Background The allocation of scarce deceased donor kidneys is a complex process. Transplant providers are increasingly relying on constructs such as frailty and cognitive function to guide kidney transplant (KT) candidate selection. Patient views of the ethical issues surrounding the use of such constructs are unclear. We sought to assess KT candidates’ attitudes and beliefs about the use of frailty and cognitive function to guide waitlist selection.Methods KT candidates were randomly recruited from an ongoing single-center cohort study of frailty and (...) cognitive function. Semi-structured interviews were conducted, and thematic analysis was performed. Inductively derived themes were mapped onto bioethics principles.Results Twenty interviews were conducted (65% contact rate, 100% participation rate) (60% male; 70% White). With respect to the use of frailty and cognitive function in waitlisting decisions, four themes emerged in which participants: (1) valued maximizing a scarce resource (utility); (2) prioritized equal access to all patients (equity); (3) appreciated a proportional approach to the use of equity and utility (precautionary utility); and (4) sought to weigh utility- and equity-based concerns regarding social support. While some participants believed frailty and cognitive function were useful constructs to maximize utility, others believed their use would jeopardize equity. Patients were uncomfortable with using single factors such as frailty or cognitive impairment to deny someone access to transplantation; participants instead encouraged using the constructs to identify opportunities for intervention to improve frailty and cognitive function prior to KT.Conclusions KT candidates’ values mirrored the current allocation strategy, seeking to balance equity and utility in a just manner, albeit with conflicting viewpoints on the appropriate use of frailty and cognitive impairment in waitlisting decisions. (shrink)

The goal of this study is to explore the cultural worldview of the prominent contemporary Arab poet and critic, Adonis (b. 1935). Adonis was one of the first thinkers to question the notion of tura>th (cultural heritage) and to consider it the main cause behind the backwardness of the Arab people of today. Better known as a poet, Adonis’s role as a cultural critic deserves to be highlighted. The present study aims to remedy this by analyzing and criticizing his position (...) on tura>th which was based on a deconstructive reading of foundational texts. His goal was to prove that tura>th was illogical and a hindrance to modernity or creativity. To better understand Adonis’s view on tura>th , this study investigates it against his intellectual and ideological background, and analyzes it in the light of primary texts. It concludes that, as a secular deconstructionist, Adonis sees inherited tura>th as a “text” retaining a static/dynamic dualism, and tries to show that the static elements of tura>th , which always appear stable, logical and capable of achieving progress, actually make it otherwise. He argues that divine revelation is responsible for the predominance of the static aspect of tura>th and hence represents an obstacle to human creativity and progress. For this reason, it must be deconstructed, paving the way for replacement of the static, i.e., religious elements, with dynamic or secular elements, which alone can enable the reconstruction of civilization. But, in the process, Adonis may, by replacing the religious with the secular, merely be setting in place a new static dimension. (shrink)

Recently, megastable systems have grabbed many researchers’ interests in the area of nonlinear dynamics and chaotic systems. In this paper, the oscillatory terms’ coefficients of the simplest megastable oscillator are forced to blink in time. The forced system can generate an infinitive number of hidden attractors without changing parameters. The behavior of these hidden attractors can be chaotic, tori, and limit cycle. The attractors’ topology of the system seems unique and looks like picture frames. Besides, the existence of different coexisting (...) attractors with different kinds of behaviors reflects the system's high sensitivity. Using the sample entropy algorithm, the system’s complexity for different initial values is assessed. In addition, the circuit of the introduced forced system is designed, and the possibility of implicating the system with analog elements is investigated. (shrink)

Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological changes before, immediately after, (...) and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F[2,26]= 6.367,p= 0.006) and ARAT (F[2,26]= 7.230,p= 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training.Clinical Trial Registration:This study has been registered atClinicalTrials.govwith clinical trial registration number NCT02323061. (shrink)

Recent work has shown that preschool-aged children and adults understand freedom of choice regardless of culture, but that adults across cultures differ in perceiving social obligations as constraints on action. To investigate the development of these cultural differences and universalities, we interviewed school-aged children (4–11) in Nepal and the United States regarding beliefs about people's freedom of choice and constraint to follow preferences, perform impossible acts, and break social obligations. Children across cultures and ages universally endorsed the choice to follow (...) preferences but not to perform impossible acts. Age and culture effects also emerged: Young children in both cultures viewed social obligations as constraints on action, but American children did so less as they aged. These findings suggest that while basic notions of free choice are universal, recognitions of social obligations as constraints on action may be culturally learned. (shrink)

Houston, Texas, is a major U.S. city with, like many, a growing aging population. The purpose of this study and ultimate book chapter is to explore the views and perceptions of long-term care (LTC) residents, family members and health care providers. Individuals primarily in independent living and group residential settings were interviewed and studied. Questions emphasized the concepts of personal autonomy, dignity, quality and location of care and decision making. Although a small sample of participants were involved, consistency was noted. (...) Keeping the elderly in caring and loving home situations (theirs or family) was most preferred. Personal choice and independence were emphasized by residents, but family members needed to act as advocates. We also noted that the legal system emphasizes family control over individual decision making as competency declines with aging. Optimal personal decision making in the residents' best interest also became more difficult with loss of individual mental capacity. (shrink)

The aim of this study is to gain an understanding of why employees misuse information systems resources in the workplace. Rather than consider “intention,” as existing behavioral research commonly does, this study investigates actual behavior and employs IS resource misuse as the dependent variable. Data from a web-based survey are analyzed using the partial least squares approach. In light of the dual-process approach and the theory of planned behavior, the findings suggest that IS resource misuse may be both an intentional (...) type of behavior and an unreasoned action. Perceived behavioral control influences employees’ IS resource misuse actions via their desires or intentions, whereas attitude toward such misuse affects these actions via employees’ desires alone. Subjective norm is found not to affect employees’ IS resource misuse via either desires or intentions. In terms of its theoretical contribution, this study considers unethical behavior in information systems by incorporating a dual-process model and the theory of planned behavior. With regard to its managerial significance, the study’s results will help managers to better understand why employees commit IS resource misuse within organizations. (shrink)

Mitigating response distortion in answers to sensitive questions is an important issue for business ethics researchers. Sensitive questions may be asked in surveys related to business ethics, and respondents may intend to avoid exposing sensitive aspects of their character by answering such questions dishonestly, resulting in response distortion. Previous studies have provided evidence that a surveying procedure called the randomized response technique is useful for mitigating such distortion. However, previous studies have mainly applied the RRT to individual dichotomous questions in (...) face-to-face survey settings. In this study, we focus on behavioral research examining the relationships between latent variables, which are unobserved variables measured by multiple items on Likert or bipolar scales. To demonstrate how the RRT can be applied to obtain valid answers from respondents answering a self-administered online questionnaire with Likert and bipolar scales, we build a behavioral model to study the effect of punishment severity on employees’ attitudes toward misuse of information systems resources in the workplace, which in turn influence misuse behavior. The survey findings meet our expectations. The respondents are generally more willing to disclose sensitive data about their attitudes and actual behavior related to misuse when the RRT is implemented. The RRT’s implications for causal modeling and the advantages and challenges of its use in online environments are also discussed. (shrink)

By around the age of 5½, many children in the United States judge that numbers never end, and that it is always possible to add 1 to a set. These same children also generally perform well when asked to label the quantity of a set after one object is added (e.g., judging that a set labeled “five” should now be “six”). These findings suggest that children have implicit knowledge of the “successor function”: Every natural number, n, has a successor, n (...) + 1. Here, we explored how children discover this recursive function, and whether it might be related to discovering productive morphological rules that govern language‐specific counting routines (e.g., the rules in English that represent base‐10 structure). We tested 4‐ and 5‐year‐old children’s knowledge of counting with three tasks, which we then related to (a) children’s belief that 1 can always be added to any number (the successor function) and (b) their belief that numbers never end (infinity). Children who exhibited knowledge of a productive counting rule were significantly more likely to believe that numbers are infinite (i.e., there is no largest number), though such counting knowledge was not directly linked to knowledge of the successor function, per se. Also, our findings suggest that children as young as 4 years of age are able to implement rules defined over their verbal count list to generate number words beyond their spontaneous counting range, an insight which may support reasoning over their acquired verbal count sequence to infer that numbers never end. (shrink)

Muscle synergies reflect the presence of a common neural input to multiple muscles. Steering small sets of synergies is commonly believed to simplify the control of complex motor tasks like walking and running. When these locomotor patterns emerge, it is likely that synergies emerge as well. We hence hypothesized that in children learning to run the number of accompanying synergies increases and that some of the synergies’ activities display a temporal shift related to a reduced stance phase as observed in (...) adults. We investigated the development of locomotion in 23 children aged 2–9 years of age and compared them with seven young adults. Muscle activity of 15 bilateral leg, trunk, and arm muscles, ground reaction forces, and kinematics were recorded during comfortable treadmill walking and running, followed by a muscle synergy analysis. We found that toddlers and preschoolers utilize a “walk-run strategy” when learning to run: they managed the fastest speeds on the treadmill by combining double support and flight phases. In particular the activity duration of the medial gastrocnemius muscle was weakly correlated with age. The number of synergies across groups and conditions needed to cover sufficient data variation ranged between four and eight. The number of synergies tended to be smaller in toddlers than it did in preschoolers and school-age children but the adults had the lowest number for both conditions. Against our expectations, the age groups did not differ significantly in the timing or duration of synergies. We believe that the increase in the number of muscle synergies in older children relates to motor learning and exploration. The ability to run with a FP is clearly associated with an increase in the number of muscle synergies. (shrink)

Trust is a key component in delivering quality and respectful care within health care systems. However, a growing lack of confidence in health care, particularly among specific subgroups of the population in the United States, could further widen health disparities. In this essay, we explore one approach to building trust and reaching diverse communities to promote health: engaging community‐based organizations (CBOs) as trusted community messengers. We present case studies of partnerships in health promotion, community education, and outreach that showcase how (...) CBOs’ programs build and leverage trust in health care systems through their workforce, services, and engagement with the community. (shrink)

The COVID-19 pandemic has significantly changed university students' life routines, such as prolonged stay at home and learning online without prior preparation. Identifying factors influencing student online learning has become a great concern of educators and researchers. The present study aimed to investigate whether family wellbeing would significantly predict university students' online learning effectiveness indicated by engagement and gains. The mediational role of individual wellbeing such as life satisfaction and sleep difficulties was also tested. This study collected data from 511 (...) undergraduate students via an online survey. Structural equation modeling analysis revealed positive effects of family support on students' learning engagement and gains through the mediational effects of life satisfaction and sleep difficulties. In contrast to our expectation, family conflict during the pandemic also positively predicted students' learning gains, which, however, was not mediated by individual wellbeing. The findings add value to the existing literature by delineating the inter-relationships between family wellbeing, individual wellbeing, and online learning effectiveness. The study also sheds light on the unique meaning of family conflict, which needs further clarification in future studies. (shrink)

Anna J Dare,1 Anthony RJ Phillips,1–3 Michael Chu,1 Anthony JR Hickey,2 Adam SJR Bartlett1–31Department of Surgery, 2Maurice Wilkins Centre for Biodiscovery, University of Auckland, Auckland, New Zealand; 3New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New ZealandBackground: Hepatic steatosis is increasingly encountered among organ donors. Currently, there is no consensus guideline as to the type or degree of donor steatosis considered acceptable for liver transplantation, and little is known about local practices in this area. The aim of this survey (...) was to evaluate current clinical practices amongst liver transplant surgeons in Australia and New Zealand in the evaluation and use of steatotic donor livers in LT.Methods: An anonymous online twelve-question survey was emailed to all practicing LT surgeons in ANZ in January 2010.Results: The response rate was 83%. Estimated prevalence of steatosis in donor livers was between 40% and 60%. In determining suitability for LT, 90% of respondents reported rejecting organs with "severe" steatosis based on visual and palpation grounds alone. A total of 68% sought further histological assessment if the donor liver looked bad and there were risk factors for steatosis. The majority of respondents performed only one biopsy of the liver, using hematoxylin and eosin staining for fat assessment. There was wide variation in the upper limit of steatosis considered to be acceptable for LT. A total of 21% of respondents still considered microvesicular steatosis a risk factor for primary graft nonfunction.Conclusion: This survey highlights the significant variation in the appraisal and use of steatotic grafts by LT surgeons in ANZ. Accurate evaluation and judicious use of mild and moderately steatotic grafts is required if we are to utilize the available donor pool best.Keywords: liver transplantation, steatosis, fatty liver, organ donors. (shrink)

Since its inception in September 2010, the Network for Public Health Law has responded to hundreds of public health legal technical assistance claims from around the country. Based on a review of these data, a series of major trends in public health practice and the law are analyzed, including issues concerning: the Affordable Care Act, tobacco control, emergency legal preparedness, health information privacy, food policy, vaccination, drug overdose prevention, sports injury law, public health accreditation, and maternal breastfeeding. These and other (...) emerging themes in public health law demonstrate the essential role of law and practice in advancing the public's health. (shrink)

Public health law research reveals significant complexities underlying the use of law as an effective tool to improve health outcomes across populations. The challenges of applying public health law in practice are no easier. Attorneys, public health officials, and diverse partners in the public and private sectors collaborate on the front lines to forge pathways to advance population health through law. Meeting this objective amidst competing interests requires strong practice skills to shift through sensitive and sometimes urgent calls for action (...) to address known threats to the health of individuals and the community. It also necessitates objective, timely information and national and regional legal support. (shrink)

Following a government campaign run by the Independent Commission Against Corruption (ICAC) in 1994, many Hong Kong companies and trade associations adopted written codes of conduct. The research study reported here examines how and why companies responded, and assesses the impact of code adoption on the moral climate of code adopters. The research involved (a) initial questionnaire surveys to which 184 organisations replied, (b) longitudinal questionnaire-based assessments of moral ethos and conduct in a focal sample of 17 code adopting companies, (...) (c) interviews with 33 managers in the focal companies examining the adoption and impact of the codes, and (d) content analysis of 41 company codes of conduct, including those of most focal companies, plus the ICAC model code.While a mixture of prudential and altruistic reasons were given for code adoption, content analysis suggested that the prime motive was corporate self-defence. The prevailing themes were bribery, conflict of interest, insider information, gambling, moonlighting, accuracy of records and misuse of corporate assets. Wider social responsibility tended to be neglected. Companies appeared to have imposed their codes top-down, emphasising disciplinary procedures rather than ethics training, and appointing neither ethics counsellors nor ombuds-people. The longitudinal study over a seven month period suggested that while moral ethos may have declined, overall standards of perceived conduct had not changed. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Adolescence is a developmental stage when adolescents are vulnerable to addictive behaviors, such as Internet addiction, which refers to pathological use of the Internet. Although there are views proposing that the links between IA and adolescent problem behavior may be bidirectional in nature, few studies have examined the reciprocal relationships between IA and other maladjustment indicators, and even fewer studies have simultaneously employed both emotional and behavioral maladjustment indicators in a single study. To address the above research gaps, the present (...) study investigated how IA is associated with both depression and delinquency among Chinese adolescents. Two waves of data were collected at two consecutive years, respectively, with 1year apart, from 3,010 students in four junior high schools in mainland China. These students completed the same questionnaire containing measures of IA, depression, and delinquency at each wave. The proposed cross-lagged panel model fitted the data very well, and there were significant positive reciprocal effects between IA and depression as well as delinquency after controlling for background socio-demographic factors. Gender differences were also observed in multi-group comparisons. Specifically, IA showed a stronger longitudinal impact on delinquency among boys than among girls. While depression significantly predicted IA in 1year among boys, such a prediction was not significant among girls. These findings delineate the bidirectionality of the associations between IA and emotional and behavioral maladjustment indexed by depression and delinquency, respectively. The findings also suggest that researchers and practitioners have to take gender differences as well as different developmental indicators in understanding the bidirectional influences between IA and adolescent behavioral and emotional development. (shrink)

Biography of Tran Duc Thao, 1917-1993, a Vietnamese philosopher.

Mitigating response distortion in answers to sensitive questions is an important issue for business ethics researchers. Sensitive questions may be asked in surveys related to business ethics, and respondents may intend to avoid exposing sensitive aspects of their character by answering such questions dishonestly, resulting in response distortion. Previous studies have provided evidence that a surveying procedure called the randomized response technique is useful for mitigating such distortion. However, previous studies have mainly applied the RRT to individual dichotomous questions in (...) face-to-face survey settings. In this study, we focus on behavioral research examining the relationships between latent variables, which are unobserved variables measured by multiple items on Likert or bipolar scales. To demonstrate how the RRT can be applied to obtain valid answers from respondents answering a self-administered online questionnaire with Likert and bipolar scales, we build a behavioral model to study the effect of punishment severity on employees’ attitudes toward misuse of information systems resources in the workplace, which in turn influence misuse behavior. The survey findings meet our expectations. The respondents are generally more willing to disclose sensitive data about their attitudes and actual behavior related to misuse when the RRT is implemented. The RRT’s implications for causal modeling and the advantages and challenges of its use in online environments are also discussed. (shrink)

On the morning of Friday, June 24, 2022, over half of the population of the United States was stripped of a fundamental constitutional right. And, within minutes, the reverberations of the Supreme...

The socialist construction in Vietnam, aspect of human role.

This study investigated the applicability of a novel instrument to assess parent–child attunement in free play interactions, in dyads with an infant with and without visual impairments. We here report the findings on the reliability and applicability of the newly developed Attune & Stimulate Mother–Infant 56-items Instrument in two separate samples: one with infants with VI and one with typically sighted infants. In addition, we assessed the contribution of parental sensitivity to attunement in dyadic interactions. The A&S M-I is an (...) observational comprehensive instrument of behaviors that captures different body parts and their motility, and different senses. The appropriate responding of a parent to the child’s signal reflects the ability to attune in the dyad as well as parent’s ability to stimulate the child to become engaged in the contact or activity. Consistency assessments revealed good reliability for maternal and infant behaviors, acceptable internal consistency and good test–retest reliability. Furthermore, both samples scored significantly above chance level on attunement, suggesting that the instrument captures parent–infant behavioral coordination, and VI was not related to parent–infant attunement. Lastly, a relation between parental sensitivity and attunement was found only in the TS sample. Altogether, these findings provide promising initial evidence of the applicability of the A&S M-I instrument for assessing dyadic attunement across different populations and ages. Having assessed the applicability of this observational instrument, future work should corroborate these findings in larger samples. (shrink)

The origins of Japan's medical ideas, which are deeply rooted in its religion, culture and history, are not widely understood in medical societies of other countries. We have taken up the task of summarising this tradition here so that some insight can be gained into the unique issues that characterise the practice of medicine in Japan. We borrow from the sayings of Tohkaku Wada, a medical philosopher of late eighteenth-century Japan, for a look at Japanese medical tradition. Wada's medical thought (...) was very much reflective of the Buddhism, Zen, and swordsmanship that informed eighteenth-century philosophy in Japan. His central concepts were “chu” and “sei”, that is, complete and selfless dedication to the patient and the practice of medicine. This paper explores Wada's thought, explaining it mainly from the standpoint of Japanese traditional culture. (shrink)

In Singapore, top down public education campaigns have long been a mode of governance by which the conduct of citizens is constantly regulated. This article examines how in two fairly recent campaigns, a new approach to campaign communication is used that involves media interdiscursivity, viz., the mixing of discourses and genres in which the media constitute a significant element. The present approach involves the appropriation of a popular local television character, ‘Phua Chu Kang’, in order to address the public through (...) educational rap music videos. Media interdiscursivity is based on an attempt to engage the public via a discourse of the ‘lifeworld’. The present article analyzes the ‘lifeworld’ discourse in terms of a combination of two processes, ‘informalization’ and ‘communitization’. The dual processes are examined and discussed in relation to the choice of Phua Chu Kang as an ‘ordinary’ and almost ‘real’ person, including his informal register and speech style; his use of Singlish; and his construction of ‘community.’ The presence of Singlish, in particular, is interesting because it is included as part of PCK’s public performance of the lifeworld. The article concludes by considering this form of media interdiscursivity as the government’s shrewd way of achieving its social governance goals. (shrink)

© The Author. Published by Oxford University Press on behalf of the Oxford Centre for Islamic Studies. All rights reserved. For Permissions, please email: [email protected] important collection of essays began life as a collaboration that arose from a workshop titled ‘Forms and Elements of Muslim Religiosity in Europe’ held at Leiden University. Jointly funded by Leiden University Centre for the Study of Islam and Society and the Dutch Organisation for Scientific Research NWO, the project enabled a number of early career (...) scholars working on lived Islam in Europe to plan the possibility of a volume on the topic. In March 2011, a seminar was held in Copenhagen, funded and convened by the Centre of European Islamic Thought, University of Copenhagen and the AHRC/ESRC Religion and Society Programme based at Lancaster University, to plan out the contents of the book. Although the completed project brought together... (shrink)