Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of (...) Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China. (shrink)

Adaptation to climate change impacts is a key research topic in business ethics that poses substantial implications on the good lives of human beings. The commercial port sector is a highly relevant study focus with its pivotal roles in supply chains and international trade. Hence, it is important to investigate whether the port planning system and practice is appropriate in tackling climate change impacts. But beforehand, we must thoroughly understand the attitude and behaviors of port planners and operators on ports’ (...) climate adaptation planning. Through a survey towards 21 ports in Canada, the paper investigates the attitude and behaviors of port planners and operators on ports’ climate adaptation planning. Towards the end, we propose a new approach so as to enable port stakeholders to carry out climate adaptation planning effectively. The paper offers important insight to researchers to investigate the ways in developing effective climate adaptation plans and practice for ports and other business sectors. (shrink)

Arbuscular mycorrhizal fungi are considered as a potential biotechnological tool for improving phytostabilization efficiency and plant tolerance to heavy metal-contaminated soils. However, the mechanisms through which AMF help to alleviate metal toxicity in plants are still poorly understood. A greenhouse experiment was conducted to evaluate the effects of two AMF species on the growth, Pb accumulation, photosynthesis and antioxidant enzyme activities of a leguminous tree at Pb addition levels of 0, 500, 1000 and 2000 mg kg-1 soil. AMF symbiosis decreased (...) Pb concentrations in the leaves and promoted the accumulation of biomass as well as photosynthetic pigment contents. Mycorrhizal plants had higher gas exchange capacity, non-photochemistry efficiency, and photochemistry efficiency compared with non-mycorrhizal plants. The enzymatic activities of superoxide dismutase, ascorbate peroxidases and glutathione peroxidase were enhanced, and hydrogen peroxide and malondialdehyde contents were reduced in mycorrhizal plants. These findings suggested that AMF symbiosis could protect plants by alleviating cellular oxidative damage in response to Pb stress. Furthermore, mycorrhizal dependency on plants increased with increasing Pb stress levels, indicating that AMF inoculation likely played a more important role in plant Pb tolerance in heavily contaminated soils. Overall, both F. mosseae and R. intraradices were able to maintain efficient symbiosis with R. pseudoacacia in Pb polluted soils. AMF symbiosis can improve photosynthesis and reactive oxygen species scavenging capabilities and decrease Pb concentrations in leaves to alleviate Pb toxicity in R. pseudoacacia. Our results suggest that the application of the two AMF species associated with R. pseudoacacia could be a promising strategy for enhancing the phytostabilization efficiency of Pb contaminated soils. (shrink)

Adaptation to climate change impacts is a key research topic in business ethics that poses substantial implications on the good lives of human beings. The commercial port sector is a highly relevant study focus with its pivotal roles in supply chains and international trade. Hence, it is important to investigate whether the port planning system and practice is appropriate in tackling climate change impacts. But beforehand, we must thoroughly understand the attitude and behaviors of port planners and operators on ports’ (...) climate adaptation planning. Through a survey towards 21 ports in Canada, the paper investigates the attitude and behaviors of port planners and operators on ports’ climate adaptation planning. Towards the end, we propose a new approach so as to enable port stakeholders to carry out climate adaptation planning effectively. The paper offers important insight to researchers to investigate the ways in developing effective climate adaptation plans and practice for ports and other business sectors. (shrink)

Objective: We aimed to evaluate the activity of the human glymphatic system in type 2 diabetes mellitus using diffusion tensor image analysis along with the perivascular space.Methods: Diffusion tensor images were acquired to calculate the diffusivities in the direction of the x-axis, y-axis, and z-axis of the plane of the lateral ventricle body in 20 patients with type 2 diabetes and 10 people in a control group. We evaluated the diffusivity along with the perivascular spaces, as well as the projection (...) fibers and association fibers, separately. The analysis along the perivascular space was defined as the mean /mean, where the Dxpro and Dxasc were the Dx values in the projection and association fiber areas, respectively.Results: There were significant differences in diffusivity along the projection fibers and the association fibers among the groups. The significant differences among the groups along the perivascular spaces, shown as the ALPS-index and medical history of T2DM, indicating lower water diffusivity along the perivascular space concerning type 2 diabetes severity, was also observed.Conclusion: Lower diffusivity along the perivascular space on DTI-APLS can reflect impairment of the glymphatic system in T2DM. This study showed that the activity of the glymphatic system could be evaluated by diffusion tensor image analysis. (shrink)

Let K be affine, that is, \\in {\mathbb {R}}^{n+m}: y_{1}=\cdots =y_{m}=0\}\). We compute the sharp constant of Hardy inequality related to the distance d for polyharmonic operator. Moreover, we show that there exists a constant \ such that for each \\), there holds $$\begin{aligned} \int _{{\mathbb {R}}^{n+m}}|\nabla ^{k} u|^{2}\mathrm{d}x\mathrm{d}y-c_{m,k}\int _{{\mathbb {R}}^{n+m}}\frac{u^{2}}{|y|^{2k}}\mathrm{d}x\mathrm{d}y\ge C\left ^{\frac{n+m-2k}{n+m}}, \end{aligned}$$where \, \}{n+m-2k}\), \p}{2}-n-m\) and \ is the sharp Hardy constant. These inequalities generalize the result of Maz’ya ) and Lu and the second author for polyharmonic operators). (...) In order to prove the main result, we establish some Poincaré–Sobolev inequalities on hyperbolic space which is of independent interest. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Great Synthesis of Wang Yang Ming Neo-Confucianism in Korea: The Chonŏn (Testament) by Chŏng Chedu (Hagok) by Edward Y.J. ChungMaria Hasfeldt Long (bio)The Great Synthesis of Wang Yang Ming Neo-Confucianism in Korea: The Chonŏn (Testament) by Chŏng Chedu (Hagok). By Edward Y.J. Chung. Landham: Lexington Books, 2020. Pp. vii+ 351. Hardcover $137.00, isbn 978-1-7936-1469-8. The Korean Neo-Confucian tradition during the Chosŏn dynasty (1392–1910) was dominated (...) by the orthodox Sŏngnihak (School of Human Nature and Principle), which is also known as the Chŏngjuhak (Cheng–Zhu School). This school of Neo-Confucianism followed the doctrines and teachings of the Great Synthesizer Zhu Xi (1130–1200) to such a point that other Neo-Confucian schools were labeled as wrong and even persecuted until the late nineteenth century. One of these schools was Simhak (School of the Mind/Heart) established by the Chinese scholar Wang Yangming (1472–1529), which during the Ming dynasty (1382–1644) had grown to rival the Cheng–Zhu school. However, the academic-political power of the Cheng–Zhu school in Korea managed to suppress Yangming scholarship and maintain dominance throughout the dynasty. Despite that, a few scholars did take up the scholarship of Simhak in Korea, with the most influential being Chŏng Chedu, also known as Hagok (1649–1736) (p. 4). In his book, The Great Synthesis of Wang Yang Ming Neo-Confucianism in Korea: The Chonŏn (Testament) by Chŏng Chedu (Hagok), Edward Y.J. Chung presents not only an annotated translation of Hagok's main writings but also a look into intellectual scholarship that opposed the orthodoxy of the Cheng–Zhu school of Korea. This in-depth study and translation of Hagok into English was motivated by the lack of attention in Western scholarship on Korean Neo-Confucianism. It presents a study that goes beyond the three most famous scholars, Yi Hwang T'oegye (1501–1570), Yi I Yulgok (1536–1584), and Chŏng Yagyong Tasan (1762–1836), who founded the three mainstream schools of the Chosŏn dynasty. According to Chung, Hagok's writing not only represents important aspects of intellectual history but also serves as a fourth and lesser-known school of Korean Neo-Confucian thinking that should be placed on the same level as the other three. Unlike other Korean scholars who tried to take up the Yangming doctrine, Hagok did not care that the doctrine was prohibited. This set him apart from other scholars. Despite the Cheng–Zhu school being the "right learning," Hagok did not agree with the majority of it and based his theories on the Yangming doctrine. Although Hagok openly followed the Yangming doctrine, he did not do so blindly. [End Page 1] Hagok was aware that Yangming's theories had their flaws and he agreed with some theories of the Cheng–Zhu school (p. 7–8). This resulted in him trying to synthesize the two schools into one harmonious doctrine, which is why Chung believes Hagok to be important and has undertaken the task of bringing attention to this Korean scholar. Consisting of two distinct parts, Chung gives the reader a solid introduction to Hagok and his main theories via the selected translations from his most influential text, Chonŏn, which can be translated into "testament" or "living words." The first part of the book is divided into notes on the translation itself, such as transliteration, citation style, abbreviations, and, more importantly, how and why Chung selected the sections of the Chonŏn that have been translated. Through the selection, translation, annotation, and discussion of forty-one important essays from Chonŏn's three parts, Chung wishes to show the heart of Hagok's Neo-Confucian thought (p. x). The Chonŏn is not organized according to any thematic system and consists of different paragraphs, notes, and comments. Chung has, therefore, chosen which parts to translate in order to best portray Hagok's interpretation of the key concepts, the theories found in the Yangming Neo-Confucianism, and Hagok's criticism of Zhu Xi and T'oegye. All of this is properly introduced and explained in... (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly (...) under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially. (shrink)

Obesity is a particularly vexing public health challenge, since it not only underlies much disease and health spending but also largely stems from repeated personal behavioral choices. The newly enacted comprehensive health reform law contains a number of provisions to address obesity. For example, insurance companies are required to provide coverage for preventive-health services, which include obesity screening and nutritional counseling. In addition, employers will soon be able to offer premium discounts to workers who participate in wellness programs that emphasize (...) behavioral choices. These policies presume that government intervention to reduce obesity is necessary and justified. Some people, however, argue that individuals have a compelling interest to pursue their own health and happiness as they see fit, and therefore any government intervention in these areas is an unwarranted intrusion into privacy and one's freedom to eat, drink, and exercise as much or as little as one wants. This paper clarifies the overlapping individual, employer, and social interest in each person's health generally to avoid obesity and its myriad costs in particular. The paper also explores recent evidence on the impact of government interventions on obesity through case studies on food labeling and employer-based anti-obesity interventions. Our analysis suggests a positive role for government intervention to reduce and prevent obesity. At the same time, we discuss criteria that can be used to draw lines between government, employer, and individual responsibility for health, and to derive principles that should guide and limit government interventions on obesity as health reform's various elements (e.g., exchanges, insurance market reforms) are implemented in the coming years. (shrink)

Presenting evidence from the social brain, we argue that neural reuse is a dynamic, socially organized process that is influenced ontogenetically and evolutionarily by the cultural transmission of mental techniques, values, and modes of thought. Anderson's theory should be broadened to accommodate cultural effects on the functioning of architecturally similar neural systems, and the implications of these differences for reuse.

Nurse practitioners can ease increased pressure on primary care shortage while providing a cost-effective and high-quality alternative to certain physician services. However, scope-of-practice laws are restrictive and their modification remains a source of controversy. Clearly, there is a need for new thinking around the scope of practice debate. This article conducted a review of literature and laws concerning the nursing scope of practice, as well as the outcomes of nurse-led care coordination models. It also examined different manifestations of the controversy (...) that arises in scope of practice debates. We argue that improved care coordination is necessary to improve outcomes and “bend the cost curve downward.” Allowing nurse practitioners and other providers to practice to the full extent of their licenses will result in improved care coordination. This can be accomplished by expanding nursing and other providers' scopes of practice. But any health care reform strategy, particularly with respect to chronic care management, must also serve to activate the patient herself as the keystone in the coordinated care process. Focusing first on the patient's need for coordinated care may be what is necessary to move beyond the existing impasse between physicians and nurses on scope of practice expansion. (shrink)

The apolipoprotein E gene plays an important role in the pathogenesis of Alzheimer's disease , and amyloid plaque comprised mostly of the amyloid-beta peptide ) is one of the major hallmarks of AD. However, the relationship between these two important molecules is poorly understood. We examined how A treatment affects APOE expression in cultured cells and tested the role of the transcription factor NF-B in APOE gene regulation. To delineate NF-B's role, we have characterized a 1098 nucleotide segment containing the (...) 5'-flanking region of the human APOE gene . Sequence analysis of this region suggests the presence of two potential NF-B elements. To demonstrate promoter activity, the region was cloned upstream of a promoterless luciferase gene. This segment was able to drive expression of luciferase in transient transfections of human fetal glial cells. Promoter activity was stimulated twofold by A treatment. Pretreatment with double-stranded DNA decoy oligonucleotides against NF-B reduced A stimulation. Deletion and mutagenetic analyses demonstrated that the distal NF-B element was functional and showed a strong DNA-protein complex band in gel shift analysis, similar to that from control NF-B consensus element. An anti-inflammatory and anti-NF-B drug, sodium salicylate, significantly blocked A-induced APOE promoter function. Our data provide evidence that upregulation of APOE by A in astroglial cells is mediated by an NF-B-element present in the 5'-flanking region of the APOE gene. (shrink)