Creativity is an essential factor in ensuring the sustainable development of a society. Improving students’ creativity has gained much attention in education, especially in Science, Technology, Engineering, Arts, and Mathematics education. In a quasi-experimental design, this study examines the effectiveness of a project-based STEAM program on the development of creativity in Chinese elementary school science education. We selected two fourth-graders classes. One received a project-based STEAM program, and the other received a conventional science teaching over 6 weeks. Students’ creativity was (...) assessed before and after the intervention using a multi-method approach, including a test of divergent thinking, a story completion through the Consensus Assessment Technique, a creative self-efficacy measure, and a group-based creative project. Moreover, all students received a test of their science knowledge after the intervention. The results showed that compared with the control group, the creativity of the experimental group students improved significantly for 6 weeks at both individual and group level, even though their knowledge in science were comparable. This result confirmed the effectiveness of a project-based STEAM educational program improving elementary school students’ creativity. Implications are discussed. (shrink)

TODIM is a well-known multiple-criteria decision-making which considers the bounded rationality of decision makers based on prospect theory. However, in the classical TODIM, the perceived probability weighting function and the difference of the risk attitudes for gains and losses are not consistent with the original idea of PT. Moreover, probabilistic hesitant fuzzy information shows its superiority in handling the situation that the DMs hesitate among several possible values with different possibilities. Hence, a novel TODIM with probabilistic hesitant fuzzy information is (...) proposed in this paper to simulate the perceptions of the DMs in PT. To show the advantages of the proposed method, a novel TODIM is combined with hesitant fuzzy information. Finally, a case study is carried out to demonstrate the feasibility of the proposed method, and a series of comparative analyses and the sensitivity analyses are used to show the stability of the proposed method. (shrink)

In China, guanxi is the basis on which Chinese exchange a lifetime of favors, resources, and business leverage. Guanxi is considered a unique construct and a product of Confucian values and the contemporary political and socioeconomic system in Chinese society. With its cultural embeddings guanxi , as the social norm of conduct, functions as complex adaptive systems that expand and interconnect to become well-knit social networks; meanwhile the functions of well-fixing and self-reinforcement of the guanxi networks ( chuens ) are (...) synergetically activated internally, externally, and interactively, which shows their extreme flexibility of adaptation. Taking as a case study an outside direct investment (ODI) Taiwanese firm in China, we address and conduct a survey to examine the effect of guanxi on management. Results of the research suggest that guanxi is not limited to interpersonal links; it is also the switch that activates social networks and that reconciles interpersonal and internetwork mismatches to influence management efficacy. (shrink)

This essay reviews the philosophical roots and the development of the concept of creativity in the West and East. In particular, two conceptions of creativity that originated in the West--divinely inspired creativity and individual creativity--are discussed and compared to the two Eastern conceptions of creativity that are rooted in ancient Chinese philosophical thought--natural and individual creativity. Both Western and Eastern conceptions of individual creativity come from a theistic or cosmic tradition of either divinely inspired or natural creativity. However, a defining (...) feature of the Western concept of creativity--novelty--is not necessarily embraced by ancient Chinese concepts of creativity, but does exist in both modern Eastern conceptions. Reasons for cultural differences are explored and discussed. 2012 APA, all rights reserved). (shrink)

《樂道》是隴菲多年精心撰著的音樂哲學專著。 自二十世紀八十年代初，隴菲潛心研究音樂哲學，試圖基於中國古典樂道，建立可與世界對話的中國音樂哲學，發表了多篇重要論著，如《行象簡論》、《形》、《春江花月夜 —— 自然、歷史、人生之千古絕唱》、《古琴與鋼琴》等等。自二零零二年起，《樂道》部分章節，陸續由期刊連載，引起廣泛關注，且被許多網站輾轉傳貼。《樂道》傳疏發明之中國古典哲學、中國古典樂道“道、形、器”（《易 經》）、“達、類、私”（《墨經》）、“人，法地地，法天天，法道道，法自然”（《道德經》）、“逝者如斯”（《論語》）、“以類相動”、“大樂與天地同和”、“大樂中天地之節”（《禮記》），以及隴菲拈出之“行 象”（《行象簡論》）等等洪範之疇，已逐漸為世人注目。.

Cardinal number knowledge-understanding “two” refers to sets of two entities-is a critical piece of knowledge that predicts later mathematics achievement. Recent studies have shown that domain-general and domain-specific skills can influence children’s cardinal number learning. However, there has not yet been research investigating the influence of domain-specific quantifier knowledge on children’s cardinal number learning. The present study aimed to investigate the influence of domain-general and domain-specific skills on Mandarin Chinese-speaking children’s cardinal number learning after controlling for a number of family (...) background factors. Particular interest was paid to the question whether domain-specific quantifier knowledge was associated with cardinal number development. Specifically, we investigated 2–5-year-old Mandarin Chinese-speaking children’s understanding of cardinal number words as well as their general language, intelligence, approximate number system acuity, and knowledge of quantifiers. Children’s age, gender, parental education, and family income were also assessed and used as covariates. We found that domain-general abilities, including general language and intelligence, did not account for significant additional variance of cardinal number knowledge after controlling for the aforementioned covariates. We also found that domain-specific quantifier knowledge did not account for significant additional variance of cardinal number knowledge, whereas domain-specific ANS acuity accounted for significant additional variance of cardinal number knowledge, after controlling for the aforementioned covariates. In sum, the results suggest that domain-specific numerical skills seem to be more important for children’s development of cardinal number words than the more proximal domain-general abilities such as language abilities and intelligence. The results also highlight the significance of ANS acuity on children’s cardinal number word development. (shrink)

This is a major contribution to the theoretical and comparative literature on welfare states, written by some of the most original and challenging feminist ...

A successful student has been defined as one who not only performs well in academics but is also happy. Hence, how to promote adolescents’ academic success and wellbeing is an important issue with which researchers have been concerned. A few studies have explored the relationship of filial piety to the academic achievement or life satisfaction of Chinese adolescents. However, in view of the close relationship between the two outcomes, the unique effects of filial piety on academic achievement and subjective wellbeing (...) and their underlying mechanisms need to be further clarified. Based on a sample of 677 students in Grade 6 (Mage = 12.24, SD = 0.36) and their parents in Beijing, China, this study examines how adolescents’ reciprocal filial piety (RFP) and authoritarian filial piety (AFP) are related to their academic achievement and subjective wellbeing. It also examines the mediating role of adolescents’ educational expectations in these relationships, and the moderating role of parents’ educational expectations in the relationships of adolescents’ filial piety to educational expectations and of adolescents’ educational expectations to academic achievement and subjective wellbeing. The results indicate that, when the two outcome factors are considered simultaneously, RFP is positively related to academic achievement and subjective wellbeing. In contrast, AFP is negatively related to academic achievement but not significantly related to subjective wellbeing. Moreover, adolescents’ educational expectations play a mediating role in the relationships of both RFP and AFP to academic achievement and subjective wellbeing. In addition, the positive effect of adolescents’ educational expectations on subjective wellbeing is stronger when mothers’ educational expectations are higher, supporting the moderating role of parents’ educational expectations. Our findings provide new insights into and implications for the moderated mediation mechanism underlying the links between filial piety and early adolescent development. (shrink)

Abstract Along with China’s stunning economic growth, marketing has become a multi-billion dollar business, afflicted by a plethora of marketing scandals. However, little attention has been paid, until now, to a more systematic approach to marketing ethics in China. This essay attempts to provide a broad and timely, but far from complete, view on marketing issues in China. It uses four ethical guidelines which capture the fundamental features particularly relevant to marketing activities: practicing honest communication; enhancing human capabilities; fostering creative (...) intercultural diversity; and promoting sustainable growth and eco-efficiency. These guidelines are then elucidated with 12 positive and negative cases of Chinese and non-Chinese companies. By combining guidelines with case studies, it is hoped that ethical challenges for marketing in China will be discerned in a more systematic and comprehensible fashion. The article concludes by indicating several perspectives for further research. Content Type Journal Article Category Original Paper Pages 1-20 DOI 10.1007/s13520-011-0014-0 Authors Georges Enderle, Mendoza College of Business, University of Notre Dame, Notre Dame, IN, USA Qibin Niu, School of Business Administration, China University of Petroleum, Changping, Beijing, People’s Republic of China Journal Asian Journal of Business Ethics Online ISSN 2210-6731 Print ISSN 2210-6723. (shrink)

This study investigates the influence of chief executive officers' (CEOs) career horizon on the adoption of Global Reporting Initiative (GRI) standards for corporate social responsibility (CSR) reporting. Using data from A-share Chinese listed firms on the Shanghai and Shenzhen stock exchanges from 2010 to 2020, we employ logistic regression analysis to examine the empirical relationship. Our findings indicate that companies led by CEOs with shorter career horizons (older CEOs) are less inclined to adopt GRI reporting standards for CSR reporting. This (...) association is particularly pronounced in non-state-owned enterprises compared to state-owned enterprises. Additionally, we observe a weaker relationship between CEO career horizon and GRI adoption when the CEO possesses foreign experience. These results remain robust across various measures of CEO career horizons and econometric methodologies as well. The implications of our findings are significant for understanding the development and implementation of GRI standards for CSR reporting, particularly within the context of China. (shrink)

ObjectiveThe main purpose of this study was to explore the association between early fundamental motor skills and executive function in preschool children.MethodsA total of 394 young children were evaluated. The FMS and EF were evaluated using the Test of Gross Motor Development-2 and the NIH Toolbox Cognition Battery, respectively.ResultsTotal FMS score was moderately and positively correlated with total EF score and was a significant predictor of total EF score. Specifically, locomotor skills were significant predictors of inhibition control, working memory, and (...) cognitive flexibility, while object control skills were only significant predictors of inhibition control.ConclusionFMS were significantly and positively correlated with EF and were significant predictors of EF. Early childhood policymakers, preschool teachers, and researchers should take these connections seriously and implement appropriate complex motor intervention programs in future teaching to stimulate the development of both motor and higher-order cognitive skills in preschool children. (shrink)

The COVID-19 pandemic has forced higher education institutions to shift their teaching activities from traditional face-to-face to online learning. This brings a great challenge to the creativity training of vocational college students, who not only learn theoretical knowledge but also cultivate technical skills. Therefore, it is very important to explore the influencing factors of online learning on students’ creativity during the epidemic. By relying on the related literature review, an extensive model is developed by integrating the expectation confirmation model, technology (...) task fit model, and the technology acceptance model to illustrate key factors that influence creativity. Based on the proposed model, theory-based hypotheses are tested through structural equation modeling employing empirical data gathered through a survey questionnaire of 229 students from different vocational colleges in China. In addition, to extend the analysis results, this paper performs a comparative analysis based on gender. The findings demonstrate that perceived ease of use and perceived usefulness significantly influence knowledge sharing; knowledge sharing significantly affects creativity. However, there is no substantial relationship between perceived usefulness and attitude, and no relationship between attitude and knowledge sharing. Moreover, a multi-group comparison shows that there is a significant gender difference between perceived ease of use and attitude. Based on the findings, theoretical and practical implications are discussed. (shrink)

The level of psychological pain in patients with COVID-19 was investigated in this study by hypothesis testing, one-way ANOVA, multi factor ANOVA, and correlation analysis. The psychological pain thermometer and post-traumatic growth assessment scale were used as research tools. Many factors appear to influence the psychological state of COVID-19 patients including practical problems, communication problems, emotional problems, physical problems, and psychiatric/relative concerns. The severity of the disease, the surrounding environment, family health problems, life perceptions, interpersonal relationships, personal strength, mental changes, (...) new possibilities, and the total post-traumatic growth score are also affected. There is a significant negative correlation between psychological pain and post-traumatic growth. There are significant differences in the degree of psychological pain across the demographic data. Practical problems, communication problems, emotional problems, physical problems, and spiritual/religious concerns show significant effects on the degree of psychological pain. (shrink)

The teaching management department carries all the work related to teaching in the whole school. A scientific, efficient, and complete teaching management system cannot only help the teaching management department improve work efficiency and quality but also greatly reduce many problems caused by manual labour risk. This paper designs and implements a teaching management system based on an improved association rule algorithm. First, aiming at the low efficiency of the Apriori algorithm for mining association rules, an association rule model based (...) on interest is proposed. Second, use the MapReduce calculation model to partition the transaction database, then use the improved Apriori optimization algorithm for mining, and finally merge the mining results to obtain frequent itemsets. Through experiments, the optimized algorithm has greatly improved selection mining and computing time than traditional algorithms. (shrink)

BackgroundThe Basal ganglia (BG) played a crucial role in the brain-level mechanisms of chronic pain disorders. However, the functional changes of BG in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are still poorly understood. This study investigated the BG subregions’ resting-state functional connectivity (rs-FC) in CP/CPPS patients compared with healthy controls.MethodsTwenty eight patients with CP/CPPS and 28 age- and education-matched healthy males underwent clinical measurements and 3T brain MR imaging, including T1-weighted structural images and resting-state functional imaging. The data were analyzed (...) by the seeded-based rs-FC analysis. Then, a machine learning method was applied to assess the feasibility of detecting CP/CPPS patients through the changed rs-FC.ResultsCompared with healthy males, patients presented decreased rs-FC between the BG subregions and right middle cingulate cortex, and correlated with pain (r = 0.51, p-uncorrected = 0.005) and urinary symptoms (r = –0.4, p-uncorrected = 0.034). The left superior temporal gyrus and right supramarginal gyrus showed decreased rs-FC with the BG subregions as well. The area under the receiver operating characteristic curve of 0.943 (accuracy = 80%, F1-score = 80.6%) was achieved for the classification of CP/CPPS patients and healthy males with support vector machine (SVM) based on the changed rs-FC.ConclusionThese findings provide evidence of altered BG subregions’ rs-FC in CP/CPPS, which may contribute to our understanding of the BG’s role in CP/CPPS. (shrink)

Using a sample of 32 work teams (32 work team leaders and their 321 followers) in Chinese cultural context, this study investigated the relationships between leaders’ and their followers’ psychological capital and the multilevel multiple mediation effects of social exchange and emotional contagion. Structural equation model and hierarchical linear model were applied to analyze the survey data. The results revealed that leaders’ psychological capital had a positive influence on their followers’ psychological capital. Leader-member exchange was the cross-level mediator between leaders’ (...) psychological capital and their followers’. The cross-level mediating effect of leaders’ positive emotions perceived by followers was not significant. The results of this study extended the social exchange theory and enriched researches on leadership. The implication was discussed in details. (shrink)

With a previous paper (Niu & Wang, 1995), a general, hypothetical outline of the mechanism of carcinogenesis was proposed. With reference to the fact of starvation-induced hypermutation in micro-organisms, we propose that the hypoxia commonly seen in the cells at the centre of solid tumours might also result in hypermutation, and then p53-dependent programmed cell death. Like the apparently adaptive mutations in micro-organisms, only those genes (e.g. p53) that enable the cells to escape from apoptosis may be selected.

The evolution in the quality of teaching for preschool education is worth studying. In this article, we solved the qualitative problems in the comprehensive quality evaluation by suggesting a method of quantitative combination and establishing a set of indicators suitable for the comprehensive quality evaluation of students in the kindergarten. According to the experience summed up by previous scholars, the weight of each index is obtained by an analytic hierarchy process. This study analyzed the defects and causes of fuzzy comprehensive (...) evaluation and the neural network model in the construction of early childhood and preschool education's comprehensive quality evaluation model and propose a Feedforward Neural Network model. FNN combined with neural network and fuzzy logic characteristics introduces fuzzy concepts and fuzzy inference rules into neural networks of neurons, the connection power, and network learning. It improves the learning ability of NN and fuzzy evaluation of the power of expression and effectively exerts the advantages of fuzzy logic and neural network to make up for their shortcomings. However, the convergence speed is very slow. To solve this problem, the similarity measure was used to improve the number of hidden layer nodes of the network. The effectiveness and feasibility of the FNN improved hidden layer nodes are verified by an example so as to realize the automation of comprehensive quality evaluation. (shrink)

This essay examines modern linguistic meaning of creativity and its roots in ancient Cinese philosophy. In particular, two kinds of creativity that originated in ancient Cinese thought -- natural and individual creativity -- are introduced and discussed.

This article is intended to discuss the issue of argumentation in Mencius in the form of book review, focusing on Haiwen Yang’s newly released monograph The World of Mencius. Unlike many scholars who are inclined to see the argumentations included in the book of Mencius in the light of logical debate, Yang attempts to embed Mencius in his social network, so as to reconstruct a “vivid” and “real” Mencius as lived in his own historical context. Yang’s narrative is characterized by (...) an emphasis on the interaction between the two lines of thought in Mencius, namely “moral idealism” and “cultural conformity.” In line with Yang’s interpretation of Mencius, our reading of Yang and of Mencius focuses on the hermeneutic circumstance in which Mencius’ argumentation came into existence, as a result of that, the political significance as well as humanistic concern in relation to Mencius’ eloquence and his argumentative character will be particularly addressed. (shrink)

Few studies have actually explored the impact of the COVID-19 pandemic on mental health in college students, although many studies have suggested that the COVID-19 pandemic poses a great threat to people’s mental health in many cohorts. Furthermore, college students may be a particularly vulnerable cohort that needs more attention and access to psychological services due to the psychological changes involved in the transition to college and the characteristics of college students’ study habits and lifestyle. Therefore, investigating the basic characteristics (...) of the impact of the COVID-19 pandemic on college freshmen is of great practical importance and has theoretical implications for the identification and provisioning of services to vulnerable cohorts. A total of 5,818 college freshmen completed the College Student Adaptability Inventory. The results suggest that the mean detection rate of the seven dimensions of undergraduate maladjustment to university is 27.13%. Specifically, livelihood self-management adaptability has the highest detection rate, while environmental general evaluation has the lowest detection rate. Moreover, the school adaptation of college freshmen is impacted by gender, number of siblings, and family socioeconomic status. Specifically, students who are female, an only child, and have a lower SES have lower levels of school adaptation. However, the school adaptation of college freshmen is not influenced by minority status or left-behind status. The findings of the present study suggest that the maladaptation of college freshmen has been a common phenomenon in China during the COVID-19 epidemic. Prevention programs may be most helpful if they pay more attention to effective intervention efforts for students who are female, an only child, and have a lower SES. (shrink)

Education public opinion information management is an important research focus in the field of Education Data Mining. In this paper, we classify the education data information based on the traditional Flat-OCC model. From the cognitive psychology perspective, we identify up to 12 kinds of emotions, including sadness and happiness. In addition, the EMO-CBOW model is also proposed in this paper to further identify emotion by using various emoticons in educational data sets. The empirical result shows that the proposed Flat-OCC model (...) can classify and identify the emotion of education public opinion data well; and for the recognition of educational emotion classification, the categorization accuracy of the Flat-OCC+EMO-CBOW model is significantly higher than that of a single Flat-OCC model, which reveals that the emotional-pack-based model we propose can enhance our benchmark model. (shrink)

Local development enhances the economic capacity and quality of life of the residents and, in particular, attracts tourism to the area. The co-creative value of the residents and the tourists can improve the consensus of the residents on the sustainable development of the place. This study focuses on the factors influencing the co-creation of value between residents and visitors in the Tamsui area near Taipei. The research hypothesis is based on the components of local attachment, economic benefits brought by tourists, (...) environmental costs, social and cultural welfare of the place, life satisfaction of the residents, and the value of co-creation between residents and tourists. A total of 430 questionnaires were collected through a questionnaire survey and statistical data were analyzed using a structural equation model, including descriptive statistical analysis, measurement reliability and validity verification, model fit, and structural model analysis to validate the research hypotheses. The study found that place attachment positively and significantly affects the economic benefits, environmental costs, and socio-cultural welfare of residents about tourists. Resident satisfaction is positively and significantly affected by the environmental costs from visitors and by socio-cultural welfare, but there is no significant impact from economic benefits. Finally, based on the findings of the study, practical recommendations were made for enhancing co-creation value between Tamsui residents and visitors, including enhancing residents’ feelings of place attachment and construction of local social culture and welfare. For the residents of Tamsui, unlike the local government and enterprises, need to be able to create value with tourists in order to have a friendly relationship with them and develop regional tourism in a sustainable manner. (shrink)

A varied air volume air-conditioning system comprises diverse input and/or output disturbances, which are commonly nonlinear, with large lag and uncertainty. Based on the traditional control methods, testing the controlling parameters of a VAV air-conditioning system is challenging. Sliding mode control could improve the robustness of the system due to the adaptive capacity of disturbance rejection. Moreover, the fuzzy algorithm could be employed to determine the stability of a sliding control system by adjusting the parameters in the approach rate, reducing (...) the switching frequency, and weakening chatter. Fuzzy sliding mode control is investigated in this paper to improve the performance of a VAV air-conditioning system. Simulation results verify that the sliding mode control is suitable for a VAV air-conditioning system to achieve good adaptability and robustness considering the influence of multiple external variable disturbances. In addition, the chattering of the system is improved after the introduction of fuzzy control. (shrink)

Because the traditional social media fuzzy static image interactive three-dimensional (3D) reconstruction method has the problem of poor reconstruction completeness and long reconstruction time, the social media fuzzy static image interactive 3D reconstruction method is proposed. For preprocessing the fuzzy static image of social media, the Harris corner detection method is used to extract the feature points of the preprocessed fuzzy static image of social media. According to the extraction results, the parameter estimation algorithm of contrast divergence is used to (...) learn the restricted Boltzmann machine (RBM) network model, and the RBM network model is divided into input, output, and hidden layers. By combining the RBM-based joint dictionary learning method and a sparse representation model, an interactive 3D reconstruction of fuzzy static images in social media is achieved. Experimental results based on the CAD software show that the proposed method has a reconstruction completeness of above 95% and the reconstruction time is less than 15 s, improving the completeness and efficiency of the reconstruction, effectively reconstructing the fuzzy static images in social media, and increasing the sense of reality of social media images. (shrink)

A total of 1,281 Chinese students in grades 3–6 participated in a study that examined the relationships among student-perceived supportive learning environment, mathematical achievement, autonomous self-regulation, and creative thinking. The results demonstrated that student PSLE is positively associated with autonomous self-regulation, creative thinking, and mathematical achievement. In addition, the study also demonstrated that the influence of PSLE on students’ mathematical achievements could be mediated through autonomous self-regulation and creative thinking, respectively. The results shed light on the effectiveness of a supportive (...) learning environment on educational and psychological outcomes in Chinese mathematical classrooms. (shrink)

Division of labour is a marked feature of multicellular organisms. Margulis proposed that the ancestors of metazoans had only one microtubule organizing center (MTOC), so they could not move and divide simultaneously. Selection for simultaneous movement and cell division had driven the division of labour between cells. However, no evidence or explanation for this assumption was provided. Why could the unicellular ancetors not have multiple MTOCs? The gain and loss of three possible strategies are discussed. It was found that the (...) advantage of one or two MTOC per cell is environment-dependent. Unicellular organisms with only one MTOC per cell are favored only in resource-limited environments without strong predatory pressure. If division of labour occurring in a bicellular organism just makes simultaneous movement and cell division possible, the possibility of its fixation by natural selection is very low because a somatic cell performing the function of an MTOC is obviously wasting resources. Evolutionary biologists should search for other selective forces for division of labour in cells. (shrink)

To cope with the water deficit resulting from saline environment, plant cells accumulate three kinds of osmotica: salts, small organic solutes and hydrophillic, glycine-rich proteins. Salts such as NaCl are cheap and available but has ion toxicity in high concentrations. Small organic solutes are assistant osmotica, their main function is to protect cytoplasmic enzymes from ionic toxicity and maintain the integrity of cellular membranes. Hydrophillic, glycine-rich proteins are the most effective osmotica, they have some characteristics to avoid crystallization even in (...) high concentration, but because they are expensive they are not as commonly used as salts or organic solutes. In addition there is the question of whether the genetic information for growth in saline environment is present in all kinds of plants, both halophytes and nonhalophytes. (shrink)

Objective: This study aimed to test the psychometric properties of the suicide stroop task in a Chinese college population. Methods: College students who were in the 1st–4th grade, fluent in Chinese, and without color blindness were recruited from a university in Guangzhou, China from September to December 2019. Participants were administered the suicide stroop task at baseline and 1-month follow-up. Results: The suicide stroop task showed excellent internal reliability. However, the suicide stroop task did not reveal suicide-related attentional biases among (...) current suicide ideators and was not significantly associated with the severity of suicidal ideation, depression, hopelessness, nor anhedonia, indicating a lack of concurrent validity for the task. Additionally, the two-time data of interference scores could not generate intraclass correlation coefficients due to a negative average covariance among data, which indicated poor test–retest consistency for the task. Conclusion: The results of this study did not support the use of the suicide stroop task on the identification of suicidal risk among Chinese college students. It is crucial to assess the psychometric properties of behavioral measures rigorously as self-report measures before large applications in clinical and community settings. (shrink)