Journal articles on the topic '發行效果'

本文以個案研究法探討一個學區內的國中小校長如何透過策略聯盟，以轉化108課綱於學校（特別著重於發展校訂課程）的學習領導。以一個垂直式策略聯盟學校中的一位國中校長、三位國小校長及一位退休輔導校長為訪談參與者，於2020年3月至5月間及2020年12月至2021年1月間進行訪談，每位參與者每次的訪談時間約為30分鐘至1小時，訪談主題包括策略聯盟發展校訂課程的歷程、行政與教學團隊在策略聯盟過程中的學習、校訂課程發展成效，以及校長在策略聯盟轉化課綱過程中的學習。以質性資料的主題分析法進行資料分析，結果發現：一、策略聯盟學校校長的自主行動，激發了行政與教學團隊的主動性與能量；二、策略聯盟學校校長、行政團隊與教學團隊間的互動，產生了多層次的學習；三、策略聯盟的運作提升了各校校訂課程的品質，進而擴大聯盟資源，有助於108課綱在學校教育現場的轉化。最後，本文提供建議作為教育行政機關與未來研究參考。

這項研究，主要是探討病患者在參加“類風濕性關節炎患者自我管理課程”後，在自我療理行為、心理狀態及健康狀況等方面的成效及持續效果。研究採用單組活動前後的比較與設計，共有70名病患者參與是次研究。結果顯示，類風濕患者在療理病徵的信心、建立自我療理炎病的行為、心理狀態以及健康狀況方面，當課程結束時和結束後的1個月，均有顯著進步，並且於結束後6個月，開始達致穩定狀態。參加者在課程結束時和結束後的6個月，亦顯著地減少了使用醫療服務。研究結果更發現早期類風濕患者在課程裏能得到較大益處和進步。由於這許多方面的成果和持續效果，“病人自我療理教育”應加以大力推廣，以彌補傳統醫療的不足，並配合現有醫療制度，發揮更大的治療效果。 This study examines whether the Rheumatoid Arthritis Self-Management Course is effective in, as well as being able to achieve stabilizing effect on, enhancing participants' perception of control over the symptoms, improving health behaviours and health status, and reducing use of health care resources. This is a single group pre-and-post design with a sample of 70 participants. After the intervention and at 1 month follow up, participants show significant improvements in arthritis self-efficacy, self-management behaviour (exercise, cognitive symptoms management and communication with doctors), psychological well-being (sense of helplessness, mood and anxiety) and health status (pain and fatigue). These improvements become stabilized at 6 months follow-up after completion of the program. In addition, the program is found effective in reducing visits to general physician on problems related to arthritis. The results in this study clearly indicate that this community based patient education program can offer substantial benefits for the participants, particularly in terms of perceived self-efficacy on managing various aspects of arthritis, the establishment of positive health behaviour and its stabilizing effects. Therefore the complementary role of patient self-management education to traditional disease-oriented medical services can offer a valuable adjunct to medical care and we strongly advocate for its full implementation.

本文釐清監理科技的發展背景，除了外在環境變遷的因素外，並透過「監理資源論」以及「監理技術的關鍵作用論」的視角，分析催化監理科技發展的內在動力。本文認為，監理科技是金融生態演化的產物，也是監理機關為了強化監理而自然形成的發展取徑。本文主張「監理資源的精準投放」以及「監理技術多樣性的實現」乃是發展監理科技的主要目標，而在此目標追求過程中，監理機關會在「監理資源」、「監理文化」、「監理責任」及「監理效果」等四大構面遭遇挑戰。本文並以臺灣純網路銀行之數位監理申報機制為例，分析上述挑戰及可能的因應方案。<br />

LANGUAGE NOTE | Document text in English; abstract also in Chinese. The purpose of this study was to investigate the effects of 10 weeks Passive Repetitive Isokinetic Training (PRI) training on hormone concentrations and physical performance. Nineteen untrained men were randomized to intervention with either PRI training (n=10) or traditional resistance training (n=9). PRI group performed five sets with ten repetitions with corresponding 70-75% repetition maximum (RM) loads on the PRI platform and 2-min rest periods, whereas TR group performed the same protocol with squat exercise. Strength and power performance testing were measured before and after 10-week training. Resting hormones were measured at pre-training (week-0), week-6, and post training (week-10). The results of our study were that after 10 weeks of PRI training, vertical jump, running vertical jump, 30-m sprint time and maximal strength by squat-test were significantly higher with respect to pre-training (p<0.05). In TR group, maximal strength by squatting test was significantly increased compared with pre-training (p<0.05), while no significantly changes were observed for the other power tests. There were no significantly changes in GH, IGF-1, testosterone, cortisol, and T/C ratio during the 10-week training period in both groups. The data indicated that PRI and traditional resistances training have similar hormonal states. The PRI training significantly increased power and strength performance. 被動反覆衝擊式訓練(Passive Repetitive Isokinetic Training；PRI)主要是依據伸展縮短循環(Stretch-Shortening-Cycle)特性所發展出的一種訓練肌力和爆發力的器材，然而PRI訓練對訓練效果及人體體內荷爾蒙的影響，尚無相關的實驗數值來證實。因此，本研究目的在探討PRI訓練前後安靜期血液中荷爾蒙之變化及肌力與爆發力等運動表現的影響。研究中共有19名受試者，隨機分為PRI訓練組(n=10)及傳統蹲舉訓練組(TR；n=9)，進行每週三次共10週之訓練，並於訓練前、訓練第6週及訓練後分別進行安靜時的血液採集，分析安靜時血液中生長激素(Growth hormone；GH)、類胰島素生長因子(Insulin-likc growth factor)、睪固酮(Testosterone)及皮質醇(Cortisol)的濃度我於訓練前後進行肌力及爆發力測試，結果發現：PRI組其肌力及爆發力表現在訓練後顯著的提升，而TR組僅增加最大肌力，兩組間以變化百分比進行比較：PRI在肌力及爆發力的變化百分比皆顯著高於TR組。血液荷爾蒙的結果：第6週和第10週時之安靜生長激素、類胰島素生長因子、睪固酮及皮質醇的濃度，組內訓練前後相比並無顯著性的改變；PRI組與TR組兩組間安靜期的荷爾蒙濃度反應亦無差異。由本研究得知：為期10週之PRI訓練能有效的提升肌力以及爆發力之運動表現，然而安靜期的荷爾蒙於訓練前、中、後並無顯著的變化。

提 要 本文旨在探究漢語母語者閱讀由不同因果關聯以及語意關聯所組成之連貫句對時, 連貫關係作用於句對處理之影響。整個實驗透過E-Prime軟體進行, 調查母語者閱讀不同句對時, 其反應在連貫性評估、目標句閱讀時間以及目標句回憶表現的情況與差異。研究結果發現, 首先, 當因果關聯的連貫關係高, 受試者認為該句對較有連貫性, 語意關聯亦是如此。第二, 因果關聯高的句對, 其目標句閱讀時間較短;語意關聯的效果僅在高因果時, 使高語意的目標句閱讀時間較低語意來得快。第三, 受試者閱讀因果關聯和語意關聯皆高的句對時, 其目標句回憶表現較佳。

本文從自我決定理論 (Self Determination Theory) 的觀點出發，探討香港中學生的抱負取向（包括外在期望及內在期望）與職業生涯探索的關係。是次研究以問卷形式進行，從10間中學總共2,122名中一至中六的學生得到有效數據。結果顯示在控制了人口因素、成績及社會支持後，學生的抱負取向與職業生涯探索有顯著的關係。對比以上各項因素，發現學生的內在期望對職業生涯探索起較大的預測作用。最後，本文會探討結果在實踐及研究的應用。 Based on Self Determination Theory, this paper explores the relationship between different aspirations (intrinsic aspirations and extrinsic aspirations) and career exploration among Hong Kong secondary school students. The sample consisted of 2,122 secondary school students from 10 secondary schools. The results found that both intrinsic and extrinsic aspirations are significant predictors of career exploration after controlling for demographic, academic results and perceived social support variables. Among the predictors examined, intrinsic aspirations explained more variance of career exploration than others. Implications of the results for theory and practice were discussed.

As the home computer and the Internet are becoming more and more popular, social service agencies in Hong Kong are beginning to show interests in making use of the new technology to extend social welfare services to the community. This paper presents the results of an empirical study to evaluate the Cyber-Parenting Project as a pioneer attempt in providing parenting education through the Internet and gives recommendations for future attempts of similar nature. The discussion covers the conceptualisation, design, implementation and utility of the Cyber-Parenting Project, and the recommendations include issues on system design, provision, testing, and monitoring of web-based social service programs. 由於家用電腦及萬維網的應用日益普及，本港的社會服務機構亦開始思考如何應用這新科技去進一步延展社會福利服務到社區；而“Cyber親職教育網”便是利用萬維網去提供親職教育的一項創新計劃。本文就對該計劃進行的實證研究結果去評估該計劃在構思、設計、執行、及效用各方面的得失，並因應評估結果作出關乎系統設計、提供、測試、及監控等多方面的建議，供有興趣發展網上服務的福利機構及人仕參考。

LANGUAGE NOTE | Document text in English; abstract also in Chinese. Obesity is an important worldwide public health problem and sedentary lifestyle has been associated with increasing rates of overweight and obesity. This presentation aims to study the relationship between psychosocial health, obesity and the lifestyle among the intellectual disability. A total of 16 adults over the age of 18 with mild to moderate intellectual disability (ID) (6 males, 6 females), (N=16, mean age 34.4.23 ± 51 years, SD= 8.67), were recruited from St. James settlements. Pedometer step counts were recorded on 4 consecutive (week) days, BMI and waist circumstance were recorded. Questionnaires regarding adult's outcome expectation, perceived barriers to exercise and performance self efficacy on physical activity were examined. Result showed that adult with intellectual disability mean on total daily step counts was 7458.44 steps, (SD=5048.19), the mean BMI is 26.43, and both performance self efficacy and barrier to exercise among them were not high. The study concluded that both physiological and psychosocial health among adult with intellectual disability were low and more physical activity is needed. 殘疾人士痴肥情況比一般普通成人嚴重，而且平均壽命較短，對健康的需求比較高。可是研究對於在職智障成年人的調查比較少，對於可行而且有效的運動計劃亦缺乏資料。為了提高在職智障成年人士的生心健康，一項了解智障成年人士的運動量以及他們對運動的態度的研究是需要的。是次調查對象為成年智能障礙人士，級別為輕，中度智障(本研究不包括重，極重度智能障礙者)，所有參與者人士都是來自於聖雅各福群會，共有16位自願參與者而他們都是18歲以上成人，參與者平均年齡為34.4 (23 ± 51歲，SD 8.67)。我們派發一個數步器(型狀跟傳呼機相似)給參與者，數步器需佩戴在右邊腰身上連續4日，在第五天早上研究人員為參與者除去數步器，並記錄總步行數量。同時我們亦派發一份有關活動量及對活動態度的問卷，內容包括:對運動預期結果，面對運動阻礙，對運動表現自我效能。調查所得出之結果顯示參與者平均每日步數為7458步(SD=5048.19)。脂肪比例為26.4，面對運動阻礙(Mean=1.8, SD=.39)和對運動表現自我效能(Mean=.8, SD=.64)顯示為不太高。結論是成年智障人士需要在工作地方有一個運動課程從而提高他們生理和心理的健康發展、成長。

社區精神復康服務在西方國家發展悠久，不同的相關文獻與實証爲本研究 ( evidence-based research) 顯示，該服務形式對生活於社區的精神病康復者有顯著成效。自2005年開始，在政府和非政府機構推動下，社區精神健康照顧服務在香港不同的地方推行。然而，有關本港社區精神健康照顧服務的研究卻相當貧乏。是次研究運用單組前測後測設計 (one group pre-test and post-test design) 方式，評估一個在本港推行的社區精神健康照顧服務，對離院後重返社區生活的服務使用者的成效。是次研究邀請了120名精神病康復者參與研究，共有87名研究對象完成所有測試。當中測試範疇包括精神病徵狀、生活質素、自我效能、社區生活技巧。研究發現在開始接受服務後的6至12個月，社區精神健康照顧服務減少精神病徵狀 ( p <.001)、提高生活質素 ( p <.05)、增強自我效能 ( p <.001)和提升社區生活技巧 ( p <.001) 能夠爲康復者帶來非常正面的效果。 Community mental health care services have been developing in Western countries for decades and have been proved to be effective in facilitating the rehabilitation of people with mental illness into the community in many evidence-based research studies. In Hong Kong, with the support of the government and non-government organisations, community mental health care services have been set up in different districts since 2005. However, research on the services is limited. By using the one-group pre-test and post-test design method, this study examines the effects of one Community Mental Health Care Services on the rehabilitation of people with mental illness discharged from hospitals. A total number of 120 service users participated in the study and 87 subjects completed all the assessments in different areas, including psychiatric symptoms, quality of life, self-efficacy and community living skills, before the commencement of intervention, 6 months after the intervention and at 12 months immediately after the intervention. Results showed that the subjects had lessened psychiatric symptoms ( p <.001), better quality of life ( p <.05), enhanced self-efficacy ( p <.001) and increased community living skills ( p <.001), after the services. The study revealed significant positive effects of the community mental heath care services on people with mental illness in the community.

摘要 學生學習動機的研究是當前華語第二語言教學的重要課題。華裔學生的繼承語言學習動機更是華語學習成效的重要關鍵。本研究通過問卷調查了印尼華裔中學生繼承語學習動機的類型，並檢視了不同背景變項對印尼華裔中學生繼承語學習動機類型的影響。研究者親自赴印尼中爪哇省進行華語教學與研究，以前導訪談和繼承語學習動機文獻為基礎，經專家進行題項審閱後，編製了印華雙語版本的「繼承語學習動機量表」。研究以分層叢集比例取樣的方式，向兩所初中和一所高中每級各兩班發出共 310 份問卷，共收回有效問卷174份。透過因素分析歸納出6種動機類型：學習情境、族裔傳承、學習期望、學習情感、綜合型、工具型。總量表Cronbach α = .85，六個分量表的α = .695~.884，顯示此量表的信度品質頗佳。研究分析顯示華裔印尼中學生的繼承語學習動機因性別、學校階段別、族裔語言背景和家族語言背景而有顯著差異。最後，文章結合研究結果提出教學應用與未來研究的具體建議，以期供繼承語教師作參考。

有鑑於108學年度施行的十二年國教強調自主行動、溝通互動，以及社會參與，要 求具備理解本土事務以及關心本土文化的教育理念，本研究擬探討融入知識翻新活動於 國小大船文化課程，對原住民學生的學習歷程與成就之影響。研究問題聚焦在了解學生 如何集體建構文化知識的學習歷程與成果。本研究採個案研究，研究對象為蘭嶼鄉朗島 國小七位達悟族六年級學生，教學設計包含想法中心的知識翻新活動及線上學習平台的 輔助。本研究採用質性研究的描述方式，分析平台上學生集體建構的文化知識與課程中 學生個別手繪大船文化心智圖的資料是否具有一致性。研究發現，知識翻新活動能有效 形成社群的學習共同體、幫助學生集體共構社群知識，以及提升個人大船文化知識與理 解。本研究並對教學創新和文化知識學習提出建言。

提要本文旨在探討若呈現隱喻映射原則，顯示展現詞彙之相關理據，藉此提升二語學習者之隱喻意識於詞彙學習，此輔助方式對於其戰爭類商業詞語學習及記憶留存之效應為何？我們以「商場如戰場」（BUSINESS IS WAR）映射原則為主題，選取十個常見高頻戰爭類相關之商業隱喻詞語為內容，調查了 31 名日籍中級以上之華語學習者。實驗組接受隱喻映射圖指導，透過連結「來源域（戰爭）」與「目標域（商業）」之對應關係，學習相關隱喻詞彙，控制組則以一般詞解和例句學習詞語，其後進行即時後測、及一週後之延時後測。結果發現：(1) 實驗組即時後測之整體詞彙學習成效明顯優於控制組（M=8.34 vs. 7.57, t(29)=2.07, p=0.024），此情況同樣見於延時後測（M=8.53 vs. 7.50, t(29)=2.24, p=0.017）； (2) 即時後測中，實驗組文意理解表現顯著較佳（M=7.19 vs. 6.40, t(29)=1.87, p=0.036）；(3)實驗組於即時後測的隱喻動詞整體表現較好，兩組達顯著差異（M=5.00 vs. 4.30, t(29)=2.76, p=0.01），而未曾教授之隱喻名詞表現則相約。

LANGUAGE NOTE | Document text in Chinese; abstract also in English.隨著現代醫療科技的發展與人類對生存質素的要求漸高，器官捐獻已成為廣受議論的倫理難題，也是現代佛教人文關懷必須面對的議題。佛教教理與生命觀自成體系，當能回應現代人因這項抉擇所帶來的煩惱，如指引他們採取何種態度、或真正面臨死生交界之時，應如何在小我利益與大我利益之間抉擇，以發起悲願心，實踐菩薩行中最難以割捨的大體佈施等。本文從中國佛教倫理的觀點立場，反省人類器官捐獻的困惑與迷茫，說明供體的一方如果自願效法菩薩大行、捨身肉頭目髓腦以利濟眾生，其“身佈施、無畏施”的慈悲心行是可貴的。我們可從佛陀釋迦牟尼本生故事中找到菩薩割肉喂鷹、捨身飼虎的豐富例證，以及由佛教“緣起緣生”之基本教義所導出的“護生”精神。With the rapid development of medicinal technology, organ transplantation and donation have become an important issue in contemporary bioethics. On the one hand, organ transplantation is an effective means to saving lifes which has benefited from the incredible progress of medical science in the past few decades. On the other hand, organ donation involves profound ethical dimensions and ambiguities. This paper attempts to examine the issue of organ donation from a Buddhist viewpoint. Through textual exegeses and the explication of some key Buddhist ideas, such as the Bodhisattva’s great compassion and doctrine of inter-dependent origination, it seems that organ donation is accepted by Buddhism. Nevertheless, whether to donate or not is entirely a personal choice, and a dead body should be handled with special care. The conclusion states that organ donation is an act of giving/charity (dāna) to those who need relief from their suffering and thus is seen as a great virtue through which we can create a world of co-existence.DOWNLOAD HISTORY | This article has been downloaded 456 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese知情同意是現代生命倫理學最重要的概念之一，也是現代生命倫理學所以充滿活力和備受世人囑目的重要原因。知情同意這一概念雖然已經歷100 多年的歷史，但在《紐倫堡法典》誕生以前，知情同意往往只是作為醫生爭取病人的配合和支持，以提高治療效果，或者為防範醫療糾紛而採取的一種手段。只是在《紐倫堡法典》問世後，特別是伴隨著聯合國的《世界人權宣言》發表後50 多年的人權運動蓬勃發展，知情同意獲得了新的意義，它首先被理解為對人的生命權和健康權的尊重，對人的權利的尊重。的確，人的生命和健康首先是屬於自己的，因而對生命和健康的任何干預，當然理應得到本人的同意，儘管這種干預有益於生命和健康的維護。特別是在當代醫學對人體生命和健康干預的力度越來越大，後果越來越嚴重，影響越來越深遠的情況下，人們怎能不關心醫學可以給本人帶來的後果呢？怎能不把對本人生命和健康的處置權利掌握在自己的手中呢？正因為如此，知情同意在全世界不同地域、不間民族和不同文化背景的國家，都得到了廣泛的認同，並體現在許多國家醫事和科學研究的法律檔中，體現在廣大醫務人員的行動中。但是，人們對知情同意的理解和認識，由於各自的文化背景和國家體制的差異，卻存在眾多的不同；同時，由於各自國家的醫療習慣和傳統的不同，在實踐知情同意原則時也遇到了各種各樣的問題。為了推動對這一問題的研究，本刊這一期就此發表了一組文章，從不同角度就知情同意原則做了分析，我們希望引起對知情同意的進一步討論和研究。DOWNLOAD HISTORY | This article has been downloaded 11 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.隨著分子和基因組信息對流行病學影的響增加，無數遺傳流行病學研究和後人類基因組計劃的研究都愈來愈依賴人類生物信息庫(biobank)。生物信息庫的建立，不但使慢性病研究獲得了很多突破性的進展，還強而有力的支持了藥物的創新研究和治療方式的改進。再者，隨著後基因組時代的來臨，誕生了以基礎研究所獲得的知識成果，快速轉化為臨床上治療這一新方法，並通過實施這新方法反過來驗證基礎研究中的發現或建立的新理論（轉化醫學）。生物信息庫的建立能促進轉化醫學研究及提高科研效率。所以，生物信息庫成為近年來各國生物醫學領域爭相發展的重點。然而，在基因組研究和後人類基因組計劃的背景下，伴隨它們十幾年發展的是無數待解決的倫理挑戰，其中是否向參與者告知研究結果就是國際倫理學界研究和關注的焦點之一。本文通過對正反觀點的論證，對比總結得出一些粗淺的建議，以期為相關政策的制定者提供一些參考。The establishment of human biobanks has begun to play an important function in promoting healthcare in many countries. Biobanks can disclose genetic data and can be used to identify health- and disease-relevant environmental, individual, and clinical factors. Indeed, studies of genetic epidemiology and human genomics increasingly rely on the use of human biobanks, which have played a positive role in breakthroughs in chronic disease research. They have also strongly supported creative research on drugs and the improvement of therapeutic methods.Currently, biobanks are an important target for development within the area of biomedicine. However, at least in the context of genome research, enormous ethical problems and challenges have arisen. Among those problems and challenges is the important issue of information disclosure: should individual donors be informed only of the average research results from all relevant donors, or should they be informed of their own specific genetic information arising from biobank research? The dominant bioethical view seems to imply the latter – that individual donor information should be made available to the individual donor – according to the fashionable bioethical principle of respect for the individual’s autonomy. However, this essay asserts that such disclosure has both positive and negative effects that should be carefully considered and balanced. It argues that individual donors should not have an absolute right to be informed of biobank findings. Rather, public policy regarding the disclosure of biobank findings to individual donors should be formulated based on the comprehensive consideration of relevant factors: the nature and severity of a genetic risk, the validity of the research findings, the clinical utility of the findings, the feasibility of using the findings, and the integrity of the research.DOWNLOAD HISTORY | This article has been downloaded 29 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in English; abstract also in Chinese.The review focuses on the aerobic energy contribution during high intensity cycling exercise. It is erroneous to assume that the energy demands of an exercise task can be met exclusively by either aerobic or anaerobic sources. During peak oxygen uptake determination, especially during the latter portions of the incremental exercise test, the anaerobic energy stores are also taxed. Not surprising, during maximal exercise of a short duration, there is also energy supplementation from aerobic energy sources. However, for a test to be considered predominantly anaerobic, the aerobic contribution to the test must be kept minimal. The quantification of aerobic contribution to a maximal exercise performance is difficult because the mechanical efficiency (ME) during a non-steady state exercise task remains speculative. Nevertheless extreme ME values for cycling have been proposed to provide a general scope of the estimated values. In adults, assumptions about oxygen uptake lag time, the size and role of the stored oxygen stores, which are taken into account also affect the magnitude to the aerobic contribution. Equivalent data on young people are insecure and greater research attention in this area is advised.本文著重介紹了大強度自行車運動中的有氧供能。如果認為運動中機體所需能量僅以某一能源系統，有氧系統或無氧系統供能是不正確的。在逐級遞增負荷測定最大攝氧量的運動中，尤其在測試的後階段，無氧系統參與供能。而在短時間的最大強度運動中，有氧供能也佔有一定的比例。即使進行無氧運動，在測試中仍能發現有低比例有氧供能。很難確定有氧系統在最大強度運動中的供能量為多少，因為不穩定狀態下的運動其供能效率仍不十分明確。但對於踏車運動中最高供能效率有一估計值範圍。對於成年人，攝氧量的延遲時間以及氧的儲存量的多少將影響最大有氧供能的比例。而在青少年中：有關這方面的資料較為缺乏，有待進一步的研究。

LANGUAGE NOTE | Document text in Chinese; abstract also in English.當治療有一定效果，卻終止了治療，這種行為對疾病、對病人能夠產生實質性作用，這時才會顯示“放棄治療”的存在意義。如果治療本身存在與否對疾病、對病人並無影響，那麼這種“放棄治療”就是毫無意義的。在臨終關懷中放棄治療的問題是個複雜的問題。當病人處於不可逆轉的臨終狀態時，一般概念下的“治療”對其已毫無意義。所以作者認為，在臨終關懷中不是什麼“放棄治療”的問題，而是應該放棄“治療”這個概念，用“關懷”（care）取代“治療”、“治癒”（cure）的問題。在臨將關懷這門學科中，充分意識到對臨終病人進行治療的無意義性，可以使我們不必徒勞無益地為臨終病人進行所謂“治療”，不必為強調治療而侵犯臨終病人的尊嚴與人格；可以使我們從生命質量論和公益論的角度認識摒棄“治療”的意義，從而有利於臨終關懷學、醫學倫理學和生命倫理學的發展。Medical treatment is rarely useless in an absolute sense. It is often beneficial and harmful to an extent. This is why withdrawing treatment is a difficult issue. If treatment is entirely futile, then there would not be a painful debate regarding weather treatment should be stopped. This paper explores the complicated issues of withdrawing treatment in the care of terminally ill patients.This paper argues for a shift of concept regarding terminally ill patients. For terminally ill patients, 'cure' or 'medical treatment' in its general medical sense is actually no longer possible in medical practice. Therefore, the real issue involved here is not whether we should give up treatment. It is rather whether we should give up the concept of cure. This paper contends that, for terminally ill patients, since the concept of cure traditionally used is not meaningful to the patients, it should be replaced by the concept of care. In caring the terminally ill patients, the quality of life and the interest of public should be taken into account. We should not violate the patient's dignity or hurt the patient's character by offering aggressove.DOWNLOAD HISTORY | This article has been downloaded 26 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本故事提出了如下一些知情同意方面的問題：面對沒有文化、且毫無醫學知識的病人，如何履行知情同意？在病情緊急情況下應否免除知情同意或待病情穩定後再向病人或家屬補充說明？如果是後者，這種事後的同意有何意義？在醫院追逐利潤並與病人利益發生衝突的情況下，費用成為病人關注的重要問題，病人如何有效的表示自己的意見？在病人本人沒有經濟能力、又無醫療保險的條件下，一切依賴家屬，病人如何維護自己的權益？病人本人的意願有何意義？如何面對既不能否定家屬的同意又有可能出現家屬違背病人本人意願行事可能的困境？The story reported in this article raises some questions on informed consent. To patients with no education and no medical knowledge, how do medical professionals perform informed consent? In the situation of emergence, should medical professionals be excused from the obligation of informed consent? Or should the patient and his or her family be informed after the illness is cured? If this is so, what is the meaning of informed consent? With the conflict between the interests and the patient and the hospital, the cost is a very importance issue. How does the patient express his or her opinions effectively? Patients who have no economic capacity and no medical insurance depend on their families for medical care. How can their rights and interests are protected? What medical professionals should do if the decision of the family is against the will and interests of the individual patient?DOWNLOAD HISTORY | This article has been downloaded 38 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in English; abstract also in Chinese.Classroom management is essential to effective teaching. However, there is little information about how physical education student teachers manage their classes. Berliner (1988) proposed five stages of learning to teach and argued that experience is a predominant element to the development of expertise in pedagogy. Cruz (2000) suggested that the in-service student teachers taught better than their pre-service counter-parts as they had more in-field experience. The purpose of the study was to examine the class management practices of in-service physical education student teachers. Three in-service student teachers were randomly selected and invited to participate in the study. They were observed teaching two ball games lessons and took part in two pre-lesson interviews and two post-lesson stimulated recall sessions. Qualitative data were collected through lesson observations and interviews. Constant comparison and analytic induction were used to organize and categorize the data. Results showed that there were common managerial behaviours and management strategies adopted by the student teachers during teaching. Teaching style, organization and supporting were the identical managerial behaviours observed, whilst the preventive management, equipment management and interactive class management were the common class management strategies identified. The findings hold implications for the preparation of physical education teachers.班級經營與敎學效能息息相關。Berliner(1988)提出五階段學習歷程理論及敎學經驗為發展成敎學專家主要元素。Cruz(2000)指出在職師訓學生的敎學表現較職前師訓學生為佳是他們有較多實踐經驗。本研究目的是探討在職師訓學生的班級經營行為及策略。三位在職師訓學生被隨機抽樣參與此研究。他們被觀察兩敎節球類課及接受兩次課前訪問及課後刺激回憶訪談。其後以持續比較法分析蒐集資料。結果顯示師訓學生有其共通班級經營行為策略及給予體育師資培訓啟示。

LANGUAGE NOTE | Document text in English; abstract also in Chinese.The importance of reducing health risk associated with high abdominal fat is frequently emphasized. Consequently, in Singapore, we have witnessed good sales on motorized mechanical oscillators touted to induce slimming based on the principles of acupressure. However, to date, no study has been done to evaluate the efficacy of such equipment. This pilot study aims to examine the efficacy of motorized mechanical oscillators in reducing waist circumference, weight and abdominal fat percentage over 4 weeks as well as augment the data on acupressure for weight reduction. Two male subjects, one mildly overweight and the other severely overweight, were recruited. They were required to keep to their existing lifestyles and dietary habits and were instructed to wear the oscillator belt for 30 minutes each time, twice a day, as per instructions given in the manual. The machine was operated using the automatic mode. The results show a slight decrease in total body fat % ascertained by DEXA scans. There was also a reduction in waist circumference and an increase in lean mass in the trunk area in both subjects. Specifically, one participant (mildly overweight) lost 1.2% of total body fat, and 0.7cm on the waist girth but gained 1 kg of lean trunk mass. The other participant (severely overweight), although having lost only 0.2% of total body fat and 1.3cm on the waist girth, lost 1.7 kg in total body weight. He also gained in trunk lean mass that resulted in trunk fat reduction of 0.4%. There appears to be some success in such treatment modality particularly with regard to reducing abdominal fat. Certainly, more work needs to be done and future studies are being considered that will involve bigger sample sizes.調查顯示腹部脂肪的累積能引起健康危害，因此減少腹部脂肪的重要性需要廣泛重視的。在新加坡，瘦身產品如動力化的機械擺動瘦身帶都獲得非常好的銷售額。此瘦身帶是以穴位理療原理為依據而設計開發的。可是至今，這類產品的瘦身效果還沒得到科學證明。這項中間試驗的目的是研究在超過4個星期的時間裏，這類瘦身帶對減少腰圍，體重和腹部脂肪的百分數效果；同時也希望增添用穴位理療原理在減肥方面的資料。在二位男性患者當中，一位屬於輕微超重，而另一位屬於嚴重超重。在這項中間試驗調查中，二位患者接受了為期四周的治療療程。療程包括每日使用本瘦身帶二次，一次療程三十分鐘。除此以外，患者需要保持原本的生活方式和飲食習慣。並遵循指導手冊方法操作。此瘦身帶的操作是採用自動化的方法。由DEXA結果顯示二位元患者的脂肪都有顯微的下降，腰圍也有所減小，並且腹部的肌肉有明顯的增加。其中一位患者(輕微肥胖者)的脂肪減少了1.2%，腰圍減少了0.7公分，而肌肉增加了1公斤。第二位患者的身體脂肪減少了0.2%，腰圍減少了 1.3公分，體重也減輕了1.7公斤。同時肌肉也增加了，這使到他的腹部的脂肪減少了0.4%。由此可見，這類瘦身方法對減少腹部脂肪似乎有效。所以，這方面的調查和研究需要更多的工作。接下來希望進行更廣泛，更大規模的研究。

LANGUAGE NOTE | Document text in Chinese; abstract also in English.對於沒有臨床救治希望的病人，要不要繼續治療？誰有最終的決定權？這既是臨床醫療問題，又是一個涉及社會倫理法規的問題。對於這樣的病人，不放棄治療可能意味著要消耗更多的醫療資源但又無法挽救病人，但是如果放棄治療，可能會遇到更多的來自社會傳統的、倫理法規的問題。筆者認為，在社會多元化發展的今天，面對臨床無效治療，應在尊重病人或病人家屬有最終決定權的前提下，以一定道德、法規為依據，按照一定的醫療程式和法律手續進行處理，可能是更為符合人道和社會公眾利益的理性選擇。There has not been a clear medical definition of futility. The concept of futile treatment involves not only medical, but also social, ethical, and legal components. This paper argues that in today's pluralistic moral circumstances, the patient and/or the family should have the final right to decision regarding futile treatment.Some are opposed to renouncing futile treatment, whatever futility is defined. For them, first, abandoning treatment is in conflict with the physician's basic duty of offering treatment. Second, giving up treatment also gives up the chance of making medical progress by attempting to treat the patient. Third, the patient would thereby lose the opportunity of prolonging the life. And finally, it would change the good image of the physician (as taking care of the patient). On the other hand, those who support renouncing futile treatment offer different reasons. First, giving up futile treatment will turn out to be respecting the value of the patient's life. Second, It would help people recognize the natural limit of contemporary medical development. Third, it would facilitate a reasonable pattern of distributing scarce medical resources. And finally, it could reduce the suffering of the patient. As a result, we face a social situation of moral pluralism: people disagree with each other regarding renouncing futile treatment.A difficult practical issue is who has the right to decide renouncing futile treatment. This paper argues that, giving individuals hold conflicting views of life, valoue and morality, the patient should have the final decision power regarding his/her own treatment. If the patient is incompetent, then the family should have the deciding right. In this respect we should overcome the longstanding medical paternalism. In addition, society should establish a prcocedure to regulate and facilitate the decision-mading of renouncing futile treatment.DOWNLOAD HISTORY | This article has been downloaded 16 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in English; abstract also in Chinese.The purpose of this study was to investigate teachers' and students' perceptions toward the implementation of teaching games for understanding (TGFU) approach to teaching team handball lessons. The paper is intended to help serving teachers decide whether to adopt this approach in their teaching. The participants were five secondary physical education teachers and their secondary one to three students. The teachers were briefed the principles of the TGFU approach and instructed to teach with an eight-lesson team handball unit lesson plans in TGFU approach. A post-teaching interview on their views of using the new approach was conducted with the teachers. Views of students on their perceptions toward the effectiveness of the instructional approach were obtained through the use of a questionnaire at the end of the unit. Results revealed that all teachers held positive views on TGFU approach. They were willing to adopt this approach in future as the students were more active and had more fun in the lessons. The students expressed they had learnt well by understanding more about the tactics and the rules of the games. The positive responses of teachers and students to TGFU have great implications for teacher education and development.本研究目的是探討體育敎師和中學生對領會敎學法敎授手球課的觀感。研究員希望本文能協助在職老師審視利用領會敎學法敎學的可行性。五位中學體育老師及其初中學生參與是次研究。研究員首先向體育老師介紹領會敎學法的敎學原則，其後他們參照領會敎學法手球單元敎案敎授八節手球課。老師在授課後接受研究員訪問，探究他們對實施領會敎學法的意見。研究員亦利用問卷收集學生對此敎學法的效能觀感。結果顯示老師對領會敎學法持正面評債及樂於使用此敎學策略。學生亦表示透過此敎學法使他們更認識球例及戰術運用。此等正面回饋給予敎師發展及培訓多方面的啟示。

PurposeThis study examines the inter-linkages between Bitcoin prices and CEE stock markets (Hungary, the Czech Republic, Poland, Romania and Croatia).Design/methodology/approachThe dynamic contemporaneous nexus has been analyzed using both the multivariate DECO-GARCH model proposed by Engle and Kelly (2012) and quantile on quantile (QQ) methodology proposed by Sim and Zhou (2015). Our study is implemented using the daily data spanning from 6 September 2012 to 12 August 2019.FindingsFirst, the findings show that the average return equicorrelation across Bitcoin prices and CEE stock indices are positive, even though it is found to be time-varying over the research period shown. Second, the Bitcoin-CEE stock market association has positive signs for most pairs of quantiles of both variables and represents a rather similar pattern for the cases of Poland, the Czech Republic and Croatia. However, a weaker and primarily negative connectedness is found for Hungary and Romania, respectively. Furthermore, the interconnectedness between the co-movements in the Bitcoin market and stock returns changes significantly across quantiles of both variables within each nation, indicating that the Bitcoin-stock market relationship is dependent on both the cycle of the stock market and the nature of Bitcoin price shocks.Practical implicationsThe evidence documented in this study has significant implications for divergent economic agents, including global investors, risk managers and policymakers, who would benefit from a comprehensive knowledge of the Bitcoin-stock market relationship to build efficient risk-hedging models and to conduct appropriate policy reactions to information spillover effects in different time horizons.Originality/valueThis paper is the first study employing both the multivariate DECO-GARCH model and QQ methodology to shed light on the nexus between Bitcoin prices and the stock markets in CEE countries. The DECO model uses more information to compute dynamic correlations between each pair of returns than standard dynamic conditional correlation (DCC) models, declining the estimation noise of the correlations. Besides, QQ approach allows us to capture some nuanced features of the Bitcoin-stock market relationship and explore the interdependence in its entirely. Therefore, the main contribution of this article to the related literature in this field is significant.研究目的本研究旨在探討比特幣的價格與中東歐股市(匈牙利、捷克共和國、波蘭、羅馬尼亞和克羅地亞) 之相互聯繫.研究設計/方法/理念研究使用恩格爾與凱利(2012)(Engle and Kelly (2012)) 提出的多變量DECO-GARCH模型及Sim 與Zhou(2015)(Sim and Zhou ( 2015)) 研製的分位數-分位數方法來分析動態同期的聯繫。我們的研究使用由2012年9月6日至2019年8月12日期間取得的每日數據來進行.研究結果首先、研究結果顯示、跨比特幣價格與中東歐股價指數的平均回報當量關聯是正相關的，即使在研究期間被發現是隨時間而變化的。第二、比特幣與中東歐股市之聯繫在大多數兩變數分位數對而言出現正相關跡象，而且，這聯繫在波蘭、捷克共和國及克羅地亞而言表現一個頗相似的模式。唯就匈牙利而言、這聯繫則較弱、而羅馬尼亞則主要是負聯繫。研究結果亦顯示: 比特幣市場內的聯動與股票回報間之內在關聯會在每個國家內跨兩個變數的分位數而顯著地改變，這顯示比特幣-股市關係是取決於股市的週期和比特幣價格衝擊的本質.實際的意義本研究所記載的證據、對不同的經濟行為者而言極具意義 (這包括國際投資者、風險管理經理和政策制定者)，因他們會受惠於對比特幣-股市關係的全面認識，他們可建立有效的風險對沖模型、及在不同時間範圍對資訊溢出效應進行適當的政策反應.研究的原創性/價值本文為首個研究使用多變量DECO-GARCH模型和分位數-分位數(QQ)方法、來解釋比特幣價格與中東歐國家之股市的關係。這DECO模型使用比標準動態條件關係模型更多資訊，來計算每對回報間之動態關係，這能減少估測雜訊，而且，QQ方法讓我們可以取得比特幣-股市關係的一些細微特徵及全面地探索其相互依賴性。因此，本文的主要貢獻是在這學術領域內有關的文獻上.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.首先闡明儒家與基督教及古希臘文化各自對於同性戀的態度。儒家與基督教的嚴厲排斥和古希臘人的某種鼓勵皆不同，對同性戀持一種有保留的寬容態度，對於同性戀個人的評價更是以其道德行為為依據。為了理解儒耶在這個問題上分歧的深層原因，審視了西方的二元分叉和古代中國陰陽互補對生的不同思想方式。儒家因此將同性戀人群的產生歸為陰陽發生過程的可能產物，有其自然的原因，並不是一種罪惡。但是，也正是由於儒家信持這樣一個陰陽生發的結構，她不可能贊許同性婚姻的合法化，因為同性戀者的結合畢竟不是陰陽化生的原真形態，將它與異性婚姻在法律地位上等同看待會導致一些對於人類社群長久延續不利的後果。它們包括：這種合法化會從道理上打開通向群婚制的缺口；它還可能會傷害一些無辜者；它具有的某種示範效應可能會引導那些在性別取向上的徘徊者走上他們本來不一定要選擇的性道路。本文的第三部分第一節還依據中英原文，考訂了美國最高法院的甘迺迪法官所引用的孔子話語，說明它在表達形式上的不嚴格和內容上的大致可行。又闡述了此法官的基本思想與這段引文及其上下文所代表的儒家思路的衝突。First, the various attitudes towards homosexuality among Confucianism, Christianity and ancient Greek culture are considered. Distinguished from the Christian harsh repulsion and the Greek slight encouragement, Confucianism has been guardedly tolerant of homosexuality and judged homosexuals according to their personal moral behavior. To reveal the deep reasons for the distinction between Confucianism and Christianity on this issue, the paper examines the differences in thinking between the Western dichotomy and the Confucian genesis by the co-opposites of yin-yang. Confucianism explains homosexuality as one of the possible results of the yin-yang process. It is thereby a natural phenomenon, not an evil thing. However, it is due to this understanding that Confucianism cannot advocate the legalization of homosexual marriage, because a union between homosexuals does not belong to a true yin-yang means of combination and production. To treat it legitimately as being the same as a marriage between heterosexuals could lead to consequences that would be unfavorable to the longevity of human communities, which include, for instance, opening up the possibility of group marriage; hurting innocent people; and leading those who do not have a definite sexual tendency to make a homosexual decision. The third part of the paper refers to the Confucian saying cited by Anthony Kennedy, the Chief Justice of the Supreme Court of the USA, in his statement on the ruling on same-sex marriage, and shows that his citation was inaccurate, but its content was not far from the original meaning of Confucius’ saying. Further, the conflict between Kennedy’s basic thinking and the Confucian thought demonstrated in the citation and its context is exposed.DOWNLOAD HISTORY | This article has been downloaded 329 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.醫生的告知義務，是指在醫療工作中，醫方應當就患者的診療資訊向患者做出適當的說明和解釋。醫生告知義務突顯了患者的人格獨立，在法律上體現為醫生的普遍行為準則，並具有對醫療行為的歸責意義。適當的履行告知義務有利於增強和提高治療效果，有利於建立良好的醫患關係，從而促進醫療事業的發展。應當注意的是，在利益主多元化的社會中，患者的知情同意與社會利益及生命價值的衝突，告知義務與保護性醫療的衝突必須予以關注，明確衝突中的價值排序。The doctors' obligation to inform means that the doctor shall inform the patient of related information on diagnosis and treatment. Specifically, it includes the following three aspects: 1) Explanation of diagnosis, that is, the explanation made by the doctor about the health condition of the patient according to medical diagnosis; 2) Ex-planation of measures used in invasive diagnosis-both preliminary and final-and treatment plan according to the diagnosis; 3) Explanation of neither diagnosis nor treatment, that is, explanation on why no diagnosis and treatment are available due to the insufficient professional skills of the doctor or lack of medical equipments.In the doctor-patient relationship, the doctor's obligation to inform reflects the feature of independence, subjectivity, rights, self- determination, and autonomy of the patient. The aim of medical treatment is to cure illness and save the life of the patient so that medical activities should be patient-centered, and respect the patient. To treat patient as equal is the prime ethical requirement for a doctor. Legally, the doctor's obligation to inform reflects the common rule of the doctor's good conducts. It is an important component in diagnosing and treating. In addition, it plays an important part in fulfilling the responsibility of the doctor. Whether the doctor has performed obligation to inform should be taken as important evidence in judging whether a medical error has occurred. If harms to the patient or delay of treatment happen due to the doctor's insufficient or inappropriate explanations about the risks of invasive diagnosis measures and treatment schedule, the doctor should take the responsibility of tort or harm compensation for his or her failure in informing. Reflecting the change of modern medicine from a bio-medical model to a bio-psycho- socio model, to inform the patient fully will help the patient gain an all-around and correct knowledge about his or her illness and take an active role in treating the disease. The process of informing is also a process of medical and health care education. To inform the patient fully will help to establish and maintain a good, reasonable and harmonious doctor-patient relationship.What should be noted is we should give close attention to the conflicts of various values in informed consent, including social and individual interests and duties to inform the patient and to protect the others. Acknowledging and ranking these conflicting values is thus important. Generally speaking, when patient's autonomy conflicts with public interests, the patient's autonomy should be limited by public interests. When the patient's autonomy endangers his own health and life, the protection of the patient's health and life will be the prime value. Protective treatment is an important rule of medical ethics and legal obligation. But the practice of protective treatment will deprive the patient's autonomy and individuality as it relieves the patient's suffering. Nevertheless, protective treatment is a reality and the solution to the problem will only depend on the careful discretion of the doctor.DOWNLOAD HISTORY | This article has been downloaded 15 times in Digital Commons before migrating into this platform.

2008年，香港大學顧問團受社會福利署的委託而進行綜合家庭服務中心服務檢討，於2010年完成研究並發表「綜合家庭服務中心服務模式實施情況檢討」報告書。 本文深入分析港大研究報告書後，發現該報告書欠缺分析過往相關文獻的討論；重複過往研究的結果，結論卻沒有進一步分析和探究；概念含混，沒有清晰的標準作評估準則；只引用社工的意見而沒有進一步分析或評論，尤其在一些重要的議題上，前後不一致；推論不合邏輯。 從這研究的資料所見，綜合家務服務中心的角色和功能不斷受到社會基層和相關持份者所修正和界定，因此我們亦應反思社會工作的政治實踐。 我們相信港大顧問團眾多學者都具備足夠能力去進行具學術水平的研究，正因為這緣故，它令我們對學者的角色和研究報告所帶來的倫理責任進行反思。

Background The potential effects of classical music (CL) and heavy metal (HM) in comparison to silence (S [“controls CO]) or noise (N) on cardiovascular parameters (blood pressure [BP], heart rate [HR]) and cortisol levels (C) has not been studied before. Objective To analyse the effect of different music styles (intervention group) on BP, HR and C compared to S (control group). Methods 120 volunteers aged 25-75 years were studied. 60 volunteers were consecutively assigned in the intervention group (n=60). Sixty volunteers were matched according to age, sex, height and weight (control group). Interventional music styles were CL (Bach, Suite No. 3, BWV 1068); HM (Disturbed, Indestructible) or various daily sounds =“noise” [N]). Sound exposure of CL, HM, or N was 21 minutes. Results In the intervention group systolic, diastolic BP (mm Hg) and HR (beats per min) decreased mostly when CL was played compared to HM, N or CO (p<0.001). Conclusions Music will influence cardiovascular parameters. Classical music (“Bach”) leads to decreased values of BP and HR. In HM, N or S we could not observe similar findings. SpanishEl efecto potencial de la música clásica (CL) y el Heavy Metal (HM) en comparación con silencio (S) o ruído (N) en parámetros cardiovasculares (presión sanguínea - BP, frecuencia cardiaca- HR, y niveles de cortisol- C) no había sido estuduado hasta el presente. Objetivo: Analizar el efecto de diferentes estilos musicales (Grupo de tratamiento) en BP, HR y C, comparado con S (grupo control). Método: 120 voluntarios entre 25 y 75 años fueron estudiados. 60 voluntarios fueron asignados consecutivamente al grupo de intervencion (n:60). 60 voluntarios fueron asignados al grupo control, de acuerdo a género, peso y talla. Los estilos musicales utilizados en la intervención fueron los siguientes: Bach, Suite No. 3, BWV 1068 (CL),Disturbed, Indestructible (HM), sonidos cotidianos =“ruido” [N]). El tiempo de exposicion a CL, HM, or N fue de 21 minutos. Resultados: En el grupo de intervencion se encontró una disminución en sistólica y diatólica BP (mm Hg) y HR (latidos por minuto) durante CL, comparado con HM, N o CO (p<0.001). Conclusion: La música influyer parámetros cardiovsaculares. Música clásica (Bach), parece disminuir BP y HR. No encontramos resultados similares en HM, N o S. FrenchEffets de différents style de musique sur l’activité cardiovasculaire chez l’homme : étude prospective contôléeHans-Joachim Trappe1, Irini Maria Breker21 Departement de Cardiologie et Angiologie, Université de Bochum, Herne, Allemagnangiology. Résumé : les effets potentiels de la musique classique (MC) et heavy métal (HM) en comparaison au silence (S [“contrôles CO]) et du bruit (B) sur les paramètres cardiovasculaires (pression artérielle [PA], fréquence cardiaque [FC] et niveau de cortisol (C) n’ont pas été étudiés auparavant. Objectif : analyser les effets des différents types de musique(groupe d’intervention) sur PA, FC et C comparés à S (groupe contrôle).Méthode : 120 volontaires âgées de 25-75 ans ont participé à l’étude. 60 volontaires ont été successivement assignés au groupe d’intervention (n=60) d’après l’âge, le sexe, la taille et le poids (groupe contrôle. Les styles de musique ont été CL (Bach, Suite N° 3, BWV 1068); HM (Disturbed Indesctructible) ou des sons variés du quotidiens = “bruit” [N]). L’exposition au sonde CL, HM ou N a été de 21 mn. Resultats : dans le groupe d’intervention, la PA systolique et diastolique (mm Hg) et la FC (battement par minute) ont diminué surtout quand la CM était jouée en comparaison avec HM, B ou CO (p<0.001). Conclusions : La musique influence les paramètres cardiovaculaires. La musique classique (“Bach”) conduit à une diminution des valeurs de PA et FC. Dans HM, N ou S nous ne pouvons pas observer de résultats similaires. Trial registration 3898-11 University of Bochum, Germany Funding German Heart Foundation, Frankfurt am Main, Germany Trial Registration German Clinical Trials Register (DRKS00009835) Mots clés : musique classique, musique métal, pression artérielle, fréquence cardiaque, cortisol GermanDie Wirkung verschiedener musikalischer Stile auf cardiovasculäre Reaktionen beim Menschen: eine prospektive kontrollierte StudieAbstract: Hintergrund: Die potentialen Effekte von klassischer Musik (CL) und Heavy Metal (HM) im Vergleich zu Stille (S [Kontrollen CO]) oder Alltagsgeräuschen =“noise“ (N) auf cardiovaskuläre Parameter (Blutdruck [BP], Herzschlag [HR] und Cortisol [C]) wurde bisher noch nicht untersucht. Ziel: Analysierung der Effekte von verschiedenen musikalischen Stilen (Interventionsgruppe) auf BP, HR und C auf S (Kontrollgruppe). Methode: 120 Teilnehmer (25-75 J.) wurden untersucht, davon 60 Teilnehmer konsekutiv für die Interventionsgruppe ausgewählt (60). Diese 60 Teilnehmer wurden über Alter, Geschlecht, Größe und Gewicht gematcht. Die genutzten Musikstile waren CL (Bach, Suite Nr 3, BWV 1068); HM (Disturbed, Indestructible) und verschiedene Geräusche aus dem täglichen Leben (=“noise“) (N). Die Zeit für die Klangdarbietung von CL, HM oder N war 21 Minuten. Ergebnisse: In der Interventionsgruppe verringerte sich meistens der systolische und der diastolische BP (mmHG) und der HR (Schläge pro Minute) bei CL im Vergleich zu HM, N oder den CO (p<0.001). Ergebnisse: Musik beeinflusst die cardiovasculären Parameter. Klassische Musik (Bach) führt zu sinkenden Werten von BP und HR, bei N oder S konnten wir keine vergleichbaren Ergebnisse feststellen. Keywords: Klassische Musik, Heavy Metal, Blutdruck, Herzschlag, CortisolJapanese要旨 背景：クラシック音楽（ＣＬ）とヘヴィメタル音楽（ＨＭ）、静寂（Ｓまたはコントロール群としてのＣＯ）と騒音（Ｎ）の比較が、人間の循環器（血圧[ＢＰ]、脈拍[ＨＲ]）そしてコルチゾール値（Ｃ）に及ぼす効果に関する研究はまだなされていない。目的：異なる音楽スタイル（介入集団）が、コントロール群と比べて、血圧、脈拍、コルチゾール値にもたらす効果を分析する。方法：２５歳から７５歳までの１２０名の被験者を対象に行われた。６０名は介入集団へ、残りの６０名は年齢、性別、身長、体重などを考慮した上で、コントロール群に分けられた。介入に使われた音楽スタイルは、クラシック音楽CL (Bach, Suite No. 3, BWV 1068)、ヘヴィメタル音楽HM (Disturbed, Indestructible)、日常の生活音N（騒音noise）であった。これらの音・音楽刺激は、２１分間であった。結果：介入グループでは、心臓収縮期、拡張期において、ヘヴィメタル音楽や騒音を聴いたときより、クラシック音楽を聴いた時の方が、血圧(mm Hg)、脈拍(beats per min)、コルチゾール値が下がる(p<0.001)ことがわかった。音・音楽刺激の前後における値は下記の通りであった。 結果：音楽は循環器の値に影響することが分った。クラシック音楽（バッハ）は血圧と脈拍を降下させた。ヘヴィメタル音楽、騒音、静寂については、共通の結果を見出すことができなかった。キーワード: クラシック音楽、ヘヴィメタル音楽、血圧、脈拍、コルチゾール値Chinese背景摘要 過去未曾有研究針對古典音樂(CL)及重金屬音樂(HM)對比安靜(S[控制組CO])或噪音(N)對於心血管參數 (血壓[BP]、心跳[HR])及皮質醇水平(C) 的潛在影響。 目的 分析不同音樂類型(實驗組)與安靜(控制組)相較之下對血壓(BP)、心跳(HR)及皮質醇水平(C)的影響。方法 對120位年齡介於25-75歲的自願參與者進行研究。60位自願參與者連續分配到研究組(n=60)。60位自願參與者則被配對年齡、性別、身高、體重分配到控制組。實驗介入的音樂風格為古典音樂組CL(巴哈，第三號組曲，BWV 1068)；重金屬音樂組HM(騷動樂團的永不毀滅)或多樣化的日常聲音=噪音(N)，志願者分別被暴露在CL、HM和N聲音環境中21分鐘。結果 比較實驗組中測得的收縮壓與舒張壓(mm Hg)及心跳速率(每分鐘幾下)。相較於重金屬音樂組、噪音組及控制組，當古典音樂播放時所測得的數值大多會下降(p<0.001)。下列為實驗組暴露於聲音前後及控制組的結果： 結論 音樂會影響心血管參數，我們發現聆聽古典音樂(巴哈)有效降低血壓及心跳的同時，在重金屬音樂組、噪音組及控制組都未觀察到類似的結果。試驗註冊 3898-11德國波鴻大學。資金 德國心臟基金會，法蘭克福，德國。試驗註冊 德國臨床試驗註冊（DRKS00009835）

The Bonny Method of Guided Imagery and Music (GIM) and modifications derived from it are potent and flexible for addressing a variety of psychological and physical concerns in both clinical and nonclinical adult populations. This paper summarizes the existing evidence relevant to medical populations with a focus on mental and physical health. Medical populations found to benefit from a series of individual GIM sessions have included individuals with cancer, cardiovascular disease, autoimmune disorders, and psychological conditions, including anxiety, chemical dependency, posttraumatic stress disorder, and disability from work stress. Researchers also have documented significant change resulting from a series of GIM sessions in physiological variables including blood pressure, cortisol, and chronic pain. Adaptations and modifications to the original method to meet individual clinical need or circumstances include shortening the session, using less evocative music, introducing supportive images, employing directive guiding of the imagery process, and foregoing the verbal dialogue in groups. Group music and imagery, in particular, has been found to contribute to improvement in global functioning for individuals with psychotic disorders and to decrease pain and improve mood in women with fibromyalgia. GIM is effective for ameliorating symptoms and improving quality of life for a variety of medical populations.Keywords: Bonny Method of Guided Imagery and Music, GIM, mental health, physical health, music imageryGermanDie Bonny Methode der Guided Imagery and Music für medizinisch auffälligePatienten: Evidenz für Effektivität und zukünftige VisionenCathy H. McKinney, Denise E. GrockeAbstract: Die BMGIM und ihre Modifikationen sind einflussreich und anpassungsfähig, sie erreichen psychologisch und physisch sowohl klinische als auch nicht-klinische erwachseneMenschen. Dieser Artikel fasst die vorhandene Evidenz zusammen, die für die medizinischauffällige Bevölkerung mit Fokus auf deren mentale und physische Gesundheit relevant sind.Diese medizinische Bevölkerung profitiert von einer Reihe individueller GIM Sitzungen, dies gilt auch für Patienten mit Krebs, cardiovasculäre Krankheiten, Autoimmunkrankheiten und psychischen Problemen, inclusive Angststörungen, Abhängigkeiten von chemischen Substanzen, posttraumatischen Stresssymptomen, und Behinderungen aufgrund von Arbeitsstress. Aufgrund einer Reihe von GIM Sitzungen konnten Forscher signifikante Veränderungen bei physiologischen Variablen dokumentieren, eingeschlossen Blutdruck, Cortisol und chronischer Schmerz. Anpassungen und Modifikationen, die individuellenklinischen Bedürfnisse oder Umstände zu treffen, waren das Verkürzen der Sitzungen, weniger aufwühlende Musik zu benutzen, Einführen unterstützender Bilder, direktives Führen während des Imagery-Prozesses und Verzicht auf den verbalen Dialog in den Gruppen. Besonders bei Music and Imagery in Gruppen wurde festgestellt, dass dies zu einer Verbesserung des globalen Funktionierens bei Patienten mit psychotischen Störungen führt und bei Frauen mit Fibromyalgie den Schmerz vermindert und die Stimmung verbessert. GIM hilft, um bei einer großen Anzahl der medizinischen auffälligen Bevölkerung die Symptome zu verbessern und die Lebensqualität zu erhöhen.Keywords: Bonny Method of Guided Imagery and Music, GIM, mentale Gesundheit, physischeGesundheit, music imageryJapanese医療現場におけるボニー式GIM: 将来に向けた効果と展望のためのエビデンスボニー式GIMとそれから派生した変形様態には、大人への臨床と非臨床の両面において様々な精神と身体の問題に対処するための効能と柔軟性がある。本稿は精神と身体に焦点をあてた医療に関連した存在エビデンスについて要約する。医療現場では、ガン、心血管疾患、自己免疫障害の患者、そして不安障害、薬物依存、心的外傷後障害、そして職場でのストレスによる障害を含む精神的状態において連続した個別GIMセッションから利益があることを発見した。研究者達は、血圧、コルチゾール、慢性疼痛を含む生理学上の変化にも連続したGIMセッションから有意な変化を 得られることをことも報告してきた。対象者の臨床的ニーズと状況に合わせるために原型のメソッドへの適応と変容は、セッション時間の短縮、喚情的な音楽の使用の回避、支援的なイメージの導入、直接的なイメージ処理の導き、そしてグループ内での言語対話を先行することを含んでいる。グループにおける音楽とイメージは、特に、精神障害者の全体機能向キーワード：ボニー式GIM, GIM, 精神医療、身体的健康、音楽イメージChinese邦尼式引導想像音樂治療法(GIM)及其衍生的方法能靈活有效的處理各種成人的心理、生理臨床或非臨床的議題。本文從現有證據針對此方法對醫療族群的心理與生理健康之相關性做一總結。 研究發現能受益於個別GIM系列療程的病患包括罹患癌症、心血管疾病、自體免疫系統疾患、心理疾患如焦慮、藥物依賴、創傷後壓力症候群以及工作壓力殘疾者。 研究人員並記錄到GIM系列療程帶來血壓、皮質醇以及慢性疼痛等生理變向上的重大變化。為了符合個案需求與情況對原方法所做的改變與調整包括縮短療程、使用較少誘發性的音樂、引入支持性意象、直接帶領意象過程以及在團體中的事前對話。音樂引導意象團體治療被發現對於提升精神疾病患者的整體功能，以及減低女性纖維肌疼痛並改善心情特別有助益。GIM可有效改善多種醫療族群的症狀並提升生活品質。Korean일반병원 환자를 위한 Bonny의 유도된 심상과 음악 기법 : 효과에 대한 근거와 미래에 대한 비전Cathy H. McKinney, Denise E. Grocke초록Bonny에 의해 개발된 유도된 심상과 음악(GIM) 및 수정/보완된 기법은 임상 및 정상범주 성인 대상군 모두에게 다양한 심리 및 신체적 어려움을 해결하는데 상당한 잠재성과 적용 가능성을 보인다. 본 논문은 정신 및 신체 건강에 포커스를 맞추면서 의료현장 환자군과 관련된 현존하는 근거들을 종합하였다. 개별 GIM 세션을 통해 혜택을 받은 의료 환경 내 대상군은 암, 심혈관 질환, 자가면역 장애, 불안 등의 심리 상태, 약물 의존, 외상 후 스트레스 장애, 업무 스트레스로 인한 장애 등을 가진 대상자들이었다. 일련의 GIM 세션 시행 후 혈압, 코티솔, 만성 통증 포함 여러 생리학적 변인에서 나타난 유의미한 변화들을 기록한 연구들도 있었다. 개인별 임상적 필요나 환경적 문제를 고려한 수정/보완 방법의 일환으로 세션 횟수의 감소, 자극이 적은 음악의 사용, 지지적 이미지의 소개, 지시적인 심상유도 도입, 심상 전 그룹내 대화 등이 활용 되었다. 그룹 대상 음악과 심상은 특히 정신증적 장애를 가진 대상자의 전반적 기능을 향상시키고, 섬유근육통이 있는 여성들의 통증을 줄여주며 기분을 향상시키는 데 기여하는 것으로 밝혀졌다. GIM은 다양한 의료환경 내 대상군의 증상을 개선시키고 삶의 질을 향상시키는 데 효과적임을 알 수 있다. 키워드: Bonny에 의해 개발된 유도된 심상과 음악기법, GIM, 정신 건강, 신체 건강, 음악 심상

Music listening may evoke meaningful emotions in listeners and may enhance certain health benefits. At the same time, it is important to consider individual differences, such as musical taste, when examining musical emotions and in considering their possible health effects. In a field experiment, 21 women listened to their own preferred music on mp3-players daily for 30 minutes during a two week time period in their own homes. One week they listened to their own chosen relaxing music and the other their own chosen energizing music. Self-reported stress, emotions and health were measured by a questionnaire each day and salivary cortisol was measured with 6 samples two consecutive days every week. The experiment group was compared to a control group (N = 20) who were instructed to relax for 30 minutes everyday for three weeks, and with a baseline week when they relaxed without music for one week (before the music intervention weeks). The results showed that when participants in the experiment group listened to their own chosen music they reported to have experienced significantly higher intensity positive emotions and less stress than when they relaxed without music. There was also a significant decrease in cortisol from the baseline week to the second music intervention week. The control group’s reported stress levels, perceived emotions and cortisol levels remain stable during all three weeks of the study. Together these results suggest that listening to preferred music may be a more effective way of reducing feelings of stress and cortisol levels and increasing positive emotions than relaxing without music. Keywords: music, emotions, stress, cortisol levelsSpanishEstudio experimental de Campo de los efectos de la Escucha de Musica seleccionada por uno mismo en las emociones, el stress y los niveles de cortisol.Marie Helsing, Daniel Västfjäll, Pär Bjälkebring, Patrik Juslin, Terry Hartig La escucha musical puede evocar emociones significativas en los oyentes y puede lograr algunos beneficios en la salud. Al mismo tiempo, es importante considerar las diferencias individuales, como por ejemplo el gusto musical, cuando examinamos las emociones musicales y al considerar sus posibles efectos en la salud. En este experimento de campo 21 mujeres escucharon su música preferida 30 minutos por dia durante 2 semanas utilizando reproductores de mp3 en sus propias casas. Una semana escucharon la música que eligieron como relajante y la semana siguiente la música que eligieron como energizante. Los auto-reportes de stress, emociones y salud fueron medidos con cuestionarios diarios a la vez que se midió el nivel de cortisol en saliva con 6 muestras tomadas durante dos días consecutivos cada semana. El grupo experimental fue comparado con el grupo control (N=20) que habían sido instruidas para realizar relajación durante 30 minutos todos los días durante tres semanas y con una semana de base en la cual se relajaban sin música (antes de las semanas de intervención musical). Los resultados mostraron que cuando las participantes del grupo experimental escucharon su propia música, reportaron haber experimentado significativamente una mayor intensidad de emociones positivas y menor stress que cuando se relajaron sin música. Hubo también una disminución significativa en el cortisol desde la semana de base a la segunda semana con la intervención musical. El grupo control reportó que los niveles de stress , percepción emocional y niveles de cortisol permanecieron estables durante las tres semanas del estudio. Estos resultados sugieren que escuchar música preferida puede ser una forma más efectiva de reducir la sensación de stress y los niveles de cortisol y de incrementar las emociones positivas que la relajación sin música. Palabras clave: Escucha musical , cortisol , respuesta al stress GermanDie Effekte vom Hören selbst gewählter Musik auf Emotionen, Stress und Cortisol Level: Eine experimentelle Feldstudie Marie Helsing, Daniel Västfjäll, Pär Bjälkebring, Patrik Juslin, Terry Hartig Musikhören kann beim Hörer bedeutsame Emotionen auslösen und gewisse Gesundheitsvorteile bewirken. Gleichzeitig ist es wichtig, individuelle Unterschiede, wie den musikalischen Geschmack, zu beachten, wenn man musikalische Emotionen untersucht und deren mögliche gesundheitliche Effekte betrachtet. In einem Feldexperiment hörten 21 Frauen ihre selbst gewählte Musik über einen mp3 Spieler täglich 30 Minuten während einem Zeitraum von 2 Wochen in ihrem eigenen Zuhause.Eine Woche lang hörten sie ihre selbst gewählte entspannende Musik, in der anderen Woche selbst gewählte energetisierende Musik. Selbstberichteter Stress, Emotionenund Gesundheit wurden mithilfe eines Fragebogens täglich, der Cortisolspiegel mit 6 Beispielen an zwei aufeinander folgenden Tagen wöchentlich gemessen. Die experimentelle Gruppe wurde mit einer Kontrollgruppe verglichen (N=20), die angewiesen wurde, 3 Wochen lang täglich 30 Minuten zu entspannen; mit einer baseline-Woche, während der sie eine Woche lang ohne Musik entspannten (vor der Musik-Interventionswoche). Die Ergebnisse zeigten, dass die Teilnehmer der experimentellen Gruppe berichteten, sie hätten bei ihrer selbst gewählten Musik signifikant höhere intensive positive Emotionen und weniger Stress, als wenn sie ohne Musik entspannten. Außerdem fand sich eine signifikante Abnahme des Cortisols von der baseline-Woche zur 2. Woche mit Musikintervention. Die von der Kontrollgruppe berichteten Stresslevel, erlebten Emotionen und der Cortisolspiegel blieben während all der drei Studienwochen stabil. Zusammengefasst lassen diese Resultate vermuten, dass Hören von selbst gewählter Musik eine effektivere Möglichkeit darstellt, Gefühle von Stress und Cortisollevel zu reduzieren und positive Gefühle zu erzeugen, wie Entspannung ohne Musik.Keywords: Musikhören, Cortisol, Stressresponse ItalianStudio Sperimentale sul Campo degli Effetti Legati all’Ascolto della Musica Auto-Selezionata sulle Emozioni, Stress, Livello del Cortisolo Marie Helsing, Daniel Västfjäll, Pär Bjälkebring, Patrik Juslin, Terry HartigAscoltare musica può suscitare emozioni e può dare benefici alla salute. Allo stesso tempo però è importante prendere in considerazione le differenze individuali ,come il gusto musicale, quando si indaga sulle emozioni musicali, e considerare il loro possible effetto sulla salute. In un esperimeto sul campo 21 donne hanno ascoltato la loro musica preferita, su lettori mp3, ogni giorno, nelle loro case, per 30 minuti lungo un periodo di tempo di 2 settimane. Una settimana hanno ascoltato musica rilassante e l’alta settimana musica energizzante. Stress, emozioni e salute sono stati misurati da un questionario ogni giorno e il cortisolo della salia è stato misurato con 6 campioni due giorni consecutivi ogni settimana. Il gruppo di sperimentazione è stato messo a confroto con un altro gruppo di controllo (N= 20) al quale è stata assegnata una settimana di controllo di relax senza musica e dopo hanno avuto istruzione di rilassarsi per 30 minuti ogni giorno per tre settimane. I risultati hanno mostrato che quando i partecipanti del gruppo hanno ascoltato la loro musica essi hanno riferito di aver avuto meno stress e di aver vissuto emozioni positive in un livello significativamente piú alto rispetto a quando si rilassavano senza musica. C’è stata anche una diminuzine significativa del cortisolo nel passaggio tra la settimana di controllo alla settimana in cui è stata introdotta la musica. Il gruppo di controllo ha riportato livelli di stress, emozioni percepite e livelli di cortisolo stabili durante tutte e tre le settimane dello studio. Tutti questi risultati ci suggeriscono che rilassarsi ascoltando la nostra musica preferita può essere un modo molto efficace per ridurre i livelli di stress e di cotisolo ed aumentare le emozioni positive, rispetto a rilassarsi senza musica. Parole Chiave: ascoltare musica, cortisolo, stress Chinese聆聽自選音樂對情緒、壓力及皮質醇水平效用之實驗性實地研究聆聽音樂能激發對聆聽者而言具有意義的情緒，並有益於促進健康。於此同時，當評估音樂對情緒及健康可能帶來的影響時，考慮到個別差異(如：個人的音樂品味)至關重要。在一個實地研究中，21位女性連續兩週，每天30分鐘在家聆聽她們喜歡的音樂mp3，其中一週，他們聆聽自己選擇的放鬆音樂，另一週則聆聽自選的活力音樂。在自陳問卷中每天測量壓力值、情緒與健康狀態，並每週連續兩天測量六個唾液皮質醇樣本。在音樂介入之前，以一週沒有聆聽音樂的放鬆作為基線期，將實驗組的結果與連續三週每天進行30分鐘放鬆的控制組(N=20)比較，結果顯示和未聆聽音樂的放鬆經驗相比，實驗組的參與者表示，在她們聆聽自選音樂的時候，感受到明顯較高強度的正向情緒以及較少的壓力。同時，與第一週的基線期相比，皮質醇在第二週音樂開始介入後也顯著降低。相對的，控制組的自陳壓力值、情緒感知及皮質醇程度在研究進行的三週之中皆保持穩定。研究結果建議，在放鬆時聆聽個人偏好的音樂比沒有聆聽音樂更能有效降低壓力感與皮質醇程度，並增加正向情緒 。 Japanese自分で選んだ音楽を聴くことによる、感情、ストレス、 コルチゾール値への影響についての実験的実地調査Marie Helsing, Daniel Västfjäll, Pär Bjälkebring, Patrik Juslin, Terry Hartig 音楽鑑賞は鑑賞者の有意義な感情を喚起し一定の健康利益を高める可能性がある。同時に、音楽感情を調査、またそれらの健康への影響の可能性を考察する際には、音楽の嗜好など、個人差を考慮することが重要である。実地調査では、21人の女性が各自の好む音楽を一日30分、2週間、MP3プレイヤーを使って自宅で聴いた。一週間は自分で選択したリラックスする音楽を、もう一週間は自分で選択した活力を与える音楽を聴いた。自己申告によるストレス、感情、健康がアンケートを使って毎日計測され、唾液内のコルチゾール値は、毎週2日連続して６つのサンプルを使って計測された。実験グループは毎日30分のリラクゼーションを3週間行ったコントロール群 (N=20) と比較され、コントロール群はベースラインとなる週（リラクゼーションを始める前の週）に音楽なしのリラクゼーションも行った。結果は、実験グループ参加者が好みの音楽を聴いている時、著しく高い強さでポジティブな感情を経験し、音楽なしでリラックスしている時よりもストレスが少ないということを示した。また、コルチゾール値は、ベースライン週に比べて音楽介入のあった2週目の方が有意に減少していた。コントロール群では、ストレスレベル、感情知覚、コルチゾール値が、調査中3週間において安定を保持したことが報告された。これらの結果を合わせると、好みの音楽を聴くことはよりストレス感情とコルチゾール値を減少させ、音楽なしのリラクゼーションよりもポジティブな感情を増加させることが示唆される。キーワード：音楽鑑賞、コルチゾール、ストレス反応 Korean개인선곡 음악감상이 정서, 스트레스, 코티졸 레벨에 미치는 영향에 대한 임상 실험 연구Marie Helsing, Daniel Västfjäll, Pär Bjälkebring, Patrik Juslin, Terry Hartig음악을 듣는 것은 듣는 사람에게 중요한 정서를 이끌어 낼 수 있으며 특정한 건강 혜택들을 증진시킬 수 있다. 동시에, 음악적 정서를 조사할 때, 또한 그것들이 건강에 끼칠 수 있는 영향들을 고려할 때 음악적 취향과 같은 개인차를 고려해야 한다. 임상 실험에서, 21명의 여성들은 자신의 집에서 2주 동안 매일 30분씩 MP3 플레이어로 자신이 좋아하는 음악을 들었다. 첫 일주일 동안, 그들은 자신이 선택한 이완 음악을 들었고, 두 번째 일주일간은 자신이 선택한 에너지를 주는 음악을 들었다. 매일 질문지로 자신이 보고한 스트레스, 감정, 건강 등을 평가했고, 매주 2일 연속 6개의 샘플을 가지고 타액내 코티졸을 측정했다. 실험집단은 3주 동안 매일 30분씩 이완을 시키라고 지시를 받은 통제 집단(N=20)과 비교했으며, 음악 중재 전 일주일 동안 음악 없이 이완을 시켰던 때를 기초선 주간(baseline week)으로 정했다. 그 결과, 실험 집단의 참가자들은 음악없이 이완을 시켰던 때보다 자신이 선택한 음악을 들었을 때 유의미하게 더 높은 강도의 긍정적 정서와 더 적은 스트레스를 경험했다고 보고했다. 또한 기초선 주간으로부터 두 번째 음악 중재 주까지 코티졸의 유의미한 감소도 있었다. 통제 집단이 보고한 스트레스 수준, 인식한 감정, 코티졸 레벨은 3주 간의 연구 기간 내내 안정적이었다. 이런 결과들을 종합했을 때, 선호하는 음악을 듣는 것이 음악 없이 이완을 시키는 것보다 긍정적인 정서를 증가시켜주고 스트레스 감정과 코티졸 수준을 줄여주는 보다 효과적인 방법이 될 수 있음을 제안한다. 키워드: 음악 감상, 코티졸, 스트레스 반응

Music care is a developing approach to care that allows the therapeutic principles of music to inform caring practices in both formal healthcare settings and community or home-based contexts, and to create an integral role in developing more relational and person-centered cultures in caregiving. A significant part of the music care approach is a conceptual framework describing 10 domains of delivery. This article is the third in a three-part series on the theory and applications of a music care framework. Music is increasingly being recognized in health care communities as an effective psychosocial and rehabilitative intervention, increasing many aspects of quality of life. Currently, there is little standardization as to how music may best be integrated into individual care goals and care settings, though a growing body of literature supports the important impact of music in health care. It is this absence of standardization that has led the authors to develop a music care conceptual framework, so the varying scopes of practice that integrate music can be distinguished from one another and new possibilities for optimizing music in care can be identified. While the first study in this series examined how music care is understood in Canadian long term care facilities (1), the purpose of the second study explored how music could be optimized in complex continuing care environments, using one such facility in Ontario, Canada, as an exploration site (2). The 10 Domains of Music Care presented in this paper can be used as both a research tool and a practical, actionable tool for healthcare providers, managers, and decision makers. The paper discusses the 10 domains of music care delivery, need for a music care conceptual framework, and the implications and applications the framework provides. (1) Foster, B., Bartel, L. (2016) Understanding music care in Canadian facility-based long term care. Music Med, 1(8) 29-35.(2) Nelson, M., Foster, B., Pearson, S., Berends, A., Ridgway, J., Lyons, R., Bartel, L. (2016) Optimizing music in complex rehabilitation and continuing care: A Community Site Facility Study (Part 2 of 3), Music Med, 8(3) 128-136. Keywords: music care, person centered care, health arts, music therapy, 10 domains of music careSpanishParte 3 de 3: Diez dominios del cuidado musical. Un encuadre para ofrecer música en entornos médicos canadiensesResumen: el cuidado musical es un abordaje de atención en desarrollo que permite utilizar los principios terapéuticos de la música para informar las prácticas de asistencia tanto en abordajes de salud formales y comunitarios como en contexto domiciliarios, y crea un rol integral en el desarrollo de cuidados relacionales y centrados en la persona. La música está siendo reconocida de manera creciente en las comunidades de atención de salud como una efectiva intervención psicosocial y biomédica, mejorando varios aspectos de la calidad de vida. Actualmente en Canadá hay muy poca estandarización sobre cómo la música puede ser integrada en los objetivos asistenciales y en los settings de atención en salud. También hay un vacío en la regulación de lenguajes y competencias de la práctica para encontrar los tipos de asistencia musical que se brindará, aunque la creciente literatura sostiene la importancia del impacto de la música en la atención de salud. Contar con un marco conceptual para el entendimiento de la asistencia musical y cómo es brindada es beneficioso y sería una herramienta oportuna para direccionar estas discrepancias. Una parte significativa del abordaje de asistencia musical es el marco conceptual que describe diez dominios de servicio. Este artículo es el tercero en una serie de tres partes sobre la teoría y las aplicaciones del marco de la asistencia musical. La música está siendo reconocida de manera creciente en las comunidades de atención de salud como una efectiva intervención psicosocial y biomédica , incrementando varios aspectos de la calidad de vida. Existe poca estandarización sobre cómo la música puede ser integrada de la mejor manera en los objetivos individuales y en los settings de atención. Es esta ausencia en la estandarización la que ha llevado a los autores a desarrollar un marco conceptual para la asistencia musical, así la variedad competencias de la práctica que integra la música pueden ser distinguidas unas de otras y pueden identificarse nuevas posibilidades de optimizar la asistencia musical. El primer estudio de esta serie examina la optimización de la asistencia musical en instituciones de cuidado prolongado en Canadá, el propósito del segundo estudio fue explorar cómo la música puede ser optimizada en ambientes de cuidado complejo continuo, usando una institución en Ontario, Canadá como sitio de exploración.Los diez dominios de asistencia musical en el presente estudio pueden ser empleados tanto como herramienta de investigación y práctica como herramienta de acción para proveedores de salud, managers, y quienes toman decisiones. Este paper analiza los diez dominios de servicio de la asistencia musical, la necesidad de un marco conceptual de la asistencia musical, como así también las implicancias y aplicaciones que este marco provee. Palabras claves: asistencia musical, cuidado centrado en la persona, arte, musicoterapia, diez dominios de asistencia musicalGerman Teil 3 von 3: Zehn Bereiche von musikalischer Pflege: Ein Rahmen, um Musik im Canadischen Gesundheitsfürsorge zu verankernMusikpflege ist ein Ansatz zur Pflege, der es den therapeutischen Prinzipien von Musik erlaubt, über Pflegepraktiken sowohl in formalen Settings der Gesundheitsfürsorge und Einrichtungen oder ambulanten Zusammenhängen zu informieren – und damit eine wesentliche Rolle für eine beziehungsorientiertere und personenzentrierte Kultur in der Pflege schafft. Musik wird zusehends mehr in Gesundheitsfürsorgeeinrichtungen als eine effektive psychosoziale und biomedizinische Intervention anerkannt, die viele Aspekte der Lebensqualität (QoL) erhöht.Zur Zeit gibt es in Canada eigentlich keine Standardisierung, wie Musik am besten in individuelle Pflegeziele und Pflegesettings zu integrieren ist. Auch gibt es eine Lücke, in Praxisstilen und –bereichen, um Modelle von Leistungen der Musikpflege einzuordnen, obwohl eine wachsende Anzahl von Literatur den wichtigen Einfluss von Musik in der Gesundheitsfürsorge unterstützt. Ein konzeptueller Rahmen, um Musikpflege zu verstehen und wie sie einzuordnen ist, ist ein nützliches und aktuelles Mittel, um diese Diskrepanz anzugehen. Ein signifikanter Teil in dem Musikpflegeansatz ist ein konzeptueller Rahmen, der zehn Bereiche der Anwendung beschreibt. Dieser Artikel ist der dritte in einer dreiteiligen Serie über Theorie und Anwendung eines Rahmens der Musikpflege. Musik wird zusehends mehr in Gesundheitsfürsorgeeinrichtungen als eine effektive psychosoziale und rehabilitative Intervention anerkannt, die viele Aspekte der Lebensqualität (QoL) erhöht. Es gibt wenig Standardisierung, wie Musik am besten in individuelle Pflegeziele und Pflegesettings zu integrieren ist. Weil es eben keine Standardisierung gibt, haben sich die Autoren vorgenommen, einen konzeptuellen Rahmen für Musikpflege zu entwickeln, damit die verschiedenen Praxisbereiche voneinander unterschieden und neue Möglichkeiten, die Musikpflege zu optimieren, bestimmt werden können. Während die erste Studie dieser Serie die Optimierung der Musikpflege in Langzeiteinrichtungen in Canada untersuchte [1], war der Zweck für die zweite Studie zu untersuchen, wie Musik in komplexen Dauerpflegeeinrichtungen optimiert werden könnte, wobei eine dieser Einrichtung in Ontario, Canada als Untersuchungsort diente [2].Die Zehn Bereiche der Musikpflege, die in dieser Studie präsentiert werden, können sowohl als Forschungstool wie auch als durchführbares, einklagbares Tool für Gesundheitsfürsorger, Manager und Entscheidungsträger dienen. Dieser Artikel diskutiert die zehn Bereiche der Anwendung der Musikpflege, die Notwendigkeit eines konzeptuellen Rahmens für Musikpflege, und die Zusammenhänge und Anwendungen, die dieser Rahmen bereitstellt.Keywords: Musikpflege; personenzentrierte Pflege, Musiktherapie, zehn Bereiche der MusikpflegeItalianParte 3 di 3: Dieci Domini di Cura con la Musica: Un Modulo per Introdurre la Musica nei Sistemi Sanitari CanadesiLa cura con la musica è un approccio che si sta sviluppando nella cura che permette ai principi terapeutici della musica di informare le practiche sia nell’ambiente sanitaria formale che in contesti communitari o delle pratiche fatte da casa, e creare un ruolo di integrazione per uno sviluppo delle culture piú relazionale e piú incentrato su una cura sulla persona. La musica è sempre piú riconosciuta nelle comunitá di assistenza sanitaria come un efficace intervento psicosociale e biomedico in aumento. Attualmente in Canada c’è poca standardizzazione su come la musica puó essere meglio integrata I obbiettivi di cura individuali e in ambiti di cura. C’è anche un vuoto nel linguaggio regolamentato o in ambiti di pratica per la localizzazione di tipi di cura con la musica, anche se c’è una crescente materiale di letteratura che sostiene l’importanza della musica nella cura sanitaria. Un modulo concettuale per la comprenzione della cura con la musica e come viene effettuata è uno stumento utile e tempestivo per affrontare questa discrepanza. Una parte simportante del metodo di cura con la musica è un modulo concettuale che descrive dieci domini di consegna. Questo articolo è il terzo di una serie in tre parti sulla teoria e le applicazioni di un modulo di cura con la musica. La musica è sempre piú riconosciuta nella comunità di assistenza sanitaria come un efficace intervento psicosociale e riabilitativo, aumentando molti aspetti della qualità della vita. C’è poca standardizzazione su come la musica può essere meglio integrata in obbiettivi di cura individuali e ambienti sanitari. Mentre il primo studio di questa serie ha esaminato l’ottimizzazione delle cure con la musica nelle strutture di assistenza a lungo termine Canadesi [[i]], lo scopo del secondo studio ha eslorato come la musica può essere ottimizzata in complessi ambienti di assistenza continua, utilizzando un impianto I Ontario, Canada, come sito di esclorazione. (2)I Dieci Domini di Cura con la Musica presentato in questo studio può essere utilizzato sia come strumento di ricerca che come stumento pratico, come strumento operativo per gli operatori sanitari, manager e coloro che fanno le decisioni. L’articolo discute I dieci domini della cura con la musica, il bisogno di un modulo concettuale della cura con la musica, e le implicazioni e applicazioni che procura il modulo.Parole Chiave: cura con la musica, cura sulla persona, musicoterapia, dieci domini della cura con la musica Chinese音樂照護是一種發展中的照護方式，能夠讓音樂的治療原則運用在正規的醫療照護場所以及社區或居家照護，並在發展重視關係、以人為本的照護文化中扮演不可或缺的角色。以音樂作為心理社會以及生理醫學的有效處遇方式，在健康照護領域逐漸被認可，且能增加各層面的生活品質。最近加拿大正針對如何將音樂最佳的在照護場域中融入個人照護目標制定標準。目前音樂在照護場域的運用缺少正規的詞彙和定位音樂照護提供的實踐範圍。透過越來越多的文獻支持音樂在照護場域的重要影響，藉由此一概念性的架構來了解音樂照護，並以此有益而即時的工具來解決矛盾。 在音樂照護方法中一個很重要的部分為論述十種可提供的照護領域的概念架構。本文是三篇音樂照護概念理論與應用系列文章當中的第三篇。在健康照護領域，音樂逐漸被認定為是有效的物理與復健介入，並促進多方面的生活品質。關於音樂如何最佳的被融入個人照護目標或照護機構中則幾乎沒有任何標準。由於缺少了這樣的標準，作者於是發展出音樂照護的概念架構，如此一來，便得以區隔各種不同範疇的音樂照護並界定出最理想化的實踐。本系列中的第一篇評估了加拿大長期照護機構音樂照護的理想[[i]]，而第二篇的目的則實地考察加拿大安大略省的一個機構，探討音樂如何最佳的被運用在複合式照護環境中(2)。在最近的研究中所提到的十種音樂照護領域可同時作為研究工具方法，並提供臨床照顧者、經營者以及決策者可用的方法。本文討論了十種音樂照護的領域，對音樂照護概念架構的需求，以及此架構的影響與應用。 JapanesePart 3 of 3: ミュージックケアにおける１０の領域: カナダのヘルスケア施設に音楽を提供する枠組み ミュージックケアは、音楽の治療的原理を用いてヘルスケア施設やコミュニティおよび在宅介護で、療法的活動を行う開発途中のアプローチである。ケア提供において、対人関係を促し、パーソンセンタードな文化を向上させる重要な役割も果たしている。音楽は、心理社会的および生物医学的な介入におけるQOL（生活／生命の質）を向上させる効果的な方法として、ヘルスケア領域で認められるようになってきた。カナダでは、個別ケアの目的と実践の中に音楽がいかに統合され得るかについて、まだ最良の形態で標準化されていない現状がある。また、ヘルスケアにおける音楽の重要な効果に関する文献は顕著に増加しているものの、ミュージックケアの実践に関する用語や介護分類を表す言語が欠けているといえるであろう。ミュージックケアを理解しいかに提供するかという概念的枠組みを考えることは、上述の不足を 解決するためにも、有益である。ミュージックケアアプローチにおける重要な側面として、実践における１０の領域の概念的枠組みがある。本論文は、ミュージックケアの枠組みにおける理論と実践について書いた3部シリーズの第3部である。音楽は、心理社会的およびリハビリテーション医学的な介入におけるQOL（生活／生命の質）を向上させる効果的な方法として、ヘルスケア領域で認められるようになってきた。個別ケアの目的と実践の中に音楽がいかに統合され得るかについて、まだ最良の形態で標準化されていない現状がある。このような標準化の不足をふまえ、筆者達はミュージックケアの概念的枠組みを展開することにし、それによって様々な音楽を活用した活動との違いを明らかにし、ケアにおける音楽の適正な利用法の新しい可能性と役割を検証した。この研究の第1部では、カナダの長期ケア施設におけるミュージックケアの適正な活用法について考察し [[i]]、第2部ではカナダ・オンタリオにおける複合施設という状況下での音楽の適正な応用について探索した(2)。 本研究におけるミュージックケアにおける10の領域は、研究ツールとしても実践および活動ツールとしても、ヘルスケア提供者、管理者など治療を提供することを決定するすべての専門職が応用できるものとなっている。本論では、ミュージックケアの実践における１０の領域、ミュージックケアの概念的枠組みに対するニーズ、そしてこの枠組みが提供する実践と応用について考察する。 キーワード:ミュージックケア、パーソンセンタードケア、音楽療法、ミュージックケアにおける１０の領域 KoreanPart 3 of 3: 음악 치료의 10가지 영역: 캐나다 건강관리 환경에서 음악을 전달할 수 있는 체계음악 치료는 발전하고 있는 치료 접근법이며, 음악 치료 원칙들이 정규 의료 환경과 공동체(커뮤니티) 또는 가정에서 치료 관행을 알리고, 보다 관계 중심적이고 사람 중심적인 치료 문화를 개발하는 데 있어서 중요한 역할을 만들 수 있도록 만들어준다. 의료 사회에서 음악은 점점 효과적인 심리사회적, 생물의학적 중재 방법으로 인식되고 있으며, 삶의 질에 여러 가지 측면들을 증가시키고 있다. 현재 캐나다에는 음악을 개별 치료 목표와 치료 환경에 가장 잘 통합시킬 수 있는 방법에 대한 표준이 거의 없다.비록 점점 더 많은 문헌들이 건강관리에 음악이 끼치는 중요한 영향들을 뒷받침 해주고 있지만, 음악 치료 제공의 유형을 찾아내는 데 필요한 언어 및 관행 범위에는 여전히 빈틈이 있다. 음악 치료와 그것을 전달하는 방법을 이해하기 위한 개념적 토대는 이런 빈틈을 해결하는 데 유익한 도구이다. 음악 치료 접근법의 중요한 부분은 10가지 전달 영역을 설명하는 개념 체계이다. 본 연구는 음악 치료 체계의 이론과 적용에 대한 3가지 시리즈 가운데 세 번째 이다.음악은 의료 사회에서 삶의 질의 여러 측면들을 증진시켜주는 효과적인 심리 사회 및 재활 중재 방법으로 점점 더 인정을 받고 있다. 음악을 개별 치료 목표와 치료 환경에 가장 잘 통합시킬 수 있는 방법에 대한 표준화는 거의 없다. 저자들은 음악을 통합하는 관행의 다양한 범위를 구분하고 치료에 있어서 음악을 최적화시킬 수 있는 새로운 가능성을 확인할 수 있도록 제안한다. 또한 저자들이 음악 치료의 개념적 토대를 개발하게 만든 목적 역시 이러한 표준화의 부재에 대한 대안을 제시하고자 함이다. 이 시리즈 중 첫 번째 연구는 캐나다 장기 요양 시설에서의 음악 치료 최적화에 대해 조사한 반면, 두 번째 연구는 조사 현장으로 캐나다 Ontario에 있는 그런 시설 한 곳을 이용해서 음악을 복합한 지속 치료 환경에서 최적화 시킬 수 있는 방법을 조사했다. 의료 제공자, 관리자들, 의사 결정자들은 본 연구에서 제시한 음악 치료의 10가지 영역을 실용적인 도구이자 연구 도구로 사용할 수 있다. 본 논문은 음악 치료 전달의 10가지 영역, 음악 치료의 개념적 토대 필요성 및 그 토대가 제공하는 의의와 적용점 등에 대해 논의할 것이다. 키워드: 음악돌봄(music care), 사람 중심 치료, 건강 예술, 음악치료, 음악치료의 10가지 영역