Confucianism is the central philosophic background for much of the culture in East Asia (EA), particularly for understanding family and social context. The purpose of this article is to examine more fully Confucianism as a conceptual framework for understanding EA family processes and health practices. Confucianism stresses the traditional boundaries of ethical responsibility and the ideal of good human life as a whole. Embedded within Confucian values are five principal relationships, through which each person defines a sense of identity, duty, and responsibility. Current studies of EA families that consider Confucianism as a theoretical base focus almost exclusively on filial piety and collectivism. Focusing only on these two aspects prevents scholars from exploring more complex interpretations of EA family life. A broader inclusion of multiple concepts from Confucianism can provide guidance in exploring the complex and multidimensional aspects of EA family life and allow for broader articulation of family processes.
OBJECTIVES To estimate risk of comorbid depression on all-cause mortality over time among individuals with diabetes METHODS Medline, CINAHL, Cochrane Library, Embase, and Science Direct database were searched through September. 30, 2012. We limited our search to longitudinal or prospective studies reporting all-cause mortality among those having depression and diabetes, compared with those having diabetes alone that used hazard ratios as the main outcome. Two reviewers independently extracted primary data and evaluated quality of studies using predetermined criteria. The pooled random effects adjusted hazard ratios (HRs) were estimated using meta-analysis. The impact of moderator variables on study effect size was examined with meta-regression. RESULTS A total of 42,363 respondents from 10 studies were included in the analysis. Depression was significantly associated with risk of mortality (Pooled HRs: 1.50, 95% CI: 1.35, 1.66). Little evidence for heterogeneity was found across the studies (Cochran Q: 13.52, p-value: 0.20, I2: 26.03). No significant possibility of publication bias was detected (Egger’s regression intercept: 0.98, p-value: 0.23). CONCLUSION Depression significantly increases the risk of mortality among individuals with diabetes. Early detection and treatment of depression may improve health outcomes in this population.
The linear receptive field describes a mapping from sensory stimuli to a one-dimensional variable governing a neuron's spike response. However, traditional receptive field estimators such as the spike-triggered average converge slowly and often require large amounts of data. Bayesian methods seek to overcome this problem by biasing estimates towards solutions that are more likely a priori, typically those with small, smooth, or sparse coefficients. Here we introduce a novel Bayesian receptive field estimator designed to incorporate locality, a powerful form of prior information about receptive field structure. The key to our approach is a hierarchical receptive field model that flexibly adapts to localized structure in both spacetime and spatiotemporal frequency, using an inference method known as empirical Bayes. We refer to our method as automatic locality determination (ALD), and show that it can accurately recover various types of smooth, sparse, and localized receptive fields. We apply ALD to neural data from retinal ganglion cells and V1 simple cells, and find it achieves error rates several times lower than standard estimators. Thus, estimates of comparable accuracy can be achieved with substantially less data. Finally, we introduce a computationally efficient Markov Chain Monte Carlo (MCMC) algorithm for fully Bayesian inference under the ALD prior, yielding accurate Bayesian confidence intervals for small or noisy datasets.
Depression is one of the most common mental health problems encountered in primary care and a leading cause of disability worldwide. In many cases, depression is a chronic or recurring disease, and as such, it is best managed like a chronic illness. Moreover, medically ill patients with depressive disorder are at greater risk for a chronic course of depression or less complete recovery. Antidepressant medications and psychotherapies can help many if not most depressed individuals, but millions of primary care patients do not receive effective treatment. Effective management of depression in the primary care setting requires a systematic, population-based approach which entails systematic case finding and diagnosis, patient engagement and education, use of evidence-based treatments including medications and / or psychotherapy, close follow-up to make sure patients are improving and a commitment to keep adjusting treatments or consult with mental health specialists until depression is significantly improved. Programs in which primary care providers and mental health specialists collaborate effectively using principles of measurement-based stepped care and treatment to target can substantially improve patients’ health and functioning while reducing overall health care costs.
BackgroundFew studies have explored the trends in central precocious puberty (CPP) in Asian populations. This study assessed the prevalence and annual incidence of CPP among Korean children.MethodsUsing data from the Korean Health Insurance Review Agency from 2004 to 2010, we reviewed the records of 21,351 children, including those registered with a diagnosis of CPP for the first time and those diagnosed with CPP who were treated with gonadotropin-releasing hormone analogs.ResultsThe prevalence of CPP was 55.9 per 100,000 girls and 1.7 per 100,000 boys, respectively. The overall incidence of CPP was 15.3 per 100,000 girls, and 0.6 per 100,000 boys. The annual incidence of CPP in girls significantly increased from 3.3 to 50.4 per 100,000 girls; whereas in boys, it gradually increased from 0.3 to 1.2 per 100,000 boys. The annual incidence of CPP in girls consistently increased at all ages year by year, with greater increases at older ages (≥6 years of age), and smaller increases in girls aged < 6 years. In contrast, the annual incidence remained relatively constant in boys aged < 8 years, while a small increase was observed only in boys aged 8 years. The increase of annual incidence showed significant differences depending on age and gender (P <0.0001).ConclusionsThe annual incidence of CPP has substantially increased among Korean girls over the past 7 years. Continued monitoring of CPP trends among Korean children will be informative.
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