ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic (...) models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)

The core aims of the Global Health Impact Project include incentivizing pharmaceutical companies for socially conscious production and promoting socially conscious consumption among consumers. Its backbone is a metric that computes the amount of illness burden alleviated by a pharmaceutical drug. This essay aims to assess the connection between values and numbers in the Global Health Impact Project. Specifically, I concentrate on two issues, the anonymity of illness burden and the distribution of health benefits. The former issue asks whether we (...) should treat the illness burden of every person the same. The latter issue asks among whom health benefits should be fairly distributed. Examination of these issues begs for clarification of some of the key concepts of the Global Health Impact Project, such as the definition of essential medicines and the significance of national borders. Although this essay focuses on the two particular metric issues in the Global Health Impact Project, its core argument is applicable to other metrics for ethically motivated initiatives—to construct a metric for an ethically motivated initiative, it is not only important to articulate underlying concepts and values, but it is also important to operationalize them, so they are consistently reflected in the metric. (shrink)

Tracheostomy with invasive ventilation may be required for the survival of patients at advanced stages of amyotrophic lateral sclerosis. In Japan it has been shown that a proactive approach toward TIV may prolong the survival of ALS patients by over 10 years by preventing the lethal respiratory failure that generally occurs within 3-5 years of the onset of the disease. Measures to prolong life expectancy without foregoing quality of life have produced better results in Japan than in other developed countries. (...) This ‘Japanese bias’ has been attributed to socio-cultural and religious factors as well as to the availability of material resources in Japan. In this article, we use the concepts of onozukara in kadō and amae to illuminate features of patient care that may contribute to this ‘Japanese bias’. (shrink)

Lysosomal positioning is an important factor in regulating cellular responses, including autophagy. Because proteins encoded by disease‐responsible genes are involved in lysosomal trafficking, proper intracellular lysosomal trafficking is thought to be essential for cellular homeostasis. In the past few years, the mechanisms of lysosomal trafficking have been elucidated with a focus on adapter proteins linking motor proteins to lysosomes. Here, we outline recent findings on the mechanisms of lysosomal trafficking by focusing on adapter protein c‐Jun NH2‐terminal kinase‐interacting protein (JIP) 4, (...) which plays a central role in this process, and other JIP4 functions and JIP family proteins. Additionally, we discuss neuronal diseases associated with aberrance in the JIP family protein. Accumulating evidence suggests that chemical manipulation of lysosomal positioning may be a therapeutic approach for these neuronal diseases. (shrink)

This meta-analysis synthesizes quantitative findings of the gender differences in moral sensitivity retrieved from 19 primary studies. We found the average effect size of 0.25, favoring women, with a standard deviation of 0.14. The variation in the observed effect sizes could not be attributed to differences in participants' educational level, the utilized measure of moral sensitivity, or the publication format in which the study was reported. This suggests that gender differences in moral sensitivity are consistent across different levels of participants' (...) education regardless of the instrument used to assess moral sensitivity or the format in which the research was reported. (shrink)

This paper provides a detailed comparison between discourse representation theory and dependent type semantics, two frameworks for discourse semantics. Although it is often stated that DRT and those frameworks based on dependent types are mutually exchangeable, we argue that they differ with respect to variable handling, more specifically, how substitution and other operations on variables are defined. This manifests itself in two recalcitrant problems posed for DRT; namely, the overwrite problem and the duplication problem. We will see that these problems (...) still pose a challenge for various extended compositional systems based on DRT, while they do not arise in a framework of DTS where substitution and other operations are defined in the standard type-theoretic manner without stipulating any additional constraints. We also compare the notions of contexts underlying these two kinds of frameworks, namely, contexts represented as assignment functions and contexts represented as proof terms, and see what different predictions they make for some linguistic examples. (shrink)

Proteins on the cell surface and secreted proteins are modified with sugar chains that generate and modulate biological complexity and diversity. Sugar chains not only contribute physically to the conformation and solubility of proteins, but also exert various functions via sugar-binding proteins that reside on the cell surface or in organelles of the secretory pathway. However, some glycosidases and lectins are found in the cytosol or nucleus. Recent studies of cytosolic sugar–related molecules have revealed that sugar chains on proteins in (...) the cytosol act as signals of adverse cellular conditions. In this review, we summarize recent reports that cytosolic sugar chains can trigger ubiquitination, followed by proteasomal and autophagic degradation to maintain cellular homeostasis. In addition, we discuss the functions of sugar-binding proteins revealed to date, along with possibilities not yet explored. The cytosolic N-glycans that normally reside on the cell surface or in organelles serves as a signal for the presence of unwanted proteins or organelles. Here, we review the monitoring system for cytosolic glycans including glycosidases and lectin in the cytosol. (shrink)

The history of the documentation of health inequality is long. The way in which health inequality has customarily been documented is by comparing differences in the average health across groups, for example, by sex or gender, income, education, occupation, or geographic region. In the controversial World Health Report 2000, researchers at the World Health Organization criticized this traditional practice and proposed to measure health inequality across individuals irrespective of individuals’ group affiliation. They defended its proposal on the moral grounds without (...) clear explanation. In this paper I ask: is health inequality across individuals of moral concern, and, if so, why? Clarification of these questions is crucial for meaningful interpretation of health inequality measured across individuals. Only if there was something morally problematic in health inequality across individuals, its reduction would be good news. Specifically, in this paper I provide three arguments for the moral significance of health inequality across individuals: (a) health is special, (b) health equity plays an important and unique role in the general pursuit of justice, and (c) health inequality is an indicator of general injustice in society. I then discuss three key questions to examine the validity of these arguments: (i) how special is health?, (ii) how good is health as an indicator?, and (iii) what do we mean by injustice? I conclude that health inequality across individuals is of moral interest with the arguments (b) and (c). (shrink)

ABSTRACTExperiences that contradict one's core concepts elicit intense emotions. Such schema incongruence can elicit awe, wherein experiences that are too vast...

The promised open space of cyber-interaction has its dark side hidden behind its brilliant rhetoric. The danger emerges within the very center of developing this technology (cyber-evolution). That is a more fundamental danger than this dark side seems to have. The possible replacement of our primary reality with virtual reality might erode the significance of our existential reality. This means also that the virtual reality might lose its own ground to be constructed. In order to clarify this fundamental problem at (...) issue I show some results from a questionnaire done on younger generation. The results seem to suggest possible way of facing this problem. (shrink)

Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical scenario. We conducted two 2-h Fairness (...) Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed that personal choice played an important role in participants’ thinking about health. Underlying the concept of personal choice was considerations of freedom and societal debt. In participants’ minds, personal and social responsibilities co-existed and they were unwilling to determine health care priority based on personal responsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons’ views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited. (shrink)

BackgroundHealthcare professionals use the ethics of justice and care to construct moral reasoning. These ethics are conflicting in nature; different value systems and orders of justice and care are applied to the cause of actual moral conflict. We aim to clarify the structure and factors of healthcare professionals’ moral conflicts through the lens of justice and care to obtain suggestions for conflict resolutions.MethodSemi-structured interviews about experiences of moral conflict were conducted with Japanese nurses recruited using the snowball sampling method. Interviews (...) were conducted based on the real-life moral conflict and choice interview. Interviews were recorded and transcribed verbatim, then analyzed based on the interpretive method of data analysis. Verbatim transcripts were read four times, first to get an overall sense of the conflict, then to understand the person’s thoughts and actions that explain the conflict, and third and fourth to identify perspectives of justice and care, respectively. Each moral perspective was classified into categories according to Chally’s taxonomy.ResultsAmong 31 responses, 2 that did not mention moral conflict were excluded, leaving 29 responses that were analyzed. These responses were classified into six cases with conflict between both justice and care perspectives or within one perspective, and into two cases without conflict between perspectives. The “rules” category of justice and the “welfare of others” category of care were included in many cases of conflict between two perspectives, and they frequently occurred in each perspective.ConclusionsThe nurses in this study suggest that they make moral judgments based on moral values that are intertwined with justice and care perspectives complex manner.Organizational, professional, and patient-related factors influenced conflicts between justice and care. Additionally, multiple overlapping loyalties created conflicts within justice perspectives, and multifaceted aspects of care-provider’s responsibility and patient need created conflicts within care. Decision-making biased towards one perspective can be distorted. It is important to consider ethical issues from both perspectives to resolve conflicts, especially the effective use of the ethics of care is recommended. (shrink)

Previous research has associated social marginalization with the rejection of mainstream cultural values. Since cultural values reflect affect valuation, the present research investigates the relationships between social marginalization and ideal/actual affect in two different non-WEIRD cultures, Brazil and Japan. As a social marginalization index, we used the NEET-Hikikomori Risk Scale. We predicted that cultural differences would emerge in the valuation of affective states. Affect valuation theory suggests that in East Asia, individuals are encouraged to pursue and value low arousal positive (...) emotions over high arousal positive emotions as they can harm social relationships in these societies. In contrast, Latin American cultures value HAP over LAP, because social relationships are promoted through vibrant positive emotional expression in these cultures. Hence, we hypothesized that individuals’ ideal affect, actual affect, and the discrepancy between ideal and actual affect would be associated with higher risk of social marginalization. Participants from Japan and Brazil reported their ideal affect and actual affect and completed the NEET-Hikikomori Risk Scale. Regression analyses showed that actual HAP and the discrepancy between ideal and actual HAP were negatively associated with NHR in Brazil, but no association was found in the Japanese data. The other variables, including ideal affect, were only minorly or not significantly associated with NHR. Though the study has limitations regarding its small sample size, we can explore future perspectives and discuss the relationships between emotion and cultural marginalization. Socioecological factors that promote actual HAP in Brazilians may encourage other mainstream cultural ideals, which buffers against cultural marginalization. (shrink)

Health inequalities are of concern both becausestudying them may help one learn how to improvehealth and because health inequalities may beunjust. This paper argues that attending tothese reasons why health inequalities may beimportant undercuts the claims of researchersat the World Health Organization in favor offocusing on individual health variation ratherthan on social group health differences. Inequalities in individual health are of littleinterest unless one goes on to study how theyare related to other factors.

This study explores the clusters of work–family balance among Japanese middle-aged and older adults and clarifies the characteristics of the derived clusters. Data on working adults were drawn from a pool of participants in the National Institute for Longevity Sciences—Longitudinal Study of Aging. The WFB scale consists of subscales assessing work–family conflict and work–family facilitation. First, a cluster analysis was performed using the WFB scale, and four clusters were extracted. Second, we examined associations between the four clusters and related variables (...) such as demographic characteristics, work, family, and lifestyle factors, social support, and mental health. Our findings showed that the clusters included high-WFC/high-WFF, high-WFC/low-WFF, low-WFC/high-WFF, and low-WFC/low-WFF. Differences were found in related variables among the clusters. Specifically, those in the Low-WFC/High-WFF cluster had a good lifestyle, received the highest levels of social support, and had the fewest mental health issues. Our findings have implications for maintaining sufficient WFB and promoting positive mental health among workers. (shrink)

Definitions of terms that are central to a theoretical understanding of the Royal Government of Bhutan's policy of Gross National Happiness.

In this article we present a parameterized model for generating multimodal behavior based on cultural heuristics. To this end, a multimodal corpus analysis of human interactions in two cultures serves as the empirical basis for the modeling endeavor. Integrating the results from this empirical study with a well-established theory of cultural dimensions, it becomes feasible to generate culture-specific multimodal behavior in embodied agents by giving evidence for the cultural background of the agent. Two sample applications are presented that make use (...) of the model and are designed to be applied in the area of coaching intercultural communication. (shrink)

Background This paper examines the degree of agreement among simple dichotomous self-report, validated screening results, and biochemical screening results of prenatal alcohol and other drug use among pregnant women. Method Secondary analysis was conducted on a cohort of pregnant women 16 years or older, presenting for prenatal care in the greater Cape Town, South Africa. Dichotomous verbal screening is a standard of care, and pregnant patients reporting alcohol and other drug use in dichotomous verbal screenings were asked to engage in (...) screening using the Alcohol Smoking and Substance Involvement Screening Test and urinalysis. Results Significant agreements between dichotomous and ASSIST scores were observed. A higher rate of self-reported alcohol use was detected, relative to urine screening with a predictive value of 34.9; while underreporting of illicit substance use was observed with an overall predictive value of 50.0. Conclusion Dichotomous verbal screening was considered valid after comparison with the ASSIST; however, combined use with urine screenings can be recommended especially for identifying illicit substance use in order to accurately detect alcohol and other drug use in pregnancy, so that women can be identified and referred for appropriate interventions where needed. (shrink)

Emotion suppression has been found to have negative psychological and social consequences in Western cultural contexts. Yet, in some other cultural contexts, emotion suppression is less likely to have negative consequences; relatedly, emotion suppression is also more common in those East-Asian cultural contexts. In a dyadic conflict study, we aim to conceptually replicate cultural differences found in previous research with respect to the prevalence and consequences of emotion suppression,and extend previous research by testing whether cultural differences are larger for some (...) than for other types of negative emotions. We postulate that cultural differences in suppression are less pronounced for socially engaging emotions than socially disengaging emotions, because the former foster the relationship, whereas the latter emphasize individual goals. Belgian and Japanese couples engaged in a 10-min conflict interaction followed by video-mediated recall, during which participants rated their emotions and emotion suppression every 30 s. As predicted, Japanese participants reported more suppression than their Belgian counterparts, but the cultural difference was more pronounced when participants experienced more socially disengaging emotions than when they experienced more socially engaging emotions. These results suggest that the type of emotion should be considered when describing cultural differences in emotion suppression. Finally, and consistent with previous research, emotion suppression was negatively associated with interaction outcomes in Belgian couples, but not in Japanese couples. (shrink)

A key issue in social intelligence design is the realization of artifacts that can fluently communicate with people. Thus, we proposed a two-layered approach to enhance a robot’s capacity of involvement and engagement. The upper layer flexibly controls social interaction by dynamic Bayesian networks (DBN) representing social interaction patterns. The lower layer improves the robustness of the system by detecting rhythmic and repetitive gestures. We designed a listener robot that can follow and record humans’ explanation on how to assemble and/or (...) disassemble a bicycle. The implementation of this system is described by assembling the key algorithms presented in this paper. (shrink)

The tenth volume of the Frontiers of Japanese Philosophy focuses on the theme of “transition,” dealing with transitory and intermediary phenomena and practices such as translation, transmission, and transformation. Written in English, German and Japanese, the contributions explore a wide range of topics, crossing disciplinary borders between phenomenology, linguistics, feminism, epistemology, aesthetics, political history, martial arts, spiritual practice and anthropology, and bringing Japanese philosophy into cross-cultural dialogue with other philosophical traditions. As exercises in “thinking in transition,” the essays reveal novel (...) modes of doing philosophy as a way of boundary crossing that takes transition not only as an object of inquiry, but also as a method of philosophical practice itself. (shrink)

ABSTRACTIt has been widely believed that individuals transform high-intensity shame into anger because shame is unbearably painful. This phenomenon was first coined “humiliated fury,” and it has since received empirical support. The current research tests the novel hypothesis that shame-related anger is not universal, yet hinges on the cultural meanings of anger and shame. Two studies compared the occurrence of shame-related anger in North American cultural contexts to its occurrence in Japanese contexts. In a daily-diary study, participants rated anger and (...) shame feelings during shame situations that occurred over one week. In a vignette study, participants rated anger and shame in response to standardised shame vignettes that were generated in previous research by either U.S. or Japanese respondents. Across the two studies, and in line with previous research on humiliated fury, shame predicted anger for U.S. parti... (shrink)

How should we measure medicines’ global health impact to set targets, monitor performance and improve health around the world? Can such a metric provide a philosophically well-grounded basis for an ethical consumption campaign that will create incentives for pharmaceutical companies and other agents to expand (equitable) access to essential medicines? And if such metrics exist, how should we think about our individual obligations to support ethical consumption campaigns on this basis? This paper reflects on these questions in light of Tim (...) Campbell’s, Yukiko Asada’s, and Andreas Albertsen’s worries about the answers I provide in Global Health Impact: Extending Access on Essential Medicines. I explain how reflecting on treatments consequences for individuals’ ability to live minimally well supports the creation of the Global Health Impact (GHI) index (https://global-health-impact.org/). I also consider how the index might be modified to better support efforts to promote everyone’s human rights. Finally, I argue that individuals should often promote positive change through GHI and other ethical consumption campaigns. (shrink)

Why should we care about global health? What obligations do we have to improve global health? How can we work towards establishing a health industry that is better equipped to deal with the most significant global health challenges? In her impressive and ambitious book, Global Health Impact: Extending Access to Essential Medicine (Hassoun, 2020), Nicole Hassoun attempts to answer these questions, by drawing on contemporary research in political philosophy, global justice, health economics and business ethics. In this symposium, Timothy Campbell, (...) Yukiko Asada and Andreas Albertsen explore three dimensions of Hassoun’s proposal: the relation between measuring global health impact and conceptions of the minimally good life, different metrics used to measure the global health burden and democratic consumption and social justice. In a response paper, Hassoun responds to the critical remarks.In her book, Hassoun presents a theoretical framework that explains why we ought to care about global health, develops a way of measuring the global health impact of health technologies and argues that individuals should be guided by this in their consumption. The book presents an ambitious proposal for how one in a very practical way can use the measuring tool in order to promote global health by labeling and certifying different market products so that consumers and investors get incentivizing information that can change their behavior in a way that promotes global health. (shrink)