1. Kwangja chŏngsin e kwanhan kich'ojŏk ihae -- 2. Yuga ŭi kwanggyŏn'gwan -- 3. Toga ŭi kwangŏn kwa kwangja chŏngsin -- 4. Ŭmju munhwa wa Wi-Chin ŭi imt'anjŏk kwang -- 5. Songdae ihakchadŭl ŭi kwangjagwan -- 6. Yangmyŏnghak ŭi kwanggyŏn'gwan -- 7. Chosŏnjo yuhakchadŭl ŭi kwanggyŏn'gwan -- 8. Chosŏnjo yuhakcha ŭi yokki yŏnggwi ihae -- 9. Sŏhwa tot'ongnon kwa kwanggyŏn esŏ chunghaeng ŭro -- 10. Kwanggyŏn mihak ŭi munyejŏk chŏgyong -- 11. Chungguk hoehwa e nat'anan kwanggyŏn mihak -- 12. Chungguk (...) sŏye e nat'anan kwanggyŏn mihak -- 13. Chosŏnjo hoehwa e nat'anan kwanggyŏn mihak -- 14. Chosŏnjo sŏye ŭi kwanggyŏn mihak. (shrink)

어떤 만남은 운명이다! 조선시대 전방위 지식인 다산 정약용, 그의 가르침을 따라 평생을 산 단 한 사람, 황상 "부지런하고 부지런하고 부지런하라" "학생은 있지만 제자는 없다"는 탄식의 소리가 높아지고 있다. 존경과 사랑이라는 단어가 무색하게 진정한 스승도 진정한 제자도 드문 요즈음이다. 정민 교수에 의해 200년 전 다산 정약용과 그의 제자 황상 사이에 이어진 도탑고 신실한 사제 간의 정리가 울림이 커다란 의미로 되살아난다.

che 1-pu. Nolli -- che 2-pu. Kachʻi tʻamgu.

BackgroundThe COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations.MethodsThis study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided (...) informed consent and completed measures that assessed utilitarian moral views, cognitive reflections, cognitive reappraisal, and moral judgment.ResultsThe healthcare-affiliated students who scored higher on the instrumental harm subscale in the measurement of utilitarian moral views were more likely to endorse not only other-sacrificial actions but also self-sacrificial ones for the greater good in moral dilemma scenarios. In particular, those engaged in deliberative processes tended to make more self-sacrificial judgments. The mediation analysis also revealed that the effect of deliberative processes on self-sacrificial judgments was mediated by cognitive reappraisal.ConclusionsThese findings suggested that cognitive reappraisal through deliberative processes is involved when the students with utilitarian inclination make prosocial decisions, that it is necessary to consider both moral views and emotional regulation when admitting candidates, and that moral education programs are needed in the healthcare field. (shrink)

Does the Ship of Theseus present a genuine puzzle about persistence due to conflicting intuitions based on “continuity of form” and “continuity of matter” pulling in opposite directions? Philosophers are divided. Some claim that it presents a genuine puzzle but disagree over whether there is a solution. Others claim that there is no puzzle at all since the case has an obvious solution. To assess these proposals, we conducted a cross-cultural study involving nearly 3,000 people across twenty-two countries, speaking eighteen (...) different languages. Our results speak against the proposal that there is no puzzle at all and against the proposal that there is a puzzle but one that has no solution. Our results suggest that there are two criteria—“continuity of form” and “continuity of matter”— that constitute our concept of persistence and these two criteria receive different weightings in settling matters concerning persistence. (shrink)

The purpose of this study was to investigate the role of perceived vulnerability to disease, emotions (disgust, anger), and perceived norms in predicting moral judgments of anti-COVID-19-preventive behaviors in US and Japan. A total of 442 Japanese and 365 American participants completed an online survey. Disgust and anger mediated the link between perceived vulnerability to disease (germ aversion) and moral judgments of preventive behaviors across both cultures. Perceived social norms among friends and family were associated with harsh judgments of anti-preventive (...) behaviors for Japanese but not for American participants. Overall, our results suggest that effective strategies for promoting preventive behaviors may be culturally valid if they focus on the fear for infectious disease and related aversive affect. We also discussed the possibility that some strategies could be characteristic of collectivistic cultures, warranting further cross-cultural comparisons. (shrink)

SignificanceElectrical burns can cause severe damage to the nervous system, resulting in autonomic dysfunction with reduced cerebral perfusion. However, few studies have investigated these consequences.AimTo elucidate changes in prefrontal cerebral hemodynamics using functional near-infrared spectroscopy (fNIRS) during the head-up tilt table test (HUT) for patients with electrical burns.ApproachWe recruited 17 patients with acute electrical burns within 1 week after their accidents and 10 healthy volunteers. The NIRS parameters acquired using an fNIRS device attached to the forehead were analyzed in five (...) distinct HUT phases.ResultsBased on their HUT response patterns, patients with electrical burns were classified into the group with abnormal HUT results (APG, n = 4) or normal HUT results (NPG, n = 13) and compared with the healthy control (HC, n = 10) participants. We found trends in hemodynamic changes during the HUT that distinguished HC, NPG, and APG. Reduced cerebral perfusion and decreased blood oxygenation during the HUT were found in both the NPG and APG groups. Patients with electrical burns had autonomic dysfunction compared to the HC participants.ConclusionsUsing fNIRS, we observed that acute-stage electrical burn injuries could affect cerebral perfusion. (shrink)

Chinese mind-body exercises are positively associated with executive function, but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through (...) June 2020. Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment and with or without chronic diseases were included. A total of 29 studies ultimately were included in this study. The results indicated that CMBEs improved overall EF, as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type, frequency of group classes, session time, total training time, and length of the CMBEs, in addition to that more frequent participation in both group classes and home practice sessions resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age, sex, and cognitive statuses, health status, as well as training mode and study language. This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

As documented by Darwin 150 years ago, emotion expressed in human faces readily draws our attention and promotes sympathetic emotional reactions. How do such reactions to the expression of emotion affect our goal-directed actions? Despite the substantial advance made in the neural mechanisms of both cognitive control and emotional processing, it is not yet known well how these two systems interact. Here, we studied how emotion expressed in human faces influences cognitive control of conflict processing, spatial selective attention and inhibitory (...) control in particular, using the Eriksen flanker paradigm. In this task, participants viewed displays of a central target face flanked by peripheral faces and were asked to judge the gender of the target face; task-irrelevant emotion expressions were embedded in the target face, the flanking faces, or both. We also monitored how emotion expression affects gender judgment performance while varying the relative timing between the target and flanker faces. As previously reported, we found robust gender congruency effects, namely slower responses to the target faces whose gender was incongruent with that of the flanker faces, when the flankers preceded the target by 0.1 s. When the flankers further advanced the target by 0.3 s, however, the congruency effect vanished in most of the viewing conditions, except for when emotion was expressed only in the flanking faces or when congruent emotion was expressed in the target and flanking faces. These results suggest that emotional saliency can prolong a substantial degree of conflict by diverting bottom-up attention away from the target, and that inhibitory control on task-irrelevant information from flanking stimuli is deterred by the emotional congruency between target and flanking stimuli. (shrink)

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice and protocol compliance in clinical research. However, they are laborious, time consuming, and require expertise. Therefore, we developed a simple auditing process and (...) evaluated its feasibility and effectiveness. The screening audit was developed using a routine audit checklist based on the Severance Hospital’s Human Research Protection Program policies and procedures. The measure includes 20 questions, and results are summarized in five categories of audit findings. We analyzed 462 studies that were reviewed by the Severance Hospital Human Research Protection Center between 2013 and 2017. We retrospectively analyzed research characteristics, reply rate, audit findings, associated factors and post-screening audit compliance, etc. Investigator reply rates gradually increased, except for the first year. The studies were graded as “critical,” “major,” “minor,” and “not a finding”, based on findings and number of deficiencies. The auditors’ decisions showed fair agreement with weighted kappa values of 0.316, 0.339, and 0.373. Low-risk level studies, single center studies, and non-phase clinical research showed more prevalent frequencies of being “major” or “critical”. Inappropriateness of documents, failure to obtain informed consent, inappropriateness of informed consent process, and failure to protect participants’ personal information were associated with higher audit grade. We were able to observe critical GCP violations in the routine internal audit results of post-screening audit compliance checks in “non-responding” and “critical” studies upon applying the screening audit. Our screening audit is a simple and effective way to assess overall GCP compliance by institutions and to ensure medical ethics. The tool also provides useful selection criteria for conducting routine audits. (shrink)