Theory Approach Research Articles

Effects of Acupressure on Psychological Symptoms in Chronic Disease Patients: A Scoping Review

Research related to the effects of acupressure on psychological problems in patients with chronic diseases has been conducted by previous researchers. However, so far reviews on this topic are still limited. The purpose of this review is to obtain an overview of the extent of the effects of acupressure on psychological symptoms of chronic disease sufferers based on the results of research that has been conducted. The method used is a scoping review, determining the research questions to be reviewed using the PICO (Population, Intervention, Comparison, Outcome) framework. The keywords used in the article search are "Acupressure" AND "Acupoints" AND "Psychological Symptoms" AND "Chronic disease" OR "Chronic ilness". Several databases used in this study such as Pubmed (n = 14), Science Direct (n = 495), Ebsco (n = 82), Proquest (n = 562), Scopus (n = 973) were then eliminated and screened into 10 articles studied. The review analysis was carried out using the Arksey and O'Malley theory approach. Based on the results of the analysis of 10 articles, it was found that acupressure has a positive effect in helping to reduce symptoms and improve the psychological condition of patients with chronic diseases, including relieving patient symptoms such as depression and anxiety in patients undergoing hemodialysis and breast cancer, reducing pain in osteoarthritis patients, overcoming insomnia which is often accompanied by anxiety disorders, emotional disorders (worry, nervousness, irritability), treating depression, anxiety, and insomnia in acute stroke patients, improving stress index, and sleep efficiency in the elderly with essential hypertension, reducing anxiety in female patients with coronary artery disease (CAD), decreasing the average stress score and improving the quality of life in patients with type 2 diabetes mellitus, increasing the quality of life and reducing emotional disorders in patients with polycystic ovary syndrome (PCOS). The conclusion of the journal review shows that acupressure has the effect of improving psychological conditions by reducing symptoms of anxiety, depression, stress, sleep disorders or insomnia and helping to improve the quality of life in patients with chronic diseases.

Fostering innovation through bio-inspired projects in engineering design education

AbstractThis paper discusses the C-K theory approach and developing templates for student's use in design courses, specifically for the conceptual design phase. Examples of C-K templates are reviewed to demonstrate the process leading to a design solution. Analysis of student's work using these templates are presented and discussed with respect to design learning attributes and design innovation during the conceptual design. Student reflections from their final design reports indicated that students did develop knowledge and skills in bio-inspired design, collaboration, and interdisciplinary mindsets.

Quantum chemistry calculation-aided discovery of potent small-molecule mimics of glutathione peroxidases for the treatment of cisplatin-induced hearing loss

Hearing loss (HL) is a health burden that seriously affects the quality of life of cancer patients receiving platinum-based chemotherapy, and few FDA-approved treatment specifically targets this condition. The main mechanisms that contribute to cisplatin-induced hearing loss are oxidative stress and subsequent cell death, including ferroptosis revealed by us as a new mechanism recently. In this study, we employed the frontier molecular orbital (FMO) theory approach as a convenient prediction method for the glutathione peroxidase (GPx)-like activity of isoselenazolones and discovered new isoselenazolones with great GPx-like activity. Notably, compound 19 exhibited significant protective effects against cisplatin-induced hair cell (HC) damage in vitro and in vivo and effectively reverses cisplatin-induced hearing loss through oral administration. Further investigations revealed that this compound effectively alleviated hair cell oxidative stress, apoptosis and ferroptosis. This research highlights the potential of GPx mimics as a therapeutic strategy against cisplatin-induced hearing loss. The application of quantum chemistry (QC) calculations in the study of GPx mimics sheds light on the development of new, innovative treatments for hearing loss.

Intention to use telemedicine services during a health crisis: A motivation‐opportunity‐ability theory approach

AbstractTelemedicine, despite its longstanding presence, has emerged as a valuable resource amidst health crises. Yet, research on individuals' willingness to embrace telemedicine in such circumstances remains scarce. This article employs the Motivation–Opportunity–Ability theory to construct a novel framework for investigating how motivational, opportunity‐related, and ability‐related factors influence individuals' intention to use telemedicine during a health crisis. A sample of 468 respondents from Indonesia participated in an online survey. The data were analyzed using covariance‐based structural equation modeling and the Hayes PROCESS macro. The findings revealed that contamination avoidance, telemedicine usability, and privacy concerns significantly influence the intention to use telemedicine services. Moreover, the findings also confirmed the moderated moderating effect of e‐health literacy and technology optimism on the relationship between contamination avoidance and intention to use telemedicine services. By deepening our understanding of the factors shaping individuals' intention to use telemedicine services, this study makes valuable academic contributions to the field of telemedicine adoption literature. Additionally, it provides practical insights for telemedicine providers aiming to enhance individuals' intention to use telemedicine services during critical health situations.

Optimal Tracking Control of Heterogeneous MASs Using Event-Driven Adaptive Observer and Reinforcement Learning.

This article considers the output tracking control problem of nonidentical linear multiagent systems (MASs) using a model-free reinforcement learning (RL) algorithm, where partial followers have no prior knowledge of the leader's information. To lower the communication and computing burden among agents, an event-driven adaptive distributed observer is proposed to predict the leader's system matrix and state, which consists of the estimated value of relative states governed by an edge-based predictor. Meanwhile, the integral input-based triggering condition is exploited to decide whether to transmit its private control input to its neighbors. Then, an RL-based state feedback controller for each agent is developed to solve the output tracking control problem, which is further converted into the optimal control problem by introducing a discounted performance function. Inhomogeneous algebraic Riccati equations (AREs) are derived to obtain the optimal solution of AREs. An off-policy RL algorithm is used to learn the solution of inhomogeneous AREs online without requiring any knowledge of the system dynamics. Rigorous analysis shows that under the proposed event-driven adaptive observer mechanism and RL algorithm, all followers are able to synchronize the leader's output asymptotically. Finally, a numerical simulation is demonstrated to verify the proposed approach in theory.

Application of Acquaintance Socialization to Overcome Social Isolation Using Peplau's Theory Approach: A Case Report

Background: Social isolation is one of the treatment problems experienced by many patients with severe mental disorders. Social isolation is an experience of being alone from someone and feeling reluctant towards other people as something negative or a threatening situation.
 Aims: The aim of this research is to provide care for social isolation clients with socialization interventions to find them in the canary room of a mental hospital.
 Methods: The method used is nursing care which is carried out by applying standard implementation actions which consist of 4 sessions, namely explaining the benefits of many friends, practicing how to get to know each other, practicing conversing and getting to know lots of people.
 Result: The patient is in a condition where for the last 2 months he rarely interacts, likes to be alone and stays in his room. During the assessment, the patient became increasingly apathetic.
 Conclusion: Based on the evaluation carried out, the client is able to carry out conversation exercises while carrying out daily activities, the client is able to carry out the schedule that has been made together, the client is able to understand the correct use of medication.

From Discrete Skills to Holistic Creative Human Potential: An Emerging Approach in Theory and Practice

The study aims to empirically demonstrate and conceptually interpret the manifestations of an emerging approach to the issues of human capital, its measurement and development on the international academic, expert, and corporate agenda. We document a gradual shift from a focus on individual skills, their measurement and development, to an approach that considers the complexity of human capital and emphasizes holistic individual activity and the proactive role of the individual in his/her human development and in transforming the corporate environment.The authors show that the formation of this novel approach can be associated with new trends in socio-economic development, including the growing share of non-routine jobs, the transformation of work formats and broader processes of de-structuration, which require a proactive role of the individual in the maintenance and development of social structures, including business organizations. The study has shown that the formation of this new approach occurs gradually and simultaneously at the global level on the academic, expert, and corporate agendas, but with varying degrees of intensity and with different focuses. At the same time, it is the corporate agenda that can be regarded as a frontier. This study is based on a content analysis of academic publications, expert reports of international organizations and think tanks, as well as public reports and documents of the world’s leading innovative companies. The research employs the Big Data intelligence system iFORA.

Elastic fields of double branched and Kalthoff–Winkler cracks in a half-plane

We demonstrate in this paper a combination of the Schwarz–Christoffel mapping and Muskhelishvili’s approach with fractional function series in solving the elastic fields of a cracked half-plane, and zoom in on two typical problems, a double branched crack with two rays emanating from one point on the edge and two edge cracks spaced by a certain distance. Typical loading conditions are considered, including far-field uniform tensile stress and concentrated loads along either the tangential or the normal direction of the free surface. We supply a semi-analytic solution to those boundary-value problems in the cracked half-plane, and validate the theory by comparing the theoretical results in terms of stress fields, stress intensity factors (SIFs) and crack opening displacement (COD) with those from finite-element simulations. The theoretical approach shows how two edge cracks may shield the stress intensity factors of each other in a quantitative manner. For the typical Kalthoff–Winkler cracks of length a and being spaced by a distance d, their SIFs KI decay with decreasing d, and KI=KI0−KI1[1−exp(−a/d)]. It converges to KI0—the SIF of a single edge crack when d approaches to infinity. Those observations and the theory approach itself provide a general way to analyze the mechanical consequence of edge cracks in engineering practice.

Narratives of Symbolic Objects: Exploring Relational Wellbeing of Young Refugees Living in Scotland, Finland, and Norway

Background: In this study, objects are used as a representation of relational wellbeing to help young refugees living in Norway, Scotland, and Finland to talk about important persons who make them feel well. At the time of this research, there is no known study that uses objects to facilitate narratives of how young refugees and members of their social networks generate relational wellbeing. Methods: Using a qualitative approach, young refugees participated in individual interviews about the objects they brought to art workshops to understand their experiences, feelings, and acts of wellbeing. Results: Treating each object as unique to the owner was powerful in revealing how relational wellbeing is experienced and expressed. There were overlaps in experiences and expressions of wellbeing, hence our themes of discussion: overlaps between old and new social ties; between time and space; and between the three constructs of relational wellbeing. Old ties were not forgotten; instead, they evolved to a different form, supporting young refugees from a distance, while new ties contributed to what is needed in their present and at their current age. Experiences of relational wellbeing transcended time and space between their disrupted places of origin, their experiences on the journey, and settling in their new countries. The constructs of relational wellbeing—feeling good, being connected, and having enough—were inseparable in the participants’ experiences. Conclusions: We conclude that these overlaps have implications for a relational wellbeing approach in theory and practice. The results leave a challenge for both researchers and practitioners to develop complex research and intervention methods that can capture these tapestries of young refugees’ experiences of relational wellbeing.

Digitization and Development of Pantok Melody Themes Tongkek Using Leon Stein's Theory Approach

ABSTRACTThis paper presents a study on the composition of traditional music performance in Pancor Village, East Lombok, Indonesia with a focus on the creation of digitalized compositions based on traditional music. The study employs the approach of Leon Stein's theory of composition, which emphasizes the importance of understanding the cultural and historical context of musical works in order to create innovative and meaningful compositions.The study involves field research, where traditional music performances in Pancor Village are recorded, transcribed, and analyzed using Stein's approach to composition. The analysis focuses on identifying the characteristic elements of traditional music, such as melody, rhythm, and instrumentation, and exploring how these elements can be integrated with digital technology to create new compositions.The study also involves experimentation with digital tools, such as software synthesizers, digital audio workstations, and other music production tools, while adhering to Stein's approach to composition. These tools are used to create digitalized compositions based on the traditional music of Pancor Village, with the aim of exploring the creative possibilities of combining traditional music with modern technology, while maintaining the cultural and historical context of the original works.The results of the study show that the integration of traditional music with digital technology while employing Stein's approach to composition, can lead to the creation of innovative and compelling musical works that are relevant to contemporary audiences. The digital compositions created in this study demonstrate how traditional music can be transformed and reimagined in new and exciting ways, while still respecting the cultural and historical context of the original works.This study contributes to the ongoing conversation on the preservation and development of traditional music and demonstrates the potential of integrating traditional music with modern technology using a theoretical framework that emphasizes cultural and historical context. It also highlights the importance of understanding and respecting the cultural and historical significance of traditional music, and the role that technology can play in preserving and evolving these musical traditions.

The Effect of Entrepreneurship Education and Social Media on Student's Entrepreneurial Intention : The Perspective of Theory of Planned Behaviour and Social Media Use Theory

This study aims to investigate the effect of entrepreneurship education and social media use on students' entrepreneurial interest using the Theory of Planned Behaviour and Social Media Use Theory approaches. This study used a survey method with a quantitative research approach, involving 139 student respondents from Semarang City, Indonesia, through an online questionnaire. The data analysis techniques used were Structural Equation Modeling (SEM) and Partial Least Square (PLS). The results of this study indicated a positive and significant relationship between entrepreneurship education, social media, and students' entrepreneurial intention. Thus, based on the principles of the Theory of Planned Behaviour and Social Media Use Theory, entrepreneurship education provided understanding, skills, and support to consider self-employment as a career. In contrast, social media provides access to information, social interaction, motivation, role model influence, and norms that support entrepreneurship, creating an ecosystem that supports students' entrepreneurial intentions.

PERAN NAHDLATUL ULAMA DALAM PENGUATAN NILA-NILAI MODERASI BERAGAMA

<p><em>Nahdlatul Ulama is the largest Islamic organization in Indonesia. The existence of Nahdlatul Ulama always unites itself with the struggle of the nation, placing NU and all its citizens to be active in the nation-building division towards a just and prosperous society that is blessed by Allah SWT. In North Sumatra, NU is one of the largest and most influential organizations for Muslims. NU with its Ahlussunnah Wal Jama'ah understanding, which is known as moderate, stands at the forefront and becomes a bulwark for the integrity of the nation by developing the notion of moderation. However, the fact is that the application of religious moderation is still a discourse for Islamic organizational institutions, especially Islamic institutions in the city of Medan, because until now there has been no real evidence of Islamic institutions implementing religious moderation.</em></p><p><em>The questions in this research are; 1) What is the Existence of Nahdatul Ulama in Medan City?; 2) What is the potential of the Nahdlatul Ulama Institution in Strengthening the Values </em><em></em><em>of Religious Moderation in Medan City?.This research method is qualitative, which the author uses is a religious phenomenological approach while the theory approach is interaction.</em></p><em>The conclusion in this study is that the strengthening of religious moderation values of Nahdlatul Ulama in Medan City always displays two characters (wisdom and flexibility). For Medan City Nahdlatul Ulama, wisdom is an action that is conducive to obtaining benefits/avoiding harm, while flexibility is a compromising attitude and avoiding all forms of extremism. One of NU's national political ijtihad is the obligation to reduce or even avoid all forms of risk or bad consequences (fiqh rules: dar'ul mafasid muqaddamun ala jalbil mashalih). In addition, the potential of NU institutions in strengthening the values of religious moderation in Medan City which includes providing social assistance to all circles of society, helping each other among others is an activity in instilling the values of religious moderation. Implementation of the Values of Religious Moderation is recognizing the rights of others, respecting other people's beliefs, agreeing on differences, understanding each other.</em>

Knowledge-guided machine learning reveals pivotal drivers for gas-to-particle conversion of atmospheric nitrate

Particulate nitrate, a key component of fine particles, forms through the intricate gas-to-particle conversion process. This process is regulated by the gas-to-particle conversion coefficient of nitrate (ε(NO3−)). The mechanism between ε(NO3−) and its drivers is highly complex and nonlinear, and can be characterized by machine learning methods. However, conventional machine learning often yields results that lack clear physical meaning and may even contradict established physical/chemical mechanisms due to the influence of ambient factors. It urgently needs an alternative approach that possesses transparent physical interpretations and provides deeper insights into the impact of ε(NO3−). Here we introduce a supervised machine learning approach—the multilevel nested random forest guided by theory approaches. Our approach robustly identifies NH4+, SO42−, and temperature as pivotal drivers for ε(NO3−). Notably, substantial disparities exist between the outcomes of traditional random forest analysis and the anticipated actual results. Furthermore, our approach underscores the significance of NH4+ during both daytime (30%) and nighttime (40%) periods, while appropriately downplaying the influence of some less relevant drivers in comparison to conventional random forest analysis. This research underscores the transformative potential of integrating domain knowledge with machine learning in atmospheric studies.

MQCT 2024: A program for calculations of inelastic scattering of two molecules (new version announcement)

This is a revised and updated version of the package MQCT. The package includes routines for the calculations of ro-vibrational state-to-state transition cross sections for molecule + molecule collisions, using the mixed quantum/classical theory approach. One important addition to the package is an efficient and accurate adiabatic-trajectory approximation method (AT-MQCT), which enables calculations for larger and more complex molecules. An efficient parallel IO is implemented for state-to-state transition matrix, which now permits to handle very large matrixes, but also helps to truncate these matrixes by neglecting insignificant matrix elements and to balance the load on different CPUs during the matrix calculations and during the trajectory propagation. A stable recursive approach is added for computation of Wigner 3j-symbols, which expands the range of rotational states of molecules up to j∼ 100. Examples of input files are provided for all ten system types covered by the package, along with updated user manual. New version program summaryProgram title: MQCT 2024CPC Library link to program files:https://doi.org/10.17632/sg36r35njz.2Developer's repository link:https://github.com/MarquetteQuantum/MQCTCode Ocean capsule:https://codeocean.com/capsule/1260072/tree/v1Licensing provisions: GNU GPL v3.0Programming language: FORTRANJournal reference of previous version: Comput. Phys. Commun. 252 (2020) 107155Does the new version supersede the previous version?: YesReasons for the new version:1)Recently, we developed and tested the adiabatic-trajectory method [1–3] within MQCT framework, which appears to be both efficient and accurate, and is likely to become a “workhorse” for inelastic scattering calculations in molecule + molecule systems. In the new version of the package this method is made available as an option, AT-MQCT.2)Since MQCT trajectory calculations became more affordable with AT-MQCT, we started doing calculations with larger and larger rotational basis sets and quickly encountered several new problems. The major one was an extremely slow serial IO of the state-to-state transition matrix to a single file, which is now replaced by a parallel IO to multiple files written to a separate directory. Very large matrixes (up to 1010 non-zero matrix elements) are now handled efficiently.3)Another problem was an incorrect calculation of Wigner 3j-symbols for the rotational states around j∼ 40 and above. In the revised version a new stable subroutine is employed that uses a recursive method and works properly at least up to j=100.4)Several “bugs” were caught and fixed, with one major in the Monte-Carlo sampling of MQCT trajectories. Now users can add a batch of new trajectories to the previously sampled batch. In addition, users can monitor the convergence of Monte-Carlo sampling in detail. These options work for all levels of theory, including AT-MQCT. Several errors were found in the equations for calculations of state-to-state transition matrix using the expansion of potential energy surface, and in symmetrization of matrix elements for the case of identical collision partners. All these have been corrected.Summary of revisions: Several technical revisions concern the treatment of diatomic molecules in the code: A bug was found and fixed in the PES interface that converts the units of vibrational coordinate (the diatomic bond distance). Now the PES can be expressed in either Angstrom or Bohr, as specified in the input file. Integration of matrix elements over the vibrational coordinate is modified to use an equidistant grid by default (Gauss-Legendre method is still available as option). And the same for integration over Euler angles α and γ (for all system types). Integration over β uses Gauss-Legendre quadrature only. The format of ro-vibrational wavefunctions pre-computed externally and supplied as input is made more intuitive, as described in the manual. Finally, a new method for the sampling of orbital quantum number ℓ is implemented, which skips some values of ℓ and obtains results by interpolation of the data at the retained values of ℓ (for all system types, as described in the manual). Last version of the code is always available at https://github.com/MarquetteQuantum/MQCT.Supplementary material: Updated and expanded MQCT user guideNature of problem: Calculations of rotationally and vibrationally inelastic scattering of two molecules, with possible applications in astrophysics and atmospheric chemistrySolution method: Mixed quantum/classical theory (MQCT) approach References[1]B. Mandal, A. Semenov and D. Babikov, J. Phys. Chem. A 124 (2020) 9877-9888[2]B. Mandal, C. Joy, A. Semenov and D. Babikov, ACS Earth Space Chem. 6 (2022) 521-529[3]B. Mandal, C. Joy, D. Bostan, A. Eng and D. Babikov, J. Phys. Chem. Lett. 14 (2023) 817–824.

The influence of motivation and habit on acceptance of elementary school students using Google Classroom

<span lang="EN-US">This study aimed to prove the factors that influence elementary school students’ interest in using the Google Classroom platform. This study also used a technology acceptance model (TAM) theory approach by adding external variables, namely motivation and habit, to the study. The survey method was conducted to collect data from 209 elementary school students. We analyzed the data using the structural equation modeling (SEM) PLS 3.0 application. The study’s results showed that one hypothesis was rejected: Motivation had no significant effect on perceived usefulness. In contrast, the other seven hypotheses had a significant positive effect. Research suggested that the habit factor fits the theoretical approach of the TAM model.</span>

Relevancy of the “Health Belief Model” on Behavior in Seeking Treatment among Families of Patients with Mental Disorders in the Work Area of the Public Health Center Taman Sidoarjo East Java

Background: Mental health is a part that is related to health and wellness. One of the indicators in Gerakan Masyarakat (GERMAS) [”society movement”] stated that people with mental disorders should be treated and not abandoned. Nevertheless, nowadays it is still common to find people with mental disorders that do not receive proper medical care. Aims: The aim of this research is to measure cues to action and self-efficacy of the family behavior in seeking treatment for people with mental disorders within the work area of the Public Health Centre Taman Sidoarjo. Method: This research utilized the observational method with the cross-sectional study design and was analyzed with the Health Belief Model (HBM) theory approach. Result: The statistical analysis results using the Pearson Chi-Square test with a significance level of < 0.05 showed a p-value of 0.034 for perceived susceptibility and severity, a p-value of 0.180 for perceived threat, a p-value of 0.009 for perceived benefit, a p-value of 0.696 for perceived barriers, a p-value of 0.555 for self-efficacy, and p-value of 0.099 for cues to action. Based on these results, it can be concluded that perceived susceptibility and severity have a positive relationship with the family behavior in seeking treatment, which means the more perceived susceptibility, and severity increase, the more the family behavior in seeking treatment for people with mental disorders increases. Conclusion: Likewise, perceived benefit has a positive relationship with the family’s behavior in seeking treatment. However, perceived threat, perceived barriers, self-efficacy, and cues to action have no relationship with the family behavior in seeking treatment for people with mental disorders.

Periodic traveling wave solutions of discrete nonlinear Klein‐Gordon lattices

We prove the existence of periodic traveling wave solutions for general discrete nonlinear Klein‐Gordon systems, considering both cases of hard and soft on‐site potentials. In the case of hard on‐site potentials, we implement a fixed‐point theory approach, combining Schauder's fixed‐point theorem and the contraction mapping principle. This approach enables us to identify a ring in the energy space for nontrivial solutions to exist, energy (norm) thresholds for their existence, and upper bounds on their velocity. In the case of soft on‐site potentials, the proof of existence of periodic traveling wave solutions is facilitated by a variational approach based on the mountain pass theorem. Thresholds on the averaged kinetic energy for these solutions to exist are also derived.

Isu-isu Masyarakat terhadap Pembangunan Rumah Ibadah di Desa Laut Dendang Percut Sei Tuan Studi Kasus Gereja di Desa Laut Dendan

Laut Dendang Village, a village located on Jalan Tegal Sari Dusun IX Kenanga, Percut Sei Tuan District, is a village where 80% of the people adhere to Islam and 20% of Christians. Issues are something that is contradictory or that creates polemics about a person or an organization. Issues can appear in the form of opinions, namely statements that can be conveyed through words. Society is a group of individuals who live together, work together to obtain common interests that already have an order of life, norms and customs that are adhered to in their environment. According to the Big Indonesian Dictionary (KBBI), a house of worship is a place used by religious people to worship according to religious teachings or beliefs. Houses of worship are buildings that have certain characteristics that are specifically used for worship for adherents of each religion on a permanent basis, excluding family places of worship. The research method used by researchers is the anthropological approach. While the theory approach is comparative theory. This type of research conducted by researchers is qualitative research. The research findings are that Islam is the majority religion in Laut Dendang Village. Data collection techniques in this study with observation, interviews and documentation. The results of this study show that the people of Laut Dendang Village partially agree that the construction of a house of worship is very significant, because it relates to religious harmony. The people of Laut Dendang Village who do not agree with the construction of a house of worship can lead to conflict because they do not get the support of the local community, who in the majority have a different religion from the owners and users of the house of worship. The conclusion of this research is that the establishment of worship is a place used by religious people to worship according to the teachings of their respective religions or beliefs. Houses of worship for every religion are centers of activity and culture. Therefore, the existence of houses of worship is a necessity for every religious community.

Reducing uncertainty in evidence-based health policy by integrating empirical and theoretical evidence: An EbM+theory approach.

To reduce their decisional uncertainty, health policy decision-makers rely more often on experts or their intuition than on evidence-based knowledge, especially in times of urgency. However, this practice is unacceptable from an evidence-based medicine (EbM) perspective. Therefore, in fast-changing and complex situations, we need an approach that delivers recommendations that serve decision-makers' needs for urgent, soundand uncertainty-reducing decisions based on the principles of EbM. The aim of this paper is to propose an approach that serves this need by enriching EbM with theory. We call this the EbM+theory approach, which integrates empirical and theoretical evidence in a context-sensitive way to reduce intervention and implementation uncertainty. Within this framework, we propose two distinct roadmaps to decrease intervention and implementation uncertainty: one for simple and the other for complex interventions. As part of the roadmap, we present a three-step approach: applying theory (step 1), conducting mechanistic studies (EbM+; step 2)and conducting experiments (EbM; step 3). This paper is a plea for integrating empirical and theoretical knowledge by combining EbM, EbM+ and theoretical knowledge in a common procedural framework that allows flexibility even in dynamic times. A further aim is to stimulate a discussion on using theories in health sciences, health policy, and implementation. The main implications are that scientists and health politicians - the two main target groups of this paper-should receive more training in theoretical thinking; moreover, regulatory agencies like NICE may think about the usefulness of integrating elements of the EbM+theory approach into their considerations.

Iris Murdoch’s Conception of Moral Development in Her Novel The Good Apprentice

The author juxtaposes two views of morality and the views of man they imply: one represented by behaviourist and existentialist approaches in theories of morality and the other proposed by Iris Murdoch, who stresses the ability to see and recognise morally significant characteristics. In Murdoch’s opinion, a person’s moral development consists in a change in the quality of consciousness as a result of the activity of attention in exploring moral reality. After contrasting these two views, the author confronts Murdoch’s approach with the conception of moral development understood along these lines as exemplified in a character of her novel The Good Apprentice. She also puts the problem of attention into the context of Murdoch’s conception of the transcendence of persons.