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)

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)

The meshed control theory assumes that cognitive control and automatic processes work together in the natural attention of experts for superior performance. However, the methods adopted by previous studies limit their capacity to provide in-depth information on the neuromotor processes. This experiment tested the theory with an alternative approach. Twelve skilled golfers were recruited to perform a putting task under three conditions: (1) normal condition, with no focus instruction (NC), (2) external focus of attention condition (EC), and (3) internal focus (...) of attention condition (IC). Four blocks of 10 putts each were performed under each condition. The putting success rate and accuracy were measured and electroencephalographies (EEGs) were recorded. The behavioral results showed that the NC produced a higher putting success rate and accuracy than the EC and IC. The EEG data showed that the skilled golfers’ attentional processes in the NC initially resembled those in the EC and then moved toward those in the IC just before putting. This indicates a switch from more automatic processes to cognitive control processes while preparing to putt. The findings offer support for the meshed control theory and indicate the dynamic nature of neuromotor processes for the superior performance of athletes in challenging situations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Understanding Confucian Philosophy: Classical and Sung-MingChenyang LiUnderstanding Confucian Philosophy: Classical and Sung-Ming. By Shu-hsien Liu. Westport and London: Praeger, 1998. Pp. xii + 273.Understanding Confucian Philosophy: Classical and Sung-Ming, by Shu-hsien Liu, a leading contemporary Neo-Confucian scholar, aims to present the Confucian tradition [End Page 312] from a contemporary Neo-Confucian perspective and purports to provide some background clues to what has led to the Third (...) Epoch of Confucianism, that is, the emergence of the contemporary Neo-Confucian movement.As its title suggests, the book is divided into two parts. Part 1 deals with Classical Confucianism, and part 2 is a study of Sung-Ming Confucian philosophy. The Classical period begins with an informative chapter on the historical background to the emergence of Confucian philosophy, which is particularly useful if the book is to be used as a university-level text. The historical chapter is followed by chapters on Confucius (Kong Zi), Mencius (Meng Zi), The Great Learning and The Doctrine of the Mean, and the Book of Changes. Part 1 ends with a chapter on the transformation of Confucianism since the Han dynasty. Compared with similar books on Confucian philosophy, the chapter on Confucius appears sketchy, but its treatment of Confucius' central concept, jen (ren), is first-rate, clear, and insightful. The chapter on Mencius is more elaborate. It surveys virtually every key concept of Mencius' philosophy. As with similar works by Chinese scholars, the sheer number of quotations in this chapter may appear excessive to Western readers. Hsün Tzu (Xun Zi), another key classical Confucian philosopher, is only mentioned in passing, although this is not surprising in a book written from a Neo-Confucian perspective; in the Neo Confucian tradition Hsün Tzu is considered unorthodox.The chapter on the Book of Changes is a breath of fresh air in that it has adopted a developmental point of view. The author argues that there are four layers of meaning in the work: it offers a system of mystical symbolism, a system of rational/natural symbolism, a system of cosmological symbolism, and finally a system of ethics/metaphysical symbolism. Professor Liu says of the four systems, "each one succeed[s] the other and yet interpenetrate[s] the other" (p. 74). Overall, Classical Confucianism is analyzed according to three inseparable aspects—spiritual, political, and popular—which define the heritage as well as the burden of this tradition.At first I was a bit surprised to see that the chapter on "The Characteristics and Contemporary Significance of Sung-Ming Neo-Confucian Philosophy" is at the beginning, not at the end, of part 2 on Sung-Ming Neo-Confucian philosophy. But it turns out that this chapter contains a brief survey of some major Neo-Confucian philosophers of the period and serves well as an introduction to part 2. Recognizing Chu Hsi's (Zhu Xi) contribution to the movement of the Second Epoch, Liu spends two chapters out of six on this great Sung philosopher. The chapter on Wang Yang-ming aims "to destroy the myth once and for all that there is no discrepancy between Lu [Hsiang-shan] and Wang and that there is not a close relationship between Wang and Chu [Hsi]" (p. 198). This goes against a widespread (mis)conception that Wang and Chu represent two distinct lines of Neo-Confucianism.Part 2 ends with a chapter on Huang Tsung-hsi (Huang Zongxi), arguably the most liberal of all Sung-Ming Neo-Confucian philosophers. Liu regards Huang as the culmination of an unfinished Sung-Ming Neo-Confucian philosophical tradition, from which the contemporary Neo-Confucian movement should take up the cause. Altogether, part 2 is not as systematic in introducing Sung-Ming Neo-Confucian philosophy as is part 1 on Classical Confucianism. [End Page 313]As a synthesis of various articles previously published by the author over a twenty-five-year period, the book bears both the strengths and the weaknesses of works of this kind: there are in-depth studies focused on specific topics of particular interest in the Neo-Confucian movement, but there is occasionally a lack of smooth transition from one chapter to another or... (shrink)

The term 'Taoism of Clarified Tenuity' designates a new branch of religious Taoism developed since the 13/14th century by priests of the long-established Heavenly Masters Taoism. They claimed to continue Taoist exorcist traditions that since the Sung-period especially flourished because emperor Sung Hui-tsung (r. 1100?1126) appreciated the exorcism of 'Taoism of the Divine Empyrean' and 'Five Thunders rituals'. The purpose of the exorcist rituals was the expulsion of demoniac molestations, relief from droughts and inundations, and the healing (...) of illnesses. Outstanding priests rationalized the exorcist practice, using theories of a meditative self-cultivation which peaked in the transformation into a Thunder divinity. The priest adopted a divine 'alter ego' for the time of the ritual. 'Taoism of Clarified Tenuity' developed on the basis of these traditions and embraced regionally different religious habits. It adopted and adapted older cults, partly including Buddhist-Tantric practices. Leading priests of 'Clarified Tenuity' presented theoretical essays, discussing the requirements of the personal cultivation of the Taoist to be a worthy performer of exorcism who was entitled to write and use amulets. The amulet was the essential ritual tool. However, the amulets of 'Clarified Tenuity' were remarkably different from the older 'Thunder' amulets of the Sung era. Also, the new branch adopted different attitudes concerning ritual practices such as the transformation into a divinity.0The book features developments of the more recent Taoist history and presents content and intention of 'Taoism of Clarified Tenuity'. The selected canonical texts also show that the priests of 'Clarified Tenuity' insisted on a clear distinction between exorcism in Heavenly Masters Taoism and shamanism that they disavowed. The book presents and analyses several 'Great Rituals' of 'Clarified Tenuity' and features elements of religious Taoism that today can still be traced. (shrink)

如果機器人的發展要能如科幻想像一般，在沒有人類監督下自動地工作，就必須確定機器人不會做出道德上錯誤的行為。 根據行為主義式的道德主體觀，若就外顯行為來看，機器人在道德上的表現跟人類一般，機器人就可被視為道德主體。從這很自然地引伸出機器人的道德擬人主義：凡適用於人類的道德規則就適用於機器人。我反對道德擬人主義 ，藉由史特勞森對於人際關係與反應態度的洞見，並以家長主義行為為例，我論述由於機器人缺乏人格性，無法參與人際關係，因此在關於家長主義行為上，機器人應該比人類受到更嚴格的限制。.

The articles assembled in this volume present an important selection of Professor Jao Tsung-i’s research in the fields of comparative mythology, early Chinese hemerology and the interrelation between divination, morals and ritual in early Chinese thought.

The American Journal of Bioethics, Volume 11, Issue 8, Page 58-59, August 2011.

This article reports on an inquiry that investigated the development of ba constructions in early childhood Mandarin. All cases of ba construction were extracted from the Early Childhood Mandarin Corpus collected from 168 preschoolers aged 2;6, 3;6, 4;6, and 5;6. Early Childhood Mandarin Corpus, University of Hong Kong. Data analysis indicated that: Mandarin-speaking children produced a repertoire of 11 types of ba construction, and the children in the youngest age group were able to produce six types of them; children at (...) 4 years old experienced a critical developmental period of pragmatic use, and at 5 years old they had attained cognitive and linguistic maturity in understanding the semantic and syntactic features of ba constructions; and there was a significant age effect on the production of three types of ba construction, but no significant association between the children’s gender and their production of ba constructions. These findings offer fresh insights into understanding Chinese children’s innate capacity to understand the co-occurrence constraints concerning the syntactic, semantic and verb features inherent in ba construction, and their developmental ability to denote telic events by resorting to the appropriate ba sentence patterns. (shrink)

We study whether changes in analyst recommendation ratings systems encouraged by the implementation of NASD 2711 in 2002 are associated with improved objectivity and independence in analyst recommendations. Using recommendations issued during windows surrounding major investment banking events, we show that reductions in analyst optimism following the reforms concentrate in the recommendations of analysts whose employer adopted a three-tier rating system at the time of the reforms, and that this effect is generally stronger for analysts whom the underlying incentives to (...) engage in unethical behaviour is greatest. We also find evidence that adoption of the three-tier system improved the market’s perception of the objectivity of analyst recommendations issued after SEOs, and that for hold and sell-type recommendations this effect was stronger for analysts subject to the greatest potential ethical conflicts. While we find some evidence of a general post-reform increase in the profitability of recommendations issued following equity transactions, this improvement was only conditioned by changes to the rating system in our IPO sample. (shrink)

Selim Berker argues that epistemic consequentialism is pervasive in epistemology and that epistemic consequentialism is structurally flawed. is incorrect, however. I distinguish between epistemic consequentialism and epistemic instrumentalism and argue that most putative consequentialists should be considered instrumentalists. I also identify the structural problem of epistemic consequentialism Berker attempts to pinpoint and show that epistemic instrumentalism does not have the consequentialist problem.

Modern education attaches great importance to interdisciplinary skills, among which computational thinking is a core element, and heralds a new era. IT application has shaped education in the 21st century. Computational thinking has provided further impetus for building an all-encompassing social network and fostering a DIY culture enabled by digital technologies. One empirical study used four apps to test children's development in computational thinking and fluency. The article will help students overcome their fears of coding. Peer reviews provide students with (...) an opportunity to learn from each other and become more motivated. These reviews also serve as feedback for teachers to evaluate students' performance. Experimental design is used in this study, and a peer review system is implemented. Freshmen attending a programming class in a university are used as samples. At the class, students write computer programs with f-Chart, which provides a graphical user interface for students to learn programming logic and design. Zuvio, a cloud-based interactive response system, is used to conduct the peer reviews. The data of this study are analyzed through R. The results show not only an improvement in students' learning performance but also a gap between students' peer review scores and teachers' evaluation scores. Learning feedback and evaluation is crucial to transform education between students and teachers into a sustainable cycle system. (shrink)

Do people with different views of what is fair attribute different intentions to actions? In a novel experimental design, participants were significantly more likely to attribute a no-redistribution vote to selfishness if they considered redistribution as being fair. I define this—attributing actions that do not adhere to one’s own fairness view to selfishness—as suspicious attribution. I develop a theory of intention attribution to show how suspicious attribution arises from two other findings from the experiment: the participants underestimate the number of (...) people with fairness views differing from their own and overestimate the selfishness of participants with other fairness views. I discuss how the findings can help explain political polarization. (shrink)

This paper investigates the representation of authors with different linguistic backgrounds in academic publishing. We first review some common rebuttals of concerns about linguistic injustice. We then analyze 1039 authors of philosophy journals, primarily selected from the 2015 Leiter Report. While our data show that Anglophones dominate the output of philosophy papers, this unequal distribution cannot be solely attributed to language capacities. We also discover that ethics journals have more Anglophone authors than logic journals and that most authors are affiliated (...) with English-speaking universities, suggesting other factors may also play significant roles. Moreover, some interesting results are revealed when we combine the factor of sex with place of affiliation and linguistic background. It indicates that while certain linguistic injustice is inevitable in academic publishing, it may be more complex than thought. We next introduce Broadbent’s :457–476, 2012, Philosophy of epidemiology, Palgrave Macmillan, New York, 2013, Stud Hist Philos Biol Biomed Sci 48:250–257, 2014) contrastive account of causation to give a causal explanation of our findings. Broadbent’s account not only well characterizes the multifaceted causality in academic publishing but also provides a methodological guideline for further investigation. (shrink)

This study analyses the types and frequencies of ethical dilemmas and the rationale of ethical decision making in student nurses; it also evaluates their decision making. One hundred senior student nurses who were enrolled in a two-credit course in nursing ethics were asked to provide an informal description of a dilemma that they had experienced during their clinical practice. The results were as follows. The ethical dilemmas identified fell into four categories and were of 27 types. Those most frequently experienced (...) were ‘family giving up on a patient because he or she could not be cured’, and ‘not telling the truth to the patient’. The Korean Nurses’ Code of Ethics was applied, in particular the preamble, and the third, fourth, seventh and tenth clauses. The most common rule of ethics and principle applied in these nurses’ ethical decision making were veracity and nonmaleficence. With regard to the moral reasoning process, the primary concern was the welfare of the patients. These students were equipped with the ability to exercise critical and reflective thought when they experienced ethical dilemmas. (shrink)

To explain why we should be structurally rational – or mentally coherent – is notoriously difficult. Some philosophers argue that the normativity of structural rationality can be explained in terms of substantive rationality, which is a matter of correct response to reason. I argue that the psychological phenomena – positive illusions – are counterexamples to the substantivist approach. Substantivists dismiss the relevance of positive illusions because they accept evidentialism that reason for belief must be evidence. I argue that their evidentialist (...) stance would imply that we are caught in unsolvable dilemmas arising from positive illusions. (shrink)

According to some philosophers, if moral agency is understood in behaviourist terms, robots could become moral agents that are as good as or even better than humans. Given the behaviourist conception, it is natural to think that there is no interesting moral difference between robots and humans in terms of moral agency (call it the _equivalence thesis_). However, such moral differences exist: based on Strawson’s account of participant reactive attitude and Scanlon’s relational account of blame, I argue that a distinct (...) kind of reason available to humans—call it _human-relative reason_—is not available to robots. The difference in moral reason entails that sometimes an action is morally permissible for humans, but not for robots. Therefore, when developing moral robots, we cannot consider only what humans can or cannot do. I use examples of paternalism to illustrate my argument. (shrink)

Regulators around the world are coming under pressure from patients, clinicians, and industry groups to streamline the market approval process for highly novel biomedical technologies, including stem cells and regenerative medicine products. The rationale for streamlining this process centers on the perceived failures of regulatory systems to encourage biomedical innovation and provide patients with timely access to potentially beneficial yet experimental therapies. Critics claim that the process of generating scientific evidence in phased clinical trials is too costly, time-consuming, and poorly (...) suited for stem cell–based products that, unlike bio-pharmaceuticals, are intended to engraft into the body for long... (shrink)