The Connection Between Medical Self-determination and the System of Adult Guardianship——The Institutional Construction of Medical Proxy

China has established the basic rules of informed consent in the medical field through Articles 1219 and 1220 of the tort liability part of the Civil Code of China to address the legality of medical conduct.Since patients’capacity to consent is the prerequisite,when the patient is a fully competent person,it is sufficient to give consent based on valid notification by the doctor.However,for those who are unable to give valid consent,especially adult patients with impaired capacity,resolving the legality of the doctor’s medical conduct remains an issue when it infringes on the patient’s body and health.To solve this issue,someone must give consent in place of the patient when the adult is unable to give valid consent.However,the personal and exclusive nature of the right to medical consent,which is informed consent,makes it impossible to simply delegate it to a guardian or other person to exercise it on behalf of the patient.In this paper,we borrow the concept of“medical proxy”proposed by Japanese scholar Teruaki Tayama,and for the first time,we discuss the construction of medical proxy from the perspective of adult guardianship by connecting the two systems from the standpoint of interpretive theory.

Strengthening Active Aging through Older People’s Association and Economic Activity of the Older People in Nepal

Aging is a natural lifelong process ending in death. Many older people are living in poverty. Older people are generally considered dependent on others as they grow older. The purpose of this article is to explore the entrepreneurship activities of Nepalese older adults. Data for this study were collected from the project Help Age International (HAI) implemented in Nepal. Qualitative data observations and interviews were used to collect data. The findings of this study show the formation of the Older People’s Association (OPA) has supported many older people to participate outside the home in various social activities. Moreover, regular deposits through OPAs offer little help. OPAs support older people in their need of financial support to implement minor entrepreneurship. Older people who received support were pleased and were actively involved in their activities and also regularly deposited money in them. Subsequently, older people’s participation in social activities has increased and also helped to lower elderly abuse, loneliness, and depression. Local governments should promote such activities which will help with healthy aging.

Alcohol and illicit drugs:prevalence of alcohol and illicit drug use and their predictors in young people from Argentina,Bulgaria,Chile and Romania

Background:Alcohol and illicit drugs(AID)continue to be a major global health concern.Although preventable,AID is linked to millions of deaths annually worldwide.The situation is particularly grave for young people,with AID being a major direct risk factor for disability-adjusted youth life-years lost and death.It further contributes to assaults,road crashes,accidental poisoning,and suicide,leading to long-term issues and public health concerns.Objective:This study aimed at disclosing current AID prevalence data for Argentinian,Bulgarian,Chilean and Romanian youth.It shed light on the predictors of AID in young people from those countries.Method:The study used an online survey to gather data from people aged 18 to 25(n=1,297).The survey was underpinned by the theory of planned behaviour(TPB).Predictors were investigated separately for drinking alcohol and using illicit drugs.Results:Our data revealed that across the four target countries,49%to 90%of the participants drank alcohol,and 8%to 35%used illicit drugs in the past three months.Between 20%and 91%of them intended to drink,and between 8%and 31%intended to use illicit drugs in the following three months.Our TPB model predicted statistically significant(P<0.001)amounts of variance in drinking alcohol(between 61%and 72%)and using illicit drugs(between 20.3%and 74.4%).Intention was consistent in significantly predicting both behaviours.Evidence around the predictive validity of self-efficacy,age and gender was mixed across the investigated countries.Conclusion:This research provided an update on the scarce AID epidemiological data.It also supplied evidence about what theoretically-informed measures might be useful targets of interventions in the case of Argentina,Bulgaria,Chile and Romania.This new knowledge of understanding substance abuse determinants and prevalence may help researchers and practitioners better meet young people's health prevention needs.

Practice of Barrier Measures against COVID-19 Among Diabetic People Followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021

Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associated factors among diabetics followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021. Methods: This was a cross-sectional study conducted from June to August 2021, including diabetics aged 18 and over, hospitalized or received for medical visits in the department of medicine at the target hospital. Data were collected during an interview with each participant thanks to a questionnaire. “Good practice” was defined as regular practice of at least two of three barrier measures: hand washing, physical distancing and mask-wearing. Results: A total of 110 diabetics were included with a female predominance (55.5%) and a mean age of 57 ± 11.3 years. Among them, 89.1% washed their hands, 41.8% respected physical distancing and 12.7% wore a mask. The proportion of good practice was 47.3%. Only 5 practiced the three barrier measures. Only age group was associated with good practice. Conclusion: The study showed a low proportion of good practice of barrier measures against COVID-19 among diabetic people surveyed. It is important to continue the action for COVID-19 prevention among diabetic people in the targeted hospital and in other hospitals in Benin.

Assessing Barriers to Mental Healthcare Interventions for Deaf People in Ghana

While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive design, consisting of interviews and focus group discussions, was used to collect data from 97 participants. Findings indicated that participants had limited knowledge on mental health issues. Mental health stigma, inaccessible mental health information and exclusion from mental health programmes were the major barriers hindering access to mental health care services. This study bridges the knowledge gap and provides evidence for the implementation of deaf-friendly services.

Understanding Behavioral Manifestations of Obsessive-Compulsive Disorder in People with Intellectual Disabilities—A Qualitative Study

Background: There is limited knowledge about obsessive-compulsive disorder (OCD) in people with intellectual disabilities (IDs). This paper describes the manifestation of compulsive behaviors associated with OCD at the behavioral level in people with ID in institutionalized settings. The aim was to gain nuanced insight into appropriate understanding and classification in this specific context, and derive implications for research and practice. Methods: Individual cases of people with ID (n = 7) were studied to assess compulsive symptoms through two days of on-site observation of the person with ID within the institution, guided group discussions (n = 28), and semi-structured interviews with key informants and caregivers of the person with ID (n = 20). Caregiver ratings of the compulsive behavior checklist were compiled. Data were analyzed using qualitative content analysis. Results: All forms of OCD were present. Characteristics of compulsive behaviors in people with ID at the behavioral level included less complex and more obvious compulsive acts, immediate responses, signs of tension, motor restlessness, facial expression changes, repetition, need for predictability, time-consuming behaviors, and aggressive reactions when these acts were interrupted. Some of the compulsive behaviors corresponded to the ICD-11 OCD code 6B20, and others to compulsions as a psychological symptom (MB23.4). Conclusions: OCD may manifest atypically at the behavioral level in people with ID, posing significant challenges for accurate classification due to symptom ambiguity. Follow-up differential diagnostic studies are needed to more accurately identify and differentiate OCD symptoms in people with ID. Further, disorder-specific guidelines for recognizing OCD in people with ID are needed for institutionalized settings without psychiatric-psychotherapeutic expertise.

Towards complex scenes: A deep learning-based camouflaged people detection method for snapshot multispectral images

Camouflaged people are extremely expert in actively concealing themselves by effectively utilizing cover and the surrounding environment. Despite advancements in optical detection capabilities through imaging systems, including spectral, polarization, and infrared technologies, there is still a lack of effective real-time method for accurately detecting small-size and high-efficient camouflaged people in complex real-world scenes. Here, this study proposes a snapshot multispectral image-based camouflaged detection model, multispectral YOLO(MS-YOLO), which utilizes the SPD-Conv and Sim AM modules to effectively represent targets and suppress background interference by exploiting the spatial-spectral target information. Besides, the study constructs the first real-shot multispectral camouflaged people dataset(MSCPD), which encompasses diverse scenes, target scales, and attitudes. To minimize information redundancy, MS-YOLO selects an optimal subset of 12 bands with strong feature representation and minimal inter-band correlation as input. Through experiments on the MSCPD, MS-YOLO achieves a mean Average Precision of 94.31% and real-time detection at 65 frames per second, which confirms the effectiveness and efficiency of our method in detecting camouflaged people in various typical desert and forest scenes. Our approach offers valuable support to improve the perception capabilities of unmanned aerial vehicles in detecting enemy forces and rescuing personnel in battlefield.

Associations of PNPLA3 and LEP genetic polymorphisms with metabolic-associated fatty liver disease in Thai people living with human immunodeficiency virus

BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.

Efficient People Detection with Infrared Images

This work focuses on the problem of monitoring the coastline, which in Portugal’s case means monitoring 3007 kilometers, including 1793 maritime borders with the Atlantic Ocean to the south and west. The human burden on the coast becomes a problem, both because erosion makes the cliffs unstable and because pollution increases, making the fragile dune ecosystem difficult to preserve. It is becoming necessary to increase the control of access to beaches, even if it is not a popular measure for internal and external tourism. The methodology described can also be used to monitor maritime borders. The use of images acquired in the infrared range guarantees active surveillance both day and night, the main objective being to mimic the infrared cameras already installed in some critical areas along the coastline. Using a series of infrared photographs taken at low angles with a modified camera and appropriate filter, a recent deep learning algorithm with the right training can simultaneously detect and count whole people at close range and people almost completely submerged in the water, including partially visible targets, achieving a performance with F1 score of 0.945, with 97% of targets correctly identified. This implementation is possible with ordinary laptop computers and could contribute to more frequent and more extensive coverage in beach/border surveillance, using infrared cameras at regular intervals. It can be partially automated to send alerts to the authorities and/or the nearest lifeguards, thus increasing monitoring without relying on human resources.

Narrative Empathy and Patriotism--An Analysis of the Chinese“Main-Melody”Film My People,My Country

Narrative empathy is a relatively new theory and it can guide researchers in the studies of main-melody films so as to promote the communication of the core values of the society.The rhetorical mechanism of narrative empathy can be illustrated from five rhetorical elements,including rhetor,rhetorical goal,rhetorical situation,rhetorical strategy and audience.The theory of narrative empathy can be applied to the case study of the film My People,My Country.In the production of this film,the directors are the rhetors.The rhetors uphold the tenet of closeness,choose the right rhetorical situation as the 70th birthday of the People’s Republic of China,and use appropriate rhetorical strategies in order to realize the rhetorical goals of evoking empathy and inspiring patriotic feelings in the audience’s minds.An exploration and application of narrative empathy can be conducive to the empathic communication of Chinese main-melody films in order to achieve better communication effect.

Hepatitis C virus eradication in people living with human immunodeficiency virus:Where are we now?

Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living with HIV(PLWH)are six times greater affected by HCV,compared to HIV negative ones;the greater prevalence is encountered among people who inject drugs and men who have sex with men:the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection.These patients experience a high rate of chronic hepatitis,which if left untreated progresses to end-stage liver disease and hepato-cellular carcinoma(HCC)HIV infection increases the risk of mother to child vertical transmission of HCV.No vaccination against both infections is still available.There is an interplay between HIV and HCV infections.Treatment of HCV is nowadays based on direct acting antivirals(DAAs),HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono-and coinfected individuals,especially when used at an early stage of fibrosis,reducing liver disease mortality and morbidity.Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication,the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV.HCV eradication can determine dyslipidemia,since HCV promotes changes in serum lipid profiles and may influence lipid metabolism.In addition to these apparent detrimental effects on the lipid profile,the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function.The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.

The Value and Realization Strategy of Teacher Ethics Construction in Colleges and Universities under the Perspective of“Cultivating People by Virtue”

“Cultivating people by virtue”has become the foundation of China’s education,and is the top priority of college education.“Only the learned can become teachers,and only those who behave properly can become role models”.The construction of teachers’ethics in colleges and universities is the premise of realizing the fundamental task of moral education,the need of teachers,the key to realizing the great rejuvenation of the Chinese nation,and it is also the way to correct the bad atmosphere in colleges and universities.In the construction of teachers’ethics,teachers should understand their roles and improve their professional ethics,schools should improve the guarantee system of teachers’ethics construction,meanwhile,improve the status of teachers and create a social environment of respecting teachers and valuing teachers.

Legislation has safeguarded the self-determination of Tibetan people——Interviewing Mr.Leque,the Chairman of the People’s Congress of TAR

My last interview of Mr.Leque was when he was the Chairman of the Government of Tibet Autonomous Region(TAR).As time went by,Mr.Leque became the Chairman of the People's Congress of TAR.Following the custom,I paid my respects by presenting a delicate Karta whereupon,he gracefully gifted me another in return.Talking and laughing between us put me at ease and then led naturally into my questions.

Historical review and reflections on the participation of acupuncture and moxibustion in the treatment of epidemics in the People’s Republic of China (from 1950 until now)

Since the establishment of the People’s Republic of China, both the Communist Party and the government have placed great emphasis on the advancement of traditional Chinese medicine. Acupuncture and moxibustion have been actively involved in combating major epidemics such as malaria, schistosomiasis, and COVID-19. This article conducts a historical review of these three significant cases to elucidate how the acupuncture community has effectively utilized its unique advantages and characteristics through theoretical discussions, clinical practices, experimental research, as well as receiving administrative leadership and political support from the Communist Party of China and government. We provide an objective evaluation of their effectiveness while summarizing historical experiences to serve as a reference for future utilization of acupuncture and moxibustion therapy in epidemic relief efforts. Additionally, propose four suggestions: strengthening Party leadership and enhancing political support;timely summarization of experiences to establish programs and systems;deepening scientific research by integrating experimental findings with clinical practice;focusing on public awareness campaigns and education to solidify grassroots foundations.

从Peoples看罗尔斯对国家是理性行为体的批判

大多数国际关系理论流派都把国家作为理性的行为体,然而罗尔斯在其晚年的著作《万民法》中却拒绝把国家作为国际关系分析的单元,而把人民(Peoples)作为国际关系的行为主体,因为后者既是理性的、又是合理性的。但是从罗尔斯对世界国家的分类以及人民同非人民社会的关系来看,人民和国家之间的差别并不大,这说明如何体现出国家的合理性仍然是一个难题。

如何理解和翻译“the Law of Peoples”?

在罗尔斯的后期思想和作品中 ,thelawofpeoples是一个非常重要的术语。国内日前出版的有关罗尔斯这个时期的著作 ,均将其译为“万民法”。但这种译法缺乏对西方法制史传统的照顾 ,也与罗尔斯本人的整体思想不大一致。本文以此为题展开考察和分析 ,以期能引起学术界和翻译界广泛、深刻的讨论 ,求得比较满意的结果。

论国际法中的indigenous peoples

自20世纪初以来,在涉及到各国家和地区人们共同体的权利关系问题的讨论中,首先在国际性文件里出现了"indigenous peoples"这一概念,并对其内涵与外延进行了界定。同时,伴随着先住民运动在世界各地的风起云涌以及世界各国家和地区政治、经济、文化等的发展,"indigenous peoples"的内涵与外延也处于不断的变化过程中。然而,由于英文的"indigenous peoples"在汉语中并无直接对应词汇,再加上学术传统的差异等各种原因,造成中西方对其内涵与外延的理解上产生歧义,进而影响到所涉及对象的基本权利以及相互关系的构建。因此,从人类学的视角出发,厘清国际法语境中"indigenous peoples"在中西方文化中内涵与外延的异同,有助于多民族国家各人们共同体权利的维护以及和谐关系的建设。

Using self-determination theory to identify organizational interventions to support coal mineworkers’ dust-reducing practices

Advancing the application of safety and health(S&H)technologies is likely to remain a value in the mining industry.However,any information that technologies generate must be translated from the organization to the workforce in a targeted way to result in sustainable change.Using a case study approach with continuous personal dust monitors(CPDMs),this paper argues for an organizational focus on technology integration.Although CPDMs provide mineworkers with near real-time feedback about their respirable coal dust exposure,they do not ensure that workers or the organization will continuously use the information to learn about and reduce exposure sources.This study used self-determination theory(SDT)to help three mines manage and communicate about information learned from the CPDM technology.Specifically,35 mineworkers participated in two mixed-method data collection efforts to discuss why they do or do not use CPDMs to engage in dust-reducing practices.Subsequently,the data was analyzed to better understand how organizations can improve the integration of technology through their management systems.Results indicate that using the CPDM to reduce sources of dust exposure is consistent with mineworkers’self-values to protect their health and not necessarily because of compliance to a manager or mine.

The Psychosomatic Traits of“People with the Five Elements in Traditional Chinese Medicine”:A Qualitative Study

Objective To identify the representative attributes of the five elements of a person with a qualitative methodology and provide the basis for the clinical diagnosis and treatment of“people with the five elements in traditional Chinese medicine(TCM).”Methods Data collected from the literature review,two sessions of brainstorming of experts with related experience in“people with the five elements in TCM”from October 2020 to December 2020,and six rounds of in-depth interviews with 30 participants who had various attributes of the five elements from March 2021 to October 2021 were analyzed.Triangulation was used in this study,and theming and synthesizing were used to analyze the data.Results A total of 31 experts and 30 interviewees participated in this study.The median age of the experts and interviewees were 48.0 and 38.5 years,respectively;51.66%and 54.8%of experts and interviewees,respectively,were men.The descriptors of facial diagrams of“people with the five elements in TCM”were complexion,shape,distribution state of facial bones,convergence trend of facial muscles,and facial expression.A theoretical model of“people with the five elements in TCM”was shaped based on these findings.Conclusion The study suggests a possibility for bridging the gap between personality and bodily state,identifying an avenue for personality research from the perspective of TCM.

Decision-making competency, self-determination, and health lifestyle in nursing students

Introduction: This study identifies and analyzes the levels of relations between decision-making competency, self-determination, and health lifestyle in nursing students. Methods: This study was designed as a descriptive research to identify the relations of nursing students’ decision-making competency, self-determination, and health lifestyle. The subjects were 187 nursing students. Data were collected using a structured questionnaire and were analyzed by the IBM SPSS Statistics 19 program. Results: Decision-making competency of nursing students was 3.38 ± 0.41 points, and self-determination was 3.07 ± 0.38 points. Stress and physical exercise were the general and health-related lifestyle factors that contributed to the differences in decision-making competency. There were no differences in self-determination according to these factors. Conclusion: The results of the study showed that the levels of decision-making competency and self-determination in nursing students were moderate. Further studies are recommended for the development of these core abilities in nursing students.