As in other countries, the traditional doctor-patient relationship in the Japanese healthcare system has often been characterised as being of a paternalistic nature. However, in recent years there has been a gradual shift towards a more participatory-patient model in Japan. With advances in technology, the possibility to use digital technologies to improve patient interactions is growing and is in line with changing attitudes in the medical profession and society within Japan and elsewhere. The implementation of an online patient engagement platform (...) is being considered by the Myotonic Dystrophy Registry of Japan. The aim of this exploratory study was to understand patients’ views and attitudes to using digital tools in patient registries and engagement with medical research in Japan, prior to implementation of the digital platform. We conducted an exploratory, cross-sectional, self-completed questionnaire with a sample of myotonic dystrophy patients attending an Open Day at Osaka University, Japan. Patients were eligible for inclusion if they were 18 years or older, and were diagnosed with MD. A total of 68 patients and family members attended the Open Day and were invited to participate in the survey. Of those, 59 % submitted a completed questionnaire. The survey showed that the majority of patients felt that they were not receiving the information they wanted from their clinicians, which included recent medical research findings and opportunities to participate in clinical trials, and 88 % of patients indicated they would be willing to engage with digital technologies to receive relevant medical information. Patients also expressed an interest in having control over when and how they received this information, as well as being informed of how their data is used and shared with other researchers. Overall, the findings from this study suggest that there is scope to develop a digital platform to engage with patients so that they can receive information about medical care and research opportunities. While this study group is a small, self-selecting population, who suffer from a particular condition, the results suggest that there are interested populations within Japan that would appreciate enhanced communication and interaction with healthcare teams. (shrink)

Little is known about health of the growing subpopulation of the working poor in Japan. We aimed to evaluate health status and healthcare utilization in relation to income among Japanese working adults. We conducted a one-month prospective cohort study using a health diary in working adults from a nationally representative random sample in Japan. Based on the government criterion, the working poor group was defined as earning an equivalent annual income of less than 1.48 million Japanese-yen. For health status, we (...) measured symptomatic episodes and health-related quality of life (HRQOL). For healthcare utilization, we measured frequencies of visits to a physician or pharmacy, and use of complementary and alternative medicine (CAM). We constructed multiple linear regression models for these measures adjusted for age, gender, and co-morbidity, using annual equivalent income as a 4-level categorical variable. (shrink)

This chapter highlighted some salient trends in pediatric ethicsEthics, pediatric from different parts of the globe. It is interesting to note that although diverse, there are many similarities between ethical challenges in pediatrics in different parts of the world.

We discuss the symmetry basis of unified field theories, i.e., the generalized concept of local gauge symmetry, and its physical implications. The generalized Ward-Takahashi identities and the explicit constraints among renormalization constants are derived by using the path integral in a specific model. These constraints are confirmed at the one-loop level.

Background: Dementia is one the major problems of aging societies, and, novel and effective non-drug therapies are required as interventions in the oldest-old to prevent cognitive decline.Objective: This study aims to examine the efficacy and safety of reminiscence using immersive virtual reality focusing on anxiety that often appears with cognitive decline. The secondary objective is to reveal the preference for VR image types for reminiscence: live-action or computer graphics.Methods: This was a pilot, open-label, and randomized crossover study which was conducted (...) on January 2020 at a single nursing home. The subjects were randomly divided into two groups in equal numbers, and they alternately viewed two types of VR images themed on the mid- to late Showa era in Japan. In group A, the CG images were viewed first, and then the LA images were viewed. In group B, the images were viewed in the opposite order. Before VR viewing, subjects responded to Mini-Mental State Examination Japanese version and State-Trait Anxiety Inventory Japanese version. After viewing the first and second VR, subjects responded to STAI and the numerical rating scale for satisfaction and side effects.Results: Ten subjects participated in this study. The values of analyses are presented in the mean. The age was 87.1 years, and the MMSE was 28.5. The total STAI score before VR viewing was 36.1, but it significantly decreased to 26.8 after the first VR viewing, and further decreased to 23.4 after the second VR viewing. The NRS score for satisfaction tended to be higher after viewing LA in group A vs. 8.6, P = 0.0993), while in group B, the score after CG was slightly lower than that after LA. There were no serious side effects.Conclusions: This study suggests that iVR reminiscence can reduce anxiety in the oldest-old without causing serious side effects. Furthermore, the impacts might be better with LA images. (shrink)

We show that the full set of Fierz identities which are used to compute electro-weak interactions reported by Y. Takahashi can be considered as particular cases of the Clifford product between multivector Cartan maps. Moreover, we think that our approach can be generalized to higher-dimensional models.We discuss the factorization and inversion theorems for the recovery of the spinor from its multivectorial Cartan map.A new classification given by P. Lounesto is applied to the recovered spinors for Cl1,3 space-time symmetry and (...) SU(2)×U(1) isotopic group. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Anime: From Akira to Princess Mononoke: Experiencing Contemporary Japanese AnimationJoseph MurphyAnime: From Akira to Princess Mononoke: Experiencing Contemporary Japanese Animation. By Susan Napier. New York: St. Martin's Press, 2001. Pp. vii + 320.Certain progressions can be marked from Antonia Levi's Samurai from Outer Space in 1996 to Susan Napier's Anime: From Akira to Princess Mononoke: Experiencing Contemporary Japanese Animation in 2001. While both survey the phenomenon of Japanese (...) animation as consumed in North America, the palpable underdog subcultural context and sense of mission in Levi's earlier work has given way to a confident mainstream appreciation in Napier's, with the term "Japanese animation" replaced in English by the naturalized anime (a-ni-mé, pl. anime). In a fast-moving media phenomenon both were dated as soon as they were published; however, bolstered by the worldwide critical and financial success of Miyazaki Hayao's work, and contemporary with the exposure to youth by the rise of 24/7 cartoon networks and the runaway success of the card game-anime nexus, Napier's Anime finds itself still in the right historical moment. Though the book has limitations in terms of both its own systematicity and its treatment of potentially interesting philosophical themes in anime, it is a reliable and sometimes inspired guide to a new phenomenon that forms an increasingly important default in the background your students bring.Napier is concerned not so much with accounting for the visual and perceptual properties of anime as with its narrative qualities: "Japanese animation merits serious consideration as a narrative art form and not simply for its arresting visual style.... Much of this book will be an investigation into the themes, imagery, and ideas of some of the most memorable anime created over the last two decades" (p. 10). The strengths and weaknesses of this book are nicely summed up here. Concentrating on narrative—a formal property of storytelling transposable across media—allows a broad and well-chosen survey of themes, images, and ideas. However, there is some question as to whether this will allow the reader to satisfy the ambition to "understand what makes anime the distinctive art form it is" (p. 10).The book is comprised of twelve chapters in four parts. Part 1 is an introduction that argues for the importance of anime and sketches a quasi-Aristotelian method as the basis for Napier's taxonomy. Parts 2-4 cover major thematic divisions that characterize the particular obsessions, power, and drama of anime, and these are particularly well-chosen to reflect not just the relatively palatable work deemed suitable for TV or subtitled for video distribution in the United States but also the anarchic diversity of the phenomenon as it circulates in Japan. Part 2 is on the essential theme of the changeable body and includes discussion of the monstrous adolescent body, pornographic anime, and the cybernetic body, and will allow you to catch up with classic anime like Akira (1988), Ranma 1/2 (TV version, 1990s), and Ghost in the Shell (theater version, 1996). Part 3 is on fantasy and romance as genres and the unusual [End Page 493] space in anime for female leads, and includes discussion of Miyazaki's pastoral work and the comedy TV series Urusei Yatsura (1980s), Oh My Goddess (1980s), and Video Girl Ai (1990s). Part 4 discusses anime that have sought to make a self-conscious contribution to historical debate, including Barefoot Gen (1983) and Grave of the Fireflies (1988), on the bombing of Japanese cities in World War II, and Miyazaki's Princess Mononoke (1997), which presents a multicultural picture of Japan's past produced in consultation with Japan's leading ethnologists. Discussions are balanced and entertaining, introducing the major auteurs of the last twenty years (Oshii Mamoru, Otomo Katsuhiro, Takahashi Rumiko, etc.) and creating the sharp impression that the genre of anime is not the same as the American concept of "cartoons."Though the anime phenomenon raises interesting sociocultural and critical questions about narrative and image culture, it is not immediately certain that there is a philosophical issue to anime. One might seek this philosophical content within the medium itself or in a systematic quality... (shrink)

Advocates have sought to prove that underdetermination obtains because all theories have empirical equivalents. But algorithms for generating empirical equivalents simply exchange underdetermination for familiar philosophical chestnuts, while the few convincing examples of empirical equivalents will not support the desired sweeping conclusions. Nonetheless, underdetermination does not depend on empirical equivalents: our warrant for current theories is equally undermined by presently unconceived alternatives as well-confirmed merely by the existing evidence, so long as this transient predicament recurs for each theory and body (...) of evidence we consider. The historical record supports the claim that this recurrent, transient underdetermination predicament is our own. (shrink)

The purpose of this study is to examine the relationship between the corporate social performance of an organization and three variables: the size of the organization, the financial performance of the organization, and the environmental performance of the organization. By empirically testing data from 1987 to 1992, the results of the study show that a firm's corporate social performance is indeed impacted by the size of the firm, the level of profitability of the firm, and the amount of pollution emissions (...) released by the firm. (shrink)

It is fortunate for my purposes that English has the two words ‘almighty’ and ‘omnipotent’, and that apart from any stipulation by me the words have rather different associations and suggestions. ‘Almighty’ is the familiar word that comes in the creeds of the Church; ‘omnipotent’ is at home rather in formal theological discussions and controversies, e.g. about miracles and about the problem of evil. ‘Almighty’ derives by way of Latin ‘omnipotens’ from the Greek word ‘pantokratōr’; and both this Greek word, (...) like the more classical ‘pankratēs’, and ‘almighty’ itself suggest God's having power over all things. On the other hand the English word ‘omnipotent’ would ordinarily be taken to imply ability to do everything; the Latin word ‘omnipotens’ also predominantly has this meaning in Scholastic writers, even though in origin it is a Latinization of ‘pantocratōr’. So there already is a tendency to distinguish the two words; and in this paper I shall make the distinction a strict one. I shall use the word ‘almighty’ to express God's power over all things, and I shall take ‘omnipotence’ to mean ability to do everything. (shrink)

By the time of his death in 2006, Sir Peter Strawson was regarded as one of the world's most distinguished philosophers. Unavailable for many years,_ Scepticism and Naturalism_ is a profound reflection on two classic philosophical problems by a philosopher at the pinnacle of his career. Based on his acclaimed Woodbridge lectures delivered at Columbia University in 1983, Strawson begins with a discussion of scepticism, which he defines as questioning the adequacy of our grounds for holding various beliefs. He then (...) draws deftly on Hume and Wittgenstein to argue that we must distinguish between 'hard', scientific naturalism; or 'soft', humanistic naturalism. In the remaining chapters the author takes up several issues in which sceptical doubts play an important role, in particular the nature of transcendental arguments and including the objectivity of moral philosophy, the mental and the physical, and the existence of abstract entities. _Scepticism and Naturalism_ is essential reading for those seeking an introduction to the work of one of the twentieth century’s most important and original philosophers. This reissue includes a substantial new foreword by Quassim Cassam and a fascinating intellectual autobiography by Strawson, which together form an excellent introduction to his life and work. (shrink)

This fourth and final volume of the monumental commentary on Wittgenstein's _Philosophical Investigations_ covers pp 428-693 of the book. Like the previous volumes, it consists of philosophical essays and exegesis.

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

Objective: To clarify whether long time constant is useful for detecting the after-slow activity of epileptiform discharges : sharp waves and spikes and for differentiating EDs from sharp transients.Methods: We employed 68 after-slow activities preceded by 32 EDs and 36 Sts from 52 patients with partial and generalized epilepsy defined by visual inspection. High-frequency activity associated with the apical component of EDs and Sts was also investigated to endorse two groups. After separating nine Sts that were labeled by visual inspection (...) but did not fulfill the amplitude criteria for after-slow of Sts, 59 activities were analyzed about the total area of after-slow under three TCs.Results: Compared to Sts, HFA was found significantly more with the apical component of EDs. The total area of after-slow in all 32 EDs under TC 2 s was significantly larger than those under TC 0.3 s and 0.1 s. Conversely, no significant differences were observed in the same parameter of 27 Sts among the three different TCs. Regarding separated nine Sts, the total area of after-slow showed a similar tendency to that of 27 Sts under three different TCs.Significance: These results suggest that long TC could be useful for selectively endorsing after-slow of EDs and differentiating EDs from Sts. These findings are concordant with the results of the HFA analysis. Visual inspection is also equally good as the total area of after-slow analysis. (shrink)

Knowing Persons is an original study of Plato's account of personhood. For Plato, embodied persons are images of a disembodied ideal. The ideal person is a knower. Hence, the lives of embodied persons need to be understood according to Plato's metaphysics of imagery.For Gerson, Plato's account of embodied personhood is not accurately conflated with Cartesian dualism. Plato's dualism is more appropriately seen in the contrast between the ideal disembodied person and the embodied one than in the contrast between mind or (...) soul and body.This study argues that Plato's analysis of personhood is intended to cohere with his two-world metaphysics as well as a radical separation of knowledge and belief. Gerson demonstrates that Plato's account of persons plays a key role not just in his theory of mind, but in his theory of knowledge, his metaphysics, and his ethics. A proper understanding of Plato's account of persons must therefore place it in the context of his doctrines in these areas. Knowing Persons fills a significant gap by showing the way to such an understanding. (shrink)

By the time of his death in 2006, Sir Peter Strawson was regarded as one of the world's most distinguished philosophers. Unavailable for many years,_ Scepticism and Naturalism_ is a profound reflection on two classic philosophical problems by a philosopher at the pinnacle of his career. Based on his acclaimed Woodbridge lectures delivered at Columbia University in 1983, Strawson begins with a discussion of scepticism, which he defines as questioning the adequacy of our grounds for holding various beliefs. He then (...) draws deftly on Hume and Wittgenstein to argue that we must distinguish between 'hard', scientific naturalism; or 'soft', humanistic naturalism. In the remaining chapters the author takes up several issues in which sceptical doubts play an important role, in particular the nature of transcendental arguments and including the objectivity of moral philosophy, the mental and the physical, and the existence of abstract entities. _Scepticism and Naturalism_ is essential reading for those seeking an introduction to the work of one of the twentieth century’s most important and original philosophers. This reissue includes a substantial new foreword by Quassim Cassam and a fascinating intellectual autobiography by Strawson, which together form an excellent introduction to his life and work. (shrink)

We develop and apply a multi-dimensional conception of explanatory depth towards a comparative analysis of inflationary and bouncing paradigms in primordial cosmology. Our analysis builds on earlier work due to Azhar and Loeb (2021) that establishes initial condition fine-tuning as a dimension of explanatory depth relevant to debates in contemporary cosmology. We propose dynamical fine-tuning and autonomy as two further dimensions of depth in the context of problems with instability and trans-Planckian modes that afflict bouncing and inflationary approaches respectively. In (...) the context of the latter issue, we argue that the recently formulated trans-Planckian censorship conjecture leads to a trade-off for inflationary models between dynamical fine-tuning and autonomy. We conclude with the suggestion that explanatory preference with regard to the different dimensions of depth is best understood in terms of differing attitudes towards heuristics for future model building. (shrink)

Background: Advocacy is an important role of psychiatric nurses because their patients are ethically, socially, and legally vulnerable. This study of Japanese expert psychiatric nurses’ judgments of interventions for patient advocacy will show effective strategies for ethical nursing practice and their relationship with Japanese culture. Objectives: This article explores Japanese psychiatric nurses’ decision to intervene as a patient advocate and examine their ethical, cultural, and social implications. Research design: Using semi-structured interviews verbatim, themes of the problems that required interventions were (...) inductively summarized by a qualitative analysis and their contexts and nursing judgments were examined. Participants and research context: The participants were 21 nurses with 5 or more years of experience in psychiatric nursing. Ethical considerations: The research was approved by Institutional Review Board of research site and study facilities. The participants gave written informed consent. Findings: Analysis of 45 cases showed that nurses decided to intervene when surrounding people’s opinions impeded patients’ safety, healthcare professionals’ policies impeded patients’ decision-making, own violent behaviors impeded treatment and welfare services for patients, own or families’ low acceptance of illness impeded patients’ self-actualization, inappropriate treatment or care impeded patients’ liberty, and their families abused patients’ property. Discussion: To solve conflicts between patients and their surrounding people, the nurses sought reconciliation between them, which is in accordance with Japanese cultural norms respecting harmony. When necessary, however, they protected patients’ rights against cultural norms. Therefore, their judgments cannot be explained by cultural norms alone. Conclusion: The findings indicate that the nurses’ judgments were based on respect for patients’ rights apart from cultural norms, and they first sought solutions fitting the cultural norms before other solutions. This seems to be an ethical, effective strategy if advocates know the culture in depth. (shrink)

J. L. Mackie's famous claim that Locke ‘anticipates’ Kripke's Causal Theory of Reference (CTR) rests, I suggest, upon a pair of important misunderstandings. Contra Mackie, as well as the more recent accounts of Paul Guyer and Michael Ayers, Lockean Real Essences consist of those features of an entity from which all of its experienceable properties can be logically deduced; thus a substantival Real Essence consists of features of a Real Constitution plus logically necessary objective connections between them and features of (...) some particular Nominal Essence. Furthermore, what Locke actually anticipates is the most significant contemporary challenge to the CTR: the qua‐problem. (shrink)

Global metaphysical antirealism (or “antirealism”) is often thought to entail that the identity of each and every concrete entity in our world ultimately depends on us—on our adoption of certain social and linguistic conventions, for instance, or on our use of certain conceptual schemes. Drawing on the middle‐period works of Maurice Merleau‐Ponty, I contend that metaphysical antirealism entails nothing of the sort. For Merleau‐Ponty, I argue, entities do not ultimately owe their identities to us, even though—as he puts it—their “articulations (...) are the very ones of our existence.” Once this is recognised, I maintain, certain interpretations of phenomenology are revealed to be caricatures and certain general objections to antirealism lose their force. (shrink)