Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses’ perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses’ harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for (...) all. Because of the unique link between harmony and the location of interaction, the ideal ‘workplace harmony’ threatened some nurses’ professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged. (shrink)

End-of-life issues have become an urgent problem in Japan, where people are among the longest lived in the world and most of them die while connected to high-technology medical equipment. This study examines a sensitive end-of-life ethical issue that concerns patients, families and nurses: the withdrawal of artificial food and fluid from terminally ill patients. A sample of 160 Japanese nurses, who completed a questionnaire that included forced-choice and open-ended questions, supported this act under only two specific conditions: if the (...) patient requested it, and if it relieved the patient’s suffering. They considered that the doctor’s orders, the family’s request, or the patient’s advanced age did not ethically justify this act. A small number of people who had recently lost a relative took part in semistructured interviews focusing on their experiences of their terminally ill relatives being given artificial food and fluid. Ethical, social and cultural factors surrounding this issue are discussed. (shrink)

This article, written from research data, focuses on the possible meaning of the data rather than on detailed statistical reporting. It defines whistleblowing as an act of the international nursing ethical ideal of advocacy, and places it in the larger context of professional responsibility. The experiences, actions, and ethical positions of 24 Japanese nurses regarding whistleblowing or reporting a colleague for wrongdoing provide the data. Of these respondents, similar in age, educational level and clinical experience, 10 had previously reported another (...) nurse and 12 had reported a physician for a wrongful act. These data raise questions about overt actions to expose a colleague in a culture that values group loyalty and saving face. Additional research is needed for an in-depth understanding of whistleblowing, patient advocacy and professional responsibility across cultures, especially those that value group loyalty, saving face and similar concepts to the Japanese Ishin Denshin, where the value is on implicit understanding requiring indirect communication. Usually, being direct and openly discussing sensitive topics is not valued in Japan because such behavior disrupts the most fundamental value, harmony (wa). (shrink)

This pilot study had two purposes: (1) to review recent Japanese nursing literature on nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as (...) necessary to enacting this role. Discussion on the meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex. (shrink)

This article explores the potent force of material objects in testimional culture by enacting an encounter with the ‘debris’ of a World War Two internment camp for Japanese Canadians. Pushing beyond the limits of the repetition of linear history, the article moves instead towards a phenomenological analysis of how yielding to remains of the past might allow us to reconnect with the destroyed worlds from which they were removed. Using Michel Taussig's notion of mimesis and Peggy Phelan's work on mimicry, (...) alongside Merleau‐Ponty's work on the habit‐body, this article brings into relief the neglected place of material objects collected by archives and brought to memorials in testimonial culture. (shrink)

Internet services, such as review sites, FAQ sites, online auction sites, online flea markets, and social networking services, are essential to our daily lives. Each Internet service aims to promote information exchange among people who share common interests, activities, or goods. Internet service providers aim to have users of their services actively communicate through their services. Without active interaction, the service falls into disuse. In this study, we consider that an Internet service has a network externality as its main feature, (...) and we model user behavior in the Internet service with network externality as a dynamic game. In particular, we model the diffusion process of users of an ISNE as an infinite-horizon extensive-form game of complete information in which: each user can choose whether or not to use the ISNE in her/his turn and the network effect of the ISNE depends on the history of each player’s actions. We then apply Markov perfect equilibrium to analyze how to increase the number of active users. We derive the necessary and sufficient condition under which the state in which every player is an active user is the unique Markov perfect equilibrium outcome. Moreover, we propose an incentive mechanism that enables the number of active users to increase steadily. (shrink)

The Christian philosopher Muto Kazuo contributed substantially to the predominantly Buddhist “Kyoto School of Philosophy.” Through critical exchange with its representatives, he opened up new perceptions of Christian faith, enabled mutual understanding between Buddhism and Christianity, and challenged the Western dialectical method.

Since September 11 2001 efforts have been made to articulate Asian people’s responses to the Bush war across the region, that crystallized as the formation of the Asian Peace Alliance in August 2002. But peace movement in Asia has different characteristics than its western counterparts. We in Asia have to create peace from bottom up, rather than conceive peace as a return to the statu quo ante. The Bush war has been grafted to the already peaceless structures, snaking there more (...) violent, repressive, and patriarchal. The challenge is to build Asian peace movement as a comprehensive and dynamic process of alliance building to dismantle the « nexus of evil e between the imperial machinery and the oppressive, exploitative, and militarized local structures by peaceful means. (shrink)

This article will show that lectio divina or the formative reading of Holy Scripture goes beyond exegetical-critical methods and fosters in the heart of every reader a more personal-reflective approach. This approach serves as a directive source guiding our faith and formation journey. Formative readers by definition desire to grow in spiritual self-knowledge and to allow the communications they receive to touch and transform their lives, if God so wills. Two requirements for formative reading will be explained herein: its meditative (...) or contemplative components and its applicative dimensions. Both facets of this discipline lead to a dynamic encounter with sacred words. We are to read the Bible and the literature of spirituality in such a way that the texts we imbibe will help us to tune into the inner life form or direction meant for us by God from eternity. Essential to this article is also a description of the difference between informational and formational reading. While there is a time and place for both, one way should not be substituted or forgotten in favor of the other. In short, the integration of head and heart, of inspiration and incarnation, is the hidden goal of formative reading. (shrink)

Previous research found that application of eyeshadow on the upper eyelids induces overestimation of eye size. The present study examined whether this eyeshadow illusion is dependent on or independent of viewpoint. We created a three-dimensional model of a female face and manipulated the presence/absence of eyeshadow and face orientation around the axis of yaw (Experiment 1) or pitch (Experiment 2) rotation. Using the staircase method, we measured perceived eye size for each face stimulus. Results showed that the eyeshadow illusion occurred (...) regardless of face orientation around axes of both yaw and pitch rotations. Crucially, the illusion’s magnitude did not vary across face orientations; lack of interaction between the illusion’s magnitude and face orientation was confirmed by small values of Bayes factors. These findings ruled out the hypothesis that eyeshadow serves as a depth cue and leads to overestimation of eye size due to size-distance scaling. Alternatively, the present findings suggest that the eyeshadow illusion can be well explained by the assimilation between the eyes and eyeshadow, which also facilitates assimilation between the eyes and eyebrows. Practical implications and the present findings’ generalizability are also discussed. (shrink)

The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of (...) professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice. (shrink)

When encountering a set of alternatives displayed in the form of a list, the decision maker usually determines a particular alternative, after which she stops checking the remaining ones, and chooses an alternative from those observed so far. We present a framework in which both decision problems are explicitly modeled, and axiomatically characterize a ‘divide-and-choose’ rule which unifies successive choice and satisficing choice.

Platforms for sharing genomic and phenotype data have been developed to promote genomic research, while maximizing the utility of existing datasets and minimizing the burden on participants. The value of genomic analysis of trios or family members has increased, especially in rare diseases and cancers. This article aims to argue the necessity of protection when sharing data from both patients and family members. Sharing patients’ and family members’ data collectively raises an ethical tension between the value of datasets and the (...) rights of participants, and increases the risk of re-identification. However, current data-sharing policies have no specific safeguards or provisions for familial data sharing. A quantitative survey conducted on 10,881 general adults in Japan indicated that they expected stronger protection mechanisms when their family members’ clinical and/or genomic data were shared together, as compared to when only their data were shared. A framework that respects decision-making and the right of withdrawal of participants, including family members, along with ensuring usefulness and security of data is needed. To enable this, we propose recommendations on ancillary safeguards for familial data sharing according to the stakeholders, namely, initial researchers, genomic researchers, data submitters, database operators, institutional review boards, and the public and participants. Families have played significant roles in genetic research, and its value is re-illuminated in the era of genomic medicine. It is important to make progress in data sharing while simultaneously protecting the privacy and interests of patients and families, and return its benefits to them. (shrink)

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure (...) to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights. (shrink)

Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, outcomes, and (...) results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB. (shrink)

This study examines public health nurses’ perceptions and concerns about the implications of Japan’s new long-term care insurance law concerning care provision for elderly people and their families. Respondents voiced their primary concern about this law as access to services for all elderly people needing care, and defined their major responsibility as strengthening health promotion and illness prevention programmes. Although wanting to expand their roles to meet the health care, social and public policy advocacy needs of elderly persons and their (...) families, respondents also stated their concern for the possible lack of enough resources for this expansion to support family caregivers adequately. They viewed their first function as developing collaborative relationships with local government officials to help to assure sufficient resources to provide the necessary foundation for long-term care programmes to deliver services to all those in need. These concerns fall within the larger ethical issue of distributive justice in a society based on the obligations of the state to citizens and the family to its members, especially elderly relatives, who, according to traditional Japanese values, retain respect. (shrink)