Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To provide (...) an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

_Huangdi Neijing_ is a classic medical text of ancient China. Composed of two sections, _Suwen_ and _Lingshu_, the book is filled with enduring wisdom and insight and is still consulted by doctors today. This translation is based largely on Li Zhongzi's concise 1642 edition, titled _Neijing Zhiyao_, and continues the centuries-long effort to annotate the text, especially in light of modern developments in medicine. Instead of "explaining a classic with a classic," this edition adds commentaries and emendations that enhance the (...) theoretical core of _Huangdi Neijing_, illuminating a seminal work of Chinese medicine that covers much more than the basic principles of yin-yang and the five elements. (shrink)

Classification is one of the distinctive features of Paralympic sport. Despite the existence of classification rules and a well-defined classification process, some Paralympic athletes intentionally misrepresent their abilities to classifiers in order to be allocated to a lower performing competition class, in which they secure an unfair advantage over other athletes. Such deception undermines the integrity of the competition by exploiting a vulnerability in the classification process. Such manipulation is hard to mitigate and harder still to prove that an athlete (...) had; intentionally misrepresented their abilities or; failed for innocent reasons to make maximum efforts during the classification or; had acted under coercive pressure from others in their entourage or environment. These challenges are compounded in the case of Paralympic athletes that have an intellectual impairment or who are accompanied by a parent/guardian who acts as a proxy, rendering evaluations as to responsibility even more complex. This article presents a conceptual analyses of intentional misrepresentation of abilities in Paralympic sport, and the differentiation of responsibility for offence thereupon, as stipulated in the draft of the International Standard for Intentional Misrepresentation, accompanying the new 2025 Athlete Classification Code (IPC, Citation2024). Drawing on philosophical and legal analysis we (i) set out existing shortcomings associated with Paralympic classification; (ii) articulate the range of potential intentional misrepresentational acts with respect to classification manipulation; and (iii) articulate the range of negative effects on the integrity of Paralympic sport. (shrink)

Information processing in neural systems can be described and analyzed at multiple spatiotemporal scales. Generally, information at lower levels is more fine-grained but can be coarse-grained at higher levels. However, only information processed at specific scales of coarse-graining appears to be available for conscious awareness. We do not have direct experience of information available at the scale of individual neurons, which is noisy and highly stochastic. Neither do we have experience of more macro-scale interactions, such as interpersonal communications. Neurophysiological evidence (...) suggests that conscious experiences co-vary with information encoded in coarse-grained neural states such as the firing pattern of a population of neurons. In this article, we introduce a new informational theory of consciousness: Information Closure Theory of Consciousness (ICT). We hypothesize that conscious processes are processes which form non-trivial informational closure (NTIC) with respect to the environment at certain coarse-grained scales. This hypothesis implies that conscious experience is confined due to informational closure from conscious processing to other coarse-grained scales. Information Closure Theory of Consciousness (ICT) proposes new quantitative definitions of both conscious content and conscious level. With the parsimonious definitions and a hypothesize, ICT provides explanations and predictions of various phenomena associated with consciousness. The implications of ICT naturally reconcile issues in many existing theories of consciousness and provides explanations for many of our intuitions about consciousness. Most importantly, ICT demonstrates that information can be the common language between consciousness and physical reality. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were statistically (...) significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

Population Dynamics fills the gap between the classical supply-side population theory of Malthus and the modern demand-side theory of economic demography. In doing so, author Cyrus Chu investigates specifically the dynamic macro implications of various static micro family economic decisions. Holding the characteristic composition of the macro population to always be an aggregate result of some corresponding individual micro decision, Chu extends his research on the fertility-related decisions of families to an analysis of other economic determinations. Within this framework, Chu (...) studies the income distribution, attitude composition, job structure, and aggregate savings and pensions of the population. While in some cases a micro-macro connection is easily established under regular behavioral assumptions, in several chapters Chu enlists the mathematical tool of branching processes to determine the connection. Offering a wealth of detail, this book provides a balanced discussion of background motivation, theoretical characterization, and empirical evidence in an effort to bring about a renewal in the economic approach to population dynamics. This welcome addition to the research and theory of economic demography will interest professional economists as well as professors and graduate students of economics. (shrink)

This paper compares some key concepts from Buddhism with ideas from different traditions of systems thinking. There appear to be many similarities, suggesting that there is significant potential for dialogue and mutual learning. The similarities also indicate that it may be possible to develop a Buddhist systems methodology to help guide exploration and change within Buddhist organisations.

Dinsel değişim, din psikolojisinin kurulduğu dönemden itibaren güncelliğini koruyan konular arasında yer almaktadır. Tarihsel süreçten bugüne kadar olumlu veya olumsuz biçimde neredeyse tüm insanların muhtelif boyutlarda dinsel unsurlar ile temas ediyor oluşu, dinsel değişim konusunu akademik alanda önemli ve güncel tutan hususlardandır. Bu çalışma; inançlı olduğu hâlde dine karşı ilgisiz bir hayat sürdüren Yaşar Alptekin’in neden ve nasıl dindarlaştığı sorusuna cevap aramaktadır. Nitel araştırma tekniklerinden olan durum çalışması desenine bağlı olarak yürütülen bu araştırmada veriler doküman incelemesi ile elde edilmiştir. Bu (...) doğrultuda Yaşar Alptekin’in bizzat kendisinin kaleme aldığı kitaplar ve onunla çeşitli sosyal medya platformlarında yapılan röportajlar, birinci elden kaynaklar olarak kullanılmıştır. Bu anlamda mevcut çalışma, psikobiyografik araştırma geleneği içinde değerlendirilebilir. Toplanan bilgi ve malumatlar, betimsel analiz tekniği ile çözümlenmiştir. Alptekin’in özel yaşamı, siyasi görüşü ve sanatçı yönü gibi konular, çalışmanın kapsamı dışında tutulmuştur. Ayrıca bu çalışmada yer alan bilgi ve malumatlar, araştırmanın yapılmış olduğu tarihe kadarki dokümanlar ile sınırlıdır. Araştırmanın temel sorusuna cevap ararken dinsel değişimin aşamaları, güdüleri, motifleri, çeşitleri, gerçekleşme biçimi ve sonuçları hakkında din psikolojisi literatüründe yer alan kuramsal yaklaşımlardan destek alınmıştır. Bu bağlamda psikanalitik ve varoluşçu yaklaşımlarla birlikte sosyal kimlik kuramından da faydalanılmıştır. Bu noktada öncelikle Alptekin’in çocukluk, gençlik ve yetişkinlik döneminde yaşadığı önemli olaylar ve hayatını etkileyen hadiseler, dinsel değişimi harekete geçiren nedenler kapsamında analize çalışılmıştır. Alptekin’in değişim öncesi ve sonrası kişilik ve kimlik bakımından nasıl bir değişim yaşadığı, bunun kendisiyle ve sosyal çevresi ile ilişkilere nasıl yansıdığı sorusuna odaklanılmıştır. Ulaşılan bulgulara göre Alptekin’in dinsel değişim sürecini harekete geçiren nedenler; “çocukluk dönemini mutsuz geçirmesi”, bu anlamda “sevgisiz ve ilgisiz büyümesi”, “yetişkinlik döneminde yaşadığı anlamsızlık duygusu”, “samimiyet arayışı”, “içerisinde bulunduğu gelişim döneminin etkileri”, “zihinsel tatminsizlik”, “aile içi sorunlar” ve “değişime eşlik eden dinî tecrübeler” şeklinde sıralanabilir. Meydana gelmiş olan dinsel değişim sonucunda Yaşar Alptekin’in kimlik ve dünya görüşü başta olmak üzere giyim tarzından arkadaş çevresine, ilişkilerine yön veren temel belirleyicilerden insanlara bakışına kadar bireysel ve sosyal hayatında köklü değişimler yaşandığı izlenmektedir. Ancak onun, temel kişilik yapısında fark edilebilir bir değişime rastlanmamıştır. Mevcut kişiliği, değişim sonrası kimliği ile bütünleşmiştir. (shrink)

Education is so strongly emphasized in the Chinese culture that academic success is widely regarded as the only indicator of success, while too much physical activity is often discouraged because it drains energy and affects academic concentration. This study investigated the relations among academic achievement, self?esteem, school conduct and physical activity level. The participants were 333 Chinese pre?adolescents (aged 8?12) in Hong Kong. Examination results and conduct grades were obtained from the school records. Global self?esteem was measured with the Physical (...) self?description questionnaire (PSDQ), while physical activity patterns of the children were assessed with the Physical activity questionnaire for children (PAQ?C). Results showed that high academic achievers consistently attained better school conduct marks. However, physical activity level was quite an independent entity that was related neither to academic achievement nor school conduct. Furthermore, regression analyses showed that only academically high?achieving boys and physically active boys had higher self?esteem. (shrink)

The current study assessed the extent to which the use of referential prosody varies with communicative demand. Speaker–listener dyads completed a referential communication task during which speakers attempted to indicate one of two color swatches (one bright, one dark) to listeners. Speakers' bright sentences were reliably higher pitched than dark sentences for ambiguous (e.g., bright red versus dark red) but not unambiguous (e.g., bright red versus dark purple) trials, suggesting that speakers produced meaningful acoustic cues to brightness when the accompanying (...) linguistic content was underspecified (e.g., “Can you get the red one?”). Listening partners reliably chose the correct corresponding swatch for ambiguous trials when lexical information was insufficient to identify the target, suggesting that listeners recruited prosody to resolve lexical ambiguity. Prosody can thus be conceptualized as a type of vocal gesture that can be recruited to resolve referential ambiguity when there is communicative demand to do so. (shrink)