Dharmapala's Yogacara Critique of Bhavaviveka's Madhyamika Explanation of Emptiness, The Tenth Chapter of Ta-ch'eng Kuang Pai-lun Shih Commenting on Aryadeva's Catuhsataka Chapter Sixteen. John P. Keenan. The Edwin Mellor Press, Lewiston, New York, 1997. 153 pp. $79.95. ISBN 0-7734-8615-1.

Aims: To examine the extent of social stigma toward diabetes among Singapore's multi-ethnic general population and determine whether this differs across socio-demographic sub-groups.Methods: Data for this study came from a nationwide cross-sectional study. A diabetes stigma questionnaire comprising Social Distance Scale and Negative Attitudes and Stereotyping Scale was administered to those respondents who had not been diagnosed with diabetes. Exploratory factor analysis was conducted to determine the dimensionality of the instruments and validated using confirmatory factor analysis. Multiple linear regression analysis (...) was conducted to examine associations between socio-demographic factors and measures of diabetes stigma.Results: In all, 2,895 participants were recruited from the general population giving a response rate of 66.2%. Factor analyses found that a one-factor model resulted in an acceptable fit for both stigma scales, which measured social distance and negative attitudes and stereotyping, respectively. Multiple linear regression analyses identified Indian ethnicity, higher personal income and having close friends or family members who had been diagnosed with diabetes to be significantly associated with lower social distance scores while those aged 50–64 years and those with secondary and vocational education were significantly associated with higher social distance scores. Those with a personal income of SG$2,000–3,999 and SGD $6,000 and above, and those with close friends or family members diagnosed with diabetes were significantly associated with lower negative attitudes and stereotyping scores. In contrast those aged 35 years and above, those with primary education and below, and those of Malay ethnicity were significantly associated with higher negative attitudes and stereotyping scores.Conclusions: The study found a relatively low level of stigma toward diabetes in the general population of Singapore, although some stigmatizing beliefs emerged. While greater knowledge of diabetes could reduce stigma, anti-stigma messaging should be incorporated into the “War on Diabetes” programme in Singapore. (shrink)

Background Developing confident capacity for ethical decision-making is vital in nursing education. However, no tool examines nursing students’ competence in ethical decision-making. Aim This study aimed to develop an Ethical Decision-Making Competence Scale (EDM-CS) to assess ethical care decision-making competencies in nursing students. Participants and research context Original items were obtained by employing a focus group and the Delphi method. A cross-sectional design was used to confirm the items remained on the scale. Additionally, the scale’s reliability and validity were assessed. (...) The EDM-CS was completed by 498 nursing students. An exploratory factor analysis (EFA) was used to examine the factor structure based on data from group 1 ( n = 250). A second-order confirmatory factor analysis (CFA) was used to examine the model’s fitness based on data from group 2 ( n = 248). This study was conducted between August 2022 and July 2023. Ethical considerations The Institutional Review Board of OO Medical University Hospital approved this study’s design and procedure. Results From the original 34 items, nine were deleted in the EFA. Thus, the EDM-CS had 25 items and a four-factor structure (ethical judgement, ethical sensitivity, ethical motivation, and ethical action), which explained 60.97% of the total variance. A second-order CFA identified a second-order factor termed ‘ethical decision-making competence’ with 18 items (root mean square residual = 0.052). The EDM-CS scores correlated significantly and positively with the scores on the Scale of Protective Factor-24 (r = 0.47, p <.001), which indicated good convergent validity. Cronbach’s alpha coefficient of the final EDM-CS was 0.90 and ranged from 0.73 to 0.80 for the four subscales. Discussion and conclusion The EDM-CS was validated to fit the data adequately. It can be used to evaluate clinical nursing students’ ethical decision-making abilities and to develop education strategies to improve their ethical care competence. (shrink)

While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears – temporal fine structure (TFS) information with acoustic hearing versus coarse spectro-temporal envelope information with electric hearing – may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of (...) stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22), and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22, and UN+SID19). After completing baseline measurements, subjects completed 6 lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p<0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing. (shrink)

As a global public health concern, elder abuse negatively affects health, psychosocial wellbeing, and mortality among elders. Research and practice efforts made to explore effective prevention and intervention strategies are growing. Despite the growing number of intervention studies on elder abuse, research synthesis on the empirical literature seems lacking. This study aims to identify the pooled effect size of prevention and interventions targeted ultimate and intermediate outcomes for elder abuse that occurred in community settings. Following the Cochrane guideline, our team (...) searched across eight electronic databases and manually searched reference lists of eligible studies and existing systematic reviews for all potentially eligible studies. A random-effects model of 51 effect size estimates reported an overall positive and statistically significant treatment effect of psychosocial interventions for elder abuse, d = 0.63, p < 0.05. The overall treatment effect was approaching statistical significance at 0.1 level for ultimate outcomes, d = 0.32, p = 0.09, and intermediate outcomes, d = 0.75, p = 0.1. An overall significant effect size was found among family-based interventions, d = 0.59, p < 0.05, and interventions targeting older adults and their caregivers, d = 0.45, p < 0.05. Existing evidence supports an overall significant effect for psychosocial interventions for elder abuse. Interventions that used a family-based model, combined education and supportive services, and targeted both caregivers and elders, showed significant effect size, suggesting such features being considered in elder abuse intervention design. Future intervention research is needed to shed light on the link between intervention activities and ultimate change in elder abuse behaviors. (shrink)

Introduction: Few studies are available on the prevalence and sleep-related factors of dementia with Lewy bodies (DLB) in Chinese older adults, aiming to explore the associations between sleep characteristics and DLB.Methods: A cross-sectional study with 7,528 individuals aged ≥65 years in 106 communities in Northern China was conducted from April 2019 to January 2020. Questionaries (including demographic characteristics, comorbidities, lifestyles, and sleep characteristics) were administered, and neuropsychological assessments and physical examination were conducted in phase I; screening for probable DLB was (...) done in phase II. Logistic regressions were used to assess associations.Results: A total of 919 (12.2%, 919/7,528) participants had dementia, and 101 (1.3%, 101/7,528) participants were diagnosed with DLB. The prevalence of dementia and DLB were slightly higher or equal in women, increased with age, and roughly decreased with nighttime sleep duration. Of the 101 participants, all of them (100.0%) had cognitive impairment, 46 (44.54%) displayed fluctuating cognition, 72 (71.29%) of them showed visual hallucination, 22 (21.78%) individuals reported RBD, and 27.71% showed Parkinsonism. Sleeping for 8 h had combined diagnostic value for DLB (AUC = 0.783, 95%CI: 0.734–0.831, p < 0.001).Conclusions: The current prevalence of DLB is 1.3% in Northern China. Short or long nighttime sleep duration is independently associated with the occurrence of dementia and DLB. (shrink)

Electroacupuncture (EA) and electroconvulsive therapy (ECT) are often used in the management of schizophrenia. This study sought to determine whether additional EA and ECT could augment antipsychotic response and reduce related side effects. In this retrospective controlled study, 287 hospitalized schizophrenic patients who received antipsychotics (controls, n = 50) alone or combined with EA (n = 101), ECT (n = 55) or both (EA+ECT, n = 81) were identified. EA and ECT were conducted for 5 and 3 sessions per week, (...) respectively, with a maximum of 12 sessions for ECT during hospitalization. The Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) were used to assess the severity of psychotic symptoms. Clinical response on SAPS and SANS, weight gain, and adverse events were compared. Survival analysis revealed that the ECT and EA+ECT groups had markedly greater clinical response rate than controls on SAPS [72.7% and 90.1% vs. 64.0%; relative risk (RR), 1.974 and 2.628, respectively, P ≤ 0.004] and on SANS (67.3% and 70.4% vs. 42.0%; RR, 1.951 and 2.009, respectively, P ≤ 0.015). A significantly greater response rate on SANS than controls was also observed in the EA group (64.4% versus 42.0%; RR = 1.938, P = 0.008). EA-containing regimens remarkably reduced weight gain and incidences of headache, insomnia, dry mouth, and electrocardiographic abnormalities. These results suggest that EA and ECT can serve as additional treatment for enhancing antipsychotic response and reduce the side effects in hospitalized patients with schizophrenia. (shrink)

Recently I have read in succession the four articles on formal logic and dialectics in the current year's Hsin chien-she: Mr. Chou Ku-ch'eng's "Formal Logic and Dialectics" in the second issue, Mr. I Chih's "A Criticism of Confused Concepts on Problems of Logic" in the fourth issue, Mr. Shen Ping-yuan's "A Discussion of ‘Formal Logic and Dialectics,’ " and Mr. Chou Ku-ch'eng's "Further Discourse on Formal Logic and Dialectics," both in the seventh issue. In my opinion, in Mr. Chou's articles, (...) several main theses on formal logic and on the relationship between formal logic and dialectics are erroneous; basically, I agree with the criticisms of Messrs. I and Shen. Nonetheless, I believe that Mr. Chou's errors have had their source in the theory of cognition in that he has unilateralized and absolutized certain aspects that were originally correct, thus leading himself in the wrong direction. In criticizing Mr. Chou, both Messrs. I and Shen failed to proceed from this premise, so they could not make others see where Mr. Chou's errors basically lie. Based on this approach, I am merely offering some personal views on several main problems concerning formal logic and the relationship between formal logic and dialectics as mentioned in Mr. Chou's article. It is hoped that Mr. Chou and other comrades will correct me. (shrink)

Rationale Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines.Aims and objectives To use registry data to: (1) investigate trends in survival and treatment; and (2) compare treatment with guidelines.Methods Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast (...) cancers during 1977–2003 (n = 4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan–Meier product limit estimates and multivariable Cox proportional hazards regression.Results The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997–2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997–2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977–1990 to 76.8% in 1997–2003 for stage I (P < 0.001) and from 31.1% to 52.2% across these periods for stage II (P < 0.001). Adjuvant radiotherapy also became more common (P < 0.001), with 20.6% of patients receiving this treatment in 1977–1990 compared with 60.7% in 1997–2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P < 0.001), from 19.6% in 1977–1990 to 36.9% in 1997–2003, and the proportion having hormone therapy also increased (P < 0.001), from 34.3% to 59.4% between these periods.Conclusions Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based. (shrink)

Mood disorder patients have greater suicide risk than members of the general population, but how suicidal behavior relates to brain functions has not been fully elucidated. This study investigated how functional connectivity (FC) values between the right/left amygdala and the whole brain relate to suicidal behavior in patients with mood disorder. The participants in this study were 100 mood disorder patients with suicidal behavior (SB group), 120 mood disorder patients with non-suicidal behavior (NSB group), and 138 age- and gender-matched healthy (...) controls (HC group). Whole-brain FC values among the three groups were compared using an analysis of covariance (ANCOVA). Compared to the NSB and HC groups, increased FC values in the right amygdala-bilateral paracentral lobule/precuneus circuit were observed in the SB group (Bonferroni-corrected,p 0.017). Moreover, there were no significant differences in FC values between mood disorder patients with suicide attempt (SA group) and mood disorder patients with suicidal ideation (SI group), while the FC values between the right amygdala and bilateral paracentral lobule/precuneus in the SA group were higher than the mean in the SI group. These findings suggest that right amygdala-paracentral lobule/precuneus dysfunction has an important role in patients with mood disorder and suicidal behavior. (shrink)

The 1973 archeological discovery of important documents of classical thought known as the Huang-Lao Boshu coupled with advancements in contemporary jurisprudence make possible a reassessment of the philosophies of pre-Qin and early Han China. This study attempts to elucidate the importance of the Huang-Lao school within the intellectual tradition of China through a comparison of the Boshu's philosophical position, particularly its understanding of the relation between law and morality, with the respective views of major thinkers of the period--Confucius, Han Fei, (...) Lao Zi, Zhuang Zi, and to a lesser extent, Shen Dao, Shen Buhai and the authors of the Guan Zi and He Guan Zi. So doing reveals Huang-Lao to be a unique and sophisticated social and political philosophy which, until its expulsion from court by Emperor Wu and subsequent adoption by Daoist religion, served as the ideological foundation for the post-Qin reforms of the early Han. (shrink)

The I Ching, or Book of Changes, has been one of the two or three most influential books in the Chinese canon. It has been used by people on all levels of society, both as a method of divination and as a source of essential ideas about the nature of heaven, earth, and humankind. During the eleventh and twelfth centuries, Sung dynasty literati turned to it for guidance in their fundamental reworking of the classical traditions. This book explores how four (...) leading thinkers--Su Shih, Shao Yung, Ch'eng I, and Chu Hsi--applied the I Ching to these projects. These four men used the Book of Changes in strikingly different ways. Yet each claimed to find in it a sure foundation for human values. Their work established not only new meanings for the text but also new models for governance and moral philosophy that would be debated throughout the next thousand years of Chinese intellectual history. By focusing on their uses of the I Ching, this study casts a unique light on the complex continuity-within-change and rich diversity of Sung culture. Originally published in 1990. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

ZusammenfassungDie Schnitzler-Forschung hat gezeigt, dass die medizinischen und die literarischen Schriften des Schriftsteller-Arztes eng verflochten sind. Dennoch haben pharmakologische Problemstellungen, wie sie für die ärztliche Praxis der Moderne grundlegend sind, bislang nur wenig Aufmerksamkeit bei der Auseinandersetzung mit Schnitzlers Werk erfahren, obwohl sie dort immer wieder zentral werden. Ausgehend von einem Fund im Archiv des Pharmakonzerns Bayer – die Firma nahm Anstoß an der Verwendung des Schlafmittels Veronal in Fräulein Else – liest dieser Aufsatz Schnitzlers Novelle erstmals vor dem Hintergrund (...) der ›Veronal-Kultur‹ des frühen zwanzigsten Jahrhunderts. Dabei erweist sich, dass Fräulein Else auch eine Intervention in die Public Health-Diskurse seiner Zeit beinhaltet. (shrink)

One of the interpretive devices that Ch'eng-kuan (澄 觀) is famous for having employed to distill the essence of the vast Mahāvaipulya Buddhāvataṃsaka Sūtra (Tafang-kuang fo-hua-yen ching 《大方廣佛華嚴經》 was a series of variations on the contemplative theme (kuan-men 觀門) of the complete interfusion (yüan-jung 圓融) of the scripture's three chief protagonists (san-sheng 三聖) ── the Buddha Vairocana (Pi-lu-che-na 毘盧遮那) and the bodhisattvas Mañjuśrī (Wen-shu-shih-li 文殊師利) and Samantabhadra (P'u-hsien 普賢). By aligning these three powerful sacred persons with a number of philosophical (...) categories that he believed to be central to the sūtra ── categories like "cause" (yin 因 ), "fruition" (kuo 果 ), "faith" (hsin 信 ), "understanding" (chieh 解), "insight" (chih 智), "practice" (hsing 行), "principle" (li 理), etc. ── he provided a focal point at which the rich and vivid meditative and liturgical lives of Hua-yen devotees could be made to converge with their philosophical reflections. -/- Although Ch'eng-kuan invoked this device in several of his writings, his most concerted development of it is a short essay entitled San-sheng yüan-jung kuan-men, which appears to have been written relatively late in his long career. Like many important Hua-yen texts, this essay seems to have been lost in China not long after its author's death. However, it was preserved in Korea and Japan and from the latter country was reintroduced to China in the last years of nineteenth century. Neither in China nor in the West has it yet been adequately studied. -/- The core of the present article is a critical edition of the Chinese text of the essay based on a careful comparison of all available versions and presented together with a copiously annotated English translation. The edition translation are preceded by a brief interpretive introduction and followed by an appendix in which are given: a detailed discussion of the work's textual history, detailed accounts of its various editions, and descriptions of its several surviving paraphrases and commentaries. (shrink)

With the increasing degrees A.I.s and machines are applied across different social contexts, the need for implementing ethics in A.I.s is pressing. In this paper, we argue for a pluralist hybrid model for the implementation of moral A.I.s. We first survey current approaches to moral A.I.s and their inherent limitations. Then we propose the pluralist hybrid approach and show how these limitations of moral A.I.s can be partly alleviated by the pluralist hybrid approach. The core ethical decision-making capacity of an (...) A.I. based on the pluralist hybrid approach consists of two systems. The first is a deterministic algorithm system that incorporates different moral rules for making explicit moral decisions. The second is a machine learning system that calculates the value of the variables required by the application of moral principles. The pluralist hybrid system is better than the existing proposals as (i) it better addresses the moral disagreement problem of the top-down approach by including different moral principles, while (ii) it reduces the opacity of ethical decision-making compared with a bottom-up system by implementing explicit moral principles for moral decision making. (shrink)

Although most existing studies have considered entrepreneurial bricolage as a means to overcome resource constraints in new ventures, few have explored the direct effects of entrepreneurial bricolage on employee creativity, particularly in the context of entrepreneurial internet firms. Drawing from multiple theories, this study proposes a cross-level mediation model for the trickle-down effects of entrepreneurial bricolage and business model innovation on employee creativity. By using a 2-wave longitudinal design, survey data were collected from multiple sources, including 49 leaders and 336 (...) employees from entrepreneurial internet firms in China. Multilevel structural equation modeling was applied to analyze the cross-level mediation model. The results show that both entrepreneurial bricolage and business model innovation failed to significantly and positively direct employee creativity. Furthermore, entrepreneurial bricolage exerted a cross-level influence on employee creativity that was sequentially transmitted through between-level business model innovation and within-level creative self-efficacy. The theoretical and managerial implications of these findings are also discussed. (shrink)