Background: Frailty is a common syndrome among older adults and patients with several comorbidities. Grip strength is a representative parameter of frailty because it is a valid indicator of current and long-term physical conditions in the general population and patients with severe mental illnesses. Physical and cognitive capacities of people with SMIs are usually impaired; however, their relationship with frailty or social functioning have not been studied to date. The current study aimed to determine if GS is a valid predictor (...) of changes in cognitive performance and social functioning in patients with type-2 diabetes mellitus and SMIs. Methods: Assessments of social functioning, cognitive performance, and GS were conducted in 30 outpatients with type 2 diabetes mellitus, 35 with major depressive disorder, 42 with bipolar disorder, 30 with schizophrenia, and 28 healthy controls, twice during 1-year, follow-up period. Descriptive analyses were conducted using a one-way analysis of variance for continuous variables and the chi-squared test for categorical variables. Differences between groups for the motor, cognitive, and social variables at T1 and T2 were assessed using a one-way analysis of covariance, with sex and age as co-variates. To test the predictive capacity of GS at baseline to explain the variance in cognitive performance and social functioning at T2, a linear regression analysis was performed. Results: Predictive relationships were found among GS when implicated with clinical, cognitive, and social variables. These relationships explained changes in cognitive performance after one year of follow-up; the variability percentage was 67.7%, in patients with type-2 diabetes mellitus and 89.1% in patients with schizophrenia. Baseline GS along with other variables, also predicted changes in social functioning in major depressive disorder, bipolar disorder, and schizophrenia, with variability percentages of 67.3, 36, and 59%, respectively. Conclusion: GS combined with other variables significantly predicted changes in cognitive performance and social functioning in people with SMIs or type-2 diabetes mellitus. Interventions aimed to improve the overall physical conditions of patients who have poor GS could be a therapeutic option that confers positive effects on cognitive performance and social functioning. (shrink)

Objective: To explore the relationship between the presentation of suffering and support for euthanasia in the British news media.Method: Data was retrieved by searching the British newspaper database LexisNexis from 1996 to 2000. Twenty-nine articles covering three cases of family assisted suicide were found. Presentations of suffering were analysed employing Heidegger’s distinction between technological ordering and poetic revealing.Findings: With few exceptions, the press constructed the complex terrain of FAS as an orderly or orderable performance. This was enabled by containing the (...) contradictions of FAS through a number of journalistic strategies: treating degenerative dying as an aberrant condition, smoothing over botched attempts, locating the object of ethical evaluation in persons, not contexts, abbreviating the decision making process, constructing community consensus and marginalising opposing views.Conclusion: The findings of this study support the view that news reporting of FAS is not neutral or inconsequential. In particular, those reports presenting FAS as an orderly, rational performance were biased in favor of technical solutions by way of the legalisation of euthanasia and/or the involvement of medical professionals. In contrast, while news reports sensitive to contradiction did not necessarily oppose euthanasia, they were less inclined to overtly support technical solutions, recognising the importance of a trial to address the complexity of FAS. (shrink)

Objective: Cognitive impairment is a common neurological complication in patients with end-stage renal disease undergoing maintenance hemodialysis. Brain network analysis based on graph theory is a promising tool for studying CI. Therefore, the purpose of this study was to analyze the changes of functional brain networks in patients on MHD with and without CI by using graph theory and further explore the underlying neuropathological mechanism of CI in these patients.Methods: A total of 39 patients on MHD and 25 healthy controls (...) matched for age, sex, and years of education were enrolled in the study. Resting-state functional magnetic resonance imaging and T1-weighted high-resolution anatomical data were obtained, and functional brain networks for each subject were constructed. The brain network parameters at the global and regional levels were calculated, and a one-way analysis of covariance was used to compare the differences across the three groups. The associations between the changed graph-theory parameters and cognitive function scores in patients on MHD were evaluated using Spearman correlation analysis.Results: Compared with HCs, the global parameters [sigma, gamma, and local efficiency ] in both patient groups decreased significantly. The clustering coefficient in patients with CI was significantly lower than that in the other two groups. The regional parameters were significantly lower in the right superior frontal gyrus, dorsolateral and gyrus rectus of patients with CI than those of patients without CI; however the nodal local efficiency in the left amygdala was significantly increased. The global Cp and regional parameters in the three brain regions were significantly correlated with the cognitive function scores.Conclusion: This study confirmed that the topology of the functional brain network was disrupted in patients on MHD with and without CI and the disruption of brain network was more severe in patients with CI. The abnormal brain network parameters are closely related to cognitive function in patients on MHD. (shrink)

BackgroundAt present, adherence to antipsychotic treatment is often poor, leading to the recurrence of symptoms. This increases the likelihood of the patient experiencing disability and thus increases the disease burden for the patient, their family, and society as a whole. However, to date, there is no clear evidence regarding the effect of medication adherence interventions on outcomes for patients with schizophrenia. Moreover, the traditional intervention methods are limited by manpower and resources in low- and middle-income countries. Recent studies have demonstrated (...) that increasing a patient’s level of self-compassion may improve their treatment adherence. Online mental health care interventions have advantages in terms of feasibility and acceptability for patients with schizophrenia. In this regard, a WeChat-based self-compassion training protocol to improve patient treatment adherence was designed in this study and will be evaluated in the future to determine its impact on patients with schizophrenia.MethodsThe protocol for the randomized controlled trial is based on the SPIRIT 2013 statement. This parallel RCT will aim to recruit 392 patients with schizophrenia who will be randomized at a 1:1 ratio into a 3-week intervention or control group. Both groups will receive routine care. The intervention group will also receive WeChat-based self-compassion training, which requires participants to complete three tasks every day, including a reading task, a meditation task, and a self-compassion journal task. The control group will receive WeChat-based psychological health education, which will only require participants to read positive articles about psychological health every day. Medication adherence, self-compassion, stigma, and social support will be measured at baseline, immediately after the intervention, and 3 weeks after the intervention. Program feasibility will be evaluated throughout the course of the study, and acceptability will be measured immediately after the intervention.Expected results:The intervention described here will address the barriers to accessing mental health care for people with schizophrenia, including patients’ desire for independent management, difficulty accessing providers, and concerns about privacy and stigma. The current study provides guidance for clinical nurses to carry out psychological intervention, with the ultimate aim of addressing the problems associated with a shortage of psychological professionals in low- and middle-income countries. (shrink)

La revolución darwiniana, lejos de ser algo ya superado, como a veces se pretende, aún no ha concluido del todo. Y no ha concluido porque todavía nos falta una adecuada explicación darwinista de uno de los aspectos fundamentales de los seres vivos. Tenemos explicaciones darwinistas de cientos, quizás de miles de rasgos adaptativos, pero aún no contamos con una explicación bien establecida del origen y desarrollo evolutivo de las capacidades cognitivas en aquellos seres vivos que las poseen, y muy en (...) particular del origen y desarrollo evolutivo de la mente humana. Este libro analiza las principales hipótesis que han elaborado los científicos al respecto e intenta obtener algunas conclusiones filosóficas relevantes a partir ellas y de los datos sobre las que se sustentan. Antonio Diéguez es catedrático de Lógica y Filosofía de la Ciencia en la Universidad de Málaga. Sus líneas principales de investigación son la epistemología evolucionista y el realismo científico. Entre sus publicaciones destacan los siguientes libros: la teoría de las ciencias morales en John Stuart Mill (1988), Realismo científico (1998) y Filosofía de la Ciencia (2005), publicado este último por Biblioteca Nueva. (shrink)

In der Zeit nach K. C. F. Krauses Tod wurde in der Philosophie darum gerungen, die umwalzende Kraft des deutschen Idealismus zeitgemass zu retten. In diesem Zusammenhang spielte Krause eine wichtige Rolle. Sein System wurde verstarkt rezipiert - in Lehrbuchern, in Ruges, Schweglers und Noacks Jahrbuchern, aber auch beispielsweise in I. H. Fichtes Zeitschrift fur Philosophie. Weiterhin aufschlussreich fur die Wirkung Krauses ist die von Urena beleuchtete Krause'sche Position zum Deutschkatholizismus im Gegensatz etwa zu Gervinus, Bayrhoffer oder Vischer. Uberdies zeigt (...) der Band die Rezeption der Krause'schen Staatslehre in der Tubinger Volkswirtschaftslehre auf. Schliesslich zeigt Urena, inwiefern sich Krause als einer der ersten fur die Gleichberechtigung der Frau eingesetzt hat - sowohl in der Theorie als auch in der Praxis. Das Buch zeichnet eine beeindruckende Wirkungsgeschichte nach, wodurch Krauses Einfluss auf die Philosophie des 19. Jahrhunderts deutlich wird. (shrink)

In der Zeit nach K. C. F. Krauses Tod (1832) wurde in der Philosophie darum gerungen, die umwalzende Kraft des deutschen Idealismus zeitgemass zu retten. In diesem Zusammenhang spielte Krause eine wichtige Rolle. Sein System wurde verstarkt rezipiert - in Lehrbuchern, in Ruges, Schweglers und Noacks Jahrbuchern, aber auch beispielsweise in I. H. Fichtes Zeitschrift fur Philosophie. Weiterhin aufschlussreich fur die Wirkung Krauses ist die von Urena beleuchtete Krause'sche Position zum Deutschkatholizismus im Gegensatz etwa zu Gervinus, Bayrhoffer oder Vischer. Uberdies (...) zeigt der Band die Rezeption der Krause'schen Staatslehre in der Tubinger Volkswirtschaftslehre auf. Schliesslich zeigt Urena, inwiefern sich Krause als einer der ersten fur die Gleichberechtigung der Frau eingesetzt hat - sowohl in der Theorie als auch in der Praxis. Das Buch zeichnet eine beeindruckende Wirkungsgeschichte nach, wodurch Krauses Einfluss auf die Philosophie des 19. Jahrhunderts deutlich wird. (shrink)

This essay addresses feminist approaches to medical aid in dying (MAID), considering whether it is a practice that should be supported for women and other marginalized groups. Some feminists have raised rights and justice-based arguments in support of MAID; others have taken a care-based approach to suggest that the practice violates relationships of care and only worsens distrust between marginalized groups and the medical establishment. I argue that we need to adopt both justice and care approaches to develop a robust (...) feminist account of MAID. I defend a woman’s right to choose death in cases of terminal illness or suffering but argue that relational concerns of care, trust, and trustworthiness must be addressed at the same time to ensure that MAID is justly practiced and accessible to all those who want it. (shrink)

A positive connection has been established between personality traits and suicidal ideation. However, the possible mediation of resilience within this association has never been thoroughly discussed. In this study, we aimed to investigate this topic by using population-based cross-sectional survey data of 4,489 Chinese children and adolescents. A self-administered questionnaire was used to collect information from the participants. Univariate and multivariate logistic regression models were adopted to measure the crude and adjusted associations between personality traits, SI, and resilience. Path analysis (...) was performed to evaluate the mediation of resilience in the association between personality traits and SI. For 4,489 study subjects, the mean age was 13.4 years, ethnic minorities accounted for 71.8%, and over a half were middle school students. The reported prevalence rates for 1-week, 1-year, and lifetime SI were 27.6%, 35.5%, and 56.7%, respectively. Girls reported a significantly higher prevalence of SI than boys. Path analysis results revealed a prominent mediation of resilience; moreover, for different dimensions of personality traits, the proportion of mediation by resilience varied. Our major findings suggest that resilience-based intervention measures could be considered in preventing personality traits related to suicidal risk among youngsters. For children and adolescents, the measuring of personality dimensions may also be helpful in targeting key subpopulations of intervention priority. (shrink)

PurposeTo examine the influence of family functioning on college students’ loneliness and the mediating effects of core self-evaluation and problematic mobile phone use.MethodsFamily Function Scale, Core Self-evaluation Scale, Problem Mobile Phone Use Scale, and Loneliness Scale were used to investigate 8,524 college students.Results Family functioning positively predicted core self-evaluation and negatively predicted loneliness ; Core self-evaluation negatively predicted problematic mobile phone use and loneliness ; Problematic mobile phone use significantly positively predicted loneliness ; Core self-evaluation and problematic mobile phone use (...) showed a significant chain-mediation effect between family functioning and loneliness.ConclusionThe results are helpful to comprehend the producing mechanism of loneliness and provide a theoretical basis for the intervention of loneliness. (shrink)

The chronic worldwide lack of organs for transplantation and the continuing improvement of strategies for in situ organ preservation have led to renewed interest in elective non-therapeutic ventilation of potential organ donors. Two types of situation may be eligible for elective intensive care: patients definitely evolving towards brain death and patients suitable as controlled non-heart beating organ donors after life-supporting therapies have been assessed as futile and withdrawn. Assessment of the ethical acceptability and the risks of these strategies is essential. (...) We here offer such an ethical assessment using the four principles of medical ethics of Beauchamp and Childress applying them in their broadest sense so as to include patients and their families, their caregivers, other potential recipients of intensive care, and indeed society as a whole. The main ethical problems emerging are the definition of beneficence for the potential organ donor, the dilemma between the duty to respect a dying patient's autonomy and the duty not to harm him/her, and the possible psychological and social harm for families, caregivers other potential recipients of therapeutic intensive care, and society more generally. Caution is expressed about the ethical acceptability of elective non-therapeutic ventilation, along with some proposals for precautionary measures to be taken if it is to be implemented. (shrink)

I argue that despite criticism from some disability rights organizations, aid in dying is morally permissible. First, I suggest that disability-related concerns can be classified as emerging from one of two kinds of harm: person affecting, and personhood affecting. Second, I examine whether person affecting harm has occurred within those jurisdictions that have legalized aid in dying. I conclude that despite suggestions to the contrary, there is no evidence to demonstrate that people with disabilities have been adversely impacted by legalized (...) medical aid in dying. Third, I entertain these same arguments as a matter of principle and conclude the principled objections should not give us reason for concern. Fourth, I explore whether we have evidence to suggest the presence of increased personhood affecting harm where aid in dying is permissible. I suggest, through a focus on disability support services, that no evidence of social attitudes that diminish the moral worth of disabled people is present. Fifth, I examine whether we ought to have a principled concern with personhood affecting harm emerging from medical aid in dying. I conclude that to the contrary, to deny people with disabilities access to aid in dying constitutes a morally egregious form of personhood affecting harm. (shrink)

Objective: To explore the experiences of people with a “terminal illness”, focusing on the patients’ perspective of euthanasia and assisted suicide.Method: A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a “terminal” illness, malignant or non-malignant.Results: That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly (...) by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse.Conclusion: Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death. (shrink)

Green innovation has been attracting much attention from academia and practice, but the influence of religion as an important informal institutional factor has not been fully investigated in existing studies. Taking Chinese listed companies from 2008 to 2019 as a sample, this study attempts to examine the relationship between religious atmosphere and corporate green innovation performance. The empirical results indicate that a religious atmosphere (Buddhism and Taoism as a whole) can significantly improve corporate green innovation performance, particularly high-quality green innovation. (...) The positive association between religion and green innovation performance is attenuated by pervasive formal institutions (i.e., environmental regulation), indicating that there is a substitutive effect between religion and formal institutions. We also find that Taoism mainly supports these results, while Buddhism has a limited impact, showing that there is a heterogeneous effect between different religions. We further find that the positive impact of religious atmosphere on green innovation performance is more pronounced in low-governance enterprises and low-polluting industries. This study contributes to research on the antecedents of corporate green innovation and the consequence of religion, which is of great significance to the value of religion in business practice. (shrink)

In his Vita Galbae Suetonius informs us that after Gaius' assassination Galba was urged by some to attempt to seize power but declined to do so. Consequently he was much favoured by Claudius, and held in such high regard that when Galba was smitten by a sudden, though mild, illness, the emperor postponed the expedition launched against Britain in A.D. 43: ‘ut cum subita ei [sc.Galbae] valetudo nee adeo gravis incidisset, dilatus sit expeditionis Britannicae dies’. The reference to the (...) postponement is clear and unequivocal, and contains nothing scurrilous or titillating that might have persuaded Suetonius to fabricate it. It does not, accordingly, seem unreasonable that modern commentators should, on the basis of this passage, record that Galba was present in Britain in A.D. 43. (shrink)