Terry Lectures. A religious philosopher's exploration of the nature and history of the word argues that the word is initially and always sound, that it cannot be reduced to any other category, and that sound is essentially an event manifesting power and personal presence. His analysis of the development of verbal expression, from oral sources through the transfer to the visual world and to contemporary means of electronic communication, shows that the predicament of the human word is the predicament of (...) man himself. (shrink)

Considered the most important work of Walter Ong's career, Ramus, Method, and the Decay of Dialogue is an elegant review of the history of Ramist scholarship ...

In Interfaces of the World, Walter J. Ong explores the effects on consciousness of the word as it moves through oral to written to print and electronic culture.

An important, but relatively neglected, aspect of human theory of mind is emotion inference: understanding how and why a person feels a certain why is central to reasoning about their beliefs, desires and plans. The authors review recent work that has begun to unveil the structure and determinants of emotion inference, organizing them within a unified probabilistic framework.

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

The current COVID-19 pandemic and the previous SARS/MERS outbreaks of 2003 and 2012 have resulted in a series of major global public health crises. We argue that in the interest of developing effective and safe vaccines and drugs and to better understand coronaviruses and associated disease mechenisms it is necessary to integrate the large and exponentially growing body of heterogeneous coronavirus data. Ontologies play an important role in standard-based knowledge and data representation, integration, sharing, and analysis. Accordingly, we initiated the (...) development of the community-based Coronavirus Infectious Disease Ontology in early 2020. -/- As an Open Biomedical Ontology (OBO) library ontology, CIDO is open source and interoperable with other existing OBO ontologies. CIDO is aligned with the Basic Formal Ontology and Viral Infectious Disease Ontology. CIDO has imported terms from over 30 OBO ontologies. For example, CIDO imports all SARS-CoV-2 protein terms from the Protein Ontology, COVID-19-related phenotype terms from the Human Phenotype Ontology, and over 100 COVID-19 terms for vaccines (both authorized and in clinical trial) from the Vaccine Ontology. CIDO systematically represents variants of SARS-CoV-2 viruses and over 300 amino acid substitutions therein, along with over 300 diagnostic kits and methods. CIDO also describes hundreds of host-coronavirus protein-protein interactions (PPIs) and the drugs that target proteins in these PPIs. CIDO has been used to model COVID-19 related phenomena in areas such as epidemiology. The scope of CIDO was evaluated by visual analysis supported by a summarization network method. CIDO has been used in various applications such as term standardization, inference, natural language processing (NLP) and clinical data integration. We have applied the amino acid variant knowledge present in CIDO to analyze differences between SARS-CoV-2 Delta and Omicron variants. CIDO's integrative host-coronavirus PPIs and drug-target knowledge has also been used to support drug repurposing for COVID-19 treatment. -/- CIDO represents entities and relations in the domain of coronavirus diseases with a special focus on COVID-19. It supports shared knowledge representation, data and metadata standardization and integration, and has been used in a range of applications. (shrink)

Renaissance logician, philosopher, humanist, and teacher, Peter Ramus (1515-72) is best known for his attack on Aristotelian logic, his radical pedagogical theories, and his new interpretation for the canon of rhetoric. His work, published in Latin and translated into many languages, has influenced the study of Renaissance literature, rhetoric, education, logic, and--more recently--media studies. Considered the most important work of Walter Ong's career, Ramus, Method, and the Decay of Dialogue is an elegant review of the history of Ramist scholarship and (...) Ramus's quarrels with Aristotle. A key influence on Marshall McLuhan, with whom Ong enjoys the status of honorary guru among technophiles, this challenging study remains the most detailed account of Ramus's method ever published. Out of print for more than a decade, this book--with a new foreword by Adrian Johns--is a canonical text for enthusiasts of media, Renaissance literature, and intellectual history. (shrink)

Background We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research. Methods We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages and analysed with qualitative content and thematic analysis. Results Four (...) key themes emerged: nuanced understandings of data security and data sensitivity; trade-offs between data protection and research benefits; trust in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore. Conclusion Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective. (shrink)

Ontologies, as the term is used in informatics, are structured vocabularies comprised of human- and computer-interpretable terms and relations that represent entities and relationships. Within informatics fields, ontologies play an important role in knowledge and data standardization, representation, integra- tion, sharing and analysis. They have also become a foundation of artificial intelligence (AI) research. In what follows, we outline the Coronavirus Infectious Disease Ontology (CIDO), which covers multiple areas in the domain of coronavirus diseases, including etiology, transmission, epidemiology, pathogenesis, diagnosis, (...) prevention, and treatment. We emphasize CIDO development relevant to COVID-19. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

Current COVID-19 pandemic and previous SARS/MERS outbreaks have caused a series of major crises to global public health. We must integrate the large and exponentially growing amount of heterogeneous coronavirus data to better understand coronaviruses and associated disease mechanisms, in the interest of developing effective and safe vaccines and drugs. Ontologies have emerged to play an important role in standard knowledge and data representation, integration, sharing, and analysis. We have initiated the development of the community-based Coronavirus Infectious Disease Ontology (CIDO). (...) As an Open Biomedical Ontology (OBO) library ontology, CIDO is an open source and interoperable with other existing OBO ontologies. In this article, the general architecture and the design patterns of the CIDO are introduced, CIDO representation of coronaviruses, phenotypes, anti-coronavirus drugs and medical devices (e.g. ventilators) are illustrated, and an application of CIDO implemented to identify repurposable drug candidates for effective and safe COVID-19 treatment is presented. (shrink)

This work explores the vast differences between oral and literate cultures, offering an account of the intellectual, literary and social effects of writing, print and electronic technology.

Open Dialogue is an approach to working with mental health problems that emphasises promoting dialogue between multiple perspectives within an individual person and between all the people present, including the therapists. Therapists’ own perspectives are often introduced during conversations called reflections, which present a potential source of different perspectives. Using conversation analysis we analysed 14 hours of video-recorded Open Dialogue sessions with a focus on therapists’ reflections. We noticed that therapists did not display explicit agreement with each other’s reflections. This (...) absence of explicit agreement was displayed through a variety of verbal and non-verbal forms. Eliding agreement facilitated deference to the epistemic authority of the client, assertion of epistemic rights from second position, emphasis of a positive perspective or to voice multiple perspectives. Therapists avoided consensus and thus presented multiple perspectives to the family while also attending to issues of contingency. The implications of epistemic primacy and asymmetry connected to sequential structures in talk pose a challenge to the generation of collaborative reflective dialogues. (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

Governments are investing in precision medicine with the aim of improving healthcare through the use of genomic analyses and data analytics to develop tailored treatment approaches for individual patients. The success of PM is contingent upon clear public communications that engender trust and secure the social licence to collect and share large population-wide data sets because specific consent for each data re-use is impractical. Variation in the terminology used by different programmes used to describe PM may hinder clear communication and (...) threaten trust. Language is used to create common understanding and expectations regarding precision medicine between researchers, clinicians and the volunteers. There is a need to better understand public interpretations of PM-related terminology. This paper reports on a qualitative study involving 24 focus group participants in the multi-lingual context of Singapore. The study explored how Singaporeans interpret and understand the terms ‘precision medicine’ and ‘personalised medicine’, and which term they felt more aptly communicates the concept and goals of PM. Results suggest that participants were unable to readily link the terms with this area of medicine and initially displayed preferences for the more familiar term of ‘personalised’. The use of visual aids to convey key concepts resonated with participants, some of whom then indicated preferences for the term ‘precision’ as being a more accurate description of PM research. These aids helped to facilitate dialogue around the ethical and social value, as well as the risks, of PM. Implications for programme developers and policy makers are discussed. (shrink)

What fundamental changes in the state, and in the analysis of the state, have been stimulated by economic globalization? In the course of interactions with global markets and regulatory agencies, so-called Asian tiger countries like Malaysia and Indonesia have created new economic possibilities, social spaces and political constellations, which in turn condition their further actions. The shifting relations between market, state, and society have resulted in the state's flexible experimentations with sovereignty. Graduated sovereignty refers to a) the different modes of (...) governing segments of the population who relate or do not relate to global markets; and b) the different mixes of legal compromises and controls tailored to the requirements of special production zones. The Asian financial crisis further demonstrates the concept of graduation in that the market-oriented agenda can mean different things, strengthening state power and protections in certain areas, but not in others. (shrink)

Mutations in citizenship are crystallized in an ever-shifting landscape shaped by the flows of markets, technologies, and populations. We are moving beyond the citizenship-versus-statelessness model. First, the elements of citizenship are becoming disarticulated from each other, and becoming re-articulated with universalizing criteria of neoliberalism and human rights. Such ‘global assemblages’ define zones of political entitlements and claims. Second, the space of the ‘assemblage’, rather than the national terrain, becomes the site for political mobilizations by diverse groups in motion. Three contrasting (...) configurations are presented. In the EU zone, unregulated markets and migrant flows challenge liberal citizenship. In Asian zones, foreigners who display self-enterprising savoire faire gain rights and benefits of citizenship. In camps of the disenfranchised or displaced, sheer survival becomes the ground for political claims. Thus, particular constellations shape specific problems and resolutions to questions of contemporary living, further disarticulating and deterritorializing aspects of citizenship. (shrink)

We report one production and one comprehension experiment investigating the effect of animacy in relative clause attachment in Chinese. Experiment 1 involved a fill-in-the-blank task that manipulated the order of an animate noun phrase in a complex NP construction. The results showed that while low attachment responses exceeded high attachment responses overall (cf. Shen, 2006), a tendency exists to attach a relative clause to an animate NP in Chinese (cf. Desmet et al., 2002). Experiment 2 used a rating task to (...) examine the interplay between animacy and structural information by manipulating the order of the animate NP as well as the relative clause type (i.e., subject vs. object relative clauses). The results showed that the animate NP modification tendency found in Experiment 1 was limited to subject-relative clauses and that no animacy-related effect was found with object-relative clauses. These results are incompatible with purely structural parsing strategies such as Late Closure (Frazier, 1987) and the Predicate Proximity Principle (Gibson et al., 1996). Instead, the current results suggest that attachment ambiguity resolution in Chinese relative clauses is sensitive to animacy as well as structural information. (shrink)

A steady demand for green products from concerned consumers has led companies to introduce new product lines that match or exceed consumer environmental concerns. Nonetheless, not all the organizations were able to achieve significant returns on their investments in green products. These failures are generally attributed towards companies’ inability to overcome consumer scepticism towards the performance of functional and green attributes of their brands to generate a positive green image and green value in consumers mind. Therefore, the question arises that (...) does the success in promoting green brand image and value depend on consumer existing perceptions about the brand quality and credibility? This study analyzes the influence of brand perceive quality and credibility on consumer perceptions towards a brand green image, green value and green equity. A theoretical model with hypothesized relationships is developed and tested to answer these research questions. Data have been collected from the consumers of electrical and electronic goods. The hypothesized relationships were tested with the help of structural equation modeling procedure. The results suggest that brand perceived quality and its overall credibility does have a significant influence on generating a greener image, green perceive value and green brand equity. (shrink)

COVID-19 often manifests with different outcomes in different patients, highlighting the complexity of the host-pathogen interactions involved in manifestations of the disease at the molecular and cellular levels. In this paper, we propose a set of postulates and a framework for systematically understanding complex molecular host-pathogen interaction networks. Specifically, we first propose four host-pathogen interaction (HPI) postulates as the basis for understanding molecular and cellular host-pathogen interactions and their relations to disease outcomes. These four postulates cover the evolutionary dispositions involved (...) in HPIs, the dynamic nature of HPI outcomes, roles that HPI components may occupy leading to such outcomes, and HPI checkpoints that are critical for specific disease outcomes. Based on these postulates, an HPI Postulate and Ontology (HPIPO) framework is proposed to apply interoperable ontologies to systematically model and represent various granular details and knowledge within the scope of the HPI postulates, in a way that will support AI-ready data standardization, sharing, integration, and analysis. As a demonstration, the HPI postulates and the HPIPO framework were applied to study COVID-19 with the Coronavirus Infectious Disease Ontology (CIDO), leading to a novel approach to rational design of drug/vaccine cocktails aimed at interrupting processes occurring at critical host-coronavirus interaction checkpoints. Furthermore, the host-coronavirus protein-protein interactions (PPIs) relevant to COVID-19 were predicted and evaluated based on prior knowledge of curated PPIs and domain-domain interactions, and how such studies can be further explored with the HPI postulates and the HPIPO framework is discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A View of Life:Nietzsche, Kierkegaard, and the NovelYi-Ping OngI"My general task," Nietzsche scrawled, in the margins of his own copy of Cervantes's Don Quixote: "to show how life philosophy and art can have a deeper and affinitive relationship with each other."1 This enigmatic inscription commands a second reading not only because it seems to articulate the thread that links many of Nietzsche's philosophical projects together, but also because of (...) the very book in which it appears. The book is not a lofty tome of Schopenhauer's philosophy, as might be expected, but a mere novel: a fact which suggests that the novel itself was the art form that precipitated reflection on the relation of art to what Nietzsche calls here "life philosophy." In this essay, my aim is to deepen critical understanding of the novel's influence on Nietzsche and Kierkegaard, the two philosophers who are widely considered the fathers of existentialism. By means of a comprehensive overview of the novelistic reading and writing of these thinkers, I will show that both Nietzsche and Kierkegaard were profoundly influenced by the literary form of the novel and by its techniques for representing consciousness, subjectivity, and worldview.My focus in the analysis that follows is on the question of why Nietzsche and Kierkegaard read novels, and not on the more specific question of what they gained from particular novels. Isolating form from theme has three main advantages. First, it elucidates an important aspect of the intellectual context for these philosophers that has received little scholarly attention, namely the issue of why Nietzsche and Kierkegaard were drawn to fictional novelistic prose and how this literary form [End Page 167] affected their philosophy. Second, it allows the "deeper... affinitive" relationship between existentialist philosophy and the novel form to emerge, revealing the way in which existentialism and realism in the novel share a distinctive stylistic approach to the understanding of lived experience. Finally, it illuminates an intellectual precedent for the work of later existentialist thinkers such as Heidegger, Sartre, Beauvoir, and Camus, who drew increasingly on novelistic forms as both vehicle and inspiration for their philosophy.There are no previous studies devoted entirely to the novels read by Nietzsche and Kierkegaard, despite the fact that Nietzsche lists Stendhal and Dostoevsky as two of the greatest influences upon his thinking and that Kierkegaard's first published work is the review of a novel. Why did Nietzsche read the works not only of "philosophical" novelists like Stendhal, Dostoevsky, and Tolstoy, but also of Eliot, Twain, Sterne, and Flaubert? Why did Kierkegaard's interest in the "life-view" of the individual crystallize through his reflections on Hans Christian Andersen's novel Only a Fiddler? How did both of these existentialist thinkers link the task of connecting life and philosophy with their reading of novels, and how is their reading of novels related to their attempt to write philosophy in novel and increasingly novelistic ways?These questions lead us to address anew the issue of how philosophy and literature are related in a way that is not simply thematic or allegorical. Furthermore, they ask us to take into account the importance of the novel to thinkers whose work has primarily been studied in the context of other "serious" philosophical texts, despite the stylistic and formal affinity of their work to the novels they read. As Thomas Brobjer points out in his recently published work on Nietzsche's reading habits and intellectual sources, Nietzsche's Philosophical Context: An Intellectual Biography (2008), none of the standard works on Nietzsche comment on his reading or library despite the fact that his private library has been more or less preserved in its entirety.2 Brobjer's work is the only large-scale study of Nietzsche's reading to date; however, it limits itself to "the philosophical influences on Nietzsche," even as it acknowledges that he "often was influenced by some who cannot conventionally be regarded as philosophers: by authors and literary critics" (NPC, p. 3). Although Brobjer mentions several of these authors and critics, even noting some of the marginalia found in these texts, he places them largely in the context of influences upon Nietzsche... (shrink)

Immersive virtual environments can produce a state of behaviour referred to as ‘presence’, during which the individual responds to the virtual environment as if it were real. Presence can be arranged to scientifically evaluate and affect our consciousness within a controlled virtual environment. This phenomenon makes the use of virtual environments amenable to existing and in-development forms of therapy for various conditions. Delirium in the intensive care unit (ICU) is one such condition for which virtual reality (VR) technology has not (...) been evaluated to date. We are currently assessing the feasibility and utility of a delirium prevention and treatment system, which implements VR to improve quality of sleep, reduce pain, lower usage of sedatives, and stimulate cognition. The proposed system will consist of 3-axis wearable accelerometers, 6-DOF position trackers, a VR system and apps designed to promote sleep quality and mindfulness. Our a priori hypothesis is that our VR therapy system would lower the occurrence of delirium in patients admitted to ICUs. (shrink)

The distinctness of each person’s life and experience is an important consideration in dominant accounts of how democratic institutions should distribute basic rights and liberties. Drawing on recent social movements, philosophers like Iris Marion Young, Miranda Fricker, and Axel Honneth have nonetheless drawn attention to the distinctive claims and challenges that plurality and difference entrain in democratic societies by analysing how the dominant discourses on rights and justice tend to elide, obscure, or reify the lived experiences of individuals belonging to (...) disadvantaged and oppressed groups. In this essay, I offer an independent justification for why we should take such lived experiences seriously. I show how the lived experiences of disadvantaged and oppressed individuals can be a resource for deep and meaningful social change. I propose a distinctive kind of social change in which the disadvantaged and oppressed themselves drive the process of transformation whereby they change the oppressive frames of difference relating to their race, class, sex, or ability. I call this kind ‘organic social change’. I also show that organic social change is distinctively important in that the disadvantaged and oppressed get to enact an empowering mode of cooperation that harnesses their singularities when they are the ones driving the process of their own and one another’s transformations. (shrink)

Ong, Caroline In February 2014, the Belgian parliament passed an amendment to the Belgian Act on Euthanasia of May 28th, 2002 removing the age limit of those requesting euthanasia provided that they have discerning capabilities and their parents approve. After mentioning briefly the arguments against legalising euthanasia, this article questions the ethical validity of removing the age limit, as well as the presumption that ending lives prematurely allows people to die with dignity. Caring for people who are vulnerable in their (...) suffering is the proper goal of the healing professions, not terminating lives. (shrink)

This paper selected Vanke as the case to study the governance problems of Vanke and the protection of the interests of small and medium shareholders under the situation of equity disputes. At the same time, the study further explored the advantages and disadvantages of the dispersed ownership structure, the long-term impact on the company’s development and the choice of the involved corporate governance methods under the current Chinese capital market conditions. This paper adopted the event research method and selected the (...) period from June 2015 to June 2017 as the observation period to analyze the market performance impact of Vanke in the equity disputes. At the same time, this paper also measured Vanke’s individual stock rate of return and market rate of return, and calculated Vanke’s normal rate of return [E], abnormal rate of return, and cumulative abnormal rate of return during different event windows. Vanke’s shareholding was too dispersed and the stock price had been sluggish for a long time, which had greatly reduced the acquisition difficulty and cost of Baoneng, thus triggering the “barbarian invasion” of Baoneng. In the struggle for control, whether it was Vanke’s anti-takeover measures or China Resources, Baoneng, and Evergrande’s competition for equity, their actions had harmed the interests of small and medium shareholders. The market supervision department was too lenient to supervise and punish the interests of small and medium shareholders, and opportunism made behaviors that infringe on the interests of others more reckless. However, small and medium shareholders cannot actively participate in the company’s management decision-making to safeguard their legitimate rights and interests, which intensifies the violations of all parties in the equity disputes, thus forming a vicious circle. Therefore, the protection of the interests of small and medium shareholders required the joint efforts and consciousness of regulators, small and medium shareholders, and acquirers. (shrink)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

Between 1946 and 1965, a period during which her contemporaries are calling into question the value of traditional novelistic realism, Simone de Beauvoir develops an extended and nuanced account of the philosophical significance of the realist novel in essays such as “Littérature et métaphysique”, “An American Renaissance in France”, and “Que peut la littérature?”. Beauvoir’s central claim is that novels do philosophical work not by articulating theoretical positions or illustrating abstract themes but by reorienting philosophical ways of understanding truth, world, (...) and reality in and through their very form. Her analysis delineates key.. (shrink)

Ong, Caroline Whilst the reason and purpose of suffering may never be fully understood, there are ways of enduring, transcending and growing resilience to how it affects us. Our experience of suffering lies in the web of perceptions that involve our physical, spiritual and cosmological beliefs. Referencing Pain Seeking Understanding: Suffering, Medicine and Faith, edited by Margaret E. Mohrmann and Mark J. Hanson, this article gives a brief exploration of some propositions as to why an all-powerful, good God would allow (...) suffering to exist. From these various perspectives and using examples cited in the book, the article proposes that the healing art of medicine, honed through years of experience, knowledge and wisdom, can help individual patients endure and transcend suffering, and be whole once again. (shrink)

Ong, Caroline As health systems become more complex, moral distress is increasingly being recognised as a significant phenomenon amongst health professionals. It can be described as the state of being distressed when one is unable to act according to what one believes to be morally right. It may compromise patient care, the health professional involved and the organisation. Cumulative experiences of incompletely resolved moral distress - a phenomenon which is called moral residue - may leave us susceptible to more frequent (...) and more severe moral distress. Clear open communication, respect, inclusivity, openness to differences, compassion, support, education and the capacity to grow in self-awareness are key aspects in minimising moral distress. Early recognition of its symptoms and addressing both personal and external constraints of actions can also minimise moral residue and build resilience to further distress. (shrink)

PurposeThis study aims to describe the adverse events following immunization of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress.MethodsA cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale before and after the first and second doses of COVID-19 vaccine.ResultsA total of 217 complete responses were received. Compared with before vaccination, both HADS Anxiety and HADS (...) Depression scores were significantly reduced after the first and second dose of the SARS-CoV-2 vaccine. Most of the participants had mild-or-moderate systemic and local AEFIs, with the most common being pain at the injection site, tiredness, and headache for both the first and second doses of the vaccine. Positive correlations between the total AEFI score and HADS-A and HADS-D scores were observed after the first dose of the SARS-CoV-2 vaccine. Similarly, positive associations were observed between the total AEFI score and HADS-A and HADS-D scores after the second dose of the SARS-CoV-2 vaccine.ConclusionMild-to-moderate AEFIs found in this study help address vaccine hesitancy in cancer patients/survivors. Receiving the SARS-CoV-2 vaccine had a positive effect on decreasing psychological distress in cancer patients/survivors. High severity of an AEFI was associated with higher anxiety and depressive symptoms. (shrink)

Ong, Caroline In the debate about euthanasia, it is important that we consider all views, including those which might not at first seem attractive to us. Whether we believe in God or not, the views of the Catholic Church make a significant contribution to this debate. The Church does not support the deliberate killing either of oneself or another person. It also emphasises our moral obligation to respect life and to uphold the dignity of each person.