Malaysia had its first four patients with COVID-19 on 25 January 2020. In the same week, the World Health Organization declared it as a public health emergency of international concern. The pandemic has since challenged the ethics and practice of medicine. There is palpable tension from the conflict of interest between public health initiatives and individual’s rights. Ensuring equitable care and distribution of health resources for patients with and without COVID-19 is a recurring ethical challenge for clinicians. Palliative care aims (...) to mitigate suffering caused by a life-limiting illness, and this crisis has led to the awareness and urgency to ensure it reaches all who needs it. We share here the palliative care perspectives and ethical challenges during the COVID-19 pandemic in Malaysia. (shrink)

We live in an increasingly globalizing world, in which countries are closely linked by international trade and investment ties. Cross-cultural comparative studies of national values and ethics have attracted growing research interest in recent years, because shared practices, values and ethical standards depend on shared beliefs. However, the findings of such studies have been unable to reach a consensus on the impact of culture on ethics-related attitudes and behavior. Empirically, many "cross–cultural" differences reported by previous studies might actually stem from (...) cross-national differences. In order to partially fill this gap, this study advocates an analytical framework that isolates the role of cultural and national differences in order to test their relationship to individual level variables. Within this framework, we test competing hypotheses based on both cultural and national contexts by comparing groups of Chinese and American respondents together with a "bridging group" of Chinese Chinese-Americans. Theoretically, this contextual approach helps resolve the debate on the role of culture, by showing that culture plays a far more important role in shaping value orientations than the national background. Specifically, the two ethnic Chinese groups had many cultural values in common, and differed significantly from the Caucasian group. Implications are discussed. (shrink)

The counseling process involves attention, emotional perception, cognitive appraisal, and decision-making. This study aimed to investigate cognitive appraisal and the associated emotional processes when reading short therapists' statements of motivational interviewing (MI). Thirty participants with work injuries were classified into the pre-contemplation (PC,n= 15) or readiness stage of the change group (RD,n= 15). The participants viewed MI congruent (MI-C), MI incongruent (MI-INC), or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the (...) frontally oriented late positive complex (P600/LPC). The P600/LPC's amplitudes were more positive-going in the PC than in the RD group for the MI congruent statements. Within the PC group, the amplitudes of the N400 were significantly correlated (r= 0.607–0.649) with the participants' level of negative affect. Our findings suggest that the brief contents of MI statements alone can elicit late cognitive and emotional appraisal processes beyond semantic processing. (shrink)

Past research suggested that when individuals feel that it is their free choice to perform a task, they are more likely to succeed. However, little has been known about the effect of perceived choice of self-control and the psychological processes underlying the benefits of this perception in everyday contexts. To fill this gap, a 7-day experience sampling study was conducted to test whether confidence in sustaining the current self-control activity and perceived value of current self-control could mediate the link between (...) perceived choice and success in the current self-control activity. The results of multilevel analysis suggested that the perceived choice can boost self-control success by increasing expectancy and value of self-control. These findings add mechanistic understanding of the effect of perceived choice on self-control success. (shrink)

IntroductionCognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. The rate of regression varies among the six cognitive domains. Current modality of cognitive assessment using neuropsychological paper-and-pencil screening tools for cognitive impairment such as the Montreal Cognitive Assessment has limitations and is influenced by age. Virtual reality is considered as a potential alternative tool to assess cognition. A novel, fully immersive automated VR system has been developed to (...) assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system.AimsThis is a feasibility study to evaluate the VR performance of cognitively healthy adults aged between 35 and 74 years old, based on the performance score and completion time using the CAVIRE system.MethodsConducted in a public primary care clinic in Singapore, 25 multi-ethnic Asian adults were recruited in each of the four age groups in years: 35–44; 45–54; 55–64, and 65–74. The eligibility criteria included a MoCA score of 26 or higher to reflect normal cognition and understanding English instructions. They completed common daily activities ranging from brushing teething to shopping, across 13 VR segments. Their performances scores and completion time were automatically computed by the CAVIRE system. These VR performance indices were compared across the four age groups using one-way ANOVA, F-test of the hypothesis, followed by pair-wise comparisons in the event of a significant F-test.ResultsOne participant dropped out from Group 1. The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups 1 and 2 attained higher VR performance scores and shorter completion time, compared to those in Groups 3 and 4, in all six cognitive domains.ConclusionThe CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices. (shrink)

Precision medicine (PM) aims to revolutionise healthcare, but little is known about the role religion and spirituality might play in the ethical discourse about PM. This Perspective reports the outcomes of a knowledge exchange fora with religious authorities in Singapore about data sharing for PM. While the exchange did not identify any foundational religious objections to PM, ethical concerns were raised about the possibility for private industry to profiteer from social resources and the potential for genetic discrimination by private health (...) insurers. According to religious authorities in Singapore, sharing PM data with private industry will require a clear public benefit and robust data governance that incorporates principles of transparency, accountability and oversight. (shrink)

Background Healthcare professionals face a myriad of ethical challenges during the coronavirus disease 2019 pandemic. However, there is limited literature examining the ethical challenges faced by HCPs in low- and medium-income countries. The research was designed to explore the ethical challenges experienced by HCPs in a Malaysian hospital setting during the pandemic. Methods Semistructured interviews were conducted via video calls with 10 Malaysian HCPs across different clinical disciplines involved in managing patients diagnosed with COVID-19 infections. The calls were audio-recorded, transcribed (...) verbatim and checked. Thematic analysis with constant comparison across transcripts was carried out to identify categories and themes. Results Three main themes emerged. Firstly, there was deprioritisation of care for non-COVID-19 patients resulting from resource limitations. HCPs raised concerns that there was curtailed access to various healthcare services by non-COVID-19 patients. There was also a trade-off between protecting individual patient safety and public health interests. Secondly, patients were disempowered from decision-making; the decision to segregate suspected COVID-19 patients to high-risk areas without seeking patients’ approval may result in an increased risk of infection. Lastly, HCPs expressed internal conflicts when balancing the professional duty of care against concerns about contracting COVID-19 and spreading it to their family members. Conclusion The study highlighted ethical issues faced by HCPs in Malaysia during the pandemic. It underscores the need for clinical ethics consultation services in hospitals to navigate the various ethical dilemmas. (shrink)

IntroductionDuring the COVID-19 outbreak, many citizens were asked to stay at home in self-quarantine, which can pose a significant challenge with respect to remaining physically active and maintaining mental health. This study aimed to evaluate the prevalence of inadequate physical activity, anxiety, and depression and to explore the relationship of physical activity with anxiety and depression symptoms among Chinese college students during quarantine.MethodUsing a web-based cross-sectional survey, we collected data from 1,396 Chinese college students. Anxiety and depression were assessed with (...) the Self-Rating Anxiety Scale and the Self-Rating Depression Scale, respectively. The data on physical activity were collected by types of physical activity and the International Physical Activity Questionnaire.ResultsDuring the COVID-19 outbreak, about 52.3% of Chinese college students had inadequate physical activity. The rates of anxiety and depression symptoms were 31.0 and 41.8%, respectively. A high level of physical activity was significantly closely associated with low anxiety, while a moderate, or high level of physical activity was significantly closely associated with reduced depression after adjusting confounding demographic factors. Moreover, specific types of physical activity, such as stretching and resistance training, were negatively correlated with both anxiety and depression; doing household chores was negatively correlated with depression.ConclusionOur findings highlight specific levels and types of home-based physical activities that need to be taken into consideration to protect the mental health of college students during the COVID-19 epidemic. (shrink)

Facing the possibility of a surge of COVID-19-infected patients requiring ventilatory support in Intensive Care Units, the Singapore Hospice Council and the Chapter of Palliative Medicine Physicians forward its position on the guiding principles that ought to drive the allocation of ICU beds and its role in care of these patients and their families.

Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examine how distinct positive emotions are perceived and whether individuals’ perceptions are linked to how societies evaluate those emotions. Participants from Hong Kong and Netherlands rated 23 positive emotions based on their individual perceptions and societal evaluations. We found that there were cultural differences in judgments about all six aspects of positive emotions; positivity, arousal, and social engagement predicted emotions being positively (...) regarded at the societal level in both cultures; and that positivity mattered more for the Dutch participants, although arousal and social engagement mattered more in Hong Kong for societal evaluations. These findings provide a granular map of the perception and evaluation of distinct positive emotions in two cultures and highlight the role of cultures in the understanding how positive emotions are perceived and evaluated. (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

Schizophrenia is considered as a self-disorder with disordered local synchronous activation. Previous studies have reported widespread dyssynchrony of local activation in patients with SZ, which may be one of the crucial physiological mechanisms of SZ. To further verify this assumption, this work used a surface-based two-dimensional regional homogeneity approach to compare the local neural synchronous spontaneous oscillation between patients with SZ and healthy controls, instead of the volume-based regional homogeneity approach described in previous study. Ninety-seven SZ patients and 126 HC (...) were recruited to this study, and we found the SZ showed abnormal 2dReHo across the cortical surface. Specifically, at the global level, the SZ patients showed significantly reduced global 2dReHo; at the vertex level, the foci with increased 2dReHo in SZ were located in the default mode network, frontoparietal network, and limbic network ; however, foci with decreased 2dReHo were located in the somatomotor network, auditory network, and visual network. Additionally, this work found positive correlations between the 2dReHo of bilateral rectus and illness duration, as well as a significant positive correlation between the 2dReHo of right orbital inferior frontal gyrus with the negative scores of the positive and negative syndrome scale in the SZ patients. Therefore, the 2dReHo could provide some effective features contributed to explore the pathophysiology mechanism of SZ. (shrink)

Electroacupuncture (EA) and electroconvulsive therapy (ECT) are often used in the management of schizophrenia. This study sought to determine whether additional EA and ECT could augment antipsychotic response and reduce related side effects. In this retrospective controlled study, 287 hospitalized schizophrenic patients who received antipsychotics (controls, n = 50) alone or combined with EA (n = 101), ECT (n = 55) or both (EA+ECT, n = 81) were identified. EA and ECT were conducted for 5 and 3 sessions per week, (...) respectively, with a maximum of 12 sessions for ECT during hospitalization. The Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) were used to assess the severity of psychotic symptoms. Clinical response on SAPS and SANS, weight gain, and adverse events were compared. Survival analysis revealed that the ECT and EA+ECT groups had markedly greater clinical response rate than controls on SAPS [72.7% and 90.1% vs. 64.0%; relative risk (RR), 1.974 and 2.628, respectively, P ≤ 0.004] and on SANS (67.3% and 70.4% vs. 42.0%; RR, 1.951 and 2.009, respectively, P ≤ 0.015). A significantly greater response rate on SANS than controls was also observed in the EA group (64.4% versus 42.0%; RR = 1.938, P = 0.008). EA-containing regimens remarkably reduced weight gain and incidences of headache, insomnia, dry mouth, and electrocardiographic abnormalities. These results suggest that EA and ECT can serve as additional treatment for enhancing antipsychotic response and reduce the side effects in hospitalized patients with schizophrenia. (shrink)

本书分四章,包括:时代政治环境与士人心态;时代学术的发展;清代学者的反思及以礼代理的出现;儒学由内到外的转变及其影响等内容.

本书内容包括:多元论、政治合法性与政治中立性;指向规范性秩序的狭义政治概念与政治中立性、指向非常状态的政治概念与政治中心性等。.

朱熹是宋代理学的集大成者，也是成就斐然的礼学大家。他一生议礼、考礼，对礼的本质、价值、结构、功能进行了具有理学特色的阐述，对古代礼制也悉心潜玩，博考深辨，其见解多为后代礼学家所称引。朱熹礼学是其宏大的 理学体系的重要组成部分，在经学思想史上具有非常重要的地位，对宋元以降的中国乃至整个东亚社会产生了深刻的影响。本书从朱熹的三《礼》学思想入手，从学、理、用三个层面对朱熹礼学进行了系统论述，将文本分析与思 想、社会、政治的互动结合起来，考察了朱熹礼学思想形成的背景、内容及其特点。对困惑学界多年的朱熹晚年思想转型、朱熹为何要编撰《仪礼经传通解》、朱熹如何处理礼学与理学的关系等重要学术问题也作了进一步的探索 。.

Hui medicine is originated from Muslim medicine through Silk Road. This medicine is a unique Chinese traditional medicine system formed by the integration of traditional Islamic Arabia medicine and traditional Chinese medicine. This ethnic medicine is Sinicization of Islamic culture. It is also the cream of ancient Eastern and Western traditional medicine of China. Religion is very important for the Islamic faith population such as Hui nationality. Although Halal food, restaurants and schools are everywhere in Qinghai Xining city, there are (...) not reports about the medical practice in the Muslim faith population. In this article, the in-patients are from Qinghai Kangle Hospital which is Hui medicine special hospital located in Hui majorities area in Qinghai Chengdong area. The data had been collected from January 1, 2020 to June 30, 2023 of COVID-19 period. This hospital served both Muslim and non-Muslim patients, and the medical doctors nurses and staffs are also come from Muslim and non-Muslim background, the education background is Western medicine and Traditional Chinese Medicine. Our results showed that there are no significant difference between the Muslim-believers and non Muslim-believers in their medical practice. The religion may not be important among the inpatients who served with Chinese Hui Medicine in Kangle Hospital. (shrink)

Ben shu dui Luling Wang xue de yan jiu, zhu yao cong yi xia liang fang mian zhan kai: shou xian, zhong dian jie shao le ti chu Luling Wang xue de li lun yi ju he Luling Wang xue fa zhan de ge ge jie duan de jie ding, te dian ji qi zhu yao de dai biao ren wu. Qi ci, ju ti lun shu le Luling Wang xue fa zhan de ge ge jie duan de zui zhu (...) yao dai biao ren wu de zhi xue li lu, xin xue si xiang, jing xue te dian. Tong guo dui Luling Wang xue zong ti shang de yan jiu, gai kuo he zheng li yi ji dui ge ge fa zhan jie duan zhu yao de dai biao ren wu Wang xue si xiang de bu tong shi jiao de tan tao chan fa, cong zong ti shang rang shi ren jiao wei xi tong de liao jie Luling Wang xue de gai mao ji qi cao chuang, fa zhan, ding sheng ji shi wei de li shi guo cheng he zhong yao dai biao ren wu de Wang xue si xiang. Tong shi, zai qian mian yan jiu de ji chu shang, dui Luling Wang xue zai Jiang you Wang xue nai zhi Yangming hou xue fa zhan guo cheng zhong de zhong yao di wei yi ji dui zhong wan Ming ru xue si xiang fa zhan de ying xiang zuo le zong jie. (shrink)

本书是一部中国哲学研究论文集,内容分作三部分:一是“新出竹简研究”,通过出土资料与传世文献相比照,讨论经学与先秦心性论、政治观问题;二是“儒释道精神重探”,讨论先秦儒家哲学、道家哲学等;三是“现代学术 发微”,讨论近现代中国哲学问题,反思传统哲学与现代哲学、东方哲学与西方哲学的关系,探讨中国哲学在当代的重建问题。.

本书回顾社会认识论研究的发展历程和三个阶段的主要学术进展,提出并初步解决了社会认识论研究中的十个难题,预示其在21世纪的发展方向。.

本书对历史唯物主义的理论来源、形成过程、人类发展和自然界的关系,历史唯物主义的实质和基础等作了探讨。.

我們已有的知識，雖然作為學科各有領域，但並不是孤立地存在，而是互為聯繫、互為影響。這些知識的積累，會逐漸地擴大認知領域，由此及彼、由近到遠，由小到大，由現象而至規律，由規律而至本質，直至去認識終極事物 ——宇宙——世界的本質。.

感通有三層結構，依照場所論來理解，主體性中的自我關係、人我關係、天人關係是按照三方向而配置。 這三種方向彼此無法任意取代，卻仍然有相互呼應的關聯。 黃冠閔《感通與迴盪：唐君毅哲學論探》核心論題是唐君毅的感通概念，此一概念選擇考慮到「感通」是一個傳統詞彙，唐君毅有意識地取用此一概念連結上傳統思想資源，但又賦與它一些新的理解，帶入新的不同脈絡。 感通概念蘊含著動態歷程中的時間性與歷史性，一方面符合中國哲學「易」（包含《易經》、《易傳》）重視時與位的思想傳統，另一方面也能夠結合歷史與文化的思想特色，不受限在自然的層面上。 本書《感通與迴盪》嘗試的方式是從批判論與觀念論的傳統略微挪移，結合著二十世紀發展出的現象學來審視感通論；本書也努力於探測這一哲學論述的理論效果，從 「迴盪」的角度來評估。迴盪，既是拉開了距離，此即觀點挪移所產生的距離，也是時間的差異，重新安置在當代的思想氛圍中來回應。迴盪，也有一個來自音響上的效果，不是追求同聲相應，但是在異音變調中尋求一種呼應的 可能，也試著重新調音，探索創造新調性的樣貌。.

有品社會是培養出來的！ 自《黃崑巖談教養》一書出版後，黃崑巖就成了「教養的代言人」 在《黃崑巖談有品社會》，他再度從家庭教育、大學教育、醫學教育，乃至中、美、英社會及日常生活來談有教養的社會，不僅借鏡國外良好的典範，也從文化、教育制度上的不同分析國內外教養的差異，希望我國的教養水準能 更為提升 回憶錄自傳出版不久以後，聯經出版公司的發行人林載爵先生，主編林芳瑜女士聯袂來我家裡，坐在一起從南談到北，也從天談到地，當然也談到我的《談教養》，就自然觸及該書銷售的實情。林先生及林女士異口同聲地說我為 何不寫《談教養二》一書？這事就此打斷，以後沒有再提。 等他們都走了，在空蕩蕩的家中一個人想起他們的建議，這本書的概念油然浮現。說實話，龍應台女土曾經打了一通電話，告訴我我的名字和教養兩個字連在一起了。龍女士打電話來以前，胡忠信先生也在台灣的電視說，黃某某 是位醫生又是教養的教父，現在胡志強的案件爆發了，他為什麼不講話？但當時我人在美國加州，答不上話。這兩個人都配得上稱為名嘴，兩個人都提起我的名字，可見教養兩個字已經掀起了一陣風潮。 其實，有不少高中以及大一的通識課程，舉行了《談教養》讀後感的論文比賽，高雄大學工學院的黃院長還以率團來見我當作入圍的獎品哩！ 嘉義縣政府也大量訂購，為的是要送縣府同仁共讀討論。這些都促成我寫這本書，期間還蒙吳豐山先生的鼓勵，他二○○四年二月十四日曾擔任兩位總統候選人陳水扁及連戰先生的電視辯論會歷史性的協調人。 本書仍以談教養為主，但從各種角度去檢視這個社會因為不重視教養而成了什麼樣子。我自從一九八二年回台之後，一直在觀察我們的社會，思辨其變化的原因。這本書選了約二十個現象是有關我們大眾教養不足的結果，加以申 論。目的無外乎在喚起國人的注意，並加以改善。 書裡提到「知識分子」四個字，我主張我們早日迎合世界潮流而改稱「智識分子」。智識分子有異於知識分子，是前者在處裡問題時，除了要有以前強調的 IQ 之外，現代的智識分子更應具有情緒管理的要領。情緒管理就是英文的 EQ ，是做人的教育，是真正教育的精髓，也是近代教育成敗的關鍵。 但是誰的情緒需要管理？答案是誰的情緒都得管理，包括自己的以及周遭有來往的人。中國近代社會與西歐列強接觸的結果，自敗於西洋的船堅砲利，而提出了學以致用的口號，迄至近年。國內的教育長期在這種醬缸裡浸淫的結 果，產生了畸型的教育法，國人叫做「一試定江山」，求學過程伴隨著學校老師及家長的體罰與關照，很少是不痛苦的。 美國教育部也清楚這種教育法的問題，所以有一次美國教育部的官員在訪查我們醫學系的運作時，曾經公開問過：「貴國依一試定江山的考試制度而招進醫護人員，怎能確保他或她會是個好醫生？」 前台灣駐南非末代大使陸以正曾經說過，一個社會若只強調學以致用，久了，會變得膚淺並技術化，我們社會所面對的教育問題，正是價值觀與技術化的問題。所幸國內具有慧眼的教育家已看到這問題的後果而呼籲改正，品格教 育的重要性也得到了應有的重視。 是的，追根究柢，人要有品格、要有教養，社會才會有文化以及品格內涵，住在人人盡責、利他而富於正義感的社會，就能享受幸福。.

本书内容包括:中国古代生态美学思想寻踪、西方文化生态资源撷英、民族文化生态美窥视、生态美的学理研讨、生态美的实证研究。.

本书运用科学的比较方法,特别是从作为科学思想的"细胞"如宇宙、生命、系统、信息、协同、进化、循环、对称、分类等思想概念进行微观比较,识其同,辨其异,探其源,汇其流,将中西的科学思想加以梳理、贯通、交汇 、融合,以期促进世界科学思想多样统一的发展.