Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

BackgroundThe therapeutic effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to the modulation of pathological neural activities, particularly the synchronization in the β band (13–35 Hz). However, whether the local β activity in the STN region can directly predict the stimulation outcome remains unclear.ObjectiveWe tested the hypothesis that low-β (13–20 Hz) and/or high-β (20–35 Hz) band activities recorded from the STN region can predict DBS efficacy.MethodsLocal field potentials (LFPs) were recorded in (...) 26 patients undergoing deep brain stimulation surgery in the subthalamic nucleus area. Recordings were made after the implantation of the DBS electrode prior to its connection to a stimulator. The maximum normalized powers in the theta (4–7 Hz), alpha (7–13 Hz), low-β (13–20 Hz), high-β (20–35 Hz), and low-γ (40–55 Hz) subbands in the postoperatively recorded LFP were correlated with the stimulation-induced improvement in contralateral tremor or bradykinesia–rigidity. The distance between the contact selected for stimulation and the contact with the maximum subband power was correlated with the stimulation efficacy. Following the identification of the potential predictors by the significant correlations, a multiple regression analysis was performed to evaluate their effect on the outcome.ResultsThe maximum high-β power was positively correlated with bradykinesia–rigidity improvement (rs = 0.549, p < 0.0001). The distance to the contact with maximum high-β power was negatively correlated with bradykinesia–rigidity improvement (rs = −0.452, p < 0.001). No significant correlation was observed with low-β power. The maximum high-β power and the distance to the contact with maximum high-β power were both significant predictors for bradykinesia–rigidity improvement in the multiple regression analysis, explaining 37.4% of the variance altogether. Tremor improvement was not significantly correlated with any frequency.ConclusionHigh-β oscillations, but not low-β oscillations, recorded from the STN region with the DBS lead can inform stimulation-induced improvement in contralateral bradykinesia–rigidity in patients with PD. High-β oscillations can help refine electrode targeting and inform contact selection for DBS therapy. (shrink)

Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...) of medical decisions of adults. Objective The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual’s relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers’ dominant voice hampers the demonstration of relational autonomy. Conclusions Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual’s values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual’s values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. (shrink)

Discovering high-utility itemsets (HUIs) consists of finding sets of items that yield a high profit in customer transaction databases. An important limitation of traditional high-utility itemset mining (HUIM) is that only the utility measure is used for assessing the interestingness of patterns. This leads to finding several itemsets that have a high profit but contain items that are weakly correlated. To address this issue, this paper proposes to integrate the concept of correlation in HUIM to find profitable itemsets that are (...) highly correlated, using the all-confidence and bond measures. An efficient algorithm named FCHM (fast correlated high-utility itemset miner) is proposed to efficiently discover correlated high-utility itemsets (CHIs). Two versions of the algorithm are proposed: FCHM|$_{all\text{-}confidence}$| and FCHM|$_{bond}$|⁠, which are based on the all-confidence and bond measures, respectively. An experimental evaluation was done using four real-life benchmark datasets from the HUIM literature: mushroom, retail, kosarak and foodmart. Results show that FCHM is efficient and can prune a huge amount of weakly CHIs. (shrink)

Consumers play an important role as one of the main actors in food safety social co-governance. To create a pattern of food safety social co-governance, the active and effective participation of consumers is critical. To encourage consumers to participate in food safety social co-governance voluntarily and positively, we attempted to develop and preliminarily validate a multidimensional questionnaire on consumer psychological capital that could be used to measure the degree of consumer participation in food safety social co-governance. The aim of the (...) initial sample and test sample 2 was to investigate the factor structure of a preliminary measure of consumer psychological capital. A 4-factor model with 23 items explained 61.05% of the total variance in item scores. The aim of test sample 3 was to measure the retest reliability. Test sample 4 was randomly allocated to the modeling sample and validation sample to verify questionnaire reliability and validity. Convergent validity, discriminant validity, and the internal inconsistency coefficients of the questionnaire were assessed in the modeling sample. While processing CFA, we deleted 9 items with small standardized factor loadings. The remaining 14 items in the final revised 4-factor model included self-efficacy, resilience, hope, and optimism. The fit indices of the revised four-factor model and second-order factor model in the modeling sample revealed an acceptable model fit. The convergent validity and discriminant validity of the revised model were good and acceptable, respectively. A cross-validation procedure confirmed the appropriateness of the revised four-factor model and second-order factor model in the validation sample. The cross-validation results confirmed that the fit indices of the revised four-factor model fitted the data well and the second-order factor model in the validation sample reached acceptable values. We concluded that the questionnaire developed in this study had good reliability and stable and acceptable construct validity. It could provide a theoretical basis for measuring psychological capital in food safety co-governance. (shrink)

Drowsy driving is a major cause of automobile accidents. Previous studies used neuroimaging based approaches such as analysis of electroencephalogram (EEG) activities to understand the brain dynamics of different cortical regions during drowsy driving. However, the coupling between brain regions responding to this vigilance change is still unclear. To have a comprehensive understanding of neural mechanisms underlying drowsy driving, in this study we use transfer entropy, a model-free measure of effective connectivity based on information theory. We investigate the pattern of (...) information transfer between brain regions when the vigilance level, which is derived from the driving performance, changes from alertness to drowsiness. Results show that the couplings between pairs of frontal, central, and parietal areas increased at the intermediate level of vigilance, which suggests that an enhancement of the cortico-cortical interaction is necessary to maintain the task performance and prevent behavioral lapses. Additionally, the occipital-related connectivity magnitudes monotonically decreases as the vigilance level declines, which further supports the cortical gating of sensory stimuli during drowsiness. Neurophysiological evidence of mutual relationships between brain regions measured by Transfer entropy might elucidate the understanding of cortico-cortical communication during drowsy driving. (shrink)

Recent advances in mobile electroencephalogram (EEG) systems, featuring non-prep dry electrodes and wireless telemetry, have urged the needs of mobile brain-computer interfaces (BCIs) for applications in our daily life. Since the brain may behave differently while people are actively situated in ecologically-valid environments versus highly-controlled laboratory environments, it remains unclear how well the current laboratory-oriented BCI demonstrations can be translated into operational BCIs for users with naturalistic movements. Understanding inherent links between natural human behaviors and brain activities is the key (...) to ensuring the applicability and stability of mobile BCIs. This study aims to assess the quality of steady-state visual-evoked potentials (SSVEPs), which is one of promising channels for functioning BCI systems, recorded using a mobile EEG system under challenging recording conditions, e.g., walking. To systemati-cally explore the effects of walking locomotion on the SSVEPs, this study instructed subjects to stand or walk on a treadmill running at speeds of 1, 2, and 3 mile (s) per hour (MPH) while con-currently perceiving visual flickers (11 and 12 Hz). Empirical results of this study showed that the SSVEP amplitude tended to deteriorate when subjects switched from standing to walking. Such SSVEP suppression could be attributed to the walking locomotion, leading to distinctly deteriorated SSVEP detectability from standing (84.87±13.55%) to walking (1 MPH: 83.03±13.24%, 2 MPH: 79.47±13.53%, and 3 MPH: 75.26±17.89%). These findings not only demonstrated the applicability and limitations of SSVEPs recorded from freely behaving humans in realistic environments, but also provide useful methods and techniques for boosting the translation of the BCI technology from laboratory demonstrations to practical applications. (shrink)

The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before (...) and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. (shrink)

Urban streetscapes are outdoor areas in which the general public can appreciate green landscapes and engage in outdoor activities along the street. This study tested the extent to which the degree of awareness of urban street trees impacts attention restoration and perceived restorativeness. We manipulated the degree of awareness of street trees. Participants were placed into four groups and shown different images: (a) streetscapes with absolutely no trees; (b) streetscapes with flashes of trees in which participants had minimal awareness of (...) the content; (c) streetscapes with trees; and (d) streetscapes with trees to which participants were told to pay attention. We compared the performance of 138 individuals on measures of attention and their evaluations of perceived restorativeness. Two main findings emerged. First, streetscapes with trees improved the performance of participants on attentional tests even without their awareness of the trees. Second, participants who had raised awareness of street trees performed best on the attentional test and rated the streetscapes as being more restorative. These findings enhance our knowledge about the role of an individual's awareness of restorative elements and have implications for designers and individuals who are at risk of attentional fatigue. (shrink)

Background This study used a scenario- and discussion-based approach to teach preclinical medical students the socio-philosophical aspects of psychiatry and qualitatively evaluated the learning outcomes in a medical humanities course in Taiwan. Methods The seminar session focused on three hypothetical psychiatry cases. Students discussed the cases in groups and were guided by facilitators from multiple disciplines and professions. At the end of the semester, students submitted a narrative report comprising their reflections on the cases and discussions. The authors utilized content (...) analysis to categorize students’ narratives into three facets, namely, the philosophical, social and individual. Results In total 163 preclinical medical students participated in the class; 150 of them mentioned the scenario-based lesson in their reports; 33.3% of these reports discussed the case at the philosophical dimension (n = 50), 45.3% at the social dimension (n = 68), and 26.6% at the individual dimension (n = 40). Four major themes emerged: (1) a psychiatric diagnosis has far-reaching consequences for an individual’s life, (2) the social structure affects how patients experience psychiatric disorders, (3) students related personal experience or those of friends and family to understand psychiatric disorders, and (4) medical humanities are of particular importance in psychiatric education. Conclusions This study demonstrated that the scenario-based discussions led by a multidisciplinary team of facilitators can benefit medical students with limited clinical experience to contemplate the socio-philosophical aspects of psychiatry. The authors suggest that this pedagogical model during preclinical education should be encouraged. (shrink)

Abstractabstract:This article presents previous attempts to map Utopia, a fictional island in the book Utopia by Thomas More, and proposes another possibility, based on the assumption that Utopia is an enclosed garden on an artificial island that is not flat, but has piedmont slopes of 2.5:1. Our mapping experiment is founded on the Renaissance analogy between the domestication of wild nature, and the civilization of the human beings in More’s enclosed garden; and on the anecdotal similarities between the Inca Empire (...) and Utopia. This approach is not only consistent with the island’s dimensional specifications, which have hampered previous mapping attempts due to their mathematical incompatibility, but it also addresses the educative capacity of utopian life not considered by previous mapping efforts. Utopia, as a result, is to be understood as a series of performative spatial arrangements where the physical and geographical specifications would inform the vernacular life of its inhabitants in the direction of self-enhancement. (shrink)

Based on attribution theory, this research defines pseudo-transformational leadership to be driven by the interaction between transformational leadership and the subordinates’ perception of their supervisor’s manipulative intention. We investigate the effects of pseudo-transformational leadership on contextual performance through organizational identification. The results of hierarchical linear modeling using a sample of 214 subordinates reporting to 66 supervisors show that when subordinates perceive that their supervisor has a high level of manipulative intention, the impact of group-level transformational leadership on the subordinates will (...) be reduced. More specifically, when subordinates perceive the manipulative intention of transformational leadership, they are less likely to identify with the organization, which ultimately limits their willingness to demonstrate contextual performance activities. The implications of these findings for theory as well as managerial practice are discussed. (shrink)

What is feminist philosophy? A difficult question for feminist scholars in China. Women's studies in the Chinese mainland are characteristically policy‐oriented, geared to practical concerns and moral urgency. Empirical research projects engage many pressing social issues related to the changing situation of women in a rapid marketification of society and commercialization of culture since the post‐1978 reform movement. Here are some examples: migrant female workers and their working conditions in the urban centers; the impact of rural industrialization on women in (...) the countryside: discrimination against women in employment as well as in other aspects of social life; marriage and sexual relations. What follows in this article however, represents an effort to identify and categorize trends in emerging feminist theories. The main questions that might be seen as in one way or another philosophical are located in the historical context of the transformation of Chinese socialism. As we have only very limited access to publications in Hong Kong and Taiwan, to avoid mispresentation we regret that we cannot discuss the feminist work developed in these areas. (shrink)

Is it possible that there are extended simples—material objects extended in space or spacetime that have no proper parts? The most commonly cited argument for this possibility is based on a version of the Humean principle: namely (and with some qualifications), any pattern of instantiation of a fundamental relation is possible. In this paper, we make the Humean argument fully explicit, and criticise it from three aspects—the Disjunction problem, the Pluralist problem, and the Accidentality problem. First, the original argument only (...) shows a disjunctive thesis: either extended simples are possible, or unextended complexes are possible. In order to reach the desired conclusion, some additional premise is needed. Yet, even though we agree that the Disjunction problem can be met, we argue that the Humean argument fails to establish the possibility of extended simples, for two reasons: the first comes from compositional pluralism, and the second is about the definition of accidental properties. We contend that the latter two problems put the proponents of the Humean argument in serious difficulty. Thus, metaphysicians who hold that there are extended simples should find better arguments for this view. (shrink)

This paper provides an explanation for Gadamer’s inconsistent ideas of the symbol in his works, arguing that his concept of the symbol has evolved from a less-authentic experience to an authentic experience. In Truth and Method, the symbol is defined as having an instituted meaning and substitution function, and is devalued as a pure appearance of the real, which is less authentic than the artistic presentation that occasions the coming-into-existence events of the real. Later, in “The Relevance of the Beautiful”, (...) Gadamer elevates the symbol to the same status as the work of art, and uses it to defend the work of art’s inexhaustibility and irreplaceability in communicating meanings and revealing truth. Gadamer’s changed concept of the symbol also serves to justify the universality of philosophical hermeneutics in addressing modern art-related issues, particularly those involving the speechlessness, definition, and technological reproductions of art. (shrink)

To support older users’ accessibility and learning of the prevalent information and communication technologies, libraries, as informal learning institutes, are committed to information literacy education activities with friendly interfaces. Chatbots using Voice User Interfaces with natural and intuitive interactions have received growing research and practical attention; however, older users report regular frustrations and problems in using them. To serve as a basis for the subsequent design and development of an automated dialog mechanism in senior-friendly chatbots, a between-subject user experiment was (...) conducted with 30 older adults divided into three groups. The preliminary findings on their interactions with the voice chatbots designed with different error handling strategies were reported. Participants’ behavioral patterns, performances, and the tactics they employed in interacting with the three types of chatbots were analyzed. The results of the study showed that the use of multiple error handling strategies is beneficial for older users to achieve effectiveness and satisfaction in human-robot interactions, and facilitate their attitude toward information technology. This study contributes empirical evidence in the genuine and pragmatic field of gerontechnology and expands upon voice chatbots research by exploring conversation errors in human-robot interactions that could be of further application in designing educational and living gerontechnology. (shrink)

This dissertation is a study in Peirce's early metaphysics embedded in his writings between 1859 and 1867, which have received scant attention. Its purpose is to unravel his concept of reality and some relevant epistemological notions. Peirce's early metaphysical speculations can be divided into two parts. One is a system which covers thought between 1859 and 1862. The other manifests in lectures and writings between 1863 and 1867. The present study, consisting of five chapters, includes both of them. ;Murray G. (...) Murphey is one of the very few scholars who have attempted to take Peirce's early theories of knowledge and reality seriously. Thus the first chapter delineates his general interpretation of Peirce's first system, as a base for further discussions in the next two chapters. The second chapter clarifies Peirce's notion of metaphysics and then criticizes Murphey's understanding of Peirce's view of metaphysics. Similarly, the task of the third chapter is twofold: on the one hand, focusing on the epistemological and metaphysical issues, it provides an exposition of Peirce's system in detail and shows that some of his philosophical doctrines can be traced back to that system; on the other hand, it critically examines Murphey's interpretations of Peirce's texts and demonstrates that they involve misunderstandings or are one-sided. The fourth chapter scrutinizes Peirce's early writings on logic, which is regarded as a branch of semiotic and the foundation of metaphysics. It first elucidates Peirce's unpsychological view of logic as well as his notion of symbol and then discloses his theory of individual and diachronic view of knowledge therein embedded. Furthermore, Peirce's thesis that the function of a proposition is to reduce the impression to unity is investigated. Finally, it sums up the epistemological and metaphysical significance of Peirce's logical theory above expounded and, especially, specifies the fundamental tenets of Peirce's concept of reality implicitly involved in his early semeiotical approach to logic. The last chapter is simply a brief conclusion, roughly adumbrating Peirce's later doctrine of reality and how, in many aspects, it is foreshadowed by his early thought. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

Career sustainability is a well-researched issue in academics and other sectors. Technology advancements and COVID-19 have jeopardized career sustainability. Numerous studies have explored the influence of individual characteristics on career sustainability, but few have focused on leadership. In addition, cultural factors must be considered because leadership is rooted in culture. In particular, inclusive leadership reflects traditional Chinese culture. Therefore, based on self-determination social exchange theories, we analyzed the effects of inclusive leadership on career sustainability as well as the roles of (...) thriving at work and supervisor developmental feedback in career sustainability. In total, 363 samples were collected from China. The results revealed that inclusive leadership improves career sustainability through SDF and thriving at work. Theoretically, our study fills the research gap and establishes a mechanism and theoretical framework for inclusive leadership and career sustainability. Practically, we offer guidance for enterprises to cultivate inclusive leadership and improve career sustainability. (shrink)

Background The Patient Right to Autonomy Act (PRAA), implemented in Taiwan in 2019, enables the creation of advance decisions (AD) through advance care planning (ACP). This legal framework allows for the withholding and withdrawal of life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) in situations like irreversible coma, vegetative state, severe dementia, or unbearable pain. This study aims to investigate preferences for LST or ANH across various clinical conditions, variations in participant preferences, and factors influencing these preferences among urban (...) residents. Methods Employing a survey of legally structured AD documents and convenience sampling for data collection, individuals were enlisted from Taipei City Hospital, serving as the primary trial and demonstration facility for ACP in Taiwan since the commencement of the PRAA in its inaugural year. The study examined ADs and ACP consultation records, documenting gender, age, welfare entitlement, disease conditions, family caregiving experience, location of ACP consultation, participation of second-degree relatives, and the intention to participate in ACP. Results Data from 2337 participants were extracted from electronic records. There was high consistency in the willingness to refuse LST and ANH, with significant differences noted between terminal diseases and extremely severe dementia. Additionally, ANH was widely accepted as a time-limited treatment, and there was a prevalent trend of authorizing a health care agent (HCA) to make decisions on behalf of participants. Gender differences were observed, with females more inclined to decline LST and ANH, while males tended towards accepting full or time-limited treatment. Age also played a role, with younger participants more open to treatment and authorizing HCA, and older participants more prone to refusal. Conclusion Diverse preferences in LST and ANH were shaped by the public’s current understanding of different clinical states, gender, age, and cultural factors. Our study reveals nuanced end-of-life preferences, evolving ADs, and socio-demographic influences. Further research could explore evolving preferences over time and healthcare professionals’ perspectives on LST and ANH decisions for neurological patients.. (shrink)

Interest in corporate citizenship has been burgeoning in the academic and managerial realms for decades. While a psychological CC climate has been conceptualized and has received empirical support for its relationship with employee outcomes, the organizational climate perspective of CC has not yet been explored. In the present study, we develop and examine a mediated moderation model that elaborates the underlying psychological process and the contingency of organizational CC climate and its individual outcomes. We follow 539 employees in 26 firms (...) for approximately one year in Taiwan. We find that organizational CC climate is positively related to employees’ organizational identification and that the firm’s high-commitment work system can augment the effect of CC on employees’ OI. In addition, employees’ OI plays a psychological process role in mediating the interactive effect of the firm’s CC and HCWS on employees’ workplace outcomes, including their job satisfaction and turnover intention. The findings shed light on the alignment of CC and human resource functions and argue that the Confucian Asian context may act as a stepping stone for the impact of CC on employees’ attitudes. The study offers valuable implications for both researchers and practitioners. (shrink)

Body ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a (...) rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

This study examines the influence of three components of corporate social responsibility on team performance. In the proposed model of this study, team performance is indirectly affected by three dimensions of perceived corporate citizenship (i.e., economic, legal, and ethical citizenship) via the mediation of team efficacy and team self-esteem. Surveying members of 172 teams confirms most of our hypothesized effects. Our results show that economic citizenship influences team performance via the mediation of both team efficacy and team self-esteem. However, legal (...) citizenship influences team performance via team efficacy alone, whereas ethical citizenship influences team performance only via team self-esteem. We discuss the theoretical and managerial implications of our findings. (shrink)

Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients’ true wishes, meaningfully engaging patients’ significant others, balancing interests among patients and significant others, and determining clinicians’ obligations to change patients’ unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients’ competence (apart from (...) decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman’s procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman’s account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician–patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care. (shrink)

There has been no consensus on the neural dissociation between emotion-label and emotion-laden words, which remains one of the major concerns in affective neurolinguistics. The current study adopted dot-probe tasks to investigate the valence effect on attentional bias toward Chinese emotion-label and emotion-laden words. Behavioral data showed that emotional word type and valence interacted in attentional bias scores with an attentional bias toward positive emotion-laden words rather than positive emotion-label words and that this bias was derived from the disengagement difficulty (...) in positive emotion-laden words. In addition, an attentional bias toward negative emotion-label words relative to positive emotion-label words was observed. The event-related potential data demonstrated an interaction between emotional word type, valence, and hemisphere. A significant hemisphere effect was observed during the processing of positive emotion-laden word pairs rather than positive emotion-label, negative emotion-label, and negative emotion-laden word pairs, with positive emotion-laden word pairs eliciting an enhanced P1 in the right hemisphere as compared to the left hemisphere. Our results found a dynamic attentional bias toward positive emotion-laden words; individuals allocated more attention to positive emotion-laden words in the early processing stage and had difficulty disengaging attention from them in the late processing stage. (shrink)

PurposeOlder adults aged 60 years and above are classified as being of high-risk for infection during the COVID-19 pandemic. This study aimed to investigate the associations of psychological factors of preventive behaviors with three preventive behaviors among Chinese older adults during the COVID-19 pandemic.MethodsA cross-sectional questionnaire survey was administered via SOJUMP, a widely used online survey platform in China. A total of 928 older adults were recruited using a snowball sampling approach from Hubei Province and outside Hubei Province in China (...) during May 18, 2020 to June 7, 2020. Multiple hierarchical regressions were conducted with four models to examine the association between demographic, past behavior, psychological factors and each preventive behavior.Principal FindingsAll three preventive behaviors in older adults increased dramatically during the pandemic of COVID-19. Gender, living status, educational level, past behavior, health knowledge, intention and planning significantly predicted hand washing behavior, R2 = 0.395, F = 54.372, p < 0.001. Gender, education level, important others infection, past behavior, health knowledge, planning and action control significantly predicted mask wearing behavior, R2 = 0.202, F = 23.197, p < 0.001. Living place, past behavior and health knowledge significantly predicted social distancing behavior, R2 = 0.204, F = 26.201, p < 0.001.Major ConclusionsPast behavior and health knowledge predicted all three preventive behaviors. Planning was an important psychological factor for both hand washing and mask wearing behaviors. All those critical demographic and psychological factors are critical for future interventions to facilitate older adults to comply with three preventive behaviors in daily life and to stay healthy during the COVID-19 pandemic. (shrink)