ObjectiveThis pilot study aimed to evaluate the efficacy of a digital cognitive behavioral therapy in patients with cancer experiencing sleep problems.MethodsA total of 57 participants aged 25–65 years were randomly assigned to three groups—21 participants to a dCBT program, 20 participants to an app-based attentional control program, and 16 participants to a waitlist control group—and evaluated offline before and after the program completion. Of the 57 participants, there were a total of 45 study completers, 15 participants in each group. The (...) dependent variables were sleep quality scores, measured by the Pittsburgh Sleep Quality Index and health-related quality of life scores, measured using the Short-Form 36, and attentional bias scores from a dot-probe computer task.ResultsFor both the intention-to-treat and study-completers analyses, a significant increase supported by a large effect size was found in the quality of sleep score of the HARUToday Sleep group compared to both the app-based attentional control and the waitlist control group. However, no significant changes were found in the quality of life and attentional bias scores.ConclusionOur results suggest that the HARUToday Sleep app has the potential to serve as an intervention module to enhance the sleep quality of patients with cancer experiencing sleep problems. (shrink)

Adult-based suicide theories have determined much of what we know about suicidal ideation. Here, we investigate the extent to which elements of theIntegrated Motivational-Volitional(IMV) model generalize to adolescence, a period when rates of suicidal ideation increase dramatically. In a sample of community-based adolescents (n= 74), we tested whether defeat and entrapment related to suicidal ideation, and whether poor positive future thinking abilities exacerbated this association. Consistent with the IMV model, we found that defeat/entrapment was associated specifically with history of suicidal (...) ideation, and not with history of suicide attempt. Defeat/entrapment was related to baseline suicidal ideation severity above and beyond depressive symptoms. While defeat/entrapment predicted future suicidal ideation controlling for history of ideation, it did not do so controlling for depressive symptoms. Counter to the IMV model, we initially found that the association between defeat/entrapment and suicidal ideation was strongest among adolescents withgreaterpositive future thinking abilities. This was driven by the tendency to imagine more positive future events, particularly those that are less realistic and achievable. These findings call for a more nuanced understanding of defeat/entrapment and positive future thinking among adolescents, particularly in how they interact to predict recurrent suicidal ideation. (shrink)

The demand for organ transplants, both globally and in South Korea, substantially exceeds the supply, a situation that might have been aggravated by the enactment of the Life-Sustaining Treatment Decision Act (LSTDA) in February 2018. This legislation may influence emergency medical procedures and the availability of organs from brain-dead donors. This study aimed to assess LSTDA’s impact, introduced in February 2018, on organ donation status in out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city and identified related factors. We conducted (...) a retrospective analysis of a regional cardiac arrest registry. This study included patients aged 16 or older with cardiac arrest and a cerebral performance category (CPC) score of 5 from January 2015 to December 2022. The exclusion criteria were CPC scores of 1–4, patients under 16 years, and patients declared dead or transferred from emergency departments. Logistic regression analysis was used to analyse factors affecting organ donation. Of the 751 patients included in this study, 47 were organ donors, with a median age of 47 years. Before the LSTDA, there were 30 organ donations, which declined to 17 after its implementation. In the organ donation group, the causes of cardiac arrest included medical (34%), hanging (46.8%), and trauma (19.2%). The adjusted odds ratio for organ donation before the LSTDA implementation was 6.12 (95% CI 3.09–12.12), with non-medical aetiology as associated factors. The enactment of the LSTDA in 2018 in South Korea may be linked to reduced organ donations among patients with OHCA, underscoring the need to re-evaluate the medical and legal aspects of organ donation, especially considering end-of-life care decisions. (shrink)

Duties of kings and rulers in Thailand on religious aspects and political ethics.

Philosophe hors du commun, François Châtelet (1925-1985) a profondément marqué le paysage intellectuel français du XXe siècle. Cofondateur, avec Michel Foucault et Gilles Deleuze, du département de philosophie du Centre universitaire expérimental de Vincennes, aujourd'hui Université Paris VIII, il a dirigé ce département jusqu'à sa mort. Les textes réunis ici se composent de quatre articles de François Châtelet devenus introuvables et une série de textes de philosophes qui mettent en valeur, tant ses talents d'historien de la philosophie, de pédagogue que (...) de philosophe engagé. C'est tout un ensemble de souvenirs d'un philosophe médiatique qui est donné à lire, luttant par l'histoire des concepts contre l'orthodoxie marxiste. François Châtelet fut le cofondateur avec Jacques Derrida, Jean-Pierre Faye et Dominique Lecourt du Collège international de philosophie. Il militait pour la pratique d'une philosophie ouverte et populaire et n'a eu de cesse de décloisonner la philosophie et de l'ouvrir pour la mettre en commun. (shrink)

With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their end-of-life treatment preferences (ELTP) while they are physically and mentally able to do so. The purpose of this study was to explore ELTP among older adults and to compare those preferences in a subset of individuals who had reported their ELTP in a survey completed the previous year. This was a descriptive study of 191 older adults (...) living in a continuing care retirement community. Approximately half of the participants did not want cardiopulmonary resuscitation, to be put on a respirator, or to receive dialysis. The findings in this study suggest that many older adults do not want aggressive interventions at the end of life, but choose rather those measures that will keep them comfortable. Moreover, treatment choices may change over time. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in dictating their end-of-life care. (shrink)

This article attempts to fill a gap in International Relations literature on East Asian security. ‘East Asia’ appears to be mostly an indeterminate conceptual construct, allowing scholars to look selectively at those aspects and areas that could justify their security thesis, albeit security dynamics in the region are all too difficult to comprehend and predict. This problem has been frequently pointed out in IR literature, but its methodological implications and suggestions have neither been appropriately illuminated nor been systematically offered, and (...) the main solution commonly found in the literature was the tautological one of ‘better defining’ the region. As an alternative, this article suggests that one needs to tighten geographical focus and differentiate the subjects of analysis. When it comes to the study of East Asian security, one needs to aim to develop specific and differentiated generalizations as opposed to generalizations of a broad character. To showcase the fact that research outcomes can be more determinate when the target of analysis is more focused and specified, this article takes Northeast Asian security as an example and challenges the so-called ‘peaceful East Asia’ thesis, one of the mainstream perspectives on East Asian security. This article ultimately argues that while apprehending East Asian security dynamics through delimiting the scope of analysis and circumscribing the subjects of investigation is often deemed to be a modest enterprise―in particular, in terms of generalizability―the merits are substantial: research outcomes will be able not only to give us a truer mapping of the real world, but also bring us closer to building knowledge which satisfies the scientific criterion of ‘falsifiability.’Export citation Request permission. (shrink)

In contrast to the juxtaposition of representative democracy and Confucian meritocracy that is currently being discussed in international political theory, we start from the hypothesis of a historical, intercultural and logical, simultaneous provenance of democracy and meritocracy in the evolution of the modern constitutional state. To this end, we examine the reception of Confucianism in the republican history of ideas of European Enlightenment using selected examples ranging from Leibniz to the classical constitutional and government theory of Sieyès. The widespread ignorance (...) of the Confucian elements in the classical core of modern republicanism that we have evaluated here is attributed to the needs of political legitimacy and the methodical ahistorism and historical amnesia of academic discourse. (shrink)

In empiricism, there are only two answers for a question: black or white. Yet, subjective meanings of human behaviours and responses toward health and illness cannot be simply explained with black and white. Gray zones are needed because they are characterized by complexity and require a contextual understanding. In this paper, we present and suggest fuzzy logic as an example of theoretical bases that help transcend the conflicts between objectivity and subjectivity, respect gray zones between black and white answers for (...) questions, and provide a contextual understanding of complex nursing phenomenon. A historical review of fuzzy logic is followed by a definition of fuzzy logic. Then, fuzzy logic is discussed in terms of its compatibility with nursing epistemological views and philosophical thoughts. Fuzzy logic agrees with three categories of epistemological views of nursing, including correspondence, coherence and pragmatism. Fuzzy logic also agrees with four major philosophical thoughts in nursing, including postempiricism, pragmatism, feminism, and postmodernism. Based on the discussion, we propose that fuzzy logic be further explored, used and developed in research and practice in the nursing areas/situations/phenomena that are characterized by complexity, ambiguousness, and vagueness. (shrink)

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim should not be (...) understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with (a child with) serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non‐invasive prenatal test (NIPT), the tendency to widen the scope of follow‐up testing, as well as the possible future scenarios of genome‐wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

The notion of subjectivity with which the argument will be carried out may be defined as our ability to reflect critically, to think creatively and to act resolutely in our relation to society and nature. Some essential marks of subjectivity are illustrated through an example taken from the rescue operation conducted in the fall of 2010 for the miners trapped deep underground at the San Jose mine site in Chile for sixty-nine days. With the science and technology applied in constructing (...) the drilling rigs and making the capsule which lifted the trapped miners to freedom, ingenuity, the resilient sense of mission and perseverance of the rescue personnel, and the purposeful solidarity among the trapped miners are among the decisive factors contributing to the successful accomplishment of the rescue undertaking. At this critical juncture of the current global economic downturn, it is consequential for us to bring ourselves to reflect upon the seriousness of the predicament which all humanity is in. It is indeed time for intellectuals to rise up and share responsibility in keeping our world sustainable by setting purposeful and resolute subjectivity before themselves and coming forward to tenaciously find ways in which to renew ourselves as well as to achieving the continuing betterment of humanity. (shrink)

In the 1990s P.H. Hirst criticizes his influential forms of knowledge theory, suggesting a new concept of education. In this paper I explain why Hirst suggests the new concept of ‘education as initiation into practices’. Although the latter Hirst’s position had positive implications on education, it is frequently confused with theutilitarian position. In order to provide a more coherent concept of education, I compare basic features of the rationalist (R), the utilitarian (U), and the practices-based (P) approach. Then I discuss (...) the implications of this concept. The main features of R, U, and P are respectively as this: 1) A person is seen as a rational being, a being of wants and desires, and a rational practitioner who is socially constructed. 2) The nature of reason is conceived as ‘rational’,‘instrumental’, and ‘practical’. 3) The aim of education is education for theoretical rationality, education for maximum satisfaction of desires, and education for identity formation by participating in practices. 4) The contents of education are theoretical knowledge, instrumental knowledge with utility, and practical knowledge for various practices. 5) R pursues absolute transcendental values, U pursues extrinsic instrumental values, and P pursues values internal to a practice. 6) R conceives education as ‘seeing’, U as ‘doing’, and I suggest ‘listening’ model for P. Based on this conception of practices-based position, I hope we can provide better education. (shrink)

Der Konfuzianismus ist auch im Westen keine unbekannte Lehre mehr. Zugleich trifft man ihr gegenüber auf erhebliche Vorurteile. Insbesondere im Zusammenhang mit der Debatte um den Kommunitarismus wird der Konfuzianismus häufig als kulturelle Grundlage autoritärer politischer Herrschaft hingestellt. Das ist nicht vollkommen falsch, beruht aber auf einer einseitigen Wahrnehmung des Konfuzianismus. Tatsächlich blickt dieser auf eine lange Geschichte politischer Instrumentalisierungen zurück. Gleichwohl enthält diese Lehre Konzepte, die dem gemeinschaftlichen Zusammenleben förderlich sein können.

Fenomenologie van het proces van bewijzen in strafzaken In deze bijdrage staat de activiteit van bewijzen in strafzaken centraal. Betoogd wordt dat de vigerende rationalistische opvatting van strafrechtelijk bewijzen eraan voorbij gaat dat het bewijzen zich allereerst voltrekt op een vóór-reflectief niveau. Het primaire blikveld van de mens is namelijk niet het objectiverende kennen, zoals in de rationele bewijstheorieën wordt voorondersteld, maar de praktische relatie tot de wereld. In dit kader wordt eerst de filosofische achtergrond van de rationalistische bewijsopvatting in (...) kaart gebracht, in het bijzonder de invloed van Aristoteles en Descartes. Vervolgens worden de daaruit voortkomende bevindingen aan de hand van ideeën en inzichten die zijn ontleend aan de existentiële fenomenologie kritisch gewaardeerd. Dit leidt tot de uiteenzetting van een hermeneutische opvatting van strafrechtelijk bewijzen. (shrink)