In the Southeast Asian city-state of Singapore, street artist SKLO has come into conflict with the authorities for her sticker bombing and stenciling. Her arrest foregrounds issues about the socio-cultural resonances and broader value of street art in local public discourse. This article explores SKLO’s praxis vis-à-vis the phenomenon of official graffiti, and its structuring of the tightly regulated public realm. Dubbed the “Sticker Lady,” SKLO has been also referred to as “Singapore’s Banksy” by local and international media. Besides prompting (...) questions regarding the value of street art as expressions of local culture, these references shed light on how the figure of Banksy has become a figure of neoliberal urban aesthetics, especially pertaining to urban entrepreneurialism – a globally circulated signifier of a particular image of street art that sees the attachment of monetary value, celebrity and cool to such artistic works of subversion. These references to Banksy also raise a deeper question: can the Singaporean authorities accept the subversive and political aspects of art as the city-state embarks on a neoliberal agenda to present itself as a considerable player in the global art market? (shrink)

A script concordance test was developed as an innovative tool for assessing ethical reasoning ability. An SCT of 12 medical ethical vignettes were constructed from the UNESCO Casebook on Human Dignity and Human Rights. The vignettes were reviewed by a panel of 15 medical experts before administration to a panel of 18 clinicians. The clinician’s answers were used to constitute the scoring key. The SCT was then administered to first and final year medical students. Data were analysed using SPSS. Internal (...) consistency was assessed using Cronbach’s alpha. SCT performance was tested for association with sex, year of study and race by comparing the mean SCT scores between categories within each variable. Internal consistency as measured by Cronbach’s alpha values, ranging from 0.597 to 0.902, indicated high intra-vignette reliability for 10 of the vignettes. Inter-vignette reliability was high at 0.797. Mean SCT scores were not significantly different between students of different gender, year of study and ethnicity. However, each vignette was able to distinguish between overall poor and good test performers. The SCT was able to differentiate between students with varying degrees of ethical reasoning ability. (shrink)

The essay discusses the presumption of one's singularity, the uniqueness of one's time, the picturesqueness of one actions, and the capacity of human beings, whether corporately or individually, to begin everything or indeed anything again from scratch. Such presumptions are indeed present in some varieties of contemporary fanaticism, but, more to the point, it is suggested that the feeling of doing something for the first time is the oldest feeling in the world.

Throughout history, the generation, exercise, and dissemination of knowledge are fraught with dangers, the root causes of which are traceable to the definition of authority relations. The authors compare Greek myths and Chinese legends, setting the stage for a metarelational analysis of authority relations between teacher and students and between scholar-teachers and political rulers in Confucian-heritage cultures. These two relations are rooted in ideological conservatism. They are related in a higher-order relation or metarelation: Political control and the definition of the (...) teacher-student relationship reinforce each other in consolidating authoritarian values. Thus, ideological conservatism shapes educational philosophy and socialization. It conflicts with present demands for creativity in the service of knowledge-based economies. Hence, a major issue in cultural change to be addressed concerns the dilemma between maintaining authoritarian control and enhancing creativity. (shrink)

The link between logic and mathematics has long been recognized by theorists from various fields. For instance, the mathematician, Bertrand Russell (1919), described logic and math as intrinsically...

It is a received view of the post-Fregean predicate logic that a universal statement has no existential import and thus does not entail its particular (existential) counterpart. This paper takes issue with the view by discussing the trespasser case, which has widely been employed for supporting the view. The trespasser case in fact involves a shift of context. Properly understood, the case provides no support for the received view but rather suggests that we rethink the ‘quantity view’ of the existential (...) import of quantifiers. (shrink)

We investigate the regulatory sanctions imposed on independent directors for their firms’ financial frauds in China. These regulatory sanctions are prima-facie evidence of significant lapses in business ethics. During the period 2003–2010, 302-person-time independent directors were penalized by the regulator, and the two stock exchanges. We find that the independent directors with accounting experiences are more likely to be penalized by the CSRC, though they do not suffer more severe penalties than do the other sanctioned independent directors. We also find (...) that independent directors suffer less severe penalties than do the insider directors. These results are consistent with the hypothesis that the sanctions on independent directors are tied to their assumed ethical and legal responsibilities. Following a regulatory sanction, penalized independent directors experience a significant decline in the number of other board seats held. However, they can gain board seats in better quality firms. We find that interlocked firms that share penalized independent directors with the fraud firm do not suffer from a valuation decline. Overall, our results suggest that regulatory sanctions have not triggered further sanctions on the penalized directors in the labor market but they have, instead, created a disincentive for these directors to serve on the company boards of high-risk firms. (shrink)

PurposeThis study aims to describe the adverse events following immunization of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress.MethodsA cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale before and after the first and second doses of COVID-19 vaccine.ResultsA total of 217 complete responses were received. Compared with before vaccination, both HADS Anxiety and HADS (...) Depression scores were significantly reduced after the first and second dose of the SARS-CoV-2 vaccine. Most of the participants had mild-or-moderate systemic and local AEFIs, with the most common being pain at the injection site, tiredness, and headache for both the first and second doses of the vaccine. Positive correlations between the total AEFI score and HADS-A and HADS-D scores were observed after the first dose of the SARS-CoV-2 vaccine. Similarly, positive associations were observed between the total AEFI score and HADS-A and HADS-D scores after the second dose of the SARS-CoV-2 vaccine.ConclusionMild-to-moderate AEFIs found in this study help address vaccine hesitancy in cancer patients/survivors. Receiving the SARS-CoV-2 vaccine had a positive effect on decreasing psychological distress in cancer patients/survivors. High severity of an AEFI was associated with higher anxiety and depressive symptoms. (shrink)

We show that the N₀-categorical structures produced by Hrushovski's predimension construction with a control function fit neatly into Shelah's $SOP_n $ hierarchy: if they are not simple, then they have SOP₃ and NSOP₄. We also show that structures produced without using a control function can be undecidable and have SOP.

Metacognitive training (MCT) was developed to promote awareness of reasoning biases among patients with schizophrenia. While MCT has been translated into 31 languages, most MCT studies were conducted in Europe, including newer evidence recommending an individualized approach of delivery. As reasoning biases covered in MCT are separable processes and are associated with different symptoms, testing the effect of selected MCT modules would help to develop a targeted and cost-effective intervention for specific symptoms and associated mechanisms. This study tested the efficacy (...) of a 4-session metacognitive training for delusions, MCTd (in Traditional Chinese with cultural adaptations, provided individually), as an adjunct to antipsychotics in reducing severity and conviction of delusions, jumping to conclusions bias and belief inflexibility. Forty-four patients with delusions were randomized into the MCTd or the wait-list control condition. Patients on wait-list received the same MCTd after four weeks of treatment as usual. Assessment interviews took place before and after the treatment, and at 4-week follow-up. There was an additional baseline assessment for the controls. Jumping to conclusions and belief flexibility were measured by the beads tasks and the Maudsley Assessment of Delusions Scale. Attendance rate of the MCTd was satisfactory (84.5%). Compared to treatment as usual, there was a greater reduction in psychotic symptoms, delusional severity and conviction following MCTd. There was a large treatment effect size in improvement in belief flexibility. Improvement in reaction to hypothetical contradiction predicted treatment effect in positive symptoms and delusions. Jumping to conclusions bias was reduced following MCTd, although the treatment effect was not significantly larger than TAU. Our results support the use of process-based interventions that target psychological mechanisms underlying specific psychotic symptoms as adjuncts to more conventional approach. (shrink)

In recent years, there has been increased awareness of unethical consumer practices in Asian countries. Asian consumers have gained a bad reputation for buying counterfeit products, such as computer software, fashion clothing and watches. In 1993, the estimated losses to US software companies due to Chinese counterfeiting stood at US $322 million (Kohut, 1994). The present study uses a consumer ethics scale developed by Muncy and Vitell (1992) to investigate consumers' ethical judgments from a Chinese perspective. The result shows that (...) consumers in different cultures utilize similar rules to assess the ethicality of a given situation. However, findings also show certain cultural elements that are unique in influencing Chinese consumers' ethical judgments. The results also indicate the need for the continued development of and investment in consumer education in Asia. (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)

Prior research suggests that most people perceive themselves to be more altruistic than the average population, an observation known as the better-than-average (BTA) effect. Understanding the BTA effect carries significant public health implications, as self-perceived altruism is closely related to altruistic behaviors, which plays a significant role in individual and societal well-being. However, little is known about whether subpopulations with specific sociodemographic profiles are more likely to hold BTA altruistic self-perceptions, making it difficult to design targeted programs based on multiple (...) sociodemographic characteristics to promote altruistic behaviors. This study addresses this gap by identifying the sociodemographic profiles of populations who are more likely to exhibit BTA effects on trait altruism. Data were derived from a representative sample of Hong Kong citizens (n= 1,185) in the 2017 Hong Kong Altruism Survey. A latent class analysis was performed using four domains of sociodemographic characteristics: sex, age, religion, and socioeconomic status. Multivariate multinomial logistic regressions were conducted to examine associations between class membership, BTA effect, and altruistic behaviors. The results yielded four classes of sociodemographic profiles. Middle-aged, Christian/Catholic, highly educated, and high-income individuals (Class 4, 17.8%) were most likely to exhibit BTA effects and behave altruistically; Class 3 (14.0%) were older, male, no/other religious belief, low education, and least likely to exhibit BTA effects and behave altruistically. Findings improve the understanding of the sociodemographic profiles of people showing BTA effects and facilitate targeted policy development to effectively promote altruism. (shrink)

Objective: To determine the usefulness of Q methodology to locate and describe shared subjective influences on clinical decision making among participant physicians using hypothetical cases containing common ethical issues. Design: Qualitative study using by-person factor analysis of subjective Q sort data matrix. Setting: University medical center. Participants: Convenience sample of internal medicine attending physicians and house staff (n = 35) at one midwestern academic health sciences center. Interventions: Presented with four hypothetical cases involving urgent decision making near the end of (...) life, participants selected one of three specific clinical actions offered for each case. Immediately afterward and while considering their decision, each respondent sorted twenty-five subjective self-referent items in terms of the influence of each statement on their decision-making process. By-person factor analysis, where participants are defined as variates, yielded information about the attitudinal background the physicians brought to their consideration of each hypothetical case. We performed a second-order factor analysis on all of the subjective viewpoints to determine if a smaller core of shared attitudes existed across some or all of the four case vignettes. Factor scores for each item and post-sort comments from interviews conducted individually with each respondent guided the interpretation of ethical perspective used by these respondents in making clinical decisions about the cases. Measurements and Main Results: Second-order factor analysis on seventeen viewpoints used by physicians in the four hypothetical urgent decision cases revealed three moderately correlated (r 2 < 40%) subjective core attitudinal guides used broadly among all the cases and among sixteen of the seventeen original factors. Across all the cases, our participants were guided in general by: (1) patient-focused beneficence, (2) a patient- and surrogate-focused perspective that includes risk avoidance, and (3) best interest of the patient guided by ethical values. Economic impact on the physician, expediency in resolution of the situation, and the expense of medical treatment were not found to be influential determinants in this study. Conclusions: Q sorting and by-person factor analysis are useful qualitative methodological tools to study the complex structure of subjective attitudes that influence physicians in making medical decisions. This study revealed the subjective viewpoints used by our physician participants as they made ethically challenging treatment decisions. The three second-order factors identified here are grounded in current bioethical values as well as the personal traits of physicians. The participants' decision methods appear to resemble casuistry more than principle-based decision making. Generalizability of results will require further studies. (shrink)

In [5, 6], Belnap proposed a number of amendments to Rescher’s strategy for reasoning with maximal consistent subsets. More recently in [18], Horty explicitly endorsed Belnap’s amendment to address a related problem in handling inconsistent instructions and commands. In this paper, we’ll examine Belnap’s amendment and point out that Belnap’s suggestion in the use of conjunctive containment is open to the very objection he raised. We’ll propose a way out. The strategy turns on the use of First Degree Entailment in (...) combination with Quine’s notion of prime implicate. (shrink)

Most neuroimaging research in stroke rehabilitation mainly focuses on the neural mechanisms underlying the natural history of post-stroke recovery. However, connectivity mapping from resting-state fMRI is well suited for different neurological conditions and provides a promising method to explore plastic changes for treatment-induced recovery from stroke. We examined the changes in resting-state functional connectivity (RS-FC) of the ipsilesional primary motor cortex (M1) in 10 post-acute stroke patients before and immediately after 4 weeks of robot-assisted bilateral arm therapy (RBAT). Motor performance, (...) functional use of the affected arm, and daily function improved in all participants. Reduced interhemispheric RS-FC between the ipsilesional and contralesional M1 (M1-M1) and the contralesional-lateralized connections were noted before treatment. In contrast, greater M1-M1 functional connectivity and disturbed resting-state networks were observed after RBAT relative to pre-treatment. Increased changes in M1-M1 RS-FC after RBAT were coupled with better motor and functional improvements. Mediation analysis showed the pre-to-post difference in M1-M1 RS-FC was a significant mediator for the relationship between motor and functional recovery. These results show neuroplastic changes and functional recoveries induced by RBAT in post-acute stroke survivors and suggest that interhemispheric functional connectivity in the motor cortex may be a neurobiological marker for recovery after stroke rehabilitation. (shrink)

_Existential and Spiritual Issues in Death Attitudes_ provides: an in-depth examination of death attitudes, existentialism, and spirituality and their relationships; a review of the major theoretical models; clinical applications of these models to issues such as infertility, bereavement, anxiety, and suicide; and an introduction to meaning management theory and how it can be applied to grief counseling. In this new volume, death is treated both as a threat to meaning and as an opportunity to create meaning. The first section introduces (...) theory and methodology to connect the latest empirical research on death attitudes to the philosophical/psychological existential and spirituality literature. Part II presents the latest empirical research on subjects such as end-of-life decisions and living with HIV. The final section considers therapeutic applications to issues including suicide, infertility, bereavement, and anxiety. The concluding chapter highlights the book’s common themes and provides questions to encourage further investigation of the most critical topics. Psychologists, counselors, social workers, physicians, nurses, and religious leaders, as well as academics in the fields of psychology, gerontology, philosophy, religion, counseling, social work, sociology, and medicine will value this new resource. Main points summarize important ideas of each chapter, making it an appropriate text in courses on death and dying and/or and spirituality. Its clinical applications will appeal to practicing professionals. (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)

The COVID-19 pandemic has presented a global threat to physical and mental health worldwide. Research has highlighted adverse impacts of COVID-19 on wellbeing but has yet to offer insights as to how wellbeing may be protected. Inspired by developments in wellbeing science and guided by our own theoretical framework, we examined the role of various potentially protective factors in a sample of 138 participants from the United Kingdom. Protective factors included physical activity, tragic optimism, gratitude, social support, and nature connectedness. (...) Initial analysis involved the application of one-sample t-tests, which confirmed that wellbeing in the current sample was significantly lower compared to previous samples. Protective factors were observed to account for up to 50% of variance in wellbeing in a hierarchical linear regression that controlled for a range of sociostructural factors including age, gender, and subjective social status, which impact on wellbeing but lie beyond individual control. Gratitude and tragic optimism emerged as significant contributors to the model. Our results identify key psychological attributes that may be harnessed through various positive psychology strategies to mitigate the adverse impacts of hardship and suffering, consistent with an existential positive psychology of suffering. (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)

This paper reports on the long-term effectiveness of a non-formal co-curricular educational program based on a campus ecogarden at a Hong Kong university in developing pro-sustainability awareness, attitudes and behavior among undergraduate students. This service-based, nature-based experiential learning program, termed the Ecogarden Farmer and Biodiversity Surveyor, has been running at the university since 2015. The program is divided into two consecutive phases: a training phase comprising various learning activities and a successive internship phase consisting of the all-round practical tasks involved (...) in managing the garden. A retrospective evaluation of the program using phenomenographic approach and content analysis was adopted to reveal the diversity of students’ learning experience, as the indicators of the success of the program. Of 112 participants from 4 cohorts, 32 completed online questionnaires, and semi-structured interviews were successfully conducted with twelve participants, three from each of the four cohorts. The results indicated that the program’s outcomes could be categorized into five themes. Most outcomes fit into the theme ‘an increase in knowledge and skill level,’ followed by ‘rise in environmental awareness,’‘facilitation of personal growth,’ and ‘enhancement of career development.’ Many structural experiences revealed may suggest the success of the program. The longer the participants had participated in the program, the more in-depth and diversified reflection of the senior participants relating to personal development were mentioned. This study provides critical insights into the validity of retrospective program evaluation for assessing the long-term impact of EfS programs by introducing a cross-sectional study of different cohorts as a serial time-point sampling strategy. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)