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)

BackgroundThe therapeutic effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to the modulation of pathological neural activities, particularly the synchronization in the β band (13–35 Hz). However, whether the local β activity in the STN region can directly predict the stimulation outcome remains unclear.ObjectiveWe tested the hypothesis that low-β (13–20 Hz) and/or high-β (20–35 Hz) band activities recorded from the STN region can predict DBS efficacy.MethodsLocal field potentials (LFPs) were recorded in (...) 26 patients undergoing deep brain stimulation surgery in the subthalamic nucleus area. Recordings were made after the implantation of the DBS electrode prior to its connection to a stimulator. The maximum normalized powers in the theta (4–7 Hz), alpha (7–13 Hz), low-β (13–20 Hz), high-β (20–35 Hz), and low-γ (40–55 Hz) subbands in the postoperatively recorded LFP were correlated with the stimulation-induced improvement in contralateral tremor or bradykinesia–rigidity. The distance between the contact selected for stimulation and the contact with the maximum subband power was correlated with the stimulation efficacy. Following the identification of the potential predictors by the significant correlations, a multiple regression analysis was performed to evaluate their effect on the outcome.ResultsThe maximum high-β power was positively correlated with bradykinesia–rigidity improvement (rs = 0.549, p < 0.0001). The distance to the contact with maximum high-β power was negatively correlated with bradykinesia–rigidity improvement (rs = −0.452, p < 0.001). No significant correlation was observed with low-β power. The maximum high-β power and the distance to the contact with maximum high-β power were both significant predictors for bradykinesia–rigidity improvement in the multiple regression analysis, explaining 37.4% of the variance altogether. Tremor improvement was not significantly correlated with any frequency.ConclusionHigh-β oscillations, but not low-β oscillations, recorded from the STN region with the DBS lead can inform stimulation-induced improvement in contralateral bradykinesia–rigidity in patients with PD. High-β oscillations can help refine electrode targeting and inform contact selection for DBS therapy. (shrink)

Packed with ideas designed to help children learn to sing, this booklet offers criteria for selecting songs, strategies to bring out the best in children's voices, and suggestions for games, ideas, and resources.

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)

Due to the crucial role of customers’ brand citizenship behaviors on brand strength, this study explored the relationship between brand uniqueness, brand credibility, brand intimacy, brand love, and brand citizenship behavior in Taiwan’s restaurant context. The participants are the customers of Wang Steak, a famous restaurant chain in Taiwan. A total of 358 valid responses were gathered from a questionnaire survey, with a response rate of 71.6%. We used structural equation modeling to analyze the data. Brand uniqueness, brand credibility, and (...) brand intimacy all have a positive relationship with brand love. Moreover, brand love was positively associated with brand citizenship behavior. The findings provide greater insights into the relationship of perceived brand uniqueness, brand credibility, brand intimacy, and brand love with customers’ brand citizenship behaviors. (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)

This article examines the textual afterlives of Utopia in China and Taiwan by surveying titles published between 2016 and the first half of 2017. We are dealing with a massive array of titles pertinent to Utopia related to multiple disciplines. Indeed, not only has the sixteenth-century neologism Utopia become "a term of common parlance" that has taken on its own life,1 but the concept of Utopia representing the ideal has also been extensively adapted and appropriated.2 Since any articulation expressing a (...) particular ideal can be considered "utopian" in its own right, it is not my intention to take into account all the titles that border on the articulation of or the desire for an... (shrink)

In a multilateral bargaining game where a proposer and responders can set up a “principal–agent” relationship by means of binding cash-offer contracts, we show that there is a Markov SPE with a delay in reaching an agreement. We also show that all the individually rational and efficient payoffs can be supported by SPE.

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)

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)

This project uses machine learning and computer vision techniques and a novel interactive visualization tool to provide street-level characterization of urban spaces such as safety and maintenance in urban neighborhoods. This is achieved by collecting and annotating street-view images, extracting objective metrics through computer vision techniques, and using crowdsourcing to statistically model the perception of subjective metrics such as safety and maintenance. For modeling human perception and scaling it up with a predictive algorithm, we evaluate perception predictions across two points (...) in time separated by economic changes in the urban core of Raleigh, North Carolina, in the aftermath of the 2008 Great Recession. We hypothesize specific socioeconomic processes can be substantially reflected in the built environment of cities and, thus, render themselves visible at the street level. This paper describes the process of incorporating subjective visual ratings across two datasets of temporally separated street-view images, an algorithm, and a visualization tool. This work serves as a case study for utilizing AI and visualization techniques in a richer characterization of urban spaces that includes both objective metrics such as income (that operates at a broader scale) and subjective metrics such as perception of individuals (that operates at a narrower scale at specific locations). We outline an interdisciplinary methodology to test this hypothesis in streetscape data from Raleigh, NC, from 2008 to 2020. We describe the results of training algorithms that utilized image features with crowdsourced human perception ratings. We provide a comparison of the results with income data. The analysis and interpretation of this comparison provide insight into the challenges and opportunities for using AI technology in characterizing changes in urban environments. One challenge is the ability of human domain experts to interpret the output of algorithms through manipulation and to integrate these results into their workflow. This is addressed with a novel interface designed for interactive analysis and visualization. We conclude with a discussion of some of the benefits and limitations of integrating AI models in the human expert’s decision-making process in the presence of both subjective and objective metrics. (shrink)

Ethics is central to leadership because of the impact leaders have on establishing organizational values and engaging followers to accomplish mutual goals. The ethical concerns of leaders may influence ethical decision-making of their followers. This paper attempts to investigate the relationship between leaders and followers on moral judgment, and make a comparison between China and Taiwan on the leader–follower moral judgment relationship. Data were collected through a questionnaire survey on purchasing professionals in China and Taiwan. The development of moral judgment (...) was measured using the defining issues test. Research findings indicate that followers exhibit higher level of moral judgment while their leaders have higher level of moral judgment. A positive moral judgment relationship exists between leaders and followers. The comparative study between China and Taiwan reveals that Chinese purchasing professionals are more easily influenced by their workplace leaders than their Taiwanese counterparts. Power distance would strengthen the leader–follower moral judgment relationship. The present research makes contributions toward the ethics literature by providing empirical insight into the relationship between leader moral judgment and follower moral judgment. This paper also suggests implications and opportunities for future research. (shrink)

Organizational citizenship behavior can foster organizational competitiveness and survival especially, facing a rapidly changing environment. There are some empirical pieces of research that shed light on the effects of OCB on extrinsic rewards, since OCB, through performance appraisal, affects extrinsic rewards which will influence OCB as well. However, researchers have overlooked the reverse effect of extrinsic rewards on OCB. It is necessary to explore the mechanism between positive verbal rewards and OCB. This study integrated psychological ownership and affective commitment to (...) form a structural model based on social exchange theory and cognitive evaluation theory. These results show that positive verbal rewards are positively correlated with psychological ownership, psychological ownership is positively correlated with affective commitment and OCB, and affective commitment is positively correlated with OCB. As refers to the mediating effects, psychological ownership fully mediates the relationship between positive verbal rewards and affective commitment. Furthermore, affective commitment plays a partial mediating role in the effect of psychological ownership on OCB. Accordingly, this psychological mechanism between positive verbal rewards and OCB reveals important theoretical and practical implications. (shrink)

Business moral values are defined as the personal moral values held by individuals who are engaged in business interactions. Direct supervisors may play an important role in shaping the business moral values of their subordinates. Using 264 supervisor— subordinate dyadic data from Taiwanese organizations, the study investigated the relationships among supervisor business moral values, subordinate business moral values, subordinate organizational commitment, job performance, and attendance. The results indicated that supervisor business moral values were positively associated with subordinate business moral values, (...) and that the latter mediated the relationship between the former and subordinate outcomes. Implications for business moral values research are discussed. (shrink)

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)

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)

Through users’ cross-system comparative experience engaging with the health systems in Taiwan and other countries, this article probes into their understandings and value judgments and specifically their reasonings for the ‘solidarity with whom?’ question in the health sector solidarity. With the cross-system comparison approach, the study adopted semi-structured interviews with 30 Taiwanese participants who have studied, lived or worked abroad and engaged with the health system in Canada, the USA or the UK. This approach offers the opportunity for one to (...) evaluate the health system in the home country from a relative viewpoint from the host country. The participants suggested that the boundary of Taiwan’s National Health Insurance (NHI) should be as inclusive as possible, covering all legal residents in Taiwan regardless of their status, and that the citizens should share more financial responsibility. The ethical reasons for supporting the NHI include recognizing health sector solidarity among people, considering the coverage as a protection of the human right to health, humanitarian reasons and self-interest. Three archetypes of users emerged from the synthesis: Universalists, Rationalists and Republicans. The cross-system comparative experience makes the participants have more supportive attitudes toward the ideals of health sector solidarity. (shrink)

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

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

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)

In this paper, we discuss the development and piloting of a new methodology for illuminating the socio-material constitution of data objects and flows as data move between different sites of practice. The data journeys approach contributes to the development of critical, qualitative methodologies that can address the geographic and temporal scale of emerging knowledge infrastructures, and capture the ‘life of data’ from their initial generation through to re-use in different contexts. We discuss the theoretical development of the data journeys methodology (...) and the application of the approach on a project examining meteorological data on their journey from initial production through to being re-used in climate science and financial markets. We then discuss three key conceptual findings from this project about: the socio-material constitution of digital data objects, ‘friction’ in the movement of data through space and time and the mutability of digital data as a material property that contributes to driving the movement of data between different sites of practice. (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)