Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

Akabayashi and Slingsby's (2006) article reminds us that the North American emphasis on individualistic autonomy is not universal. As the authors explain, personal identity in Japan is not construc...

A number of traditional philosophers and religious thinkers advocated an ineffability thesis to the effect that the ultimate reality cannot be expressed as it truly is by human concepts and words. However, if X is ineffable, the question arises as to how words can be used to gesture toward it. We can't even say that X is unsayable, because in doing so, we would have made it sayable. In this article, I examine the solution offered by the fifth-century Indian grammarian-philosopher (...) Bhartrhari and develop it into a linguistic strategy based on the imposition-cum-negation method. The purpose is to show how we can non-contradictorily say, or rather indicate, the unsayable. (shrink)

Quy hoạch phê duyệt nêu rõ giai đoạn 2021-2030 phấn đấu tốc độ tăng trưởng GRDP bình quân đạt khoảng 8,5-9%/năm, GRDP bình quân đầu người đạt 14.800-15.400 USD.

Although project failure is commonly considered a negative event, it can provide valuable resources for learning. Despite well documented research on the antecedents of learning from project failure at the individual level, individuals’ attitude toward failures, a relatively proximal antecedent of learning from failure, has attracted limited attention in organizational studies. To address this paucity of research, based on the sensemaking theory, in the current study we specifically focused on individuals’ failure aversion and explored how it would influence learning from (...) failure through the process of arguing and expectation. Using a sample of 774 employees from R&D teams in China, our findings revealed that individuals’ failure aversion enhanced their learning from failure through inducing a loss-focused coping, but failure aversion negatively affected learning from failure through increasing the individuals’ perceived loss of self-esteem. We also found that individuals’ learning goal orientation weakened the negative relationship between the loss of self-esteem and learning from failure; however, LGO did not moderate our hypothesized relationship between loss-focused coping and learning from failure. Our study extends the literature on learning from failure in two ways. First, it explores the learning from failure process at the individual level based on the sensemaking theory and second, it sheds light on the underlying cognitive mechanisms operating between failure aversion and learning from project failure. (shrink)

In all fields of clinical medicine, there is an increasing awareness that outcome must be assessed in terms of quality of life and cost effectiveness, rather than merely length of survival. This is especially the case when considering decompressive craniectomy for severe traumatic brain injury. The procedure itself is technically straightforward and involves temporarily removing a large section of the skull vault in order to provide extra space into which the injured brain can expand. A number of studies have demonstrated (...) many patients going on to make a good long-term functional recovery, however, this is not always the case and a significant number survive but are left with severe neurocognitive impairment. Unfortunately, many of these patients are young adults who were previously fit and well and are, therefore, likely to spend many years in a condition that they may feel to be unacceptable, and this raises a number of ethical issues regarding consent and resource allocation. In an attempt to address these issues, we have used the analytical framework proposed by Jonsen, that requires systematic consideration of medical indications, patient preferences, quality of life and contextual features. (shrink)

This article offers a reading of Plato in light of the recent debates concerning the unique ‘ontology’ of International Relations (IR) as an academic discipline. In particular, this article suggests that Plato’s metaphysical account of the integral connection between human individual, the domestic state, and world order can offer IR an alternative outlook to the ‘political scientific’ schema of ‘levels of analysis’. This article argues that Plato’s metaphysical conception of world order can not only provide IR theory with a way (...) to re-imagine the relation between the human, the state, and world order. Moreover, Plato’s outlook can highlight or even call into question the post-metaphysical presuppositions of contemporary IR theory in its ‘borrowed ontology’ from modern social science, which can in turn facilitate IR’s re-interpretation of its own ‘ontology’ as well as its distinct contributions to the understanding of the various aspects of the social world and human life. (shrink)

1. Sŏngnihak ŭi hwakchang kwa simhwa -- 2. Sŏngnihak ŭi pip'anjŏk sŏngch'al.

In the United States, approximately 2.53 million people sustain a concussion each year. Relative to adults, youth show greater cognitive deficits following concussion and a longer recovery. An accurate and reliable imaging method is needed to determine injury severity and symptom resolution. The primary objective of this study was to characterize concussions with diffusion tensor imaging. This was performed through a normative Z-scoring analysis of DTI metrics, fractional anisotropy, axial diffusivity, and radial diffusivity, to quantify patient-specific injuries and identify commonly (...) damaged brain regions in paediatric concussion patients relative to healthy controls. It was hypothesized that personalizing the detection analysis through normative Z-scoring would provide an understanding of trauma-induced microstructural damage. Concussion patients were volunteers recruited from the Emergency Department of the McMaster Children’s Hospital with a recent concussion, 9 males and 17 females, mean age 14.22 ± 2.64, while healthy paediatric brain DTI datasets were obtained from an MRI data repository. Significant abnormalities were commonly found in the longitudinal fasciculus, fronto-occipital fasciculus, and corticospinal tract, while unique abnormalities were localized in a number of other areas reflecting the individuality of each child’s injury. Total injury burden, determined by the number of regions containing outliers per DTI metric per patient, was used as the metric to quantify the overall injury severity of each patient. The primary outcome of this analysis found that younger patients experienced a significantly greater injury burden when measured using fractional anisotropy. These results show that DTI was able to detect microstructural changes caused by concussion, on a per-person basis, and has the potential to be a useful tool for improving diagnostic accuracy and prognosis of a concussion. (shrink)

1. Kyoyuk iran muŏt in'ga -- 2. Kyoyuk ponwi ui sam -- 3. Kyoyuk yŏn'gu ŭi sae chip'yŏng.

Mahayana Buddhist philosophers’ attitude toward language is notoriously negative. The transcendental reality is often said to be ineffable. One’s obsession to apprehend the truth through words is an intellectual disease to be cured Attachment to verbal and conceptual proliferation enslaves oneself in the afflictive circle of life and death. Nevertheless, no Buddhist can afford to overlook the significance of language in preaching Buddhist dharmas as well as in day-to-day transactions. The point is not that of keeping silence. Rather, one should (...) understand and use language in such a way that one alludes to the unsayable reality and somehow escapes the bewitchment of language. Perhaps with this realization in mind, Mahayana Buddhist metaphysicians had fostered the penchant for using, at the sentential level, denials, negations and paradoxes to couch their views. In a similar vein but mainly at the word level, Dignaga (ca. 480-540 CE) the Yogacara epistemologist’ offered us a theory of language known as apoha doctrine in his landmark work Pramiinasamuccaya (henceforth PS). It is the purpose of this article to construe the doctrine. (shrink)

This article offers a reading of Colin Gunton’s trinitarian theology in light of recent theological attempts to develop accounts of ‘new trinitarian ontologies’ in a strongly Christian Neo-Platonic vein. In particular, this article seeks to situate Gunton’s work within the broader context of late twentieth-century European thought by comparing his ‘trinitarian ontology’ to the anti-Platonic ontologies of Martin Heidegger and Gilles Deleuze. By way of considering the ‘anti-Platonic’ aspects of Gunton’s trinitarian theology, this article presents his theological project as a (...) testcase which highlights the stakes in constructing ‘new’ trinitarian ontologies as well as possible objections to the affirmative attitude towards Christian Neo-Platonism in contemporary theological metaphysics. (shrink)