BackgroundDrawing from Erikson’s theory, Domino and Affonso constructed the Inventory of Psychosocial Balance, a scale with satisfactory reliability and validity. However, the lack of a credible Chinese version of the scale may hinder research on ego development in Taiwan. The aim of the present study was to construct a short form Chinese IPB. In addition, factor analysis was employed to shorten the original 120-item scale to make it suitable for application in the older adults in the future.MethodsThe study involved three (...) steps: The first step was to establish the 120-items of the Chinese Inventory of Psychosocial Balance, and we conducted translation, back-translation, expert validity, and reliability of pilot study for this step. Following the first step was to construct the short-form C-IPB in the second step, and the CIPB-SF was developed via item analysis and factor analysis. Finally, we assessed the reliability and validity of the CIPB-SF via structural equation model in the third step.ResultsThree hundred eight older adults without cognitive disorder completed the IPB. The 40-item CIPB-SF was completed through item analysis and factor analysis. The internal consistency test of CIPB-SF and the eight stages were good. The CIPB-SF had acceptable validity, except in the intimacy and identity stages, in which validity was only fair. Compared with the IPB, the CIPB-SF had good reliability and acceptable validity. However, because of its conciseness, the 40-item CIPB-SF was more suited for application among the Chinese elderly population because its application avoids physical overload.ConclusionThe CIPB-SF served as a concise scale for assessing ego development in our study. This scale can also serve as a useful tool for convenient screening in the future. (shrink)

Purpose Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education. Methods From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year and 109 third-year (...) students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores. Results In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively. Conclusion During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission. (shrink)

A survey was conducted on the advertising practitioners in Taiwan concerning their experiences of ethical challenges at work. Among 120 respondents, while 32.5 percent responded that ethical problems did not exist, 67.5 percent admitted that ethical problem was a commonplace at work. According to these respondents, the most frequently mentioned ethical problems area representing unethical products or services, the message of advertisements, agency-client relationship, the creditability of research, undertable rebate, and the quality of service. Suggestions for international advertising managers were (...) also provided by comparing the finding from the present study with earlier studies in the United States. However, due to its preliminary nature, the present study should be considered exploratory and descriptive rather than conclusive, with the hope to inspire more research on advertising ethics in Taiwan as well as in other countries in the world. (shrink)

With the increase in depth of coal mining, the hydrogeological complexity largely increases and water inrush accidents happen more frequently. For the safety of coal mining, horizontal directional drilling and grouting techniques have been implemented to detect and plug the fractures and conduits that deliver high-pressure groundwater to coal mine. Taking the grouting engineering performed at Xingdong coal mine at 980 m below sea level as an example, we collected the data of grouting quantity, the loss of drilling fluid, gamma (...) value, water temperature, average water absorption, distance between grouting loss points, water pressure on coal seam floor, and aquifuge thickness at 90 boreholes in the mine to conduct grey relational analysis, first. The analysis showed that the grouting quantity was highly correlated with all other factors. Subsequently, grey system evaluation was used to evaluate the risk of water inrush from the coal seam floor. The results of risk analysis illustrated that three water inrushes from Ordovician limestone occurred in mining face 2127, 2125, and 2222 in the study area were all located in the area with a risk score higher than 65. Through grouting, the identified cracks were effectively blocked and waterproof layers beneath the coal seam floors were constructed to reduce the threat of water inrush. By comparing the risk assessment results with three water inrush cases before grouting operation, we found that water inrush areas were consistent with the area of higher risk. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.

Background Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals’ judgments of stigma, empathy, and compassion. Methods We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, (...) empathy, and compassion. Results Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists. Conclusions The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others. (shrink)

This research aims to examine access to medical treatment during the COVID-19 pandemic for people living with disabilities. During the COVID-19 pandemic, the practical and ethical problems of allocating limited medical resources such as intensive care unit beds and ventilators became critical. Although different countries have proposed different guidelines to manage this emergency, these proposed criteria do not sufficiently consider people living with disabilities. People living with disabilities are therefore at a higher risk of exclusion from medical treatments as physicians (...) tend to assume they have poor quality of life, whereas access to medical treatment should be based on several parameters, including clinical data and prognosis. However, the COVID-19 pandemic shifts the medical paradigm from person-centred medicine to community-centred medicine, challenging the main ethical theories. We reviewed the main guidelines and recommendations for resources allocation and examined their position toward persons with disabilities. Based on our findings, we propose criteria for not discriminating against people with disabilities in allocating resources. The shift from person-centred to community-centred medicine offers opportunities but also risks sacrificing the most vulnerable people. The principle of reasonable accommodation must always be considered to guarantee the rights of persons with disabilities. (shrink)

concepts typically are defined in terms of lacking physical or perceptual referents. We argue instead that they are not devoid of perceptual information because knowledge of real-world situations is an important component of learning and using many abstract concepts. Although the relationship between perceptual information and abstract concepts is less straightforward than for concrete concepts, situation-based perceptual knowledge is part of many abstract concepts. In Experiment 1, participants made lexical decisions to abstract words that were preceded by related and unrelated (...) pictures of situations. For example, share was preceded by a picture of two girls sharing a cob of corn. When pictures were presented for 500 ms, latencies did not differ. However, when pictures were presented for 1,000 ms, decision latencies were significantly shorter for abstract words preceded by related versus unrelated pictures. Because the abstract concepts corresponded to the pictured situation as a whole, rather than a single concrete object or entity, the necessary relational processing takes time. In Experiment 2, on each trial, an abstract word was presented for 250 ms, immediately followed by a picture. Participants indicated whether or not the picture showed a normal situation. Decision latencies were significantly shorter for pictures preceded by related versus unrelated abstract words. Our experiments provide evidence that knowledge of events and situations is important for learning and using at least some types of abstract concepts. That is, abstract concepts are grounded in situations, but in a more complex manner than for concrete concepts. Although people's understanding of abstract concepts certainly includes knowledge gained from language describing situations and events for which those concepts are relevant, sensory and motor information experienced during real-life events is important as well. (shrink)

The following article proposes an empirical study to explore communication strategies in the Cosa Nostra. Psychological studies on the characteristics of the language within the criminal organization are undoubtedly recent, but crucial to thoroughly understand the characteristics of implicit and explicit communication it adopts in the various contexts it works, as well as the power and value they assume. The data we have obtained from some videos concerning interviews and police interrogations to men of honor have been analyzed through a (...) method that refers to the grounds of qualitative research in clinical psychology, the Grounded Theory by Glaser and Strauss. The analysis we have carried out and its relevant data show us a world of the Mafia where the care for linguistic choices, for both form and contents, is characterized as a crucial activity, even when words are replaced by silence or gestures. (shrink)

Taiwan was affected by an outbreak of severe acute respiratory syndrome (SARS) in early 2003. A questionnaire survey was conducted to determine (1) the perceptions of risk of SARS infection in nurses; (2) the proportion of nurses considering leaving their job; and (3) work as well as non-work factors related to nurses' consideration of leaving their job because of the SARS outbreak. Nearly three quarters (71.9%) of the participants believed they were 'at great risk of exposure to SARS', 49.9% felt'an (...) increase in workload', and 32.4% thought that people avoided them because of their job; 7.6% of the nurses not only considered that they should not care for SARS patients but were looking for another job or considering resignation. The main predictors of nurses' consideration of leaving their job were shorter tenure, increased work stress, perceived risk of fatality from SARS, and affected social relationships. The findings are important in view of potential impending threats of pandemics such as avian influenza. (shrink)

The editors of the JRE solicited short essays on the COVID‐19 pandemic from a group of scholars of religious ethics that reflected on how the field might help them make sense of the complex religious, cultural, ethical, and political implications of the pandemic, and on how the pandemic might shape the future of religious ethics.

Several previous studies have reported atypicality in resting-state functional connectivity in autism spectrum disorder, yet the relatively small effect sizes prevent us from using these characteristics for diagnostic purposes. Here, canonical correlation analysis and hierarchical clustering were used to partition the high-functioning ASD group into subgroups. A support vector machine model was trained through the 10-fold strategy to predict Autism Diagnostic Observation Schedule scores within the ASD discovery group, which was further validated in an independent sample. The neuroimage-based partition derived (...) two subgroups representing severe versus mild autistic patients. We identified FCs that show graded changes in strength from ASD-severe, through ASD-mild, to controls, while the same pattern cannot be observed in partitions based on ADOS score. We also identified FCs that are specific for ASD-mild, similar to a partition based on ADOS score. The current study provided multiple pieces of evidence with replication to show that resting-state functional magnetic resonance imaging FCs could serve as neural biomarkers in partitioning high-functioning autistic individuals based on their symptom severity and showing advantages over traditional partition based on ADOS score. Our results also indicate a compensatory role for a frontocortical network in patients with mild ASD, indicating potential targets for future clinical treatments. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

ABSTRACTDifficulties with inhibiting fear have been associated with the emergence of anxiety problems and poor response to cognitive–behavioural treatment. Fear inhibition problems measured using experimental paradigms involving aversive stimuli may be inappropriate for vulnerable samples and may not capture fear inhibition problems evident in everyday life. We present the Fear Inhibition Questionnaire, a self-report measure of fear inhibition abilities. We assess the FIQ’s factor structure across two cultures and how well it correlates with fear inhibition indices derived experimentally. Adolescent participants (...) from Hong Kong and England completed the FIQ, with the English participants also completing a conditioning and extinction task to assess fear inhibition problems. Across both cultures, the FIQ showed a single factor structure and low FIQ scores, or worse fear inhibition problems, were associated with self-reports of heightened anxiety. Correlation of FIQ scores with experimental indices, whi... (shrink)

Organizational identification has increasingly attracted scholarly attention as a key factor in understanding organizational processes and in fostering efficient human resource management. Available evidence shows that organizational ethical climate crucially predicts OI, a key determinant of both employees’ attitudes and behaviors. In the present paper, we examined the relationship between two specific ethical climates, distributed leadership, and employees’ attitudes and behaviors, incorporating OI as a core underlying mechanism driving these relationships. Three hundred and forty-two employees filled out questionnaires to examine (...) ethical climate, DL, OI, and a series of measures concerning attitudes and behaviors toward the organization. Structural equation modeling confirmed that a perception of an ethical climate of friendship fostered OI, which elicited higher commitment, perceived trust and recommendation, and lower turnover intention. Perception of DL further contributed to increasing OI. Our findings suggest that HR practices should carefully consider employee perceptions of a collectivistic ethical climate, together with perceptions of DL, as key determinants of positive organizational outcomes. We discuss results in light of the social identity approach and present practical implications for HR management. (shrink)

For scholars, practitioners, and legislators concerned about sexual minority adolescents, one of the main goals is to create more positive and inclusive learning environments for this minority group. Numerous factors, such as repeated patterns of homophobic bullying by classmates and others in school, have been a significant barrier to achieving this goal. In addition, lesbian, gay, bisexual, transgender, and queer adolescents encounter substantial inequality across a broad spectrum of wellbeing and education consequences. Compared with their heterosexual counterparts, LGBTQ adolescents experience (...) more anxiety, depression, suicidal thoughts, antisocial behavior, poorer academic performance, less school attachment and protection, and a weaker desire to finish their studies. Such discrepancies based on gender and sexuality were linked to more maltreatment encountered by LGBTQ adolescents. It is crucial to recognize the backgrounds and expectations of LGBTQ adolescents to offer them the best resources. To overcome the inequality and obstacles faced by these LGBTQ adolescents, it is essential to examine tools and techniques that can be utilized. This study examined the literature that explains why society fails to provide enough support to LGBTQ students. Specifically, mechanisms explaining how LGBTQ adolescents interact with others in the learning environment and how such discrepancies arise will be examined. Following that, violence and prejudice, which are fundamental causes of psychological problems among LGBTQ adolescents, will be explored. This review paper thus provides supportive strategies for schools to develop more inclusive learning environments for LGBTQ adolescents. (shrink)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were statistically (...) significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

Collection of texts on philosophical positions (sidhānta) of Vaibhāṣika, Sautrāntika, Yogācārya, and Mādhyamika schools of Buddhism with Hindusim.

ObjectiveHead and neck cancer treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: the prevalence, level, and course of body image concerns; correlates of upon cancer diagnosis body image concerns; predictors of immediate post-treatment body image concerns; and association between body image concerns (...) and levels of anxiety, depression, suicidal ideation, support, and alcohol and drug misuse.MethodsTwo hundred and twenty-three, newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model.ResultsSixty-eight percent of patients with HNC presented some level of body image concerns. Body image concerns at baseline and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment, 89% presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism.ConclusionThis longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions. (shrink)

La déshumanisation à l’œuvre dans le projet génocidaire et l’héritage d’un tel événement traumatique entraîne une catastrophe de la transmission et de la filiation. S’ensuit une impasse des processus d’identification et de différenciation sur plusieurs générations. Dans cette contribution, on interroge la nature des obstacles entravant le processus de deuil, de séparation et l’investissement de la vie après une catastrophe sociale. Il s’agit pour cela de rendre compte du travail de subjectivation nécessaire à l’appropriation de sa propre histoire et de (...) celle de sa propre famille de manière à pouvoir engager un processus de séparation/différenciation. À travers une étude de cas, l’article montre la pertinence d’une rencontre clinique « médiatisée » pour la compréhension et la perlaboration du vécu traumatique d’une famille survivante qui vit entre-soi. Nous discuterons, en particulier, l’apport de la photographie comme une première tentative de figuration des affects et de mise au travail des processus intermédiaires garants de leur symbolisation. (shrink)

Explanatory notes on the philosophical position (sidhānta) of Vaibhāṣika, Sautrāntika, Yogācārya, and Mādhyamika schools of Buddhist with Hinduism according to Sa-skya-pa scholar.