Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

This study aimed to explore the association between self-oriented empathy and compassion fatigue, and examine the potential mediating roles of dispositional mindfulness and the counselor’s self-efficacy. A total of 712 hotline psychological counselors were recruited from the Mental Health Service Platform at Central China Normal University, Ministry of Education during the outbreak of Corona Virus Disease 2019, then were asked to complete the questionnaires measuring self-oriented empathy, compassion fatigue, dispositional mindfulness, and counselor’s self-efficacy. Structural equation modeling was utilized to analyze (...) the possible associations and explore potential mediations. In addition to reporting confidence intervals, we employed a new method named model-based constrained optimization procedure to test hypotheses of indirect effects. Results showed that self-oriented empathy was positively associated with compassion fatigue. Dispositional mindfulness and counselor’s self-efficacy independently and serially mediated the associations between self-oriented empathy and compassion fatigue. The findings of this study confirmed and complemented the etiological and the multi-factor model of compassion fatigue. Moreover, the results indicate that it is useful and necessary to add some training for increasing counselor’s self-efficacy in mindfulness-based interventions in order to decrease compassion fatigue. (shrink)

PurposeTo study the changes in functional connections between the left and right hemispheres of patients with high myopia and healthy controls by resting functional magnetic resonance imaging based on voxel-mirrored homotopic connectivity. To study the changes in resting-state functional connectivity between the left and right hemispheres of patients with HM and healthy controls at rest by using resting functional magnetic resonance imaging based on voxel-mirror homotopy connectivity.Patients and MethodsA total of 89 patients with HM and 59 HCs were collected and (...) matched according to gender, age, and education level. The VMHC method was used to evaluate the changes in rsFC between cerebral hemispheres, and a correlation analysis was carried out to understand the differences in brain functional activities between the patients with HM and the HCs.ResultsCompared with the HCs, the VMHC values of the putamen and fusiform in the HM group were significantly lower.ConclusionThis study preliminarily confirmed the destruction of interhemispheric functional connection in some brain regions of the patients with HM and provided effective information for clarifying the neural mechanism of patients with HM. (shrink)

AimResting state functional magnetic resonance imaging was used to analyze changes in functional connectivity within various brain networks and functional network connectivity among various brain regions in patients with high myopia.Methodsrs-fMRI was used to scan 82 patients with HM and 59 healthy control volunteers matched for age, sex, and education level. Fourteen resting state networks were extracted, of which 11 were positive. Then, the FCs and FNCs of RSNs in HM patients were examined by independent component analysis.ResultsCompared with the HC (...) group, FC in visual network 1, dorsal attention network, auditory network 2, visual network 3, and sensorimotor network significantly increased in the HM group. FC in default mode network 1 significantly decreased. Furthermore, some brain regions in default mode network 2, default mode network 3, auditory network 1, executive control network, and significance network increased while others decreased. FNC analysis also showed that the network connection between the default mode network and cerebellar network was enhanced in the HM group.ConclusionCompared with HCs, HM patients showed neural activity dysfunction within and between specific brain networks, particularly in the DMN and CER. Thus, HM patients may have deficits in visual, cognitive, and motor balance functions. (shrink)

林毓生是研究近現代中國思想史的著名學者，其英文論著《中國意識的危機》在1980 年代出版中、日、韓譯本，對於東亞地區、台灣和大陸的學界與文化界都有極大的影響，奠定了他在西方和東亞近現代思想史領域的重要地位。從1960 年起在芝加哥大學攻讀博士期間，受海耶克（F. A.Hayek）親自指導和影響，林毓生對自由主義在中國前途的討論提出以往中文世界從未觸碰到的關鍵議題，使海耶克的理論以及西方其他重要思想家的言說獲得真切實際的理解與融合，轉為建設本土憲政民主的有利資源 ，成為重建文化認同的價值基礎。 《現代知識貴族的精神》共收錄34 篇林毓生的代表著作，主要在2000 年以後發表， 按照其學術追求與思想關懷，分別編入「意識危機的探索與回應」、「自由的基礎與理據」、「學思之路與民主建設」及「人文傳統的存續與『創造性轉化』」四個範疇以及附錄。整體來看，這些彼此具有密切關聯的範疇及其所 涵攝的各篇文章，可以說是構成林先生對中國自清末以來尋找現代性出路的一個系統性的論述。讀者可以看到林毓生對「現代性」這個二十世紀中國最迫切的根本問題提出的研究分析，以及他認為解決這一問題的可行路徑。他提 出了憲政民主在中文世界前途的看法與觀點，而數十年來的論述，代表了他以學術思想的言說介入公共議題的巨大努力。.

Detailed summary in vernacular field only.

Objective: To systematically analyze the effects of art therapy on the levels of depression, anxiety, blood glucose, and glycated hemoglobin in diabetic patients.Methods: We searched Cochrane Library, PubMed, Embase, and ClinicalTrials.gov databases from inception to January 24, 2021. The language of publication was limited to English. Randomized controlled trials that used art therapy to improve mental disorders in diabetic patients were involved. After selection of eligible studies, data were extracted, including the first author's full-name, year of publication, the first author's (...) country of residence, number of intervention and control groups, the mean age of participants, method of intervention, duration of follow-up, and outcome measures. Assessment of quality of the included studies and data extraction were independently carried out by two researchers. RevMan 5.3 software was used to perform statistical analysis.Results: A total of 396 samples from five studies were included, and the eligible studies were RCTs with a parallel design. Methods of art therapy included music therapy and painting therapy. The results showed that compared with the control group, art therapy could positively affect the levels of depression [standardized mean difference, −1.36; 95% confidence interval, ; P < 0.00001] and blood glucose in diabetic patients [mean difference, −0.90; 95% CI, ; P < 0.0001], while it had no influence on the levels of anxiety [SMD, −0.31; 95% CI, ; P = 0.32] and glycated hemoglobin [MD, 0.22; 95% CI, ; P = 0.07].Conclusion: Art therapy may have significant effects on the levels of depression and blood glucose for diabetic patients. (shrink)

Xunzi yu ru shu kao shi -- Zhongguo guo yue kao yuan.

1. Gu dai zhe xue dao zhong shi ji zhe xue shi -- 2. 16-18 shi ji zhe xue shi -- 3. 19-20 shi ji zhe xue shi.

How might science and technology studies and science, technology and society studies learn from its studies of other knowledge traditions? This article explores this question by looking at Chinese medicine. The latter has been under pressure from modernization and “scientization” for a century, and the dynamics of these pressures have been explored “symmetrically” within STS and related disciplines. But in this work, CM has been the “the case” and STS theory has held stable. This article uses a CM term, reasoning-as-propensity, (...) to look at contemporary practices of cancer care in a hospital in Taiwan. It describes how shi informed the design of a new decoction, Kuan Sin Yin, while also relating to the production of scientific knowledge, biomedical interventions, Buddhist practices, and the patients living with cancer themselves. Does CM’s use of shi simply confirm the essential and incompatible otherness of CM? Looked at from outside the answer seems to be yes. However, this article explores how STS might change itself—and the theory–practice division in STS—by thinking through shi in dialogue with its othered object. This opens the possibility of an STS for CM. (shrink)

Empathy is essential for human survival and social interaction. Although mindfulness-based interventions have been used to improve empathy in healthy populations, its therapeutic efficacy remains unknown. This study aims to investigate the therapeutic effects of MBIs on empathy in a healthy population and the potential factors affecting the efficacy of MBIs. The literature search focused on PubMed, Embase, Web of Science, Cochrane Library, and CNKI from inception to September 2022. Randomized controlled trials and quasi-experimental studies reporting the effects of using (...) MBIs on empathy in healthy populations were included. A total of 13 studies were included in this review. Results of the meta-analysis showed that MBIs improved empathy in the healthy population compared with that in the control group. Moreover, results of the subgroup analysis showed that intervention dose, format, and types were important factors affecting treatment outcomes. This comprehensive review suggests that MBIs are effective treatment for empathy in healthy population. Future research should markedly focus on large-sample, rigorously designed experiments to explore the long-term effects of MBIs on empathy and to elucidate the underlying mechanisms of MBIs. This study provides a reference for the daily application of MBIs. (shrink)

Cellular reprogramming can manipulate the identity of cells to generate the desired cell types1– 3. The use of cell intrinsic components, including oocyte cytoplasm and transcription factors, can enforce somatic cell reprogramming to pluripotent stem cells4– 7. By contrast, chemical stimulation by exposure to small molecules offers an alternative approach that can manipulate cell fate in a simple and highly controllable manner8– 10. However, human somatic cells are refractory to chemical stimulation owing to their stable epigenome2,11,12 and reduced plasticity13,14; it (...) is therefore challenging to induce human pluripotent stem cells by chemical reprogramming. Here we demonstrate, by creating an intermediate plastic state, the chemical reprogramming of human somatic cells to human chemically induced pluripotent stem cells that exhibit key features of embryonic stem cells. The whole chemical reprogramming trajectory analysis delineated the induction of the intermediate plastic state at the early stage, during which chemical-induced dedifferentiation occurred, and this process was similar to the dedifferentiation process that occurs in axolotl limb regeneration. Moreover, we identified the JNK pathway as a major barrier to chemical reprogramming, the inhibition of which was indispensable for inducing cell plasticity and a regeneration-like program by suppressing pro-inflammatory pathways. Our chemical approach provides a platform for the generation and application of human pluripotent stem cells in biomedicine. This study lays foundations for developing regenerative therapeutic strategies that use well-defined chemicals to change cell fates in humans. (shrink)

本书共分两大部分:一为“关于‘启蒙’的再反思”,共由12篇文章组成;二是“世俗化与现代性”,由13篇文章组成。全书对西方启蒙运动及中国明清以来的启蒙思想脉络进行了一番梳理,有助于读者更加深入地了解启蒙 运动、世俗化与现代化的关系。.

馬克思主義哲學中國化的實質是馬克思主義哲學與中國社會實踐和中國文化傳統之間雙向建構的互動關系。關系的展開表現為一個與時俱進的歷史過程，過程在不同歷史時期又凝結生成為“實踐觀念”和“理論觀念”的成果形態 。本專著從哲學解釋學角度，注重史淪結合來研究馬克思主義哲學中國化所蘊涵的實踐和文化歷史內涵。通過“關系”的詮釋，“過程”的描述、“形態”的建構、歷史經驗的反思，對馬克思主義哲學中國化做一種總體性的研究 ，以觀照馬克思主義哲學在中國的歷史、現實與未來。 林默彪，1958年生，福建平潭人，福建省委黨校哲學部副主任，哲學教授，福建師範大學碩士生導師，福建省歷史唯物主義學會副會長。曾在《哲學研究》、《馬克思主義與現實》、《新華文摘》、《東南學術》等刊物發表 論文數十篇。.