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

The unified theory of dose and effect, as indicated by the median-effect equation for single and multiple entities and for the first and higher order kinetic/dynamic, has been established by T.C. Chou and it is based on the physical/chemical principle of the massaction law (J. Theor. Biol. 59: 253-276, 1976 (質量作用中效定理) and Pharmacological Rev. 58: 621-681, 2006) (普世中效指數定理). The theory was developed by the principle of mathematical induction and deduction (數學演繹歸納法). Rearrangements of the median-effect equation lead to Michaelis-Menten, Hill, Scatchard, (...) and Henderson-Hasselbalch equations. The “median” serves as the universal reference point and the “common link” for the relationship of all entities and is also the “harmonic mean” of kinetic dissociation constants. Over 300 mechanism-specific equations have been derived and published using the mathematical induction-deduction process. These equations can be deduced into several general equations, including the median-mediated whole/part equation, combination index theorem, isobologram equation, and polygonogram. It is proven that “dose” and “effect” are interchangeable, thus, “substance” and “function” are interchangeable, which leads to “the unity theory” (劑效、心物、知行一元論) in quantitative mathematical philosophy (數學的定量哲學) in functional context. Therefore, a general theory centered on the “median” and based on equilibrium dynamics has evolved. In other words: [「中」的宇宙觀： 以「中」爲基凖的動力學生態平衡]. Based on the median-effect equation of the mass-action law, the fundamental claim is that we can draw “a specific cure” for only two data points, if they are determined accurately. This claim has far reaching consequences since it defies the general held belief that two points can dray only a straight line. Remarkably, the unity theory (一元論) providesscientific/mathematical interpretation in equations and in graphics of Chinese ancient philosophy, including Fu-Si Ba Gua (伏羲八卦), Dao’s Harmony (和諧), the Confucian doctrine of the mean (儒家中庸之道), Chou Dun-Yi’s (周敦頤, 1017-1073) From Wu-ji to Tai-ji and Taiji Tu Sho (無極而太極及太極圖說). The moderntopological analysis for trinity yields an exact correspondence to the Ba-Gua, which was introduced over 4,000 years ago. Furthermore, the median-centered algorithm, promotes modern ecological content (生態學) in the equilibral dynamic state of harmony. It is concluded that Western science and Eastern philosophy are directly linked and complementary to each other. Since the truth in mathematical quantitative philosophy (數學的定量哲學) has no boundaries, East and West philosophies can flourish together for the common goal and ideal in science and in humanity (世界大同). (shrink)

Given that citizenship challenges the basis and workings of the basic institutions market, state, and civil society, organizational citizenship behaviors (OCBs) become an important moral tenet found in some codes of ethical principles. This study explores service-oriented OCBs and their determinants. Three dimensions of service-oriented OCBs (loyalty, service delivery, and participation) are hypothetically influenced by distributive justice, procedural justice, personal cooperativeness, and the need for social approval through the mediation of organizational commitment. The three dimensions of OCBs are hypothetically influenced (...) by personal cooperativeness, need for social approval, task interdependence, and outcome interdependence through the mediation of social network ties. The model is tested using data from contact employees at several financial holding companies in Taiwan. Test results reveal that the relationships between need for social approval and organizational commitment and those between task interdependence and social network ties are insignificant, whereas all other paths are significant. This study also provides managerial implications and limitations. (shrink)

In this study, we examined the role of culture on early adolescents’ social reasoning about peer exclusion. A total of 80 U.S. and 149 Taiwanese early adolescents independently completed a social reasoning essay about peer exclusion. Analyses of the essays based on social-moral theories showed that U.S. students tended to reason about peer exclusion based on social conventional thinking whereas Taiwanese students were more attentive to personal and moral issues. Despite this difference, both groups of students referred to some common (...) social-moral concepts while reasoning about peer exclusion, including consideration of personal benefit, harming others’ welfare, personal concern, and punishment. The use of social reasoning strategies was similar across the two groups of students except that Taiwanese students relied more on judgment whereas U.S. students generated more alternative hypotheses. (shrink)

Yan Xin Life Science Technology-Optimized Caloric Restriction (YXLST-CR) is a unique food abstinence, which suppresses appetite and sensation of hunger while maintaining physiological homeostasis. The authors review the first clinical case study on YXLST-CR, or YXLST-bigu, a 15-day, 24-hour observation in 1987 on a 21-year-old female undergoing YXLST-bigu for several months. The participant took no food or water and conducted normal physical activities. The daily records of body weight, temperature, pulse rate, blood pressure, and daily urine test results showed no (...) abnormalities. Homeostasis was maintained during YXLST-CR. The authors also report serum leptin levels in a group of individuals undergoing YXLST-CR and a control group before and after a 24-hour water-only period. The leptin level prior to the observation for the YXLST-CR group was lower than that for the control group and remained unchanged during the observation, suggesting the possibilities of an established metabolic adaptation. (shrink)

Research investigating the underlying mechanisms and boundary conditions under which leader humility influences employee voice remains underdeveloped. Drawing from approach–inhibition theory of power and leader humility literature, we developed a moderated-mediation model in which personal sense of power (i.e., employees’ ability to influence other individuals such as their leader) was theorized as a unique mechanism underlining why employees feel motivated to speak up under the supervision of humble leaders. Additionally, the cultural value of power distance was proposed to be a (...) relevant boundary condition to influence such relationship. We tested the model using time-lagged supervisor–subordinate matched data. Results of mixed models analyses provided support for our hypotheses confirming that employees’ personal sense of power mediates the relationship between leader humility and employee voice, and such relationship was found to be stronger when employees’ power distance was lower rather than higher. (shrink)

This chapter provides an introduction to the study of the philosophical notions of mechanisms and causality in biology and economics. This chapter sets the stage for this volume, Mechanism and Causality in Biology and Economics, in three ways. First, it gives a broad review of the recent changes and current state of the study of mechanisms and causality in the philosophy of science. Second, consistent with a recent trend in the philosophy of science to focus on scientific practices, it in (...) turn implies the importance of studying the scientific methods employed by researchers. Finally, by way of providing an overview of each chapter in the volume, this chapter demonstrates that biology and economics are two fertile fields for the philosophy of science and shows how biological and economic mechanisms and causality can be synthesized. (shrink)

With the rise of China in the global economy, it has never been more important for business leaders to understand Chinese leadership philosophies and practices. This is the first book to explain how ancient Chinese thinking and Western ideas have shaped the development of leadership styles in China. Leadership theories associated with Confucianism, Daoism, Legalism, the Arts of War, and the writings of Mao and Deng are analysed by both Chinese and Western experts. To set this in a modern business (...) context, the book includes interviews with top executives, who reflect on how their business values are affected by ancient Chinese philosophers, modern Chinese leaders, and Western management writers and thinkers. The book also includes research on paternalistic leadership as practised by business leaders in Taiwan, Hong Kong, and mainland China. (shrink)

This volume addresses fundamental issues in the philosophy of science in the context of two most intriguing fields: biology and economics. Written by authorities and experts in the philosophy of biology and economics, Mechanism and Causality in Biology and Economics provides a structured study of the concepts of mechanism and causality in these disciplines and draws careful juxtapositions between philosophical apparatus and scientific practice. By exploring the issues that are most salient to the contemporary philosophies of biology and economics and (...) by presenting comparative analyses, the book serves as a platform not only for gaining mutual understanding between scientists and philosophers of the life sciences and those of the social sciences, but also for sharing interdisciplinary research that combines both philosophical concepts in both fields. -/- The book begins by defining the concepts of mechanism and causality in biology and economics, respectively. The second and third parts investigate philosophical perspectives of various causal and mechanistic issues in scientific practice in the two fields. These two sections include chapters on causal issues in the theory of evolution; experiments and scientific discovery; representation of causal relations and mechanism by models in economics. The concluding section presents interdisciplinary studies of various topics concerning extrapolation of life sciences and social sciences, including chapters on the philosophical investigation of conjoining biological and economic analyses with, respectively, demography, medicine and sociology. (shrink)

Natural language processing is a critical part of the digital transformation. NLP enables user-friendly interactions between machine and human by making computers understand human languages. Intelligent chatbot is an essential application of NLP to allow understanding of users’ utterance and responding in understandable sentences for specific applications simulating human-to-human conversations and interactions for problem solving or Q&As. This research studies emerging technologies for NLP-enabled intelligent chatbot development using a systematic patent analytic approach. Some intelligent text-mining techniques are applied, including document (...) term frequency analysis for key terminology extractions, clustering method for identifying the subdomains, and Latent Dirichlet Allocation for finding the key topics of patent set. This research utilizes the Derwent Innovation database as the main source for global intelligent chatbot patent retrievals. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

The piRNA class of small RNAs are distinct from other small RNAs by their ∼26–31 nucleotide size, single‐strandedness and strand‐specificity as well as by the clustered arrangement of their origins. Here, we highlight how these features are reminiscent of the mechanisms of DNA replication, and then present three models suggesting that the origin of piRNAs may be mechanistically similar to key processes in DNA replication. BioEssays 29:382–385, 2007. © 2007 Wiley Periodicals, Inc.

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

Remanufacturing widely exists in production activities. Two different game models are involved while considering reverse channels: In Model P, the manufacturer provides new and remanufactured products to two retailers. New products are sold through an online platform, while remanufactured products are sold in offline physical stores in a decentralized scenario. In Model C, the manufacturer provides new and remanufactured units to only one retailer that operates both online and offline channels in a centralized scenario. This research showed that a manufacturer’s (...) profitability and industry profits in Model P were higher than those in Model C from the perspective of economic performance; the sum of the profits of both retailers in Model P was worse than the profits of the retailer in Model C. Moreover, Model P was found to be greener than Model C from the perspective of environmental sustainability. From a social viewpoint, Model P had a higher consumer surplus than Model C; the higher the cost of distributing a remanufactured unit, the more disadvantageous the model to the consumers. (shrink)

The strap-down inertial navigation system is a commonly used sensor for autonomous underground navigation, which can be used for shearer positioning under a coal mine. During the process of initial alignment, inaccurate or time-varying noise covariance matrices will significantly degrade the accuracy of the initial alignment of the shearer. To overcome the performance degradation of the existing initial alignment algorithm under complex underground environment, a novel adaptive filtering algorithm is proposed by the integration of the strong tracking Kalman filter and (...) the sequential filter for the initial alignment of the shearer with complex underground environment. Compared with the traditional multiple fading factor strong tracking Kalman filter method, the proposed MSTSKF algorithm integrates the advantage of strong tracking Kalman filter and sequential filter, and multiple fading factor and forgetting factor for east and north velocity measurement are designed in the algorithm, respectively, which can effectively weaken the coupling relationship between the different states and increase strong robustness against process uncertainties. The simulation and experiment results show that the proposed MSTSKF method has better initial alignment accuracy and robustness than existing strong tracking Kalman filter algorithm. (shrink)

ABSTRACT This study seeks exploration of how employees’ moral identity is related to voice behavior in the current organizational dynamics. By integrating the self-consistency theory with a situational strength perspective, a moderated mediation model was constructed to examine connections among moral identity, leader secure-base support, work engagement, and voice behavior. Surveys were collected at 2 time points, 1 month apart, from 206 full-time employees in various organizations and industries in Taiwan. Supporting results indicated that employees’ moral identity was positively related (...) to voice behavior. The mediating impact of work engagement as a motivational mechanism between moral identity and voice behavior was observed. Relative to when LSBS was low, the effect of moral identity on work engagement and the indirect effect of moral identity on voice behavior through work engagement were more substantial when LSBS was high. Academic and managerial implications were discussed. (shrink)

The impact of genetic technologies is being felt in many aspects of society, including medicine and the legal system, as well as the personal lives of individuals. How do we make sure that all segments of the population are equally aware of these technologies and have ample opportunity to voice opinions and shape the future? One ongoing effort, which began ten years ago and in which we are directly involved, is the Personal Genetics Education Project, a nonprofit initiative housed within (...) and largely supported by the Department of Genetics at Harvard Medical School. The goal of pgEd is to raise public awareness and promote conversations about the benefits and implications of the genetics revolution in ways that are inclusive of all voices regardless of socioeconomic, educational, ethnic, cultural, or religious background. This essay describes our approach and experience in hopes that they will be of help to others engaged in similar efforts. (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)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (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)

Business students appear predisposed to select disciplines consistent with pre-existing worldviews. These disciplines then further reinforce the worldviews which may not always be adaptive. For example, high levels of Social Dominance Orientation is a trait often found in business school students :691–721, 1991). SDO is a competitive and hierarchical worldview and belief-system that ascribes people to higher or lower social rankings. While research suggests that high levels of SDO may be linked to lower levels of empathy, research has not established (...) the potential relationship between another related adaptive trait in the workplace, compassion. Compassion facilitates workplace performance by lowering levels of litigation, easing stress, and facilitating cooperation. Accordingly, the following study aimed to examine the relationship between SDO and compassion while hypothesizing Economic Systems Justification would mediate this relationship. Because of the importance of compassion in the workplace, the prevalence of SDO in the business academic community and the topicality of ESJ, we conducted our study with business school students. Results confirmed all but one hypothesis. (shrink)

Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; (...) and factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the stress of the COVID-19 pandemic, 12.3% of frontline healthcare workers in general hospitals reported having mental distress and perceived lower social adaptation status compared with those working in psychiatric hospitals. Christians/Catholics perceived better psychological well-being, and Buddhists/Taoists were less likely to experience mental distress. The results at 6 weeks of follow-up showed that the perceived lower social adaptation status of general hospital healthcare workers was temporary and improved with time. Christian/Catholic religion and time had independent positive effects on psychological well-being; however, the interaction of Christian/Catholic religion and time had a negative effect.Conclusions: Collectivism and individualism in the cultural context are discussed with regard to alexithymic trait and Buddhist/Taoist and Christian/Catholic religious faiths. Early identification of mental distress and interventions should be implemented to ensure a healthy and robust clinical workforce for the treatment and control of the COVID-19 pandemic. (shrink)

Life education, also known as life and death education, is an important subject in Taiwan with institutions offering degree programs and courses that focus on quality learning and implementation of life education. What is interesting from the perspective of Taiwanese Education is that the teaching of life education also incorporates a number of Eastern-derived and conceptualized tenets, for example, Buddhist teaching and the importance of spiritual wisdom. This premise contends then that life education in Taiwan, in general, is concerned with (...) the promotion, fulfillment, and cherishing of quality life experiences (e.g., personal contentment, happiness). One example of life education, which resonates with other spiritual beliefs and religious faiths (e.g., Hinduism), is related to spiritual cultivation and the enlightenment of life wisdom. Our own teaching of the subject, likewise, places emphasis on the goal of teaching students to seek meaningful understanding of and appreciation for three major, interrelated components of life education: life wisdom, life practice, and life care. Life education is a beneficial subject as its theoretical understanding may help individuals cope with pathologies and negative life experiences. One negative life experience, in this case, is the ultimate fate of humankind: death. Approaching death and/or the onset of grief is something that we all have to experience. How does one approach death? It is not easy feat and, of course, grief for a loved one is personal and some of us struggle with this. We contend that spiritual cultivation and enlightenment, arising from life education, may assist us with the coping of death (e.g., the possibility of transcendence beyond the realm of life). Forming the premise of the present article, we propose that a person’s ‘spiritual and enlightened self’, reflecting the convergence of three major aspects of life education (i.e., Philosophical reflection, Enrichment of personal well-being, and Spiritual cultivation), would result in the initiation and creation of a number of virtues and positive characteristics – for example: having a positive outlook in life, showing compassion, forgiveness, etc. These virtues and quality characteristics, from our philosophical reasoning, are equivalent to those qualities that positive psychology advocates for. (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)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

Research investigating the underlying mechanisms and boundary conditions under which leader humility influences employee voice remains underdeveloped. Drawing from approach–inhibition theory of power and leader humility literature, we developed a moderated-mediation model in which personal sense of power was theorized as a unique mechanism underlining why employees feel motivated to speak up under the supervision of humble leaders. Additionally, the cultural value of power distance was proposed to be a relevant boundary condition to influence such relationship. We tested the model (...) using time-lagged supervisor–subordinate matched data. Results of mixed models analyses provided support for our hypotheses confirming that employees’ personal sense of power mediates the relationship between leader humility and employee voice, and such relationship was found to be stronger when employees’ power distance was lower rather than higher. (shrink)

唯识学种子说通过在微分、刹那层面探讨深层心识的构造活动和存在的本质，论证了佛教缘起性空的非本体立场，属于一种“非本体”的本体诠释。但是，由于受到中国固有思维的影响，中国佛学不再侧重强调法性即空性的“非 本体”立场，而是把法性和心性主体结合起来，倾向于设立一种“实体化”的本体，形成了“心性本体论”。由非本体的本体诠释逐渐转向心性本体的本体诠释是印度唯识学在心识哲学层面中国化的基本趋势。.

Although there are various studies comparing Greek and Indian philosophy and religion, and Chinese and Western philosophy and religion, Brahman and Dao: Comparatives Studies in Indian and Chinese Philosophy and Religion is a first of its kind that brings together Indian and Chinese philosophies and religions. Brahman and Dao helps close the gap on a much needed examination on the rich history of Buddhist transmission to China, and the many generations of Indian Buddhist missionaries to China and Chinese Buddhist pilgrims (...) to India, including the legendary Bodhidharma, and Faxian and Xuanzang. (shrink)

To understand the gaps between current bioethics education and the requirements of practicing nurses, a semistructured questionnaire was used to invite the directors of nursing departments at all 82 teaching hospitals in Taiwan to participate in this survey. The response rate was 64.6%. Through content analysis we obtained information about previous bioethical training, required themes and content, recommended teaching strategies, and difficulties with education and its application. The results suggest that Taiwanese nursing personnel need to be instilled with both self-cultivation (...) of morality and mental cultivation to acquire nursing virtues and the right attitudes toward bioethical issues. Good communication skills to prevent damage to the harmonious relationships between patients, their families and medical team members, policies that support the provision of systematic formal knowledge of ethics, small group training, and clarification of values were also shown to be important in bioethics education. (shrink)

In ‘Equity and Marxist Buddhism,’ Tzu-wei Hung engages with the Marxist Buddhism developed by Taiwanese philosopher Lin Qiu-wu in the 1920s, brings this underexplored theory to the table and discusses a few merits and insights of the theory. Building on Hung’s analysis, this paper paper elaborates on the lessons and insights that Taiwanese Marxist Buddhism provides for modern times. The first three lessons are distinctive points that Taiwanese Marxist Buddhism brings to the discussion on combining Marxism and Buddhism: the connections (...) between the ethical and political, the responsibility for pursuing social justice and the nonviolence means towards social justice. The last lesson comes at the meta-philosophical level, focusing on how Hung’s engagement with Taiwanese Marxist Buddhism sheds light on the issue of diversifying the discipline philosophy. Overall, I argue that Taiwanese Marxist Buddhism not only makes contributions to theoretical frameworks while providing a practical means for pursuing equity and social justice, but it also manifests the epistemic and moral values for engaging with under-represented philosophical traditions. (shrink)

Data heterogeneity is the obstacle for the resource sharing on Semantic Web, and ontology is regarded as a solution to this problem. However, since different ontologies are constructed and maintained independently, there also exists the heterogeneity problem between ontologies. Ontology matching is able to identify the semantic correspondences of entities in different ontologies, which is an effective method to address the ontology heterogeneity problem. Due to huge memory consumption and long runtime, the performance of the existing ontology matching techniques requires (...) further improvement. In this work, an extended compact genetic algorithm-based ontology entity matching technique is proposed, which uses both the compact encoding mechanism and linkage learning approach to match the ontologies efficiently. Compact encoding mechanism does not need to store and maintain the whole population in the memory during the evolving process, and the utilization of linkage learning protects the chromosome’s building blocks, which is able to reduce the algorithm’s running time and ensure the alignment’s quality. In the experiment, ECGA-OEM is compared with the participants of ontology alignment evaluation initiative and the state-of-the-art ontology matching techniques, and the experimental results show that ECGA-OEM is both effective and efficient. (shrink)