As the aging population, including frail older people, continues to grow in Mainland China, quality of life and end-of-life care for frail older people has attracted much attention. Advance care planning is an effective way to improve end-of-life care for people with advanced diseases, and it is widely used in developed countries; however, it is a new concept in Mainland China. The effects of advance care planning and its acceptability in Mainland China are uncertain because of its culture-sensitive characteristics. The (...) objective of this article is to discuss the serious social issue of caring for frail older people and illustrate the possibility of implementing advance care planning in nursing homes in Mainland China through a review of relevant literature, which will focus on legislation, healthcare system engagement, public engagement, and cultural issues. Recommendations to promote and implement advance care planning include choosing nursing homes as a proper setting, establishing an ethical climate, and enhancing public awareness. (shrink)

This study inspected the effect of Massive Open Online Course and flipped instruction on EFL learners’ foreign language speaking anxiety, foreign language learning motivation, and attitude toward English learning. To fulfill this objective, the Oxford Quick Placement Test was given to 160 Iranian EFL learners, of whom 120 upper-intermediate participants were chosen and divided into two experimental groups—MOOC and flipped —and one control group. After that, all selected participants were administered a speaking anxiety questionnaire and a motivation questionnaire as the (...) pre-test of the research. Then, one of the experimental groups received an online-based instruction via Skype: one conversation was instructed to this group online every session. The other experimental group received the treatment via flipped-based instruction. The audio files and the texts of the conversations were sent to this group via the WhatsApp application because they all had easy access to it. On the other hand, the control group did not receive any Internet-delivered treatment yet was trained through a face-to-face method. This process continued until the last session, and after the treatment period, the post-tests of speaking anxiety and motivation were given to all three groups to determine the effectiveness of the treatment. Moreover, two attitude questionnaires were administered to the experimental groups to examine their attitudes toward the MOOC and the flipped models of instructions. The findings of the One-way ANOVA test, Post-hoc Scheffe test, and paired samples t-test showed that there were significant differences between the post-test of the experimental groups and the control group. The results indicated that the experimental groups significantly outflanked the control group after the treatment. Lastly, the outcomes showed that participants in both experimental groups had positive attitudes toward technological-based instructional environments. (shrink)

The progress of electronic health technologies and biobanks holds enormous promise for efficient research. Evidence shows that studies based on sharing and secondary use of data/samples have the potential to significantly advance medical knowledge. However, sharing of such resources for international collaboration is hampered by the lack of clarity about ethical and legal requirements for transfer of data and samples across international borders. Here, the International Clinical Trial Center Network reports the legal and ethical requirements governing data and sample exchange (...) across four continents. The most recurring requirement is ethical approval, whereas only in specific conditions approval of national health authorities is required. Informed consent is not required in all sharing situations. However, waiver of informed consent is only allowed in certain countries/regions and under certain circumstances. The current legal and ethical landscape appears to be very complex and under constant evolution. Regulations differ between countries/regions and are often incomplete, leading to uncertainty. With this work, ICN illuminates the unmet need for a single international collaborative framework to facilitate DSE. Harmonising requirements for global DSE will reduce inefficiency and waste in research. There are many challenges to realising this ambitious vision, including inconsistent terminology and definitions, and heterogeneous and dynamic legal constraints. Here, we identify areas of agreement and significant difference as a necessary first step towards facilitating international collaboration. We propose the establishment of a working group to continue the comparison across jurisdictions, create a standardised glossary and define a set of basic principles and fundamental requirements for DSE. (shrink)

Hui-yüan was born in Tai hsien of Shansi Province in A. D. 334 and died in A. D. 416.

ObjectivePrevious studies have demonstrated altered brain activity in strabismic amblyopia. In this study, low-frequency repetitive transcranial magnetic stimulation was applied in children with strabismic amblyopia after they had undergone strabismus surgery. The effect of rTMS was investigated by measuring the changes of brain features using the amplitude of low-frequency fluctuation.Materials and MethodsIn this study, 21 SA patients were recruited based on their age, weight, and sex. They all had SA in their left eyes and they received rTMS treatment one month (...) after strabismus surgery. Their vision before and after surgery were categorized as pre-rTMS and post-rTMS. All participants received rTMS treatment, underwent magnetic resonance imaging, and their data were analyzed using the repeated measures t-test. The team used correlation analysis to explore the relationship between logMAR visual acuity and ALFF.ResultsPre- versus post-rTMS values of ALFF were significantly different within individuals. In the POT group, ALFF values were significantly decreased in the Angular_R, Parietal_Inf_L, and Cingulum_Mid_R while ALFF values were significantly increased in the Fusiform_R and Frontal_Inf_Orb_L compared to the PRT stage.ConclusionOur data showed that ALFF recorded from some brain regions was changed significantly after rTMS in strabismic amblyopes. The results may infer the pathological basis of SA and demonstrate that visual function may be improved using rTMS in strabismic amblyopic patients. (shrink)

Collaborative filtering technology is currently the most successful and widely used technology in the recommendation system. It has achieved rapid development in theoretical research and practice. It selects information and similarity relationships based on the user’s history and collects others that are the same as the user’s hobbies. User’s evaluation information is to generate recommendations. The main research is the inadequate combination of context information and the mining of new points of interest in the context-aware recommendation process. On the basis (...) of traditional recommendation technology, in view of the characteristics of the context information in music recommendation, a personalized and personalized music based on popularity prediction is proposed. Recommended algorithm is MRAPP. The algorithm first analyzes the user’s contextual information under music recommendation and classifies and models the contextual information. The traditional content-based recommendation technology CB calculates the recommendation results and then, for the problem that content-based recommendation technology cannot recommend new points of interest for users, introduces the concept of popularity. First, we use the memory and forget function to reduce the score and then consider user attributes and product attributes to calculate similarity; secondly, we use logistic regression to train feature weights; finally, appropriate weights are used to combine user-based and item-based collaborative filtering recommendation results. Based on the above improvements, the improved collaborative filtering recommendation algorithm in this paper has greatly improved the prediction accuracy. Through theoretical proof and simulation experiments, the effectiveness of the MRAPP algorithm is demonstrated. (shrink)

Background:There is controversy concerning the use of physical restraint. Despite this controversy, some nurses still consider the application of physical restraint unavoidable for some of their clients.Aim:Identify the perceptions and practice of physical restraint in China.Research design:This was a descriptive study that combined qualitative interviews with a quantitative cross-sectional survey.Participants:A total of 18 nurses were interviewed and 330 nurses were surveyed.Ethical considerations:Approval of the study was obtained from the hospital ethics committee. Permission to conduct the study was obtained from the (...) director of nursing. Participants were assured that their participation is voluntary.Results:Physical restraint was commonly used to protect patients’ safety. Naturally, intensive care unit nurses used physical restraint much more frequently than general medical/surgical ward nurses ( p < 0.01). In addition, night shift nurses tended to use physical restraint more frequently.Conclusion:Nursing managers should be aware of the role nurses play in the use of physical restraint. In-service training regarding the proper use of physical restraint should be strengthened and nurse staffing levels should be improved in order to minimize the use of physical restraint in China. (shrink)

Greenway is a kind of corridors in the city that takes natural elements as the main constituent foundation and connects open spaces with functions such as leisure and recreation. The assessment of the built greenway is a review of the past construction experiences, and it is also a supplement and improvement to the future greenway planning concept system, which has important academic and application value. This study will explore how greenway design factors influenced the local cyclists’ perception of the landscape (...) using on-site questionnaire and photo rating method. The results indicated that greenways with continuous cycling paths, high security awareness, open landscapes, and rich human activities evoke positive perceptions. Among the visual elements, natural elements such as plants and sky are more favorable than artificial elements. The research results show that the formation of greenway cyclists’ landscape imagery is affected by visual perception elements, which suggests that special consideration should be given to the laws of cyclists’ mental perception when designing greenways. (shrink)

Emotions are now considered critical elements of a successful education. In English as a Foreign Language context, there are many challenges for teachers to deal with. Hence, it is necessary to take their emotions into consideration. Despite many studies in this area, researching teachers’ positive mood, hope, and academic buoyancy has been left less attended. Trying to introduce this line, the present study reviewed the definitions, related concepts, theories, and previous studies done on these three variables in detail. It also (...) touched upon the origins of researching emotion in educational contexts describing different schools of psychology. Additionally, the study offered some practical implications for EFL teachers, students, policy-makers, teacher trainers, and researchers. Finally, it enumerated the existing gaps in this area and made a number of research suggestions for future research. (shrink)

When there is no immediate response after a proposal and normally the silence is longer than 0.2 s, the proposer would take subsequent actions to pursue a preferred response or mobilize at least an articulated one from the recipient. These actions modulate the prior deontic stance embedded in the original proposal into four trends as follows: maintaining the prior deontic stance with a self-repair or by seeking confirmation; making the prior deontic stance more tentative by making a revised other-attentiveness proposal, (...) providing an account, pursuing with a tag question, or requesting with an intimate address term; making the prior deontic stance more decisive by making a further arrangement, closing the local sequence, or providing a candidate unwillingness account ; and canceling the prior deontic stance by doing a counter-like action. Additionally, these trends inherently embody a decisive-to-tentative gradient. This study would penetrate into the phenomena occurring in Mandarin mundane talk with the methodology of Conversation Analysis to uncover the underflow of deontic stance. (shrink)

The "gang of four" — Wang Hung-wen, Chang Ch'un-ch'iao, Chiang Ch'ing and Yao Wen-yuan — have created great chaos by confusing the relations between ourselves and the enemy, obliterating the differences between the two kinds of contradiction, wrecking Chairman Mao's policy of uniting with, educating and reforming intellectuals, calling intellectuals the "stinking number nine," smothering the revolutionary initiative of the broad masses of intellectuals, and destroying the ranks of revolutionary intellectuals.

Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: We recruited 500 nurses (...) from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40%. The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity. Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

Objective: To systematically analyze the effects of art therapy on the levels of depression, anxiety, blood glucose, and glycated hemoglobin in diabetic patients.Methods: We searched Cochrane Library, PubMed, Embase, and ClinicalTrials.gov databases from inception to January 24, 2021. The language of publication was limited to English. Randomized controlled trials that used art therapy to improve mental disorders in diabetic patients were involved. After selection of eligible studies, data were extracted, including the first author's full-name, year of publication, the first author's (...) country of residence, number of intervention and control groups, the mean age of participants, method of intervention, duration of follow-up, and outcome measures. Assessment of quality of the included studies and data extraction were independently carried out by two researchers. RevMan 5.3 software was used to perform statistical analysis.Results: A total of 396 samples from five studies were included, and the eligible studies were RCTs with a parallel design. Methods of art therapy included music therapy and painting therapy. The results showed that compared with the control group, art therapy could positively affect the levels of depression [standardized mean difference, −1.36; 95% confidence interval, ; P < 0.00001] and blood glucose in diabetic patients [mean difference, −0.90; 95% CI, ; P < 0.0001], while it had no influence on the levels of anxiety [SMD, −0.31; 95% CI, ; P = 0.32] and glycated hemoglobin [MD, 0.22; 95% CI, ; P = 0.07].Conclusion: Art therapy may have significant effects on the levels of depression and blood glucose for diabetic patients. (shrink)

BackgroundThe prognosis of patients undergoing lung cancer treatment might be influenced by mental health status. Resilience is one of the important predictors to reflect the mental health status. It has been shown that patients with higher levels of social support, self-care self-efficacy, and positive coping have greater resilience. This study aimed to determine the mediating role of self-efficacy and positive coping in the relationship between social support and psychological resilience in patients with lung cancer.MethodThis is a cross-sectional study that was (...) conducted in in the oncology departments and thoracic surgical wards of four tertiary hospitals in Hunan Province, China, between November 2016 and November 2017. Three hundred and three patients who were undergoing treatment for lung cancer volunteered their participation in the study. Participants completed questionnaires, including the Chinese version of the Perceived Social Support Seale Scale, the Chinese version of Strategies Used by People to Promote Health Scale, and the Chinese version of the Connor-Davidson Resilience Scale.ResultsMediation analysis indicated that self-care self-efficacy and social support partially mediate the effect of social support on resilience. Direct paths from social support to self-efficacy, self-efficacy to positive coping, positive coping to psychological resilience, self-efficacy to psychological resilience, and social support to psychological resilience were significant. The indirect paths from social support to self-efficacy and self-efficacy to psychological resilience were also significant. The chain mediation from social support to self-efficacy, self-efficacy to positive coping, and positive coping to resilience were significant.ConclusionSelf-efficacy and positive coping play an important role in the relationship between social support and resilience in patients receiving cancer treatment. Social support not only directly influenced psychological resilience but also indirectly influenced psychological resilience through self-efficacy and positive coping. (shrink)

ObjectiveVirtual reality grasping exercise training helps patients participate actively in their recovery and is a critical approach to the rehabilitation of hand dysfunction. This study aimed to explore the effects of active participation and VR grasping on brain function combined with the kinematic information obtained during VR exercises.MethodsThe cerebral oxygenation signals of the prefrontal cortex, the motor cortex, and the occipital cortex were measured by functional near-infrared spectroscopy in 18 young people during the resting state, grasping movements, and VR grasping (...) movements. The EPPlus plug-in was used to collect the hand motion data during simulated interactive grasping. The wavelet amplitude of each cerebral cortex and the wavelet phase coherence of each pair of channels were calculated by wavelet analysis. The total difference in acceleration difference of the hand in the VR grasping movements was calculated to acquire kinematic characteristics. The cortical activation and brain functional connectivity of each brain region were compared and analyzed, and a significant correlation was found between VR grasping movements and brain region activation.ResultsCompared with the resting state, the WA values of LPFC, RPFC, LMC, RMC, and ROC increased during the grasping movements and the VR grasping movements, these changes were significant in LPFC and LMC. The WA values of LMC in the VR grasping movements were significantly higher than those in the grasping movements. The WPCO of the cerebral cortex increased during grasping exercise compared with the resting state. Nevertheless, the number of significant functional connections during VR grasping decreased significantly, and only the WPCO strength between the LPFC and LMC was enhanced. The increased WA of the LPFC, RPFC, LMC, and RMC during VR grasping movements compared with the resting state showed a significant negative correlation with KCs.ConclusionThe VR grasping movements can improve the activation and FC intensity of the ipsilateral brain region, inhibit the FC of the contralateral brain region, and reduce the quantity of brain resources allocated to the task. Thus, ordered grasping exercises can enhance active participation in rehabilitation and help to improve brain function. (shrink)

From a largely Western phenomenon, the “animal turn” has, in recent years, gone global. Animals and Human Society in Asia: Historical, Cultural and Ethical Perspectives is just such a timely product that testifies to this trend.But why Asia? The editors, in their very helpful overview essay, have from the outset justified the volume's focus on Asia and ensured that this is not simply a matter of lacuna filling. The reasons they set out include: the fact that Asia is the cradle (...) of early human settlement and animal domestication; Asia encompasses an extreme diversity of closely connected ecosystems and human cultures; Asia is the place where the world's major religions originated; and, as in other parts of the world, Asia's use of animals for food and other utilitarian purposes constitutes a prominent feature of its culture. All of these factors, they argue, made Asia a unique lab for the exploration of major developments in human civilization and the complexities of human-animal interactions.Based on these premises, the book is divided into four parts, each concentrating on areas that the editors consider to have paramount significance in world history: Part I, “Hunting and Domestication”; Part II “Animals as Food”; Part III “Animals at War”; and Part IV “Animals in Culture and Religion.” As many good works on animal studies do, the volume adopts a truly cross-disciplinary approach, uniting scholars from disciplines as diverse as archaeology, history, anthropology, art, religion, literature, and cultural studies. It too takes an interregional approach and covers a vast geographical area, stretching from the western edge of Asia in the Levant to Central Asia, where once roamed the horses of the nomadic pastoral tribes, to the other end of Asia, including India, China, and Japan. Temporally impressive as well, the work takes us from the deep history of the Paleolithic period up to the contemporary world, exploring the diverse roles that a wide range of animals—horses, donkeys, camels, elephants, tigers, and so forth—have played in Asia's rich and unique past and present.Strong in archaeology, Part I, “Hunting and Domestication,” responds to the much-called for “deep” or “coevolutionary” history of human-animal relations in recent years. The three chapters discuss, respectively, the roles that proboscideans have played in the diet and culture of early societies in Paleolithic China and beyond; the ways in which animals of all sizes have been increasingly integrated into the diet, daily uses, trade, and warfare in Holocene Negev; and the diversifying roles played by donkeys in the early Bronze Age in Southern Levant as a food source, a means of transport and in ritual sacrifices. Together, they demonstrate, with reference to telling archaeological evidence how the early societies in this region have been highly dependent upon the increasingly sophisticated interactions with and uses of mega-herbivores in the protracted and by no means clear-cut transition from hunting and herding towards the agricultural way of life, affirming the co-existing and co-constituting relations between humans and other animals in the deep past of Asia.The chapters in the section on “Animals at War” equally reveal the crucial roles that animals have played in the military sphere, as either a practical war technology or a show of military power. “Elephants in Mongol History” revisits the thesis of elephant-mounted troops in South and Southeast Asia as a barrier to Mongol expansion. Through its lively account of the pivotal battles in Mongolian history, especially that against India and China, it illustrates with great success the complex interactions between animals (especially elephants, horses, and humans), technology, and the geographical environment, which jointly exercised their influence on the outcome of warfare and degree of success of political rule. Turning away from the dynamic of warfare, the following two chapters explore the biopolitical question of the management of the horse as a bio-resource in the Mamluk Sultanate of Egypt and Syria (1250–1517) and early Ming Dynasty China, respectively. The first one places its focus on the breeding, procurement, and feeding of the horse subjects in question, while the latter concentrates on the human organization of various resources for the upkeep of government horses—a conventional area of study called “horse administration” in the institutional history of the government in China.The last section, “Animals in Culture and Religion,” examines the changing images of apex predators, such as lions and tigers, in Buddhist perceptions from South Asia to East Asia; the cult of the Horse King in late Imperial China; and the significance of animal signs in Mongolian historiography. They represent an established approach in animal studies that seeks to understand different aspects of human culture through symbolic or metaphorical animals. Instead of treating the animals discussed as mere abstractions, which has been a frequent criticism of works that adopt this approach, the relations between the symbolic animals and their prototype in the natural world were attentively explored. The essay on the cult of the Horse King, for example, closely links the wax and wane of the cult since late imperial China with the changing use and subsequent disuse of the actual horses in agriculture, transportation, commerce, and quotidian life. Yet, classic as these essays on symbolic animals are, one does feel slightly unsatiated when coming to the end of this section, which also marks the end of this volume. Having been reminded early in the introductory essay that Asia was “a major site for the emergence of moral teachings and ethical guidance on the treatment of animals” and how this legacy “still affects the lives of billions of humans to this very day,” one feels naturally rather let down that no article in this volume directly addresses this vital ethical dimension, especially since it belongs to a series on “animal ethics.”Indeed, regarding the task of placing either the nonhuman animals or the ethical relations between humans and other animals center stage, the essays in this volume achieve only varying levels of success. Some authors exhibit a more acute awareness of what “animal studies” or “animal ethics” might entail epistemically and methodically and experiment by paying closer attention to the species-specific characteristics, experience, and agency of nonhuman animals in order to cast off the deified anthropocentrism previously ruled in humanist scholarship. However, others have made no such attempt. For example, in Part II of “Animals as Food,” an essay on the production and consumption of milk in contemporary China, albeit alert to the issue of health hazards to consumers, omits any consideration of the subject from the dairy cows’ perspective under the modern intensive farming system. Moreover, otherwise superb research on the tuna-fishing industry in Japan, with its insightful discussion of the nexus between knowledge economies and imperial politics, too passes over any discussion of the fate of the tuna, whether collectively as a group of living organisms containing 15 species or individually as animals with an embodied experience. One does ponder whether these essays would fit better in a volume on the cultural history of food or on the entwining history of knowledge production, economics, and politics, which conventionally position human interests at the center of research.Taken as a whole, this is an impressive volume that directs our attention to the hitherto understudied world of Asia in animal studies. The long durée, with its interdisciplinary and interregional approach, also most powerfully presents a past in Asia that could not have been the same without the participation of animals at every level, from everyday life to the shaping of cultural values, the construction of belief systems, the building of a national identity, and even the rise and fall of regimes. Scholars and students interested in expanding the frontier of our understanding of the world with a more inclusive “we” should find a wealth of interesting subjects on which to build further research. Finally, the volume also presents a fitting occasion for all scholars committed to animal studies to consider the grave challenge confronting the field that arose alongside its growing respectability and rapid expansion: Should it be oriented toward the destabilization of our previously anthropocentric conception of the world? Or should no such perimeter be imposed, as in this volume? The overall breadth and limitations of this volume leave one pondering this issue. (shrink)

This work explored the mediating effects of affective commitment on transformational leadership and job performance and job insecurity on transformational leadership and affective commitment. Meanwhile, the inter-relationships between the four verified the mediating effect of affective commitment, including job insecurity. The results were as follows: transformational leadership and job performance were positively related. Transformational leadership was proportional to an emotional commitment. The affective commitment had a positive impact on job performance. Transformational leadership indirectly positively affected job performance through the intermediary (...) effect of affective commitment. Transformational leadership regulated affective commitment through job insecurity. The more job security employees have, the higher the impact of transformational leadership on affective commitment; the lower the contrary. (shrink)