Despite numerous published writings on China's regional role, the world still knows very little about Beijing's perception and strategy. This article seeks to make an intellectual contribution in understanding China's foreign policy and its efforts to participate in East Asian integration. This article argues that under the rhetoric of peaceful development and community building, China's foreign policy is pragmatic and changes with the tide of events in international relations. China's participation in regional integration serves as a good case for examining (...) changes in Beijing's strategy. In the past two decades, China has moved from a reluctant participant of regional affairs to an active participant and potential future leader. China's adjusting role is a consequence of Beijing's pragmatism in policy and its growing economic confidence. Pragmatism has led China to and wait for the proper timing to step onto the world stage. (shrink)

This study investigated the relative role of sub-syllabic components in spoken word recognition of Mandarin Chinese using an eye-tracking experiment with a visual world paradigm. Native Mandarin speakers were presented with four pictures and an auditory stimulus. They were required to click the picture according to the sound stimulus they heard, and their eye movements were tracked during this process. For a target word, nine conditions of competitors were constructed in terms of the amount of their phonological overlap with the (...) target: consonant competitor, rime competitor, tone competitor, consonant plus rime competitor, consonant plus tone competitor, rime plus tone competitor, cohort competitor, cohort plus tone competitor, and baseline competitor. A growth curve analysis was conducted with the fixation to competitors, targets, and distractors, and the results showed that competitors with consonant or rime overlap can be adequately activated, while tone overlap plays a weaker role since additional tonal information can strengthen the competitive effect only when it was added to a candidate that already bears much phonological similarity with the target. Mandarin words are processed in an incremental way in the time course of word recognition since different partially overlapping competitors could be activated immediately; like the pattern found in English, both cohort and rime competitors were activated to compete for lexical activation, but these two competitors were not temporally distinctive and mainly differed in the size of their competitive effects. Generally, the gradation of activation based on the phonological similarity between target and candidates found in this study was in line with the continuous mapping models and may reflect a strategy of native speakers shaped by the informative characteristics of the interaction among different sub-syllabic components. (shrink)

Despite numerous published writings on China's regional role, the world still knows very little about Beijing's perception and strategy. This article seeks to make an intellectual contribution in understanding China's foreign policy and its efforts to participate in East Asian integration. This article argues that under the rhetoric of peaceful development and community building, China's foreign policy is pragmatic and changes with the tide of events in international relations. China's participation in regional integration serves as a good case for examining (...) changes in Beijing's strategy. In the past two decades, China has moved from a reluctant participant of regional affairs to an active participant and potential future leader. China's adjusting role is a consequence of Beijing's pragmatism in policy and its growing economic confidence. Pragmatism has led China to and wait for the proper timing to step onto the world stage. (shrink)

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

Interest in corporate citizenship has been burgeoning in the academic and managerial realms for decades. While a psychological CC climate has been conceptualized and has received empirical support for its relationship with employee outcomes, the organizational climate perspective of CC has not yet been explored. In the present study, we develop and examine a mediated moderation model that elaborates the underlying psychological process and the contingency of organizational CC climate and its individual outcomes. We follow 539 employees in 26 firms (...) for approximately one year in Taiwan. We find that organizational CC climate is positively related to employees’ organizational identification and that the firm’s high-commitment work system can augment the effect of CC on employees’ OI. In addition, employees’ OI plays a psychological process role in mediating the interactive effect of the firm’s CC and HCWS on employees’ workplace outcomes, including their job satisfaction and turnover intention. The findings shed light on the alignment of CC and human resource functions and argue that the Confucian Asian context may act as a stepping stone for the impact of CC on employees’ attitudes. The study offers valuable implications for both researchers and practitioners. (shrink)

Drawing on social information processing theory and a career development perspective, we examined the effect of transformational leadership on the perceived overqualification via career growth opportunities, and how the supervisor–subordinate guanxi moderates the relationship between transformational leadership and perceived overqualification. We tested this proposal using three waves of lagged data collected from 351 company employees in the Yangtze River Delta region in China. The results revealed that transformational leadership had an indirect effect on perceived overqualification through career growth opportunities, and (...) supervisor–subordinate guanxi moderated the positive association between transformational leadership and career growth opportunities. In addition, the mediating effect of transformational leadership on perceived overqualification through career growth opportunities was stronger when the level of supervisor–subordinate guanxi was high and weaker when it was low. The findings have theoretical and practical implications for reducing employees’ perceptions of overqualification in the organizational context. (shrink)

Background: The work engagement of police officers pertains to social stability and security, as well as to the orderly operation of the political-economic environment. Although there are many studies on work engagement at present, few studies focus on the influencing factors of police officers’ work engagement. According to the job demands-resources model and the conservation of resources theory, organizational job resources (e.g., perceived organizational support) and personal resources (e.g., regulatory emotional self-efficacy) are important factors influencing work engagement. We assume a (...) moderated mediation model in which job satisfaction plays a mediating role in the relationship between perceived organizational support and work engagement, regulatory emotional self-efficacy moderates not only the relationship between perceived organizational support and job satisfaction but also the relationship between job satisfaction and work engagement. Objective and Method: This study explores the drivers of work engagement through perceived organizational support and regulatory emotional self-efficacy among Chinese police officers using a convenient sampling method to administer a questionnaire to 744 Chinese police officers. A mediated model is proposed to investigate the mediating role of job satisfaction and the regulating role of regulatory emotional self-efficacy. Results: Job satisfaction mediated a positive relationship between organizational support and work engagement, and the perceived organizational support-job satisfaction and the job satisfaction-work engagement relationships were positively moderated by regulatory emotional self-efficacy, such that these relationships were stronger at higher levels of regulatory emotional self-efficacy. These findings, have a practical significance for Chinese police officers’ work engagement advancement. (shrink)

BackgroundThe Health Research Council of New Zealand is the first major government funding agency to use a lottery to allocate research funding for their Explorer Grant scheme. This is a somewhat controversial approach because, despite the documented problems of peer review, many researchers believe that funding should be allocated solely using peer review, and peer review is used almost ubiquitously by funding agencies around the world. Given the rarity of alternative funding schemes, there is interest in hearing from the first (...) cohort of researchers to ever experience a lottery. Additionally, the Health Research Council of New Zealand wanted to hear from applicants about the acceptability of the randomisation process and anonymity of applicants.MethodsThis paper presents the results of a survey of Health Research Council applicants from 2013 to 2019. The survey asked about the acceptability of using a lottery and if the lottery meant researchers took a different approach to their application.ResultsThe overall response rate was 39%, with 30% from applicants in the years 2013 to 2018, and 68% for those in the year 2019 who were not aware of the funding result. There was agreement that randomisation is an acceptable method for allocating Explorer Grant funds with 63% in favour and 25% against. There was less support for allocating funds randomly for other grant types with only 40% in favour and 37% against. Support for a lottery was higher amongst those that had won funding. Multiple respondents stated that they supported a lottery when ineligible applications had been excluded and outstanding applications funded, so that the remaining applications were truly equal. Most applicants reported that the lottery did not change the time they spent preparing their application.ConclusionsThe Health Research Council’s experience through the Explorer Grant scheme supports further uptake of a modified lottery. (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)

This paper first extracted 11 indicators from four aspects of infrastructure, educational equity, teaching quality, and scientific research level and established a multidimensional higher education evaluation system. After that, according to TOPSIS and the entropy method, a comprehensive score of the development of higher education was obtained, and a comprehensive index of higher education was proposed. According to the level of the score, we divide the development status into 5 categories, and use discrete Hopfield neural network for verification. In addition, (...) we applied the model to many countries and chose Vietnam to conduct an in-depth analysis of the model, including reforming policies and evaluating policy effects based on cobweb model. Finally, we found that the application of the model is very universal, but in reality the reform is very difficult. (shrink)

Although narcissism is an important factor influencing entrepreneurial activity and outcomes, not much research has been conducted on the relationship between narcissism and entrepreneurship. To summarize the current literature on this relationship and provide an agenda for further in-depth research, a systematic review was conducted based on the PRISMA guidelines using Web of Science, Elsevier ScienceDirect, and EBSCO host databases. Accordingly, 33 articles have been identified as being eligible for the final synthesis. The findings of the present study showed, in (...) general, that (1) life history theory, person-environment fit theory (P-E theory), and career choice theory were mostly used to explore the topic of narcissism and entrepreneurial intention, social exchange theory was used to analyze narcissistic entrepreneurs' entrepreneurial motives and attitudes, and upper echelons theory (UET) was applied to research on the relationship between narcissism and entrepreneurial outcomes, (2) Narcissistic Personality Inventory (NPI) and narcissistic sub-dimension of the Dark Triad were frequently used self-report scales among 23 identified empirical studies, and (3) narcissism has both bright and dark sides to entrepreneurial activities and outcomes. While narcissism makes potential entrepreneurs have higher entrepreneurial intentions and greater willingness to take risks, it also prevents entrepreneurs from discovering opportunities, acquiring resources, and learning from failure. Besides, results also showed that relations between narcissism and entrepreneurial intentions and performance are more complex. For a deeper understanding of this complex relations and advancing research on narcissism and entrepreneurship, more research is necessary to explore the relations between narcissism and entrepreneurship-related variables from a temporal perspective and at the team level, examine the relationship between narcissism and entrepreneurship ethics, and investigate the interaction effects of narcissism and other personalities. (shrink)

BackgroundPatients with chronic heart failure and their family caregivers may experience adverse emotional problems, such as depression. Mutuality, which refers to the relationship between caregivers and those they care for, is an important factor affecting depression in the dyads. The purpose of this study was to investigate the relationship between mutuality and depression in patients with CHF and their caregivers in China.MethodsIn this cross-sectional study, we used the Mutuality Scale and the Self-Rating Depression Scale to measure mutuality and depression of (...) patients and caregivers. We used SPSS version 26.0 and AMOS version 21.0 to analyze the data. An APIM was established to analyze the actor-partner effects of patient-caregiver mutuality and depression.ResultsA total of 250 dyads of patients and caregivers were included in the study. There were statistically significant differences in mutuality and depression between CHF patients and caregivers. The 4 dimensions of patients’ mutuality all have the actor effect on depression. There were 3 partner effects of caregivers’ “pleasurable activities”, “shared values”, and “reciprocity” on depression. Regarding caregiver depression, we only found an actor effect of caregivers’ “shared values” on depression.ConclusionThe relationship between patients and caregivers should be evaluated in the clinical setting, and it is very important to develop intervention measures to improve the adverse emotional problems affecting both patients and their caregivers. (shrink)

How does civic disengagement develop? This article examines the theory that the dissatisfaction and disengagement citizens develop toward one government agency can extend to an alternative agency. Leveraging police precinct-level data on 311 calls and criminal complaints from 2004 to 2012 in New York City, it investigates whether government responsiveness to municipal issues predicts citizens’ willingness to submit criminal complaints to the police. The study finds that predictors of disengagement with law enforcement extend beyond negative interactions with law enforcement alone. (...) Rather, the time it takes local government officials to fix a 311 request for services, such as filling potholes and abating noise, shapes the likelihood that residents will file misdemeanor criminal complaints. Thus policymakers must account for the policy environment beyond their agency’s domain to alleviate citizens’ dissatisfaction and disengagement with government overall. (shrink)

Recognized as a simple communicative behavior, referential pointing is cognitively complex because it invites a communicator to consider an addressee's knowledge. Although we know referential pointing is affected by addressees’ physical location, it remains unclear whether and how communicators’ inferences about addressees’ mental representation of the interaction space influence sensorimotor control of referential pointing. The communicative perspective-taking task requires a communicator to point at one out of multiple referents either to instruct an addressee which one should be selected (communicative, COM) (...) or to predict which one the addressee will select (non-communicative, NCOM), based on either which referents can be seen (Level-1 perspective-taking, PT1) or how the referents were perceived (Level-2 perspective-taking, PT2) by the addressee. Communicators took longer to initiate the movements in PT2 than PT1 trials, and they held their pointing fingers for longer at the referent in COM than NCOM trials. The novel findings of this study pertain to trajectory control of the pointing movements. Increasing both communicative and perspective-taking demands led to longer pointing trajectories, with an under-additive interaction between those two experimental factors. This finding suggests that participants generate communicative behaviors that are as informative as required rather than overly exaggerated displays, by integrating communicative and perspective-taking information hierarchically during sensorimotor control. This observation has consequences for models of human communication. It implies that the format of communicative and perspective-taking knowledge needs to be commensurate with the movement dynamics controlled by the sensorimotor system. (shrink)

Integrating regulatory focus theory and personality literature, we develop and test a moderated mediation model to specify the underlying mechanisms and boundary conditions of the linkage between employee conscientiousness and job crafting. Two-wave data collected from 389 employees and 95 supervisors showed that: Employee conscientiousness had a positive effect on work promotion focus and work prevention focus. Employee conscientiousness was positively related to job crafting via work promotion focus, negatively related to job crafting via work prevention focus. Error management climate (...) positively moderated the relationship between employee conscientiousness and work promotion focus, negatively moderated the relationship between employee conscientiousness and work prevention focus. The indirect relationship between employee conscientiousness and job crafting through work promotion focus and work prevention focus were more pronounced respectively when the error management climate is higher rather than lower. (shrink)

Women account for a large proportion of the hotel industry. Work-life conflict has become one of the main obstacles to the organizational commitment of women. Thus, this study investigates the relationship for women between work-life balance, as an independent variable, and organizational commitment, as a dependent variable. Specifically, we examine women's work-life balance in the hospitality industry and compare women's organizational commitment under different levels of work-life balance. Then, we assess whether women's work-life balance and organizational commitment are associated with (...) their sociodemographic characteristics. Data were collected from 525 women employees in China. Multiple linear regression analyses were conducted to identify the relationship between work-life balance and organizational commitment. The results showed that work-life balance had a significant effect on organizational commitment. There was also a significant relationship between women's sociodemographic characteristics, work-life balance, and organizational commitment. (shrink)

Ethical voice involves individuals’ perceptions of what is right and what is wrong. Although prior research has investigated the impacts of individual-level prohibitive ethical expression on personal outcomes, there has been limited examination of ethical voice at the group level. Our study examines how and when different types of ethical voice influence group outcomes. Using data gathered from 363 participants from 61 groups in two Chinese companies, the results reveal that promotive and prohibitive ethical voices at the group level exert (...) opposing influences on group moral transitive motivation. Group moral transitive motivation serves as a mediating factor in the association between the two types of ethical voice and group ethical behaviors (GEB). In addition, group faultlines moderate the impact of promotive ethical voice and prohibitive ethical voice on group moral transitive motivation and on GEB (via group moral transitive motivation). Our study extends the focus of research from a single type of ethical voice at the individual level to multiple types at the group level. The findings contribute to the body of knowledge regarding group ethical voice (GEV) by articulating its mediating mechanism as well as its boundary condition. This research provides valuable insights for researchers and managers by offering a comprehensive understanding about the role of different types of GEV and how to reform GEV. (shrink)

ObjectiveTo investigate the characteristics of response inhibition of overweight/obese people, using behavior experiments combine with neural electrophysiological technology and discussing the difference in impulse level between obesity/overweight and normal-weight people through EEG data, questionnaire, and behavior experiment.Method All participants completed the Go/Nogo task; meanwhile, behavior data and 64 channel EEG data were recorded. Participants completed the Stop-Signal task and behavior date was recorded.Results During Go/Nogo task, no significant differences were found in reaction time, omission errors of the Go task between (...) the two groups, while commission errors of the Nogo task of the control group were significantly greater than the overweight/obesity group. About SSRT during the Stop-Signal Task, the interaction of stimulus type and group was significant. No significant differences were found between the two groups in amplitude and latency of N2. About the amplitude of P3, the interaction of task type, electrode point, and groups were significant, the control group P3 amplitude was significantly greater than overweight/obesity group during the Nogo task. Regarding about latency of P3, the interaction of group and electrode point were not significant, but the main effect of task type was significant.Conclusion In terms of behavioral outcomes, overweight–obese subjects had lower dominant response inhibition and response cessation compared to normal-weight subjects. In terms of EEG results, overweight–obese subjects showed no difference in processing speed and level of conflict monitoring for early inhibitory processing compared to normal-weight subjects, but there was a deficit in behavioral control for late inhibitory processing. (shrink)

Conquering print-sound mappings is vital for developing fluent reading skills. In neuroimaging research, this ability can be indexed by activation differences between audiovisual congruent against incongruent conditions in brain areas such as the left superior temporal cortex. In line with it, individuals with dyslexia have difficulty in tasks requiring print-sound processing, accompanied by a reduced neural integration. However, existing evidence is almost restricted to alphabetic languages. Whether and how multisensory processing of print and sound is impaired in Chinese dyslexia remains (...) underexplored. In this study, we applied a passive audiovisual integration paradigm with functional magnetic resonance imaging to investigate the possible dysfunctions in processing character-sound and pinyin-sound associations in Chinese dyslexic children. Unexpectedly, the dyslexic group did not show reduced neural integration compared with typically developing readers in either character or pinyin experiment. However, the results revealed atypical correlations between neural integration and different reading abilities in dyslexia. Specifically, while the neural integration in the left inferior frontal cortex in processing character-sound pairs correlated with silent reading comprehension in both children with and without dyslexia, it was associated with morphological awareness in controls but with rapid naming in dyslexics. This result indicates Chinese dyslexic children may not use the same grapho-semantic processing strategy as their typical peers do. As for pinyin-sound processing, while a stronger neural integration in the direction of “congruent > incongruent” in the left occipito-temporal cortex and bilateral superior temporal cortices was associated with better oral reading fluency in the control group, an opposite pattern was found in dyslexia. This finding may reflect dyslexia's dysfunctional recruitment of the regions in grapho-phonological processing, which further impedes character learning. (shrink)

Dual organizational identification (DOI) is generally considered beneficial to multinational corporations (MNCs) and their employees. However, this study challenges this consensus by exploring the potential negative impacts of DOI in the ethical controversy context when MNCs and host countries have conflicting views on a business decision and both feel that they are ethically correct. Integrating role identity theory, we propose that the DOI of host country nationals (HCNs) may create conflict in their work-related perceptions and behaviors amid an ethical controversy. (...) In Study 1, we interviewed 51 HCNs from MNCs’ Chinese subsidiaries and found that HCNs’ DOI caused their role conflict during ethical controversies, which in turn affected their perceptions (i.e., perceived isolation, ethical pressure) and behaviors (i.e., procrastination, exit, voice, headquarters (HQ)–subsidiary cooperation). We also found that the job level of HCNs played a key role in moderating the above relationship. In Study 2, we tested the theoretical framework developed in Study 1 using a multi-wave survey from a sample of 300 HCNs working in MNCs’ Chinese subsidiaries. The results generally validated the Study 1 model. Theoretical and practical implications are discussed. (shrink)

Background This study used a scenario- and discussion-based approach to teach preclinical medical students the socio-philosophical aspects of psychiatry and qualitatively evaluated the learning outcomes in a medical humanities course in Taiwan. Methods The seminar session focused on three hypothetical psychiatry cases. Students discussed the cases in groups and were guided by facilitators from multiple disciplines and professions. At the end of the semester, students submitted a narrative report comprising their reflections on the cases and discussions. The authors utilized content (...) analysis to categorize students’ narratives into three facets, namely, the philosophical, social and individual. Results In total 163 preclinical medical students participated in the class; 150 of them mentioned the scenario-based lesson in their reports; 33.3% of these reports discussed the case at the philosophical dimension (n = 50), 45.3% at the social dimension (n = 68), and 26.6% at the individual dimension (n = 40). Four major themes emerged: (1) a psychiatric diagnosis has far-reaching consequences for an individual’s life, (2) the social structure affects how patients experience psychiatric disorders, (3) students related personal experience or those of friends and family to understand psychiatric disorders, and (4) medical humanities are of particular importance in psychiatric education. Conclusions This study demonstrated that the scenario-based discussions led by a multidisciplinary team of facilitators can benefit medical students with limited clinical experience to contemplate the socio-philosophical aspects of psychiatry. The authors suggest that this pedagogical model during preclinical education should be encouraged. (shrink)

Existing research on leader humility primarily demonstrates its positive effects. This study challenges this view by proposing the potential negative effects of leader humility on followers’ behaviors. Furthermore, this paper employs the person-situation interactionist perspective to extend the research on integrating followers’ personality traits and leader humility. Specifically, this study proposed that leader humility triggers their followers’ sense of power; moreover, this study wagers that whether followers’ sense of power encourages self-interested or prosocial behavior in followers depends on their particular (...) Machiavellian traits. The theoretical model was tested using the time-lagged supervisor–subordinate matched data obtained. Our findings revealed that follower Machiavellianism fosters the relationship between a sense of power and self-interested behavior but it weakens the relationship between a sense of power and prosocial behavior. Thus, this study provides a better understanding regarding the effect of follower personality and leader humility on follower behavioral reactions. (shrink)

Teacher beliefs are a pivotal psychological quality for sustainable teacher development. Previous studies have mainly focused on the beliefs of English-as-a-second/foreign-language teachers, while little attention has been paid to those of Chinese-as-an-additional-language teachers. Particularly, there is a paucity of effort made to develop and validate instrument for measuring pre-service CAL teacher beliefs. Therefore, to further quantify the beliefs of CAL teachers is increasingly called for as an essential means to help teachers sensitize their beliefs system and promote teacher development as (...) a sustainable goal. To be specific, the present study aims to construct a scale for gauging beliefs of pre-service CAL teachers. It firstly conceptualizes the dimensions of pre-service CAL teacher beliefs by means of semantic analysis with ROST CM6, and then cross-validates the reliability and validity of the scale with psychometric methods. Two independent samples composed of 221 and 222 pre-service CAL teachers participated in a questionnaire survey. The two samples were utilized for later Exploratory Factor Analysis and Confirmatory Factor Analysis, respectively. The two data sets have satisfactory psychometric results, all confirming that the scale subsumes three factors: Beliefs about Chinese Language Teaching, Beliefs about Chinese Language, and Beliefs about Chinese Language Learners. The scale validated in the present study contributes to research on pre-service CAL teacher beliefs, and provides implications for sustainable pre-service CAL teacher training. (shrink)

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)

BackgroundBilateral cerebral palsy is the most common type of CP in children and is often accompanied by different degrees of communication impairment. Several studies have attempted to identify children at high risk for communication impairment. However, most prediction factors are qualitative and subjective and may be influenced by rater bias. Individualized objective diagnostic and/or prediction methods are still lacking, and an effective method is urgently needed to guide clinical diagnosis and treatment. The aim of this study is to develop and (...) validate an objective, individual-based model for the prediction of communication impairment in children with BCP by the time they enter school.MethodsA multicenter prospective cohort study will be conducted in four Chinese hospitals. A total of 178 children with BCP will undergo advanced brain magnetic resonance imaging at baseline. At school entry, communication performance will be assessed by a communication function classification system. Three-quarters of children with BCP will be allocated as a training cohort, whereas the remaining children will be allocated as a test cohort. Multivariate lesion- and connectome-based approaches, which have shown good predictive ability of language performance in stroke patients, will be applied to extract features from MR images for each child with BCP. Multiple machine learning models using extracted features to predict communication impairment for each child with BCP will be constructed using data from the training cohort and externally validated using data from the test cohort. Prediction accuracy across models in the test cohort will be statistically compared.DiscussionThe findings of the study may lead to the development of several translational tools that can individually predict communication impairment in children newly diagnosed with BCP to ensure that these children receive early, targeted therapeutic intervention before they begin school.Trial registrationThe study has been registered with the Chinese Clinical Trial Registry. (shrink)