Objectives: To quantify the use of do-not-resuscitate orders in a tertiary-care children’s hospital and to characterise the circumstances in which such orders are written.Design: Retrospective study conducted in a 500-bed children’s hospital in Taiwan.Patients: The course of 101 patients who died between January 2002 and December 2005 was reviewed. The following data were collected: age at death, gender, disease and its status, place of death and survival. There were 59 males and 42 females with a median age of 103 months (...) . 50 children had leukaemias, and 51 had malignancies other than leukaemia. The t test and the χ2 test were applied as appropriate.Results: The study found that 44% of patient deaths occurred in the paediatric oncology ward; 29% of patient deaths occurred in the intensive care unit; and 28% of patients died in their home or at another hospital. Other findings included the following: 46 of 101 patients died after attempted cardiopulmonary resuscitation and 55 died with a DNR order in effect. The mean age at death was 9.8 years in both groups with or without DNR orders.Conclusions: From the study of patient deaths in this tertiary-care children’s hospital, it was concluded that an explicit DNR order is now the rule rather than the exception, with more DNR orders being written for patients who have been ill longer, who have solid tumours, who are not in remission and who are in the ward. (shrink)

How foreign policy embodies human values is an issue worth studying. Such a value not only refers to the interests of social and political elites but to the prevailing welfare of people. In 2016, t...

Although considerable research indicates that mental energy is an important factor in many domains, including athletic performance (Cook & Davis, 2006), athletic mental energy (AME) has never been conceptualized and measured. Therefore, the aim of this study was to conceptualize and develop a reliable and valid instrument to assess athletic mental energy. In Study 1, a focus group interview established the initial framework of athletic mental energy. Study 2 used a survey to collect athletes’ experiences of athletic mental energy and (...) develop a scale draft titled “Athletic Mental Energy Scale (AMES).” In Study 3, we examined the psychometric properties and the underlying structure of AMES via item analysis, internal consistency, and exploratory factor analysis (EFA). In Study 4, we used confirmatory factor analysis (CFA) to examine AMES’s factorial validity; and examined concurrent and discriminant validity by examining correlations with athletes’ life stress, positive state of mind, and burnout. In study 5, we examined the measurement invariance of the 6-factor, 18-item AMES with Taiwanese and Malaysian samples. Study 6 examined the predictive validity by comparing AMES scores of successful and unsuccessful martial artists. Across these phases, results showed a 6-factor, 18-item AMES had adequate content validity, factorial structure, nomological validity, discriminant validity, predictive validity, measurement invariance, and reliability. We suggest future studies may use AMES to examine its relationships with athletes’ cognition, affect, and performance. The application of AMES in sport psychology was also discussed. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

Given a Polish groupG, let$E(G)$be the right coset equivalence relation$G^{\omega }/c(G)$, where$c(G)$is the group of all convergent sequences inG. The connected component of the identity of a Polish groupGis denoted by$G_0$.Let$G,H$be locally compact abelian Polish groups. If$E(G)\leq _B E(H)$, then there is a continuous homomorphism$S:G_0\rightarrow H_0$such that$\ker (S)$is non-archimedean. The converse is also true whenGis connected and compact.For$n\in {\mathbb {N}}^+$, the partially ordered set$P(\omega )/\mbox {Fin}$can be embedded into Borel equivalence relations between$E({\mathbb {R}}^n)$and$E({\mathbb {T}}^n)$.

The fundamental tenet of contemporary sociobiology, namely the assumption of a single process of evolution involving the selection of genes, is critically examined. An alternative multiple-level, multiple-process model of evolution is presented which posits that the primary process that operates via selection upon the genes cannot account for certain kinds of biological phenomena, especially complex, learned, social behaviours. The primary process has evolved subsidiary evolutionary levels and processes that act to bridge the gap between genes and these complex behaviours. The (...) subsidiary levels are development, individual animal learning, and socioculture itself. It is argued that individual learning is pivotal to the derivation and biological analysis of culture. The differences between cultural and noncultural societies are stressed. It is concluded that such a multiple-level model of evolution can form the basis for reconciling opposing sides in the sociobiology debate. (shrink)

In this book Professor Baldry describes this development from Homer to Cicero when, although the traditional divisions and prejudices still remained string, the ...