Although advance care planning can lead to more patient-centered care, the communication around it can be challenging in acute care hospitals, where saving a life or shortening hospitalization is important priorities. Our qualitative study in an acute care hospital in Japan revealed when specifically physicians and nurses start communication to facilitate ACP. Seven physicians and 19 nurses responded to an interview request, explaining when ACP communication was initiated with 32 patients aged 65 or older. Our qualitative approach employed descriptive analysis (...) to identify major themes, which included “initiation by patients” and “initiation by healthcare professionals.” In the latter case, seven specific triggers were identified: when the patients’ medical condition changed in terms of symptom relief, when the patients’ medical condition changed in terms of prognostic prediction, when serious events occurred, when a choice of treatment was presented, when the location for end-of-life care was chosen, when the patients’ cognitive function deteriorated, and when serious events settled down. Within this group of healthcare professionals, physicians were more focused on changes in their patients’ medical condition, whereas nurses focused more on their patients’ desire for a long-term perspective. Nurses encouraged patients to consider ACP themselves, which developed into an approach to respect patients’ autonomy. In acute care hospitals, it appeared to be desirable to have an early discussion where patients could understand the significance ACP, which would matter even after their discharge from the hospital. (shrink)

How parents talk about social events shapes their children’s understanding of the social world and themselves. In this study, we show that parents in a society that more strongly values individualism and one that more strongly values collectivism differ in how they talk about negative social events, but not positive ones. An animal puppet show presented positive social events and negative social events. All shows contained two puppets, an actor and a recipient of the event. We asked parents to talk (...) to their 3- and 4-years old children about these events. A total of 26 parent–child dyads from the United States and Japan participated. The principal dependent measure was how much parent talk referred to the actor of each type of social event. There were no cultural differences observed in positive events – both the United States and Japanese parents discussed actors more than recipients. However, there were cultural differences observed in negative events – the United States parents talked mostly about the actor but Japanese parents talked equally about the actor and the recipient of the event. The potential influences of these differences on early cognitive and social development are discussed. (shrink)

中国古代(おもに戦国期~漢代初期)の新出土文献を検討により、古代思想史の空白を埋め、その変遷過程を明らかにする。.

We propose an efficient algorithm for deciding the reachability between any nodes on XML data represented by connected directed graphs. We develop a technique to reduce the size of the reference table for the reachability test. Using the small table and the standard range labeling method for rooted ordered trees, we show that our algorithm answers almost queries in a constant time preserving the space efficiency and a reasonable preprocessing time.

Este ensayo está dedicado a la serie grey paintings del artista norteamericano Cy Twombly. A partir de un análisis de Panorama y Cold Stream, planteo que la serie se vincula a formas de inscripción asociadas, simultáneamente, a lo verbal y lo pictórico. Si bien no es posible identificar letras ni palabras, estas obras manifiestan un estrecho vínculo con una dimensión gestual y corporal de la escritura. En mi análisis establezco relaciones con inscripciones arcaicas, con la criptografía, y con procesos de (...) alfabetización escolar. (shrink)

技術が進歩すればするほど、技術者に対する信頼が必要となる。技術者は専門職として、どんな倫理をもたねばならないのか。それはほかの専門職の倫理とは違うのか?「技術者は公衆の安全・健康・福利を最優先しなけれ ばならない」という理念にもとづいて指針を示したテキストを、原発事故や製造物責任などの最新事例をふまえて改訂!

1. Tōzai bunka no kōryū -- 2. Shōtoku Taishi -- 3. Kinsei Nihon no hihanteki seishin -- 4. Nihon shūkyō no kindaisei.

あの高名な「絶対矛盾的自己同一」とは、いったいどういう意味なのか―。西田哲学の本質をつかみ、その全貌をわかりやすく示す!

江戸中期の儒学者・荻生徂徠(1666‐1728)の思想は難解といわれるが、その「ことば」は広く開かれている。徂徠は人/もの/世界を「活物」として看ることを説き、その思索は学者世間の外にまで届くものであ った。徂徠の「ことば」の魅力を探り、徂徠学の構想・方法・世界認識を明快に論じた本格的入門書。.