Despite extinction-based processes demonstrating efficacy in the animal extinction and human anxiety literatures, extinction for substance use disorders has shown poor efficacy. Reasons for this lack of success include common threats to extinction, such as renewal and reinstatement. In recent decades, research on mindfulness for SUD has flourished, and a key aspect of these mindfulness-based interventions includes teaching individuals to stay present with whatever experience they have, even if unpleasant, without trying to change/escape/avoid it. Similarly, CET teaches individuals to not (...) escape/avoid conditioned responses by engaging in drug use behavior. This paper discusses how mindfulness-based research and practices could positively influence CET through future research, with the long-term goal of improving SUD treatment. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Despite the increasing number of studies on user experience and user interfaces, few studies have examined emotional interaction between humans and deformable objects. In the current study, we investigated how the anthropomorphic design of a flexible display interacts with emotion. For 101 unique 3D images in which an object was bent at different axes, 281 participants were asked to report how strongly the object evoked five elemental emotions (e.g., happiness, disgust, anger, fear, and sadness) in an online survey. People rated (...) the object’s shape using three emotional categories: happiness, disgust–anger, and sadness–fear. It was also found that a combination of axis of bending (horizontal or diagonal axis) and convexity (bending convexly or concavely) predicted emotional valence, underpinning the anthropomorphic design of flexible displays. Our findings provide empirical evidence that axis of bending and convexity can be an important antecedent of emotional interaction with flexible objects, triggering at least three types of emotion in users. (shrink)

Kim Dong-ri et Seo Jeong-ju sont deux monuments de la littérature coréenne du XX e siècle. Les deux écrivains nouèrent une profonde amitié à partir des années 1930 et contribuèrent ensemble à la reconstruction du milieu littéraire de la Corée après la période de l’Occupation japonaise. Dans quel contexte le romancier et le poète se sont-ils rencontrés? Quelles sont les caractéristiques de leur lien amical? Comment celui a-t-il résisté aux vicissitudes du temps et au désaccord momentané lié aux circonstances? (...) À partir d’éléments biographiques, autobiographiques et de leurs témoignages réciproques, nous découvrons que la connaissance intime de l’univers de l’un par l’autre et leur inspiration mutuelle se fondent sur les valeurs littéraires et humanistes qu’ils partagent : fins connaisseurs de la littérature du monde, ils valorisent dans leur écriture des éléments proprement coréens. (shrink)

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid levels and cerebral blood flow in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a (...) diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress, anxiety, fatigue, and sleep quality improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms. The prefrontal GABA levels decreased, while relative CBF increased after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention. The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress. (shrink)

Background: While nursing ethics education is commonly provided for undergraduate nursing students in most nursing colleges, consensus on the content and teaching modules for these ethics courses have still not been established. Objectives: This study aimed to examine the effects of nursing ethics education on the moral sensitivity and critical thinking disposition of nursing students in Korea. Research design: A one-group pre- and post-test design was used. Moral sensitivity was measured using the Korean version of the Moral Sensitivity Questionnaire. Critical (...) thinking disposition was measured using the Critical Thinking Disposition Questionnaire. Participants and research context: Participants were 70 undergraduate nursing students who were attending a university located in Seoul, Korea. The nursing ethics education was provided 7 times, from September to December 2010, and comprised 90-min sessions each week. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines. Findings: After the education, the levels for the patient-oriented care, a sub-domain of moral sensitivity, and inquisitiveness, a sub-domain of critical thinking disposition, significantly improved. There were no changes in overall scores for moral sensitivity and critical thinking disposition. There were significant positive correlations between moral sensitivity and critical thinking disposition both pre- and post-intervention. Conclusion: These results reflect the need for ongoing efforts to develop innovative content, structure, and instructional methods for undergraduate nursing ethics education programs. (shrink)

Virtual reality is a rapidly developing technology that simulates the real world. However, for some cybersickness-susceptible people, VR still has an unanswered problem—cybersickness—which becomes the main obstacle for users and content makers. Sensory conflict theory is a widely accepted theory for cybersickness. It proposes that conflict between afferent signals and internal models can cause cybersickness. This study analyzes the brain states that determine cybersickness occurrence and related uncomfortable feelings. Furthermore, we use the electroencephalogram microstates and functional connectivity approach based on (...) the sensory conflict theory. The microstate approach is a time–space analysis method that allows signals to be divided into several temporarily stable states, simultaneously allowing for the exploration of short- and long-range signals. These temporal dynamics can show the disturbances in mental processes associated with neurological and psychiatric conditions of cybersickness. Furthermore, the functional connectivity approach gives us in-depth insight and relationships between the sources related to cybersickness. We recruited 40 males, and they watched a VR video on a curved computer monitor for 10 min to experience cybersickness. We recorded the 5-min resting state EEG and 10-min EEG while watching the VR video. Then, we performed a microstate analysis, focusing on two temporal parameters: mean duration and global explained variance. Finally, we obtained the functional connectivity data using eLoreta and lagged phase synchronization. We discovered five sets of microstates, including four widely reported canonical microstates, during baseline and task conditions. The average duration increased in microstates A and B, which is related to the visual and auditory networks. The GEV and duration decreased in microstate C, whereas those in microstate D increased. Microstate C is related to the default mode network and D to the attention network. The temporal dynamics of the microstate parameters are from cybersickness disturbing the sensory, DMN, and attention networks. In the functional connectivity part, the LPS between the left and right parietal operculum significantly decreased compared with the baseline condition. Furthermore, the connectivity between the right OP and V5 significantly decreased. These results also support the disturbance of the sensory network because a conflict between the visual and vestibular system causes cybersickness. Changes in the microstates and functional connectivity support the sensory conflict theory. These results may provide additional information in understanding brain dynamics during cybersickness. (shrink)

Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to (...) interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress. (shrink)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

Adaptation can optimize information processing by allowing the visual system to always adjust to the environment. However, only a few studies have investigated how the visual system makes adjustments to repeatedly occurring changes in the input, still less about the related neural mechanism. Our previous study found that contrast adaptation attenuated after multiple daily sessions of repeated adaptation, which was explained by the habituation of either the adapter’s effective strength or the adaptation mechanisms. To examine the former hypothesis, in the (...) present study we used the frequency tagging technique to measure the adapter-elicited steady-state visual evoked potential amplitudes. Participants repeatedly adapted to the same contrast adapter in a top-up manner for six continuous days, which was called training of adaptation. The behavioral adaptation effect and SSVEP response to the trained adapter and an untrained control adapter were measured before and after training. The psychophysical results showed that the effect of adaptation in the trained condition significantly reduced after training, replicating our previous finding. Contradicting the prediction of the hypothesis that repeated adaptation attenuated the effective strength of the adapter, the SSVEP amplitude was unchanged after training, which was further confirmed by an equivalence test. Taken together, the results challenge the account of habituation of adapter in repeated adaptation, while leaving the account of habituation of adaptation mechanism to be tested. (shrink)

Издание содержит: Есть ли ошибка в формуле мира?; Бегство от смысла; Секрет формулы мира - закон притяжения?

All of the world's religions refer to death in some way. Everyone is somewhat familiar with stories about where we go or what happens to us after death. From an early age, we have all heard stories of heaven or hell or some other version of paradise. Many of us believed such stories, and a great number of us still do. When considering that such stories manage to persist in modern times, an age of science and logic, we can be (...) sure that death is an issue to which humans attach great importance. In a sense, the idea of an afterlife can be a great source of comfort to those whose death is imminent, as well as to their loved ones. Those who have led especially difficult lives can look forward to a more pleasant world, while those who have enjoyed happiness and abundance have the chance to experience more good fortune. To those left behind, the idea of an afterlife presents the chance to meet a loved one again. We may not be conscious of it, but such hopes and expectations stay with us throughout our lives. If such an afterlife does exist, then there is no reason to avoid or fear death. Moreover, if we believe that another life awaits us, then we would believe that we are only separated from our loved ones temporarily before being reunited with them later on. (shrink)

Technological products such as computer, communication, and consumer electronic products, apps, smart wearables, and streaming services have become inseparable from people’s lives. In technological fields of practice, imagination, creativity, innovation, and entrepreneurship may influence one another. A vivid imagination can generate creativity and trigger the entrepreneurial intention to “bring new things to the market.” This study aims to understand the formation of internet entrepreneurial intention to use technology products. Drawing on social cognitive theory, this study explores and empirically tests how (...) technology product imagination disposition and social support impact internet entrepreneurial intention to use technology products. Drawing from self-determination theory, this study proposes and examines the mediating role of intrinsic and extrinsic motivation in the relationship between technology product imagination disposition and internet entrepreneurial intention, as well as the relationship between social support and internet entrepreneurial intention. We conducted a survey of 568 adults in Taiwan and used partial least squares to test our hypotheses. The results show the following: Technology product imagination disposition is positively associated with challenge, enjoyment, compensation, and outward motivation. Social support is positively associated with challenge, enjoyment, compensation, and outward motivation. Challenge, enjoyment, and outward motivation are positively associated with internet entrepreneurial intention to use technology products. Technology product imagination disposition intensifies internet entrepreneurial intention to use technology products by strengthening challenge, enjoyment, and outward motivation. Social support intensifies internet entrepreneurial intention by increasing challenge, enjoyment, and outward motivation. The partial mediation model represents a significant improvement in the total effect over the direct effect. We discuss the implications of these results for research and internet entrepreneurship practices. (shrink)

As negative information about companies becomes widely available and spreads rapidly through digital communications, understanding consumer reactions to these events and how human perceptions are shaped becomes increasingly important. In this paper, we investigate how consumers’ identification with brands and their love for them affect their support for the brand during extremely unethical situations. The results indicate that brand identification both decreases and increases consumers’ ethical judgment following extremely unethical events. Moreover, we find that consumers who are in a love (...) type relationship with the brand proactively shield the brand from other consumers by employing two brand supportive behaviors; sin of omission and brand defense. (shrink)

The COVID-19 pandemic has dramatically changed the patterns of lifestyle and posed psychological stress on pregnant women. However, the association of sleep duration and screen time with anxiety among pregnant women under the backdrop of the COVID-19 pandemic scenario has been poorly addressed. We conducted one large-scale, multicenter cross-sectional study which recruited 1794 pregnant women across middle and west China. Self-reported demographic characteristics, lifestyle, and mental health status were collected from 6th February to 8th May 2020. We investigated the association (...) of sleep duration and screen time with the risk of anxiety by multivariable logistic regression analysis and linear regression analysis after adjusting potential confounders. The dose-response relationship of sleep duration and screen time with anxiety was visualized using a cubic spline plot. Our data revealed that almost 35% of pregnant women suffered from anxiety during the COVID-19 pandemic. Sleep duration was dose-dependently associated with a lower risk of anxiety among pregnant women, while screen time exhibited a conversed effect. Notably, sleep duration synergistically combined with screen time to diminish the risk of anxiety. Taken together, sleep duration and screen time were independently and jointly associated with anxiety. Therefore, promoting a more active lifestyle and maintaining higher sleep quality could improve the mental health of pregnant women, especially under public health emergency. (shrink)

To realize the coordinated and sustainable development of hydropower projects and regional society, comprehensively evaluating hydropower projects’ influence is critical. Usually, hydropower project development has an impact on environmental geology and social and regional cultural development. Based on comprehensive consideration of complicated geological conditions, fragile ecological environment, resettlement of reservoir area, and other factors of future hydropower development in each country, we have constructed a comprehensive evaluation index system of hydropower projects, including 4 first-level indicators of social economy, environment, safety, (...) and fairness, which contain 26 second-level indicators. To solve the problem that existing models cannot evaluate dynamic nonlinear optimization, a projection pursuit model is constructed by using rough set reduction theory to simplify the index. Then, an accelerated genetic algorithm based on real number coding is used to solve the model and empirical study is carried out with the Y hydropower station as a sample. The evaluation results show that the evaluation index system and assessment model constructed in our paper effectively reduce the subjectivity of index weight. Applying our model to the social impact assessment of related international hydropower projects can not only comprehensively analyze the social impact of hydropower projects but also identify important social influencing factors and effectively analyze the social impact level of each dimension. Furthermore, SIA assessment can be conducive to project decision-making, avoiding social risks and social stability. (shrink)

More and more studies showed that strabismus is not simply an ocular disease, but a neuro-ophthalmology disease. To analyze potential changes in brain activity and their relationship to behavioral performance in comitant strabismus patients and healthy controls. Our study recruited 28 patients with comitant strabismus and 28 people with matched weight, age range, and sex ratio as healthy controls. Using resting-state functional magnetic resonance imaging, we evaluated fALFF to compare spontaneous brain activity between comitant strabismus and healthy controls. We did (...) hospital anxiety and depression scale questionnaires for these patients. We found significantly lower fALFF value in comitant strabismus patients compared with controls in the left frontal superior medial gyrus and the right middle cingulum. In the latter region, fALFF was significantly negatively correlated with the hospital anxiety and depression scale, as well as the duration of disease. Receiver operating characteristic curve analysis indicated that the fALFF method has clear potential for the diagnosis of comitant strabismus patients. These results revealed abnormal spontaneous activity in two brain regions of comitant strabismus patients, which may indicate underlying pathologic mechanisms and may help to advance clinical treatment. (shrink)

For efficient energy distribution, microgrids provide significant assistance to main grids and act as a bridge between the power generation and consumption. Renewable energy generation resources, particularly photovoltaics, are considered as a clean source of energy but are highly complex, volatile, and intermittent in nature making their forecasting challenging. Thus, a reliable, optimized, and a robust forecasting method deployed at MG objectifies these challenges by providing accurate renewable energy production forecasting and establishing a precise power generation and consumption matching at (...) MG. Furthermore, it ensures effective planning, operation, and acquisition from the main grid in the case of superior or inferior amounts of energy, respectively. Therefore, in this work, we develop an end-to-end hybrid network for automatic PV power forecasting, comprising three basic steps. Firstly, data preprocessing is performed to normalize, remove the outliers, and deal with the missing values prominently. Next, the temporal features are extracted using deep sequential modelling schemes, followed by the extraction of spatial features via convolutional neural networks. These features are then fed to fully connected layers for optimal PV power forecasting. In the third step, the proposed model is evaluated on publicly available PV power generation datasets, where its performance reveals lower error rates when compared to state-of-the-art methods. (shrink)

The purpose of this study is to investigate the relationships among corporate social responsibility (CSR), corporate brand credibility, corporate brand equity, and corporate reputation. Structural equation modeling analysis provided support for the hypotheses from a sample of 867 consumers in South Korea. The results showed that CSR has a direct positive effect on corporate brand credibility and corporate reputation. In addition, the results indicate that corporate brand credibility mediates the relationship between CSR and corporate reputation. Moreover, corporate brand credibility mediates (...) the relationship between CSR and corporate reputation. Finally, the relationship between CSR and corporate brand equity is sequentially and fully mediated by corporate brand credibility and corporate reputation. The theoretical and managerial implications of the results and limitations are discussed, and future research directions are suggested. (shrink)