Discussion Of Thoughts Research Articles

Caring for people with intellectual disabilities: Insights from a cross-sectional study among nursing students

BackgroundCaring for people with intellectual disabilities poses substantial challenges. Nursing students' emotions, thoughts, and behaviors during their education in the context of people with intellectual disabilities, remain relatively unexplored. ObjectivesTo examine nursing students' emotions, thoughts, competence, and expected professional behaviors in care provision for people with intellectual disabilities, as well as to identify factors associated with their expected professional behaviors with this population. DesignA cross-sectional study using a closed self-report questionnaire and one open-ended question. SettingThe largest academic nursing department in Israel. ParticipantsOf 245 sophomore nursing students, 177 agreed to participate (71.4 % response rate). MethodsThe study measured feelings, thoughts, competence, and expected professional behaviors in care provision for people with intellectual disabilities based on the Multidimensional Attitudes Scale. One open-ended question addressed how students believe their competence in caring for people with intellectual disabilities could be improved during their nursing studies. A hierarchical linear regression analysis was performed to investigate the contribution of emotions, thoughts, and competence to explaining expected behaviors in care provision. The significance of the model and the R2 were calculated. The open-ended question was analyzed by the constant comparative method. ResultsNegative emotions and thoughts (β = −0.37, 95 % CI −0.47; −0.15 and β = −0.33, 95 % CI −0.39; −0.13, respectively), along with positive emotions (β = 0.25, 95 % CI 0.07;0.33), showed significant associations with expected professional behaviors. Qualitative analysis revealed three key themes: communication concern, knowledge gap, and curiosity. The findings of the open-ended question corroborate the quantitative findings. ConclusionIt is important to realize that in order to develop quality professional skills for caring for people with intellectual disability, nursing educators must adopt a deep discussion of negative emotions and thoughts with their students regarding people with intellectual disabilities. Ignoring these negative emotions and thoughts can exacerbate the neglect of people with intellectual disabilities' health needs.

Instructional Video of a Standardized Interprofessional Postsimulation Facilitator-guided Debriefing of a Fatality in Plastic Surgery

Background: Postsimulation facilitator-guided debriefing (PSFGD) is the process of intentional discussion of thoughts, actions, and events that took place during simulation amongst the facilitator(s) and trainees. Despite the significance of delivering high-quality debriefings, there is a lack of evidence-based guidelines. Our study aimed to provide an instructional video demonstration of a PSFGD of a fatality. Methods: Fifty surgical interns participated in a burn simulation scenario in two groups. Group 1 (control, or “no exposure,” n = 25) consisted of residents who received oral postsimulation debriefing from an independent faculty member who had no exposure to our instructional video on how to debrief effectively. Group 2 (intervention, or “exposure,” n = 25) consisted of interns who were debriefed by the second faculty member who did watch our instructional video before the simulation and learned about “advocacy and inquiry” techniques. The outcome measures were the Debriefing Assessment for Simulation in Healthcare score and the postdebrief multiple-choice question (MCQ) quiz scores to assess debriefers’ performance and interns’ knowledge consolidation, respectively. Results: The “exposure” group presented statistically significantly higher values for the Debriefing Assessment for Simulation in Healthcare score (P < 0.001) and MCQ score (P < 0.001) compared with the “no exposure” group. Conclusions: Debriefers who followed the methodology as demonstrated in our instructional video were considered more competent, and the residents achieved higher MCQ scores. The quality of the debriefing ensures improved critical thinking and problem-solving skills. Safer practice and better patient outcomes are achieved by developing debriefing programs for educators.

Assessing the Accessibility of Digital Libraries for Individuals with Digital Libraries

The advancement of science and technology, digital libraries have evolved, to give access to up-to-date information for the readers. The digital libraries allow the users to access educational resources at any time and from any location. The flexibility of digital libraries allows the user to gather knowledge and conduct research in their own place. The easy accessibility of the digital libraries enhances the interaction among the users, by facilitating participation and conversation with the help of various interactive tools leading to effective discussion and exchange of thoughts.

Development of a common dyadic coping scale in couples facing breast cancer: the importance of open communication

Objective Couples’ joint coping is important in managing the impact of breast cancer. However, measures assessing couples’ communication as a way of coping are insufficient. This study aimed to generate a self-report valid and reliable measure of couples’ coping with a particular focus on communication. Method We used baseline data of 343 couple dyads who participated in a randomized clinical trial targeting marital communication. Women were diagnosed with early-stage breast cancer in the past eight months; couples were married or in an intimate relationship for at least six months, could read and write English, and lived within 100 miles of the study center. An expert panel selected items with conceptual fit from the Mutuality and Interpersonal Sensitivity Scale (MIS) that was originally designed to evaluate marital communication about breast cancer. Results Exploratory and confirmatory factor analyses supported a 12-item measurement model with four factors: Keeping the communication open with each other about breast cancer (4 items), Sharing a positive outlook on breast cancer (2 items), Avoiding discussion of negative thoughts and feelings about breast cancer (3 items), and Spending sufficient time together talking about breast cancer (3 items). Reliability ranged from 0.76 to 0.87 for women and 0.70 to 0.83 for spouses. Conclusion This new measure has potential application in clinical practice and future research to assess couple’s joint coping efforts especially through communication.

Stories of childhood sexual abuse (CSA) among older adults living with HIV (OALH) in South Carolina: a qualitative study

ABSTRACT Childhood sexual abuse (CSA) devastatingly impacts an individual’s behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, “nobody believed me”, “cannot live like others”, lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors.

Exploring the limits to our understanding of whether fish feel pain.

Exploring the limits to our understanding of whether fish feel pain.

Nudging General Practitioners to explore suicidal thoughts among depressed patients

BackgroundWhile frank discussion of suicidal thoughts in patients with depression is important for the prevention of suicide, suicide exploration of General Practitioners (GPs) is suboptimal. This study aimed to assess whether an intervention that prompts pop-up screens nudges GPs to more frequently explore suicidal thoughts over the course of two years.MethodsFrom January 2017 to December 2018, the intervention was incorporated in the information system of the Dutch general practice sentinel network. New registration of an episode of depression triggered a pop-up screen referring to a questionnaire about GPs’ behaviour with regard to exploring suicidal thoughts. In two years, 625 questionnaires were completed by GPs and analysed using multilevel logistic regression analyses.ResultsCompared to the first year, GPs were 50% more likely to explore suicidal thoughts among patients in the second year (OR 1.48; 95%CI 1.01–2.16). When adjusting for patients’ gender and age we found that the effect of the pop-up screens disappeared (OR 1.33; 95% CI 0.90–1.97). Suicide exploration occurred less frequently in women than in men (OR 0.64; 95% CI 0.43–0.98) and in older compared to younger patients (OR 0.97; 95% CI 0.96–0.98 per year older). In addition, 26% of variation in suicide exploration was because of differences in general practice. There was no evidence that general practices developed differently over time.ConclusionsAlthough low cost and easy to administer, the pop-up system was not effective in nudging GPs to explore suicidality more frequently. We encourage studies to test whether implementing these nudges as part of a multifaceted approach will lead to a stronger effect. Moreover, we recommend researchers to include more variables, such as work experience or previous mental health training, to better understand the effects of the intervention on GPs’ behaviour.

Unverified information and reconstruction of rumor regulation

ABSTRACT Rumor is defined as false information under the framework of Chinese laws, but in practice, law enforcement agencies tend to incorporate unverified information into the regulation of rumor, which broadens the range of enforcement. Unverified information may be subjectively and honestly believed to be true, and it could be false, inaccurate or accurate in an objective manner. In contrast, rumor, circulated with subjective malice, will inevitably lead to objective falsehood. As an important part in the marketplace of ideas, the existence of unverified information can promote the discussion and exchange of thoughts from which facts and truth are derived. Common law and most civil law systems adopt a subjective criterion to judge whether speech can be regarded as legal. This article suggests that China law should adopt the following approach. It should be determined whether the speech is unverified information before further judgment is made. Specifically speaking, speech should be presumed as unverified information rather than rumor if it is not targeted at a specific subject, or it is aimed at a specific subject with public interest involved. Speech deemed as rumor should be curbed, and the rumormongers are punishable, while the dissemination of unverified information shall be restricted if there is objective and obvious inaccuracy but the speaker should not be punished.

"Keep It to Yourself": A Qualitative Study of HIV Disclosure Perspectives Among Older Adults Living With HIV in South Carolina Who Are Childhood Sexual Abuse Survivors.

HIV disclosure is an important consideration for people living with HIV. The prevalence of childhood sexual abuse (CSA) may range from 16% to 22% among older adults living with HIV. There is a dearth of research on HIV disclosure among older CSA survivors. Therefore, the aim of this study was to qualitatively examine HIV disclosure among older CSA survivors living with HIV. Twenty-four CSA survivors living with HIV (aged 50-67 years) participated in in-depth, semistructured interviews. Data were analyzed thematically, and the iterative coding and analytic process included discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes. Four themes emerged: (a) secrecy/not planning to disclose HIV; (b) disclose HIV regardless; (c) disclose HIV depending on the person; and (d) disclose HIV depending on the circumstance. Lack of disclosure may be due to HIV-related stigma. HIV disclosure intervention programs may be beneficial for this population.

A Qualitative Study of the Impact of HIV on Intimacy and Sexuality Among Older Childhood Sexual Abuse Survivors Living with HIV.

Childhood sexual abuse (CSA) is a traumatic event known to influence health outcomes, and the rate of CSA among people living with HIV is more than twice that of the general population. Individuals living with HIV with a history of CSA may find establishing intimacy and sexual relations more challenging due to the dual adverse impact of HIV and CSA. This study aimed to explore the effects of HIV on intimacy and sexuality among older CSA survivors living with HIV. We collected data from 24 older adults living with HIV (OALH) aged 50 and older with a history of CSA in South Carolina via in-depth, semi-structured, one-on-one interviews. We used a thematic analysis approach comprising discussion of initial thoughts and key concepts, identifying and reconciling codes, and naming emergent themes for analysis. Five themes emerged: rejection, avoidance, vulnerability, relationship with a partner living with HIV, and no or low sexual intimacy. Study participants reported that they desired to establish intimate relationships; however, living with HIV impacted their ability to do so, affecting their overall health and quality of life. Our findings suggest that addressing the intimacy and sexuality of older CSA survivors living with HIV is warranted in their continuum of care to improve their health outcomes and overall quality of life.

The Robustness of Balinese Hindu Sacred Art in the Face of Hegel's Theory 'The Death of Art'

The integration of art as an integral part of the sacred rituals of Balinese Hindu worship to this day makes the discussion of Hegel's thoughts on art is interesting. This paper attempts to discuss Hegel's theory as confronted with the sacred Balinese Hindu art. The most basic reason for the death of art is that since romantic, art has lost its subject matter. The process of dematerialisation in art gave rise to Hegel's very famous adage; the death of art. Art loses subject matter because of the limited media to express the complexity of the Absolute Spirit. However, the sacredness of Balinese Hindu art has been deeply guarded by the Balinese people. Various concepts and classifications are made to maintain its sacredness, such as the concept of belief, the concept of sekala-niskala, the concept of tri hita karana,the concept of kala patra village, the concept of karmaphala, and the concept of taksu/jengah. There is also a classification of sacred and profane arts. It is made by Balinese Hindus to maintain the sacredness of art itself. Through the art of wali and bebalih, the Balinese Hindu art maintains its subject matter concerning the complexity of the Absolute Spirit, as suggested by Hegel. Based on library research, the paper argues that the unique concept of Balinese Hindu, which may represent the wealth of indigenous religions in Indonesia, concerning sacred art can maintain its uniqueness in the global discourse arena and be able to respond creatively to contemporary challenges.

“Psychologically and emotionally, it affects me ‘til this day”: exploration of childhood sexual abuse perspectives among older adults living with HIV in South Carolina

ABSTRACT: Objectives The influence of childhood sexual abuse (CSA) may be seen immediately or across the life course. CSA is also associated with increased HIV-risk behavior, and greater likelihood of an HIV/STI diagnosis. The aim of this study was to explore the perspectives of CSA among older adults living with HIV. Methods Twenty-four adults living with HIV aged 50 to 67 years (mean age = 58.5 years), with a history of CSA, receiving care from an HIV clinic in South Carolina, participated in the study. In-depth semi-structured interviews were conducted, audio recorded and analyzed using a thematic analytic approach. The iterative analytic process included a three-step approach: discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes. Results Four themes emerged: Psychological issues due to CSA, relationship challenges due to CSA, self-blame, and reliving childhood trauma (subtheme: lack of influence of CSA today). Some participants reported feeling the influence of CSA several years after the event while others noted that that there was a lack of influence of CSA at present. Conclusions Trauma-informed intervention programs are needed for older adults living with HIV who still experience the influence of their CSA experience. Future research should delve into the design and feasibility of implementing these programs.

Views on HIV Disclosure Among Older Adults Living With HIV Who Are Childhood Sexual Abuse Survivors

Rates of childhood sexual abuse (CSA) among people living with HIV are twice the CSA estimates among the general population. These statistics suggest that CSA prevalence may range from 16-22% among older adults living HIV (OALH). HIV disclosure continues to be a key consideration among people living with HIV. However, studies examining the views on HIV disclosure among OALH who are CSA survivors are lacking. Therefore, the aim of this study was to explore the views on HIV disclosure among OALH who are CSA survivors using a qualitative approach. Twenty-four adults aged 50-67 years, living with HIV and with a CSA history participated in the study. In-depth semi-structured interviews were conducted, audio-recorded and were analyzed using thematic analysis. The iterative analytic process included discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes. Three themes emerged: “You don’t have to tell the person if it’s just casual sex”, “Nothing ought to be hidden especially when you get ready to engage in sex”, and “As for me, I don’t disclose”. Views on HIV disclosure among OALH varied. Some participants stated that disclosure of HIV status should be dependent on the type of sexual relationship, while some OALH stated that participants should disclose regardless of type of relationship. Some participants were hesitant to disclose their HIV status due to anticipated HIV-related stigma. Understanding the perspectives on HIV disclosure among OALH with a CSA history may help to inform disclosure intervention programs for this vulnerable population.

余英時의 〈宋明理學의 發展이란 측면에서 淸代思想史를 論함〉(下) 譯註와 解題

余英時는 현재까지도 중국학술사상 연구에 있어서 가장 영향력 있는 학자 중 한 명이다. 20세기 중국학술사 연구의 거목이라 할 수 있는 錢穆의 제자로서, 그의 학설을 계승 · 발전시켜서 청대학술사상이 宋明理學을 계승한 것임을 논증했다. 이러한 논증에서 그는 외재적인 요인은 일단 제쳐두고, 철저하게 학술사상 내부의 자율적이고 주동적인 발전역량을 탐구하는 데에 주력했다. 余英時는 학술사상의 발전을, 내부적으로 主知主義와 反主知主義의 대립과 경쟁으로 보고, 淸代 考證學의 등장이 송명이학에 내부 갈등에서 주지주의의 대두를 의미한다고 보았다. 본 글은 그의 이러한 주장이 가장 확실하게 闡明되어 있는 글로써, 지어진지 이미 30여년의 시간을 흘렀지만 여전히 학계에서 인정받고 주목받고 있는 글이다. 이에 이 글의 학술적 의의를 설명하고 全文을 번역하면서 譯註를 첨가했다. 이미 발표했던 해제 및 전반부 번역에 이어 나머지 후반부를 번역하고 주장의 득실을 따져보았다.

Tailored Activation of Middle-Aged Men to Promote Discussion of Recent Active Suicide Thoughts: a Randomized Controlled Trial.

Middle-aged men are at high risk of suicide. While about half of those who kill themselves visit a primary care clinician (PCC) shortly before death, in current practice, few spontaneously disclose their thoughts of suicide during the visits, and PCCs seldom inquire about such thoughts. In a randomized controlled trial, we examined the effect of a tailored interactive computer program designed to encourage middle-aged men's discussion of suicide with PCCs. We recruited men 35-74years old reporting recent (within 4weeks) active suicide thoughts from the panels of 42 PCCs (the unit of randomization) in eight offices within a single California health system. In the office before a visit, men viewed the intervention corresponding to their PCC's random group assignment: Men and Providers Preventing Suicide (MAPS) (20 PCCs), providing tailored multimedia promoting discussion of suicide thoughts, or control (22 PCCs), composed of a sleep hygiene video plus brief non-tailored text encouraging discussion of suicide thoughts. Logistic regressions, adjusting for patient nesting within physicians, examined MAPS' effect on patient-reported suicide discussion in the subsequent office visit. Sixteen of the randomized PCCs had no patients enroll in the trial. From the panels of the remaining 26 PCCs (12 MAPS, 14 control), 48 men (MAPS 21, control 27) were enrolled (a mean of 1.8 (range 1-5) per PCC), with a mean age of 55.9years (SD 11.4). Suicide discussion was more likely among MAPS patients (15/21 [65%]) than controls (8/27 [35%]). Logistic regression showed men viewing MAPS were more likely than controls to discuss suicide with their PCC (OR 5.91, 95% CI 1.59-21.94; P = 0.008; nesting-adjusted predicted effect 71% vs. 30%). In addressing barriers to discussing suicide, the tailored MAPS program activated middle-aged men with active suicide thoughts to engage with PCCs around this customarily taboo topic.

Microinsurance: A short history

AbstractTwenty years ago, the International Social Security Review published an article that introduced a new term to the vocabulary of development and social protection: Microinsurance. Now, twenty years later, it is suitable to take stock of the contribution of microinsurance towards promoting coverage and social security. The article reviews the main insights gained from 20 years of implementation, including a clear expression of the value proposition of health microinsurance, understanding the demand for microinsurance, the business process for successful implementation, and conditions that must be satisfied for scaling and sustainable operations. It also explains the context that led to a considerable divergence in the microinsurance space. The article offers a discussion of unresolved issues and thoughts about the future of microinsurance. The conclusion of this article is that microinsurance can flourish when the necessary four pillars for its implementation exist, namely mainstreaming through political support, enhanced insurance literacy of the customers, technical assistance to self‐administer the schemes, and availability of seed capital. The sufficient additional condition is that customers perceive microinsurance as offering welfare gains that cannot be obtained by other means.

Bayesian Model Selection in Fisheries Management and Ecology

AbstractResearchers often test ecological hypotheses relating to a myriad of questions ranging from assemblage structure, population dynamics, demography, abundance, growth rate, and more using mathematical models that explain trends in data. To aid in the evaluation process when faced with competing hypotheses, we employ statistical methods to evaluate the validity of these multiple hypotheses with the goal of deriving the most robust conclusions possible. In fisheries management and ecology, frequentist methodologies have largely dominated this approach. However, in recent years, researchers have increasingly used Bayesian inference methods to estimate model parameters. Our aim with this perspective is to provide the practicing fisheries ecologist with an accessible introduction to Bayesian model selection. Here we discuss Bayesian inference methods for model selection in the context of fisheries management and ecology with empirical examples to guide researchers in the use of these methods. In this perspective we discuss three methods for selecting among competing models. For comparing two models we discuss Bayes factor and for more complex models we discuss Watanabe–Akaike information criterion and leave-one-out cross-validation. We also describe what kinds of information to report when conducting Bayesian inference. We conclude this review with a discussion of final thoughts about these model selection techniques.

余英時의 〈宋明理學의 發展이란 측면에서 본 淸代思想史〉(上) 譯註와 解題

余英時는 현재까지도 中國學術思想 硏究에 있어서 가장 영향력 있는 학자 중 한 명이다. 20세기 中國學術史 硏究의 巨木이라 할 수 있는 錢穆의 제자로서, 그의 학설을 계승 발전시켜서 淸代學術思想이 宋明理學을 계승한 것임을 논증했다. 이러한 논증에서 그는 외재적인 요인은 일단 제쳐두고, 철저하게 學術思想 내부의 자율적이고 主動的인 발전역량을 탐구하는 데에 주력했다. 余英時는 學術思想의 발전을, 내부적으로 主知主義와 反主知主義의 대립과 경쟁으로 보고, 淸代 考證學의 등장이 宋明理學에 내부 갈등에서 主知主義의 대두를 의미한다고 보았다. 본 글은 그의 이러한 주장이 가장 확실하게 闡明되어 있는 글로써, 나온 지 이미 30여년의 시간을 흘렀지만, 여전히 학계에서 인정받고 주목받고 있는 글이다. 이에 이 글의 학술적 의의를 설명하고 全文을 번역하면서 譯註를 첨가했다.

Ureteral ectopia and urethral sphincter mechanism incompetence: an update on diagnosis and management options

The two leading causes of urinary incontinence in dogs are ureteral ectopia in juveniles and urethral sphincter mechanism incompetence in adults. While the accuracy of diagnosis of ectopic ureters has improved due to increased use of CT and/or cystoscopy, the diagnosis of urethral sphincter mechanism incompetence largely remains one of exclusion. New treatment options have been developed for both conditions, which have reduced morbidity and mortality, although the rate of long-term urinary continence has not significantly improved for either and neither has our understanding of the pathophysiology behind these failures. This review provides updates on the management of both of these conditions, with discussion of controversial areas and thoughts for future directions.

The Intermediate World: A Key Concept in Beautiful Thinking

Abstract The term ‘the intermediate world’ is a key concept in Den skønne tænkning (Beautiful Thinking) and the metaphysics of experience presented by this book. The metaphysics of experience is about the experiences of transcendence and beautiful thinking that take place in the intermediate world. In the article “The Intermediate World,” this subject is introduced through a discussion of thoughts and concepts formulated by Paul Klee (Zwischenwelt), Alexander Gottlieb Baumgarten (beautiful thinking), Aristotle (phantasia), Immanuel Kant (expanded thinking), Mark C. Taylor (imagination), and Eugenio Trías (the limit). The text depicts the intermediate world as the level of experience at which the understanding does not yet distinguish between subject and object. The intermediate world is thus not a realm between human and world, nor is it something outside the world we know. The intermediate world is rather the present world in its most original state: the ‘place’ where we find the source of all experience and cognition, a source called ‘basic experience’ characterized by sensation, faith, and comprehension. In this realm, imagination is active and takes the form of an objective force rather than a subjective mental power. Imagination opens mind and world, thus allowing not-yetactualized possibilities to become perceivable.