Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong (...) class='Hi'>Kong Chinese parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

Defining moral competence using a virtue approach, this longitudinal study examined the prospective relationships between moral competence and externalizing behavior indexed by delinquency and intention to engage in problem behavior in a large and representative sample of Hong Kong Chinese adolescents. Starting from the 2009–2010 academic year, Grade 7 students in 28 randomly selected secondary schools in Hong Kong were invited to join a longitudinal study, which surveyed participating students annually during the high school years. The current study (...) used data collected in the first three years (Wave 1 to Wave 3) across junior secondary school stage (Grade 7 to Grade 9) with a sample of 3,328 students (Age = 12.59 ±.74 years and 52.1% boys at Wave 1). Cross-lagged panel path analyses were conducted to compare four models involving different hypothesized patterns of relationships between moral competence and externalizing behavior. Results revealed that the reciprocal effects model best fit the data, supporting reciprocal causal relationships between moral competence and externalizing behavior measures. Specifically, a higher level of moral competence significantly predicted a lower level of delinquency and problem behavioral intention over time. At the same time, a higher level of externalizing behavior also significantly predicted a lower level of moral competence one year later. As the magnitudes of the significant findings were not high, replications in different Chinese communities are needed. Nevertheless, the present findings provide important theoretical insights on how moral competence and externalizing behavior in adolescents are associated with each other. Practically speaking, the findings suggest that it is promising to reduce adolescent externalizing behavior by promoting their virtues through moral education programs, and guiding adolescents to behave in a good manner would help promote the development of their virtues. (shrink)

Law abidance is very important for effective leaders. Without law abidance, abuse of power and corruption would easily happen, which would eventually erode organizational health. To promote law abidance leadership in university students in Hong Kong, we developed a law abidance leadership program with 3 h of face-to-face lecture and 7 h of self-study of materials disturbed to students. To understand students’ perception of the 3-h lecture, we conducted a post-lecture evaluation study using a 26-item measure. Results showed that (...) the scale possessed good reliability and validity. Confirmatory factor analyses showed that the assessment tool has three internally consistent and factorial invariant dimensions: program attributes, appreciation of law abidance, and teacher attributes. Regarding students’ perception of the program, students were generally satisfied with the lecture attributes, including design, content, lecture atmosphere, teaching quality, and benefits to students. In particular, students agreed that the lecture helped them understand the importance and value of law abidance and national security; over 95% of the students indicated that they would try their best to serve as law-abiding citizens and socially responsible leaders. Multiple regression analyses showed that program attributes, appreciation of law abidance, and teacher attributes predicted overall satisfaction with the lecture. Qualitative comments of the student echoed the quantitative findings, with most of the comments being positive in nature. The present study replicated the findings reported previously. Local and international contextual factors relevant to the interpretations of the findings are highlighted. (shrink)

In response to the severe lack of leadership assessment tools in the Chinese context, the Service Leadership Behavior Scale was developed based on the Service Leadership Model proposed by Po Chung, the co-founder of DHL International. Utilizing responses from 4,486 Hong Kong undergraduates, this paper reports the findings of a validation study on the Short-Form Service Leadership Behavior Scale (SLB-SF-65). Previous findings based on exploratory factor analysis revealed a six-factor 48-item solution (SLB-SF-48). With the removal of ten items, confirmatory (...) factor analysis showed that the final 38-item scale (SLB-SF-38) possessed excellent psychometric properties and factorial stability based on multigroup invariance analyses. The SLB-SF-38 also exhibited excellent reliability and convergent validity. Overall speaking, the present study underscored the utility of the SLB-SF-38 as an objective assessment instrument of service leadership behavior in the education, research and personnel training contexts. (shrink)

This article presents Mencius' concept of human dignity in the Chinese Confucian moral tradition, focused on the context of long-term care. The double nature of Mencius' notion of human dignity as an intrinsic quality of human beings qua being human is analyzed and contrasted with the dominant Western account of human dignity as grounded in personhood. Drawing on the heuristic force of an interview with an elder person in Hong Kong, the insights of the Mencian theory of human dignity (...) are used to provide a moral foundation for long-term care for elder persons in a context of diminishing personhood and shrinking autonomy. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

Background:Nurses exposed to community health nursing commonly encounter situations that can be morally distressing. However, most research on moral distress has focused on acute care settings and very little research has explored moral distress in a community health nursing setting especially among nursing students.Aim:To explore the moral distress experiences encountered by undergraduate baccalaureate nursing students in community health nursing.Research design:A descriptive qualitative design was employed to explore the community health nursing experiences of the nursing students that led them to have (...) moral distress.Participants and research context:The study included 14 senior nursing students who had their course in Community Health Nursing in their sophomore year and stayed in the partner communities in their junior year for 6 and 3 weeks during their senior year.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Nursing students are vulnerable and likely to experience moral distress when faced with ethical dilemmas. They encounter numerous situations which make them question their own values and ideals and those of that around them. Findings of the study surfaced three central themes which included moral distress emanating from the unprofessional behavior of some healthcare workers, the resulting sense of powerlessness, and the differing values and mindsets of the people they serve in the community.Conclusion:This study provides educators a glimpse of the morally distressing situations that often occurs in the community setting. It suggests the importance of raising awareness and understanding of these situations to assist nursing students to prepare themselves to the “real world,” where the ideals they have will be constantly challenged and tested. (shrink)

Background:Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students.Aim/objective:The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students.Research design:The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students.Participants and research (...) context:A total of 293 baccalaureate Filipino nursing students who have been exposed to various clinical areas participated in the study.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Results indicate that a majority of the nursing students in the clinical areas encounter morally distressing situations that compromise quality patient care. However, despite the fact that they want to do what is in the best interest of their patients, their perception of being the inexperienced among the healthcare team drives the majority of them to ignore morally distressing situations to avoid conflict and confrontation. Another interesting finding is that 79.20% of the respondents hardly consider quitting the nursing profession even if they frequently encounter morally distressing situations. Analysis also shows associations between moral distress intensity and frequency ( r = 0.13, p < 0.05) and moral distress intensity and moral sensitivity ( r = 0.25, p < 0.05). The dimensions of moral courage are also related to both moral distress and moral sensitivity.Conclusion:Results of the study imply that moral distress is a reality among all healthcare professionals including nursing students and requires more consideration by nurse educators. (shrink)

Although the two volumes of _Logic, Language, and Meaning_ can be used independently of one another, together they provide a comprehensive overview of modern logic as it is used as a tool in the analysis of natural language. Both volumes provide exercises and their solutions. Volume 1, _Introduction to Logic_, begins with a historical overview and then offers a thorough introduction to standard propositional and first-order predicate logic. It provides both a syntactic and a semantic approach to inference and validity, (...) and discusses their relationship. Although language and meaning receive special attention, this introduction is also accessible to those with a more general interest in logic. In addition, the volume contains a survey of such topics as definite descriptions, restricted quantification, second-order logic, and many-valued logic. The pragmatic approach to non-truthconditional and conventional implicatures are also discussed. Finally, the relation between logic and formal syntax is treated, and the notions of rewrite rule, automation, grammatical complexity, and language hierarchy are explained. (shrink)

Although the two volumes of _Logic, Language, and Meaning _can be used independently of one another, together they provide a comprehensive overview of modern logic as it is used as a tool in the analysis of natural language. Both volumes provide exercises and their solutions.

The central role played by Darwin's analogy between selection under domestication and that under nature has been adequately appreciated, but I have indicated how important the domesticated organisms also were to other elements of Darwin's theory of evolution-his recognition of “the constant principle of change,” for instance, of the imperfection of adaptation, and of the extent of variation in nature. The further development of his theory and its presentation to the public likewise hinged on frequent reference to domesticates.We have seen (...) that Darwin's reliance on the analogy between domesticated varieties and wild species was a bold and original step, in light of contemporary views on the nature of domesticates. However, as Darwin undoubtedly foresaw, his reliance on the analogy created difficulties as well as solving problems, and these began with his Malthusian codiscoverer of the principle of natural selection, Alfred Russel Wallace. Wallace's paper “On the Tendency of Varieties to Depart Indefinitely from the Original Type,” presented to the Linnean Scoiety along with the first public unveiling of Darwin's theory, states: We see, then, that no inferences as to varieties in a state of nature can be deduced from the observation of those occurring among domestic animals. The two are so much opposed to each other in every circumstance of their existence, that what applies to the one is almost sure not to apply to the other. Domestic animals are abnormal, irregular, artificial; they are subject to varieties which never occur and never can occur in a state of nature.62Much has been made of the similarity of views of Darwin and Wallace, but this quotation surely reveals how utterly different their views were on what to Darwin was an important matter. Several critics of the Origin saw Darwin's reliance on the domesticates as his Achilles heel. As Young has pointed out, Samuel Wilberforce included the following passage in his attack on the Origin: Nor must we pass over unnoticed the transference of the argument from the domesticated to the untamed animals. Assuming that man as the selector can do much in a limited time, Mr. Darwin argues that Nature, a more powerful, a more continuous power, working over vastly extended ranges of time, can do more. But why should Nature, so uniform and persistent in all her operations, tend in this instance to change? Why should she become a selector of varieties?63Another critic, Fleeming Jenkin, found the analogy a weakness in Darwin's theory because of the limited extent of variation in any one direction in domestic animals and plants.64 We have already seen that Darwin had confided a similar view to his notebook thirty years earlier, but changed his mind as a result of his profound study of domesticates. De Beer's reference to “an English country gentleman's knowledge of domestic plants and animals and their breeding”65 fails totally to recognize the originality and depth of Darwin's knowledge of domesticates.Why did Darwin, against the currents of his time, rely so heavily on mankind's experience with domesticated organisms to shape his theory about species in nature? On reason is that only with domesticates was an approach that came close to experimental verification possible. Darwin fully realized the inadequacies of the experiment, as is emphasized by his repeated contrasting of selection under nature and selection by man. Yet the extensive experience and data of plant and animal breeders offered the only reliable base against which Darwin could continually challenge his views. As he wrote in the introduction to Variation, with domestication, “man ... may be said to have been trying an experiment on a gigantic scale.”66 Given Darwin's high opinion of the quantitative work of Malthus and Quetelet (as emphasized by Schweber),67 and his unremitting efforts to secure data by which to test his theories, it was inevitable that he should attach high significance to domesticated varieties. John Tyndall, in his Belfast address of 1874, said: “The strength of the doctrine of Evolution consists, not in experimental demonstration (for the subject is hardly accessible to this mode of proof), but in its general harmony with scientific thought.”68 Darwin would have agreed with the latter thought, but I think he would have challenged the preceding one on the grounds that long experience with domesticated varieties did provide an element of experimental demonstration. It gave him confidence in his theory, and he used his vast knowledge of artificial selection boldly and creatively. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

purpose, the train of events which it sets up and the* ultimate end are seen as an ... Conversely, an organic whole is one which is determined by a purpose. ...