In empiricism, there are only two answers for a question: black or white. Yet, subjective meanings of human behaviours and responses toward health and illness cannot be simply explained with black and white. Gray zones are needed because they are characterized by complexity and require a contextual understanding. In this paper, we present and suggest fuzzy logic as an example of theoretical bases that help transcend the conflicts between objectivity and subjectivity, respect gray zones between black and white answers for (...) questions, and provide a contextual understanding of complex nursing phenomenon. A historical review of fuzzy logic is followed by a definition of fuzzy logic. Then, fuzzy logic is discussed in terms of its compatibility with nursing epistemological views and philosophical thoughts. Fuzzy logic agrees with three categories of epistemological views of nursing, including correspondence, coherence and pragmatism. Fuzzy logic also agrees with four major philosophical thoughts in nursing, including postempiricism, pragmatism, feminism, and postmodernism. Based on the discussion, we propose that fuzzy logic be further explored, used and developed in research and practice in the nursing areas/situations/phenomena that are characterized by complexity, ambiguousness, and vagueness. (shrink)

Design research has been positioned as an important methodological contribution of the learning sciences. Despite the publication of a handbook on the subject, the practice of design research in education remains an eclectic collection of specific approaches implemented by different researchers and research groups. In this paper, I examine the learning sciences as a design science to identify its fundamental goals, methods, affiliations, and assumptions. I argue that inherent tensions arise when attempting to practice design research as an analytic science. (...) Drawing inspiration and insight from Chinese philosophy and the practice of Chinese medicine, I propose that the learning sciences may better attain its claims to science through greater reliance on inductive synthesis rather than linear causal analysis. In so doing, I reposition the endeavor of science making within the metaphysics of process philosophy instead of classical Western philosophy. I suggest that theory building will be strengthened empirically and pragmatically by more careful observation and systematic generalization of the stability patterns of design related phenomena. It also needs to be more situated in its orientation. (shrink)

This paper asks how the intensity of individual local eParticipation affects users’ perception of democratically valuable effects. Drawing on participatory and deliberative theory literature we extract four participatory effects- internal political efficacy, common good orientation, tolerance, and legitimacy. Furthermore, the paper examines which cognitive factors may moderate the relationship between intensity of participation and perception of participatory effects. Drawing on online survey data from 670 citizens engaged in public budgeting online consultations on the local level, the conducted path analysis shows (...) that intensity of participation seems to foster the perception of common good orientation and tolerance. The other perceptions of participatory effects were not influenced by participation intensity. Findings on moderating factors indicate that the beneficial effects of online participation were not distributed unequally among participants. In conclusion, the research presents evidence for an optimistic view on local eParticipation that is able to promote democratically valuable user experiences. (shrink)

Translation of western philosophical concept into Chinese is often considered to be challenging. This is attributed to both linguistic and cultural differences. This article discusses these challenges under four categories, namely terminology, semantic understanding and context, philosophical disputes, and language reconstruction and combination. For each category, one or two examples are presented to illustrate the challenges. How each of these challenges is resolved is also discussed so as to provide the readers with some guidelines if they encounter similar challenges in (...) their work. (shrink)

Purpose This paper aims to engage with the social issues emerging from the increasing reliance upon app-driven services, as they pertain to precarious labor and ethical standpoints in a digital era. Popular ride services such as Uber have been lauded for bringing much needed transportation services that are superior to expensive taxis or unpleasant or inaccessible public transit. Design/methodology/approach As a result of over three years of ongoing research and analysis, this paper is a comprehensive assessment of a number of (...) social issues facing the integration of practices both signified and enacted in an economy driven by apps such as Uber. While these companies are indeed profitable, questions remain as to just how much of a panacea these practices actually herald. Findings Findings indicate that privatization and a lack of labor regulation may present a significant savings to the user, but full cost economics suggest that the social and environmental costs require consideration. Research limitations/implications The recommendations here refer to the ethical considerations forwarded in this paper and serve to open up dialog to further discuss the persistent issues facing a precarious future. Practical implications In terms of practical implications, there is a point of tension between governmental/regulatory bodies, disruptive innovators and users. Social implications Stakeholders of all stripes are scrambling to keep up with the pace and problematics of digital innovations and an inclusive critical dialog on app-driven services has yet to become a priority. Originality/value The original value of this analytical framework from a social justice perspective stands to catalyze action on a number of pervasive social issues surrounding digital ethics and policy. (shrink)

The conception of saviour siblings using preimplantation genetic diagnosis coupled with human leukocyte antigen typing or HLA typing alone is controversial and receives a wide divergence of legal responses among countries around the world. The resulting child conceived through this procedure is dubbed a ‘saviour sibling’ as the child can potentially act as a compatible donor for an elder ailing sibling who needs a haematopoietic stem cell transplantation. At present, the acceptability of this procedure in Malaysia is ambiguous as there (...) is no specific statute governing assisted reproductive technology, and the guideline issued by the Malaysian Medical Council does not expressly address this issue. The ethical arguments relating to the conception of saviour siblings in the current literature are mainly thought to reflect a liberal viewpoint which is predominantly Western in nature. This paper seeks to explore the perception of selected key stakeholders on the acceptability of and ethical concerns related to this procedure in the Malaysian context. The findings indicate that stakeholders generally support the conception of saviour siblings and some of their concerns echo the Western viewpoint. Interestingly, many were highly anxious about its economic implication, which is rarely discussed in the current literature on saviour siblings. (shrink)

Many current theories of human rights are flawed in that they fail to recognise differences between fundamental human rights and others of lesser significance. If some rights are superior to others than it is possible to formulate a hierarchy of rights, and rules to resolve potential conflicts of rights. Only by self-examination can we determine what is personally significant in how we live meaningful and directed lives. This in turn aids in defining social values and determining the rights individuals should (...) reasonably expect to be provided by society. (shrink)

Drama pedagogy has evolved in recent years as one the most creative and adaptable tools for engaged learning in language teaching. This paper discusses the teaching of modern Chinese play selected to be a prescribed text in pre-university Chinese literature curriculum. The play in focus is Teahouse by the renowned Chinese writer, Lao She. The study aims to pilot qualitative research through concrete individual teaching, in order to perform a preliminary classification and analysis of how teaching methods of modern plays (...) are carried out. These include the use of the Theatre in Education and Drama in Education models to conduct the teaching of modern plays. The study purported that the use of Theatre in Education and Drama in Education are methods to trigger students’ interest in learning before lessons and to carry out warm-up activities and to evaluate lesson results. These methods also aid students to familiarize the core of the original texts and use meaningful, theatrical real scenarios for the teaching of language and literature. Keywords - Education, drama pedagogy, classroom pedagogy, qualitative design, Singapore. (shrink)

The advancement of human reproductive technology has made it possible for parents with a child affected by a haematological disorder to select and bring into being, a prospective child who can act as a matched stem cell donor. This can be done through the use of preimplantation genetic diagnosis (PGD) coupled with human leukocyte antigen (HLA) typing (PGD-HLA typing), or HLA tying as a standalone procedure, where a healthy embryo, which is an HLA match to the existing sick sibling, is (...) chosen for implantation. The creation of such a sibling (saviour sibling) is normally taken as a last resort when there is no related or unrelated matched donor. While the conception of a saviour sibling may serve as a reliable and realistic treatment option for the ailing child, it also poses new moral questions that challenge a religiously pluralistic society such as Malaysia. The use of PGD-HLA typing may be controversial as it involves creating a life to save a life, selection of compatible human embryos and destruction of the unselected embryos. At present, there is no legal framework regulating the conception of saviour siblings. The development of ethically sound and appropriate local laws and policies should consider the views of religious communities, especially when it involves a controversial subject such as the conception of saviour siblings. This article seeks to explore the perceptions of religious scholars and representatives of the major religions professed and practised in Malaysia, namely Islam, Buddhism, Christianity and Hinduism, through qualitative interviews. (shrink)

In order to produce a coherent narrative, speakers must identify the characters in the tale so that listeners can figure out who is doing what to whom. This paper explores whether speakers use gesture, as well as speech, for this purpose. English speakers were shown vignettes of two stories and asked to retell the stories to an experimenter. Their speech and gestures were transcribed and coded for referent identification. A gesture was considered to identify a referent if it was produced (...) in the same location as the previous gesture for that referent. We found that speakers frequently used gesture location to identify referents. Interestingly, however, they used gesture most often to identify referents that were also uniquely specified in speech. Lexical specificity in referential expressions in speech thus appears to go hand‐in‐hand with specification in referential expressions in gesture. (shrink)

A large body of research links testosterone and cortisol to male-male competition. Yet, little work has explored acute steroid hormone responses to coalitional, physical competition during middle childhood. Here, we investigate testosterone, dehydroepiandrosterone, androstenedione, and cortisol release among ethnically Chinese boys in Hong Kong, aged 8–11 years, during a soccer match and an intrasquad soccer scrimmage, with 63 participants competing in both treatments. The soccer match and intrasquad soccer scrimmage represented out-group and in-group treatments, respectively. Results revealed that testosterone showed (...) no measurable change. DHEA increased during both treatments in the majority of participants and the degree of change had no relation to independent variables or covariate measures. Most boys experienced androstenedione increases during match play, but no significant differences during the intrasquad soccer scrimmage competitions. The magnitude of change differed significantly between treatments and was positively associated with age. These latter findings suggest boys’ androstenedione responses may be sensitive to competitor type. For most subjects, cortisol significantly increased during match play, decreased during the intrasquad soccer scrimmage, and differed significantly between treatments, suggesting each treatment promoted a different psychological state among competitors. Cortisol/DHEA molar ratio decreased during the intrasquad scrimmage, suggestive of a more relaxed mental state. These data shed new light on potential proximate mechanisms associated with coalitional competition among prepubescent boys, with relevance to adrenarche and life history theory. (shrink)

In 1990, the Federal Trade Commission (FTC) issued a consent order to the American Institute of Certified Public Accountants (AICPA). The order decreed the AICPA to lessen its longstanding ethics code which had until then banned the receipts of commissions, referral fees and contingent fees. The FTC alleged that the AICPA banned receipt of the fees as an attempt to restrain trade (FTC, 1990).In the present study, we sought to determine if CPAs'' preference for bans on commissions, referral fees and (...) contingent fees is related to their moral reasoning whereby CPAs perceive the bans to serve as a means of resolving ethical issues. While determining this matter cannot prove whether the bans did or did not actually result in restrained trade, it can offer insight into the perceived ethical importance to CPAs of the overturned rules. Based on a random sample of AICPA members and using Rest''s Defining Issues Test (DIT) to measure moral reasoning, we did not find a CPA''s moral reasoning to be related to his/her preference for ethics rules which ban commissions, referral fees or contingent fees. However, our results did indicate that most CPAs prefer banning commissions, referral fees and contingent fees, with those CPAs holding a higher financial stake in public accounting, namely partners, favoring banning referral fees and contingent fees significantly less than CPAs with a lesser stake. Further, we noted a significant negative relationship between financial stake and moral reasoning. These results seem to suggest that self-interest among CPAs may influence their moral reasoning.Further study is needed to examine the relationship between self-interest of CPAs and their moral reasoning. If self-interest clouds moral judgments made by CPAs, capital markets are in danger. Rendering an independent audit opinion must exclude self-interest. (shrink)

Rationale, aims and objectives To compare the pharmacotherapeutic approaches to diabetic hypertension of family physicians (FPs) and general practitioners (GPs). Methods A retrospective prescription-based study was conducted in 15 out of a total of 20 health centres, involving 115 primary care physicians – 77 FPs and 38 GPs, representing 74% of the primary care physicians of Bahrain. Prescriptions were collected during May and June 2000 to comprise a study population of 1266 diabetic-hypertensive patients. Results As monotherapy, angiotensin-converting enzyme (ACE) inhibitors (...) (37.9%) and β-blockers (38.3%) were the most commonly prescribed classes of antihypertensives by FPs and GPs, respectively. Calcium channel blockers (CCBs) were ranked third by both categories of physicians. For two-drug combinations, a β-blocker and an ACE inhibitor was the combination of choice for both physician categories. Patients managed by the FPs were more likely to receive a β-blocker–CCB combination (17.4 vs. 14.9%) or a diuretic–ACE inhibitor combination (16.7 vs. 11.4%) and less likely to receive a β-blocker–diuretic combination (11.8 vs. 16.7%) than those managed by the GPs. The proportion of patients receiving antihypertensive combinations was 40.6 and 38.5% for FPs and GPs, respectively. While the GPs prescribed CCB as a monotherapy to the elderly most often, the FPs choice was a β-blocker. Diuretics were less preferred by both FPs and GPs. β-Blocker–ACE inhibitor was again the most preferred combination of both FPs and GPs. FPs prescribed CCB–β-blocker combinations more often than GPs (P = 0.01), whereas CCB–ACE inhibitor combinations were less preferred (P = 0.09). A trend towards excessive use of short-acting nifedipine as monotherapy for elderly patients, both by FPs and by GPs, was noticed. Glibenclamide, alone or in combination with metformin, was the foremost antidiabetic drug prescribed by FPs and GPs. Middle-aged (45–64 years) patients seen by GPs were more likely to receive glibenclamide than those treated by FPs (P = 0.001) and less likely to receive gliclazide (P = 0.01). Combinations of a β-blocker with either glibenclamide or insulin were prescribed considerably more often by GPs.Conclusions Within the same practice setting, a substantial difference was observed between FPs and GPs in terms of preference for different classes of drugs in the management of diabetic hypertension. The compliance of both FPs and GPs was suboptimal; overall, the compliance of the FPs was closer to the recommended guidelines, however. Educational programmes should specifically address these inadequacies in order to improve the quality of health care. (shrink)

Lexical alignment, a communication phenomenon where conversational partners adapt their word choices to become more similar, plays an important role in the development of language and social communication skills. While this has been studied extensively in the conversations of preschool‐aged children and their parents in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) communities, research in other pediatric populations is sparse. This study makes significant expansions on the existing literature by focusing on alignment in naturalistic conversations of school‐aged children from a (...) non‐WEIRD population across multiple conversational tasks and with different types of adult partners. Typically developing children aged 5 to 8 years (n = 45) engaged in four semi‐structured conversations that differed by task (problem‐solving vs. play‐based) and by partner (parent vs. university student), resulting in a corpus of 180 conversations. Lexical alignment scores were calculated and compared to sham conversations, representing alignment occurring at the level of chance. Both children and adults coordinated their conversational utterances by re‐using or aligning each other's word choices. This alignment behavior persisted across conversational tasks and partners, although the degree of alignment was moderated by the conversational context. These findings suggest that lexical alignment is a robust phenomenon in conversations between school‐age children and adults. Furthermore, this study extends lexical alignment findings to a non‐WEIRD culture, suggesting that alignment may be a coordination strategy employed by adults and children across diverse linguistic and cultural backgrounds. (shrink)

This study uses three audit-specific ethical dilemmas to assess the level of ethical reasoning between Chinese accounting students (as proxies for new entrants to the auditing profession) and experienced auditors. A sample of U.S. accounting students is used as a base for comparison. Consistent with expectations based on particularly salient aspects of Chinese national culture, we find the Chinese students’ levels of ethical reasoning to be significantly lower than those of their U.S. counterparts in the two cases that invoked these (...) cultural attributes. In contrast, the Chinese students’ level of ethical reasoning is slightly higher than that of the U.S. students in the third, control case. We further find that the Chinese auditors’ levels of ethical reasoning are even lower than those of the Chinese students in two cases, while not being significantly different in the third. Together, these findings suggest that cross-national differences in auditors’ ethical reasoning depend on the nature of the ethical dilemma and caution against wholesale inferences about ethical reasoning levels in China. (shrink)

Sign languages modulate the production of signs in space and use this spatial modulation to refer back to entities—to maintain coreference. We ask here whether spatial modulation is so fundamental to language in the manual modality that it will be invented by individuals asked to create gestures on the spot. English speakers were asked to describe vignettes under 2 conditions: using gesture without speech, and using speech with spontaneous gestures. When using gesture alone, adults placed gestures for particular entities in (...) non-neutral locations and then used those locations to refer back to the entities. When using gesture plus speech, adults also produced gestures in non-neutral locations but used the locations coreferentially far less often. When gesture is forced to take on the full burden of communication, it exploits space for coreference. Coreference thus appears to be a resilient property of language, likely to emerge in communication systems no matter how simple. (shrink)