BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

This research develops and tests a multiple-mediator model of the relationship between organizational fairness and employees’ perceived meaningfulness. Integrating (Rosso et al., Research in Organizational Behavior 30:91–127, 2010) theoretical framework on meaningfulness with theories on fairness, we examined four parallel mechanisms linking organizational fairness to perceived meaningfulness: organization-based self-esteem (OBSE), authenticity at work, moral identification, and organizational identification. We tested our model with three time-lagged studies. All of the studies found significant mediating effects of OBSE and authenticity at work, whereas (...) the results of moral identification and organizational identification were mixed. Studies 2 and 3 also found that the combined mediating effect of the self-oriented mechanisms (OBSE and authenticity at work) was significantly stronger than that of the other-oriented mechanisms (moral identification and organizational identification). These findings suggest organizational fairness as a key antecedent of perceived meaningfulness and the prominent role of the self in the relationship between fairness and meaningfulness. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

Singapore, a highly affluent island city-state located in Southeast Asia, has increasingly leveraged new assisted reproductive technologies (ART) to overcome its dismal fertility rates in recent years. A new frontier in ART is preimplantation genetic testing (PGT) for polygenic risk scores (PRS) to predict complex multifactorial traits in IVF (in vitro fertilisation) embryos, such as type 2 diabetes, cardiovascular diseases and various other characteristics like height, intelligence quotient (IQ), hair and eye colour. Unlike well-known safety risks with human genome editing, (...) there are negligible risks with PGT-P, because there are no man-made genetic modifications that can be transmitted to future generations. Nevertheless, the current efficacy of using PGT-P to select IVF embryos for either increased or decreased probability of developing specific polygenic traits is still far from certain. Hence, the regulatory safeguards proposed here will be based on the assumption that the efficacy of this new technology platform has already been validated. These include: (1) restricting the application of PGT-P only for prevention of clinically relevant polygenic disease traits, (2) securely blocking patients’ access to the raw genomic DNA sequencing data of their IVF embryos, (3) validating diagnosis of polygenic disease traits in the prospective parents/grandparents of IVF embryos, and restricting PGT-P only for preventing specifically diagnosed polygenic disease traits and (4) mandating rigorous and comprehensive genetic counselling for IVF patients considering PGT-P. There is an urgent and dire need to prevent abuse of the PGT-P technique, as well as protect the interests and welfare of patients if its clinical application is to be permitted in the country. (shrink)

BackgroundRecent advancements in neuroscientific techniques have allowed us to make huge progress in our understanding of memories, and in turn has paved the way for new memory modification technologies that can modulate memories with a degree of precision, which was not previously possible. With advancements in such techniques, new and critical ethical questions have emerged. Understanding and framing these ethical questions within the current philosophical theories is crucial in order to systematically examine them as we translate these techniques to the (...) clinic.Main bodyIn this paper, we discuss the ethical implications of modern neuroscience techniques that aim to disrupt or enhance memories. We attempt to frame the MMTs in the context of existing ethical philosophical theories to provide a cohesive analysis of the myriad of ethical quagmires that might emerge from such technologies. We argue the application of Aristotle’s Golden Mean and multiple accounts of authenticity are useful in approaching the ethical questions surrounding MMTs. We then propose a framework in which ethical considerations can be systematically examined. Lastly, we provide caveats and considerations for the use of this framework. Overall, we provide a practical approach for the ethical use of MMTs depending on the situation.ConclusionWhile at face value, our model appears to put severe limitations on the application of MMTs, we are not completely opposed to their use, but rather our framework guides the agent to consider the implications before making any decisions. Most importantly, we argue that the use of MMTs does not reduce the responsibility of the initial decision, and the agent must accept the post-MMT self as the new “true self” regardless of the outcome. As the developmental trajectory of MMTs suggests we are getting closer to practical clinical applications, ethical concerns across a wide range of disciplines need to be addressed to develop best strategies and policies when dealing with MMTs. If this can be achieved, we believe the ethical use of MMTs is not only possible but would also be of tremendous benefit to many people suffering from memory-related mental disorders. (shrink)

IntroductionCognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. The rate of regression varies among the six cognitive domains. Current modality of cognitive assessment using neuropsychological paper-and-pencil screening tools for cognitive impairment such as the Montreal Cognitive Assessment has limitations and is influenced by age. Virtual reality is considered as a potential alternative tool to assess cognition. A novel, fully immersive automated VR system has been developed to (...) assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system.AimsThis is a feasibility study to evaluate the VR performance of cognitively healthy adults aged between 35 and 74 years old, based on the performance score and completion time using the CAVIRE system.MethodsConducted in a public primary care clinic in Singapore, 25 multi-ethnic Asian adults were recruited in each of the four age groups in years: 35–44; 45–54; 55–64, and 65–74. The eligibility criteria included a MoCA score of 26 or higher to reflect normal cognition and understanding English instructions. They completed common daily activities ranging from brushing teething to shopping, across 13 VR segments. Their performances scores and completion time were automatically computed by the CAVIRE system. These VR performance indices were compared across the four age groups using one-way ANOVA, F-test of the hypothesis, followed by pair-wise comparisons in the event of a significant F-test.ResultsOne participant dropped out from Group 1. The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups 1 and 2 attained higher VR performance scores and shorter completion time, compared to those in Groups 3 and 4, in all six cognitive domains.ConclusionThe CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices. (shrink)

While participation in social media has become everyday practice among young people, there have been few studies examining how youth as social media users are represented in the media discourse. Focusing on the promotional materials of an award-winning and widely-viewed documentary film, The Social Dilemma, this paper examines the media depictions of youth that attract the public’s attention. Through a social semiotic analysis, we analyzed the representational, interactive, and compositional meanings in the poster and trailer to identify how young people (...) have been represented in the media discourse. Our findings show that they are constructed as vulnerable social media users who are manipulated by social media companies. We argue that such depictions of youth not only negate their sense of agency but also ignore their active engagement in the participatory culture afforded by social media. The implications of such depictions propagate a protectionist perspective of youth. This can undermine efforts towards the development of an empowerment approach in digital literacy education. (shrink)

Distinctive aspects of a culture are often reflected in the meaning and usage of words in the language spoken by bearers of that culture. Keywords such as душа (soul) in Russian, hati (heart) in Indonesian and Malay, and gezellig (convivial/cosy/fun) in Dutch are held to be especially culturally revealing, and scholars have identified a number of such keywords using careful linguistic analyses (Peeters, 2020b; Wierzbicka, 1990). Because keywords are expected to have different statistical properties than related words in other languages, (...) we argue that a quantitative comparison of word usage across languages can help to identify cultural keywords. To support this claim, we describe a computational method that compares word frequencies across languages, and apply it to both linguistic corpora and word association data. The method identifies culturally specific words that range from “obvious” examples, such as Amsterdam in Dutch, to non‐obvious yet independently proposed examples, such as hati (heart) in Indonesian. We show in addition that linguistic corpora and word association data provide converging evidence about culturally specific words. Our results therefore show how computational analyses and behavioral experiments can supplement the methods previously used by linguists to identify culturally salient words across languages. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (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)

本书包括:古朝鲜三国及统一新罗时期、高丽时期、朝鲜王朝(李朝)时期、近代时期四编。.

Life education, also known as life and death education, is an important subject in Taiwan with institutions offering degree programs and courses that focus on quality learning and implementation of life education. What is interesting from the perspective of Taiwanese Education is that the teaching of life education also incorporates a number of Eastern-derived and conceptualized tenets, for example, Buddhist teaching and the importance of spiritual wisdom. This premise contends then that life education in Taiwan, in general, is concerned with (...) the promotion, fulfillment, and cherishing of quality life experiences (e.g., personal contentment, happiness). One example of life education, which resonates with other spiritual beliefs and religious faiths (e.g., Hinduism), is related to spiritual cultivation and the enlightenment of life wisdom. Our own teaching of the subject, likewise, places emphasis on the goal of teaching students to seek meaningful understanding of and appreciation for three major, interrelated components of life education: life wisdom, life practice, and life care. Life education is a beneficial subject as its theoretical understanding may help individuals cope with pathologies and negative life experiences. One negative life experience, in this case, is the ultimate fate of humankind: death. Approaching death and/or the onset of grief is something that we all have to experience. How does one approach death? It is not easy feat and, of course, grief for a loved one is personal and some of us struggle with this. We contend that spiritual cultivation and enlightenment, arising from life education, may assist us with the coping of death (e.g., the possibility of transcendence beyond the realm of life). Forming the premise of the present article, we propose that a person’s ‘spiritual and enlightened self’, reflecting the convergence of three major aspects of life education (i.e., Philosophical reflection, Enrichment of personal well-being, and Spiritual cultivation), would result in the initiation and creation of a number of virtues and positive characteristics – for example: having a positive outlook in life, showing compassion, forgiveness, etc. These virtues and quality characteristics, from our philosophical reasoning, are equivalent to those qualities that positive psychology advocates for. (shrink)

Metro driver is the prime person who is responsible for metro operation safety. The mental health of a metro driver is very important for the operation of the subway and requires the driver to keep high mental alertness to monitor the surrounding environment and also handle emergencies under uncertain or dangerous conditions. After a long-term occupational strain, a metro driver is likely to suffer from some mental health problems, such as anxiety and depression, that ultimately threaten the lives of passengers. (...) Therefore, in this study, we focus on the psychological symptoms of metro drivers from the angle of occupational strain and neuroticism. A total of 396 metro drivers from Kunming Rail Transit Operation Co., Ltd. in China were investigated through a questionnaire survey. Symptom Checklist-90, Personal Strain Questionnaire, and NEO-Five-Factor Inventory-Neuroticism Subscale were applied to evaluate the psychological symptoms, occupational strain, and neuroticism in metro drivers, respectively. The surveyed data were analyzed by SPSS software. Based on the data, a path structural equation model was established to explore the correlation among occupational strain, psychological symptoms, and neuroticism. The results show that the scores for psychological symptoms and occupational strain are higher than the Chinese adult norm among metro drivers. The occupational strain, neuroticism, and psychological symptoms are all positively correlated in the metro drivers. Occupational stress has a direct influence on the psychological symptom, while neuroticism plays a partial mediation role between occupational strain and psychological symptoms. The results of this study can be applied to optimize the employee selection system and training system for metro operation companies. (shrink)

El concepto de dignidad humana ha sido considerado o demasiado denso o demasiado delgado. Sin embargo, desde el punto de vista del no-positivismo, la normatividad jurídica de la dignidad humana puede ser justificada y reforzada por medio de su corrección moral. Desde una perspectiva individual, la comprensión de Mencio sobre la dignidad humana como un valor intrínseco y el imperativo categórico de Kant (el ser humano como un fin en sí mismo) podrían ser adecuadamente comprendidos con base en la diferencia (...) (así como la conexión) entre el principium diiudicationis y el principium executionis, entre voluntad y “elección”; así como entre homo phaenomenon y homo noumenon (es decir, humanidad en la persona de los seres humanos). Desde una perspectiva social, las dimensiones del individuo y la persona social son construcciones ficticias; inclusive Radbruch -alguna vez defensor del derecho social- no remplazó el concepto de “persona jurídica” y, en el periodo de posguerra, reconoció la dignidad humana individual como el criterio para aplicar su famosa “fórmula de Radbruch". Por una parte, la dignidad humana muestra cuando menos un carácter normativo débil, el cual requiere, primero, ponderar entre el ejercicio de los poderes estatales y el control de constitucionalidad bajo la guía de la dimensión dual del ser humano y, segundo, la optimización del principio de la dignidad humana en casos particulares. Por otra, a través de la conexión necesaria entre el concepto de dignidad y personalidad, la dignidad humana puede exhibir un carácter normativo fuerte, el cual requiere inevitablemente una justificación metafísica. (shrink)

Music; philosophy and aesthetics; Islamic philosophy.

El concepto de dignidad humana ha sido considerado o demasiado denso o demasiado delgado. Sin embargo, desde el punto de vista del no-positivismo, la normatividad jurídica de la dignidad humana puede ser justificada y reforzada por medio de su corrección moral. Desde una perspectiva individual, la comprensión de Mencio sobre la dignidad humana como un valor intrínseco y el imperativo categórico de Kant (el ser humano como un fin en sí mismo) podrían ser adecuadamente comprendidos con base en la diferencia (...) (así como la conexión) entre el principium diiudicationis y el principium executionis, entre voluntad y “elección”; así como entre homo phaenomenon y homo noumenon (es decir, humanidad en la persona de los seres humanos). Desde una perspectiva social, las dimensiones del individuo y la persona social son construcciones ficticias; inclusive Radbruch -alguna vez defensor del derecho social- no remplazó el concepto de “persona jurídica” y, en el periodo de posguerra, reconoció la dignidad humana individual como el criterio para aplicar su famosa “fórmula de Radbruch". Por una parte, la dignidad humana muestra cuando menos un carácter normativo débil, el cual requiere, primero, ponderar entre el ejercicio de los poderes estatales y el control de constitucionalidad bajo la guía de la dimensión dual del ser humano y, segundo, la optimización del principio de la dignidad humana en casos particulares. Por otra, a través de la conexión necesaria entre el concepto de dignidad y personalidad, la dignidad humana puede exhibir un carácter normativo fuerte, el cual requiere inevitablemente una justificación metafísica. (shrink)

Resumen: El corpus, siendo una herramienta eficaz, se está empleando en múltiples ámbitos, entre los que se encuentran los estudios de traducción. Sin embargo, dicho recurso no se utiliza con mucha frecuencia en las investigaciones traductológicas cuando una de las lenguas en cuestión es chino clásico (la lengua escrita empleada antiguamente en China), y autores que sí hacen estas investigaciones suelen no mencionar los pasos a seguir cuando se trata un corpus paralelo ad hoc. El objetivo del presente artículo es (...) presentar cómo se elabora un corpus paralelo chino clásico-español tomando como ejemplo la novela histórica Romance de los Tres Reinos y sus traducciones al español. Para ello, hemos descrito la problemática de creación y explotación de este tipo de corpus, siguiendo el orden de las fases del proceso. Resulta que algunas fases del proceso son universales, mientras que otras son propias de lenguas clásicas y de la combinación lingüística chino-otra lengua, en cuyo caso sí faltan aplicaciones eficaces. Con el trabajo, esperamos deparar información a los estudiosos que quieran realizar y profundizar las investigaciones basadas en corpus paralelo y en las obras clásicas de China. Abstract: The corpus, being an effective tool, is utilized in multiple fields. One of them is the Translation. However, this resource isn´t used frequently in translation studies when one of the languages in question is classical chinese (written language used anciently in China). And when it comes to an ad hoc parallel corpus, the steps of how to create it are usually omitted by researchers who make such investigations. The objective of this article is to present how to elaborate a classic Chinese-Spanish parallel corpus taking as example the historic novel Romance of the Three Kingdoms and its two translations into Spanish. To reach the objective, we have described the problem of creation and exploitation of this type of corpus, following the order of the phases of the process. We’ve found that some of the phases are universal while other phases are unique for old languages and for the linguistic combination Chinese-other language. And in this latter case, there’s a lack of effective applications. With the current work, we hope to offer useful information to those scholars who are willing to carry out their own investigations based on self-built parallel corpus and at the same time related to the classic Chinese works. (shrink)

Resumen: El corpus, siendo una herramienta eficaz, se está empleando en múltiples ámbitos, entre los que se encuentran los estudios de traducción. Sin embargo, dicho recurso no se utiliza con mucha frecuencia en las investigaciones traductológicas cuando una de las lenguas en cuestión es chino clásico (la lengua escrita empleada antiguamente en China), y autores que sí hacen estas investigaciones suelen no mencionar los pasos a seguir cuando se trata un corpus paralelo ad hoc. El objetivo del presente artículo es (...) presentar cómo se elabora un corpus paralelo chino clásico-español tomando como ejemplo la novela histórica Romance de los Tres Reinos y sus traducciones al español. Para ello, hemos descrito la problemática de creación y explotación de este tipo de corpus, siguiendo el orden de las fases del proceso. Resulta que algunas fases del proceso son universales, mientras que otras son propias de lenguas clásicas y de la combinación lingüística chino-otra lengua, en cuyo caso sí faltan aplicaciones eficaces. Con el trabajo, esperamos deparar información a los estudiosos que quieran realizar y profundizar las investigaciones basadas en corpus paralelo y en las obras clásicas de China. Abstract: The corpus, being an effective tool, is utilized in multiple fields. One of them is the Translation. However, this resource isn´t used frequently in translation studies when one of the languages in question is classical chinese (written language used anciently in China). And when it comes to an ad hoc parallel corpus, the steps of how to create it are usually omitted by researchers who make such investigations. The objective of this article is to present how to elaborate a classic Chinese-Spanish parallel corpus taking as example the historic novel Romance of the Three Kingdoms and its two translations into Spanish. To reach the objective, we have described the problem of creation and exploitation of this type of corpus, following the order of the phases of the process. We’ve found that some of the phases are universal while other phases are unique for old languages and for the linguistic combination Chinese-other language. And in this latter case, there’s a lack of effective applications. With the current work, we hope to offer useful information to those scholars who are willing to carry out their own investigations based on self-built parallel corpus and at the same time related to the classic Chinese works. (shrink)

本书收录了胡适、梁启超、冯友兰、萧公权等名家论中国哲学史、中国思想史的文章20余篇.