This study proposes a research model based on social identity theory, which examines the moderating role of organizational trust on the relationship between corporate citizenship and organizational commitment. In the model, organizational commitment is positively influenced by organizational trust and four dimensions of perceived corporate citizenship, including economic, legal, ethical and discretionary citizenship. The model paths are hypothesized to be moderated by organizational trust. Empirical testing using a survey of personnel from 12 large firms confirms most of our hypothesized effects. (...) Theoretical and managerial implications of our findings are discussed. (shrink)

This study proposes a research model based on social identity theory, which examines the moderating role of organizational trust on the relationship between corporate citizenship and organizational commitment. In the model, organizational commitment is positively influenced by organizational trust and four dimensions of perceived corporate citizenship, including economic, legal, ethical and discretionary citizenship. The model paths are hypothesized to be moderated by organizational trust. Empirical testing using a survey of personnel from 12 large firms confirms most of our hypothesized effects. (...) Theoretical and managerial implications of our findings are discussed. (shrink)

On analysis of Singapore local politics and the "Singapore Dream.

This study examines the effects of corporate governance mechanisms on CSR performance in an emerging economy, China. Because of the need of gaining legitimacy in the new institutional context, Chinese firms have to adopt global CSR practices in order to remain competitive. Using the corporate governance framework, this study examines how board composition, ownership, and TMT composition influence corporate social performance. The propositions are tested using data gathered from 471 firms in China. By and large, empirical findings supported the hypothesized (...) relationships. (shrink)

Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in (...) MP pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)

In this paper, the single-machine scheduling problem is studied by simultaneously considering due-date assignment and group technology. The objective is to determine the optimal sequence of groups and jobs within groups and optimal due-date assignment to minimize the weighted sum of the absolute value in lateness and due-date assignment cost, where the weights are position dependent. For the common due-date assignment, slack due-date assignment, and different due-date assignment, an O n log n time algorithm is proposed, respectively, to solve the (...) problem, where n is the number of jobs. (shrink)

Image restoration is a research hotspot in computer vision and computer graphics. It uses the effective information in the image to fill in the information of the designated damaged area. This has high application value in environmental design, film and television special effects production, old photo restoration, and removal of text or obstacles in images. In traditional sparse representation image restoration algorithms, the size of dictionary atoms is often fixed. When repairing the texture area, the dictionary atom will be too (...) large to cause blurring. When repairing a smooth area, the dictionary atom is too small to cause the extension of the area, which affects the image repair effect. In this paper, the structural sparsity of the block to be repaired is used to adjust the repair priority. By analyzing the structure information of the repair block located in different regions such as texture, edge, and smoothing, the size of the dictionary atom is adaptively determined. This paper proposes a color image restoration method that adaptively determines the size of dictionary atoms and discusses a model based on the partial differential equation restoration method. Through simulation experiments combined with subjective and objective standards, the repair results are evaluated and analyzed. The simulation results show that the algorithm can effectively overcome the shortcomings of blurred details and region extension in fixed dictionary restoration, and the restoration effect has been significantly improved. Compared with the results of several other classic algorithms, it shows the effectiveness of the algorithm in this paper. (shrink)

This paper proposes extending the appearance of artefacts from human to zoomorphic on the basis of the uncanny valley phenomenon, while simultaneously realising the effects of bionic species, product realism, and gender differences on preschool children’s preferences for artificial animal appearances. In this study, animal toys were created as stimuli and a three-factor experiment was conducted with preschool children. Overall, the children demonstrated significantly stronger preferences for animal toys with extremely high or moderate realism compared with those with extremely low (...) realism. Specifically, the boys preferred the toys with extremely high realism, and the girls preferred those with moderate realism. We conclude with some suggestions regarding the direction of design guidelines for the appearance of artificial animals, to facilitate the design and creation of animal products that promote human–robot interactions and design education. (shrink)

This study examines the impact of chief executive officer ability on firms’ corporate social responsibility performance. We find that firms’ CSR performance increases with CEO ability. Specifically, firms with more able CEOs are associated with more socially responsible activities and fewer socially irresponsible activities, and are associated with more stakeholder CSR rather than third-party CSR. We further find that the positive relation between CEO ability and CSR is weakened for CEO who is also the chair of the board and for (...) CEO who is close to retirement; and is weakened when the CSR emphasis exerted by a firm’s external environment is high. Our results are robust after controlling for firm fixed effects and to the use of multiple measures of CSR performance and CEO ability. Overall, our evidence is consistent with our conjecture that more able CEOs have less career concerns so that these CEOs are more willing to undertake long-term investments in socially beneficial activities, leading to better CSR performance. (shrink)

We introduce a new operator, called rational evaluation, in belief change. The operator evaluates new information according to the agent’s core beliefs, and then exports the plausible part of the new information. It belongs to the decision module in belief change. We characterize rational evaluation by axiomatic postulates and propose two functional constructions for it, based on the well-known constructions of kernel sets and remainder sets, respectively. The main results of the paper are two representation theorems with respect to the (...) two functional constructions. We also compare and connect the evaluation operator with some related operators in belief revision, including contraction, set contraction, and prioritized multiple revision. (shrink)

We investigate the effectiveness of corporate social responsibility disclosure in protecting corporate reputation following financial restatements. As expected under legitimacy theory, firms can signal their legitimacy via nonfinancial disclosure after the negative effects of financial restatements. Our results show that restating firms make substantial improvements to overall CSR disclosure quality by changing their standalone reports to a more conservative tone, increasing readability and report length, even though they strategically disclose less forward-looking and sustainability-related content. Such improvements are more pronounced in (...) restating firms with prior low-quality CSR disclosure. Moreover, restating firms with CSR disclosure have smaller forecast errors than non-CSR disclosers, yet the change in CSR disclosure after restatements does not further improve analyst forecast accuracy. Finally, we find that compared with nondisclosers, restating firms with CSR disclosure suffer smaller firm value losses. Overall, the evidence supports the view that consistent CSR reporting alleviates reputational damage and plays an insurance-like or value protection role during crisis periods. (shrink)

This study was conducted to investigate the relationship between posttraumatic growth, resilience, positive coping style, and self-efficacy among the primary caregivers of children with developmental disorders in Chongqing, China. A total of 198 primary caregivers aged from 22 to 66 years old, including 155 females and 43 males, were enrolled. The Posttraumatic Growth Inventory, Connor-Davidson Resilience Scale-10, Simplified Coping Style Questionnaire, and General Self-Efficacy Scale were used for data collection. The results found that PTG could be positively predicted by resilience. (...) Positive coping style and self-efficacy mediated the relationship between resilience and PTG. The different levels of PTG were determined by the resident location, monthly income and education of the primary caregivers. The results suggest that it is critical to improve the mental health of the primary caregivers of children with developmental disabilities. Our results also provide a scientific basis for future research. (shrink)

Global climate change arouses people’s attention to environmental protection and, therefore, changes consumption habits. Food overconsumption not only produces extra waste but also pollutes the environment. Therefore, it is important to understand the factors that motivate people to eat green, an eco-friendly way to consume food. To keep the body in good shape, the fitnessers concern more about diet than the general people. This study explored intrinsic motivations, such as social recognition, environmental ethics, curiosity, joy of purchase, perceived usefulness, subjective (...) norm, and perceived behavior control as constructs that affect fitnesser’s green eating intention. All constructs except curiosity have significant impacts on behavior intention. The results demonstrate that social recognition and environmental ethics have significant effects on curiosity, joy of purchase, perceived usefulness, subjective norm, and perceived behavior control. The mediation effects between social recognition and behavior intention are not supported. The mediators between environmental ethics and behavior intention are joy of purchase, perceived usefulness, subjective norm, and perceived behavior control. (shrink)

This study examines the relation between a firm’s business strategy and its corporate social responsibility performance. Using a comprehensive measure of business strategy based on the Miles and Snow theoretical framework, we find that firms following an innovation-oriented strategy are associated with better CSR performance than those following an efficiency-oriented strategy. Specifically, compared with defenders, prospectors engage in more socially responsible activities, fewer socially irresponsible activities, and perform better in both stakeholder- and third-party-related CSR areas. Taken together, our results suggest (...) that business strategy is an important determinant of CSR performance. Prospectors take advantage of CSR, as their innovation-oriented strategy allows them not only to benefit more from CSR, but also to have more tolerance for the uncertainty, risk, and long time-horizon associated with CSR engagement. (shrink)

Hydromechanical continuously variable transmission is capable of bearing large torque and has wide transmission range, which is suitable for high-power tractors. Dynamic characteristics could influence the tractor life, especially in a high-power tractor. Wet clutch is the crucial component in the HMCVT, which could smooth and soft power transmission. Therefore, it is important to study the dynamic characteristics and implement the wet clutch test of HMCVT. In this paper, AMESim is used to establish virtual models of gearbox, pump-controlled hydraulic motor (...) system, and shifting hydraulic system. Then, a simulation study of tractor operation under working condition is carried out. The internal and external meshing forces of the planetary row are analyzed. Finally, the wet clutch engagement process of HMCVT in the high-power tractor is tested to verify the oil pressure. The simulation results show that the values of internal and external meshing force become larger as the throttle opening increases. At the moment of shifting change, the meshing forces of the planetary gear have great impact. The clutch test shows that the trend of the oil filling curve obtained from the bench test is similar to that obtained from the theoretical curve, which verifies the simulation results. (shrink)

BackgroundThere are limited sensitive evaluation methods to distinguish people’s symptoms of peripheral fatigue and central fatigue simultaneously. The purpose of this study is to identify and evaluate them after acute exercise with a simple and practical scale.MethodsThe initial scale was built through a literature review, experts and athlete population survey, and a small sample pre-survey. Randomly selected 1,506 students were evaluated with the initial scale after exercise. Subjective fatigue self-assessments were completed at the same time.ResultsThe Acute Exercise-Induced Fatigue Scale was (...) determined after performing a factor analysis. In the exploratory factor analysis, the cumulative variance contribution rate was 65.464%. The factor loadings of the total 8 questions were 0.661–0.816. In the confirmatory factor analysis, χ2/df = 2.529, GFI = 0.985, AGFI = 0.967, NFI = 0.982, IFI = 0.989, CFI = 0.989, and RMSEA = 0.048. The Cronbach’s alpha coefficient for the scale was 0.872, and it was 0.833 for peripheral fatigue and 0.818 for central fatigue. The intra-class correlation coefficient for the scale was 0.536, and the intra-class correlation coefficients for peripheral fatigue and central fatigue were 0.421 and 0.548, respectively. The correlation coefficient between the total score of the AEIFS and the SFSA score was 0.592.ConclusionOur results demonstrate that the AEIFS can distinguish peripheral fatigue and central fatigue and can also reflect their correlation. This scale can be a useful evaluation tool not only for measuring fatigue after acute exercise but also for guiding reasonable exercise, choosing objective testing indicators, and preventing sports injuries resulting from acute exercise-induced fatigue. (shrink)

Although the ethical judgment of consumers in the United States and other industrialized countries has received considerable attention, consumer ethics in Asian-market settings have seldom been explored. The purchase and making of counterfeit products are considered common, but disreputable, attributes of Southeast Asian consumers. According to the Association of South-East Asian Nations (ASEAN), Indonesia ranks third among the leading countries of counterfeit items in Asia. Retail revenue losses attributed to counterfeiting amounted to US $183 million in 2004. Therefore, elucidating the (...) ethical perspectives of Indonesian consumers is an effective means of clarifying an important cultural influence on consumer behavior. This exploratory study of 230 Indonesians has many meaningful findings. First, certain personal attitudes apparently affect the ethical judgments of Indonesian consumers. Second, Indonesian consumers who exhibited high ethical concern over actively benefiting from illegal actions had high levels of materialism and idealism, as well as low levels of relativism. Third, materialism, idealism, and relativism significantly influenced whether benefits were created from actively engaging in some questionable activities (DELEGAL). Analytical results indicated that Indonesians with high materialism and relativism were more likely to engage in actions that were questionable but legal. Finally, consumer ethics were compared by applying demographic variables such as gender, age, education, religion, and occupation, indicating that all variables significantly varied except for religion. (shrink)

Creative association is inherent and essential to creativity and insight. Here we utilised a Chinese compound Remote Associates Task (cRAT) to identify the potential impact of word order (i.e., solution position hereinafter) and word frequency on creative association across two behavioural experiments. Experiment 1 identified the effects of (a) word order and word frequency on cRAT-induced association without considering the specific strategies used during solving such problems and (b) their interaction not only on performance in solving the cRAT, including solution (...) time and accuracy, but also on difficulty rating. Following a coarse-to-fine approach, Experiment 2 examined the effect of both factors on creative association determined according to each participant’s trial-by-trial reports regarding insight solution strategies. Main effects of word order and word frequency, and a two-way interaction, were found on the accuracy and self-rated difficulty. These findings shed light on creative association, multiply-constrained problem solving and constructing compounds. (shrink)

ObjectiveTo explore the relationships between dispositional mindfulness and their post-traumatic stress symptoms of emergency nurses, and the mediating effects of coping styles and emotional exhaustion.MethodsA cross-sectional survey study was conducted to collect data on DM, coping styles, EE, and PTSS among 571 emergency nurses from 20 hospitals in Chongqing, China. Correlation and structural equation models were used to evaluate the relationship among variables.ResultsEmergency nurses with lower dispositional mindfulness, higher emotional exhaustion and preference for negative coping revealed more PTSS. The effect (...) of NC on PTSS was partially mediated by emotional exhaustion. Negative coping and emotional exhaustion played concurrent and sequential mediating roles between dispositional mindfulness and PTSS.ConclusionThis study has made a significant contribution to existing literature. It was suggested to develop interventions aimed at enhancing mindfulness, reducing negative coping strategies, and alleviating emotional exhaustion, which may be effective at reducing or alleviating post-traumatic stress symptoms of emergency nurses. (shrink)

The COVID-19 pandemic has caused a dramatic reshaping of passenger risk perception for airline industry. The sharp increase in risk aversion by air passenger has caused a disastrous impact on the tourism service industry, particularly airline industry. Although the existing literature has provided a lot of studies on the impact of the pandemic on travel industry, there are very few studies discussing the impact of change in passenger risk perception on the stock market performance of airline industry. This study considers (...) two types of airline companies, full-service and low-cost. In order to overcome the traditional problem of the Chow test, Quandt–Andrews test is used to identify structural change points during the pandemic in the stock prices of United States airline companies. The result shows that an industry-wide structural change in the stock market performance indeed is found to take place during the pandemic for United States airline companies. Meanwhile, no significant difference is found in the structural change date between the two types of airline companies. The selected airline companies are found to be clustered toward the end of 2020 in their structural change dates. Although the strike of the COVID-19 pandemic on airline industry has proven to be widespread and profound, our investigation implies that air passengers have gradually adapted to the new normal of travel activities at some level and partly rebuild their sense of safety under the strict epidemic-control measures. (shrink)

本书对诸如文学本质论、构成论、发展论、批评鉴赏论等问题作了符合马克思主义观点的论述。.

In the mid-T'ang movement for the reform of literary style, literary form, and literary language, Liu Tsung-yüan made brilliant contributions. His travelogues, metaphorical satires, and miscellaneous other works are a precious heritage of Chinese literature. This has long been well known, but his important place in the history of the development of Chinese materialism and atheism, on the other hand, has long since been hidden in obscurity.

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students from the Be Resilient to Nursing Career program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest, Med-low, Med-high, and Highest. The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role (...) models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies. (shrink)

The COVID-19 pandemic has pressed a pause button on global economic development, and induced significant mental health problems. In order to demonstrate the progressed relationship between the pandemic, economic slowdown, and mental health burden, we overviewed the global-level gross domestic product changes and mental problems variation since the outbreak of COVID-19, and reviewed comprehensively the specific sectors influenced by the pandemic, including international trade, worldwide travel, education system, healthcare system, and individual employment. We hope to provide timely evidence to help (...) with the promotion of policymakers’ effective strategies in mitigating economic losses induced by the pandemic; we suggest different governments or policy makers in different countries to share information and experience in dealing with COVID-19-induced economic slowdown and promote COVID-19 vaccine popularization plan to protect every individual worldwide against the coronavirus essentially; and we appeal international information share and collaboration to minimize stigmatization related to adverse mental consequences of COVID-19 and to increase mental health wellbeings of people all over the world. (shrink)

Previous studies have demonstrated that orientation-specific deprivation in early life can lead to neural deficits of spatial vision in certain space, and can even result in meridional amblyopia. Individuals with astigmatism are the optimal and natural models for exploring this asymmetric development of spatial vision in the human visual system. This study aims to assess the contrast sensitivity function and EEG signals along two principal meridians in participants with regular astigmatism when being optimal optical corrected. Twelve participants with astigmatism and (...) thirteen participants with were recruited in the current study. CSFs and spatial sweep visual evoked potentials were measured with vertical and horizontal sinewave gratings along two principal meridians monocularly. Area under log CSF, spatial frequency threshold corresponding to 80% contrast gratings, and CSF acuity were calculated from CSF test. In addition, sVEP amplitudes and thresholds were calculated with the recursive least square method. Participants with astigmatism exhibited marked vertical-horizontal resolution disparities even after they were corrected with optimal optical corrections. CSF tests showed that AULCSF along weak meridian was lower than that along strong meridian in both groups. Significant meridional disparity of CSF acuity was also found in both groups. In addition, the MA group showed larger meridional disparity compared to the AST group. Spatial sVEP thresholds also supported the existence of marked meridional disparity. Our results suggest that meridian-specific partial deprivation in early life might lead to monocularly asymmetric development of spatial vision in the human visual system. In terms of application, we tested the feasibility and reliability of adopting psychophysical and EEG scalings to investigate the asymmetric development of spatial vision related to astigmatism. These paradigms are potentially applicable to reduce and even eliminate the meridional disparity in the primary visual cortex by adopting perceptual learning or other vision-related interventions. (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)

This study is based on the situation of Taiwan listed companies as derivative financial products from 2015 to 2017, analyzing the relationship between the hedging of derivative financial products and characteristics of enterprises and the factors that affect the hedging decision-making of companies. It is found that even after the announcement of Taiwan’s No. 34 and No. 36 bulletins, there are still some problems that are needed to improve in the disclosure of derivative financial product investment information by Taiwan’s listed (...) companies, at least in the disclosure of the reasons for this conduct which is still insufficient. In this study, two-stage regression analysis method is applied to empirical analysis, and it is found that hedging activities are related to corporate characteristics, such as expected financial crisis costs, corporate size, equity issues, growth investment opportunities, and information asymmetry. In the investment of derivative financial products, enterprises should evaluate their own financial characteristics as a reference for the risk avoidance decision. At the same time, it is necessary to investigate different natures of hedging tools used in appropriate risk categories, so as to fully achieve the hedging effect and maximize the hedging benefits. This study also found that companies with higher growth investment opportunities, larger size, and higher financial crisis costs will tend to use derivative financial products for hedging. As for the impact of other industries, it is found that the electronic and electrical machinery industries are more active than other industries in hedging behaviors of undertaking derivative financial products’ transaction. (shrink)

This study investigated the characteristics and development of peer support networks in an effort to unravel the role of friendship in this developmental process. The relationships between friendship networks and peer support networks were explored, and the influence of dyadic and triadic friendships on the development of peer support relationships was examined. Two waves of data were collected among a sample of adolescents in six Chinese junior high schools (n= 913 students from 28 classrooms; mean age = 14.13 years; 50.49% (...) boys), and classroom friendship networks and peer support networks were analyzed. The results showed that peer support networks were sparse, hierarchical, and sex-segregated. Furthermore, peer support networks and friendship networks partially overlapped. Friends tended to have similar support-seeking and support-providing ties. Longitudinal multiplex social network analysis revealed that peer support networks changed moderately over time, and friendships played various roles in the development of peer support networks. Dyadic friendships improved the formation of peer support ties. A mutual friend improved the formation of support relationships between two students when the mutual friend chose the two students as friends, but a mutual friend also hindered or had no effects on the formation of support relationships in other cases. The implications for educators to improve peer support networks are presented, and directions for future research are discussed. (shrink)

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. 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. 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. 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. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

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)

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)

BackgroundThe neural activity of irritable bowel syndrome patients in the resting state without any intervention has not been systematically studied. The purpose of this study was to compare the resting-state brain functions of IBS patients with healthy controls.MethodsThe published neuroimage studies were obtained from electronic databases including PubMed, EMBASE, PsycINFO, Web of Science Core, CNKI Database, Wanfang Database, VIP Database, and CBMdisc. Search dates were from inception to March 14th, 2022. The studies were identified by the preidentified inclusion and exclusion (...) criteria. Two independent reviewers compiled the studies and evaluated them for quality and bias.ResultsAltogether 22 fMRI studies were included in this review. The risk of bias of the included studies was generally low. The findings indicated that in IBS patients, increased or decreased brain areas were mostly associated with visceral sensations, emotional processing, and pain processing. According to brain network research, IBS may exhibit anomalies in the DMN, CEN, and emotional arousal networks. The fluctuations in emotion and symptoms in IBS patients were associated with alterations in the relevant brain regions.ConclusionThis study draws a preliminary conclusion that there are insufficient data to accurately distinguish the different neurological features of IBS in the resting state. Additional high-quality research undertaken by diverse geographic regions and teams is required to reach reliable results regarding resting-state changed brain regions in IBS. (shrink)