BackgroundBreast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.MethodsA cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at (...) least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received and did not receive CHM treatment were enrolled. The incidence rate and hazard ratio citation for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.ResultsDuring the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation], and the adjusted HR remained significant at 0.74 in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.ConclusionFinding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials. (shrink)

A major problem posed by cases of self-deception concerns the inconsistent behavior of the self-deceived subject (SDS). How can this be accounted for, in terms of propositional attitudes and other mental states? In this paper, we argue that key problems with two recent putative solutions, due to Mele and Archer, are avoided by “the shifting view” that has been advanced elsewhere in order to explain cases where professed beliefs conflict with actions. We show that self-deceived agents may possess highly unstable (...) degrees of belief concerning the matters about which they are self-deceived. (shrink)

Tamar in Genesis 38.6–30 has conventionally been interpreted as either a righteous woman who restored the discontinuity of the line of Judah or a wicked woman who employed wit and cunningness to achieve her desired ends. This paper tries to reinterpret Tamar’s act by taking account of imagination, and the women’s perspective and experiences.

Huang's book analyzes the major Neo-Confucian philosophers from the eleventh to the sixteenth centuries. Focusing on metaphysical, epistemological, and ethical philosophical issues, this study presents the historical development of the Neo-Confucian school, an outgrowth of ancient Confucianism, and characterizes its thought, background, and influence. Key concepts—for example ^Utai-ji (supreme ultimate), ^Uxin (mind), and ^Uren (humanity)—as interpreted by each thinker are discussed in detail. Also examined are the two major schools that developed during this period, Cheng-Zhu, School of Principle, and (...) Lu-Wang, School of Mind. These schools, despite different philosophical orientations, were convinced that their common goal, to bring about a harmonious relationships between man and the universe and between man and man, could be achieved through different ways of philosophizing. To understand the Chinese mind, it is necessary to understand Neo-Confucianism as a reformation of early Confucianism. This analytical presentation of major Neo-Confucian philosophers, from the eleventh to the sixteenth centuries, examines Zhou Dun-yi (1017-1073), Shao Yong (1011-1077), Zhang Zai (1020-1077), Cheng Hao (1032-1085), Cheng Yi (1033-1107), Zhu Xi (1130-1200), Lu Xiang-shan (1139-1193), and Wang Yang-ming (1427-1529). With its focus on metaphysical, epistemological, and ethical philosophical issues, Huang's study presents the historical development of the Neo-Confucian school, an outgrowth of ancient Confucianism, and characterizes its thought, background, and influence. Key concepts—for example, ^Utai-ji (supreme ultimate), ^Uxin (mind), and ^Uren (humanity)—as interpreted by each thinker are discussed in detail. The two major schools that developed during these six centuries are examined as well. Lu-Wang, School of Mind, developed in criticism of Cheng-Zhu, School of Principle. The two schools, despite different approaches toward their philosophical pursuits, were convinced that their common goals, to bring about harmonious relationships between man and the universe and between man and man, could be achieved through different ways of philosophizing. To understand the Chinese mind, it is necessary to understand Neo-Confucianism as a reformation of early Confucianism. Scholars of Eastern religions and philosophy will appreciate the objective interpretations of each thinker's philosophy, for which pertinent passages spoken by each man have been selected and translated by the author from the original Chinese, and the comparisons of the Neo-Confucian philosophies with those of the West. An introduction provides the historical background in which to study the rise of Neo-Confucianism. The study is organized ehronologically and includes a glossary of terms and a bibliography which serves as a helpful guide for further research. (shrink)

The Humility Thesis is a persistent thesis in contemporary metaphysics. It is known by a variety of names, including, but not limited to, Humility, Intrinsic Humility, Kantian Humility, Kantian Physicalism, Intrinsic Ignorance, Categorical Ignorance, Irremediable Ignorance, and Noumenalism. According to the thesis, we human beings, and any knowers that share our general ways of knowing, are irremediably ignorant of a certain class of properties that are intrinsic to material entities … Continue reading Humility Regarding Intrinsic Properties →.

Russellian monism – an influential doctrine proposed by Russell (1927/1992) – is roughly the view that the natural sciences can only ever tell us about the causal, dispositional, and structural properties of physical entities and not about their categorical properties, and, moreover, that our qualia are constituted by categorical properties. Recently, Stoljar (2001a, 2001b), Strawson (2008), Montero (2010, 2015), Alter and Nagasawa (2012), and Chalmers (2015) have attempted to develop this doctrine into a version of physicalism. Russellian monism faces the (...) so-called combination problem, according to which it is difficult to see how categorical properties could collectively constitute qualia. In this paper, I suggest that there is an insufficiently discussed aspect of the combination problem which I call the difference-maker problem. Taking the difference-maker problem into account, I argue that the combination problem – whether or not it can be solved – results in a dilemma for the project of developing Russellian physicalism. That is, Russellian monism is either physicalistically unacceptable or it is implausible; hence, Russellian monism and physicalism are incompatible. (shrink)

In this paper, we describe four broad ‘meta-methods’ employed in scientific and philosophical research of qualia. These are the theory-centred metamethod, the property-centred meta-method, the argument-centred meta-method, and the event-centred meta-method. Broadly speaking, the theory-centred meta-method is interested in the role of qualia as some theoretical entities picked out by our folk psychological theories; the property-centred meta-method is interested in some metaphysical properties of qualia that we immediately observe through introspection ; the argument-centred meta-method is interested in the role of (...) qualia in some arguments for non-physicalism; the event-centred metamethod is interested in the role of qualia as some natural events whose nature is hidden and must be uncovered empirically. We will argue that the event-centred metamethod is the most promising route to a comprehensive scientific conception of qualia because of the flexibility of ontological and methodological assumptions it can provide. We also reveal the hidden influences of the different meta-methods and in doing so show why consideration of meta-methods has value for the study of consciousness. (shrink)

Alexander Bird (2001; 2002; 2007) offers a powerful argument showing that, regardless of whether necessitarianism or contingentism about laws is true, salt necessarily dissolves in water. The argument is that the same laws of nature that are necessary for the constitution of salt necessitate the solubility of salt. This paper shows that Bird’s argument faces a serious objection if the possibility of emergentism – in particular, C. D. Broad’s account – is taken into account. The idea is (roughly) that some (...) emergent laws in some possible worlds may disrupt the solubility of salt without disrupting its constitution. (shrink)

For scholars, practitioners, and legislators concerned about sexual minority adolescents, one of the main goals is to create more positive and inclusive learning environments for this minority group. Numerous factors, such as repeated patterns of homophobic bullying by classmates and others in school, have been a significant barrier to achieving this goal. In addition, lesbian, gay, bisexual, transgender, and queer adolescents encounter substantial inequality across a broad spectrum of wellbeing and education consequences. Compared with their heterosexual counterparts, LGBTQ adolescents experience (...) more anxiety, depression, suicidal thoughts, antisocial behavior, poorer academic performance, less school attachment and protection, and a weaker desire to finish their studies. Such discrepancies based on gender and sexuality were linked to more maltreatment encountered by LGBTQ adolescents. It is crucial to recognize the backgrounds and expectations of LGBTQ adolescents to offer them the best resources. To overcome the inequality and obstacles faced by these LGBTQ adolescents, it is essential to examine tools and techniques that can be utilized. This study examined the literature that explains why society fails to provide enough support to LGBTQ students. Specifically, mechanisms explaining how LGBTQ adolescents interact with others in the learning environment and how such discrepancies arise will be examined. Following that, violence and prejudice, which are fundamental causes of psychological problems among LGBTQ adolescents, will be explored. This review paper thus provides supportive strategies for schools to develop more inclusive learning environments for LGBTQ adolescents. (shrink)

The disciplinary characterisation (DC) is the most popular approach to defining metaphysical naturalism and physicalism. It defines metaphysical naturalism with reference to scientific theories and defines physicalism with reference to physical theories, and suggests that every entity that exists is a posited entity of these theories. DC has been criticised for its inability to solve Hempel’s dilemma and a list of problems alike. In this paper, I propose and defend a novel version of DC that can be called a historical (...) paths approach. The idea is (roughly) that metaphysical naturalism can be defined with reference to the historical ideas that current scientific ideas descend from. I argue that it is not rendered implausible by the above problems, and hence that DC is more defensible and attractive than it may first appear. I then argue that the approach also provides a useful framework for the naturalisation of the philosophy of mind and phenomenology. (shrink)

Russellian monism—an influential doctrine proposed by Russell (The analysis of matter, Routledge, London, 1927/1992)—is roughly the view that physics can only ever tell us about the causal, dispositional, and structural properties of physical entities and not their categorical (or intrinsic) properties, whereas our qualia are constituted by those categorical properties. In this paper, I will discuss the relation between Russellian monism and a seminal paradox facing epiphenomenalism, the paradox of phenomenal judgment: if epiphenomenalism is true—qualia are causally inefficacious—then any judgment (...) concerning qualia, including epiphenomenalism itself, cannot be caused by qualia. For many writers, including Hawthorne (Philos Perspect 15:361–378, 2001), Smart (J Conscious Stud 11(2):41–50, 2004), and Braddon-Mitchell and Jackson (The philosophy of mind and cognition, Blackwell, Malden, 2007), Russellian monism faces the same paradox as epiphenomenalism does. I will assess Chalmers’s (The conscious mind: in search of a fundamental theory. Oxford University Press, New York, 1996) and Seager’s (in: Beckermann A, McLaughlin BP (eds) The Oxford handbook of philosophy of mind. Oxford University Press, New York, 2009) defences of Russellian monism against the paradox, and will put forward a novel argument against those defences. (shrink)

ABSTRACT Lewtas [2017] recently articulated an argument claiming that emergent conscious causal powers are impossible. In developing his argument, Lewtas makes several assumptions about emergence, phenomenal consciousness, categorical properties, and causation. We argue that there are plausible alternatives to these assumptions. Thus, the proponent of emergent conscious causal powers can escape Lewtas’s challenge.

Purpose This study aims to develop an interdisciplinary political theory of data justice by connecting three major political theories of the public good with empirical studies about the functions of big data and offering normative principles for restricting and guiding the state’s data practices from a public good perspective. Design/methodology/approach Drawing on three major political theories of the public good – the market failure approach, the basic rights approach and the democratic approach – and critical data studies, this study synthesizes (...) existing studies on the promises and perils of big data for public good purposes. The outcome is a conceptual paper that maps philosophical discussions about the conditions under which the state has a legitimate right to collect and use big data for public goods purposes. Findings This study argues that market failure, basic rights protection and deepening democracy can be normative grounds for justifying the state’s right to data collection and utilization, from the perspective of political theories of the public good. The state’s data practices, however, should be guided by three political principles, namely, the principle of transparency and accountability; the principle of fairness; and the principle of democratic legitimacy. The paper draws on empirical studies and practical examples to explicate these principles. Originality/value Bringing together normative political theory and critical data studies, this study contributes to a more philosophically rigorous understanding of how and why big data should be used for public good purposes while discussing the normative boundaries of such data practices. (shrink)

Monism is our name for a range of views according to which the connection between dispositions and their categorical bases is intimate and necessary, or on which there are no categorical bases at all. In contrast, Dualist views hold that the connection between dispositions and their categorical bases is distant and contingent. This paper is a defence of Monism against an influential conceivability argument in favour of Dualism. The argument suggests that the apparent possibility of causal behaviour coming apart from (...) categorical bases is best explained by Dualism. We argue that Monism can explain the apparent possibility as well, if we take metaphysically alien laws — namely, laws whose metaphysical nature is alien to the actual world — into account. (shrink)

Macau, as a society, is a crossroads where East–West encounters have been taking place for centuries. This paper examines some of the contemporary issues and implications for moral education. After a brief introduction to the social background of Macau, the paper describes the characteristics of Macau's education in general and the development of its moral education in particular. This has taken place in the context of the strong influences on morality of both Catholicism and Confucianism. An outline of the current (...) curriculum of moral and civic education is followed by a critical appraisal of its implementation over the last few years. By means of this case study of Macau, the paper argues that a communitarian‐oriented morality in Macau is justified, and it also suggests how, by turning attention to its history, a minimal set of values can be constructed for Macau's particular social setting. Finally, some further educational challenges for Macau's future moral and civic education are reviewed. (shrink)

Technological products such as computer, communication, and consumer electronic products, apps, smart wearables, and streaming services have become inseparable from people’s lives. In technological fields of practice, imagination, creativity, innovation, and entrepreneurship may influence one another. A vivid imagination can generate creativity and trigger the entrepreneurial intention to “bring new things to the market.” This study aims to understand the formation of internet entrepreneurial intention to use technology products. Drawing on social cognitive theory, this study explores and empirically tests how (...) technology product imagination disposition and social support impact internet entrepreneurial intention to use technology products. Drawing from self-determination theory, this study proposes and examines the mediating role of intrinsic and extrinsic motivation in the relationship between technology product imagination disposition and internet entrepreneurial intention, as well as the relationship between social support and internet entrepreneurial intention. We conducted a survey of 568 adults in Taiwan and used partial least squares to test our hypotheses. The results show the following: Technology product imagination disposition is positively associated with challenge, enjoyment, compensation, and outward motivation. Social support is positively associated with challenge, enjoyment, compensation, and outward motivation. Challenge, enjoyment, and outward motivation are positively associated with internet entrepreneurial intention to use technology products. Technology product imagination disposition intensifies internet entrepreneurial intention to use technology products by strengthening challenge, enjoyment, and outward motivation. Social support intensifies internet entrepreneurial intention by increasing challenge, enjoyment, and outward motivation. The partial mediation model represents a significant improvement in the total effect over the direct effect. We discuss the implications of these results for research and internet entrepreneurship practices. (shrink)

Drawing upon conservation of resources theory, we develop and test a theoretical model that specifies how and when employee humor toward leaders affects leader abusive supervision. We propose that employee humor is negatively associated with leader abusive supervision via leader relational energy. Furthermore, the negative indirect relationship between employee humor and leader abusive supervision via leader relational energy is stronger for female leaders than for male leaders. An experiment and a multi-wave, multi-source field study provide substantial support for our hypotheses. (...) Our findings contribute to the abusive supervision literature by identifying employee humor as a safe and effective bottom-up approach to prevent leader abusive supervision. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

Drug abuse has been and continues to be, a common social issue worldwide, yet the efficiency of widely adopted sweeping speech for anti-drug campaigns has proven inefficient. To provide students with a safe and efficient learning situation related to drug refusal skills, we used a novel approach rooted in a serious learning game and concept map during a brief extracurricular period to help students understand drugs and their negative effects. The proposed game-based situational learning system allowed all students to participate (...) simultaneously and individually in multiple scenarios of drug temptation posed by peers and classmates to practice responding and refusing drugs in school and community settings. Moreover, to explore whether different personality traits result in different anti-drug responses, we used a serious game to conduct an anti-drug experiment on 53 junior middle school students aged 13–15. Each participant’s decision-making process was recorded in the serious game as behavioral patterns for lag sequential analysis. The outcomes revealed seven behavioral patterns including differentiation, acceptance, effective and ineffective responses, effective and ineffective solution-seeking, and failure to refuse. The GSEQ which is a computer program for analyzing sequential observational data was used. The results indicated the following: Neuroticism was performed at a relatively low level under the guidance of a concept map. “Neuroticism” was associated with the lowest risk of accepting drugs. Students with “openness to experiences” were at high risk of accepting drugs. Almost all personality behavioral transition diagrams showed that failure to refuse drugs was followed by inefficient seeking of help and inefficient refusal. These findings provide reference points for designing adaptive anti-drug education programs. (shrink)

This article examines the way in which the British press reported on typhoons that affected Hong Kong during the nineteenth and early twentieth centuries. Typhoons were a significant element in the narration of the British Empire, featuring frequently in British accounts of their involvements in the Far East, where Hong Kong was its only colony. I suggest that these accounts need to be considered alongside the consolidation of the ‘tropics’ as a region in British perceptions, and in doing so, this (...) article opens discussions of the study of tropicality to the consideration not just of climate, but also of the significance of singular weather events. This article argues that the cultural representations of typhoons in the British press were a tool of ‘othering’. In particular, there were two significant shifts around the 1880s in these reports. First, the term ‘typhoon’ became tied to these types of storms that affected Hong Kong. Second, the stories that were told about typhoon events emphasized British heroism and colonial management. Both these shifts in reporting stripped away the weather wisdom that British sailors had earlier identified in the local population. (shrink)

We study the synchronization of complex networks by using event-sampling information. The nodes of the network are connected with event-triggered communication via multiple couplings. The couplings are split into several channels. Not all the channels are connected. Only a part of the states of each node can be communicated by the channels. An event detector is designed for each channel to independently determine the sampling moments. The couplings of the network are partial and event-triggered. Both features make that less information (...) can be used for synchronization. The pinning controllers are also designed based on the sampled information. By establishing a time-dependent Lyapunov functional and utilizing an efficient event condition, we derive less conservative criteria for the synchronization of complex networks. Finally, the effectiveness of our main results is verified by an illustrative example, and comparisons are also presented to show how much conservatism can be reduced. (shrink)

This article discusses the arguments of chang tsai (1020-1077) against buddhism on the one hand and for reassertion of the confucian ethics on the other, With quotations translated from the chinese texts relevant to the following points: i) chang's criticism of buddhism, Ii) "the western inscription" or hsi ming, Iii) the dual concept of nature or hsing, Iv) man by nature a moral being, V) the problem of evil, Vi) the problem of moral knowledge, And vii) the religious significance of (...) li or rituals. (shrink)

Because of the importance of Confucian doctrines in shaping ethical business practices under Chinese leadership, revealing the roles of other Chinese ethical doctrines in modern Chinese leadership is informative. A thorough understanding of the ethical foundations of Chinese leadership is necessary for fruitful interaction with Chinese leaders, according to cultural fit theory. The present study illustrates the philosophical foundations of business management, based on dialogues with five eminent corporate executive officers (CEOs). It reveals that the CEOs practice a style of (...) Chinese leadership synthesizing Confucian, Daoist, Mohist, and Legalist doctrines. The Confucian doctrines advocate benevolence, harmony, learning, loyalty, righteousness, and humility. They are the most prevalent tenets that support paternalism and collectivism. The Daoist doctrines emphasize flexibility and reversion (e.g., the principle that the weak can defeat the strong). They bolster the leader’s forbearance. The Mohist doctrines underpin thrift and working with the masses whereas the Legalist doctrines inculcate self-control and innovativeness. Hence, contemporary Chinese leadership does not rely exclusively on Confucian ethics and this reflects evolution over 1000s of years. (shrink)

Because of the importance of Confucian doctrines in shaping ethical business practices under Chinese leadership, revealing the roles of other Chinese ethical doctrines in modern Chinese leadership is informative. A thorough understanding of the ethical foundations of Chinese leadership is necessary for fruitful interaction with Chinese leaders, according to cultural fit theory. The present study illustrates the philosophical foundations of business management, based on dialogues with five eminent corporate executive officers. It reveals that the CEOs practice a style of Chinese (...) leadership synthesizing Confucian, Daoist, Mohist, and Legalist doctrines. The Confucian doctrines advocate benevolence, harmony, learning, loyalty, righteousness, and humility. They are the most prevalent tenets that support paternalism and collectivism. The Daoist doctrines emphasize flexibility and reversion. They bolster the leader's forbearance. The Mohist doctrines underpin thrift and working with the masses whereas the Legalist doctrines inculcate self-control and innovativeness. Hence, contemporary Chinese leadership does not rely exclusively on Confucian ethics and this reflects evolution over 1000s of years. (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)

A large body of research links testosterone and cortisol to male-male competition. Yet, little work has explored acute steroid hormone responses to coalitional, physical competition during middle childhood. Here, we investigate testosterone, dehydroepiandrosterone, androstenedione, and cortisol release among ethnically Chinese boys in Hong Kong, aged 8–11 years, during a soccer match and an intrasquad soccer scrimmage, with 63 participants competing in both treatments. The soccer match and intrasquad soccer scrimmage represented out-group and in-group treatments, respectively. Results revealed that testosterone showed (...) no measurable change. DHEA increased during both treatments in the majority of participants and the degree of change had no relation to independent variables or covariate measures. Most boys experienced androstenedione increases during match play, but no significant differences during the intrasquad soccer scrimmage competitions. The magnitude of change differed significantly between treatments and was positively associated with age. These latter findings suggest boys’ androstenedione responses may be sensitive to competitor type. For most subjects, cortisol significantly increased during match play, decreased during the intrasquad soccer scrimmage, and differed significantly between treatments, suggesting each treatment promoted a different psychological state among competitors. Cortisol/DHEA molar ratio decreased during the intrasquad scrimmage, suggestive of a more relaxed mental state. These data shed new light on potential proximate mechanisms associated with coalitional competition among prepubescent boys, with relevance to adrenarche and life history theory. (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)

Background Adherence to ethical guidelines and regulations and protecting and respecting the dignity and autonomy of participants by obtaining a valid informed consent form (ICF) prior to participation in research are crucial; The subjects did not add signatures next to the corrections made to signatures or dates on the ICF, Multiple signatures in other fields, ICF missing/missing signature, Incorrect ICF version Signed after modification, Correction tape used to correct signature, Impersonated signature, Non-research-member signature, however, ICFs are often not properly completed, (...) which must be addressed. This study analyzed ICF signing errors and implemented measures to reduce or prevent these errors. Methods We used the plan–do–check–act (PDCA) cycle to help improve the correctness and validity of ICF signing. Results Interim and final reports from January 2016 to February 2020 including 363 ICFs were studied. The total proportion of correct ICF signatures (200, 83.3%) following the PDCA intervention was significantly higher than that before the intervention (P < 0.05). Analysis of the types of signing error demonstrated that signature errors were significantly reduced after the intervention, particularly for subjects did not add signatures next to the corrections made to signatures or dates on the ICF (16, 6.7%) and impersonated signature (0; P < 0.05). Conclusions The proportions of other error types—multiple signatures in other fields, missing or unsigned ICF, incorrect signature order, incorrect ICF version, use of correction tape to correct signature, and non-medical profession members signing the ICF—did not differ significantly. (shrink)