Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

This paper aims to propose an improved learning algorithm for feature selection, termed as binary superior tracking artificial bee colony with dynamic Cauchy mutation. To enhance exploitation capacity, a binary learning strategy is proposed to enable each bee to learn from the superior individuals in each dimension. A dynamic Cauchy mutation is introduced to diversify the population distribution. Ten datasets from UCI repository are adopted as test problems, and the average results of cross-validation of BSTABC-DCM are compared with other seven (...) popular swarm intelligence metaheuristics. Experimental results demonstrate that BSTABC-DCM could obtain the optimal classification accuracy and select the best representative features for the UCI problems. (shrink)

BackgroundMeasurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.ObjectiveTo investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal (...) Treatment Programme.MethodsTwo-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire’s total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire’s minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires’ responder classifications.ResultsThe total scores of all three questionnaires showed high agreement before and after therapy. All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable and the THI higher responder rates. The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire’s total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.ConclusionThe total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches. (shrink)

St, what did the word nien itself mean? There are five retations. The first holds that it referred to a place people congregated. Ch'a K'uei's "Lun An-hui li-chih" [On ficer System in Anhwei] states,1 "They carried swords and ed into units by the tens and hundreds. … The places they gathered were known as nien-tzu; the large nien-tzu red several hundred people." In 1814, T'ao Chu, the Im- Censor wrote,2 "They gather and commit improprieties ad daylight. Each group is known (...) as a nien. A small onsists of from several to several dozen persons. A nien includes from one to two hundred people.". (shrink)

In lieu of an abstract, here is a brief excerpt of the content:398 Feminist Studies 46, no. 2. © 2020 by Feminist Studies, Inc. Becky Thompson In the Slip Between Coasts Every morning the sea announces the day intimate crashing against the high stone wall we scan the waves for black dots floating becoming new moons and then arms waving rafts carrying the world Cartography in Greece after Zeina Hashem Beck’s “To Hamra” Here is the Oleander bush where a family (...) hid before their walk up the hill from Eftalou to Molyvos after eating eggs and croissants in my seaside room thirteen pairs of shoes lined up on the patio slate Here is seaweed beach where one raft landed in perched sea another behind carrying the elders and children Becky Thompson 399 stalled, taking in saltwater coast guard delayed in Petra sea ten, twenty, fifty minutes shouting and prayer finally a rescue exhaustion lining every pore They say memories fade, mine multiply, a cacophony tossing Here is the beach where the Syrian man strapping muscles and whimsical eyes gave me his salmon shirt with a finely made collar his friends ordered selfies called home saying yes began the climb to Mytilini defiant, alive There were moments of freedom jubilation in the air rest on the beach with dates and cool water children tossing stones into the sea lovers sitting close, feet in Europe cell phones that worked, telegraphing safety What does it mean to miss the intimacy of disaster? Now rescue teams mechanic pick-ups intercept rafts before shore whisk people away to Skala Sikamia then Moria no time to touch sand rest with the breeze Here is life jacket graveyard next to the dump perched between two hills above the seacoast 400 Becky Thompson a German couple toots up on a scooter taking photographs while eating nine-grain toast academics from the US talking postmodern flight a film crew from Barcelona picking through jackets amid ashes and twisted plastic crows memorize the wind as two garbage trucks trudge up the road bringing old fish and more jackets I wave at the sheepherder as I walk down the hill Save the people, bury the dead, photograph the remains, repeat Here is the hotel by the beach in Petra where children would run to the iron swing set let the arc carry them then jump off dance in the sprinklers the owner emerging mumbling generations handing us apricots and bottles of water Here is the computer store where the young Greek tells me he can’t copy my poems since he sees Arabic words menacing the page Here is my patience as I sit in his smoke ask him about his family and dancing Becky Thompson 401 eye his automatic weapon perched next to a wooden door Down the highway is a new bar next to Moria. Of course. Here is barbed wire that doubles as a fence a clothesline for diapers space to toss out rotten food Here is the highway lined with pickups and two-door sedans young Greek employment guarding people in tents Here is a baby carriage a young mother pushes that seconds as a grocery cart and shade for her five-year-old a step up from before when babies were in arms toddlers walking Here is the refugee people center where they built a strong swing set men lifting weights growing rings around their arms women stretching out in a new room eyeing the Lesvos sky Here are the streets of Mytilini looking like Beirut the Greeks who ran from Turkey the Turks who kicked out Afghans the Afghans who wish they were Syrian 402 Becky Thompson Syrians joined by Congolese— teachers, holy seers, and men selling hats. The sidewalk sparkles an atlas in transit.... (shrink)

Yi Hwang, better known by his pen name T'oegye, is generally considered Korea's preeminent Neo-Confucian scholar. The Ten Diagrams on Sage Learning is his final masterpiece, a distillation of the learning and practice of a lifetime, and one of the most important works of Korean Neo-Confucianism. In it he crystallized the essence of Neo-Confucian philosophy and spiritual practice in ten brief chapters that begin with the grand vision of the universe and conclude with a description of a well-lived day. In (...) To Become a Sage, Michael Kalton supplements a superb translation of this pivotal text with useful commentary that will greatly enhance its value and interest to the lay reader. The Ten Diagrams is the first complete primary text of Korean Neo-Confucianism to be translated into English. Korea's Yi Dynasty, the only East Asian regime founded exclusively under Neo-Confucian auspices, was unique in its allegiance to the orthodox Ch'eng Chu school, predominant in China, Korea, and Japan. Although the Ten Diagrams is a relatively short work, it fully presents the entire vision of Neo-Confucianism as framed in that school. Kalton provides a brief history of Neo-Confucianism in China and Korea as well as commentary that includes extensive passages from T'oegye's voluminous personal correspondence. These annotations expand the meaning distilled in each chapter. They help the uninitiated reader understand the basic elements of the complex Ch'eng Chu school of Neo-Confucianism, while enabling the scholar to distinguish characteristic aspects of Korean Neo-Confucianism as presented in the thought of the nation's leading philosopher of the time. (shrink)

This paper evaluates the ways in which European business schools are implementing sustainability and ethics into their curricula. Drawing on data gathered by a recent large study that the Academy of Business in Society conducted in cooperation with EFMD, we map the approaches that schools are currently employing by drawing on and expanding Rusinko’s :507–519 2010) and Godemann et al.’s matrice of integrating sustainability in business and management schools. We show that most schools adopt one or more of the four (...) approaches outlined by Godemann et al.. However, we also argue that a fifth dimension needs to be added as the existing matrices do not capture the systemic nature of such curricular initiatives and how these are influenced by internal factors within the business school and external factors beyond. We suggest calling this fifth dimension ‘Systemic Institutional Integration’ and demonstrate that any business school which aims to integrate sustainability further into the curricula cannot succeed without the following: Systemic thinking and systemic leadership, Connectedness to business, the natural environment and society and Institutional capacity building. Utilising further literature and the answers provided by the deans and faculty, we discuss each factor in turn and suggest paths towards the successful systemic institutional integration of sustainability and ethics into management education. (shrink)

This paper reports a European Forum for Good Clinical Practice workshop held in 2011 to consider a research ethics committee training syllabus, subsequent training needs and resources. The syllabus that was developed was divided into four competencies: committee working; scientific method; ethical analysis and the regulatory framework. Appropriate training needs for each, with possible resources, were discussed. Lack of funding for training was reported as a major problem but affordable alternatives were debated. Strengths and weaknesses of this approach were discussed (...) and the resultant proposal will be disseminated through the European Forum for Good Clinical Practice and the research ethics committees of member states. (shrink)

In Croatia, the subject of medical ethics, or bioethics, was introduced into the curriculum in the early 1990s at the medical schools of the University of Rijeka and the University of Zagreb. Today, bioethics education has become a basic part of undergraduate medical education not only in Rijeka and Zagreb but also in Osijek.

自由的核心概念在康德的建構中，除了奠定了道德法則與法權法則的普遍性、必然性與約束性之外，它還有一個軸心的關鍵作用，居間連結道德哲學與法權哲學。自由是實踐哲學的基本概念，藉此設定，康德業已以不言而喻的必 然方式，將法權哲學的法權論，與倫理學的德行論，一併歸編列於道德哲學的大系統之內。這樣一個大系統的建構，反過來使法權哲學的法權論能夠具有道德形上學的向度，從外在的強制法，通過意念的反思建立德行，成為可能 。再透過理性本體之自由理念的溯源，自由基本人權明確顯示的，即是「人作為人」不可冒犯的尊嚴。在康德通過道德法則的理性事實證成自由理念的客觀真實性之後，我們可以合理地倒反過來，從存有的觀點來鳥瞰他的道德哲 學的這整個系統的基本架構，是透過一個核心作用的統籌運用：從作為核心的自由概念出發，一方面「縱向貫徹」，另外一方面「橫向一致」，動態交錯地開展出來。.

The COVID-19 pandemic has significantly changed university students' life routines, such as prolonged stay at home and learning online without prior preparation. Identifying factors influencing student online learning has become a great concern of educators and researchers. The present study aimed to investigate whether family wellbeing would significantly predict university students' online learning effectiveness indicated by engagement and gains. The mediational role of individual wellbeing such as life satisfaction and sleep difficulties was also tested. This study collected data from 511 (...) undergraduate students via an online survey. Structural equation modeling analysis revealed positive effects of family support on students' learning engagement and gains through the mediational effects of life satisfaction and sleep difficulties. In contrast to our expectation, family conflict during the pandemic also positively predicted students' learning gains, which, however, was not mediated by individual wellbeing. The findings add value to the existing literature by delineating the inter-relationships between family wellbeing, individual wellbeing, and online learning effectiveness. The study also sheds light on the unique meaning of family conflict, which needs further clarification in future studies. (shrink)

Clinical reports suggest that children with autism spectrum disorder (ASD) struggle with time perception, but few studies have investigated this. This is the first study to examine these children’s understanding of before and after. These temporal conjunctions have been argued to require additional cognitive effort when conjoining two events in a clause order that is incongruent with their order in time. Given the suggested time perception impairment and well-established cognitive deficits of children with ASD, we expected them to have difficulties (...) interpreting temporal conjunctions, especially in an incongruent order. To investigate this, the interpretation of before and after in congruent and incongruent orders was examined in 48 children with ASD and 43 typically developing (TD) children (age 6–12). Additional tasks were administered to measure Theory of Mind (ToM), working memory (WM), cognitive inhibition, cognitive flexibility, IQ, and verbal ability. We found that children with ASD were less accurate in their interpretation of temporal conjunctions than their TD peers. Contrary to our expectations, they did not have particular difficulties in an incongruent order. Furthermore, older children showed better overall performance than younger children. The difference between children with ASD and TD children was explained by WM, ToM, IQ, and verbal ability, but not by cognitive inhibition and flexibility. These cognitive functions are more likely to be impaired in children with ASD than in TD children, which could account for their poorer performance. Thus, the cognitive factors found to affect the interpretation of temporal language in children with ASD are likely to apply in typical development as well. Sufficient WM capacity and verbal ability may help children to process complex sentences conjoined by a temporal conjunction. Additionally, ToM understanding was found to be related to children’s interpretation of temporal conjunctions in an incongruent order, indicating that perspective taking is required when events are presented out of order. We conclude from this that perspective-taking abilities are needed for the interpretation of temporal conjunctions, either to shift one’s own perspective as a hearer to another point in time, or to shift to the perspective of the speaker to consider the speaker’s linguistic choices. (shrink)