The so-called “Harvard Team Report,” commissioned by the Hong Kong government (Hong Kong SAR Government, 1999), suggests significant institutional changes to the local health care system, including a partial shift of the financial burden directly to the citizens. I argue that 1) the Report's adoption of the contextuality principle as its research framework encounters practical problems in collecting data for a reliable analysis; 2) the existing health care system already satisfies the Report's first guiding principle; 3) the Report's employment of (...) the “working assumption” of the government (i.e., not increasing its financial support of health care) as its second guiding principle is questionable, for the share of the percentage of GDP as represented by the existing system (4.6% in 1996) is small enough; and 4) because of 3), the Report is unnecessarily constrained in its choices of considered options and seems to overlook some feasible ones. In conclusion, the methodological reasonableness of the Report is questioned. (shrink)

This article argues for an alternative interpretation of the ekphrasis of Pelops and Myrtilos among Adrastus’ parade of ancestral images in lines 6.283–5 of Statius’ Thebaid. The majority of scholarly readings believe that the scene described in these lines alludes to the mythical chariot-race between Pelops and Oenomaus. Using a combination of visual, intertextual and intratextual evidence, this article suggests that these lines more likely refer to a later part of the myth—Pelops’ murder of Myrtilos, as the former hurls the (...) latter into the Myrtoan sea from a flying chariot. This paper concludes by exploring what implications this alternative reading has for our understanding of Statius’ use of ekphrasis as a narrative technique and, more specifically, its significance on our reading of the ekphrasis of Adrastus’ ancestral images. (shrink)

A large body of research links testosterone and cortisol to male-male competition. Yet, little work has explored acute steroid hormone responses to coalitional, physical competition during middle childhood. Here, we investigate testosterone, dehydroepiandrosterone, androstenedione, and cortisol release among ethnically Chinese boys in Hong Kong, aged 8–11 years, during a soccer match and an intrasquad soccer scrimmage, with 63 participants competing in both treatments. The soccer match and intrasquad soccer scrimmage represented out-group and in-group treatments, respectively. Results revealed that testosterone showed (...) no measurable change. DHEA increased during both treatments in the majority of participants and the degree of change had no relation to independent variables or covariate measures. Most boys experienced androstenedione increases during match play, but no significant differences during the intrasquad soccer scrimmage competitions. The magnitude of change differed significantly between treatments and was positively associated with age. These latter findings suggest boys’ androstenedione responses may be sensitive to competitor type. For most subjects, cortisol significantly increased during match play, decreased during the intrasquad soccer scrimmage, and differed significantly between treatments, suggesting each treatment promoted a different psychological state among competitors. Cortisol/DHEA molar ratio decreased during the intrasquad scrimmage, suggestive of a more relaxed mental state. These data shed new light on potential proximate mechanisms associated with coalitional competition among prepubescent boys, with relevance to adrenarche and life history theory. (shrink)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before (...) and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. (shrink)

People have little difficulty distinguishing effects they cause and those they do not. An important question is what underlies this sense of agency. A prevailing idea is that the sense of agency arises from a comparison between a predictive representation of the effect and the actual effect that occurs, with a clear match between the two producing a strong sense of agency. Although there is general agreement on this comparison process, one important theoretical issue that has yet to be fully (...) determined is whether these computations are consciously performed. Here, we studied this issue by requiring participants to perform a simple judgment of agency task under conditions of different concurrent working memory load. Working memory operations are known to tax conscious cognitive resources. We found that agency judgments were moderated by working memory load, with lower agency ratings being observed in the high load condition, suggesting that the sense of agency is dependent on the availability of conscious cognitive resources. An examination of the time-course of this load effect suggests that it is the construction of the mental representation of the predicted effect which is particularly dependent on said resources. (shrink)

With the worldwide spread of the Internet, human activity has become permeated by digital media, which shapes communication and interaction and speeds up the improvement of the experience and diffusion of museum exhibitions. Contemporary museums must understand their audiences, especially with respect to online preferences and surfing involvement experiences. Museums are changing in an effort to attract young netizens to access and use museum resources. Virtual museums are increasingly using digital exhibitions to preserve and apply their collections and establishing online (...) community platforms to interact with young people. This study investigates the underlying mechanism of online community characteristics that enhance audiences’ emotional resonance and involvement. Results from a questionnaire survey of Taiwan undergraduate students show that perceived relevance and esteem improve their emotional resonance, which can attract new people and maintain existing relationships within their communities. Following flow theory, maintaining community relationship characteristics increases emotional resonance, which, in turn, enhances user involvement, but we found only small significant effects of emotional resonance on involvement. These findings illuminate the mechanism of the attitudinal relationship building and maintenance for online museum communities and advance the practical contributions of online museum community use and effects. (shrink)

The global pandemic needs to mark a turning point for the peoples of Aotearoa New Zealand. How can we make sure that our culturally diverse nation charts an equitable and sustainable path through and beyond this new world? In a less affluent future, how can we ensure that all New Zealanders have fair access to opportunities? One challenge is to preserve the sense of common purpose so critical to protecting each other in the face of Covid-19. How can we centre (...) what we have learnt about resilience within Māori and wider Pacific communities in our reforms? How can public understanding of Covid-19 science create a platform for the future social valuing of expertise? How can we ensure that the impact of Covid-19 in New Zealand results in a more sustainable, and inclusive workforce–for instance by expanding our perceptions of the value of our workers through promoting digital inclusion? To meet these challenges, we must reimagine our existing traditions of thought, breathing new life into perennial concepts and debates. Our paper indicates some of the ways that Philosophy is central to this collective reimagining, highlighting solutions to be found across our rich philosophical traditions. (shrink)

Background: Burnout is a stress-induced syndrome considered to be closely related to work. Although social support could relief burnout syndrome, its effect on learning burnout in medical students remains unclear. The objectives of the study are to evaluate the association between learning burnout and social support in Chinese medical students.Methods: A cross-sectional online survey was distributed to students who participated in online learning in a medical college in Wuhan during the COVID-19 epidemic. We used the Lian version of the Maslach (...) Burnout Inventory to assess learning burnout and the Social Support Rating Scale to assess social support. Chi-square tests were used to analyze factors associated with burnout. Independent t-test and multiple logistic regression were explored to analyze the relationship between social support and burnout.Results: A total of 684 students have completed the survey, of which 315 met standard criteria for learning burnout. Multiple logistic regression analysis has revealed that seniors, low family income and low social support were significant predictors of learning burnout. After adjusting for the grade and family income, there was a significant and relevant association between social support and learning burnout.Conclusions: Learning burnout was highly prevalent in medical students at our college. Senior students and low family income might be risk factors for learning burnout. Social support, especially subjective support and utilization of support might play a protective role in reducing the risk of learning burnout. (shrink)

Entrepreneurship may be taught, and entrepreneurship education is flourishing at colleges and universities. However, previous documents show that entrepreneurship education is inconsistent with the research conclusions of entrepreneurial intention, which is a lack of discussion on the mediating effect of government subsidies from external resources. Based on the cognitive behavior theory, a mediating effect of entrepreneurship education on entrepreneurial strategy and entrepreneurial intention is built. By collecting the data of 334 questionnaires of college students in Pearl River Delta in China, (...) a structural equation is used for empirical analysis. The result indicates that entrepreneurship education does not have a significant influence on entrepreneurial intention; exploration innovation and exploitation innovation have a positive influence on entrepreneurial intention, and exploration innovation and exploitation innovation have a mediating effect on entrepreneurship education and entrepreneurial intention; government subsidies have a positive regulating effect on exploration innovation, exploitation innovation, and entrepreneurial intention. In this article, the application of the cognitive behavior theory in the field of entrepreneurship research is expanded to provide the theoretical basis for building the entrepreneurship education ecosystem, which is conductive to innovation and entrepreneurship to promote regional economic development. (shrink)

Being Indigenous and operating in an institution such as a university places us in a complex position. The premise of decolonizing history, literature, curriculum, and thought in general creates a tenuous space for Indigenous and non-Indigenous peoples to confront a shared colonial condition. What does decolonization mean for Indigenous peoples? Is decolonization an implied promise to squash the tropes of coloniality? Or is it a way for non-Indigenous people to create another paradigm or site for their own resistance or transgression (...) of thinking? What are the roles of Indigenous and non-Indigenous peoples in this space of educational potential, this curriculum called decolonization? This article presents a multi-vocal reflection on these and related questions. (shrink)

Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung (...) Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses. (shrink)

Critical types of infrastructure are provided by the state to maintain the people’s livelihood, ensure economic development, and systematic government operations. Given the development of ever more complicated critical infrastructure systems, increasing importance is being attached to the protection of the components of this infrastructure to reduce the risk of failure. Power facilities are one of the most important kinds of critical infrastructure. Developing an effective risk detection system to identify potential failure modes of power supply equipment is crucial. This (...) study seeks to improve upon prior approaches for risk assessment by proposing a hybrid risk-assessment model using the concepts of failure mode and effect analysis and multiple-criteria decision-making. The proposed model includes a cost-based factor for decision-makers. The subjectivity and uncertainty in FM assessment are adjusted through the rough number method. The original risk priority number can be expanded by including the entropy weights in the risk index. Furthermore, to rank the risk priorities in a rational manner, a modified technique for order preference by similarity to ideal solution is adopted. The applicability and effectiveness of the proposed method were demonstrated by considering an example of a turbine steam engine in a nuclear power plant. (shrink)

In recent years, due to factors such as rising sea levels, several island nations such as Maldives, Tuvalu, Kiribati, and the Marshall Islands are in danger of disappearing completely. When the land of an island country disappeared, the human rights protection of Environmentally Displaced Persons in the migration process and the possible loss of their unique culture, language, and lifestyle have aroused great concern. We call such Environmentally Displaced Persons as EDPs. This study selects the EDPs’ data of 241 countries (...) or regions from 2008 to 2018, establishes an ARIMA model, and predicts the future population of EDPs. By combining the influencing factors of cultural loss, the risk assessment model of cultural loss is established to evaluate the possibility of cultural loss during the migration process of EDPs. We have established a Bayesian Network and a Fault Tree Model to demonstrate the improvement brought about by the implementation of policy recommendations from both qualitative and quantitative perspectives and use the method of fault tree analysis to illustrate the importance of policies from the degree of probability reduction after policy changes. Finally, based on the above model establishment and data analysis, corresponding countermeasures are proposed to protect EDPs’ human rights from being violated and their culture will not be lost. (shrink)

v. 1 Egyetem, nevelés, értelmiségi lét.

This study applies the concept of reported speech advanced by the renowned Russian literary scholar Mikhail Bakhtin to compare the argumentative styles of Mainland China and Taiwan. These societies in question are considered by many scholars as sharing the same argumentative style. The study reports that the Mainland debaters more frequently than the Taiwanese debaters maintained the authenticity of the quotations cited from ancient Confucian sources, whereas Taiwanese debaters paraphrased more frequently. On the other hand, this difference cannot be found (...) when debaters quoted from sources other than Ancient Confucians. The findings, according to Bakhtin, imply a contrast of monologic and dialogic tendencies toward authority, which results in a style difference between Mainland and Taiwan argumentation. (shrink)

Several previous studies have reported atypicality in resting-state functional connectivity in autism spectrum disorder, yet the relatively small effect sizes prevent us from using these characteristics for diagnostic purposes. Here, canonical correlation analysis and hierarchical clustering were used to partition the high-functioning ASD group into subgroups. A support vector machine model was trained through the 10-fold strategy to predict Autism Diagnostic Observation Schedule scores within the ASD discovery group, which was further validated in an independent sample. The neuroimage-based partition derived (...) two subgroups representing severe versus mild autistic patients. We identified FCs that show graded changes in strength from ASD-severe, through ASD-mild, to controls, while the same pattern cannot be observed in partitions based on ADOS score. We also identified FCs that are specific for ASD-mild, similar to a partition based on ADOS score. The current study provided multiple pieces of evidence with replication to show that resting-state functional magnetic resonance imaging FCs could serve as neural biomarkers in partitioning high-functioning autistic individuals based on their symptom severity and showing advantages over traditional partition based on ADOS score. Our results also indicate a compensatory role for a frontocortical network in patients with mild ASD, indicating potential targets for future clinical treatments. (shrink)

Globalization has led to a redefinition of the functions and roles of the state. Based on data drawn from a cross-national social survey, this article examines the influences of globalization on the public's attitudes towards their state in Australia, China, India, Japan, Russia, and the United States, by focusing on satisfaction with government performance and demands on the government. The six countries differ extensively in their sociopolitical and technological situations, as well as in the experiences of their people with globalization (...) in terms of the following aspects: connectivity with the world through personal ties and digital means, English language capacity, and support for the forces of globalization. There are also huge disparities in the public rankings of government performance and demands for expanding government spending in a wide range of policy areas. Our analysis reveals that, although both intra- and inter-country variations in the influences of globalization on public attitudes towards the state are not particularly prominent, those who support globalization not only are more inclined than others to be satisfied with the government's performance, but also demand more government intervention. (shrink)

As one of the basic manufacturing industries in China, injection molding industry is faced with the problems of low degree of informatization and intelligence, resulting in low production efficiency and high costs. It is urgent to integrate deeply with new generation of information technology to achieve transformation and upgrade. In this paper, an integrative industrial Internet architecture of “integration of intelligent equipment, intelligent production lines, intelligent workshops, intelligent factories, and intelligent formats” was described. The injection molding intelligent control system, the (...) production management, control platform based on the MES system, and other key technologies were researched. Also, the smart factory architecture based on digital twin was established, and the implementation method of the smart factory digital twin system was elaborated. The feasibility and effectiveness of the method had been verified through the industrial application, which provided the technical supports for the injection molding industrial Internet system. Finally, the intelligent manufacturing industrial Internet cloud platform for injection molding industry was prospected. (shrink)

Forecasting blood glucose values for patients can help prevent hypoglycemia and hyperglycemia events in advance. To this end, this study proposes an intelligent ensemble deep learning system to predict BG values in 15, 30, and 60 min prediction horizons based on historical BG values collected via continuous glucose monitoring devices as an endogenous factor and carbohydrate intake and insulin administration information as exogenous factors. Although there are numerous deep learning algorithms available, this study applied five algorithms, namely, recurrent neural network, (...) which is optimized for sequence data, and RNN-based algorithms, stacked LSTM, bidirectional LSTM, and gated recurrent unit). Then, a genetic algorithm was applied to the five prediction models to optimize their weights through ensemble techniques and to yield the final predicted BG values. The performance of the proposed model was compared to that of the autoregressive integrated moving average model as a baseline. The results show that the proposed model significantly outperforms the baseline in terms of the root mean square error and continuous glucose error grid analysis. For the valid 29 diabetic patients for the multivariate models, the RMSE was 11.08, 19.25, and 31.30 mg/DL for 15, 30, and 60 min PH, respectively. When the same data were applied to univariate models, the RMSE was 11.28, 19.99, and 33.13 mg/DL for 15, 30, and 60 min PH, respectively. Both the univariate and multivariate models showed a statistically significant difference compared with the baseline at a 5% statistical significance level. Instead of using a model with a single algorithm, applying a GA based on each output of a model with multiple algorithms was found to play a significant role in improving model performance. (shrink)

People are adept at perceiving interactions from movements of simple shapes, but the underlying mechanism remains unknown. Previous studies have often used object movements defined by experimenters. The present study used aerial videos recorded by drones in a real-life environment to generate decontextualized motion stimuli. Motion trajectories of displayed elements were the only visual input. We measured human judgments of interactiveness between two moving elements and the dynamic change in such judgments over time. A hierarchical model was developed to account (...) for human performance in this task. The model represents interactivity using latent variables and learns the distribution of critical movement features that signal potential interactivity. The model provides a good fit to human judgments and can also be generalized to the original Heider–Simmel animations. The model can also synthesize decontextualized animations with a controlled degree of interactiveness, providing a viable tool for studying animacy and social perception. (shrink)

Transcranial direct current stimulation has been widely utilized in research settings and modulates brain activity. The application of anodal tDCS on the prefrontal cortex has indicated improvement in cognitive functioning. The cingulate cortex, situated in the medial aspect of the prefrontal cortex, has been identified as a core region performing cognitive functions. Most of the previous studies investigating the impact of stimulation on the prefrontal cortex stimulated the dorsolateral prefrontal cortex, however, the impact of stimulation on cingulate has not been (...) explored. The current study investigates the effect of stimulation on the resting-state functional connectivity of the anterior cingulate cortex with other regions of the brain and changes in behavioral results in a color-word Stroop task, which has repeatedly elicited activation in different regions of the cingulate. Twenty subjects were randomly assigned to the experimental and sham group, and their medial prefrontal area was stimulated using MRI compatible tDCS. Resting-state functional magnetic resonance imaging and cognitive Stroop task were monitored before, during, and after the stimulation. Neuroimaging results indicated a significant decrease in resting-state functional connectivity in the experimental group during and after stimulation as compared to before stimulation in two clusters including right insular cortex, right central operculum cortex, right frontal operculum cortex and right planum polare with the left anterior cingulate cortex selected as the seed. The behavioral results indicated a significant decrease in reaction time following stimulation in the experimental group compared to the sham group. Moreover, the change in functional connectivity in subcortical regions with L-ACC as the seed and change in RT was positively correlated. The results demonstrated that ACC has a close functional relationship with the subcortical regions, and stimulation of ACC can modulate these connections, which subsequently improves behavioral performance, thus, providing another potential target of stimulation for cognitive enhancement.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04318522. (shrink)

Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients’ true wishes, meaningfully engaging patients’ significant others, balancing interests among patients and significant others, and determining clinicians’ obligations to change patients’ unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients’ competence (apart from (...) decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman’s procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman’s account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician–patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care. (shrink)

本书在故乡的土地上出现过一代又一代的文化名人和仁人志士而感到骄傲和自豪。书中以文学传记的形式,将他们中杰出人物介绍给广大读者,他们坚韧不拔、克服困难和精神给人以鼓舞,他们各具特色的人生经历和杰出贡献给 人以启发。.

Objectives: The corona virus disease-2019 pandemic spread globally, and we aimed to investigate the psychosocial impact on healthcare workers in China during the pandemic.Methods: In this systematic review and meta-analysis, we searched seven electronic databases for cross-sectional studies on psychosocial impact on HWs in relation to COVID-19 from January 1, 2020 to October 7, 2020. We included primary studies involving Chinese HWs during the pandemic, and data were extracted from the published articles. Our primary outcome was prevalence of anxiety, depression, (...) and stress disorders. We pooled prevalence value with their 95% confidence interval using random effect models and assessed study quality on the basis of an 11-item checklist recommended by the Agency for Healthcare Research and Quality. The study protocol was registered in PROSPERO.Results: We identified 25 articles comprising a total of 30,841 completed questionnaires and 22 studies for meta-analysis. The prevalence of anxiety, depression, and stress disorders was 34.4%, 31.1%, and 29.1% for HWs. The pooled prevalence of anxiety disorders for HWs from late January to early February was 46.4%, significantly higher than those in mid-term February and after late February. The pooled prevalence of depression disorders for HWs from late January to early February was 46.5%, significantly higher than those in mid-term February and after late February. HWs working in Hubei Province had a higher prevalence of anxiety and a lower prevalence of depression than those working in other regions. Nurses had a higher prevalence of anxiety and depression than other HWs.Conclusions: About one-third of HWs in China suffered anxiety, depression, and stress at the early epidemic of COVID-19. HWs in Hubei Province, especially nurses, had a higher prevalence of psychological disorders. During the pandemic, a negative psychological state may persist in a proportion of Chinese HWs, fluctuating with the control of the pandemic. The long-term impact should continue to be observed. Attention should be paid to HWs for their psychological impact due to the pandemic.Systematic Review Registration: The study protocol was registered with PROSPERO. (shrink)

An Arabic language summary of the history and principles of four key Hellenic schools of philosophy: Cynicism, Skepticism, Epicureanism, and Stoicism.