Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

While social interaction and play in a VR environment are becoming ever more popular, little is known about how social VR games affect users. The purpose of this study was to elucidate the role of several contingent factors in social VR games by modeling the relationships between involvement, well-being, depression, self-esteem, and social connectedness. A conditional process-moderated mediation model of the measured variables was analyzed with 220 pieces of collected data. The result showed that: the direct effect of involvement on (...) well-being was significant, and the index of moderated mediation involving depression, self-esteem, and social connectedness was significant. We conclude that high levels of involvement in social VR games by socially isolated users with low self-esteem can negatively affect their well-being. The findings of this study contribute in several ways to our understanding of the effect of social VR games upon users and provide important practical implications. (shrink)

This study investigates the effects of cultural orientation and the degree of disdain for robots on the preferred conversational styles in human-to-robot interactions. 203 participants self-reported on questionnaires through a computer-based online survey. The two requesting situations were intended to simulate the participants' interactions with humanoid social robots through an Internet video-phone medium of communication. Structural equation modeling was performed to examine the mediating role of mechanistic disdain between multicultural orientation and conversational constraints. The findings reveal that between the two (...) dimensions of multicultural orientation, only open-mindedness inversely influences mechanistic disdain. Mechanistic disdain, in turn, negatively affects three face-related conversational constraints, thereby leading to a lesser concern for robots' feelings, for minimizing impositions on robots, and for avoiding robots' negative evaluations. The implications of our findings on humans' relations with virtual robot entities and on the future development of humanoid robots are discussed. (shrink)

This study investigates the effects of cultural orientation and the degree of disdain for robots on the preferred conversational styles in human-to-robot interactions. 203 participants self-reported on questionnaires through a computer-based online survey. The two requesting situations were intended to simulate the participants’ interactions with humanoid social robots through an Internet video-phone medium of communication. Structural equation modeling was performed to examine the mediating role of mechanistic disdain between multicultural orientation and conversational constraints. The findings reveal that between the two (...) dimensions of multicultural orientation, only open-mindedness inversely influences mechanistic disdain. Mechanistic disdain, in turn, negatively affects three face-related conversational constraints, thereby leading to a lesser concern for robots’ feelings, for minimizing impositions on robots, and for avoiding robots’ negative evaluations. The implications of our findings on humans’ relations with virtual robot entities and on the future development of humanoid robots are discussed. (shrink)

If, today, ‘politics is in culture and culture is relentlessly political’ (Brown, 2002), if the domains of ‘the political’ and ‘the cultural’ can no longer be easily distinguished or kept separate, then contemporary political theory requires an understanding and analysis of cultural politics. This essay undertakes the first stages of such a project by trying to theorize ‘cultural politics’. I argue that ‘cultural politics’ proves to be an object of discourse — it indeed has a certain discursive existence — but (...) not an object of discipline, since no single field or discipline produces it as an object of knowledge. I read this disciplinary failure optimistically, arguing that the study of cultural politics requires a reorientation of theory. The sort of interdisciplinary and multiple-genre work needed to study cultural politics produces a conception of theory as fugitive. Fugitive theory must travel among disciplines, calling on a variety of theoretical and political resources to sustain itself; it refuses the very notion of ‘applied’ theory, insisting that theory ‘is already at work’ in politics (Butler, 1997). To link politics to culture is to practise fugitive theory. And the practice of fugitive theory therefore has the capacity to reveal and explore the workings of cultural politics. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Do liberals’ and conservatives’ brain processes differ in moral reasoning? This research explains these groups’ dissimilar moral stances when they face ethical transgressions in business. Research that explores the effects of ideological asymmetry on moral reasoning processes through moral foundations has been limited. We hypothesize two different moral reasoning processes and test them in the South Korean culture. Study 1 uses the neuroscientific method of event-related potentials to explore the dissociable neural mechanisms that underlie Korean liberals’ and conservatives’ moral reasoning (...) processes in business ethical transgressions. Liberals’ early frontal negative-going brain waves showed that they are quick to pass negative judgment by intuitively detecting violations of fairness, while conservatives’ temporoparietal positive-going brain waves showed that they have a higher motivation to respect authority. Both liberals’ and conservatives’ ERP components occur within the first second of the decision-making phase, suggesting the rapid and intuitive nature of moral reasoning processes. Study 2 tests a mediating process and confirms that Korean liberals exhibit the moral engagement strategy, through the fairness foundation. These findings from our interdisciplinary research deepen the knowledge of the complexity of human morality in business ethics research. (shrink)

ObjectiveThis pilot study aimed to evaluate the efficacy of a digital cognitive behavioral therapy in patients with cancer experiencing sleep problems.MethodsA total of 57 participants aged 25–65 years were randomly assigned to three groups—21 participants to a dCBT program, 20 participants to an app-based attentional control program, and 16 participants to a waitlist control group—and evaluated offline before and after the program completion. Of the 57 participants, there were a total of 45 study completers, 15 participants in each group. The (...) dependent variables were sleep quality scores, measured by the Pittsburgh Sleep Quality Index and health-related quality of life scores, measured using the Short-Form 36, and attentional bias scores from a dot-probe computer task.ResultsFor both the intention-to-treat and study-completers analyses, a significant increase supported by a large effect size was found in the quality of sleep score of the HARUToday Sleep group compared to both the app-based attentional control and the waitlist control group. However, no significant changes were found in the quality of life and attentional bias scores.ConclusionOur results suggest that the HARUToday Sleep app has the potential to serve as an intervention module to enhance the sleep quality of patients with cancer experiencing sleep problems. (shrink)

schaften vorkommenden Aussagen deskriptiv und empirisch nachprüfbar sind, besteht zwischen Realisten und Strukturalisten keine Meinungsdifferenz."33 Aber was die Theorie selbst betrifft, vertritt der Strukturalismus die instrumentalistische ...

Background: Infectious disease outbreaks such as COVID-19 and MERS pose a major threat to healthcare workers' physical and mental health. Studies exploring the positive changes gained from adapting to traumatic events, known as post-traumatic growth, have attracted much attention. However, it is unclear which factors or experiences lead to PTG among HCWs. The purpose of this mixed-method study was to investigate factors associated with PTG among HCWs who experienced the MERS outbreak in South Korea, and fully describe their experience of (...) developing PTG.Methods: Quantitative data from 78 participants were collected using psychometric tools for Psychological distress, Resilience, and Support for coping, and Post-traumatic growth. Qualitative interviews were conducted with seven nurses. Data were analyzed using the qualitative content analysis method according to the sub-themes of resilience, which was the main factor associated with PTG.Results: We found resilience to have a significant impact on PTG. Thus the qualitative interviews were analyzed using the core concepts of resilience. Qualitative interviews with nurses illustrated how participants experienced the development of resilience in terms of its sub-factors: hardiness, persistence, optimism, and support.Conclusion: HCWs who endured the MERS outbreak showed high levels of PTG, and the analysis of the interview data provided a fuller understanding on the experience of remaining resilient and developing PTG. These results provide practical and pragmatic information helpful for developing intervention strategies and protocols that can help HCWs transform adversity into growth and development. (shrink)

ABSTRACTDespite the wide and daunting array of cross‐cultural obstacles that the formulation of a global policy on advance directives will clearly pose, the need is equally evident. Specifically, the expansion of medical services driven by medical tourism, just to name one important example, makes this issue urgently relevant. While ensuring consistency across national borders, a global policy will have the additional and perhaps even more important effect of increasing the use of advance directives in clinical settings and enhancing their effectiveness (...) within each country, regardless of where that country's state of the law currently stands. One cross‐cultural issue that may represent a major obstacle in formulating, let alone applying, a global policy is whether patient autonomy as the underlying principle for the use of advance directives is a universal norm or a construct of western traditions that must be reconciled with alternative value systems that may place lesser significance on individual choice. A global policy, at a minimum, must emphasize respect for patient autonomy, provision of medical information, limits to the obligations for physicians, and portability. And though the development of a global policy will be no easy task, active engagement in close collaboration with the World Health Organization can make it possible. (shrink)

Tumor‐infiltrating lymphocyte (TIL) therapy is a promising approach for treating refractory or advanced solid cancers by using autologous TILs harvested from cancer tissues. Despite the heterogeneity of cancer, TIL therapy can potentially produce a positive therapeutic response, including complete remission.After decades of research on lymphocyte functions, culture/expansion methods, therapeutic protocols, and multiple clinical trials, TIL therapy has finally reached a stage where it can be formally approved for clinical use.TIL therapy is expected to hold a unique position among anti‐cancer therapeutic (...) options as a standard intervention. To successfully introduce TIL therapy into clinical settings, there is a need to expand therapeutic indications and set up the best protocols for cancer tissue sampling and manufacturing, and related clinical trials. Moreover, studies on next‐generation TIL therapy have already begun, and post‐approval real‐world data will promote and support further research. (shrink)

In the United States, targeted school shootings have become a distinct genre of violence. In this essay, Bryan Warnick, Sang Hyun Kim, and Shannon Robinson examine the social meanings that exist in American society that might contribute to this phenomenon, focusing on the question: “Why are schools conceptualized as appropriate places to enact this form of gun violence?” The authors analyze the social meaning of American schooling by using empirical data, everyday observations, films, and poetry, and then connect these (...) points of meaning to stories of individual school shooters. Through this analysis, three aspects of school stand out. First, schools are places of both real and symbolic violence, where force and power often rule the day. Second, schools are places connected to expectations of hope and refuge, friendship and romance, and when these expectations are not met, bitter resentment flows against schools. Third, suburban schools are seen as places of expressive individualism, which, in rare cases, is manifest in terms of “expressive violence.” Together, these points of meaning can make schools, for some youth, seem like appropriate places to express violent intentions. The essay concludes by speculating about how this analysis can be applied to prevent school shootings. (shrink)

This paper presents a case in whom a differential diagnosis of akinetic mutism with a disorder of consciousness was made using diffusion tensor tractography. A 69-year-old female patient was diagnosed with subarachnoid hemorrhage, intraventricular hemorrhage, and intracerebral hemorrhage produced by the subarachnoid hemorrhage. She exhibited impaired consciousness with a Coma Recovery Scale-Revised score of 13 until 1 month after onset. Her impaired consciousness recovered slowly to a normal state according to the Coma Recovery Scale-Revised at 7 weeks after onset. On (...) the other hand, she exhibited the typical clinical features of akinetic mutism. On the DTT performed at 1-month, the upper, and lower dorsal ascending reticular activating systems, which are related to a disorder of consciousness, showed an almost normal state. In contrast, the prefronto-caudate and prefronto-thalamic tracts, which are related to akinetic mutism, showed severe injuries. These DTT results suggested that the patient's main clinical features were not a disorder of consciousness but akinetic mutism. Therefore, DTT for the ascending reticular activating system, and the prefronto-caudate and prefronto-thalamic tracts could provide additional evidence for a differential diagnosis of DOC and AM at the early stages of stroke. (shrink)

This study focuses on CEO hubris and its detrimental effect on corporate financial performance along with an examination of critical corporate governance contingencies that may moderate the negative effect. From 654 observations of 164 Korean firms over the years 2001–2008, we found that CEO power exacerbated the negative effect of CEO hubris on corporate financial performance, whereas board vigilance mitigated it. This study provides empirical evidence that entrenchment problems arising from CEO hubris would be exacerbated as CEOs become more powerful, (...) but weakened as board of directors become more vigilant. Theoretical contributions and practical implications will be discussed. (shrink)