To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (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)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

In China's healthcare sector, a popular and socio-culturally distinctive phenomenon known as guanxi jiuyi, whereby patients draw on their guanxi with physicians when seeking healthcare, is thriving. Integrating anthropological investigation with normative inquiry, this paper examines medical guanxi through the lens of patient–physician trust and mistrust. The first-hand empirical data acquired – on the lived experiences and perspectives of both patients and physicians – is based on six months' fieldwork carried out in a county hospital in Guangdong, southern China, which (...) included in-depth interviews with 20 patients and 20 medical professionals. Patients who emphasized the positive effects of guanxi on patient–physician trust believed that it facilitates access to experienced medical specialists, enhances clinical communication, and reduces the financial and medical risks of over diagnosis and overtreatment by physicians. At the same time, these findings reveal patients' strong sense of mistrust, not only towards individual health professionals but also to the medical profession and China's commercialized healthcare industry. While some health professionals in the study responded favourably to medical guanxi, most were opposed to it on the grounds that it undermines professional standards and equitable healthcare. We found that the practice of medical guanxi is not morally justifiable, chiefly because it reinforces the present high levels of patient–physician mistrust and erodes trust between patients and the medical profession as a whole. In China, both the medical profession and the state need to promote patient–physician trust based on medical professionalism and institutional norms, rather than on guanxi or individual relationships. (shrink)

This study introduces visual cognition into Lithium-ion battery capacity estimation. The proposed method consists of four steps. First, the acquired charging current or discharge voltage data in each cycle are arranged to form a two-dimensional image. Second, the generated image is decomposed into multiple spatial-frequency channels with a set of orientation subbands by using non-subsampled contourlet transform. NSCT imitates the multichannel characteristic of the human visual system that provides multiresolution, localization, directionality, and shift invariance. Third, several time-domain indicators of the (...) NSCT coefficients are extracted to form an initial high-dimensional feature vector. Similarly, inspired by the HVS manifold sensing characteristic, the Laplacian eigenmap manifold learning method, which is considered to reveal the evolutionary law of battery performance degradation within a low-dimensional intrinsic manifold, is used to further obtain a low-dimensional feature vector. Finally, battery capacity degradation is estimated using the geodesic distance on the manifold between the initial and the most recent features. Verification experiments were conducted using data obtained under different operating and aging conditions. Results suggest that the proposed visual cognition approach provides a highly accurate means of estimating battery capacity and thus offers a promising method derived from the emerging field of cognitive computing. (shrink)

At present, with the continuous rise in public consumption level, the pressure on college students’ entrepreneurship or employment is increasingly severe. Under the concept of positive psychological intervention, the present work aims to alleviate the entrepreneurial pressure of college students and improve college students’ entrepreneurial education through the analysis of enterprise management elements. A 3-month intervention experiment, including the pre-test, preventive curriculum intervention, post-test, and delayed test, is conducted on a control group and an experimental group, to investigate entrepreneurial intention, (...) emotional management ability, and ability to deal with entrepreneurial pressure of college students. In addition, based on a complex adaptive system, the enterprise management elements are analyzed, and a three-layer network model is constructed. Meanwhile, new diversified elements of enterprise management are defined to discuss the effectiveness and psychological impact of diversified management, proving that psychological security plays an intermediary role in the cross-layer relationship chain in the three-layer CAS network. The experimental results indicate that on the whole, the positive psychological intervention reduces the pressure of students in the experimental group, significantly ameliorates depression and anxiety, and promotes the positive personality in all directions. Besides, in the delayed test after 3 months, the experimental group can maintain a relatively better state than the control group. By exploring the role effectiveness and characteristics of diversified management, this experiment confirms that the improvement of psychological security under positive psychological intervention has a positive impact on the effectiveness of diversified management. The present work discusses the hierarchical construction in enterprise management and puts forward reasonable suggestions and theoretical development for the influence of the entrepreneurial practice of college students. (shrink)

It has been found in many cases that consumers are prone to exhibit impulsive buying behavior that is manifested as being immediate, emotional, and irresponsible especially under short video scenario. Supported by the customer inspiration theory, this study explores the psychological mechanism underlying impulse purchase in short videos that differentiates the traditional web shopping by the strong sense of presence in short video marketing. On the basis of a questionnaire survey and three laboratory experiments, this study examines the relationship among (...) presence, customer inspiration, and impulse purchase intention. The empirical results point to the fact that social presence, co-presence, and physical presence have significant positive effects on impulse purchase intention, and customer inspiration mediates the effect of social presence, physical presence, and co-presence on impulse purchase intention. Furthermore, it is indicated that social and co-presence have stronger influences on impulse purchase intention than physical presence, thus proving a stronger effect of social factors on impulse purchase intention than physical factors in short video environment. The research results testify the impact of presence on consumer behavior in the upgrading short video marketing and provide valuable reference for marketing strategies to shorten consumers' decision-making time in short video purchase. (shrink)

This book's importance is derived from three sources: careful conceptualization of teacher induction from historical, methodological, and international perspectives; systematic reviews of research literature relevant to various aspects of teacher induction including its social, cultural, and political contexts, program components and forms, and the range of its effects; substantial empirical studies on the important issues of teacher induction with different kinds of methodologies that exemplify future directions and approaches to the research in teacher induction.

While studies of Chinese landscape literature usually focus on landscape poetry (shanshui shi), I wish to take Xie Lingyun’s “Rhapsody on Mountain Dwelling” as my point of departure to discuss how the rhapsody draws from the categorization of geographic designations and local products (mingwu leiju) at work in traditional geographical texts such the “Yu Gong [Tribute to Yu]” chapter in Shangshu and the “Diguan [Regional Offices]” chapter in Zhouli More broadly, I discuss how “landscape literature” participated in contemporaneous writings on (...) geography. Xie was part of an Eastern Jin discovery of the landscape that engaged it through bodily movement. This new embodied mode of experience altered the system of naming and explicating the terms of landscape. Xie Lingyun, hailed asthe great “landscape poet” of Chinese literature, might be better described as someone who helped construct a new geographical discourse. (shrink)

In this paper we give new criterions for left distributive posets to have neatest representations. We also illustrate a construction that would embed left distributive posets into representable semilattices.

Construction schedules play an important role in construction project management. However, during construction activities, risks may arise due to unexpected schedule changes, resulting in the ineffective delivery of projects. This study aims to reveal the law of schedule change risk propagation and to analyze the effects on the risk propagation through numerical simulations. First, construction projects are represented by activity-on-node networks. A model of risk propagation is then built based on a susceptible-infected model considering the effects of the nodal characteristics (...) on the propagation process. Next, the model is tested on a real-world project to examine cascading failures with varying parameters. The experimental results demonstrate that the model is effective in identifying the activities most capable of affecting a project schedule and evaluating the impact of schedule change risk propagation. This study will provide a basis for enhancing the robustness of AON networks and controlling the propagation of schedule change risks. (shrink)

In February 2020, the coronavirus disease 2019 appeared and spread rapidly in Italy. With the health emergency and social isolation, parents started spending more time with their children, and they might have experienced greater distress. Attachment style is considered as an effective emotion regulation strategy in the parent–child relationship. However, few empirical studies have addressed this issue. Based on attachment theory, this study aimed to find parental attachment style as a candidate to moderate the relation between parents’ negative emotions and (...) their perceptions of their children’s negative emotions related to COVID-19. Parents of 838 Italian children and adolescents aged 3 to 18 years participated in an online survey. Results showed that parents with a fearful attachment style had significantly higher negative emotions when facing COVID-19 than those with other attachment styles. Moreover, parents with a dismissing attachment style perceived fewer negative emotions in their children than parents with fearful and preoccupied styles. At last, higher parents’ negative emotions were associated with greater perception of children’s negative emotions only in parents classified as secure and fearful. These findings suggest that parents with dismissing and fearful attachment styles and their children may be at higher risk during the COVID-19 pandemic and they should be given long-term attention. (shrink)

This study aimed to develop cross-domain deep learning courses of artificial intelligence in vocational senior high schools and explore its impact on students’ learning effects. It initially adopted a literature review to develop a cross-domain SPOC-AIoT Course with SPOC and the Double Diamond 4D model in vocational senior high schools. Afterward, it adopted participatory action research and a questionnaire survey and conducted analyses on the various aspects of the technology acceptance model by SmartPLS. Further, this study explored the impact on (...) the effects of deep learning and knowledge-ability learning of artificial intelligence after 16 weeks of course teaching among 36 Grade I students from the electrical and electronic group of a vocational senior high school. This study revealed that the four stages of the SPOC-AIoT Teaching Mode of the Double Diamond 4D model may effectively guide students to learn AIoT knowledge and skills. Based on the technology acceptance model, the analysis of learning and participation in SmartPLS indicated that this model conformed to the academic fitness requirements of the overall model. After learning with the SPOC-AIoT Teaching Mode, the learning effects of students in AIoT have been significantly improved to a positive aspect. Finally, some suggestions were put forward to promote the development of the SPOC-AIoT Teaching Mode Course in the future. (shrink)

Are traditional marketing mix strategies still suitable for hotel banquet marketing? Using the binary logistic regression analysis method, this study used 763 banquet sales records at the Quanzhou Hilton Hotel to comprehensively test the influence of traditional marketing mix strategies on banquet marketing effects. By focusing on new marketing methods, this study tested the effectiveness of traditional marketing strategies in the new media era. The findings revealed that a combination of products is easier to market than a single product, whereas (...) price is still a key factor in hotel banquet marketing. However, sales channels and personal identity have no significant effects on banquet marketing. Finally, based on the failure cases analysis, this study proposed a feasible path for promoting banquet marketing. (shrink)

Healthcare workers’ voice is of importance in decreasing medical accidents and improving the efficacy of hospital units. To investigate the impact and the underlying mechanisms of supervisors’ negative mood on healthcare workers’ voice behavior, based on the mood contagion perspective, we designed a cross-sectional study, with 299 healthcare workers from mainland China completed the questionnaires. The results indicated supervisors’ negative mood was positively related to healthcare workers’ negative mood, which further led to less constructive voice and more defensive voice. Moreover, (...) the healthcare worker’s emotional intelligence aspect of self-emotion appraisal moderated this relationship, but not others-emotion appraisal. We believe healthcare workers’ supervisors should pay attention to their negative mood expression and regulation. In the hope of reducing being influenced by supervisors’ negative mood, training about noticing and recognizing their own emotions are needed for healthcare workers. (shrink)

In this paper, in order to achieve automatic defect identification for pneumatic pressure equipment, an improved feature extraction algorithm eddy current pulsed thermography is presented. The presented feature extraction algorithm contains four elements: data block selection; variable step search; relation value classification; and between-class distance decision function. The data block selection and variable step search are integrated to decrease the redundant computations in the automatic defect identification. The goal of the classification and between-class distance calculation is to select the typical (...) features of thermographic sequence. The main image information can be extracted by the method precisely and efficiently. Experimental results are provided to demonstrate the capabilities and benefits of the proposed algorithm in automatic defect identification. (shrink)

This study examined the factors that affect the attitude and behavioral intentions toward electronic sports among students of higher education institutions based on the technology acceptance model. The conditional impact of preventive regulatory focus was analyzed in various aspects developed on the regulatory focus theory. These aspects comprised of perceived usefulness, perceived ease of use, and perceived risk on the attitude toward eSports. Accordingly, data were collected from 293 students of higher education institutions in China's Henan Province, presenting a 54.56% (...) response rate. The PLS-SEM analysis was subsequently implemented to confirm the proposed hypotheses. The empirical findings confirmed the significant positive impact of perceived usefulness and perceived ease of use on the attitude toward eSports. However, perceived risk negatively affected the attitude toward eSports. Meanwhile, the findings on the moderating hypotheses found a negligible impact on preventive regulatory focus. This impact was found explicitly on the perceived usefulness-perceived ease of use link with attitude toward eSports. However, the preventive regulatory focus negatively moderated the perceived risk attitude toward eSports. Finally, the implication and limitations were illustrated at the end of the paper. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)