Een goed begin

Well begun is half done. Deontic and epistemic authority in the opening phase of medical consultations Context: An effective consultation opening with attention to patient participation not only increases patient satisfaction, but is also a prerequisite for shared decision making, which may improve health outcomes and reduce healthcare costs. Methods: Using conversation analysis, we examined linguistic and structural characteristics of 41 video recorded consultation openings of medical specialists at a large Dutch teaching hospital. The main purpose was to give an overview of how doctors and patients interactionally shape deontic and epistemic authority. Results: Conversation analysis showed different ways in which doctors open their consultations and patients’ reactions to this. Agenda setting occurred in 6 cases, this was always the doctor’s agenda. Most of the doctors’ utterances during this phase displayed a high deontic stance and none of the patients were invited to discuss their expectations or goals for the consultation. 30 doctors started with their opening question, which in itself also reflects a high deontic stance. During the opening questions, the doctors’ epistemic stances differed. Conclusion: During the consultation openings, the doctor was clearly in charge of the conversation and often did not explore the knowledge domain of the patient. This can limit patient participation and can hinder shared decision making in the consultation.

The Opening Phase of the Science Wars

Kuhn’s monograph fed into the broad antiestablishment spirit of the 1960s and elicited polar-opposite responses, from the defense of objectivity and realism within scientific knowledge to an enthusiastic embrace of the view of scientific knowledge as ineluctably subjective interpretations of experience. The philosopher of science Paul Feyerabend aggressively attacked the rationality of scientific reasoning and eventually rationality itself. Kuhn’s new image of science fed into the emerging postmodernist critique of reason and truth as rhetorical devices wielded for political ends. Jacques Derrida’s “deconstruction” swept the humanities and social sciences, concluding that there could not be a single correct meaning of any text, including scientists’ “reading” of the “book” of nature. Concurrently, philosophers of science, among them Israel Scheffler, Imre Lakatos, and Karl Popper, began a counterattack against Kuhn, defending the rationality and objectivity of scientific knowledge and reason generally.

Effects of Vertical Glottal Duct Length on Intraglottal Pressures in the Convergent Glottis

In a previous study, the vertical glottal duct length was examined for its influence on intraglottal pressures and other aerodynamic parameters in the uniform glottis [J Voice 32, 8–22 (2018)]. This study extends that work for convergent glottal angles, the shape of the glottis during the glottal opening phase of vocal fold vibration. The computational fluid dynamics code ANSYS Fluent 6.3 was used to obtain the pressure distributions and other aerodynamic parameters for laminar, incompressible, two-dimensional flow in a static vocal fold model. Four typical vertical glottal duct lengths (0.108, 0.308, 0.608, 0.908 cm) were selected for three minimal diameters (0.01, 0.04, 0.16 cm), three transglottal pressures (500, 1000, 1500 Pa), and three convergent glottal angles (−5°, −10°, −20°). The results suggest that a longer vertical glottal duct length increases the intraglottal pressures, decreases the glottal entrance loss coefficient, increases the transglottal pressure coefficient, causes a lower gradient of both the intraglottal flow velocity and the wall shear stress along the glottal wall—especially for low flows and small glottal minimal diameters—and has little effect on the exit pressure coefficient and volume flow. The vertical glottal duct length in the convergent glottis has important effects on phonation and should be well specified when building computational and physical models of the vocal folds.

RESETTLEMENT OF JEWS TO THE CRIMEA: THE OPENING PHASE (1924-1928)

The article analyzes the process of resettlement of Jews to the Crimean ASSR in the context of Soviet national policy. The main factors that led to the adoption of a political decision on resettlement are identified. The Crimean ASSR became the most important region of Jewish rural relocation. The participation of international Jewish organizations in the resettlement processes has been analyzed as well. The changes in the ethnic composition of the population of the peninsula in the 1920s have been thoroughly studied. The article presents the processes of settlement of Jewish immigrants, the formation of Jewish village councils, building schools, clubs, and hospitals.

Manufacturing Consent Revisted: China’s image in selected South African media in the opening phase of the Covid-19 pandemic

The absence of any real substantial critique of China in South Africa media in the aftermath of Covid-19 is cause of concern given the increasing evidence to suggest that China is exporting its authoritarian press censorship culture abroad. South Africa, a strategic partner of China, offers insight into this “export.” In developing a methodology which asks if “China is crafting its image”, this research examines a sample of South African media between March- July 2020 to ascertain if censorship occurred. Deploying the theoretical framework of the Propaganda Model (PM) developed Herman and Chomsky’s “Manufacturing Consent” theory, the research cross analyzes via five filters to determine if China is “Manufacturing Consent” within the South African media.

The impact of COVID-19 restriction measures on loneliness among older adults in Austria

Background To halt the spread of COVID-19, Austria implemented a 7-week ’lockdown’ in March/April 2020. We assess whether the ensuing reduction in social contacts led to increased loneliness among older adults (60+). Methods Three analyses were conducted: (1) A comparison between pre-pandemic (SHARE: 2013-2017) and pandemic (May 2020) levels of loneliness (UCLA-3 scale), (2) an assessment of the cross-sectional correlation between being affected by COVID-19 restriction measures and loneliness (May 2020), and (3) a longitudinal analysis of weekly changes (March-June 2020) in loneliness (Corona panel). Results We found (1) increased loneliness in 2020 compared with previous years, (2) a moderate positive association between the number of restriction measures older adults were affected from and their loneliness, and (3) that loneliness was higher during ’lockdown’ compared to the subsequent re-opening phase, particularly among those who live alone. Conclusion We provide evidence that COVID-19 restriction measures in Austria have indeed resulted in increased levels of loneliness among older adults. However, these effects seem to be short-lived, and thus no strong negative consequences for older adults’ mental health are expected. Nonetheless, the effects on loneliness, and subsequent mental health issues, might be both more long-lasting and severe if future restriction measures are enacted repeatedly and/or over longer time periods.