Modification of established rejection of canine kidney and liver homografts with antilymphocyte gamma-G globulin

Heterologous ALG was administered to ten canine recipients of renal homografts and one recipient of an orthotopic liver. Treatment was started after rejection was well established. Death from homograft failure was thereby significantly delayed and in several experiments the rejection was at least partially reversed. © 1969

Communicative underpinnings in grooming interactions of wild-living chimpanzees

In my doctoral thesis, I investigated the turn-taking abilities in the grooming interactions of wild-living male Eastern chimpanzees (Pan troglodytes schweinfurthii). Turn-taking in humans, characterised as the reciprocal exchange of short and flexible turns, is suggested to be an ancient underpinning in language found across the primate lineage. However, turn-taking across primates is yet to be understood in a cooperative and relaxed context which does not require immediate coordination, and whether demographic and social factors of individuals drive these turn-taking systems. Therefore, by applying a comparative approach in relation to our closest living relatives, I first investigated the turn-taking elements found in human social action in the grooming interactions of male – male chimpanzee dyads. This is the first study to address the turn-taking elements in grooming interactions of wild-living chimpanzees, where I observed chimpanzees of the Ngogo population located in Kibale National Park, Uganda. To assess the turn-taking elements present in chimpanzees, I applied a comparative approach, using the Comparative Framework that addresses four main elements: flexibility of turn-taking organisation, participation frameworks, temporal relationships, and adjacency pairs found in human social action that can be applied to non-human species to allow for systematic comparison between species. In addition, I broadened the scope of the Comparative Framework by addressing a fifth foundational element – communicative repair, which is the fixing of a troubled turn. Thus, I addressed the gestures and actions chimpanzees used during their grooming interactions, looking into all five elements of turn-taking. This dissertation dffers from the extensive studies that have looked into grooming in chimpanzees, as it delves into the coordinated infrastructure of grooming interactions, gains insight into cases when these interactions entail breakdowns, and investigates the effect of demographic (i.e., age) and social factors (i.e., dominance rank, affiliation, and relatedness) of dyads. The main results of this thesis entail the following: Chimpanzees are shown to coordinate their grooming interactions through various turn transition types, including action - action, action - gesture, gesture - action, and gesture - gesture transitions. Hence, the infrastructure of grooming interactions of chimpanzees involves a high degree of flexibility, no preference for overlap avoidance, but turn transitions occurring promptly between zero and two seconds and lastly involve clear adjacency – like pair structures with certain gestures - action transitions being contingent and constrained (Chapter 3). Then to understand whether this infrastructure found in chimpanzees is driven by demographic and social factors of the interactional partners are, I found that age and dominance rank play an important role in influencing the presence of turn-transitions, gesture – gesture turn transitions and temporal relationships (Chapter 4). Then an element that was not part of the initial investigation of the turn-taking elements is communicative repair. Therefore, to gain insight into communicative repair in non-human species, I addressed the different mechanisms of repair (Chapter 5), which showed that negotiation was the most frequently used mechanism compared to repetition, substitution, and modification. The timings did not significantly differ between the different mechanisms; however, the median time was one second and 24 milliseconds, suggesting a rapid turnover. I additionally assessed whether demographic and social factors have an influence on the mechanisms and timings, but there was no influence. Communicative repair is yet to be directly studied in animal communication systems. However, to address studying this fifth element, I have conducted a literature review on communicative repair in humans, as well as studies in non-human species indirectly addressing this element (Chapter 6). Furthermore, I delve deeper into the cognitive levels underlying communicative repair to determine if chimpanzees exhibit a less cognitively demanding form compared to humans. Therefore, I propose a further research avenue on understanding communicative repair in species, hoping to inspire future studies in this area. In sum, my dissertation provides previously undocumented evidence of turn-taking elements existing in the infrastructure of grooming interactions in chimpanzees. The output from my dissertation will further address multiple turn-taking elements to gain a more complete picture of this phenomenon in non-human species. These studies will address the Interaction Engine hypothesis, which posits that social interactions and the underlying assemblages that brought about language made social interactions possible, rather than language itself. In turn, this may shed further light on the extent to which the communicative and cognitive abilities of our primate ancestors informed the evolution of the unique human communication system known as 'language'

Education for Human Rights: Which Way Forward?

A workshop paper on human rights education in Southern Africa, originally presented at SARIPS Workshop on Education for Human Rights in Southern Africa.Anno 1994, the world we live in seems more and more contradictory and incomprehensible. On the one hand, instruments containing provisions for the protection and promotion of universal human rights and fundamental freedoms are recognized by almost all governments; on the other hand, the same human rights and fundamental freedoms are violated to a high degree either by governments, groups of people or individual human beings. On the one hand, people and individuals strive for a more peaceful, equal and democratic world; on the other hand, their fellows prefer the use of weapons and the method of war. The current international tensions and conflicts raging over all continents, the continuing inequalities, the mass and gross violations of human rights, and the growing economic, political, cultural and social relations and interdependence, demonstrate a compelling need for international understanding, peace, human rights and fundamental freedoms.SARIP

Indië en de wereldgeschiedenis

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Referring abroad

Summary Cross-border health care is an issue of growing importance in the European Union. It offers health care services and products to patients in other countries than the country which covers their residency or insurance. Through rulings of the European Court of Justice, the possibilities for patients to receive cross-border care have been clarified. Although data on patient mobility within the EU is limited, the extent of cross-border health care is estimated to be around 1% of total health care expenditure in the EU. The numbers of patients seeking cross-border care can vary enormously per border and the direction can be either unidirectional or bidirectional depending on the border. Though cross-border care is unlikely to become a dominant activity in any country’s health care system, there is scope for increased patient mobility. ZorgSaam hospitals believes that there is greater scope for crossborder care and therefore wishes to attract Belgian patients. One of the ways through which patients seek cross-border care, is through their GP. The role of GPs is important in two ways: as referrers they can channel patients, and as the professionals that patients usually trust most and being the first contact point, GPs can influence patients’ choices about where to be treated. This has lead to the following main research question of this study: How can ZorgSaam increase referrals from Belgian GPs? In order to be able to answer this question, the concept of cross-border care has first been looked into. The conceptual model that followed from this consists the interlinked elements of the institutional factors, processes, contextual factors and actors on various levels (European, national, regional). This model helped develop the research method used. This method consisted of semi-structured interviews held with GPs in the border region (most of whom had Dutch patients and therefore had some experience with ZorgSaam) and interviews with representatives of two leading mutualities. GPs were asked about their referral decision making. Both groups were asked about possible enablers and barriers of cross-border care and their attitude towards it. From the results it can be concluded that, GPs and representatives of the mutualities have a positive attitude towards cross-border care as long as it is of benefit to the patients. The GPs do not perceive any real advantages for Belgian patients to cross the border to seek care in a ZorgSaam hospital, other than the extra choice it provides for patients. However, there is adequate hospital care available in Belgium. The GPs have therefore never referred their patients to ZorgSaam. The results have also given some insight into the other barriers and enablers of cross-border care. The enabling factors are the cultural and linguistic similarities and the short distance to a ZorgSaam hospital from Belgium. However, as the GPs remarked: “It is not so much the distance to Terneuzen that is the problem; it is rather the idea that you are going abroad that is the problem”. That going abroad is the problem, is made evident by other barriers found. The unfamiliarity with the Dutch health care system, differences in organisation within Dutch hospitals and ICT applications and the unfamiliarity with Dutch specialists too are reasons for Belgian GPs not to refer their patients to ZorgSaam. Many of the barriers found are similar to those factors that determine whereto GPs generally refer their patients. Therefore ZorgSaam will need to compete with Belgian hospitals on these factors. For ZorgSaam to be able to increase the referrals from Belgian GPs it will be necessary that they improve the relationship between GPs and ZorgSaam specialists. Provide information to GPs (and patients) concerning the possibilities and procedures of cross-border care, and what patients can expect from ZorgSaam. It has also been suggested that ZorgSaam not only puts effort in attracting Belgian patients, but also those Dutch patients that are now more orientated towards Belgian health care services. 4 Management summary Objective Cross-border health care, is of growing importance and through rulings of the European Court of Justice, the possibilities for patients to receive cross-border care have been clarified. Though cross-border care is not or is unlikely to become a great phenomena, there is scope for increased patient mobility. ZorgSaam hospitals believes that there is greater scope for cross-border care and therefore wishes to attract Belgian patients. One of the ways through which patients seek cross-border care, is through their GP. The role of GPs is important in two ways: as referrers they can channel patients, and as the professionals that patients usually trust most and being the first contact point, GPs can influence patients’ choices about where to be treated. This has lead to the following main research question of this study: How can ZorgSaam increase referrals from Belgian GPs? Recommendations Based on this study, the following recommendations can be made: • ZorgSaam should improve the relationship between Belgian GPs and specialist o Inviting Belgian GPs to functions specifically aimed at them that are held at convenient hours. This will allow Belgian GPs to get acquainted with ZorgSaam specialists o Encouraging ZorgSaam specialists to present at refresher courses organised by Belgian GP associations. This too will allow Belgian GPs to get acquainted with ZorgSaam specialists o Enabling GPs to have direct contact with ZorgSaam specialists by handing out a phone list with direct contact numbers. This will ease the working relationship between GPs and specialists o Creating an understanding of the differences in the organisation of hospitals, making it easier for Belgian GPs and ZorgSaam specialists to work together • Providing Belgian GPs with information concerning cross-border care: when can patients seek cross-border care, how should they go about it, what is the procedure, what can patients and GPs expect • ICT solutions reducing the administrative burden put on GPs when they refer patients to ZorgSaam • Not only aiming to attract Belgian patients, but also aiming to attract Dutch patients who are now more Belgium orientated. Thus showing Belgian GPs that ZorgSaam can also provide adequate care to Belgian patients Motivation Interviews were held with Belgian GPs in the border region with Zeeuws-Flanders. These interviews have covered the perceived enablers and barriers to receiving health care in the Netherlands and the practical barriers they have encountered when having referred patients to the Netherlands. Interviews were also held with representatives of two leading mutualities to get a better insight in the barriers and enablers of cross-border care and differences between the health care systems of Belgium and the Netherlands. Analysis of the data was qualitative in nature. The results have shown that both GPs as well as the representatives of the mutualities are generally favourable towards cross-border care, as long as it benefits the patient. Various barriers have been mentioned by the both the Belgian GPs as well as the representatives of the mutualities. These barriers are concerned with the several elements of cross-border care discussed in the theoretical framework of this study. They include the lack of knowledge concerning the possibilities and procedures of cross-border care, differences between systems and the organisation within hospitals, cultural differences and distance. By taking away these barriers, ZorgSaam could increase the referrals from Belgian GPs. However, not all barriers can be influenced by actions of ZorgSaa