Although advance care planning can lead to more patient-centered care, the communication around it can be challenging in acute care hospitals, where saving a life or shortening hospitalization is important priorities. Our qualitative study in an acute care hospital in Japan revealed when specifically physicians and nurses start communication to facilitate ACP. Seven physicians and 19 nurses responded to an interview request, explaining when ACP communication was initiated with 32 patients aged 65 or older. Our qualitative approach employed descriptive analysis (...) to identify major themes, which included “initiation by patients” and “initiation by healthcare professionals.” In the latter case, seven specific triggers were identified: when the patients’ medical condition changed in terms of symptom relief, when the patients’ medical condition changed in terms of prognostic prediction, when serious events occurred, when a choice of treatment was presented, when the location for end-of-life care was chosen, when the patients’ cognitive function deteriorated, and when serious events settled down. Within this group of healthcare professionals, physicians were more focused on changes in their patients’ medical condition, whereas nurses focused more on their patients’ desire for a long-term perspective. Nurses encouraged patients to consider ACP themselves, which developed into an approach to respect patients’ autonomy. In acute care hospitals, it appeared to be desirable to have an early discussion where patients could understand the significance ACP, which would matter even after their discharge from the hospital. (shrink)

The recent discovery of the medullary circuit driving “hunger responses” – reduced thermogenesis and promoted feeding – has greatly expanded our knowledge on the central neural networks for energy homeostasis. However, how hypothalamic hunger and satiety signals generated under fasted and fed conditions, respectively, control the medullary autonomic and somatic motor mechanisms remains unknown. Here, in reviewing this field, we propose two hypothalamomedullary neural pathways for hunger and satiety signaling. To trigger hunger signaling, neuropeptide Y activates a group of neurons (...) in the paraventricular hypothalamic nucleus (PVH), which then stimulate an excitatory pathway to the medullary circuit to drive the hunger responses. In contrast, melanocortin‐mediated satiety signaling activates a distinct group of PVH neurons, which then stimulate a putatively inhibitory pathway to the medullary circuit to counteract the hunger signaling. The medullary circuit likely contains inhibitory and excitatory premotor neurons whose alternate phasic activation generates the coordinated masticatory motor rhythms to promote feeding. (shrink)

1. Katachi no odissei -- 2. Rinshō no chi -- 3. Aku no tetsugaku nōto 4. Zōho 21-seiki mondaigun ; Jutsugoshū II -- 5. Shūkyō to kagaku; Jinruichi shō -- 6. Shinpen Nihon bunka ni okeru aku to tsumi ; Shōnenba -- 7. Jutsugoteki sekai to seido -- 8. Seishin no fūga -- 9. Shinpen Pasukaru to sono jidai -- 10. Shinpen kindai Nihon ni okeru seido to shisō.

1. Kodai shisō -- 3. Chūsei shisō -- 4. Kindai shisō -- 5. Tōzai bunka no kōryū -- 6. Shōtoku Taishi -- 7. Kinsei Nihon no hihanteki seishin -- 8. Nihon shūkyō no kindaisei.

This study considers food commercials featuring the term otona, meaning ‘adult, mature person’. Although the term is not explicitly gendered, this study demonstrates that food advertising using otona becomes a conduit for the construction of gendered lifestyle formulations via consumption practices offering consumers entrance into a range of gendered adult life stage practices. Unlike the socially aspirational consumption practices described by Agha, the consumption of inexpensive otona-marked products, which cost the same as their non-otona-marked counterparts but are intended by commercial (...) producers to be viewed by prospective consumers as more mature, is linked to the process of entering adulthood. However, whereas male performance of otona masculinity is shown in the commercials to be based on psychological maturity and economic and social independence, female performance of otona femininity is determined by the commercial producers and the product manufacturers to be based on successful performance of external beauty, sexuality and support of male social sphere members. This article shows how otona becomes a catch-all for aspirational gendered performance, arguing that terms like otona are particularly suited for normative gendered performance presentations. (shrink)

Notre article se propose d’articuler au domaine de l’esthétique notre expérience en tant qu’organisateur d’expositions présentant des artistes internationaux dans un centre d’art indépendant au Japon. En nous basant sur une théorie de la réception des œuvres, nous proposerons une lecture des appréhensions habituelles des modalités courantes au Japon par le renvoi aux formules de Nishida concernant l’acte artistique. Dès lors se croisent deux notions de marginalité. La première renvoie à l’opposition entre philosophie analytique et philosophie existentielle, la seconde consiste (...) à minorer les formes d’art qui ne renvoient pas au bien de la communauté. (shrink)

As kendo continues to gain in international popularity, there are hopes for its adoption in the Olympic Games as an international competitive event, even while moves to further this aim have not necessarily occurred in Japan or elsewhere. One reason for the efforts to achieve a form of globalization of kendo different from Judo is the attempt to adhere to and preserve the unique concepts kendo, the sport embodies by remaining true to the forms of traditional Japanese culture. This is (...) epitomized by the importance given to zanshin (the combination of posture and fighting spirit after striking), one of the key concepts that constitute yuko-datotsu in kendo. Our purpose in this study is to discuss the intersubjective nature of the decisions regarding the conditions for point-scoring in competitive sports. In particular, we will focus on the aesthetics required for zanshin in kendo, focusing on the theory behind yuko-datotsu (point score), which will also considerably influence its international dissemination. Kendo is characterized from the perspective of western rationalism as an appreciation of form and rules of behavior referred to as formalism and, in this respect, it has unique characteristics differing from those of modern sports that are disseminated internationally. In martial arts, besides refinement and proficiency in the rules of behavior by rigidly adhering to form and rules of behavior and repetition, the aim is to transcend said form and the rules of behavior and embody the spiritual nature dwelling in the background. Kendo should remain traditional path and keep zanshin in the value of point (yuko-datotsu) for its virtue. Kendo has not yet developed into an international competitive sport, but it is in the process of traversing that Geido path as a Do for the purpose of character building through it. Throughout life, one should try to devote oneself to kendo with thought for the value of transcending form and the rules of behaviour, and embodying the spiritual nature of the sport that inheres in its background. That is why one may perceive an evident hesitation or indeed negativity regarding the possible internationalization or development as an Olympic event. (shrink)

合理主義、自我の自覚、宗教的伝統や人間性に対する評価の変化など、近代的思惟の特徴を解明。刊行開始から11年、決定版中村元選集全巻完結。.

The essay is a written version of a talk Nakamura Yūjirō gave at the College international de philosophie in Paris in 1983. In the talk Nakamura connects the issue of common sense in his own work to that of place in Nishida Kitarō and the creative imagination in Miki Kiyoshi. He presents this connection between the notions of common sense, imagination, and place as constituting one important thread in contemporary Japanese philosophy. He begins by discussing the significance of (...) place (basho) that is being rediscovered today in response to the shortcomings of the modern Western paradigm, and discusses it in its various senses, such as ontological ground or substratum, the body, symbolic space, and linguistic or discursive topos in ancient rhetoric. He then relates this issue to the philosophy of place Nishida developed in the late 1920s, and after providing an explication of Nishida’s theory, discusses it further in light of some linguistic and psychological theories. Nakamura goes on to discuss his own interest in the notion of common sense traceable to Aristotle and its connection to the rhetorical concept of topos, and Miki’s development of the notion of the imagination in the 1930s in response to Nishida’s theory. And in doing so he ties all three—common sense, place, and imagination—together as suggestive of an alternative to the modern Cartesian standpoint of the rational subject that has constituted the traditional paradigm of the modern West. (shrink)

We propose an efficient algorithm for deciding the reachability between any nodes on XML data represented by connected directed graphs. We develop a technique to reduce the size of the reference table for the reachability test. Using the small table and the standard range labeling method for rooted ordered trees, we show that our algorithm answers almost queries in a constant time preserving the space efficiency and a reasonable preprocessing time.

This ethnographic research features Shugendō (mountain asceticism), Japan’s centuries-old, mystical tradition. I and approximately fifty other lay participants took part in a three-day Shugendō program for the secular. The program is physically demanding and takes secular trainees to three holy mountains in Yamagata, Japan, where they take part in the water purification and holy fire rituals in the mountain asceticism tradition. Using the theoretical framework of semiotics, I explicate the visual signifiers of this esoteric mysticism in the context of Shugendō (...) teachings represented in twenty photographs taken during the training. The purpose of this article is to promote semiotics as an analytical standpoint alternative to other approaches to studying culture, in this case, a Japanese religion sourced in my fieldwork. I argue that, living in today’s global age and visual culture, college students can and should benefit from learning about semiotics and developing visual literacy for their future career opportunities. (shrink)

Mutations within the Steel and Dominant Spotting loci of mice have led to the recent identification of a growth factor/receptor system required for the normal development of germ cells, pigment cells and hematopoietic cells. Interactions between the products of these genes, Steel factor and c‐Kit respectively, have now been demonstrated to influence various developmental processes, including survival, proliferation, and/or differentiation of cells in a tissue specific manner. In addition, our current understanding of the molecular basis of various Steel and Dominant (...) Spotting alleles coupled with the emerging information on the expression pattern of steel factor and c‐kit transcripts during development, is now beginning to explain the pleiotropic affects of these mutations. (shrink)

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In (...) addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self. (shrink)

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In (...) addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self. (shrink)

LetL be any modal or tense logic with the finite model property. For eachm, definer L (m) to be the smallest numberr such that for any formulaA withm modal operators,A is provable inL if and only ifA is valid in everyL-model with at mostr worlds. Thus, the functionr L determines the size of refutation Kripke models forL. In this paper, we will give an estimation ofr L (m) for some linear modal and tense logicsL.

Dr Caitríona L Cox’s recent article expounds the far-reaching implications of the ‘Healthcare Hero’ metaphor. She presents a detailed overview of heroism in the context of clinical care, revealing that healthcare workers, when portrayed as heroes, face challenges in reconciling unreasonable expectations of personal sacrifice without reciprocity or ample structural support from institutions and the general public. We use narrative medicine, a field primarily concerned with honouring the intersubjective narratives shared between patients and providers, in our attempt to deepen the (...) discussion about the ways Healthcare Heroes engenders military metaphor, antiscience discourse, and xenophobia in the USA. We argue that the militarised metaphor of Healthcare Heroes not only robs doctors and nurses of the ability to voice concerns for themselves and their patients, but effectively sacrifices them in a utilitarian bargain whereby human life is considered the expendable sacrifice necessary to ‘open the U.S. economy’. Militaristic metaphors in medicine can be dangerous to both doctors and patients, thus, teaching and advocating for the critical skills to analyse and alter this language prevents undue harm to providers and patients, as well as our national and global communities. (shrink)

Dr Caitríona L Cox’s recent article expounds the far-reaching implications of the ‘Healthcare Hero’ metaphor. She presents a detailed overview of heroism in the context of clinical care, revealing that healthcare workers, when portrayed as heroes, face challenges in reconciling unreasonable expectations of personal sacrifice without reciprocity or ample structural support from institutions and the general public. We use narrative medicine, a field primarily concerned with honouring the intersubjective narratives shared between patients and providers, in our attempt to deepen the (...) discussion about the ways Healthcare Heroes engenders military metaphor, antiscience discourse, and xenophobia in the USA. We argue that the militarised metaphor of Healthcare Heroes not only robs doctors and nurses of the ability to voice concerns for themselves and their patients, but effectively sacrifices them in a utilitarian bargain whereby human life is considered the expendable sacrifice necessary to ‘open the U.S. economy’. Militaristic metaphors in medicine can be dangerous to both doctors and patients, thus, teaching and advocating for the critical skills to analyse and alter this language prevents undue harm to providers and patients, as well as our national and global communities. (shrink)

This chapter focuses on the use of effortless attention in performing daily activities and tasks. It details a study developed by The University of Chicago and Claremont Graduate University, and named the Experience Sampling Method to collect data from subjects of the study investigating the use of effortless attention in daily life. The findings are based on an ESM study of subjects consisting of middle and high school students from around the United States and the Sloan Study of Youth and (...) Social Development. The Sloan study focuses on investigating both effortful and effortless attention experiences of the subjects. A large number of students reveal how effortless attention has helped them to focus better on several tasks without much effort. (shrink)