Consumers play an important role as one of the main actors in food safety social co-governance. To create a pattern of food safety social co-governance, the active and effective participation of consumers is critical. To encourage consumers to participate in food safety social co-governance voluntarily and positively, we attempted to develop and preliminarily validate a multidimensional questionnaire on consumer psychological capital that could be used to measure the degree of consumer participation in food safety social co-governance. The aim of the (...) initial sample and test sample 2 was to investigate the factor structure of a preliminary measure of consumer psychological capital. A 4-factor model with 23 items explained 61.05% of the total variance in item scores. The aim of test sample 3 was to measure the retest reliability. Test sample 4 was randomly allocated to the modeling sample and validation sample to verify questionnaire reliability and validity. Convergent validity, discriminant validity, and the internal inconsistency coefficients of the questionnaire were assessed in the modeling sample. While processing CFA, we deleted 9 items with small standardized factor loadings. The remaining 14 items in the final revised 4-factor model included self-efficacy, resilience, hope, and optimism. The fit indices of the revised four-factor model and second-order factor model in the modeling sample revealed an acceptable model fit. The convergent validity and discriminant validity of the revised model were good and acceptable, respectively. A cross-validation procedure confirmed the appropriateness of the revised four-factor model and second-order factor model in the validation sample. The cross-validation results confirmed that the fit indices of the revised four-factor model fitted the data well and the second-order factor model in the validation sample reached acceptable values. We concluded that the questionnaire developed in this study had good reliability and stable and acceptable construct validity. It could provide a theoretical basis for measuring psychological capital in food safety co-governance. (shrink)

In recent years, due to factors such as rising sea levels, several island nations such as Maldives, Tuvalu, Kiribati, and the Marshall Islands are in danger of disappearing completely. When the land of an island country disappeared, the human rights protection of Environmentally Displaced Persons in the migration process and the possible loss of their unique culture, language, and lifestyle have aroused great concern. We call such Environmentally Displaced Persons as EDPs. This study selects the EDPs’ data of 241 countries (...) or regions from 2008 to 2018, establishes an ARIMA model, and predicts the future population of EDPs. By combining the influencing factors of cultural loss, the risk assessment model of cultural loss is established to evaluate the possibility of cultural loss during the migration process of EDPs. We have established a Bayesian Network and a Fault Tree Model to demonstrate the improvement brought about by the implementation of policy recommendations from both qualitative and quantitative perspectives and use the method of fault tree analysis to illustrate the importance of policies from the degree of probability reduction after policy changes. Finally, based on the above model establishment and data analysis, corresponding countermeasures are proposed to protect EDPs’ human rights from being violated and their culture will not be lost. (shrink)

What is feminist philosophy? A difficult question for feminist scholars in China. Women's studies in the Chinese mainland are characteristically policy‐oriented, geared to practical concerns and moral urgency. Empirical research projects engage many pressing social issues related to the changing situation of women in a rapid marketification of society and commercialization of culture since the post‐1978 reform movement. Here are some examples: migrant female workers and their working conditions in the urban centers; the impact of rural industrialization on women in (...) the countryside: discrimination against women in employment as well as in other aspects of social life; marriage and sexual relations. What follows in this article however, represents an effort to identify and categorize trends in emerging feminist theories. The main questions that might be seen as in one way or another philosophical are located in the historical context of the transformation of Chinese socialism. As we have only very limited access to publications in Hong Kong and Taiwan, to avoid mispresentation we regret that we cannot discuss the feminist work developed in these areas. (shrink)

PurposeOlder adults aged 60 years and above are classified as being of high-risk for infection during the COVID-19 pandemic. This study aimed to investigate the associations of psychological factors of preventive behaviors with three preventive behaviors among Chinese older adults during the COVID-19 pandemic.MethodsA cross-sectional questionnaire survey was administered via SOJUMP, a widely used online survey platform in China. A total of 928 older adults were recruited using a snowball sampling approach from Hubei Province and outside Hubei Province in China (...) during May 18, 2020 to June 7, 2020. Multiple hierarchical regressions were conducted with four models to examine the association between demographic, past behavior, psychological factors and each preventive behavior.Principal FindingsAll three preventive behaviors in older adults increased dramatically during the pandemic of COVID-19. Gender, living status, educational level, past behavior, health knowledge, intention and planning significantly predicted hand washing behavior, R2 = 0.395, F = 54.372, p < 0.001. Gender, education level, important others infection, past behavior, health knowledge, planning and action control significantly predicted mask wearing behavior, R2 = 0.202, F = 23.197, p < 0.001. Living place, past behavior and health knowledge significantly predicted social distancing behavior, R2 = 0.204, F = 26.201, p < 0.001.Major ConclusionsPast behavior and health knowledge predicted all three preventive behaviors. Planning was an important psychological factor for both hand washing and mask wearing behaviors. All those critical demographic and psychological factors are critical for future interventions to facilitate older adults to comply with three preventive behaviors in daily life and to stay healthy during the COVID-19 pandemic. (shrink)

Is it possible that there are extended simples—material objects extended in space or spacetime that have no proper parts? The most commonly cited argument for this possibility is based on a version of the Humean principle: namely (and with some qualifications), any pattern of instantiation of a fundamental relation is possible. In this paper, we make the Humean argument fully explicit, and criticise it from three aspects—the Disjunction problem, the Pluralist problem, and the Accidentality problem. First, the original argument only (...) shows a disjunctive thesis: either extended simples are possible, or unextended complexes are possible. In order to reach the desired conclusion, some additional premise is needed. Yet, even though we agree that the Disjunction problem can be met, we argue that the Humean argument fails to establish the possibility of extended simples, for two reasons: the first comes from compositional pluralism, and the second is about the definition of accidental properties. We contend that the latter two problems put the proponents of the Humean argument in serious difficulty. Thus, metaphysicians who hold that there are extended simples should find better arguments for this view. (shrink)

Over the past two decades, Victor and Cullen's (Adm Sci Q 33:101-125, 1988) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan's top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical climates. The results confirm the relationship between (...) these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

Background Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. Methods This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, (...) 2013 were reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. Results We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Conclusion Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order. (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)

Career sustainability is a well-researched issue in academics and other sectors. Technology advancements and COVID-19 have jeopardized career sustainability. Numerous studies have explored the influence of individual characteristics on career sustainability, but few have focused on leadership. In addition, cultural factors must be considered because leadership is rooted in culture. In particular, inclusive leadership reflects traditional Chinese culture. Therefore, based on self-determination social exchange theories, we analyzed the effects of inclusive leadership on career sustainability as well as the roles of (...) thriving at work and supervisor developmental feedback in career sustainability. In total, 363 samples were collected from China. The results revealed that inclusive leadership improves career sustainability through SDF and thriving at work. Theoretically, our study fills the research gap and establishes a mechanism and theoretical framework for inclusive leadership and career sustainability. Practically, we offer guidance for enterprises to cultivate inclusive leadership and improve career sustainability. (shrink)

The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before (...) and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. (shrink)

Concerns with improper collection and usage of personal information by businesses or governments have been seen as critical to the success of the emerging electronic commerce. In this regard, computer professionals have the oversight responsibility for information privacy because they have the most extensive knowledge of their organization's systems and programs, as well as an intimate understanding of the data. Thus, the competence of these professionals in ensuring sound practice of information privacy is of great importance to both researchers and (...) practitioners. This research addresses the question of whether male computer professionals differ from their female counterparts in their self-regulatory efficacy to protect personal information privacy. A total of 103 male and 65 female subjects surveyed in Taiwan responded to a 10-item questionnaire that includes three measures: protection, non-distribution, and non-acquisition. The findings show significant gender differences exist in the subjects' overall self-regulatory efficacy for information privacy, and, in particular, that female subjects in this study exhibited a higher level of self-regulatory efficacy than males for the protection and non-acquisition of personal privacy information. The identification of the factorial structure of the self-regulatory efficacy concerning information privacy may contribute to future research directed to examining the links between privacy efficacy and psychological variables, such as ethical attitude, ethical intention, and self-esteem. Studies can also be extended to investigate how different cultural practices of morality and computer use in men and women may shape the different development patterns of privacy self-efficacy. Understanding the different cultural practices may then shed light on the social sources of privacy competence and the appropriate remedies that can be provided to improve the situation. (shrink)

The topic of employee work engagement in the public sector has attracted broad attention because it is critical to the efficiency and effectiveness of public services. Based on the Job Characteristics Model and the Integrative Theory of Employee Engagement, the present research adopts a multilevel design to examine a moderated mediation model in which task characteristics and social context jointly impact employee work engagement via individual perception of meaningfulness in work. A total of 349 grassroots police officers from 35 police (...) substations were invited to anonymously complete a survey via mobile app. After performing the cross-sectional analysis, the results indicated that in contrast to task significance, the conditional effect of task autonomy on work engagement via perceived meaningfulness was more positive at a lower level of transformational leadership. Implications, limitations, and future research directions are discussed. (shrink)

Recent advances in mobile electroencephalogram (EEG) systems, featuring non-prep dry electrodes and wireless telemetry, have urged the needs of mobile brain-computer interfaces (BCIs) for applications in our daily life. Since the brain may behave differently while people are actively situated in ecologically-valid environments versus highly-controlled laboratory environments, it remains unclear how well the current laboratory-oriented BCI demonstrations can be translated into operational BCIs for users with naturalistic movements. Understanding inherent links between natural human behaviors and brain activities is the key (...) to ensuring the applicability and stability of mobile BCIs. This study aims to assess the quality of steady-state visual-evoked potentials (SSVEPs), which is one of promising channels for functioning BCI systems, recorded using a mobile EEG system under challenging recording conditions, e.g., walking. To systemati-cally explore the effects of walking locomotion on the SSVEPs, this study instructed subjects to stand or walk on a treadmill running at speeds of 1, 2, and 3 mile (s) per hour (MPH) while con-currently perceiving visual flickers (11 and 12 Hz). Empirical results of this study showed that the SSVEP amplitude tended to deteriorate when subjects switched from standing to walking. Such SSVEP suppression could be attributed to the walking locomotion, leading to distinctly deteriorated SSVEP detectability from standing (84.87±13.55%) to walking (1 MPH: 83.03±13.24%, 2 MPH: 79.47±13.53%, and 3 MPH: 75.26±17.89%). These findings not only demonstrated the applicability and limitations of SSVEPs recorded from freely behaving humans in realistic environments, but also provide useful methods and techniques for boosting the translation of the BCI technology from laboratory demonstrations to practical applications. (shrink)

The purpose of this study is to examine preservice Chinese language teachers’ cognition in teaching intercultural communicative competence. In the study we collected data through in-depth interviews with seven preservice teachers in a Master of Education program at a university in Hong Kong SAR, China. The findings indicated that the participants had a relatively positive attitude and inclination toward the development of students’ intercultural communicative competence, while their conceptualizations of culture tended to be static and ambiguous. In addition, the participants’ (...) objectives in teaching intercultural communicative competence were found to be more attitude-than knowledge- or skill-oriented. The study offers valuable insights that preservice language teachers’ cognition plays a crucial role in their future professional development and calls for curricular innovations with intercultural aims in teacher education programs. (shrink)

Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients’ true wishes, meaningfully engaging patients’ significant others, balancing interests among patients and significant others, and determining clinicians’ obligations to change patients’ unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients’ competence (apart from (...) decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman’s procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman’s account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician–patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care. (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)

Urban streetscapes are outdoor areas in which the general public can appreciate green landscapes and engage in outdoor activities along the street. This study tested the extent to which the degree of awareness of urban street trees impacts attention restoration and perceived restorativeness. We manipulated the degree of awareness of street trees. Participants were placed into four groups and shown different images: (a) streetscapes with absolutely no trees; (b) streetscapes with flashes of trees in which participants had minimal awareness of (...) the content; (c) streetscapes with trees; and (d) streetscapes with trees to which participants were told to pay attention. We compared the performance of 138 individuals on measures of attention and their evaluations of perceived restorativeness. Two main findings emerged. First, streetscapes with trees improved the performance of participants on attentional tests even without their awareness of the trees. Second, participants who had raised awareness of street trees performed best on the attentional test and rated the streetscapes as being more restorative. These findings enhance our knowledge about the role of an individual's awareness of restorative elements and have implications for designers and individuals who are at risk of attentional fatigue. (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)

This study draws on Relevance Theory, Conversation Analysis, and Politeness Theory in investigating a full range of discourse functions for hao and dui with reference to recurrent patterns, distributions, and forms of organization in a large corpus of talk. Special emphasis is placed on a comparison of hao and dui in combination with a small subset of discourse particles: in particular hao/hao le/ hao la/hao a/hao ba and dui/dui a/dui le in spoken discourse. We find that both of the markers (...) signal special sequential relatedness in talk and carry information which is relevant in determining the boundaries of conversational exchange. However, in interaction hao is used for expressing acceptance of the other speaker’s move or act, whereas dui conveys acknowledgment of the propositional content of the utterance produced by the other speaker. (shrink)

This paper provides an explanation for Gadamer’s inconsistent ideas of the symbol in his works, arguing that his concept of the symbol has evolved from a less-authentic experience to an authentic experience. In Truth and Method, the symbol is defined as having an instituted meaning and substitution function, and is devalued as a pure appearance of the real, which is less authentic than the artistic presentation that occasions the coming-into-existence events of the real. Later, in “The Relevance of the Beautiful”, (...) Gadamer elevates the symbol to the same status as the work of art, and uses it to defend the work of art’s inexhaustibility and irreplaceability in communicating meanings and revealing truth. Gadamer’s changed concept of the symbol also serves to justify the universality of philosophical hermeneutics in addressing modern art-related issues, particularly those involving the speechlessness, definition, and technological reproductions of art. (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)

ObjectiveThis study aimed to better understand the current situation involving work stressors and the coping styles of outpatient and emergency nurses in 29 pediatric specialty hospitals across China. The study analyzed this correlation to provide a reference for the occupational stress management of pediatric nurses.MethodsFrom June to September 2020, 1,457 outpatient and emergency nurses in 29 pediatric specialty hospitals across China were selected as study participants, and a questionnaire survey was conducted using the Basic Information Questionnaire, the Chinese version of (...) the Work Stressor Scale for Nurses, and the Simple Coping Style Scale.ResultsThe assessed stress level of outpatient and emergency nurses in 29 tertiary pediatric specialty hospitals nationwide is lower than the results of the survey of the 2007 domestic norm, p < 0.05. The stressors related to nurses’ expectations, family conflicts, the nature of nursing work, patient factors, and workload were lower compared with the national norm. The positive coping style score on the Simple Coping Style Scale for pediatric outpatient nurses was, and work stressors were positively associated with negative coping styles. Multiple regression analysis showed that the influencing factors of work stressors among pediatric outpatient and emergency nurses correlated with the authorized size, age, working years of nurses, work department, and negative coping styles.ConclusionNegative coping styles were present among pediatric outpatient and emergency nurses and were associated with work stressors. The influencing factors of stressors mainly correlated with the clinical establishment, age, years of employment as a nurse, work department, and negative coping styles. (shrink)

This study aims to disclose how the magnetic resonance imaging neuroimaging approach has been applied in education studies, and what kind of learning themes has been investigated in the reviewed MRI neuroimaging research. Based on the keywords “brain or neuroimaging or neuroscience” and “MRI or diffusion tensor imaging or white matter or gray matter or resting-state,” a total of 25 papers were selected from the subject areas “Educational Psychology” and “Education and Educational Research” from the Web of Science and Scopus (...) from 2000 to 2019. Content analysis showed that MRI neuroimaging and learning were studied under the following three major topics and nine subtopics: cognitive function, science education, and brain development. As for the type of MRI neuroimaging research, the most frequently used approaches were functional MRI, followed by structural MRI and DTI, although the choice of approach was often motivated by the specific research question. Research development trends show that the neural plasticity theme has become more prominent recently. This study concludes that in educational research, the MRI neuroimaging approach provides objective and empirical evidence to connect learning processes, outcomes, and brain mechanisms. (shrink)

Many applications of intuitionistic fuzzy sets depend on ranking or comparing intuitionistic fuzzy numbers. This paper presents a novel ranking method for intuitionistic fuzzy numbers based on the preference attitudinal accuracy and score functions. The proposed ranking method considers not only the preference attitude of decision maker, but also all the possible values in feasible domain. Some desirable properties of preference attitudinal accuracy and score functions are verified in detail. A total order on the set of intuitionistic fuzzy numbers is (...) established by using the proposed two functions. The proposed ranking method is also applied to select renewable energy. The advantage and validity of the proposed method are shown by comparing with some representative ranking methods. (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)

Background The Patient Right to Autonomy Act (PRAA), implemented in Taiwan in 2019, enables the creation of advance decisions (AD) through advance care planning (ACP). This legal framework allows for the withholding and withdrawal of life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) in situations like irreversible coma, vegetative state, severe dementia, or unbearable pain. This study aims to investigate preferences for LST or ANH across various clinical conditions, variations in participant preferences, and factors influencing these preferences among urban (...) residents. Methods Employing a survey of legally structured AD documents and convenience sampling for data collection, individuals were enlisted from Taipei City Hospital, serving as the primary trial and demonstration facility for ACP in Taiwan since the commencement of the PRAA in its inaugural year. The study examined ADs and ACP consultation records, documenting gender, age, welfare entitlement, disease conditions, family caregiving experience, location of ACP consultation, participation of second-degree relatives, and the intention to participate in ACP. Results Data from 2337 participants were extracted from electronic records. There was high consistency in the willingness to refuse LST and ANH, with significant differences noted between terminal diseases and extremely severe dementia. Additionally, ANH was widely accepted as a time-limited treatment, and there was a prevalent trend of authorizing a health care agent (HCA) to make decisions on behalf of participants. Gender differences were observed, with females more inclined to decline LST and ANH, while males tended towards accepting full or time-limited treatment. Age also played a role, with younger participants more open to treatment and authorizing HCA, and older participants more prone to refusal. Conclusion Diverse preferences in LST and ANH were shaped by the public’s current understanding of different clinical states, gender, age, and cultural factors. Our study reveals nuanced end-of-life preferences, evolving ADs, and socio-demographic influences. Further research could explore evolving preferences over time and healthcare professionals’ perspectives on LST and ANH decisions for neurological patients.. (shrink)

Abstractabstract:This article presents previous attempts to map Utopia, a fictional island in the book Utopia by Thomas More, and proposes another possibility, based on the assumption that Utopia is an enclosed garden on an artificial island that is not flat, but has piedmont slopes of 2.5:1. Our mapping experiment is founded on the Renaissance analogy between the domestication of wild nature, and the civilization of the human beings in More’s enclosed garden; and on the anecdotal similarities between the Inca Empire (...) and Utopia. This approach is not only consistent with the island’s dimensional specifications, which have hampered previous mapping attempts due to their mathematical incompatibility, but it also addresses the educative capacity of utopian life not considered by previous mapping efforts. Utopia, as a result, is to be understood as a series of performative spatial arrangements where the physical and geographical specifications would inform the vernacular life of its inhabitants in the direction of self-enhancement. (shrink)

To support older users’ accessibility and learning of the prevalent information and communication technologies, libraries, as informal learning institutes, are committed to information literacy education activities with friendly interfaces. Chatbots using Voice User Interfaces with natural and intuitive interactions have received growing research and practical attention; however, older users report regular frustrations and problems in using them. To serve as a basis for the subsequent design and development of an automated dialog mechanism in senior-friendly chatbots, a between-subject user experiment was (...) conducted with 30 older adults divided into three groups. The preliminary findings on their interactions with the voice chatbots designed with different error handling strategies were reported. Participants’ behavioral patterns, performances, and the tactics they employed in interacting with the three types of chatbots were analyzed. The results of the study showed that the use of multiple error handling strategies is beneficial for older users to achieve effectiveness and satisfaction in human-robot interactions, and facilitate their attitude toward information technology. This study contributes empirical evidence in the genuine and pragmatic field of gerontechnology and expands upon voice chatbots research by exploring conversation errors in human-robot interactions that could be of further application in designing educational and living gerontechnology. (shrink)

Emerging evidence suggests that microRNA (miRNA)‐mediated post‐transcriptional gene regulation plays an essential role in modulating embryonic stem (ES) cell pluripotency maintenance, differentiation, and reprogramming of somatic cells to an ES cell‐like state. Investigations from ES cell‐enriched miRNAs, such as mouse miR‐290 cluster and human miR‐302 cluster, and ES cell‐depleted miRNAs such as let‐7 family miRNAs, revealed a common theme that miRNAs target diverse cellular processes including cell cycle regulators, signaling pathway effectors, transcription factors, and epigenetic modifiers and shape their protein (...) output. The combinatorial effects downstream of miRNA action allow miRNAs to modulate cell‐fate decisions effectively. Furthermore, the transcription and biogenesis of miRNAs are also tightly regulated. Thus, elucidating the interplay between miRNAs and other modes of gene regulation will shed new light on the biology of pluripotent stem cells and somatic cell reprogramming. (shrink)

With the development and support of modern technologies such as digital media and online live stream, it has become an effective way to promote the online transaction of museum cultural and creative products. Based on the Technology Acceptance Model combined with the Post-Acceptance Model of Information System Continuance and the theories on customer satisfaction index, this research introduces perceived interest and media richness as variables and constructs a model of the influencing factors of online consumers’ persistent purchase of museum products. (...) The research model and related hypotheses were verified through structural equation modeling. The research found that perceived value and satisfaction are the key variables that have impact on the PP of consumers. Perceived quality, brand trust, MR, PI, and perceived usefulness have significant effects on PV and SAT. Involvement in purchasing decisions positively moderates the impact on SAT of PV. The conclusion can be referred to for operators and product developers. (shrink)

Only problems that cannot be solved without representational changes can be regarded as pure insight problems; others are classified as pseudo-insight problems. Existing studies using neuroimaging...