Fourth-year medical students at the University of Colorado School of Medicine distributed cards to patients in the emergency department asking, "What Worries You Most?" The patients' responses provided insight about their most pressing concerns, often unrelated to their "chief complaints.".

BackgroundPsychological resilience may reduce the impact of psychological distress to some extent. We aimed to investigate the mental health status of the public during the outbreak of coronavirus disease 2019 and explore the level and related factors of anxiety and depression.MethodsFrom February 8 to March 9, 2020, 3,180 public completed the Zung’s Self-Rating Anxiety Scale for anxiety, Zung’s Self-Rating Depression Scale for depression, the Connor–Davidson resilience scale for psychological resilience, and the Simplified Coping Style Questionnaire for the attitudes and coping (...) styles.ResultsThe number of people with depressive symptoms was 1,303. The number of people with anxiety symptoms was 1,184. The depressed group and anxiety group had less education, more unmarried and younger age, as well as had significant different in SDS total score, SAS total score, CD-RISC total score, and SCSQ score. The binary logistic regression showed that female, strength, and the subscales of active coping style in SCSQ remained protective factors and passive coping style and higher SAS score were risk factors for depression. Optimism in CD-RISC was a protective factor, and passive coping styles and higher SDS score were risk factors for anxiety.LimitationsThis study adopted a cross-sectional design and used self-report questionnaires.ConclusionThe mental health of the public, especially females, the younger and less educational populations, and unmarried individuals, should be given more attention. Individuals with high level of mental resilience and active coping styles would have lower levels of anxiety and depression during the outbreak of COVID-19. (shrink)

Enlivening the spirit without overwhelming the mind, the poem Hsin-Hsin Ming, or Song of Trusting the Heart, was written in the sixth century by the third Zen patriarch of China. It is perhaps the most encompassing and profound statement of Zen awareness we have. A beautiful daily meditation guide, the book will become a year-round fixture in readers' lives. These haunting lyrics inspire a peaceful awakening that helps one see through attachments, judgments, and illusions.

ABSTRACTPrevious studies have identified two powerful ways to regulate emotional responses to a stressor: experiencing incidental positive emotions and using cognitive reappraisal to reframe the stressor. Several cognitive and motivational theories of positive emotion support the formulation that incidental positive emotions may facilitate cognitive reappraisal. To test the separate and interacting effects of positive emotions and cognitive reappraisal, we first adapted an established picture-based reappraisal paradigm by interspersing blocks of positive emotion inducing and neutral pictures. Across two pre-registered studies, reappraisal (...) effectively decreased self-reported negative emotions and increased self-reported positive emotions; however, experiencing incidental positive emotions did not facilitate reappraisal success. In another preregistered study, we employed a more powerful positive emotion induction via virtual reality, used a social stress anticipation task, and... (shrink)

Following the idea of L -fuzzy generalized neighborhood systems as introduced by Zhao et al., we will give the join-complete lattice structures of lower and upper approximation operators based on L -fuzzy generalized neighborhood systems. In particular, as special approximation operators based on L -fuzzy generalized neighborhood systems, we will give the complete lattice structures of lower and upper approximation operators based on L -fuzzy relations. Furthermore, if L satisfies the double negative law, then there exists an order isomorphic mapping (...) between upper and lower approximation operators based on L -fuzzy generalized neighborhood systems; when L -fuzzy generalized neighborhood system is serial, reflexive, and transitive, there still exists an order isomorphic mapping between upper and lower approximation operators, respectively, and both lower and upper approximation operators based on L -fuzzy relations are complete lattice isomorphism. (shrink)

Purpose The debate about the end-of-life care decision is becoming a serious ethical and legal concern in the Far-Eastern countries of Korea, China and Japan. However, the issues regarding end-of-life care will reflect the cultural background, current medical practices and socioeconomic conditions of the countries, which are different from Western countries and between each other. Understanding the genuine thoughts of patients who are critically ill is the first step in confronting the issues, and a comparative descriptive study of these perspectives (...) was conducted by collaboration between researchers in all three countries. Methods Surveys using self-reporting paper questionnaire forms were conducted from December 2008 to April 2009 in Korea (six hospitals in two regions), China (five hospitals in four regions) and Japan (nine hospitals in one region). The subjects were patients who were critically ill who had been diagnosed as having cancer. A total of 235 participants (Korea, 91; China, 62; Japan, 52) were eventually recruited and statistically analysed. Results Most respondents had sometimes or often thought of their own death, mostly fear of ‘separation from loved ones’. They wanted to hear the news regarding their own condition directly and frankly from the physician. A quarter of them preferred making end-of-life care decisions by themselves, while many respondents favoured a ‘joint decision’ with their family members. The most favoured proxy decision maker was the spouse, followed by the children. Most admitted the necessity of ‘advance directives’ and agreed with artificial ventilation withdrawal in irreversible conditions. The most common reason was ‘artificial prolongation of life is unnecessary’. Most respondents agreed with the concept of active euthanasia; however, significant differences were sometimes observed in the responses according to variables such as patient's country of origin, age, gender and education level. Conclusion Patients in Far-Eastern countries gave various responses regarding end-of-life care decisions. Although familial input is still influential, most patients think of themselves as the major decision maker and accept the necessity of advance directives with Westernization of the society. Artificial ventilation withdrawal and even active euthanasia may be acceptable to them. (shrink)

This is a “bottom-up” paper in the sense that it draws lessons in defining disciplinary categories under study from a series of empirical studies of interdisciplinarity. In particular, we are in the process of studying the interchange of research-based knowledge between Cognitive Science and Educational Research. This has posed a set of design decisions that we believe warrant consideration as others study cross-disciplinary research processes.

By analyzing how Korea has upgraded its industrial capabilities in the course of corporate globalization, this article holds that some versions of developmental state work better in the globalization process. Globalizing national corporations, neoliberal optimism notwithstanding, does not necessarily result in upgrading domestic innovation capabilities. In the United States, free-market firms may benefit through offshoring, but they create holes in the industrial linkages or industrial commons at home, enfeebling US capability for innovation. By contrast, the Korean government successfully upgraded domestic (...) firms’ innovation capabilities and reduced the possibility of deindustrialization in the course of globalization by moving from classical developmentalism to a new form of development based on inclusive and collaborative networks. Korea’s earlier classical developmentalism focused on mobilization of physical capital, funneling it exclusively to a few firms. (shrink)

Kit Fine has argued that the Tarski Semantics for the language of first order logic is inadequate. A semantic theory for FOL is inadequate if there are formulae of FOL whose meanings or satisfaction conditions it cannot compositionally account for. It is argued here that Fine’s case against Tarski rests on a mistake.

There are close parallels between Frank Jackson's case of black-and-white Mary and David Lewis's case of the two omniscient gods. This essay develops and defends what may be called “the ability hypothesis” about the knowledge that the gods lack, by adapting Lewis's ability hypothesis about the knowledge that Mary acquires. What the gods might lack despite their propositional omniscience is not any distinctive kind of information, but certain abilities of introspection. The motivating idea is that knowledge one acquires by exercising (...) introspective abilities cannot fail to be knowledge about oneself or indexical knowledge. So in order to envisage the gods' epistemic situation coherently, we need to assume that they lack those introspective abilities. But once we recognize that, it turns out that positing a special kind of information is a gratuitous addition. The two gods' ignorance simply consists in their lack of introspective abilities. (shrink)

In the present paper we shall see that the different ways of understanding mind between Confucianism and Enlightenment in the 18th century. In this study each of these two different traditions is regarded as the East Asian context of mind study or as the Western European context of mind study. This idea comes from a kind of constructivism and constructive realism. The former, which comes from ideas of Lev Vygotsky, stresses that human mind is constructed on its cultural context. The (...) latter insisted by Fridriech Wallner approves that every truth constructed on its cultural context can be an absolute truth depending on its cultural context. Due to these two viewpoints, we can see that the truth about human mind is not singular but plural and it should be an important theme of discussionhow to communicate between different understandings of mind and cultural context. Therefore three steps to approach the difference between Asian and European should be discussed in the following way: first, I will explain Confucian ways of understanding mind. It is Confucian cultural context as a social being that used to be the basis of cultural construction of East Asian’s mind. There were three types of Confucianism in 18th century Korea; second I will explain Western European way of understanding mind and the philosophy of Enlightenment as the basic context of cultural construction of mind; and third, I will conclude by comparing these two different ways of understanding mind and mind construction and by looking for a feasible way to communicate and understand each other. (shrink)

The progress of social economy has created a better environment for the healthy development of young people, but the heavy schoolwork and life pressure have caused many students to ignore the scientific management of physical health. At this stage, people need a scientific physical health service system to help students understand their own health data, propose targeted exercise methods and health knowledge, and actively encourage and guide students to participate in physical exercise. The purpose of this article is to cultivate (...) students’ good self-exercise awareness and improve their physical fitness and health. To this end, this article has designed a smart health service system for young people. This article introduces the various service functions in the health management service system and explains in detail the entry, induction, and analysis of student physical health data in the system. The essence of the health intelligent service system is to provide students with targeted healthy exercise strategies through data analysis. This paper studies the health intervention plan of the health intelligent service system. From the experimental data, the improved particle swarm algorithm in this paper increases the effectiveness of the system in adolescent health data mining from 80.5% to 92.19%, which undoubtedly optimizes the system. It helps a lot. (shrink)

Mere physical experiences of warmth, distance, hardness, and roughness are found to activate the more abstract psychological concepts that are analogically related to them, such as interpersonal warmth and emotional distance, thereby influencing social judgments and interpersonal behavior without the individual's awareness. These findings further support the principle of neural reuse in the development and operation of higher mental processes.

Memory reconsolidation holds great hope for memory modification approaches and clinical treatments of mental disorders associated with maladaptive memories. However, it remains controversial as to whether reconsolidation is a general property of all types of memory. Especially, discrepancies have been reported in research focusing on whether declarative memory undergoes reconsolidation, and whether old memories can be reorganized after retrieval. Here, we discuss how these inconsistent results can be reconciled and what information we need to uncover for the general use of (...) reconsolidation. (shrink)

In the past two decades, Confucian meritocrats have justified the unequal distribution of political power by appeal to the ideal of Confucian virtue politics. In this article, I demonstrate that at the heart of Confucian virtue politics lies a political leader’s affective accountability and show that non-democratic Confucian meritocracy fails to embody this moral ideal. Then, I argue that the ideal of Confucian virtue politics can be better realized in democratic system. To this end, I first describe how ordinary citizens’ (...) moral demand for a political leader’s affective accountability in a consolidated democratic society can make theoretical space for a Confucian political leader. Next, I articulate the role of a Confucian political leader in contemporary democratic society from a normative standpoint and show that at the core of Confucian democratic meritocracy lies ‘mutual moral transformation’, formed by dialectical interactions between a virtuous Confucian political leader and empowered citizens. (shrink)

ObjectiveThis study aimed to better understand the current situation involving work stressors and the coping styles of outpatient and emergency nurses in 29 pediatric specialty hospitals across China. The study analyzed this correlation to provide a reference for the occupational stress management of pediatric nurses.MethodsFrom June to September 2020, 1,457 outpatient and emergency nurses in 29 pediatric specialty hospitals across China were selected as study participants, and a questionnaire survey was conducted using the Basic Information Questionnaire, the Chinese version of (...) the Work Stressor Scale for Nurses, and the Simple Coping Style Scale.ResultsThe assessed stress level of outpatient and emergency nurses in 29 tertiary pediatric specialty hospitals nationwide is lower than the results of the survey of the 2007 domestic norm, p < 0.05. The stressors related to nurses’ expectations, family conflicts, the nature of nursing work, patient factors, and workload were lower compared with the national norm. The positive coping style score on the Simple Coping Style Scale for pediatric outpatient nurses was, and work stressors were positively associated with negative coping styles. Multiple regression analysis showed that the influencing factors of work stressors among pediatric outpatient and emergency nurses correlated with the authorized size, age, working years of nurses, work department, and negative coping styles.ConclusionNegative coping styles were present among pediatric outpatient and emergency nurses and were associated with work stressors. The influencing factors of stressors mainly correlated with the clinical establishment, age, years of employment as a nurse, work department, and negative coping styles. (shrink)

BackgroundSocial support plays an important role for health outcomes. Support for those living with chronic conditions may be particularly important for their health, and even for their survival. The role of support for the survival of cancer patients after receiving an allogeneic hematopoietic cell transplant is understudied. To better understand the link between survival and support, as well as different sources and functions of support, we conducted two studies in alloHCT patients. First, we examined whether social support is related to (...) survival. Second, we examined who provides which support and which specific support-related functions and tasks are fulfilled by lay caregivers and healthcare professionals.MethodsIn Study 1, we conducted a retrospective chart review of alloHCT patients and registered availability of a dedicated lay caregiver and survival. In Study 2, we prospectively followed patients after alloHCT from the same hospital, partly overlapping from Study 1, who shared their experiences of support from lay caregivers and healthcare providers in semi-structured in-depth interviews 3 to 6 months after their first hospital discharge.ResultsPatients with a dedicated caregiver had a higher probability of surviving to 100 days than patients without a caregiver, OR = 2.84, p = 0.042. Study 2 demonstrated the importance of post-transplant support due to patients’ emotional needs and complex self-care regimen. The role of lay caregivers extended to many areas of patients’ daily lives, including support for attending doctor’s appointments, managing medications and financial tasks, physical distancing, and maintaining strict dietary requirements. Healthcare providers mainly fulfilled medical needs and provided informational support, while lay caregivers were the main source of emotional and practical support.ConclusionThe findings highlight the importance of studying support from lay caregivers as well as healthcare providers, to better understand how they work together to support patients’ adherence to recommended self-care and survival. (shrink)

A growing interest across disciplines in the nature of empathy has sparked a debate over the place of empathy in morality. Proponents are eager to capitalize on the apparent close connection between empathy and altruism, while critics point to serious problems in our exercise of empathy - we are naturally biased, empathize too much or too little, and prone to making all sorts of mistakes in empathizing. The proponents have a promising response, that it is not empathy simpliciter, but empathy (...) in some “proper” form, that does the work they claim for it. This paper aims to propose a cautiously optimistic position for the proponent by rethinking the suggested approach. I argue that empathy plays two important roles in morality, one epistemic and the other relational, but the proponent must be careful not to exaggerate the contribution that empathy, even in its “proper” form, can make to our moral life. (shrink)

This article investigates, based on in-depth interviews and mail surveys, the different ways liberal market regimes are constituted by looking at two small market societies, the U.S. and German automotive parts markets. In a situation in which neoliberal paradigm is being challenged and prior norms about contracts and contractual relations do not work either, this article explores how different conceptions of fairness and divergent market regimes are constituted. This article claims that divergent market regimes result from different kinds of problem-solving (...) practices in a novel context among reflexive agents—public deliberation versus isolated dyadic deliberation of conflicts. (shrink)

This paper investigates how and why the Japanese model has undergone changes in the context of its internationalization, during which foreign countries, particularly the U.S. and Germany, adopted Japanese methods, departing from their own traditional models at the turn of the twentieth century. By examining the dynamicprocesses of these transformations in national models, this paper critically reviews prevalent paradigms of neoliberalism and institutionalism, proposing an alternative of “mutual learning by reflexive agents.” By exploring the dynamic processes of the Japanese model’s (...) internationalization and transformation, in which the Japanese model fell into crisis and underwent transformation in the changed context of international competition caused by the internationalization of the Japanese model, this paper proposes a new conception of “mutual learning by reflexive agents” in the context of international competition, in which agents, inspired by foreign competitors, critically reconsider their own institutions and, in turn, generate a new divergence in the process of creative learning. (shrink)

We report one production and one comprehension experiment investigating the effect of animacy in relative clause attachment in Chinese. Experiment 1 involved a fill-in-the-blank task that manipulated the order of an animate noun phrase in a complex NP construction. The results showed that while low attachment responses exceeded high attachment responses overall (cf. Shen, 2006), a tendency exists to attach a relative clause to an animate NP in Chinese (cf. Desmet et al., 2002). Experiment 2 used a rating task to (...) examine the interplay between animacy and structural information by manipulating the order of the animate NP as well as the relative clause type (i.e., subject vs. object relative clauses). The results showed that the animate NP modification tendency found in Experiment 1 was limited to subject-relative clauses and that no animacy-related effect was found with object-relative clauses. These results are incompatible with purely structural parsing strategies such as Late Closure (Frazier, 1987) and the Predicate Proximity Principle (Gibson et al., 1996). Instead, the current results suggest that attachment ambiguity resolution in Chinese relative clauses is sensitive to animacy as well as structural information. (shrink)

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...) end-of-life care and its consequential impacts. Research objectives To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design A qualitative descriptive approach was employed. Participants and research context Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings The moral distress-inducing factors and nurses’ perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. (shrink)

This paper examines the globalization process of German core export metalworking industries, to show how the globalization of national corporations has different effects on domestic economies. Contrary to the prevalent views on the globalization of production, this paper holds that the outcomes and patterns of globalization vary, due mainly to the politics of the main actors inside and outside corporations. This paper compares Germany’s negotiated globalization with U.S. employer unilateralism. In most U.S. corporations, employers decide how to globalize based on (...) the short-term perspective of shareholder value. By contrast, in Germany, main industrial actors—including employers, works councils, and trade unions—collectively negotiate how to globalize. In this conflict-laden process of collective negotiation, German actors have created a political compromise that combines the upgrading of domestic production with globalizing overseas, whereas Americans have failed to do so. Furthermore, this paper emphasizes that divergent patterns of globalization are not predetermined by national institutions. To the contrary, the successful outcomes in German globalization come mainly from actors’ proactive readjustments in their traditional model of industrial relations, creating new practices, such as active union involvement in company-level bargaining, and the democratic bottom-up process instead of the traditional top-down process of negotiation. (shrink)

Background Recently, palliative care is increasingly important, with an emphasis on the process of dying with dignity. However, nurses who care for such patients experience the associated ethical dilemmas. Objective To explore the meaning of nurses’ experiences in dealing with ethical dilemmas in relation to palliative sedation. Research design A qualitative research design was employed with a thematic analysis approach. Participants and research context Using purposive sampling, 15 nurses, working at palliative care units for at least 1 year, were recruited (...) as participants. Data were collected using unstructured in-depth interviews, and data collection and analysis was performed simultaneously. Ethical considerations Ethical approval was obtained from the authors’ institutional review board. All participants provided informed consent. For the face-to-face interview, the South Korean standard COVID-19 quarantine guidelines, such as mandatory masking and social distancing, were followed. Results Dilemmas raised by patients, were related to concerns about appropriate drug dose; dilemmas raised by nurses, were related to passive care, sense of guilt for failure to predict death, and colleague’s disrespectful attitudes toward patients; dilemmas from patients’ families were related to demands for palliative sedation and reversal of those demands. Care actions to deal with ethical dilemmas comprised evidence-based care, person-centered thinking, reflecting on the death situation, compassion, providing explanation and help to family members. Conclusion Nurses’ ethical dilemmas were pre-dominantly influenced by themselves, rather than by the patients or their families, especially if they felt they could not do their best for patients. The core concept of care actions to deal with the ethical dilemmas, was person-centered care and compassion. Then, how patients and their family members perceive person-centered care and compassion, should be further explored to improve palliative sedation. (shrink)