based on mutual protocol discrepancies could lead to PSI application by EMS nurses while not deemed necessary. Recommendations: To enhance PSI procedures, optimizing the knowledge and skills of EMS nurses that facilitate on-scene decision-making may be indicated. A learning loop for feedback between the EMS nurses and the involved hospitals may add to their professional performance. More efforts are needed to create support for the changed Emergency Medical Services strategy in PSI to prevent unnecessary PSI and practice variation.
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In 2016, a selective preventive spinal immobilization protocol for emergency medical service (EMS) nurses was introduced in the Netherlands. This protocol leaves more room for autonomous decision-making in the pre-hospital phase regarding preventive spinal immobilization (PSI), compared to the previous strict protocol. In this study, we explored the experiences and perspectives of EMS nurses on decision making about PSI after the change from a strict to a selective PSI protocol. Methods: We used a qualitative design with semi structured face-to-face interviews. Thematic analysis was applied. The capability-opportunity-motivation behavior-model was used to interpret the experiences and perspectives. Results: Thirteen EMS nurses from three emergency medical services were interviewed. Respondents appreciated autonomous decision-making as there was more room for patient-centered informed decision-making. However, autonomous decision-making required optimized knowledge and skills and elicited the need to receive feedback on their decision not to apply PSI. When nurses anticipated resistance to selective PSI from receiving hospitals, they were doubtful to apply it. Conclusion: Nurses appreciate the increased autonomy in decision-making, encouraging them to focus on patient-centered care. Increased autonomy also places higher demands on knowledge and skills, calling for training and feedback. Anticipated resistance to receiving hospitals based on mutual protocol discrepancies could lead to PSI application by EMS nurses while not deemed necessary. Recommendations: To enhance PSI procedures, optimizing the knowledge and skills of EMS nurses that facilitate on-scene decision-making may be indicated. A learning loop for feedback between the EMS nurses and the involved hospitals may add to their professional performance. More efforts are needed to create support for the changed Emergency Medical Services strategy in PSI to prevent unnecessary PSI and practice variation.
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At first glance, Public Sector Innovation (PSI) Labs are gaining prominence within academic literature, the European Union (EU) and beyond. However, because of the relative newness and conceptual ambiguity of this concept, the exact contribution of these labs to theory and practice is still unclear. In addition, most research has been looking at case studies. This publication breaks new ground by elaborating on the concept and also by looking at the perception of these labs in different contexts, by comparing multiple labs in multiple countries. In doing so, we raised the question: ‘What is the perceived added value of Public Sector Innovation labs for further developing theory as well as for society?’ In order to answer this question, by way of an experiment, we combined theoretical research together with focus groups with members of the EU funded project Multi Disciplinary Innovation for Social Change (SHIINE) in combination with questionnaires to selected PSI labs, thus providing us with rich data. Our experimental methodology uncovered a conceptual bias that is probably existent in similar studies and needs to be acknowledged more. In addition, we found that PSI labs have developed over time into an amalgam of two competing concepts. To conclude, we believe that the specific potential of PSI labs as an internal space for innovation within institutions is underutilised. We believe this could be improved by acknowledging the specific aim of PSI labs in a co-creative setting between relevant stakeholders, such as Higher Education Institutions (HEIs).
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Dreams that appear to predict future events that could not have been anticipated through any known inferential processes have been reported for centuries, and dreams that appear to anticipate the death of an acquaintance or loved one are particularly common. Such reports become more suggestive of genuine precognition if there are no natural cues (such as an illness) to an impending death and if the time interval between the dream and the subsequent death is brief. Most reports are difficult to evaluate because we dream many times each night but typically remember and report only a salient subset of our dreams. Thus we cannot assess whether the time interval between a death-related dream and the death of the dream character is brief or lengthy because we have no control set of non-death-related dreams to which its time interval can be compared. The study reported here provides just such a control set by comparing deathrelated and non-death-related dreams featuring the same set of dream characters who died after the dreams occurred. These were drawn from the author's own dream journal in which he has recorded his nightly dreams for nearly twenty-five years. The mean time interval between death-related dreams and the person's subsequent death was significantly shorter than the time interval between non-death-related dreams and his or her death, t(11) = 3.30, p =.004, one-tailed. Cases in which death-related dreams occurred after the characters had died are also considered. Seven of the cases are discussed in detail.
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Background: In Turkey, nursing care in hospitals has gradually included more older patients, resulting in a need for knowledgeable geriatric nurses. It is unknown, however, whether the nursing workforce is ready for this increase. Therefore, the aim of this study is to validate the Knowledge about Older Patients Quiz (KOPQ) in the Turkish language and culture, to describe Turkish hospital nurses’ knowledge about older patients, and to compare levels of knowledge between Turkish and Dutch hospital nurses. Conclusions: The KOPQ-TR is promising for use in Turkey, although psychometric validation should be repeated using a better targeted sample with a larger ability variance to adequately assess the Person Separation Index and Person Reliability. Currently, education regarding care for older patients is not sufficiently represented in Turkish nursing curricula. However, the need to do so is evident, as the results demonstrate that knowledge deficits and an increase in older patients admitted to the hospital will eventually occur. International comparison and cooperation provides an opportunity to learn from other countries that currently face the challenge of an aging (hospital) population.
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