With more countries implementing Open Notes, the practice of providing patients with unhindered access to their clinical visit notes, research on this practice is finally increasing. Many studies report positive findings, especially around self-reported outcomes, such as feeling more in control of one’s care, increased medication adherence and a strengthened patient–doctor relationship. 1 However, comparatively less research has been done on the potential ramifications that may also arise from Open Notes. Blease’s recent article underscores this and demonstrates why Open Notes (...) must also be considered in terms of nocebo effects, negative side effects that arise from negative expectations. 2 The article presents a compelling and well-thought-out argument for how nocebo effects may vary across different populations by linking patient–clinician communication inequalities with and by presenting preliminary evidence of nocebo effects. Blease’s argument does not detract from Open Notes, but rather takes a balanced approach by imploring us... (shrink)

As the world’s most populous country, China is experiencing unprecedented magnitude and speed of population ageing since it entered the ageing society two decades ago. The rapid population ageing- driven by decreasing fertility rate and prolonged life expectancy- has profound impacts on economic development and poses significant challenges for formal and informal care provision. Although the Chinese government has implemented a series of progressive policy reforms on pension, healthcare, and long-term care systems, the capacity gaps regarding the coverage, adequacy, affordability, (...) and sustainability remain large. At the same time, social and economic changes have eroded the supportive role of family, especially for rural-dwelling, childless, and empty-nest older adults. This chapter documents the statistical and social reality of ageing in China, introduces a series of policy reforms implemented by the Chinese government in response to population ageing, and describes the family dynamics and intergenerational support patterns under the changing socioeconomic background. Besides pressing challenges of ageing for family and society, this chapter also looks at the emerging lifestyle and proactivity for active ageing in China. (shrink)

The appearance of mass media and a versatile medium of videos can serve the convenience and instructive information for children; on the other hand, it could abet them in implicit image consumption. Now is the time for kids' to be in need of thinking power which enables them to make a choice, applications andcriticism of information within such visual cultures. In spite of these social changes, the realities are that our curriculum still doesn't meet a learner's demand properly. This research, (...) in this context, is aimed at looking out on the currently implemented art appreciation learning process in a critical fashion, and also aimed at suggesting a plan for visual culture learning by applying the philosophy program for kids as a new alternative. The purpose of such education is toenhance the capability to solve a variety of problems they are facing in the course of daily life by reflecting their matter of concern in a curriculum. What we have to pay attention to in visual culture learning is 'visual literacy.' Such an interpretative faculty of a critical reading of images is a must especially when kids should make a judgment of value hidden in images in their daily events, make an analysis of an ideological message and make an information-oriented decision. Therefore, learners have to enrich their higher-order thinking power as well as critical thinking faculty in modern society. If there is no objection to these social surroundings, it is quite natural that philosophy education, which forms a base of a higher-order thinking for children should be handled significantly at school. (shrink)

Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; (...) and factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the stress of the COVID-19 pandemic, 12.3% of frontline healthcare workers in general hospitals reported having mental distress and perceived lower social adaptation status compared with those working in psychiatric hospitals. Christians/Catholics perceived better psychological well-being, and Buddhists/Taoists were less likely to experience mental distress. The results at 6 weeks of follow-up showed that the perceived lower social adaptation status of general hospital healthcare workers was temporary and improved with time. Christian/Catholic religion and time had independent positive effects on psychological well-being; however, the interaction of Christian/Catholic religion and time had a negative effect.Conclusions: Collectivism and individualism in the cultural context are discussed with regard to alexithymic trait and Buddhist/Taoist and Christian/Catholic religious faiths. Early identification of mental distress and interventions should be implemented to ensure a healthy and robust clinical workforce for the treatment and control of the COVID-19 pandemic. (shrink)

Research from cognitive science and geoscience education has shown that sketching can improve spatial thinking skills and facilitate solving spatially complex problems. Yet sketching is rarely implemented in introductory geosciences courses, due to time needed to grade sketches and lack of materials that incorporate cognitive science research. Here, we report a design-centered, collaborative effort, between geoscientists, cognitive scientists, and artificial intelligence researchers, to characterize spatial learning challenges in geoscience and to design sketch activities that use a sketch-understanding program, CogSketch. We (...) developed 26 CogSketch worksheets that use cognitive science–based principles to scaffold problem solving of spatially complex geoscience problems and report observations of an implementation in an introductory geoscience course where students used CogSketch or human-graded paper worksheets. Overall, this research highlights the principles of interdisciplinary design between cognitive scientists, geoscientists, and AI researchers that can inform the collaborative design process for others aiming to develop effective educational materials. (shrink)

The salience of social risks and the incidence of various crises in China have induced widespread concerns among urban residents. Encountering frequent risks places higher demands on the cognition of urban residents. The concept of safety cognition capability is defined within the context of urban residents' daily life, and measurement instruments are developed and tested to lay the foundation for grasping the current safety cognition capability of urban residents and conducting further research. In this study, the five-dimensional structure of urban (...) residents' safety cognition capability was proposed by using the grounded theory method to sort out the interview transcript of interviews with 30 urban residents, and a 38-item URSCC scale was designed and used for surveys conducted in China. The results show that the scale can be used as a valid tool to measure the URSCC, and it can help city managers to better understand the safety needs of residents, as well as monitor the effectiveness of policy implementation. (shrink)

Based on their framework, Müller & Schumann (M&S) propose a staged drug policy that matches well the neoliberal governance scheme. To mend the sad loss of the sociocultural dimension in their model, I propose three such considerations: first, sociocultural interactions with the brain; second, sociocultural context and justice of drug use; and third, sociocultural preparedness for implementing their drug policy.

Classification and gradation system adopts different security protection schemes for different types of data by implementing classification and gradation management of data, which is an important pretechnical means for data security protection and prevention of data leakage. This paper introduces artificial intelligence classification, machine learning, and other means to learn and train enterprise documents according to the characteristics of enterprise sensitive data. The generated training model can intelligently identify and classify file streams, improving work efficiency and accuracy of classification and (...) gradation. At the same time, the differences, advantages, and disadvantages of K-NN, DT, and LinearSVC algorithms are compared. The experimental data shows that LinearSVC algorithm is applicable to high-dimensional data, with discrete, sparse data features and large number of features, which is more suitable for classification of sensitive data of enterprises. (shrink)

The Hygiene Hypothesis has been recognized as an important cornerstone to explain the sudden increase in the prevalence of asthma and allergic diseases in modernized culture. The recent epidemic of allergic diseases is in contrast with the gradual implementation of Homo sapiens sapiens to the present-day forms of civilization. This civilization forms a gradual process with cumulative effects on the human immune system, which co-developed with parasitic and commensal Helminths. The clinical manifestation of this epidemic, however, became only visible (...) in the second half of the twentieth century. In order to explain these clinical effects in terms of the underlying IgE-mediated reactions to innocuous environmental antigens, the low biodiversity of antigens in the domestic environment plays a pivotal role. The skewing of antigen exposure as a cumulative effect of reducing biodiversity in the immediate human environment as well as in changing food habits, provides a sufficient and parsimonious explanation for the rise in allergic diseases in a highly developed and helminth-free modernized culture. Socio-economic tendencies that incline towards a further reduction of environmental biodiversity may provide serious concern for future health. This article explains that the “Hygiene Hypothesis”, the “Old Friends Hypothesis”, and the “Skewed Antigen Exposure Hypothesis” are required to more fully explain the rise of allergy in modern societies. (shrink)

This paper investigates the impact of diversity on corporate philanthropy. Compared to previous studies that have considered the influence of board diversity and CEO gender on corporate philanthropy, this study introduces the concept of operational diversity, which is the implementation of diversity programs at management, employee, and supply chain levels, and further, it explains why operational diversity influences corporate philanthropy, by using the premises of resource dependence theory. Second, this study also investigates the influence of board diversity on corporate (...) philanthropy. Third, this study uses a large sample of U.S. firms over the period of 1991–2009 and tries to mitigate possible omitted variables and endogeneity problems that are often overlooked in previous research. We demonstrate that firms with operational diversity programs are likely more dependent on a broad variety of resources and give more to community as a strategic maneuver; hence, operational diversity is a better indicator for predicting future corporate giving than board diversity alone. However, having a woman or a member of a minority as a company’s chief executive officer is not sufficient to impact its charitable giving. A battery of robustness tests support our conclusion and confirm that our results are not driven by a firm’s general corporate social responsibility (CSR) score, gender or independence of board members, or firm ownership. This paper will assist researchers, practitioners, and other stakeholders in deepening their understanding of the predictors of corporate giving. (shrink)

Peer assessment is employed as one fundamental practice of classroom-based assessment in terms of its learning-oriented and formative nature. The exercise of peer assessment has multiple and additional benefits for student learning. However, research into the learning processes in peer assessment is scarce both in theory and in practice, making it difficult to evaluate and pinpoint its value as a tool in assessment as learning. This study focuses both on the learning process and outcome through assessment activities. We set out (...) with three goals in mind: to examine students' assessment performance in context, to evaluate its impact on student progress, and to illuminate teachers on organizing assessment activities. Three specific research questions are answered in this study: How do student raters perform in the process of PA in an advanced English class? To what extent do assessment activities influence the students' speaking ability? What are students' perceptions of PA regarding its benefits and caveats? A total of 29 undergraduate students participated in two assessment activities on argumentative speaking. Many-Facet Rasch Model analysis was conducted to measure the rater effects both at the group level and the individual level. Bias/interaction analyses were performed to diagnose rater behavior in different contexts including the rating session, speaking session, and peer assessment vs. self-assessment. Questionnaire and semi-structured interview data were also collected to explore factors and strategies that could interfere with PA as AaL. Results show that students exhibited stable rating behavior and made progress in argumentative speaking in all dimensions, including delivery, organization, and language use. They are more stringent with themselves than with peers although there is one rare case with a bias against peers. Participants acknowledged the benefits of PA but also shared reasonable concerns in practice. This study validated the feasibility and the effectiveness of PA for student learning. Discussion on findings and guidelines for effective implementation of PA as AaL are provided. (shrink)

Visual programming language is a crucial part of learning programming. On this basis, it is essential to use visual programming to lower the learning threshold for students to learn about artificial intelligence to meet current demands in higher education. Therefore, a 3-h AI course with an RGB-to-HSL learning task was implemented; the results of which were used to analyze university students from two different disciplines. Valid data were collected for 65 students in the Science -student group and 39 students in (...) the Humanities -student group. Independent sample t-tests were conducted to analyze the difference between cognitive styles and computational thinking. No significant differences in either cognitive style or computational thinking ability were found after the AI course, indicating that taking visual AI courses lowers the learning threshold for students and makes it possible for them to take more difficult AI courses, which in turn effectively helping them acquire AI knowledge, which is crucial for cultivating talent in the field of AI. (shrink)

Functional near-infrared spectroscopy has attracted increasing attention in the field of brain–computer interfaces owing to their advantages such as non-invasiveness, user safety, affordability, and portability. However, fNIRS signals are highly subject-specific and have low test-retest reliability. Therefore, individual calibration sessions need to be employed before each use of fNIRS-based BCI to achieve a sufficiently high performance for practical BCI applications. In this study, we propose a novel deep convolutional neural network -based approach for implementing a subject-independent fNIRS-based BCI. A total (...) of 18 participants performed the fNIRS-based BCI experiments, where the main goal of the experiments was to distinguish a mental arithmetic task from an idle state task. Leave-one-subject-out cross-validation was employed to evaluate the average classification accuracy of the proposed subject-independent fNIRS-based BCI. As a result, the average classification accuracy of the proposed method was reported to be 71.20 ± 8.74%, which was higher than the threshold accuracy for effective BCI communication as well as that obtained using conventional shrinkage linear discriminant analysis. To achieve a classification accuracy comparable to that of the proposed subject-independent fNIRS-based BCI, 24 training trials were necessary for the traditional subject-dependent fNIRS-based BCI. It is expected that our CNN-based approach would reduce the necessity of long-term individual calibration sessions, thereby enhancing the practicality of fNIRS-based BCIs significantly. (shrink)

With an estimated 12.1% of children aged 2–5 years already obese, prevention efforts must target our youngest children. One of the best places to reach young children for such efforts is the early care and education setting. More than 11 million U.S. children spend an average of 30 hours per week in ECE facilities. Increased attention at the national, state, and community level on the ECE setting for early obesity prevention efforts has sparked a range of innovative efforts. To assist (...) these efforts, CDC developed a technical assistance and training framework – the Spectrum of Opportunities for Obesity Prevention in the ECE setting – which also served as the organizing framework for the Weight of the Nation ECE track. Participants highlighted their efforts at national, state, and local levels pursuing opportunities on the Spectrum, the standards and best practices that had been the emphasis of their efforts, and common steps for developing, implementing, and evaluating initiatives. Strong leadership and collaboration among a broad group of stakeholders; systematic assessment of needs, opportunities and resources; funding sources; and training and professional development were reported to be integral for successful implementation of standards and best practices, and sustainability. (shrink)

The concept of work engagement has aroused the interest of many scholars. However, there has been limited academic research in examining how authentic leadership can influence WE, which consequently influences organizational citizenship behavior and task performance. In particular, this study divides WE into cognitive engagement, emotional engagement, and physical engagement to fully reflect the engagement theory. This study introduces three dimensions of WE and tests the theoretical model to validate cognitive engagement, emotional engagement, and physical engagement. Empirical testing using a (...) survey of 151 employees of retail travel agencies in Taiwan revealed that the AL can influence cognitive engagement, emotional engagement, and physical engagement, and also OCB and TP. These analysis results can assist vendors to implement OCB and TP through WE and AL. (shrink)

Attending cram school has long been a trend in ethnic Chinese culture areas, including Taiwan. Despite the fact that school reform policies have been implemented in Taiwan, cram schools have continued to prosper. Therefore, in this educational culture, how to achieve a good educational effect is also a topic worthy of discussion. However, whether students really engage in those tutoring programs provided by cram schools has seldom been studied. To address this gap, this study explored how parents’ hovering attitude toward (...) life and coursework influences their children’s engagement in cram schools. This study targeted those students who attend English cram schools to test the correlates between two types of helicopter parenting, tutoring engagement and continued attendance at cram schools. A total of 320 questionnaires were sent out, and 300 were returned, giving an overall response rate of 93.75%. Excluding seven incomplete or invalid questionnaires, 293 valid questionnaires were received. The results of this study show that hovering behavior awareness is negatively related to cram school engagement, whereas cram school engagement is positively related to the intention to continue attending cram school. Moreover, the results imply that parents should alleviate their helicoptering behavior to enhance their children’s engagement in cram school tutoring programs. (shrink)

Learning disabilities are highly prevalent on college campuses, yet students with learning disabilities graduate at lower rates than those without disabilities. Academic and psychosocial supports are essential for overcoming challenges and for improving postsecondary educational opportunities for students with learning disabilities. A holistic, multi-level model of campus-based supports was established to facilitate culture and practice changes at the institutional level, while concurrently bolstering mentors’ abilities to provide learning disability-knowledgeable support, and simultaneously creating opportunities for students’ personal and interpersonal development. Mixed (...) methods were used to investigate implementation of coordinated personal, interpersonal, and institutional level supports for undergraduate science, technology, engineering, and math (STEM) students with learning disabilities. A one-group pre-test post-test strategy was used to examine undergraduate outcomes. Participants included 52 STEM undergraduates with learning disabilities, 57 STEM graduate student mentors, 34 STEM faculty mentors, and 34 university administrators and personnel as members of a university-wide council. Enrolled for two years, undergraduates were engaged in group meetings involving psychoeducation and reflective discussions, development of self-advocacy projects, and individual mentorship. Undergraduates reported improved self efficacy (p =.001), campus connection (p <.001), professional development (p ≤.002), and self advocacy (p <.001) after two academic years. Graduate student mentors increased their understanding about learning disabilities and used their understanding to support both their mentees and other students they worked with. Council members identified and created opportunities for delivering learning disability-related trainings to faculty, mentors and advisors on campus, and for enhancing coordination of student services related to learning and related disorders. Disability-focused activities became integrated in broader campus activities regarding diversity. This research explicates a role that college campuses can play in fostering the wellbeing and the academic and career development of its students with developmental learning and related disorders. It offers an empirically tested campus-based model that is multilevel, holistic, and strengths-based for supporting positive outcomes of young people with learning disabilities in STEM. Moreover, findings advance the knowledge of supports and skills that are important for self-regulating and navigating complex and multi-faceted disability-related challenges within both the post-secondary educational environment and the young adults’ sociocultural context. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Background There is a high incidence of burns in China and the sequelae of post-burn scar growth, disfigurement, and other body image disorders can cause serious psychological distress to burns patients, and negatively affecting the patient’s dignity. However, there is limited knowledge relating to the dignity of burns patients. Aim To investigate the factors that affect dignity in burns patients. Design Cross-sectional study. Participants and research context We recruited 323 burn patients from the burn unit of a tertiary care hospital. (...) The Patient Dignity Scale, Burn Specific Health Scale-Brief, Hospital Anxiety and Depression Scale were used to assess burn patients’ dignity, quality of life, anxiety, and depression, respectively. 18 sociodemographic variables were included in the questionnaire. Ethical considerations Before the data were collected, the study protocol was reviewed and approved by the Ethics Committee of the Guangzhou Red Cross Hospital of Jinan University (Reference: 2022-149-02) and all patients provided and signed informed consent forms. Findings This study included 323 burns patients; of these, 26 (8%) had a mild loss of dignity, 94 (29.1%) had a moderate loss of dignity, 125 (38.7%) had a severe loss of dignity, and 78 (24.1%) had a very severe loss of dignity. The main factors that influence the loss of dignity in burns patients, including the department in which the patient was treated after their burns, gender, the clinical stage of the burn, quality-of-life, depression, resident medical insurance, the cause of the burn, and the burn site. Conclusions In most cases, the loss of dignity after burn injury is serious. Clinical health care professionals can provide personalized whole-life dignity care for patients by considering the factors that affect the dignity of burns patients, developing targeted dignity management programs, and implementing individualized interventions to maintain dignity, thus helping burns injury patients return to social life and work. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

This study attempts to examine the direct impact of corporate social responsibility initiatives on employees’ job performance and the indirect relationships between CSR initiatives on employees’ job performance via industrial relations climate and psychological contract fulfillment. Data were collected from 764 supervisor–subordinate dyads and 271 middle managers from 85 companies. Using a multilevel approach, the results showed that organizational-level CSR was positively related to employees’ job performance. Moreover, the industrial relations climate and psychological contract fulfillment played mediating effects between CSR (...) initiatives and job performance. This study provides novel theoretical evidence for why and how CSR initiatives improve job performance. Theoretical and practical implications for implementing CSR initiatives are discussed. (shrink)

Modern education attaches great importance to interdisciplinary skills, among which computational thinking is a core element, and heralds a new era. IT application has shaped education in the 21st century. Computational thinking has provided further impetus for building an all-encompassing social network and fostering a DIY culture enabled by digital technologies. One empirical study used four apps to test children's development in computational thinking and fluency. The article will help students overcome their fears of coding. Peer reviews provide students with (...) an opportunity to learn from each other and become more motivated. These reviews also serve as feedback for teachers to evaluate students' performance. Experimental design is used in this study, and a peer review system is implemented. Freshmen attending a programming class in a university are used as samples. At the class, students write computer programs with f-Chart, which provides a graphical user interface for students to learn programming logic and design. Zuvio, a cloud-based interactive response system, is used to conduct the peer reviews. The data of this study are analyzed through R. The results show not only an improvement in students' learning performance but also a gap between students' peer review scores and teachers' evaluation scores. Learning feedback and evaluation is crucial to transform education between students and teachers into a sustainable cycle system. (shrink)

Photovoltaic power forecasting can provide strong support for the safe operation of the power system. Existing forecasting methods are ineffective for grid scheduling decisions or risk analysis. The novel multicluster interval prediction method is proposed to consider the volatility and randomness of PV power output. First, this method utilizes the sparse autoencoder and Bayesian regularized NARX network for point forecasting of PV power. Second, density peak clustering improved by kernel Mahalanobis distance is applied to classify the dataset into multiple clusters, (...) including forecasting error and meteorological factors. Finally, the joint probability density is established by multivariate kernel density estimation to accomplish the PV power interval prediction. The proposed hybrid method is applied for the interval prediction of PV power at Yulara, Australia. Comparative research of point forecasting is implemented to evaluate the machine learning and deep learning methods, with the proposed SAE-BRNARX under four different periods. Results shows that the average values of nRMSE, MRE, nMAE, and R2 for the four periods are 4.45%, 0.90%, −0.15%, 3.39%, and 95.93%, respectively. Moreover, the results of interval prediction obtained by the other interval prediction approaches are compared with the proposed KMDDPC-MKDE. It shows that the average values of PICP, PINAW, ACE, and nMPICD for four periods are 93.93%, 9.50%, 3.93%, and 7.10% at 90% confidence level, respectively. Outcomes demonstrate that the proposed method can obtain more accuracy, a higher coverage rate, narrower average bandwidth, and a closer distance between the middle of interval and actual value than other methods. (shrink)

BackgroundThe biopharmaceutical industry operates at the intersection of life sciences, clinical research, clinical care, public health, and business, which presents distinct operational and ethical challenges. This setting merits focused bioethics consideration to complement legal compliance and business ethics efforts. However, bioethics as applied to a biopharmaceutical industry setting often is construed either too broadly or too narrowly with little examination of its proper scope.Main textAny institution with a scientific or healthcare mission should engage bioethics norms to navigate ethical issues that (...) arise from the conduct of biomedical research, delivery of clinical care, or implementation of public health programs. It is reasonable to assume that while bioethics norms must remain constant, their application will vary depending on the characteristics of a given setting. Context “specification” substantively refines ethics norms for a particular discipline or setting and is an expected, needed and progressive ethical activity. In order for this activity to be meaningful, the scope for bioethics application and the relevant contextual factors of the setting need to be delineated and appreciated. This paper defines biopharmaceutical bioethics as: the application of bioethics norms (concepts, principles, and rules) to the research, development, supply, commercialization, and clinical use of biopharmaceutical healthcare products. It provides commentary on this definition, and presents five contextual factors that need to be considered when applying bioethics norms to a biopharmaceutical industry setting: (1) dual missions; (2) timely and pragmatic guidance; (3) resource stewardship; (4) multiple stakeholders; and (5) operational complexity.ConclusionUnderstanding the scope of the biopharmaceutical enterprise and contextual factors of a biopharmaceutical industry setting is foundational for the application of bioethics norms. Establishing a common language and approach for biopharmaceutical bioethics will facilitate breadth and depth of discussion and subsequent implementation to benefit patients, the healthcare system and society. (shrink)

This paper examines the institutional mechanisms supporting the ethical oversight of human participant research conducted by the United Nations (UN). The UN has served an instrumental role in shaping international standards on research ethics, which invariably require ethical oversight of all research studies with human participants. The authors’ experiences of conducting research collaboratively with UN agencies, in contrast, have led to concern that the UN frequently sponsors, or participates in, studies with human participants that have not received appropriate ethical oversight. (...) It is argued that the institutional mechanisms in place to prevent research with human participants from being undertaken by the UN without ethical oversight do not, at present, extend substantively beyond the provision of guidelines and online training offered by a minority of UN bodies. The WHO and UNICEF are identified as notable exceptions, having implemented various measures to prevent health research with human participants from being undertaken without ethical oversight. Yet, it is highlighted that the WHO and UNICEF are not the only UN bodies that undertake health research with human participants and there are countless actors under the umbrella of the UN system that are regularly involved in non-health research with human participants. Arguments for the pursuit of the highest standard of ethical oversight by UN bodies are presented. Moving forward, the paper asks the question: is it time for the UN to set the standards for the oversight of ethical oversight? (shrink)

Although emerging evidence has implicated structural/functional abnormalities of patients with Autism Spectrum Disorder, definitive neuroimaging markers remain obscured due to inconsistent or incompatible findings, especially for structural imaging. Furthermore, brain differences defined by statistical analysis are difficult to implement individual prediction. The present study has employed the machine learning techniques under the unified framework in neuroimaging to identify the neuroimaging markers of patients with ASD and distinguish them from typically developing controls. To enhance the interpretability of the machine learning model, (...) the study has processed three levels of assessments including model-level assessment, feature-level assessment, and biology-level assessment. According to these three levels assessment, the study has identified neuroimaging markers of ASD including the opercular part of bilateral inferior frontal gyrus, the orbital part of right inferior frontal gyrus, right rolandic operculum, right olfactory cortex, right gyrus rectus, right insula, left inferior parietal gyrus, bilateral supramarginal gyrus, bilateral angular gyrus, bilateral superior temporal gyrus, bilateral middle temporal gyrus, and left inferior temporal gyrus. In addition, negative correlations between the communication skill score in the Autism Diagnostic Observation Schedule and regional gray matter volume in the gyrus rectus, left middle temporal gyrus, and inferior temporal gyrus have been detected. A significant negative correlation has been found between the communication skill score in ADOS_G and the orbital part of the left inferior frontal gyrus. A negative correlation between verbal skill score and right angular gyrus and a significant negative correlation between non-verbal communication skill and right angular gyrus have been found. These findings in the study have suggested the GM alteration of ASD and correlated with the clinical severity of ASD disease symptoms. The interpretable machine learning framework gives sight to the pathophysiological mechanism of ASD but can also be extended to other diseases. (shrink)

While the theory of belief change has attracted a lot of interest from researchers, work on implementing belief change and actually putting it to use in real-world problems is still scarce. In this paper, we present an implementation of propositional belief change using Binary Decision Diagrams. Upper complexity bounds for the algorithm are presented and discussed. The approach is presented both in the general case, as well as on specific belief change operators from the literature. (...) In an effort to gain a better understanding of the empirical efficiency of the algorithms involved, a fault diagnosis problem on combinational circuits is presented, implemented and evaluated. (shrink)

This paper proposes a conceptual framework for understanding the implementation process of a complex intervention concerned with professional role change. The proposed framework holds that the intervention must address three interacting systems (socio-cultural, educational and disciplinary) through which a health professional role is evolved. Each system is operationalized by four dimensions (values, methods, actors and targets). As for the implementation, the framework posits that it can be analyzed, by depicting the barriers and facilitators located within the dimensions (...) of the three interacting systems and within the intervention involved in the process through using the “menu of constructs” approach suggested by the Consolidated Framework for Implementation Research (CFIR). The implications of this framework, on theoretical research and practical levels, are reviewed. (shrink)

There are some problems in the implementation of rulings of the Constitutional Court. The legislator should make more efforts for implementing the concept of the provisions of the Constitution provided in the reasoning parts of rulings of the Constitutional Court. The Statute of the Seimas should be supplemented with provisions obligating structural sub-units of the Seimas to carry out permanent and systemic analysis of reasoning parts of rulings of the Constitutional Court. It would allow timely to prepare proposals how (...) to amend still unchallenged legal regulation which, however, from the constitutional standpoint is doubtful. One should consider whether the norm of Item 4 of Paragraph 1 of Article 64 of the Law on the Constitutional Court, which allows one to challenge the compliance of a legal act with the Constitution on the grounds of the procedure for adoption regardless of any terms expired after the adoption of a law or other legal act, should be amended. It is to be presumed that the principles of legal certainty and legal security entrenched in the Constitution, as well as other constitutional provisions, imply a certain reasonable period of time within which the subjects provided for in the Constitution may apply to the Constitutional Court with a petition requesting to investigate whether a law or other legal act is not in conflict with the Constitution according to the procedure of their adoption. This period of time should not be a long one, for example, half a year or a year since the official publishing of the law; this term should be a prescriptive one–after it has finished, it would not be allowed to challenge the compliance of a law or other legal act with the Constitution according to the procedure of their adoption. In order to speed up the consideration of cases at the Constitutional Court, one would have to change the procedure of consideration of cases in this Court in essence. (shrink)

Two analyzes of Spark engine performance strategies to implement the Spark technique in a matrix distributed computational algorithm, the multiplication of a sparse multiplication operational test model. The dimensions of the two input sparse matrices have been fixed to 30,000 × 30,000, and the density of the input matrix have been changed. The experimental results show that when the density reaches about 0.3, the original dense matrix multiplication performance can outperform the sparse-sparse matrix multiplication, which is basically consistent with the (...) relationship between the sparse matrix multiplication implementation in the single-machine sparse matrix test and the computational performance of the local native library. When the density of the fixed sparse matrix is 0.01, the distributed density-sparse matrix multiplication outperforms the same sparsity but uses the density matrix storage, and the acceleration ratio increases from 1.88× to 5.71× with the increase in dimension. The overall performance of distributed operations is improved. (shrink)

The genderalization of the learning process is currently of key importance for the formation of the academic and political foundations of pedagogical innovations in the education system. This article presents the results of a study aimed at defining the concept of modern pedagogical innovations in the field of gender education. The analysis of the obtained data allowed us to identify seven different concepts of the concept of gender pedagogical innovations, formulate an updated definition and propose a cycle of the pedagogical (...) innovation concept. The article analyzes the factors contributing to the successful implementation of gender-based innovative pedagogical practices in the education system. Considers the issues of configuration and level of intensity of the influence of different gender factors involved in the implementation of innovative pedagogical practices, the relationship between the level of intensity of the identified factors affecting the dynamics of pedagogical innovation and change level of the education system as a whole. (shrink)

HALLETT C and WAGNER L. Nursing Inquiry 2011; 18: 359–368 Promoting the health of Europeans in a rapidly changing world: a historical study of the implementation of World Health Organisation policies by the Nursing and Midwifery Unit, European Regional Office, 1970–2003The World Health Organisation (WHO) was inaugurated in 1948. Formed in a period of post‐war devastation, WHO aimed to develop and meet goals that would rebuild the health of shattered populations. The historical study reported here examined the work of (...) the Nursing and Midwifery Unit (NMU) of WHO’s European Regional Office during the later part of the twentieth century. The study examined archive sources lodged at the NMU archive. The sources included manuscripts relating to important NMU initiatives, reports and papers published by WHO, and a range of secondary sources. The study identified three main driving forces in the work of the NMU of the European Regional Office of WHO. One of the strongest of these was a drive to develop and promote the nursing profession within the countries of the European Region. The second was the promulgation and implementation of the positive public health strategies of WHO, particularly its ‘38 Targets for Health for All by the Year 2000’. The third focussed on securing equity across the European continent and on promoting the development of the nursing professions in poorer and less‐developed countries. The study concludes that the nursing professions in European states grew in strength and influence, and that the health of populations improved throughout the continent between 1970 and 2003. It discusses the extent to which the role of the NMU in these advances may have been significant. (shrink)

La formación profesional tiene un carácter contextualizado que responde a las exigencias que la época, la sociedad y el país reclaman a las universidades. La Estomatología en Cuba no se encuentra al margen de estos preceptos por lo que desarrolla un plan de estudio que acentúa la flexibilidad para realizar modificaciones necesarias y pertinentes. El estudiante al culminar la carrera debe brindar una atención estomatológica integral donde las anomalías dentomaxilofaciales constituyen la tercera línea de trabajo. Estas ocasionan afectaciones estéticas que (...) repercuten en la autoestima y adaptación social de niños y adolescentes por lo que se necesita de una orientación sicoeducativa, acción para la cual el profesional deberá estar preparado. A partir de las insuficiencias detectadas en el proceso formativo del estomatólogo, el objetivo del presente trabajo es proponer un curso propio sobre la temática para favorecer la graduación de un profesional capaz de resolver los problemas que afectan el complejo estomatognático con un enfoque biosicosocial. Los métodos empleados fueron el histórico-lógico y análisis-síntesis. Professional training has a contextualized nature which reflects the demands that the time, society and the country require from universities. In Cuba, Stomatology is not out of these precepts and therefore it carries out a syllabus that emphasizes flexibility to make necessary and appropriate changes. When students graduate, they must provide a complete stomatological care where dental maxillofacial anomalies are the third line of work. They cause aesthetic harm that affects children and teenagers' self-esteem and social adaptation which makes psych educational guidance necessary; a situation professional must be prepared for. Starting from the weak points discovered in the training process of stomatologists, a crash course in the subject is suggested in order to favor the graduation of professionals who are able to solve problems that affect the stomatognatic complex with a biopsychosocial approach, through the use of required methods, techniques and procedures. (shrink)

During the past decade teamwork in manufacturing, as in other sectors, has become the organisational form of choice. In contrast to earlier manifestations such as autonomous workgroups some 30 years earlier, this appears to have been largely for business and production reasons rather than being directly aimed at improving the quality of work life. Taken from part of a larger study of teamworking in several different manufacturing companies this paper draws upon a retrospective analysis of cases of self-managed team (...) class='Hi'>implementation in UK manufacturing. Examples of good and bad practice and consequent guidance have been identified where the weight of evidence gives confidence in their general applicability. A basis for benchmarking is provided, related to preparation, implementation and maintenance of self-managed teams in manufacturing. Key gaps identified are for tools to assist in early functional analysis, leadership decisions and boundary setting, and appropriate team performance measurement and reward systems. (shrink)

This article concerns the implementation of new EU Directives coordinating the procedures for awarding public contracts in European Union Member States. In a number of countries, including Poland, the process of their implementation (Directive 2014/24/eu of the European Parliament and of the Council of 26 February 2014 on public procurement; Directive 2014/25/eu of the European Parliament and of the Council of 26 February 2014 on procurement by entities operating in the water, energy, transport, and postal services sectors; Directive (...) 2014/23/eu of the European Parliament and of the Council of 26 February 2014 on the award of concession contracts) was delayed. In most cases, the modernization of EU regulations on public procurement required a thorough modification of national regulations in this respect. As a result of the introduction of the package of new Directives, the European Union public procurement market has undergone substantial changes. The need to adjust legal regulations to the changing political, social, and economic situations in a better way has resulted in the transposition of the modernized EU Directives concerning public procurement to the Polish legal system, affecting the final shape of the new Polish Public Procurement Law. The implementation of the package of new Directives has significantly affected the functioning of the Polish public procurement market. For the entities operating in this market, this means the necessity to expand their knowledge, so as to become familiar with the new legal solutions in this respect. (shrink)

The upcoming Regulation No 536/2014 on clinical trials on medicinal products for human use, which will replace the current Clinical Trial Directive at the end of 2021, has triggered a significant reform of research ethics committee systems in Europe. Changes related to ethics review of clinical trials in the EU were considered to be essential to create a more favourable environment to conduct clinical trials in the EU. The concern is, however, that the role of the research ethics committees will (...) weaken in at least some of the Member States because the new Regulation allows narrowing down the scope of ethics review as compared with the currently valid Clinical Trial Directive. Although the new Regulation may lead to faster approval procedures for clinical trials, which is especially relevant in the context of pandemics, high-quality ethics reviews integrating methodological aspects of a clinical trial should nevertheless be ensured. To maintain high research ethics standards as well as to foster measures to mitigate potential negative consequences of the reform, it is therefore of vital importance to start debating and sharing the reflections about the potential consequences of these transformations and trends as soon as possible. (shrink)

Our research involves the study of vocational education in the context of postmodern trends in society. We analyzed how postmodern manifestations of the 21st century have affected vocational education standards. The main theoretical and methodological approaches to the formation of postmodernism and the process of formation of standards of vocational education were studied. Based on the results of the research, the main approach to the basics and basic trends in the formation of standards of vocational education was established. Education as (...) a process is relevant throughout historical development, because everyone understands his importance in society, realizes his responsibility to him since the early days of man needs new knowledge to continue living. The formation of the process of professional education itself begins several centuries ago, which confirms the maturation of man in social development. The period of postmodernism in the educational process is marked by globalization and the integration of society. This trend requires continuous professional growth. The worker in the conditions of postmodernism must be able to quickly change their skills, adapt to new challenges that may constantly evolve due to the rapid development of information technology. In the course of our research the integration method of synthesis of figurative structure, and the analysis, the characteristic of pedagogical activity at the formation of professional education is used. There are methods of synthesis, analysis, and interpretation of postmodernism in educational development. The results of the research confirm the postmodern trends in the formation of vocational education. (shrink)

With the rise of an innovation agenda in science policy, previous studies have identified a shift in how the state delegates responsibility to funding agencies in order to change the behaviour of the scientific community. This paper contributes to this literature through a micro-level study of how one of Canada’s largest research funding agencies, the Natural Sciences and Engineering Research Council, has changed resource allocation for research over 25 years. Our study foregrounds research funding agencies as key sites for (...) examining the reconfiguration of the relationship between the state and science, as expressed in programmatic and resource allocation decisions. Through analysis of an original dataset compiled from NSERC’s funding and documentary data, we demonstrate the relationship between the introduction of innovation objectives in funding instruments, the adoption of new delegation modes to guide resource allocation, and changes in funding among research fields over time. Our study empirically demonstrates the cumulative effect of programmatic and funding decisions in a major agency, going beyond previous accounts of more general trends at the national level. (shrink)

This article investigates some special criteria of implementation of the EU directives into the national legal order and the consequences of their non-compliance, that could arise from the EU membership obligation to the European Union law. The most important acting form for the Institutions of European Union comes after the Reform treaty of Lisbon the form of the EU directive. The law-making practice of the Institution of the European Union set out with different levels of full or partial harmonization (...) of the EU directives. Consequently, there comes the problem of the enforcement of the adopted EU directives into the domestic legal order. The article analyses the changes in European Union law after the Reform of Lisbon. The investigation begins with treatment of the general characteristic of the EU directive. After that it analyses the choice of primary legal ground for adopting of the EU directive and the consequences of its wrong choice for the legality of the EU directive. (shrink)

Directive 2002/73 enacted by the Council and Parliament of the European Union introduces substantial and procedural amendments to the European Community's `old' Equal Treatment Directive 76/207, providing, in particular, clarification of the definitions of concepts such as direct and indirect discrimination and harassment. Yet, while the European Commission has praised the progressive nature of the new European legislation, a critical assessment of its provisions reveals some serious shortcomings and a host of missed opportunities. Although the new Directive generally reflects the (...) spirit of the case law of the E.C.J., it does so without any originality or pro-activism meaning that the European legislature has once again left the initiative of pursuing sex equality in the E.U. to the Court. (shrink)

RESUMEN Introducción: la implementación del sistema de gestión de la calidad en el Centro de Inmunología y Productos Biológicos no ha producido los resultados esperados. Objetivo: exponer factores que afectan la implementación del mismo. Métodos: se realizó un estudio descriptivo exploratorio a través de encuesta de enero a mayo de 2018 en el Centro de Inmunología y Productos Biológicos de la Universidad de Ciencias Médicas Carlos J. Finlay de Camagüey, Cuba. El universo de las personas involucradas fue de 31, a (...) estos se les realizó un cuestionario de 16 preguntas estructuradas. Esta encuesta fue analizada con los métodos test re-test y Alpha de Cronbach. Resultados: las respuestas a la encuesta reflejaron que no se ha logrado integrar en el sistema de gestión de la calidad a todas las actividades del centro, no se logra la motivación intrínseca y extrínseca para su implementación, se evidenció liderazgo de ordeno y mando, persistía la opinión de que con los manuales de organización y una estructura jerarquizada se lograrían los resultados esperados, los directivos no aportan todo su potencial a este trabajo, los beneficiarios no se han convertido en participantes ni han constituido redes rizomas con alta comunicación entre sí y estilo de trabajo auto-organizado y no se han sistematizado actividades participativas en busca de consenso de equipo. Conclusiones: se identificaron factores que afectan la implementación del sistema de gestión de la calidad y se propone un cambio de paradigma hacia la integración de saberes para lograr de manera sustentable los cambios deseados. ABSTRACT Introduction: The implementation of the system of management of the quality in the Center of Immunology and Biological Products has not produced the expected results. Target: to exhibit factors that affect the implementation of the system. Methods: An exploratory descriptive study was carried out through a survey from January until May, 2018 in the Center of Immunology and Biological Products of the University of Medical Sciences of Camagüey, Cuba. The universe shaped by 31 persons to whom there was applied a survey, which was analyzed by the methods of test re-test and Alpha of Cronbach. Results: The answers to the survey reflected that all the activities of the center have not been integrated to the system of management of the quality, the intrinsic and extrinsic motivation is not achieved for its implementation. It was demonstrated leadership of order and control and it persisted the opinion that with the manuals of organization and a hierarchical structure would achieve the expected results. The managers do not contribute all their potential to this work, the beneficiaries neither have turned into participants nor have constituted networks rhizome with high communication among themselves and style of self-organized work and participative activities have not been systematized in search of team consensus. Discussion: There were identified factors that affect the implementation of the system of management of the quality and a change of paradigm is proposed towards the knowledge integration to achieve sustainably the wished changes. (shrink)

In April 2018, Japan’s first law regulating clinical research went into effect. The law aimed to strengthen regulations on research integrity and conflicts of interest, which had been limited under existing administrative guidelines; the law also provided stipulations for legal penalties. The scope of the new regulations, however, is limited entirely to studies that evaluate unapproved drugs or the off-label use of approved drugs, and those that receive funding from companies. On the other hand, the law’s application brings numerous complications, (...) including the establishment of new review committees, troublesome procedures for transitioning studies that are currently underway, and ambiguities about the scope of what constitutes best efforts. Thus, the change has led to substantial strain and confusion in the field. This paper offers an overview of the law and its background, and discusses its future prospects from the practical standpoint of managing ethics committees and providing research ethics support in the field. (shrink)

A major concern of public health authorities is to also encourage adults to be exposed to enriched environments during the pandemic lockdown, as was recently the case worldwide during the COVID-19 outbreak. Games for adults that require physical activity, known as exergames, offer opportunities here. In particular, the output of the gaming industry nowadays offers computer games with extended reality which combines real and virtual environments and refers to human-machine interactions generated by computers and wearable technologies. For example, playing the (...) game in front of a computer screen while standing or walking on a force plate or treadmill allows the user to react to certain infrastructural changes and obstacles within the virtual environment. Recent developments, optimization, and minimizations in wearable technology have produced wireless headsets and sensors that allow for unrestricted whole-body movement. This makes the virtual experience more immersive and provides the opportunity for greater engagement than traditional exercise. Currently, XR serves as an umbrella term for current immersive technologies as well as future realities that enhance the experience with features that produce new controllable environments. Overall, these technology-enhanced exergames challenge the adult user and modify the experience by increasing sensory stimulation and creating an environment where virtual and real elements interact. As a therapy, exergames can potentially create new environments and visualizations that may be more ecologically valid and thus simulate real activities of daily living that can be trained. Furthermore, by adding telemedicine features to the exergame, progress over time can be closely monitored and feedback provided, offering future opportunities for cognitive-motor assessment. To more optimally serve and challenge adults both physically and cognitively over time in future lockdowns, there is a need to provide long-term remote training and feedback. Particularly related to activities of daily living that create opportunities for effective and lasting rehabilitation for elderly and sufferers from chronic non-communicable diseases. The aim of the current review is to envision the remote training and monitoring of physical and cognitive aspects for adults with limited mobility, through the implementation of concurrent telehealth and exergame features using XR and wireless sensor technologies. (shrink)

As modern information and communication technologies (ICT) now offer new possibilities for improving almost every aspect of health care, their implementation is a very relevant and fast accelerating process around Europe and internationally. The processes themselves vary greatly from scattered single initiatives of various IT solutions to large national programmes. Often treated as purely technical in nature, ICT implementation in health care should gravitate towards the “softer/complex” i.e. people-related issues end of the change. The approach taken by (...) the Informing Healthcare programme in Wales broadens understanding on the value that engagement of stakeholders can bring to the process. (shrink)