In the course of an immune response, antibodies undergo affinity maturation in order to increase their efficiency in neutralizing foreign invaders. Affinity maturation occurs by the introduction of multiple point mutations in the variable region gene that encodes the antigen binding site. This somatic hypermutation is restricted to immunoglobulin genes and occurs at very high rates. The precise molecular basis of this process remains obscure. However, recent studies using a variety of in vivo and in vitro systems have revealed important (...) regulatory regions, base motifs that are preferred targets of mutation and evidence that transcription may play an active role in hypermutation. BioEssays 20:227–234, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

As the most frequently used tool for measuring empathy, the Interpersonal Reactivity Index (IRI) is often scored by researchers arbitrarily and casually. Many commonly used IRI scoring approaches and their corresponding measurement models are unverified, which may make the conclusions of subsequent variable relation studies controversial and even misleading. We make the first effort to summarize these measurement models and to evaluate rationality of the common scoring methods of the IRI by confirmatory factor analysis, focusing on model fitting, factor loading, (...) and model-based reliability simultaneously. The results show that most of these models do not fit well, indicating that the scoring approaches of the IRI corresponding to these models may be problematic. Relatively speaking, better scoring approaches of the IRI include summing empathic concern and perspective taking as the total score of the IRI and reporting the score of perspective taking as cognitive empathy. (shrink)

This study introduces a music therapy project for young offenders through community collaboration and its efficacy through a mixed method. The project called Young & Great Music is carried out via collaboration among three parties, which are the educational institution, the district prosecutor’s office, and corporate sponsor, forming a tripartite networking system. In this paper, we present an efficacy evaluation of the project’s implementation with 178 adolescents involved with the juvenile justice system: 115 youth was on suspension of indictment and (...) 63 youth was under supervised probation. Quantitative and qualitative measures were collected and analyzed to examine the efficacy of the project. The music therapy program was developed for 15 sessions based on the use of music to prompt positive resources through music making and song writing. The efficacy was examined using three scales; self-concept, resilience, and stress coping skills. The paired t-test showed that there were significant improvement in all three scales respectively. In order to examine the group difference between suspended indictment and supervised probation groups, Welch–Aspin t-test was conducted due to unequal variance of the group. Results showed there was a significant group difference in self-concept and resilience. The study further examined participant’s experience of music and perceived benefits. Twenty participants had in-depth interviews about their music therapy experience which were recorded, transcribed and analyzed. Of the 109 statements derived from a qualitative content analysis of the interview transcripts, music making and song writing was repeatedly reported as helpful in gaining “new perspectives,” “courage to challenge and pursuit,” “perseverance,” and “self-acknowledgment.” The positive result of the study showed that the collaborative networking of regional and social resource to support for adolescents at-risk was successful. The results of this project are promising and suggest that other arts-based rehabilitation services and programs should be developed and implemented in juvenile justice system. For this, strategies for program sustainability for long-term facilitation are needed. (shrink)

We test the hypothesis that US corporations headquartered in states with greater public corruption are also prone to more unethical behavior when operating abroad. We exploit passage of Foreign Corrupt Practices Act that curtailed bribery of foreign officials and find firms in corrupt states, especially those exporting to more corrupt countries, suffer greater performance decline following FCPA, suggesting larger loss from anticipated bribery restrictions. Controlling for industry, firms in corrupt states are more likely to be targets of FCPA enforcement actions. (...) They are also more likely to have paid foreign bribes, as disclosed during pre-FCPA investigations. (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)

Antibiotic resistance in bacteria has become a great threat to global public health. Tigecycline is a next‐generation tetracycline that is the final line of defense against severe infections by pan‐drug‐resistant bacterial pathogens. Unfortunately, this last‐resort antibiotic has been challenged by the recent emergence of the mobile Tet(X) orthologs that can confer high‐level tigecycline resistance. As it is reviewed here, these novel tetracycline destructases represent a growing threat to the next‐generation tetracyclines, and a basic framework for understanding the molecular epidemiology and (...) resistance mechanisms of them is presented. However, further large‐scale epidemiological and functional studies are urgently needed to better understand the prevalence and dissemination of these newly discovered Tet(X) orthologs among Gram‐negative bacteria in both human and veterinary medicine. (shrink)

In this study, we built and tested a theoretical model to determine how ethical leadership affects team creativity among teams composed of different characteristics. Following social learning theory and an antecedent–benefit–cost framework, we conducted analyses of multisource data from 50 team supervisors and 186 employees, which revealed an inverted U-shaped relationship between ethical leadership and team creativity. The teams exhibited more creativity when there was a moderate level of ethical leadership than when there were very low or very high levels. (...) Moreover, from an interactional perspective, we found that team faultlines significantly moderated the curvilinear relationship between ethical leadership and team creativity such that the inverted U-shaped relationship was more significant among teams with weak team faultlines. The theoretical and practical implications of these findings are discussed. (shrink)

This book is about the philosophical, historical, and interpretative aspects of Mencius. It explores his influence, reception, and relevance in China from the third century BCE to the present, as well as offers comparative studies of Mencius and major figures in the history of Chinese and Western philosophy. With 34 accessible articles written by leading philosophers and scholars, the Dao Companion to the Philosophy of Mencius provides both broad pictures and in-depth discussions regarding the work of one of the most (...) important and influential Chinese philosophers. It covers his normative ethics, meta-ethics, political philosophy, epistemology and moral psychology. The last section of the volume, “Mencius and Western Philosophers: Comparative Perspectives,” explicitly puts him in dialogue with major Western philosophers. The Dao Companion to the Philosophy of Mencius serves as an essential volume for college students, graduate students, and scholars who study and teach Mencius as well as Chinese philosophy and comparative philosophy in general.​. (shrink)

Color coding is used to guide attention in computer displays for such critical tasks as baggage screening or air traffic control. It has been shown that a display object attracts more attention if its color is more similar to the color for which one is searching. However, what does similar precisely mean? Can we predict the amount of attention that a display color will receive during a search for a given target color? To tackle this question, two color‐search experiments measuring (...) the selectivity of saccadic eye movements and mapping out its underlying color space were conducted. A variety of mathematical models, predicting saccadic selectivity for given target and display colors, were devised and evaluated. The results suggest that applying a Gaussian function to a weighted Euclidean distance in a slightly modified HSI color space is the best predictor of saccadic selectivity in the chosen paradigm. Hue and intensity information by itself provides a basis for useful predictors, spanning a possibly spherical color space of saccadic selectivity. Although the current models cannot predict saccadic selectivity values for a wide variety of visual search tasks, they reveal some characteristics of color search that are of both theoretical and applied interest, such as for the design of human–computer interfaces. (shrink)

PurposeAs fake information has become the norm on the internet, it is important to investigate how skepticism impacts an individual’s attitude toward word-of-mouth (eWOM). This study examines eWOM skepticism via three dimensions: suspicion of motivation, suspicion of truthfulness and suspicion of identity. It investigates not only which of the three dimensions is more influential in eWOM situations but also the variations and relationships among these three. Furthermore, this study evaluates how an individual’s dispositional trust and perceptions regarding structural assurance can (...) impact each dimension, which in turn affects the assessment of the eWOM messages’ credibility.Design/methodology/approachUsing an online scenario-based survey, data were collected via Amazon Mechanical Turk from 195 participants in the U.S. PLS and cluster analysis were used to analyze the data.FindingsThe results reveal that the suspicion of identity play a major role in message credibility assessment and that people who are naturally less likely to trust others also hold higher suspicion of motivation and truthfulness. Further, structural assurance has significant negative effects on all three dimensions.Practical implicationsThe findings highlight the importance of enhancing the protective measures on eWOM platforms and call for stricter regulations to prevent organizations from adopting deceptive eWOM propagandas.Originality/valueThis research contributes to the literature by exploring the impact of skepticism on eWOM message credibility assessment and helping to validate this newly created construct by considering eWOM skepticism as a formative construct. (shrink)

PurposeAs fake information has become the norm on the internet, it is important to investigate how skepticism impacts an individual’s attitude toward word-of-mouth (eWOM). This study examines eWOM skepticism via three dimensions: suspicion of motivation, suspicion of truthfulness and suspicion of identity. It investigates not only which of the three dimensions is more influential in eWOM situations but also the variations and relationships among these three. Furthermore, this study evaluates how an individual’s dispositional trust and perceptions regarding structural assurance can (...) impact each dimension, which in turn affects the assessment of the eWOM messages’ credibility.Design/methodology/approachUsing an online scenario-based survey, data were collected via Amazon Mechanical Turk from 195 participants in the U.S. PLS and cluster analysis were used to analyze the data.FindingsThe results reveal that the suspicion of identity play a major role in message credibility assessment and that people who are naturally less likely to trust others also hold higher suspicion of motivation and truthfulness. Further, structural assurance has significant negative effects on all three dimensions.Practical implicationsThe findings highlight the importance of enhancing the protective measures on eWOM platforms and call for stricter regulations to prevent organizations from adopting deceptive eWOM propagandas.Originality/valueThis research contributes to the literature by exploring the impact of skepticism on eWOM message credibility assessment and helping to validate this newly created construct by considering eWOM skepticism as a formative construct. (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)

Recent studies on the effects of mandatory online teaching, resulting from the COVID-19 pandemic, have widely reported low levels of satisfaction, unwillingness to continue online teaching, and negative impacts on the psychological well-being of teachers. Emerging research has highlighted the potential role of psychological need thwarting, in terms of autonomy, competence, and relatedness thwarting, resulting from online teaching. The aim of this study was to evaluate the immediate and delayed effects of PNT of online teaching on teachers’ well-being, intention to (...) continue online teaching, and job satisfaction. Moreover, data collected from both cross-sectional and longitudinal surveys allowed for a systematic validation of an important instrument in the field of teacher psychology, the Psychological Need Thwarting Scale of Online Teaching, in terms of longitudinal reliability and validity. The data reveal the usefulness of the construct of PNT in terms predicting and explaining teachers’ willingness to continue using online teaching as well as the degree of burnout after a period of 2 months, such that PNT is positively associated with burnout and negatively associated with willingness to continue online teaching. As such, the PNTSOT is recommended for future research evaluating the long-term psychological, affective, and intentional outcomes stemming from teachers’ PNT. Moreover, based on our findings that the impact from PNT of online teaching is persistent and long-term, we suggest that school leaders provide flexible and sustained professional development, model respectful and adaptive leadership, and create opportunities for mastery for the development of community of practice that can mitigate the thwarting of teachers’ autonomy, competence, and relatedness during times of uncertainty. Additionally, in terms of the psychometric properties of the PNTSOT instrument, our empirical findings demonstrate internal reliability, test–retest reliability, measurement invariance, and criterion validity based on cross-sectional and longitudinal data. (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)

Phonemes have variant pronunciations depending on context. For instance, in American English, the [t] in pat [pæt] and the [d] in pad [pæd] are both realized with a tap [ɾ] when the –ing suffix is attached, [pæɾɪŋ]. We show that despite greater distributional and acoustic support for the [t]-tap alternation, 12-month-olds successfully relate taps to stems with a perceptually-similar final [d], not the dissimilar final-[t]. Thus, distributional learning of phonological alternations is constrained by infants' preference for the alternation of perceptually-similar (...) segments. Further, the ability to relate variant surface forms emerges between 8- and 12-months. Our findings of biased learning provide further empirical support for a role for perceptual similarity in the acquisition of linguistically-relevant categories. We discuss the implications of our findings for phonological theory, language acquisition and models of the mental lexicon. (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)

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists (...) to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients. (shrink)

Due to the individual differences controlling brain-computer interfaces, the applicability and accuracy of BCIs based on motor imagery are limited. To improve the performance of BCIs, this article examined the effect of transcranial electrical stimulation on brain activity during MI. This article designed an experimental paradigm that combines tES and MI and examined the effects of tES based on the measurements of electroencephalogram features in MI processing, including the power spectral density and dynamic event-related desynchronization. Finally, we investigated the effect (...) of tES on the accuracy of MI classification using linear discriminant analysis. The results showed that the ERD of the μ and β rhythms in the left-hand MI task was enhanced after electrical stimulation with a significant effect in the tDCS group. The average classification accuracy of the transcranial alternating current stimulation group and transcranial direct current stimulation group were improved significantly compared to the pre-and pseudo stimulation groups. These findings indicated that tES can improve the performance and applicability of BCI and that tDCS was a potential approach in regulating brain activity and enhancing valid features during noninvasive MI-BCI processing. (shrink)

It is well known that Mozi criticizes the ritual practices of the Ru for being wasteful. However, another criticism has been less appreciated: These practices are merely conventional habituations and violate the Ru’s own moral ideals of ren 仁 , yi 義 and xiao 孝 . Xunzi responds to both criticisms in the Li Lun Pian 禮論篇 . Based on an account of Mozi’s arguments and Xunzi’s replies, this essay discusses the significance of ritual transformation in Xunzi’s moral philosophy.

本書以20世紀80年代震動一時的“潘曉討論”為中心，為當代文學研究——特別是關於80年代文學的研究——帶入新的“問題意識”，一方面挑戰既有的線性文學史描述、豐富我們的文學研究範式；一方面將廣闊的社會、 文化“大本文”引入對於80年代具有代表性的文學“小文本”的解讀之中，以從方法上賦予當代文學研究以新質。.

In lieu of an abstract, here is a brief excerpt of the content:Clinical CommentaryChong Siow Ann, Associate ProfessorDr. G appears to experiencing symptoms of schizophrenia, which is arguably the most severe mental disorder and which afflicts about one in a hundred people. This is a psychotic disorder that causes disturbances and distortions in thinking, including neurocognitive impairments, perception and behaviour. There is no cure for this often devastating disorder. Current antipsychotic medications can alleviate some of the symptoms but it often (...) comes at a price as these antipsychotics have burdensome side effects.A feature of this disorder is anosognosia, which is a lack of awareness or “insight” that an illness is present. This lack of insight presents a particular challenge because these individuals would, as in the case of Dr. G, refuse needed treatment as they do not perceive that they are ill. This is not necessarily an all-or-none phenomenon but is rather more complex and multidimensional; there might be an unawareness or recognition on behalf of the patient that they are suffering from a mental illness, the failure to appreciate the necessity of treatment; and/or the inability to recognise and define the psychotic symptoms like unusual thoughts and hallucinations as signs of illness1 and in many instances, all three are present. It is also by no means uncommon. Studies have found that between 60% and 80% of people with schizophrenia lack awareness of their illness to varying degrees.2This phenomenon remains an enigma. Some regard it as a form of psychological defence against the harsh reality of a psychotic illness — awareness of having a chronic and devastating illness might lead to demoralisation, hopelessness and suicide.3 Recent research, however, [End Page 250] indicates that this psychological denial plays a small part, if any, and instead has found an association with certain neuropsychological and neurocognitive deficits,4 as well as functional and structural brain abnormalities in the frontal lobe of the brain.5The prevailing clinical view thus is that this is an intrinsic and organic aspect of the schizophrenic illness which has nothing to do with wilfulness but rather the incapacity to perceive the presence of the illness. Edwin Fuller Torrey, an eminent psychiatrist and executive director of the Stanley Medical Research Foundation, calls anosognosia the “single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications”, and he has remarked that “to keep talking about civil liberty is illogical. Patients are anything but free when they’re at the beck and call of their own delusions”.6It is also this view that it is a product of a brain disorder that some — particularly patients — find unacceptable. At one level, it does not take into context the person’s own experiences, and at a deeper level it calls into question the conception of the self with its capacity to exercise judgements and the autonomy to make decisions.This is a perennial ethical issue in psychiatry when people with severe mental illnesses refuse treatment. This becomes a Catch-22 situation where part of the illness that needs treatment is also preventing any treatment to be given: implicit in the principle of informed consent for treatment is that the person should be aware of the nature and course of their illness and acknowledge the need for treatment. While there are laws for involuntary commitment, the bar is usually high in that there must be a clear and present risk of harm to the person or others. Alan Stone, a professor of law and psychiatry at Harvard University proposed a possible justification for involuntary treatment based on his “thank-you theory” which assumes that patients will become well and subsequently agree that the intervention was in their best interests but research suggests that only half of these patients would admit so.7One suggested mechanism is the use of advance directives — psychiatry’s version of the living will in which people can specify what sort of medical care they would like should they become mentally unwell and unable to exercise appropriate judgement. An intrinsic part of this might include a “Ulysses contract” — just as Ulysess instructed his crew to lash him to the mast of the his ship so that he could... (shrink)

本书是一本关于陈冲体验人生感悟人生的书法集子。内容包括:悟道篇;明理篇;做人篇;处世篇等。.

This study explored the relations between the social support network of mothers of children with autism spectrum disorder, perceived social support, and their subjective wellbeing. The participants were mothers of children with ASD in Shanghai. Their social support network structure was explored via the nomination method. Perceived social support was measured using the Revised Social Provisions Scale for Autism, and the mothers’ subjective wellbeing was assessed using the Index of Wellbeing, Index of General Affect. A significant correlation was observed between (...) the subjective wellbeing of mothers of children with ASD and perceived social support. Meanwhile, perceived social support was significantly correlated with the effectiveness of overall social support. Finally, perceived social support was also significantly correlated with the network size of social support. Moreover, the effectiveness of social support was significantly associated with the network size of social support and was highly significantly associated with the degree of intimacy of social support. Furthermore, the network size of instrumental support has a significant influence on all perceived social support subdimensions. Overall, social support effectiveness plays an important role in the social support network mechanism on perceived social support and subjective wellbeing in China. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

This paper intends to append the frame of dialectic upon St. John of the Cross’ delineation of mysticism. Its underlying hypothesis is that the dialectical structuring of St. John’s mystical theology promises to unravel the web of relational concepts embedded within his immense writings on this unique phenomenon. It is hoped that as a consequence of this undertaking, relevant pairs of correlative opposites that figure prominently in mysticism can be elucidated and perhaps come to some form of resolution.

本书内容包括:传统价值观的整体透视、简论传统文化中各学派的价值理论、儒家价值理想及其现代意义论析、道家风骨和生命哲学的现代诠释等。.

本书收录了“说出你的权利”、“被遗忘的和被轻侮的”、“理性与宽容”、“民主的后援力量”等文集。.