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)

ObjectiveBasic combat training is a kind of necessary high-intensity training to help each military recruit convert into a qualified soldier. In China, both the physical fatigue and passive psychological state have been observed in new recruits during BCT. However, after same-intensity training, the degree of fatigue and passive mood vary among recruits. Therefore, this study aimed to explore the effect of BCT on mood state of recruits with different physical fitness levels from a perspective of fatigue.Materials and methodsBefore and after (...) BCT, the degree of fatigue and mood state of participants were evaluated via the Borg Rating of Perceived Exertion Scale and Profile of Mood States Questionnaire immediately after 20 push-ups as RPE and POMS scores [total mood disturbance, passive mood and positive mood ]. The participants were divided into two groups according to the RPE score measured after BCT: group 1: RPE score after BCT < 13 and group 2: RPE score after BCT ≥ 13.ResultA total of 564 recruits were included. After BCT, in group 1, TMD and passive mood Ttension, Tfatigue, Tdepression, Tconfusion declined significantly, but positive mood both increased significantly ; while in group 2, only Tanger and Testeem increased significantly.ConclusionBCT could alleviate passive mood and add to positive mood for recruits with better physical fitness, while had no ameliorative effects on or even deteriorate most of the passive mood for recruits with worse physical fitness. (shrink)

In practical application studies of glider formations, ocean currents are a major influencing factor in their path planning. The purpose of this paper is to solve the path planning problem of glider formations in time-varying ocean currents and establish gliders, glider formation, and ocean current models based on existing data. The Doc-CNN architecture is tailored to conform to the operation and environment characteristics of gliders in practical application. After experiments, the algorithm of the improved architecture can be used in the (...) path planning task of glider formation. The algorithm architecture is compared and tested on two datasets, grid maps and ocean maps. Doc-CNN has an advantage over architecture without being tailored to glider characteristics and makes full use of known global information and local information collected by gliders themselves. The results show that the path planning problem of glider formation in ocean currents can be solved by using Doc-CNN. (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)

Resumen: El corpus, siendo una herramienta eficaz, se está empleando en múltiples ámbitos, entre los que se encuentran los estudios de traducción. Sin embargo, dicho recurso no se utiliza con mucha frecuencia en las investigaciones traductológicas cuando una de las lenguas en cuestión es chino clásico (la lengua escrita empleada antiguamente en China), y autores que sí hacen estas investigaciones suelen no mencionar los pasos a seguir cuando se trata un corpus paralelo ad hoc. El objetivo del presente artículo es (...) presentar cómo se elabora un corpus paralelo chino clásico-español tomando como ejemplo la novela histórica Romance de los Tres Reinos y sus traducciones al español. Para ello, hemos descrito la problemática de creación y explotación de este tipo de corpus, siguiendo el orden de las fases del proceso. Resulta que algunas fases del proceso son universales, mientras que otras son propias de lenguas clásicas y de la combinación lingüística chino-otra lengua, en cuyo caso sí faltan aplicaciones eficaces. Con el trabajo, esperamos deparar información a los estudiosos que quieran realizar y profundizar las investigaciones basadas en corpus paralelo y en las obras clásicas de China. Abstract: The corpus, being an effective tool, is utilized in multiple fields. One of them is the Translation. However, this resource isn´t used frequently in translation studies when one of the languages in question is classical chinese (written language used anciently in China). And when it comes to an ad hoc parallel corpus, the steps of how to create it are usually omitted by researchers who make such investigations. The objective of this article is to present how to elaborate a classic Chinese-Spanish parallel corpus taking as example the historic novel Romance of the Three Kingdoms and its two translations into Spanish. To reach the objective, we have described the problem of creation and exploitation of this type of corpus, following the order of the phases of the process. We’ve found that some of the phases are universal while other phases are unique for old languages and for the linguistic combination Chinese-other language. And in this latter case, there’s a lack of effective applications. With the current work, we hope to offer useful information to those scholars who are willing to carry out their own investigations based on self-built parallel corpus and at the same time related to the classic Chinese works. (shrink)

Resumen: El corpus, siendo una herramienta eficaz, se está empleando en múltiples ámbitos, entre los que se encuentran los estudios de traducción. Sin embargo, dicho recurso no se utiliza con mucha frecuencia en las investigaciones traductológicas cuando una de las lenguas en cuestión es chino clásico (la lengua escrita empleada antiguamente en China), y autores que sí hacen estas investigaciones suelen no mencionar los pasos a seguir cuando se trata un corpus paralelo ad hoc. El objetivo del presente artículo es (...) presentar cómo se elabora un corpus paralelo chino clásico-español tomando como ejemplo la novela histórica Romance de los Tres Reinos y sus traducciones al español. Para ello, hemos descrito la problemática de creación y explotación de este tipo de corpus, siguiendo el orden de las fases del proceso. Resulta que algunas fases del proceso son universales, mientras que otras son propias de lenguas clásicas y de la combinación lingüística chino-otra lengua, en cuyo caso sí faltan aplicaciones eficaces. Con el trabajo, esperamos deparar información a los estudiosos que quieran realizar y profundizar las investigaciones basadas en corpus paralelo y en las obras clásicas de China. Abstract: The corpus, being an effective tool, is utilized in multiple fields. One of them is the Translation. However, this resource isn´t used frequently in translation studies when one of the languages in question is classical chinese (written language used anciently in China). And when it comes to an ad hoc parallel corpus, the steps of how to create it are usually omitted by researchers who make such investigations. The objective of this article is to present how to elaborate a classic Chinese-Spanish parallel corpus taking as example the historic novel Romance of the Three Kingdoms and its two translations into Spanish. To reach the objective, we have described the problem of creation and exploitation of this type of corpus, following the order of the phases of the process. We’ve found that some of the phases are universal while other phases are unique for old languages and for the linguistic combination Chinese-other language. And in this latter case, there’s a lack of effective applications. With the current work, we hope to offer useful information to those scholars who are willing to carry out their own investigations based on self-built parallel corpus and at the same time related to the classic Chinese works. (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)

This paper presents an adaptive fuzzy sliding-mode controller for multiple Euler–Lagrange systems communicated with directed topology. Based on the graph theory and Lyapunov–Krasovskii functions, a delay-dependent sufficient condition for the existence of sliding surfaces is given in terms of linear matrix inequalities. The asymptotic stability is analyzed by using the Lyapunov method in the presence of unknown parametric dynamics, actuator faults, and time-varying delays. The usage of adaptive techniques is to adapt the unknown parameters so that the objective of globally (...) asymptotic stability is achieved. Finally, simulation results are provided to illustrate the effectiveness of the proposed control scheme. (shrink)

This study investigated how Paul’s Jewish background, including some elements of pre-rabbinical Jewish literature, influenced the letter to the Galatians with regard to the concept of adoption (υἱοθεσία) (Gl 4:1–7). As Paul was writing to a Gentile audience, wanting to persuade them to return to the true gospel, metaphors of adoption, embedded in the understanding of the Graeco-Roman household, became effective communication bridges to reach his audience. Within this framework, Israel’s God was depicted as the caring father of the household, (...) who through his son Jesus Christ redeems all human beings from the status of slaves to that of children with full rights of inheritance. Contribution: God’s redemption is not merely a forensic sense of justification but also the imagery of relationship in the household by which God does not merely set one free from sin by securing us through Jesus Christ into the society of the righteous, but also adopts us into his family. (shrink)

This research examines wearable, fashionable interaction design to mediate the narrative and semiotic concepts found in technology and fashion. We discuss the principles of design anthropology using Taiwan proverbs to transmit the “people-situation-reason-object” method and analyze five case studies that provide new approaches for designers engaged in future industry. Design anthropology attempts to engage physiological and psychological design through technological function, meaning formation, and fashion aesthetics to achieve cognition between people and the environment. The wearable, fashionable interaction displays characteristics of (...) narrative and semantics transmitted through craft culture as well as collective, cheerful, and creative performance. It is a confident and innovative attempt, which bears a joyful and fundamental interface. This study takes two directions, with cultural thinking serving as the basis to establish a set of traditional craft designs and interactive objects that assist designers in using the senses to inform and initiate new lifestyle values. (shrink)

This research examines wearable, fashionable interaction design to mediate the narrative and semiotic concepts found in technology and fashion. We discuss the principles of design anthropology using Taiwan proverbs to transmit the “people-situation-reason-object” method and analyze five case studies that provide new approaches for designers engaged in future industry. Design anthropology attempts to engage physiological and psychological design through technological function, meaning formation, and fashion aesthetics to achieve cognition between people and the environment. The wearable, fashionable interaction displays characteristics of (...) narrative and semantics transmitted through craft culture as well as collective, cheerful, and creative performance. It is a confident and innovative attempt, which bears a joyful and fundamental interface. This study takes two directions, with cultural thinking serving as the basis to establish a set of traditional craft designs and interactive objects that assist designers in using the senses to inform and initiate new lifestyle values. (shrink)

In this article, we introduce the theory of archetype, which explains the connection between ancient myths and the human mind. Based on the assumption that archetypes are in the deepest level of human mind, we propose that archetypal symbolism is a kind of knowledge that supports the cognitive process for creating subjective world-view towards the physical world we live in. According to archetypal symbolism, we conducted an empirical study to identify archetypal symbols in modern movies. A new collection of movie (...) clips was developed to represent eight essential archetypes: anima, animus, mentor, mother, shadow, hero’s departure, hero’s initiation and hero’s return, which can be used in future studies on human emotion. In order to investigate the emotions towards these archetypal symbols, we provide suggestions from the psychological point of view. The present study demonstrates how to identify symbolic meanings in movies, and indicates a new direction for future studies in psychology. (shrink)

Social media users have increased rapidly in recent years; however, most are “silent users” who rarely share information online. To maintain social media companies’ stable operation and development, this research explored the effects of flow experience and identity formation on users’ intrinsic motivation to facilitate aggressive, spontaneous, and habitual participation in virtual communities. A total of 487 valid questionnaires were collected and underwent regression analysis. The results revealed that all three intrinsic motivations had a significant impact on social media participation, (...) with social interaction exerting the strongest influence. Flow experience and identification had significant, partial mediating effects on the relationship between motivation and participation. Several suggestions were provided based on the results to help social media enterprises increase user participation. It is hoped that this research could facilitate in transforming users into habitual participants to keep the operations of the virtual community stable and enduring. (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)

Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents anonymously completed questionnaires to assess the study variables. The present study demonstrated that stressful (...) life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI. (shrink)

This study examines the influence of corporate environmental performance on the propensity that auditors issue modified audit opinions and further investigates the moderating effects of internal control and greenwashing. Using a sample of Chinese listed firms, our findings reveal that corporate environmental performance is significantly negatively associated with modified audit opinions, suggesting that auditors applaud environmentally friendly firms. Moreover, internal control reinforces the negative association between corporate environmental performance and modified audit opinions, but greenwashing attenuates the negative effect of corporate (...) environmental performance on modified audit opinions. The findings are robust to various sensitivity tests, and our conclusions are still valid after controlling for the potential endogeneity. Additional tests reveal that corporate environmental performance is negatively associated with modified audit opinions only for firms without audit opinion shopping and corporate environmental performance is significantly negatively associated with both earnings management and audit fees. (shrink)

In 2015, the Chinese pharmacologist, Tu Youyou, was awarded the Nobel Prize for Physiology or Medicine for the discovery of artemisinin. Traditional Chinese medicine (TCM) was the source of inspiration for Tu's discovery and provides an opportunity for the world to know more about TCM as a source of medical knowledge and practice. In this article, the value of TCM is evaluated from an ethical perspective. The characteristics of ‘jian, bian, yan, lian’ are explored in the way they promote accessibility (...) and economic efficiency for TCM. The article also examines how the increased use and prevalence of TCM reflects the scientific, cultural, and ethical values of TCM and their increasing attraction in meeting major challenges to medicine and health systems currently and in the future. The article discusses safety issues within TCM, which is a controversial area, and also comments on some shortcomings and challenges which pose difficulties for more widespread and greater uptake of TCM‐derived clinical or therapeutic interventions. The article concludes that TCM is generally safe if it is used according to TCM theory and where such applications are cognizant of the strengths and weaknesses of TCM. TCM has important bioethical values which may inform potential measures for meeting challenges facing global health care systems and the article argues that it can have an increasing role in improving human health. (shrink)

The American Journal of Bioethics, Volume 11, Issue 10, Page 11-13, October 2011.

Given the current popularization of computer programming and the trends of informatization and digitization, colleges have actively responded by making programming lessons compulsory for students of all disciplines. However, students from different ethnic groups often have different learning responses to such lessons due to their respective cultural backgrounds, the environment in which they grew up, and their consideration for future employment. In this study, an AI-assisted programming module was developed and used to compare the differences between multi-ethnic college students in (...) terms of their theoretical and actual learning expectancy, motivation, and effectiveness. The module conducted analysis through the deep learning network and examined the relevant processes that the students underwent during programming lessons, as well as the types of errors they had committed. Their learning motivation for and actual learning performance in programming were then examined based on the cognitive learning theory. The results of the experiment, which involved 96 multi-ethnic college students, indicated that the two groups had dissimilar theoretical performance in terms of their expectancy and motivation for learning programming. The indigenous students’ main concern was whether programming would affect their families or tribes, and this concern affected and was reflected in their learning outcomes. In contrast, the learning motivation and goals of Han Chinese students were driven by the cognition of the value of programming to themselves. The research findings can contribute toward the cognition and understanding of multi-ethnic students when learning computer programming and development of the appropriate teaching methods, and serve as a reference for subsequent research on integrating multiculturalism into computer programming lessons. (shrink)

To improve sustainable practices and attract investors, companies in emerging markets have increasingly embraced strategies for inclusion in rapidly expanding sustainability indices. However, most early studies on socially responsible investment or sustainability investment have only focused on exploring the relationship between corporate sustainability and firm value. Moreover, little has been done to explore the practices of emerging market companies for engaging with a sustainability index. To address this research gap, we employed the decision-making trial and evaluation laboratory method to identify (...) critical factors that influence the inclusion of emerging market companies in the Dow Jones Sustainability Index. Five critical factors and best practices were identified based on the analysis of seven Taiwanese electronics companies that have been listed in the DJSI for several consecutive years. Our results provide insights on the critical factors and best practices that reinforce the sustainable practices of emerging market companies for inclusion in the DJSI. This study also contributes to the literature by investigating the engagement of emerging market companies with the DJSI. (shrink)