Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions in older Chinese adults with HAs and with untreated hearing loss. Participants were 49 Chinese older adults who used HAs and had moderate to severe HL, and 46 older Chinese who had mild to moderately (...) severe HL but did not use HAs. Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group. Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL. (shrink)

Many researchers have identified a process they call ‘deskilling’, which they use to describe the daily experience of teachers who have been gradually losing control of their own labour within ‘low‐trust’ workplaces. Conversely, other scholars have found that under similar conditions, some teachers have their own ways of dealing with it which leads them towards a process of ‘reskilling’. This study is an attempt to explore the actual teachers’ perceptions towards their daily practice within the context of educational decentralization, a (...) neglected area of research which needs to be further discussed and explored. This paper uses data gathered from seven schools in Guangdong Province, China as a case study to show that educational decentralization in China not only results in teachers being deskilled because indirect control is still being maintained, but also provides a small number of teachers with a competitive working environment to reskill their pedagogical techniques and educational knowledge, and to pursue good practices in teaching under the pressure of competition. All in all, educational decentralization provides a context in which teachers can experience either deprofessionalization or reprofessionalization. (shrink)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were statistically (...) significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

The counseling process involves attention, emotional perception, cognitive appraisal, and decision-making. This study aimed to investigate cognitive appraisal and the associated emotional processes when reading short therapists' statements of motivational interviewing (MI). Thirty participants with work injuries were classified into the pre-contemplation (PC,n= 15) or readiness stage of the change group (RD,n= 15). The participants viewed MI congruent (MI-C), MI incongruent (MI-INC), or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the (...) frontally oriented late positive complex (P600/LPC). The P600/LPC's amplitudes were more positive-going in the PC than in the RD group for the MI congruent statements. Within the PC group, the amplitudes of the N400 were significantly correlated (r= 0.607–0.649) with the participants' level of negative affect. Our findings suggest that the brief contents of MI statements alone can elicit late cognitive and emotional appraisal processes beyond semantic processing. (shrink)

On advancement of science and technology in controversy to occult sciences in Thai society.

Le néologisme dévalider est formé sur le radical « valide » (compris au sens de : validé par le validisme) auquel s’ajoute le préfixe privatif « dé- » (compris au sens de : défaire, déconstruire, détruire). Il reprend et littéralise l’anglais disabled, qui se traduit habituellement en « personne handicapée ». À côté de cette signification ordinaire, les luttes handies se sont emparées du verbe dévalider pour signifier deux aspects contradictoires mais complémentaires. D’un côté, les mondes dévalidés sont les mondes (...) que prépare la lutte anti-validiste, c’est-à-dire une société sans validisme (dé-validé en ce sens qu’il n’est plus rapporté à la norme valide). De l’autre, les mondes dévalidés désignent les mondes que prépare le capitalisme extractiviste, c’est-à-dire des mondes où plus personne ne peut être dit valide (dévalidé en ce sens que tout le monde, bien qu’à des degrés différents, y voit ses capacités déplacées, par exemple en raison de la toxicité de l’atmosphère). Les mouvements pour la justice handie se situent au point de tension entre d’un côté une lutte pour une dévalidation libératrice (contre le validisme qui rend le handicap invivable) et de l’autre une lutte contre la dévalidation forcée (contre l’extractivisme qui exploite la débilitation des vies). Ce texte sert d’introduction à la majeure « Justice handie », qui rassemble des écrits universitaires, militants et poétiques écrits depuis et avec les luttes anti-validistes. (shrink)

:Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be (...) intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: the literal meaning, the physician’s intended meaning, and the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area. (shrink)

In the creep literature, time has often been elevated from its role as a means of ordering events to that of a fully fledged state variable. It is hoped that this paper will highlight the dangers of this approach and will illustrate the proper role of time in mathematical physics, emphasizing the important distinction between coordinate and state variables.

Study of the social determinants of consciousness is one of the more timely problems of contemporary philosophy. It requires a complex study of various factors determining the social nature of human consciousness and the cultural-historical mediation of humankind's reflection of the world. Esthetics, which studies the phenomenon of esthetic consciousness, has a place among these scientific disciplines.