Resolving the challenge of flight delays caused by air traffic congestion renders it necessary to explore the mode of congestion propagation. By applying complex network theory, this article establishes a complex network structure where airspace sectors act as nodes, and the edges represent traffic flow relationships between sectors. In addition, a cascading failure model is proposed to analyze the airspace sector network’s invulnerability. The critical threshold and the sector abnormality rate are determined according to the cascading failure measurement indexes. Based (...) on the remaining capacity of sector nodes, two optimization strategies are proposed: adjacent load redistribution strategy and local load redistribution strategy. The simulation results demonstrate that the local load redistribution strategy greatly improves the airspace sector network’s invulnerability to cascading failure. (shrink)

The sizes of individual data files have steadily increased along with rising demand for customized services, leading to issues such as low efficiency of web-based geographical information system -based data compression, transmission, and rendering for rich Internet applications in complicated visualization systems. In this article, a WebGIS-based technical solution for the efficient transmission and visualization of meteorological big data is proposed. Based on open-source technology such as HTML5 and Mapbox GL, the proposed scheme considers distributed data compression and transmission on (...) the server side as well as distributed requests and page rendering on the browser side. A high-low 8-bit compression method is developed for compressing a 100 megabyte file into a megabyte-scale file, with a compression ratio of approximately 90%, and the recovered data are accurate to two decimal places. Another part of the scheme combines pyramid tile cutting, concurrent domain name request processing, and texture rendering. Experimental results indicate that with this scheme, grid files of up to 100 MB can be transferred and displayed in milliseconds, and multiterminal service applications can be supported by building a grid data visualization mode for big data and technology centers, which may serve as a reference for other industries. (shrink)

Backgrounds Moral distress significantly affects pediatric ICU nurses, leading to nurse burnout, increased turnover and reducing patient care quality. Despite its importance, there’s a notable gap in knowledge on how to manage it effectively. Aims This review aimed to systematically identify and analyze coping strategies and interventions targeting moral distress among pediatric nurses in ICU, uncovering research gap and future studies directions. Methods A scoping review was conducted followed framework by Levac, Colquhoun, and O'Brien and Arksey and O'Malley. Searches were (...) performed in 11 electrical databases, like PubMed and China Biology Medicine disc, within a timeframe of the database construction to November 2023, and performed literature screening and data extraction. Results Sixteen articles were ultimately included. Coping strategies adopted by pediatric ICUs nurses can be categorized into adaptive and maladaptive strategies, with the latter including passive acceptance, taking leave, and drinking, while the former involve pursuing interests outside of work, reflection and philosophizing, and communication. Nine articles described and evaluated the effectiveness of interventions for moral distress, categorizing them into individual and institutional levels. Individual-level interventions include Interprofessional Perspective-Taking, the PICU Resiliency Bundle, Ethics Education/Skills, and the Center for Caring. Institutional-level interventions encompasses Comprehensive Care Round, Goals of Care Conversations, Pediatric Ethics and Communication Excellence Rounds, Nursing Ethics Council, and Medical Ethical Decision-Making, though not all were effective in alleviating moral distress. Conclusions Nurses often use self-adjustment strategies for moral distress, institutional ethical support focusing on enhancing nurses’ moral resilience, promoting reflective thinking and improving communication remains crucial. Various interventions for moral distress are currently available, but nurse engagement is low and their effectiveness remained to be verified. Future studies should explore what aids or hinders these interventions. There’s also a need for large, multicenter trials and ongoing evaluations to create effective support systems for pediatric ICU nurses. (shrink)

As English plays a significant role in most professions, improving the English for Specific Purpose writing competence allows individuals to participate in the global professional community, which makes ESP writing important for research. However, research on ESP writing is reported to be insufficient, and how factors such as emotions affect ESP writing is rarely and marginally studied. Therefore, this study aimed at investigating how induced emotions influence the learning outcome in ESP writing classes with an emphasis on a particular rhetorical (...) choice among medical university undergraduates. A total of 63 medical university undergraduates were recruited. After the emotional inducement, they were taught with materials selected and adopted from the BioCauses corpus and with an explicitly inductive teaching approach. Results revealed that positive emotions positively correlated with better learning outcomes, while negative emotions hindered participants in their learning. The results shed light on the impact of emotional states on ESP/medical research article writing, learning, and teaching. Further study implications were provided accordingly. (shrink)

Although Canadian consumer magazine advertising still portrayed men more favourably in 1990, its portrayal of women was more positive than before. Advertising faces the dilemma as both a selling tool and a means of social communication. Advertisers have a social responsibility as corporate citizens in ensuring that advertising reflects the continuing improvement of women 's socioeconomic status and power.

This study aimed to test the association between personality traits and affect among boxers and to figure out whether loneliness mediated this relationship. This study used The Big Five Personality Traits Scale, The UCLA Loneliness Scale, and The Positive and Negative Affect Scale which were administered to N = 231 boxers, of which 62% were male and 38% were female. The results showed that conscientiousness, extraversion, and agreeableness were negatively related with negative affect, neuroticism was positively associated with negative affect, (...) and openness showed no relationship with negative affect; conscientiousness, extraversion, and agreeableness were all positively correlated with positive affect, neuroticism was negatively associated with positive affect, and openness showed no relationship with positive affect; conscientiousness, extraversion, openness, and agreeableness were negatively related with loneliness and neuroticism was positively associated with loneliness; and loneliness was positively associated with negative affect; loneliness was negatively associated with positive affect; and loneliness had mediating effect on the relationship between the personality traits and affect. Furthermore, these findings suggest that loneliness might be one mechanism explaining how boxer’s personality traits influence their athletic performance. Therefore, in the future, we should start by helping them reduce their loneliness to reduce their negative affect and improve their positive affect and also, in some degree, to enhance boxers’ athletic ability and mental quality health. (shrink)

The adaptation aftereffect plays a critical role in human development and survival. Existing studies have found that, compared with general individuals, individuals with learning disability, autism and dyslexia show a smaller amount of non-affective-based cognitive adaptation aftereffect. Nevertheless, it is unclear whether individuals with depression or depression tendency show similar phenomenon in the adaptation aftereffect, and whether such depression tendency occurs in the non-affective-based cognitive or emotional adaptation aftereffect. To address this question, the present study conducted two experiments. Experiments 1A (...) and 1B used the emotional facial expression adaptation paradigm to examine whether Chinese participants showed the emotional adaptation aftereffect and whether the emotional adaptation aftereffect was influenced by physical features of faces, respectively. Experiment 2 recruited two groups of participants, with high and low depression, respectively, to examine whether they showed differences in the emotional or cognitive adaptation aftereffect. Results showed that Chinese participants showed the typical emotional adaptation aftereffect, which was not influenced by physical features of faces. More importantly, compared to the low-depression group, the high-depression group showed a smaller emotional adaptation aftereffect, but the two groups showed a similar cognitive adaptation aftereffect. These results suggest that level of depressive symptoms is associated with the emotional adaptation aftereffect. (shrink)

Studies have shown that performance‐dependent monetary rewards facilitate visual perception. However, no study has examined whether such a positive effect is limited to the rewarded task or may be generalized to other tasks. In the current study, two groups of people were asked to perform two visual perception tasks, one being a reward‐relevant task and the other being a reward‐irrelevant task. For the reward‐relevant task, the experimental group received performance‐dependent monetary rewards, whereas the control group did not. For the reward‐irrelevant (...) task, both groups were not rewarded. The two tasks were randomly intermixed trial by trial (Experiment 1) or presented block by block (Experiment 2) or session by session (Experiments 3a, 3b, and 3c). Results showed that performance‐dependent monetary rewards improved participants' performance on the relevant task in all experiments and impaired their performance on the irrelevant task in Experiments 2, 3a, 3b, and 3c. These results suggested that monetary rewards might incur a cost on reward‐irrelevant tasks. Finally, the benefit of monetary rewards disappeared when they were no longer provided during the final session. This is the first study that reveals both the bright and dark sides of the performance‐dependent monetary rewards in visual perception. (shrink)

As traditional methods such as questionnaires for measuring risk propensity are not applicable in some scenarios, a nonintrusive method that could automatically identify individuals' risk propensity could be valuable. This study utilized Defense of the Ancients 2 single match data and historical statistics to train predictive models to identify risk propensity by machine learning methods. Self-reported risk propensity scores from 218 DOTA 2 players were paired with their behavioral metrics. The best-performing model occurred with Gaussian process regression. The root mean (...) square error of this model was 1.10, the correlation between predicted scores and self-reported questionnaire scores was 0.44, the R-squared was 0.17, and the test–retest reliability was 0.67. We discussed how selected behavioral features could contribute to predicting risk propensity and how the approach could be of potential value in the application of perceiving individuals' risk propensities. Moreover, the limitations of our study were discussed, and recommendations were made for future studies in this field. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

本书一套3本,运用辨证,发展和历史的观点,重新审视传统孝道文化,记录和反映了岭南孝道文化的概貌,呈现出岭南人如何认识和践行孝道,探讨了当代孝道文化建设应该如何开展,现代人应该如何行孝的问题.本册上篇对 古代二十四孝故事进行了解读和点评,指出了其中的合理思想和糟粕文化,中篇介绍了岭南先贤的行孝故事,下篇收录了有关孝的经典语录.

Orphans and vulnerable children fall under the category of children who are at risk of exposure to more stressful circumstances and receive less social assistance compared to other children. This study aims to investigate the impact of group counseling based on social intervention and psychological therapy on social support and the perceived stress growth of orphans and vulnerable children. In one special educational needs school in Nanning, China, the SSGPC was developed and implemented. Using the social support and post-stress growth (...) scales, the researchers investigated the effects of SSGPC on orphans and vulnerable children. Twenty-seven orphans and vulnerable children between the ages of nine and 12 were arbitrarily assigned to the experimental and control groups. A pre-test post-test method of quasi-experimental design was applied, with 13 participants in the experimental group and 14 in the control group. The results revealed that the intervention group had significantly higher scores for social support and post-stress growth than the control group. The SSGPC had significantly improved the levels of social support for orphans. The findings indicated that the SSGPC provided an effective way to improve social support and post-stress growth of orphans and vulnerable children. (shrink)

History and development of Buddhism in general and Tibet in particular; includes comparative philosophy of Buddhism with Hinduism.

History and development of Buddhism in general and Tibet in particular; includes comparative philosophy of Buddhism with Hinduism.

Ben shu jie shao le gong zi zhen, wei yuan, yan fu, kang you wei, tan si tong, liang qi chao, chen tian hua, zhang bing lin deng wan qing si xiang jia de zhe xue si xiang.

Yi jing dian jie du he guan nian quan shi wei ji nen jin lu de si xiang shi yan jiu, yu wei rao xin yang yu she hui shen g huo de hu dong zhan kai de she hui shi yan jiu ke yi bei shi zuo zong jiao li shi yan jiu de liang ge zhi dian. Xin yang cong dai dou shi yi ti liang mian de: shi zhong guan qie chao yue de zhi qu bi ran (...) shi de xin yang yi mou zhong si xiang huo guan nian de fang shi fou ding huo shu li ri chang sheng huo he shi su shi jie, que li du te de yu zhou zhi xu yu xin yang jia zhi; yu zhi xiang dui, xin yang shi jian de zhan kai you shi yu ri chang sheng huo xu yu bu li de, cong xian shi de yi yi shang shuo, yi zhong chun cui qie tuo li le shi su sheng huo de xin yang shi nan yi xiang xiang de. Jiu dao jiao er yan, xiu zhen deng xian de xuan si yu rang zai qi fu de shi jian shi bu ke fen ge de, ke yi jie lu de gui zhi yu du die zhang ji de lu fa ye shi bing xing bu bei de. Ru guo yao chang shi li jie mou yi ge li shi shi qi zhong de dao jiao xin yang, jiu xu yao jie he qi shi de jing dian wen xian yu she hui sheng huo. Jian ci, ben shu yi Tang Song shi qi de dao jiao xin yang wei zhu ti, fen bie cong Sui Tang shi qi de dao jiao xin yang si xiang yu Tang Song shi qi de lu fa ji xin yang guan lian liang ge shi jiao zhan kai zhuan ti yan jiu, zhan shi shang shu yi ti liang mian de xin yang shi kuang jia. (shrink)

Xue xi he yan jiu Zhongguo zhe xue, yi ban lai shuo, Feng xian sheng shi ke chao er bu ke yue de. Yi si shi, hou ren wan quan ke neng er qie ye ying dang sheng guo Feng xian sheng, dan shi que bu neng rao guo Feng xian sheng. Rao guo Feng xian sheng, bu dan bi ran yao duo fei li qi, er qie rong yi zou wan lu er nan yu shen ru tang ao. Feng (...) Youlan zuo wei wo guo jin dai zhe xue de yi dai ju bo, zai mou zhong yi yi shang, ying xiang liao zheng ge jin dai Zhongguo zhe xue de ge ju. Er dui yu Feng Youlan zhe xue ji qi xue shu sheng ya de yan jiu, ye sui zhe dang dai guo xue yan jiu de xing qi, shou dao yue lai yue duo de guan zhu. Minguo shi qi de Zhongguo xue shu jie, ying gai shuo shi hui ju le yi da pi kua shi dai de xue shu jing ying, te bie shi zai chuan tong xue shu ling yu, kan cheng yi chang si xiang de sheng yan.ben shu zuo zhe zai hao ru yan hai de Minguo wen xian zhong, jing xin zheng li chu dang shi xue jie dui Feng Youlan zhe xue de hui ying he dui hua, qi zhong bao kuo zhu ru Chen Yinke, Jin Yuelin, Hu Shi, Zhang Dainian, Cai Shangsi deng yi da pi xue jie tai dou de wen zhang, zi liao xing fei chang qiang, bu jin fan ying le zhu wei xue zhe ge ren de du dao jian jie, geng cong yi ge ce mian fan ying le Minguo shi qi Feng Youlan zhe xue yan jiu de sheng kuang, dui dang xia yan jiu Feng Youlan zhe xue si xiang ju you zhong yao de can kao jia zhi. (shrink)

A strongly deterministic theory of physics is one that permits exactly one possible history of the universe. In the words of Penrose (1989), "it is not just a matter of the future being determined by the past; the entire history of the universe is fixed, according to some precise mathematical scheme, for all time.” Such an extraordinary feature may appear unattainable in a world like ours. In this paper, I show that it can be achieved in a simple way and (...) discuss its implications for metaphysics and philosophy of science, including natural properties, free will, explanation, and modality. First, I propose a precise definition of strong determinism. Next, I discuss its philosophical ramifications and a toy example. Finally, I provide a realistic example of a strongly deterministic (and simple) physical theory---the Everettian Wentaculus. A surprising consequence is that whether or not our world is strongly deterministic may be empirically underdetermined. (shrink)

If there are fundamental laws of nature, can they fail to be exact? In this paper, I consider the possibility that some fundamental laws are vague. I call this phenomenon 'fundamental nomic vagueness.' I characterize fundamental nomic vagueness as the existence of borderline lawful worlds and the presence of several other accompanying features. Under certain assumptions, such vagueness prevents the fundamental physical theory from being completely expressible in the mathematical language. Moreover, I suggest that such vagueness can be regarded as (...) 'vagueness in the world.' For a case study, we turn to the Past Hypothesis, a postulate that (partially) explains the direction of time in our world. We have reasons to take it seriously as a candidate fundamental law of nature. Yet it is vague: it admits borderline (nomologically) possible worlds. An exact version would lead to an untraceable arbitrariness absent in any other fundamental laws. However, the dilemma between fundamental nomic vagueness and untraceable arbitrariness is dissolved in a new quantum theory of time's arrow. (shrink)

In a quantum universe with a strong arrow of time, it is standard to postulate that the initial wave function started in a particular macrostate---the special low-entropy macrostate selected by the Past Hypothesis. Moreover, there is an additional postulate about statistical mechanical probabilities according to which the initial wave function is a ''typical'' choice in the macrostate. Together, they support a probabilistic version of the Second Law of Thermodynamics: typical initial wave functions will increase in entropy. Hence, there are two (...) sources of randomness in such a universe: the quantum-mechanical probabilities of the Born rule and the statistical mechanical probabilities of the Statistical Postulate. I propose a new way to understand time's arrow in a quantum universe. It is based on what I call the Thermodynamic Theories of Quantum Mechanics. According to this perspective, there is a natural choice for the initial quantum state of the universe, which is given by not a wave function but by a density matrix. The density matrix plays a microscopic role: it appears in the fundamental dynamical equations of those theories. The density matrix also plays a macroscopic / thermodynamic role: it is exactly the projection operator onto the Past Hypothesis subspace. Thus, given an initial subspace, we obtain a unique choice of the initial density matrix. I call this property "the conditional uniqueness" of the initial quantum state. The conditional uniqueness provides a new and general strategy to eliminate statistical mechanical probabilities in the fundamental physical theories, by which we can reduce the two sources of randomness to only the quantum mechanical one. I also explore the idea of an absolutely unique initial quantum state, in a way that might realize Penrose's idea of a strongly deterministic universe. (shrink)

Two of the most difficult problems in the foundations of physics are (1) what gives rise to the arrow of time and (2) what the ontology of quantum mechanics is. I propose a unified 'Humean' solution to the two problems. Humeanism allows us to incorporate the Past Hypothesis and the Statistical Postulate into the best system, which we then use to simplify the quantum state of the universe. This enables us to confer the nomological status to the quantum state in (...) a way that adds no significant complexity to the best system and solves the ''supervenient-kind problem'' facing the original version of the Past Hypothesis. We call the resultant theory the Humean unification. It provides a unified explanation of time asymmetry and quantum entanglement. On this theory, what gives rise to time's arrow is also responsible for quantum phenomena. The new theory has a separable mosaic, a best system that is simple and non-vague, less tension between quantum mechanics and special relativity, and a higher degree of theoretical and dynamical unity. The Humean unification leads to new insights that can be useful to Humeans and non-Humeans alike. (shrink)

What is the quantum state of the universe? Although there have been several interesting suggestions, the question remains open. In this paper, I consider a natural choice for the universal quantum state arising from the Past Hypothesis, a boundary condition that accounts for the time-asymmetry of the universe. The natural choice is given not by a wave function but by a density matrix. I begin by classifying quantum theories into two types: theories with a fundamental wave function and theories with (...) a fundamental density matrix. The Past Hypothesis is compatible with infinitely many initial wave functions, none of which seems to be particularly natural. However, once we turn to density matrices, the Past Hypothesis provides a natural choice---the normalized projection onto the Past Hypothesis subspace in the Hilbert space. Nevertheless, the two types of theories can be empirically equivalent. To provide a concrete understanding of the empirical equivalence, I provide a novel subsystem analysis in the context of Bohmian theories. Given the empirical equivalence, it seems empirically underdetermined whether the universe is in a pure state or a mixed state. Finally, I discuss some theoretical payoffs of the density-matrix theories and present some open problems for future research. (Bibliographic note: the thesis was submitted for the Master of Science in mathematics at Rutgers University.). (shrink)

The persistent challenge of formulating ontic structuralism in a rigorous manner, which prioritizes structures over the entities they contain, calls for a transformation of traditional logical frameworks. I argue that Univalent Foundations (UF), which feature the axiom that all isomorphic structures are identical, offer such a foundation and are more attractive than other proposed structuralist frameworks. Furthermore, I delve into the significance in the case of the hole argument and, very briefly, the nature of symmetries.

According to the algebraic approach to spacetime, a thoroughgoing dynamicism, physical fields exist without an underlying manifold. This view is usually implemented by postulating an algebraic structure (e.g., commutative ring) of scalar-valued functions, which can be interpreted as representing a scalar field, and deriving other structures from it. In this work, we point out that this leads to the unjustified primacy of an undetermined scalar field. Instead, we propose to consider algebraic structures in which all (and only) physical fields are (...) primitive. We explain how the theory of natural operations in differential geometry—the modern formalism behind classifying diffeomorphism-invariant constructions—can be used to obtain concrete implementations of this idea for any given collection of fields. For concrete examples, we illustrate how our approach applies to a number of particular physical fields, including electrodynamics coupled to a Weyl spinor. (shrink)

English uses the horizontal spatial metaphors to express time (e.g., the good days ahead of us). Chinese also uses the vertical metaphors (e.g., 'the month above' to mean last month). Do Chinese speakers, then, think about time in a different way than English speakers? Boroditsky [Boroditsky, L. (2001). Does language shape thought? Mandarin and English speakers' conceptions of time. Cognitive Psychology, 43(1), 1-22] claimed that they do, and went on to conclude that 'language is a powerful tool in shaping habitual (...) thought about abstract domains' (such as time). By estimating the frequency of usage, we found that Chinese speakers actually use the horizontal spatial metaphors more often than the vertical metaphors. This offered no logical ground for Boroditsky's claim. We were also unable to replicate her experiments in four different attempts. We conclude that Chinese speakers do not think about time in a different way than English speakers just because Chinese also uses the vertical spatial metaphors to express time. (shrink)

The book offers an interdisciplinary perspective on finance, with a special focus on stock markets. It presents new methodologies for analyzing stock markets’ behavior and discusses theories and methods of finance from different angles, such as the mathematical, physical and philosophical ones. The book, which aims at philosophers and economists alike, represents a rare yet important attempt to unify the externalist with the internalist conceptions of finance.

Banks play a unique role in society. They not only maximize profits but also consider the interests of stakeholders. We investigate whether banks consider firms’ pollution records in their lending decisions. The evidence shows that banks offer significantly higher loan spreads, higher total borrowing costs, shorter loan maturities, and greater collateral to firms with higher levels of chemical pollution. The costly effects are stronger for borrowers with greater risk and weaker corporate governance. Further, the results show that banks with higher (...) social responsibility account for their borrowers’ environmental performance and charge higher loan spreads to those with poor performance. These results support the idea that banks with higher social responsibility can promote the practice of business ethics in firms. (shrink)

The gaze cueing effect is characterized by faster attentional orienting to a gazed-at than a non-gazed-at target. This effect is often enhanced when the gazing face bears an emotional expression, though this finding is modulated by a number of factors. Here, we tested whether the type of task performed might be one such modulating factor. Target localization and target discrimination tasks are the two most commonly used gaze cueing tasks, and they arguably differ in cognitive resources, which could impact how (...) emotional expression and gaze cues are integrated to orient attention. In a within-subjects design, participants performed both target localization and discrimination gaze cueing tasks with neutral, happy, and fearful faces. The gaze cueing effect for neutral faces was greatly reduced in the discrimination task relative to the localization task, and the emotional enhancement of the gaze cueing effect was only present in the localization task and only when this task was performed first. These results suggest that cognitive resources are needed for gaze cueing and for the integration of emotional expressions and gaze cues. We propose that a shift toward local processing may be the mechanism by which the discrimination task interferes with the emotional modulation of gaze cueing. The results support the idea that gaze cueing can be greatly modulated by top-down influences and cognitive resources and thus taps into endogenous attention. Results are discussed within the context of the recently proposed EyeTune model of social attention. (shrink)

Policies promoted and adopted for allocating ventilators during the COVID-19 pandemic have often prioritised healthcare workers or other essential workers. While the need for such policies has so far been largely averted, renewed stress on health systems from continuing surges, as well as the experience of allocating another scarce resource—vaccination—counsel revisiting the justifications for such prioritisation. Prioritising healthcare workers may have intuitive appeal, but the ethical justifications for doing so and the potential harms that could follow require careful analysis. Ethical (...) justifications commonly offered for healthcare worker prioritisation for ventilators rest on two social value criteria: instrumental value, also known as the ‘multiplier effect’, which may preserve the ability of healthcare workers to help others, and reciprocity, which rewards past usefulness or sacrifice. We argue that these justifications are insufficient to over-ride the common moral commitment to value each person’s life equally. Institutional policies prioritising healthcare workers over other patients also violate other ethical norms of the healthcare professions, including the commitment to put patients first. Furthermore, policy decisions to prioritise healthcare workers for ventilators could engender or deepen existing distrust of the clinicians, hospitals and health systems where those policies exist, even if they are never invoked. (shrink)

Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To provide (...) an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)