Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...) Results Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the _main_ reasons for futile care. Conclusions Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. (shrink)

Robert Putnam's work was a double-edged sword for social capital scholars. It brought unprecedented attention to the research agenda but also created conceptual confusion. Many scholars have tried to disentangle Coleman's concept of social capital from what some described as Putnam's “fuzzy psychological notion” of civic culture values. Despite the rigour of these efforts, Putnam's influence remains, because scholars and policy makers are drawn to the benefits his work promised. This article takes a different tack, and seeks to extricate Putnam's (...) early ideas from the social capital debates by offering an alternate theorization of his original findings. It returns to Making Democracy Work and argues that Putnam mis-stepped when he took the rational choice route and invoked Coleman's concept of social capital. It takes an ideational approach to explaining civic culture. The resulting “ideational social capital” suggests a different research agenda, which just might deliver on Putnam's early promise. (shrink)

Fourteen subjects were tape‐recorded while they undertook to find a law to summarize numerical data they were given. The source of the data was not identified, nor were the variables labeled semantically. Unknown to the subjects, the data were measurements of the distances of the planets from the sun and the periods of their revolutions about it—equivalent to the data used by Johannes Kepler to discover his third law of planetary motion.Four of the 14 subjects discovered the same law as (...) Kepler did (the period varies as the 3/2 power of the distance), and a fifth came very close to the answer. The subiects' protocols provide a detailed picture of the problem‐solving searches they engaged in, which were mainly, but not exclusively, in the space of possible functions for fitting the data, and provide explanations as to why some succeeded and the others failed.The search heuristics used by the subjects are similar to those embodied in the BACON program, computer simulation of certain scientific discovery processes. The experiment demonstrates the feasibility of examining some of the processes of scientific discovery by recreating, in the laboratory, discovery situations of substantial historical relevance. It demonstrates also, that under conditions rather similar to those of the original discoverer, a law can be rediscovered by persons of ordinary intelligence (i.e., the intelligence needed for academic success in a good university). The data for the successful subjects reveal no “creative” processes in this kind of a discovery situation different from those that are regularly observed in all kinds of problem‐solving settings. (shrink)

Christian development agencies have been the primary vehicle of choice for holistic involvement and witness. This has played straight into an Enlightenment manner of thinking that compartmentalizes values, limiting the opportunities for explaining the theological and conceptual foundations for development practice and for public witness concerning religious faith. New institutional models appropriate to witness and holistic Christian service need to be considered. An `S4' type organization, explored in practice in Indonesia in an interfaith setting, allows for a more effective sharing (...) of the gospel and robust development work. (shrink)

Since the mid-twentieth century, the ‘Scientific Revolution’ has arguably occupied centre stage in most Westerners’, and many non-Westerners’, conceptions of science history. Yet among history of science specialists that position has been profoundly contested. Most radically, historians Andrew Cunningham and Perry Williams in 1993 proposed to demolish the prevailing ‘big picture’ which posited that the Scientific Revolution marked the origin of modern science. They proposed a new big picture in which science is seen as a distinctly modern, western phenomenon rather (...) than a human universal, that it was invented in the Age of Revolutions 1760–1848, and that science be de-centred within the new big picture: treated as just one of many forms of human knowledge-seeking activity. Their paper is one of the most highly cited in the history of science field, and has the potential to transform the way that science educators, science communicators, science policy-makers and scientists view science. Yet the paper and historians’ scholarly response to it are not well-known outside the history discipline. Here I attempt to bridge that disciplinary gap with a review of scholarly papers published 1994–2014 that cited Cunningham and Williams or otherwise discussed the Scientific Revolution, to gauge the extent of support for the old and new big pictures. I find that the old big picture is disintegrating and lacks active defenders, while many scholars support aspects of the new big picture. I discuss the significance of this for scholars in ‘applied’ fields of science studies such as education, communication and policy. (shrink)

This paper will first introduce the development of professional ethics of counseling and psychotherapy in mainland China. Ethical awareness is often limited due to variations in training experiences. Aligning with ethics codes can also bring challenges due to nuances within Chinese culture. Furthermore, the authors discuss the ethical challenges regarding the principles of multiple relationships, informed consent, and confidentiality in the context of Chinese culture. These ethical issues are often discussed within an individualistic cultural frame and presentation from a collectivist (...) culture offers a unique perspective in the ethics literature. (shrink)

The computer distance teaching system teaches through the network, and there is no entrance threshold. Any student who is willing to study can log in to the network computer distance teaching system for study at any free time. Neural network has a strong self-learning ability and is an important part of artificial intelligence research. Based on this study, a neural network-embedded architecture based on shared memory and bus structure is proposed. By looking for an alternative method of exp function to (...) improve the speed of radial basis function algorithm, and then by analyzing the judgment conditions in the main loop during the algorithm process, these judgment conditions are modified conditionally to reduce the calculation scale, which can double the speed of the algorithm. Finally, this article verifies the function, performance, and interface of the computer distance education system. (shrink)

Contextualism and Disagreement This paper argues that attributor contextualism is in conflict with ordinary language methodology. Attributor contextualism has at its center the thesis that, the truth-values of knowledge attributions vary with the conversational contexts. This thesis entails that if two speakers in similar contexts make conflicting knowledge attributions, at least one of these attributions is false. One important argument for attributor contextualism depends on ordinary language methodology, a methodology that places great trust in ordinary speakers and prevents judging a (...) substantial group of ordinary speakers' simple knowledge attributions false. I argue that there is strong empirical evidence that ordinary speakers do extensively disagree in similar contexts. My conclusion is that one cannot coherently hold the attributor contextualist thesis and use ordinary language methodology, because the lesson we learn from the empirical evidence is that using the methodology would prove the thesis false. Since prominent attributor contextualists explicitly adopt the methodology, and that the methodology is what distinguishes attributor contextualism from its main rival, invariantism, the conflict with the methodology is a problem for attributor contextualism. (shrink)

Background Victoria was the first Australian state to legalize voluntary assisted dying (elsewhere known as physician-assisted suicide and euthanasia). Some institutions indicated they would not participate in voluntary assisted dying. The Victorian government issued policy approaches for institutions to consider Objective To describe and analyse publicly available policy documents articulating an institutional objection to voluntary assisted dying in Victoria. Methods Policies were identified using a range of strategies, and those disclosing and discussing the nature of an institutional objection were thematically (...) analysed using the framework method. Results The study identified fifteen policies from nine policymakers and developed four themes: (1) extent of refusal to participate in VAD, (2) justification for refusal to provide VAD, (3) responding to requests for VAD, and (4) appeals to state-sanctioned regulatory mechanisms. While institutional objections were stated clearly, there was very little practical detail in most documents to enable patients to effectively navigate objections in practice. Conclusion This study demonstrates that despite having clear governance pathways developed by centralized bodies (namely, the Victorian government and Catholic Health Australia), many institutions’ public-facing policies do not reflect this guidance. Since VAD is contentious, laws governing institutional objection could provide greater clarity and regulatory force than policies alone to better balance the interests of patients and non-participating institutions. (shrink)

Research has revealed that child abuse experience can increase pathological Internet use; however, few studies have focused on the influence of child abuse experience on pathological Internet use. This study examined the mediating roles of security and maladaptive cognitions in the association between child abuse and pathological Internet use. A total of 918 Chinese university students participated in the study, with measurements of child abuse, security, maladaptive cognitions, and pathological Internet use being employed. Structural equation modeling results indicated that child (...) abuse could positively predict pathological Internet use, pathological Internet use through the mediating role of security, pathological Internet use through the mediating role of maladaptive cognitions, and pathological Internet use through the chain mediating role of security and maladaptive cognitions. These results indicated that security and maladaptive cognitions were the primary factors in the association between child abuse and pathological Internet use. (shrink)

本书包括中国古代的和谐思想与构建社会主义和谐社会、中华传统伦理道德与以德治国方略、传统国民心理与当代国民意识等专题。.

Much of the commentary in the wake of the Charlie Gard litigation was aimed at apparent shortcomings of the law. These include concerns about the perceived inability of the law to consider resourcing issues, the vagueness of the best interests test and the delays and costs of having disputes about potentially life-sustaining medical treatment resolved by the courts. These concerns are perennial ones that arise in response to difficult cases. Despite their persistence, we argue that many of these criticisms are (...) unfounded. The first part of this paper sets out the basic legal framework that operates when parents seek potentially life-sustaining treatment that doctors believe is against a child’s best interests, and describes the criticisms of that framework. The second part of the paper suggests an alternative approach that would give decision-making power to parents, and remove doctors’ ability to unilaterally withhold or withdraw life-sustaining treatment that they regard is futile. This proposal is grounded in several values that we argue should guide these regulatory choices. We also contend that the best interests test is justifiable and since the courts show no sign of departing from it, the focus should be on how to better elucidate the underlying values driving decisions. We discuss the advantages of our proposed approach and how it would address some of the criticisms aimed at the law. Finally, we defend the current role that the judiciary plays, as an independent state-sanctioned process with a precedent-setting function. (shrink)

Objectives To determine the role played by law in medical specialists9 decision-making about withholding and withdrawing life-sustaining treatment from adults who lack capacity, and the extent to which legal knowledge affects whether law is followed. Design Cross-sectional postal survey of medical specialists. Setting The two largest Australian states by population. Participants 649 medical specialists from seven specialties most likely to be involved in end-of-life decision-making in the acute setting. Main outcome measures Compliance with law and the impact of legal knowledge (...) on compliance. Results 649 medical specialists (of 2104 potential participants) completed the survey (response rate 31%). Responses to a hypothetical scenario found a potential low rate of legal compliance, 32% (95% CI 28% to 36%). Knowledge of the law and legal compliance were associated: within compliers, 86% (95% CI 83% to 91%) had specific knowledge of the relevant aspect of the law, compared with 60% (95% CI 55% to 65%) within non-compliers. However, the reasons medical specialists gave for making decisions did not vary according to legal knowledge. Conclusions Medical specialists prioritise patient-related clinical factors over law when confronted with a scenario where legal compliance is inconsistent with what they believe is clinically indicated. Although legally knowledgeable specialists were more likely to comply with the law, compliance in the scenario was not motivated by an intention to follow law. Ethical considerations (which are different from, but often align with, law) are suggested as a more important influence in clinical decision-making. More education and training of doctors is needed to demonstrate the role, relevance and utility of law in end-of-life care. (shrink)

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and patients/relatives; nurses' personal responses (...) to ethical issues; and the patient—nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field. (shrink)

This paper begins by reviewing dominant themes in current teaching of professional ethics in engineering education. In contrast to more traditional approaches that simulate ethical practice by using ethical theories to reason through micro-level ethical dilemmas, this paper proposes a pragmatic approach to ethics that places more emphasis on the practical plausibility of ethical decision-making. In addition to the quality of ethical justification, the value of a moral action also depends on its effectiveness in solving an ethical dilemma, cultivating healthy (...) working relationships, negotiating existing organizational cultures, and achieving contextual plausibility in everyday professional practice. This paper uses a cross-cultural ethics scenario to further elaborate how a pragmatic approach can help us rethink ethical reasoning, as well as ethics instruction and assessment. This paper is expected to be of interest to educators eager to improve the ability of engineers and other professional students to effectively and appropriately deal with the kinds of everyday ethical issues they will likely face in their careers. (shrink)

Science and Society presents comments on some of the social and economic implications of the new biology. Here, Cao Tian‐qin presents a perspective from China on recent developments in biotechnology.

我們已有的知識，雖然作為學科各有領域，但並不是孤立地存在，而是互為聯繫、互為影響。這些知識的積累，會逐漸地擴大認知領域，由此及彼、由近到遠，由小到大，由現象而至規律，由規律而至本質，直至去認識終極事物 ——宇宙——世界的本質。.

This paper employs the theoretical framework of phenomenology of the body to explore embodiment and existentialism in contemporary Chinese dance. With the backdrop of the current status and influence of Chinese contemporary dance in the realm of dance arts, it analyzes the unique forms and techniques of bodily expression in Chinese contemporary dance, attempting to explore how personal emotions, inner experiences, and spiritual states are conveyed through bodily expression in Chinese contemporary dance. The paper utilizes case analysis and observational research (...) methods to delve into the cognition of bodily expression and identity construction in Chinese contemporary dance, as well as how the body is used to reflect on the cognition and positioning of Chinese traditional and modern cultural identities, exploring the diversity and changes in Chinese cultural identity. Finally, by applying Merleau-Ponty's phenomenology of the body theory, it deeply analyzes the significance and existentialism of bodily expression in contemporary Chinese dance, experiencing and understanding the relationship between bodily subjectivity and self through dance. Through these studies, we can gain a deeper understanding of the complexity and diversity of bodily expression in contemporary Chinese dance, enabling dancers to reassess their ability to express emotions, as well as the application and insights of Merleau-Ponty's phenomenology of the body therein. (shrink)

Various studies have recognized the importance of humility as a foundational aspect of virtuous leadership and have revealed the beneficial effects of leader humility on employee moral attitudes and behaviors. However, these findings may overestimate the benefits of leader humility and overlook its potential costs. Integrating person–supervisor fit theory and balance theory with the humility literature, we employ a dyadic approach to consider supervisor and employee humility simultaneously. We investigate whether and how the congruence of supervisor and employee humility influences (...) employee citizenship and deviance behaviors. We conducted a multilevel, multiphase, and multisource field study to test our hypotheses. The results of cross-level polynomial regression analyses revealed that when supervisors and employees were incongruent in humility, employees experienced higher levels of negative affect toward supervisors. Also, compared to those in low–low congruent dyads, employee negative affect toward supervisors was lower in high–high congruent dyads. The results further revealed asymmetric incongruence effects: employees experienced the highest levels of negative affect toward supervisors when their own humility was lower than their supervisors’. In addition, we found that employee negative affect toward supervisors mediated the impacts of supervisor–employee congruence in humility on employee organizational citizenship behavior and counterproductive work behavior. (shrink)

Many of the negative connotations of corporate social responsibility (CSR) are linked to its perceived role as a public relations exercise. Following on calls for more positive engagement by public relations professionals in organisational strategic planning and given the rapidly increasing interest in CSR as a business strategy, this article addresses the question of how the theory and practice of public relations can provide direction and support for CSR. To this end, this article explores leadership styles and motivations of a (...) sample of corporate leaden from prominent Australian-based corporations in relation to their chosen CSR activities to examine the current position of, and potential for, professional communicators' impact in shaping CSR-driven policies at a strategic level. We find that while public relations theory has evolved, many leaders still see public relations professionals only as a source of positive publicity. Our findings suggest that the model of distributive leadership has more relevance to an emerging idea of public relations involvement in CSR than more traditional understandings of leadership. We conclude that the public relations profession needs to develop a greater understanding of senior management approaches to the development and dissemination of CSR activities to support organisational leadership as it currently operates with respect to CSR. (shrink)

Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors’ decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative “constitutive” model is supported on (...) the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values. The model requires that ethics and law be taught across the medical education curriculum and integrated with the basic and clinical sciences and that they be perceived as an integral component of medical evidence and practice. Law, in particular, would rank as equal in normative authority to the relevant clinical scientific “facts” of the case, with graduating doctors having as strong a basic command of each category as the other. The normalization of legal knowledge as part of the clinician’s evidence base to be utilized in practice may provide adequate consolation for clinicians who may initially resent further perceived incursions on their traditional independence and discretion. (shrink)

To investigate the effects of left-behind children’s empathy and coping styles on school adjustment, 605 left-behind children in the third grade from three rural elementary schools in Suzhou, Anhui Province were selected to complete the Chinese version of the Interpersonal Reaction Index Scale, the Coping Style Scale, and the School Adjustment Behavior Scale for Primary and Secondary School Students. The results showed that emotional empathy positively predicted children’s social competence, and negatively predicted children’s antisocial behavior; cognitive empathy positively predicted children’s (...) social competence; the role of positive coping styles mediated the relationship between cognitive empathy and social competence, and that between cognitive empathy and antisocial behavior; negative coping styles mediated the relationship between cognitive empathy and antisocial behavior; both positive and negative coping styles mediated the relationship between emotional empathy and social competence, and that between emotional empathy and antisocial behavior. The findings of the study are valuable for understanding the relationship between empathy and school adjustment, which also helps to enhance the school adjustment of left-behind children. (shrink)

In this paper, we mainly investigate the coordinated tracking control issues of multiple Euler–Lagrange systems considering constant communication delays and output constraints. Firstly, we devise a distributed observer to ensure that every agent can get the information of the virtual leader. In order to handle uncertain problems, the neural network technique is adopted to estimate the unknown dynamics. Then, we utilize an asymmetric barrier Lyapunov function in the control design to guarantee the output errors satisfy the time-varying output constraints. Two (...) distributed adaptive coordinated control schemes are proposed to guarantee that the followers can track the leader accurately. The first scheme makes the tracking errors between followers and leader be uniformly ultimately bounded, and the second scheme further improves the tracking accuracy. Finally, we utilize a group of manipulator networks simulation experiments to verify the validity of the proposed distributed control laws. (shrink)

本书内容包括:曹魏时期名士的儒道兼治;正始名士:名教出于自然;竹林名士:越名教而任自然;西晋时期士大夫的玄儒兼治;东晋时期士大夫的玄儒兼治等。.

As one of the most widely used methods in deep learning technology, convolutional neural networks have powerful feature extraction capabilities and nonlinear data fitting capabilities. However, the convolutional neural network method still has disadvantages such as complex network model, too long training time and excessive consumption of computing resources, slow convergence speed, network overfitting, and classification accuracy that needs to be improved. Therefore, this article proposes a dense convolutional neural network classification algorithm based on texture features for images in virtual (...) reality videos. First, the texture feature of the image is introduced as a priori information to reflect the spatial relationship between pixels and the unique characteristics of different types of ground features. Second, the grey level cooccurrence matrix is used to extract the grey level correlation features of the image in space. Then, Gauss Markov Random Field is used to establish the statistical correlation characteristics between neighbouring pixels, and the extracted GLCM-GMRF texture feature and image intensity vector are combined. Finally, based on DenseNet, an improved shallow layer dense convolutional neural network is proposed, which can compress network parameters and improve the feature extraction ability of the network. The experimental results show that compared with the current classification method, this method can effectively suppress the influence of coherent speckle noise and obtain better classification results. (shrink)

Defining the purposes of engineering ethics education (EEE) is paramount for the engineering education community, and understanding the purposes of EEE can be a catalyst for actively involving students in the learning process. This chapter presents a conceptual framework for systematically describing and comparing various approaches to the purposes of EEE. Such a framework is inherently embedded with a tension between a normative approach and a pragmatic approach regarding the purposes of EEE. The normative approach focuses on what the purposes (...) of EEE should be, an ‘ideal world’ scenario, given the needs of the engineering profession and of society at large. Conversely, the pragmatic approach starts from the question ‘What can be achieved through educational practice?‘ and results from ‘actual world’ situated outcomes of stakeholder negotiations. The authors’ framework balances these. They – scholars from diverse cultural backgrounds – assert that the purposes of EEE are socially constructed and vary from country to country based on unique historical, political, and cultural contexts. Their framework embraces both the individualistic and holistic aspects of EEE, incorporating perspectives from both Western and non-Western traditions. It identifies six purposes of EEE (knowledge, actions, personal traits, relationships, etc.), aligning these with examples (e.g., moral knowledge, desirable actions, ethical skills or competencies, care ethics, etc.) and theoretical frameworks (moral epistemology, moral psychology, virtue ethics, objects or qualities of relations, etc.). It is problematic and potentially dangerous when engineering educators design ethics-learning activities without critically examining the purposes of these activities and assessing whether these purposes are justified for educating ethically and professionally competent engineers. This chapter provides tools to help avoid such pitfalls. (shrink)

Empirical studies have suggested that language-capable robots have the persuasive power to shape the shared moral norms based on how they respond to human norm violations. This persuasive power presents cause for concern, but also the opportunity to persuade humans to cultivate their own moral development. We argue that a truly socially integrated and morally competent robot must be willing to communicate its objection to humans’ proposed violations of shared norms by using strategies such as blame-laden rebukes, even if doing (...) so may violate other standing norms, such as politeness. By drawing on Confucian ethics, we argue that a robot’s ability to employ blame-laden moral rebukes to respond to unethical human requests is crucial for cultivating a flourishing “moral ecology” of human–robot interaction. Such positive moral ecology allows human teammates to develop their own moral reflection skills and grow their own virtues. Furthermore, this ability can and should be considered as one criterion for assessing artificial moral agency. Finally, this paper discusses potential implications of the Confucian theories for designing socially integrated and morally competent robots. (shrink)