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)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

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)

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 impostor phenomenon refers to a false internal experience of low intelligence or ability that is associated with anxiety, depression, psychological distress, and burnout. The emotions associated with the IP affect not only personal mental health but also patient care. To address this issue, we need to completely understand the prevalence of and factors related to the IP and ways to resolve/overcome IP feelings. The aim of this scoping review was to identify the existing evidence regarding the IP among nursing (...) students and nurses and determine gaps that can be addressed in future research. We conducted our study based on the scoping review methodological framework proposed by Arksey and O’Malley and advanced by Levac et al.. After searching the Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science and ProQuest databases, we identified 11 studies for inclusion in this review. We found that while the IP exists in nursing students and nurses, clinical nurse specialist students and final-year nursing students are at significant risk of impostor behavior. We also found that research in the nursing field has focused on the prevalence of and factors related to the IP, but few studies have addressed ways to resolve/overcome IP feelings. Thus, research in this area should be increased. This scoping review presents research gaps that may serve as a starting point for future work on the IP in the nursing field. (shrink)

1. Yŏn'gyŏngjae Sŏng Hae-ŭng. "Yŏn'gyŏngjae chŏnjip", innŭn sasil ŭl kŭdaero kirok hada -- 2. P'ungsŏk Sŏ Yu-gu. "Imwŏn kyŏngjeji", hŭlkuk kwa chongittŏk in hangmun ŭn anŭrira -- 3. Oju Yi Kyu-gyŏng. "Ojuyŏn munjang chŏnsan'go", pakhak kwa kojŭnghak ŭro modŭn kŏt ŭl pyŏnjŭng hara -- 4. Tasan Chŏng Yag-yong. "Mongmin simsŏ", sidae rŭl ap'ahago paeksŏngdŭl ŭi pich'am han sam e punno haeya handa -- 5. Ch'ujae Cho Su-sam. "Ch'ujae chip", nara ka mangharyŏmyŏn pandŭsi yomul i naonda -- 6. Nakhasaeng Yi Hak-kyu. (...) "Yŏngnam akpu", mal hanŭn cha nŭn choe ka ŏpta -- 7. Kuhwajae Hong Sŏng-mo. "Tongguk sesigi", sot e kadŭkhan kuk ŭl han sutkal ro mat poda -- 8. Hosan Cho Hŭi-ryong. "Sŏgu mangnyŏllok", hanŭl arae kajang t'ongk'wae han il ida -- 9. Sŏp'a Yu Hŭi. "Munt'ong", ilsaeng ŭl nŭl sibi sok esŏ saranne -- 10. Hyegang Ch'oe Han-gi. "Kihak", taedong ilt'ong ŭi isang segye rŭl kuhyŏn hada -- 11. Kosanja Kim Chŏng-ho. "Taedong yŏjido", chido ro ch'ŏnha ŭi hyŏngse rŭl salp'il su itta -- 12. Paegun Sim Tae-yun. "Pongni chŏnsŏ", mani ilgŭlsurok pongni ka tŏuk manajinda -- 13. Suun Ch'oe Che-u. "Tonggyŏng taejŏn", hangmun ŭro marhajamyŏn 'tonghak' irago haeya handa -- 14. Tongmu Yi Che-ma. "Kyŏkch'igo", i ch'aek i ch'ŏllima ka toeji ank'ennŭn'ga? (shrink)

Why do people comply with coronavirus disease 2019 public health guidance? This study considers cultural-psychological foundations of variation in beliefs about motivations for such compliance. Specifically, we focused on beliefs about two sources of prosocial motivation: desire to protect others and obligation to society. Across two studies, we observed that the relative emphasis on the desire to protect others as an explanation for compliance was greater in the United States settings associated with cultural ecologies of abstracted independence than in Chinese (...) settings associated with cultural ecologies of embedded interdependence. We observed these patterns for explanations of psychological experience of both others and self, and for compliance with mandates for both social distancing and face masks. Discussion of results considers both practical implications for motivating compliance with public health guidance and theoretical implications for denaturalizing prevailing accounts of prosocial motivation. (shrink)

This article provides information about Berne's financial situation at the time the Economic Society was founded. The canton was in an exceptionally fortunate position, having accumulated a sizeable cash reserve that was in part used for loans and investments on the London capital market. Throughout the century, the Bernese government followed a very cautious investment strategy. The main reason for purchasing overseas securities was that they helped the patricians to become independent from tax-paying subjects. Economic imperatives ruled out increases of (...) the cash reserve or further involvement in the overcrowded domestic capital market. However, by investing abroad Berne became increasingly dependent on the goodwill of its debtors, for which it was criticised by the Economic Patriots amongst others. (shrink)

Recent years have seen a surge in accounts motivated by information theory that consider language production to be partially driven by a preference for communicative efficiency. Evidence from discourse production (i.e., production beyond the sentence level) has been argued to suggest that speakers distribute information across discourse so as to hold the conditional per-word entropy associated with each word constant, which would facilitate efficient information transfer (Genzel & Charniak, 2002). This hypothesis implies that the conditional (contextualized) probabilities of linguistic units (...) affect speakers’ preferences during production. Here, we extend this work in two ways. First, we explore how preceding cues are integrated into contextualized probabilities, a question which so far has received little to no attention. Specifically, we investigate how a cue's maximal informativity about upcoming words (the cue's effectiveness) decays as a function of the cue's recency. Based on properties of linguistic discourses as well as properties of human memory, we analytically derive a model of cue effectiveness decay and evaluate it against cross-linguistic data from 12 languages. Second, we relate the information theoretic accounts of discourse production to well-established mechanistic (activation-based) accounts: We relate contextualized probability distributions over words to their relative activation in a lexical network given preceding discourse. (shrink)

Status updates on social network sites (SNSs) as a new medium for people to express “what is on your mind” on the Internet can provide much information. In the current study, we statistically analysed survey data to examine whether individuals utilize impression management in their status updates on SNSs, whether their attempts at impression management are successful, and whether users who post these status updates can infer how others view them based on these contents, whether the status updates posted on (...) SNSs reflect information about users’ Big Five personality traits. The findings suggested that the meta–perception and perceivers’ judgments of all five traits are quite accurate, despite users’ aim to create different impression of most traits in their status updates. This study offers new empirical evidence about the model of interpersonal perception on SNSs and shows that status updates on SNSs can provide considerable information about their authors. (shrink)

The unified theory of dose and effect, as indicated by the median-effect equation for single and multiple entities and for the first and higher order kinetic/dynamic, has been established by T.C. Chou and it is based on the physical/chemical principle of the massaction law (J. Theor. Biol. 59: 253-276, 1976 (質量作用中效定理) and Pharmacological Rev. 58: 621-681, 2006) (普世中效指數定理). The theory was developed by the principle of mathematical induction and deduction (數學演繹歸納法). Rearrangements of the median-effect equation lead to Michaelis-Menten, Hill, Scatchard, (...) and Henderson-Hasselbalch equations. The “median” serves as the universal reference point and the “common link” for the relationship of all entities and is also the “harmonic mean” of kinetic dissociation constants. Over 300 mechanism-specific equations have been derived and published using the mathematical induction-deduction process. These equations can be deduced into several general equations, including the median-mediated whole/part equation, combination index theorem, isobologram equation, and polygonogram. It is proven that “dose” and “effect” are interchangeable, thus, “substance” and “function” are interchangeable, which leads to “the unity theory” (劑效、心物、知行一元論) in quantitative mathematical philosophy (數學的定量哲學) in functional context. Therefore, a general theory centered on the “median” and based on equilibrium dynamics has evolved. In other words: [「中」的宇宙觀： 以「中」爲基凖的動力學生態平衡]. Based on the median-effect equation of the mass-action law, the fundamental claim is that we can draw “a specific cure” for only two data points, if they are determined accurately. This claim has far reaching consequences since it defies the general held belief that two points can dray only a straight line. Remarkably, the unity theory (一元論) providesscientific/mathematical interpretation in equations and in graphics of Chinese ancient philosophy, including Fu-Si Ba Gua (伏羲八卦), Dao’s Harmony (和諧), the Confucian doctrine of the mean (儒家中庸之道), Chou Dun-Yi’s (周敦頤, 1017-1073) From Wu-ji to Tai-ji and Taiji Tu Sho (無極而太極及太極圖說). The moderntopological analysis for trinity yields an exact correspondence to the Ba-Gua, which was introduced over 4,000 years ago. Furthermore, the median-centered algorithm, promotes modern ecological content (生態學) in the equilibral dynamic state of harmony. It is concluded that Western science and Eastern philosophy are directly linked and complementary to each other. Since the truth in mathematical quantitative philosophy (數學的定量哲學) has no boundaries, East and West philosophies can flourish together for the common goal and ideal in science and in humanity (世界大同). (shrink)

全书分五个部分, 分别从经济秩序的伦理理论、经济学的秩序理论、经济秩序的法律问题、文化性质和关于秩序政策的第三条道路的可能性等观点, 研讨了经济秩序问题.

This study explores the connections between time, travel, and creative acts such as painting and poetry, highlighting the similarities that unite these themes. It also focuses on the relationships between the East and the West in regards to these subjects, and posits that travel can be understood as an active form of meditation. The study argues that the meaning of wanderings can be found by learning to make them conscious, and that there has been a deep reflection on time, consciousness, (...) and mobility since ancient times. (shrink)

In association with the development of intermittent renewable energy generation, dynamic multiobjective dispatch faces more challenges for power system operation due to significant REG uncertainty. To tackle the problems, a day-ahead, optimal dispatch problem incorporating energy storage is formulated and solved based on a robust multiobjective optimization method. In the proposed model, dynamic multistage ES and generator dispatch patterns are optimized to reduce the cost and emissions. Specifically, strong constraints of the charging/discharging behaviors of the ES in the space-time domain (...) are considered to prolong its lifetime. Additionally, an adaptive robust model based on minimax multiobjective optimization is formulated to find optimal dispatch solutions adapted to uncertain REG changes. Moreover, an effective optimization algorithm, namely, the hybrid multiobjective Particle Swarm Optimization and Teaching Learning Based Optimization, is employed to seek an optimal Pareto front of the proposed dispatch model. This approach has been tested on power system integrated with wind power and ES. Numerical results reveal that the robust multiobjective dispatch model successfully meets the demands of obtaining solutions when wind power uncertainty is considered. Meanwhile, the comparison results demonstrate the competitive performance of the PSO-TLBO method in solving the proposed dispatch problems. (shrink)

Volume five focuses on the central teaching of non-attachment to our desires. Its premise is the more we crave, the more we suffer. Venerable Master Hsing Yun points out it is not only our attachment to things, but also to our own views, that is the source of suffering.

This study explores how people with different cultural backgrounds comprehend diverse sacred spaces all over the world, from a cross-linguistic perspective. The challenges surrounding intelligibility relate to spatial resemblance, complexity of religion, as well as many obscure proper names. With the lexicalization of relevant religious concepts, “cultural synonyms” are generated. Through surveying the vocabulary within the domain of “TEMPLE” as an exemplification, the cultural synonymy of the Chinese lexicon in demonstrating spiritual intricacy has been elucidated. Based on the theory of (...) “multi-competence”, a reasonable hypothesis on cross-culturally understanding the sacred space is proposed: Multicompetent individuals can have other comprehensions about sacred spaces when compared with monolinguals of either the native or the target language; A monolingual or a cross-cultural experiencer without knowledge of the regional language depends on translation to apprehend the sacred space, which may result in confusion; Deficient translations may also interfere with multicompetent individuals, while their linguistic awareness allows them more chances of differentiating cultural synonyms and accordingly clarification of any misguided perceptions. (shrink)

A longstanding orthodoxy holds that the Mohists regard the promotion of li (benefit, 利) as their ultimate normative criterion, meaning that they measure what is yi (just, 義) or buyi (unjust, 不義) depending on whether it maximizes li or not. This orthodoxy dates back at least to Joseph Edkins (1859), who saw Mozi as a utilitarian and an ally of Bentham. In this paper, we will argue that this orthodoxy should be reconsidered because it does not square with several passages (...) from the Mozi. That the Mohists place a strong weight on the promotion of ‘li for the whole world (tianxia zhi li, 天下之利)’ is uncontroversial. We argue, however, that in certain cases the Mohist moral calculus diverges in its rationale or outcome from li-promotionalism. This position rejects the orthodoxy by showing that Mohism and li-promotionalism are not entirely coterminous. (shrink)

Peut-on tenter une nouvelle approche de Descartes? Penser philosophiquement la notion de creation, c'est la traduire dans le registre des quatre causes: ainsi la cause efficiente relie et separe a la fois le createur et le cree; mais Dieu est aussi cause formelle, ce qui sauve la continuite entre l'auteur et son ouvrage. Cette continuite se nomme analogie et cette analogie assure l'autonomie de la pensee finie. Ce transfert d'autorite dans la production meme, particulierement manifeste chez Descartes, permet de comprendre (...) la devolution a l'homme d'un certain pouvoir createur. L'agir humain peut etre inaugural. L'est-il en matiere de philosophie? La dette de Descartes envers la scolastique tardive semble indiquer qu'on ne pense qu'a partir de ce qu'on herite. L'ambivalence de la notion de creation ne nous permettrait-elle pas cependant de montrer que le commencement dans la pensee reste a tout moment possible? Telle pourrait etre l'explication du radicalisme cartesien. (shrink)

Although Marxism and deconstruction of differences, but can be associated with. To associate Marxism and deconstruction, not only back to Marx's radical critique of capitalist ideology, the basic theory of Marxism screening of metaphysical factors, but also avoids Marx's logocentric misappropriation. Despite the divergent attitudes between Marxism and deconstruction, there exists a possible link between the two of them. A critical articulation of them can not only restore the radical edge to Marxism devoted to the critique of bourgeois ideology, which (...) is tainted with metaphysical presuppositions, but also be able to avoid the influence of the implicit logocentrism in Marxism. (shrink)