To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

ObjectiveThis study aimed to examine the effectiveness and safety of the Brain-computer interface in treatment of upper limb dysfunction after stroke.MethodsEnglish and Chinese electronic databases were searched up to July 2021. Randomized controlled trials were eligible. The methodological quality was assessed using Cochrane’s risk-of-bias tool. Meta-analysis was performed using RevMan 5.4.ResultsA total of 488 patients from 16 RCTs were included. The results showed that the meta-analysis of BCI-combined treatment on the improvement of the upper limb function showed statistical significance [standardized (...) mean difference : 0.53, 95% CI: 0.26–0.80, P < 0.05]; BCI treatment can improve the abilities of daily living of patients after stroke, and the analysis results are statistically significant ; and the BCI-combined therapy was not statistically significant for the analysis of the Modified Ashworth Scale.ConclusionThe meta-analysis indicates that the BCI therapy or BCI combined with other therapies such as conventional rehabilitation training and motor imagery training can improve upper limb dysfunction after stroke and enhance the quality of daily life. (shrink)

Alcohol use disorder is one of the most common substance use disorders contributing to both behavioral and cognitive impairments in patients with AUD. Recent neuroimaging studies point out that AUD is a typical disorder featured by altered functional connectivity. However, the details about how voxel-wise functional coordination remain unknown. Here, we adopted a newly proposed method named functional connectivity density to depict altered voxel-wise functional coordination in AUD. The novel functional imaging technique, FCD, provides a comprehensive analytical method for brain's (...) “scale-free” networks. We applied resting-state functional MRI toward subjects to obtain their FCD, including global FCD, local FCD, and long-range FCD. Sixty-one patients with AUD and 29 healthy controls were recruited, and patients with AUD were further divided into alcohol-related cognitive impairment group and non-cognitive impairment group. All subjects were asked to stay stationary during the scan in order to calculate the resting-state gFCD, lFCD, and lrFCD values, and further investigate the abnormal connectivity alterations among AUD-NCI, ARCI, and HC. Compared to HC, both AUD groups exhibited significantly altered gFCD in the left inferior occipital lobe, left calcarine, altered lFCD in right lingual, and altered lrFCD in ventromedial frontal gyrus. It is notable that gFCD of the ARCI group was found to be significantly deviated from AUD-NCI and HC in left medial frontal gyrus, which changes probably contributed by the impairment in cognition. In addition, no significant differences in gFCD were found between ARCI and HC in left parahippocampal, while ARCI and HC were profoundly deviated from AUD-NCI, possibly reflecting a compensation of cognition impairment. Further analysis showed that within patients with AUD, gFCD values in left medial frontal gyrus are negatively correlated with MMSE scores, while lFCD values in left inferior occipital lobe are positively related to ADS scores. In conclusion, patients with AUD exhibited significantly altered functional connectivity patterns mainly in several left hemisphere brain regions, while patients with AUD with or without cognitive impairment also demonstrated intergroup FCD differences which correlated with symptom severity, and patients with AUD cognitive impairment would suffer less severe alcohol dependence. This difference in symptom severity probably served as a compensation for cognitive impairment, suggesting a difference in pathological pathways. These findings assisted future AUD studies by providing insight into possible pathological mechanisms. (shrink)

BackgroundRepetitive transcranial magnetic stimulation applied to the mylohyoid cortical region has positive clinical effects on post-stroke. Therefore, we conducted a meta-analysis to investigate the efficacy of rTMS for patients with post-stroke dysphagia.MethodsAccording to PRISMA guidelines, we searched the databases of MEDLINE, Cochrane Library, Embase, Web of Science, CNKI, Wangfang. We searched for studies of randomized controlled trials of rTMS to treat dysphagia after stroke and screened by inclusion and exclusion criteria. Features of RCTs were extracted. The heterogeneity of the trials (...) was measured by I2 statistic.ResultsIn total, 11 RCTs with 463 dysphagia patients fulfilled our inclusion criteria. In our analysis, rTMS demonstrated a great beneficial effect for post-stroke dysphagia when combined with traditional swallowing exercises. Moreover, a greatly significant difference was noted based on stimulation frequency. Additionally, no significant difference was observed based on stimulation site.ConclusionsOverall, rTMS can effectively accelerate the improvement of swallowing function in patients with post-stroke swallowing disorders. (shrink)

The goal of the present study is to explore whether the affective states of a pedagogical agent in an online multimedia lesson yields different learning processes and outcomes, and whether the effects of affective PAs depend on the learners’ emotion regulation strategies and their prior knowledge. In three experiments, undergraduates were asked to view a narrated animation about synaptic transmission that included either a happy PA or a neutral PA and subsequently took emotions, motivation, cognitive outcomes tests. Across three experiments, (...) the happy PA group reported more positive emotions and higher level of motivation than the neutral PA group. Moreover, the happy PA prompted higher germane load than a neutral PA in Experiment 3. However, adding a happy PA to the screen did not improve learning performance. In addition, in Experiment 2, learners’ usage of emotion regulation strategies moderated the effectiveness of affective PA on positive emotions in learners. Specifically, happy PAs increased the positive emotions of students who used expressive suppression strategy but not those who used cognitive reappraisal strategy. In Experiment 3, the effectiveness of affective PAs was not moderated by learners’ prior knowledge. Results support the cognitive affective theory of learning with media that students are happier and more motivated when they learn from happy PAs than from neutral PAs. (shrink)

In this paper, we put forward a time-delay ecological competition system with food restriction and diffusion terms under Neumann boundary conditions. For the case without delay, the conditions for local asymptotic stability and Turing instability are constructed. For the case with delay, the existence of Hopf bifurcation is demonstrated by analyzing the root distribution of the corresponding characteristic equations. Furthermore, by using the normal form theory and the center manifold reduction of partial functional differential equations, explicit formulas are obtained to (...) determine the direction of bifurcations and the stability of bifurcating periodic solutions. Finally, some simulation examples are provided to substantiate our analysis. (shrink)

Ben shu gong fen san bu: di yi bu hui gui zhen wo, di er bu hui gui tian di, di san bu hui gui tai ji. Nei rong bao kuo: lun sheng ming; sheng ming yu shi ge; sheng ming yu yin yue; xian dai ren sheng ming de yan bian; wo shi shui, tian di yu wo deng.

本书由三篇七章组成,分别是实用主义法学的产生、法律实用主义的影响、后现代法理学、罗蒂后现代实用主义法理学、波斯纳法律实用主义、道德理论与司法裁判、法律经济学与实用主义等。.

內容簡介 儒學不應僅是「思辯哲學」或「實踐理論」。從「半日靜坐，半日讀書」到當代身體觀，透過理學工夫論研究，反思儒學進入現代西方學術之轉譯過程，所產生的實踐脫落，召喚逐漸被學院哲學遺忘的實踐向度。 本書是一部探討宋明理學工夫論的著作，雖概括不同時代理學家，但貫穿其間的是儒學作為「實踐之學」的基本信念。儒學現代化過程中，在學科分類下被勉強劃入「哲學」學門，但哲學家一向擅長以理論的方式探討實踐，卻往 往無法自己親自實踐。當代儒學也出現一個難題：學術化的儒家哲學如何「實踐」？如何不僅成為「思辯哲學」或「實踐理論」？如何避免「實踐的脫落」？此實是儒學現代化、學術化下的一項挑戰。 藉著回顧理學傳統的修養方法，尋找返本開新的可能。本書關注理學工夫的具體實踐與操作方法，如何被運作、展開；此訴求下，靜坐、讀書與與身體觀，是本書比較集中探討的理學工夫論面向。將工夫論研究，由思想文獻中靜 態結構描述的「實踐理論」，返回實修實證的動態歷程之展現。使儒家哲學研究從心性形上學，往身體向度落實，發展成完整的「身心之學」。 名人推薦 理學做為成德之學，向來與生命實踐密不可分。實踐工夫成為理學家日常性功課，甚至以證本體為生命大事，那種古典求道精神的實踐神聖性，在當今學術專技化的客觀年代，已逐漸成為一種實踐理論之客觀研究。而當存在體驗 化為抽象理論時，理學原初最濃厚的實踐動能與召喚力道，是否也將靈光消逝？本書作者的初發心，便具有這種存在的憂心與感受。換言之，身為現代的學者，作者仍懷有強烈的求道之古典關懷。本書的基本主題關涉：靜坐與讀 書這兩種工夫論的辯證，而除了心性修養的傳統論述以外，作者亦吸收當代的身體實踐觀點，企圖更為完整地描述理學家身心一體轉化的體證內涵。現今從事理學工夫理論的研究者不算少，但在理論與實踐之間尋尋覓覓者已不多 ，在這種儒門淡泊的工夫遺忘的現代氣氛下，作者的懷古初心尤為可貴，其研究成果也值得觀察。──賴錫三╱中山大學中文系教授 現代儒學研究，儒家的工夫論常被本體論取代，而呈失語現象。此書真正立基於工夫實踐的立場，可做為現今儒者內聖學道德實踐之重要參考著作。──廖俊裕╱南華大學生死學系副教授.

◎孔子為何周遊列國？因為沒有一個國君想用儒家治國，他只好到處教書遊說。 ◎秦國用法家統一天下，漢高祖劉邦用道家蓄積國力，直到漢武帝登基，儒家才被注意。 ◎儒學為何從沒人理，轉眼變治國工具？這得從董仲舒的「解釋」說起。 ◎儒學就像作業系統，幾千年來更新過四次版本，孔子的儒學不等於現在的儒學。 作者馬大勇，清華大學、上海交通大學國學特聘教授。 曾被推舉為最受歡迎的中文教授。 在本書中，他將儒家文明分為五個時期： 孔子奠基期、孟子成熟期、兩漢經學期、宋代理學期和明代心學期。 解析儒家思維是如何像電腦作業系統一樣，歷經四次的版本更新， 從原本的中庸之道、民為貴、君為輕的民主思想， 一步步變成君權神授，天人感應， 成為各朝代帝王穩固皇權的最佳推手。 就此儒學變成帝王學，開啟了千年以來人民為皇權奴隸的中央集權體制。 ◎孔子的儒學，是教你如何當君子 《論語》中，仁字出現了104次，禮字出現74次， 孔子的重要理念「中庸之道」，更成為宋元以後科舉考試的必讀書。 這個具有人道主義的思維，為何不被當時的統治者如春秋諸侯或秦國採納？ 因為亂世中，做君子的好處太少，當小人能得到的利益比較多。 ◎孟子是民主思想的啟蒙者，但被後代皇帝刪掉了 孟子思想的最大亮點就是「民為貴，社稷次之，君為輕」， 這套民主思維後來為何會消失？ 因為明太祖朱元璋看到「君為輕」三個字，就把《孟子》一書狠狠摔地上， 刪節版《孟子》就此誕生，往後一百年，學生學到的孔孟儒學知識都是不完整的。 ◎因為董仲舒的「特殊解釋」，從此百家遭罷黜，皇帝獨尊儒術 秦國用法家思想滅六國一統天下，漢高祖劉邦用道家治國，修生養息， 兩大皇權都對儒家思維沒興趣，直到漢武帝劉徹時期， 董仲舒為了拍皇帝馬屁，重新解釋，儒術從此轉化帝王術。 他口中的儒教，跟孔孟闡述的儒學，哪裡不一樣？差在造神。 ◎宋元明清重新詮釋儒學，想當官者必讀四書 宋、元之後，孔子的《中庸》又重新被提起， 因為它教你用大學之道維持國家秩序。 儒學家朱熹更讓《四書集注》成為為官者的必讀聖書。 至於為什麼是宋朝與明朝，跳過了大唐盛世？ 因為東漢黨錮之禍殺害許多知識分子，儒家文化走向低谷； 南北朝興盛佛教；至於唐朝則儒、釋、道並重。 直到韓愈寫的《原道》為儒家文明打下基礎，在宋代發揚光大。 打天下靠武力，龍椅要坐穩就靠統治， 儒家思想如何經過五階段改造，從民主思維變中央集權， 而且延續千年「至今」不墜。 本書特色 儒學為何從沒人理，轉眼變治國工具？這得從董仲舒的「解釋」說起。 孔子的儒學，如何經過五階段改造，從民主思維變中央集權。 名人推薦 淡江大學中文系教授／高柏園.

本书分为九篇,包括形势政策篇、非战争行动篇、战备训练篇、履行使命篇、理想前途篇、作风纪律篇、家庭生活篇、思想转化篇、内外关系篇。.

本书通过对群星璀璨的犹太精英成功智慧的深刻剖析, 揭示了犹太人独特的价值观和伟大的理想, 让人在先进的理念和最优的实践中感受到犹太精英教育成功的奥秘.

本书从原则指导、规律制度、方法艺术、心理疏导和提高素质等五个方面,比较系统、完整而又深刻细致地分析了部队基层经常性思想工作。.

Ben shu shen ru tao lun lun li zai qi ye jing ying yu jing ji fa zhan zhong zhi gong neng.

Includes the complete Dao de jing in English and its original Chinese text, as well as the translator's commentary and analysis of each chapter.

Since Leibniz first put forward the sufficient reason law in his philosophical work "The Monadology" (1914), the issue of the law of sufficient reason has aroused heated discussions in the field of logic in our country. The question of whether the law of sufficient reason is the basic law of formal logic was particularly heated in the domestic logic circle in 1978-1980. Since then, there has been little discussion, but from the newly compiled formal logic textbooks published one after another, (...) no consensus has been reached. Although they didn't agree on the question of "whether or not", the two sides elaborated their arguments in detail and put forward some new opinions, thus creating new conditions for solving this problem scientifically. Firstly, this paper analyzes the different viewpoints of both sides of the argument. Secondly, it analyzes whether the law of sufficient reason is the basic law of formal logic from whether Leibniz put forward the law of sufficient reason. Finally, on this basis, a new transformation method is put forward. After this transformation, the law of sufficient reason is an important basic law of deductive logic, which can be juxtaposed with the other three logical laws, such as identity, and coordinated with the "three laws" and complement each other. (shrink)

In his recent works on daily face-to-face encounters, Zahavi claims that the phenomenon of sharing involves reciprocity. Following Zahavi’s line of thought, we wonder what exactly reciprocity amounts to and how the shared experience emerges from the dynamic process of interaction. By turning to the highly specialized field of elite sports dance, we aim at exploring the way in which reciprocity unfolds in intensive deliberate practices of movement. In our analysis, we specifically argue that the ongoing dynamics of two separate (...) flows of movement constitute a shared experience of dancing together. In this sense, moving together, in sports dance, is a practical way of understanding each other. In agreement with Zahavi, our analysis emphasizes the bi-directed nature of sharing. However, at the same time, we contribute to Zahavi’s ongoing endeavour as the special case of sports dance reveals how reciprocity can be deliberately shaped through the mutual coordination and affective bound dynamics of movement. Our article thus both pursues the methodological point that qualitative research of expert competences can constructively enrich phenomenological analysis and indicates how movement can be fundamental to the reciprocity of shared experience. (shrink)

This book presents a variety of discussions from different countries about regulations and applications of ethics in business practice. It demonstrates how Ethics, both in the world of business and in academic life, is consistently a central and unavoidable issue that institutions must devise new regulations on a regular basis to address. Given that applying such regulations becomes complicated in a global business landscape and that International companies have lost large amounts of revenues due to fraudulent activities, the book provides (...) insights for professionals in business world to teach, learn, apply, measure and report on companies' daily business. Business and Professional Ethics: Theories, Standards, and Analysis is essential reading for researchers and students in business schools around the world. (shrink)