The purpose of this study was to explore whether the performance of the green innovation brought positive effect to the competitive advantage. This study found that the performances of the green product innovation and green process innovation were positively correlated to the corporate competitive advantage. Therefore, the result meant that the investment in the green product innovation and green process innovation was helpful to the businesses. This study argued that the businesses should cognize the correct value and positioning of the (...) green innovation. (shrink)
Previous studies with Westerners have found that both the mouth and eyes are crucial in identifying and interpreting smiles. We proposed that Easterners (e.g., Chinese and Japanese) evaluate the role of the mouth and eyes in smiles differently from Westerners. Individuals in collectivistic Eastern society heavily rely on information from the eyes to identify and interpret the meaning of smiles.
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)
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)
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)
In order to usurp the Party, seize power and restore capitalism, the Wang-Chang-Chiang-Yao anti-Party clique has turned out counterrevolutionary opinions in the ideological realm. They have tried in every way to distort and revise history and have fabricated the "struggle between the Confucianists and the Legalists" in history. They have confounded different social contradictions and have replaced the class struggle with the "struggle between the Confucianists and the Legalists" and the antagonism within the landlord class with the "line struggle." To (...) them, Legalists were always "progressive" and "innovative" while Confucianists always "represented the forces of restoration." They have tried their best to glorify emperors, kings, generals and ministers in history, to praise Legalists as "saviors," to cover up the Legalists' nature as an exploiting class, to call for metaphysics and the idealist viewpoint of history, and to turn out revisionist fallacies. Because important changes took place in the Confucian and Legalist schools during the periods of the Western and Eastern Han dynasties, the "Gang of Four" and the writers in its service have showed a great interest in histories of the dynasties and have published a series of articles on the so-called "struggle between the Confucianists and the Legalists." In the current struggle against the "Gang of Four," it is of great practical significance to review the changes in the Confucian and Legalist schools and their roles and class nature during the Han dynasties, to criticize and expose the criminal clique's counterrevolutionary political intrigues and plots, and to clarify the historical facts confused by the "Gang of Four.". (shrink)
The antibody candidate set generated by the clonal selection algorithm has only a small number of antibodies with high antigen affinity to obtain high-frequency mutations. Among other antibodies, some low-affinity antibodies are replaced by new antibodies to participate in the next clonal selection. A large number of antibodies with high affinity make it difficult to participate in clonal selection and exist in antibody concentration for a long time. This part of inactive antibody forms a “black hole” of the antibody set, (...) which is difficult to remove and update in a timely manner, thus affecting the speed at which the algorithm approximates the optimal solution. Inspired by the mechanism of biological forgetting, an improved clonal selection algorithm is proposed to solve this problem. It aims to use the abstract mechanism of biological forgetting to eliminate antibodies that cannot actively participate in high-frequency mutations in the antibody candidate set and to improve the problem of insufficient diversity of antibodies in the clonal selection algorithm, which is prone to fall into the local optimal. Compared with the existing clonal selection and genetic algorithms, the experiment and time complexity analysis show that the algorithm has good optimization efficiency and stability. (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)
Recent studies of the rubber hand illusion (RHI) have shown that the sense of body ownership is constrained by several factors and yet is still very flexible. However, exactly how flexible is our sense of body ownership? In this study, we address this issue by investigating the following question: is it possible that one may have the illusory experience of owning four hands? Under visual manipulation, the participant adopted the experimenter’s first-person perspective (1PP) as if it was his/her own. Sitting (...) face to face, the participant saw four hands—the experimenter’s two hands from the adopted 1PP together with the subject’s own two hands from the adopted third-person perspective (3PP). We found that: (1) the four-hand illusion did not occur in the passive four-hand condition. (2) In the active four-hand condition, the participants tapped their index fingers, imitated by the experimenter. When tactile stimulations were not provided, the key illusion was not induced, either. (3) Strikingly, once all four hands began to act with the same pattern and received synchronous tactile stimulations at the same time, many participants felt as if they had two more hands. These results show that the sense of body ownership is much more flexible than most researchers have suggested. (shrink)
We investigate two issues about the subjective experience of one's body: first, is the experience of owning a full-body fundamentally different from the experience of owning a body-part?Second, when I experience a bodily sensation, does it guarantee that I cannot be wrong about whether it is me who feels it? To address these issues, we conducted a series of experiments that combined the rubber hand illusion (RHI) and the “body swap illusion.” The subject wore a head mounted display (HMD) connected (...) with a stereo camera set on the experimenter's head. Sitting face to face, they used their right hand holding a paintbrush to brush each other's left hand. Through the HMD, the subject adopted the experimenter's first-person perspective (1PP) as if it was his/her own 1PP: the subject watched either the experimenter's hand from the adopted 1PP, and/or the subject's own hand from the adopted third-person perspective (3PP) in the opposite direction (180°), or the subject's full body from the adopted 3PP (180°, with or without face). The synchronous full-body conditions generate a “self-touching illusion”: many participants felt that “I was brushing my own hand!” We found that (1) the sense of body-part ownership and the sense of full-body ownership are not fundamentally different from each other; and (2) our data present a strong case against the mainstream philosophical view called the immunity principle (IEM). We argue that it is possible for misrepresentation to occur in the subject's sense of “experiential ownership” (the sense that I am the one who is having this bodily experience). We discuss these findings and conclude that not only the sense of body ownership but also the sense of experiential ownership call for further interdisciplinary studies. (shrink)
Self-location—the sense of where I am in space—provides an experiential anchor for one's interaction with the environment. In the studies of full-body illusions, many researchers have defined self-location solely in terms of body-location—the subjective feeling of where my body is. Although this view is useful, there is an issue regarding whether it can fully accommodate the role of 1PP-location—the sense of where my first-person perspective is located in space. In this study, we investigate self-location by comparing body-location and 1PP-location: using (...) a head-mounted display (HMD) and a stereo camera, the subjects watched their own body standing in front of them and received tactile stimulations. We manipulated their senses of body-location and 1PP-location in three different conditions: the participants standing still (Basic condition), asking them to move forward (Walking condition), and swiftly moving the stereo camera away from their body (Visual condition). In the Walking condition, the participants watched their body moving away from their 1PP. In the Visual condition, the scene seen via the HMD was systematically receding. Our data show that, under different manipulations of movement, the spatial unity between 1PP-location and body-location can be temporarily interrupted. Interestingly, we also observed a “double-body effect.” We further suggest that it is better to consider body-location and 1PP-location as interrelated but distinct factors that jointly support the sense of self-location. (shrink)
In a recent study (Chen et al., 2018), we conducted a series of experiments that induced the “four-hand illusion”: using a head-mounted display (HMD), the participant adopted the experimenter’s first-person perspective (1PP) as if it was his/her own 1PP. The participant saw four hands via the HMD: the experimenter’s two hands from the adopted 1PP and the subject’s own two hands from the adopted third-person perspective (3PP). In the active four-hand condition, the participant tapped his/her index fingers, imitated by the (...) experimenter. Once all four hands acted synchronously and received synchronous tactile stimulations at the same time, many participants felt as if they owned two more hands. In this paper, we argue that there is a philosophical implication of this novel illusion. According to Merleau-Ponty (1945/1962) and Legrand (2010), one can experience one’s own body or body-part either as-object or as-subject but cannot experience it as both simultaneously, i.e., these two experiences are mutually exclusive. Call this view the Experiential Exclusion Thesis. We contend that a key component of the four-hand illusion—the subjective experience of the 1PP-hands that involved both “kinesthetic sense of movement” and “visual sense of movement” (the movement that the participant sees via the HMD)—provides an important counter-example against this thesis. We argue that it is possible for a healthy subject to experience the same body-part both as-subject and as-object simultaneously. Our goal is not to annihilate the distinction between body-as-object and body-as-subject, but to show that it is not as rigid as suggested by the phenomenologists. (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)
In 2016, Taiwan’s President Tsai Ing-wen officially apologised to the island’s indigenous peoples. This national apology not only plays a persuasive role in informing the general public about the historical wrongdoings inflicted on the Taiwanese aborigines, but also constitutes a therapeutic and restorative role in the process of reconciliation with the indigenous victims. This article provides a critical discourse analysis of President Tsai’s apology. In particular, it examines the power and ideology embedded in both the speech and the related ceremony, (...) and is supplemented with extracts from interviews with a cross-section of key stakeholders, such as a former Constitutional/supreme Court Justice, indigenous/tribal leaders and members/staff/advisers from the Presidential Office Indigenous Historical Justice and Transitional Justice Committee. The analysis reveals that, despite President Tsai’s apology and reconciliation policies, instead of facilitating reconciliation, the apology appears to exacerbate the long-standing latent tension between indigenous and non-indigenous groups. While the apology opens a window for reconciliation, a higher level of commitment is required to promote structural and systemic changes, such as land restitution, before the apology can be deemed adequate. (shrink)
For centuries, westerners have referred to China's numerous traditions of spiritual expression as "religious"--a word born of western thought that cannot completely characterize the passionate writing that fills the pages of this pathbreaking anthology. The first of its kind in well over thirty years, this text offers the student of Chinese ritual and cosmology the broadest range of primary sources from antiquity to the modern era. Readings are arranged chronologically and cover such concepts as Taoism, Confucianism, Buddhism, and even communism. (...) A large number of the selections concern the role of the female in Chinese religion, and are either by or about women. Through invocations, poetry, drama, philosophical texts, religious treatises, and modern fiction, students hear the voices of numerous Chinese masters expounding on the movements and traditions that inspired them: the mysterious Tao-te ching of Lao Tzu, cloaked in the mists of deepest antiquity; the Analects of stately, reverent Confucius; "Nailing a Stick into Empty Space," from The Recorded Conversations of Ch'an Master I-hsuan, and many others, including the work of Mencius, Pan Chao, Han Shan, Chang Tsai, Wang Yang-ming, Lu Hsun, and Mao Tse-tung. Fully one third of the translations are new, and each reading is preceded by an introduction that explains its importance and salient features. Complete with a helpful chronology of dynasties and list of possible video sources, this remarkable volume collects under one cover the most significant and influential works of China's dynamic spiritual tradition, making a fundamental contribution to courses in Chinese religion, literature, and history. (shrink)
When we say “I know why he was late”, we know not only the fact that he was late, but also an explanation of this fact. We propose a logical framework of “knowing why” inspired by the existing formal studies on why-questions, scientific explanation, and justification logic. We introduce the Kyi\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\mathcal {K}}{}\textit{y}}_i$$\end{document} operator into the language of epistemic logic to express “agent i knows why φ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} (...) \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varphi $$\end{document}” and propose a Kripke-style semantics of such expressions in terms of knowing an explanation of φ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varphi $$\end{document}. We obtain two sound and complete axiomatizations w.r.t. two different model classes depending on different assumptions about introspection. Finally we connect our logic with justification logic technically by providing an alternative semantics and an in-depth comparison on various design choices. (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)
Decision-making regarding healthcare expenditure hinges heavily on an individual's health status and the certainty about the future. This study uses data on propensity of general health exam (GHE) spending to show that despite the debate on the necessity of GHE, its objective is clear—to obtain more information and certainty about one’s health so as to minimise future risks. Most studies on this topic, however, focus only on factors associated with GHE uptake and overlook the shifts in behaviours and attitudes regarding (...) different levels of cost. To fill the gap, this study analyses a dataset of 2068 subjects collected from Hanoi (Vietnam) and its vicinities using the baseline-category logit method. We evaluate the sensitivity of Vietnamese healthcare consumers against two groups of factors (demographic and socioeconomic-cognitive) regarding payment for periodic GHE, which is not covered by insurance. Our study shows that uninsured, married and employed individuals are less sensitive to cost than their counterparts because they value the information in reducing future health uncertainty. The empirical results challenge the objections to periodic health screening by highlighting its utility. The relevance of behavioural economics is further highlighted through a look at the bounded rationality of healthcare consumers and private insurance companies in using and providing the service, respectively. (shrink)