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)
Mindfulness training has been used to improve emotional wellbeing in early adolescents. However, little is known about treatment outcome moderators, or individual differences that may differentially impact responses to treatment. The current study focused on gender as a potential moderator for affective outcomes in response to school-based mindfulness training. Sixth grade students (N = 100) were randomly assigned to either the six weeks of mindfulness meditation or the active control group as part of a history class curriculum. Participants in the (...) mindfulness meditation group completed short mindfulness meditation sessions four to five times per week, in addition to didactic instruction (Asian history). The control group received matched experiential activity in addition to didactic instruction (African history) from the same teacher with no meditation component. Self-reported measures of emotional wellbeing/affect, mindfulness, and self-compassion were obtained at pre and post intervention. Meditators reported greater improvement in emotional wellbeing compared to those in the control group. Importantly, gender differences were detected, such that female meditators reported greater increases in positive affect compared to females in the control group, whereas male meditators and control males displayed equivalent gains. Uniquely among females but not males, increases in self-reported self-compassion were associated with improvements in affect. These findings support the efficacy of school-based mindfulness interventions, and interventions tailored to accommodate distinct developmental needs of female and male adolescents. (shrink)
This is an evaluation study of a pilot multicomponent program with animal-assisted therapy for socially withdrawn youth with or without mental health problems in Hong Kong. There were fifty-six participants. Decreased level of social anxiety, and increased levels of perceived employability and self-esteem across two withdrawn groups were observed. When comparing those who did and did not receive the AAT component, however, AAT did not seem to have additional impacts on outcomes. The qualitative data collected through interviews with ten participants (...) reflected that the AAT component was attractive because the nonhuman animals made them feel respected and loved. This pilot study showed that a multicomponent program with a case management model correlated with increased levels of self-esteem and perceived employability, and a decreased level of social interaction anxiety. In addition, using nonhuman animals in a social service setting appears to be a good strategy to engage difficult-to-engage young people. (shrink)
Employees perceive illegitimate tasks as inappropriate assignments because such tasks are beyond what they expect to do in any given job position. Extant literature indicates that, in addition to creating psychological strain and reducing well-being, illegitimate task assignments can result in counterproductive work behavior. This study extends the literature by examining whether illegitimate tasks may lead to two specific forms of CWB targeting organizations: destructive voice and time theft. To understand how and when this happens, we investigate the mediating role (...) of moral disengagement and the moderating role of psychological entitlement. Survey results based on 258 supervisor–subordinate dyads in China reveal that illegitimate tasks are positively related to destructive voice and time theft through moral disengagement. Furthermore, psychological entitlement strengthens the positive relationship between illegitimate tasks and moral disengagement and the indirect effect of illegitimate tasks on destructive voice and time theft. Overall, the findings provide insightful theoretical and managerial implications for research related to illegitimate tasks and CWB. (shrink)
Ng and singer derive the principle of utility from the fact of finite sensibility and another principle, weak majority preference: "for a community of n individuals choosing between two possibilities, x and y, if no individual prefers y to x, and at least n/2 individuals prefer x to y, then x increases social welfare and is preferable." this derivation is regarded as incorrect in a comment. this reply explains why the derivation is valid and shows that the comment is based (...) on confusing a general social ordering with a utilitarian one. (shrink)
OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)
En este ambicioso libro, el biólogo Daniel W. McShea y el filósofo de la biología Robert N. Brandon desafían las explicaciones explícitas encontradas en la litera-tura acerca del origen de la diversidad y la complejidad en los seres vivos. Estas explicaciones recurren en su mayoría a la acción de la selección natural, como ser, a la selección diversificadora/disruptiva, a la selección de niveles superiores favoreciendo a especies/clados con mayor propensión a la especiación, o a las ventajas de una mayor división (...) del trabajo, entre otras alternativas (p. 1). Si bien estas explicaciones pueden ser correctas, no constituirían toda la historia, según los autores, pues habría una tendencia de fondo no reconocida en la literatura (pero invocada en las explicaciones de casos concretos) hacia un aumento de la diversidad y la complejidad. Esta tendencia surgiría simplemente de que las variaciones azarosas, cuando se heredan, se acumulan en diferentes direcciones en diferentes poblaciones, con el resultado de que la diversidad se incrementa. Para expresar esta tendencia, los autores proponen una ley, que denominan ZFEL (por zero-force evolutionary law) y que formulan de la siguiente manera: “En cualquier sistema evolutivo en el que hay variación azarosa y he-rencia, en ausencia de fuerzas y constricciones, la diversidad y la complejidad tenderán a aumentar” (p. 4). (shrink)
Major hallmarks of Alzheimer's disease include brain deposition of the amyloid-beta peptide , which is proteolytically cleaved from a large Abeta precursor protein by beta and gamma- secretases. A transmembrane aspartyl protease, beta-APP cleaving enzyme , has been recognized as the beta-secretase. We review the structure and function of the BACE1 protein, and of 4129 bp of the 5'-flanking region sequence of the BACE1 gene and its interaction with various transcription factors involved in cell signaling. The promoter region and 5'-untranslated (...) region contain multiple transcription factor binding sites, such as AP-1, CREB and MEF2. A 91 bp fragment is the shortest region with significant reporter gene activity and constitutes the minimal promoter element for BACE1. The BACE1 promoter contains six unique functional domains and three structural domains of increasing sequence complexity as the "ATG" start codon is approached. Notably, the BACE1 gene promoter contains basal regulatory elements, inducible features and sites for regulation by various important transcription factors. Herein, we also discuss and speculate how the interaction of these transcription factors with the BACE1 promoter can modulate synaptic plasticity, neuronal apoptosis and oxidative stress, which are pertinent to the pathogenesis and progression of AD. (shrink)
6. Seeing With the Mind ’ s Eye 1 : The Puzzle of Mental Imagery 6. 1 What is the puzzle about mental imagery? 6. 2 Content, form and substance of representations 6. 3 What is responsible for the pattern of results obtained in imagery studies?
