BackgroundExperience with open disclosure and its study are restricted to certain western countries. In addition, there are concerns that open disclosure may be less suitable in non-western countries. The present study explored and compared the in-depth perceptions of the general public and physicians regarding open disclosure in Korea.MethodsWe applied the COREQ checklist to this qualitative study. We conducted 20 in-depth interviews and four focus group discussions with 16 physicians and 18 members of the general public. In-depth interviews and focus group (...) discussions were performed according to semi-structured guidelines developed according to a systematic review of open disclosure. We conducted a directed content analysis by analyzing the verbatim transcripts and field notes in accordance with the predetermined guidelines.ResultsOpen disclosure perceptions were summarized in terms of the “five Ws and one H”. All physician and general public participants acknowledged the normative justifiability of open disclosure. The participants mostly agreed on the known effects of open disclosure, but the physicians had negative opinions on its expected effects, such as decreased intention of the general public to file lawsuits and increased credibility of medical professionals. Generally, the participants thought that open disclosure is required for medical errors causing major harm. However, the physicians and general public had conflicting opinions on the need for open disclosure of near misses. Most physicians did not know how to conduct open disclosure and some physicians had bad experiences due to inappropriate or incomplete open disclosure.ConclusionPhysicians and the general public in Korea acknowledge the need for open disclosure. Guidelines according to the type of patient safety incident are required to encourage physicians to more readily conduct open disclosure. Furthermore, hospitals need to consider organizing a dedicated team and hiring experts for open disclosure. (shrink)

This paper is about activities of ‘community of inquiry’ on the basis of Lipman’s model applied at a kindergarten in Seoul, Korea. The activities of community of inquiry, basically, includes a series of activities, for example, reading textbooks, making up questions, discussing on themes, working out exercises and further responding. At the beginning of P4C lessons, young children had difficulties in reading texts with no pictures, and making up questions. Having philosophy lessons repeatedly, they were accustomed to the activities, felt (...) joy of thinking by themselves, and enjoyed dialoguing with friends and discussing together. The young children in the community of inquiry showed intimacy and curiosity about the stories written by Dr, Chung, which described typical Korean young child’s daily life and were full of situations experienced in their families and kindergartens. The young children were interested in inquiring philosophical aspects of the stories, tried to think by themselves like philosophers, and finally could achieve the goals of P4C, in short, to think by themselves, to cultivate ethical and aesthetic mind, and to harmonize with others. (shrink)

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self‐reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self‐Confidence, and Korean Bioethics and Biosafety Action restriction perception. (...) The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. (shrink)

The structure of the deep artificial neural network is similar to the structure of the biological neural network, which can be well applied to the 3D visual image recognition of aerobics movements. A lot of results have been achieved by applying deep neural networks to the 3D visual image recognition of aerobics movements, but there are still many problems to be overcome. After analyzing the expression characteristics of the convolutional neural network model for the three-dimensional visual image characteristics of aerobics, (...) this paper builds a convolutional neural network model. The model is improved on the basis of the traditional model and unifies the process of aerobics 3D visual image segmentation, target feature extraction, and target recognition. The convolutional neural network and the deep neural network based on autoencoder are designed and applied to aerobics action 3D visual image test set for recognition and comparison. We improve the accuracy of network recognition by adjusting the configuration parameters in the network model. The experimental results show that compared with other simple models, the model based on the improved AdaBoost algorithm can improve the final result significantly when the accuracy of each model is average. Therefore, the method can improve the recognition accuracy when multiple neural network models with general accuracy are obtained, thereby avoiding the complicated parameter adjustment process to obtain a single optimal network model. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self-reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self-Confidence, and Korean Bioethics and Biosafety Action restriction perception. (...) The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. (shrink)

In April 2011, the Korea Centers for Disease Control and Prevention announced the results of an epidemiological investigation that an unknown cause of lung disease that occurred throughout Korea was caused by humidifier disinfectants. The unprecedented social catastrophe caused by humidifier disinfectants, a household chemical, has so far reported 1,784 deaths and 5,984 survivors in South Korea. This study was designed to investigate the multi-layer relationships between psychological symptoms and adaptive functioning in survivors of the Humidifier disinfectants in South Korea (...) caused by chemical toxic substances. Specifically, this study aimed to explore how psychological symptoms affect actual interpersonal relationships and job adjustment with two variable sets, six internalizing and externalizing subscales, and three adaptation subscales. A total of 224 survivors recruited from a program to support humidifier disinfectant survivors by the government participated in this study. This research was approved by the Institutional Review Board of one of the Universities in South Korea. The age range of the participants was 18–73 years, 37.1% were male, and 62.9% were female. The participants responded to the Adult Self-Report of the Achenbach System of Empirically Based Assessment. A Canonical Correlation Analysis generated three unique patterns in the relationships between psychological symptoms and adaptive functions. Humidifier disinfectant survivors in the first pattern were more vulnerable to psychological symptoms and showed maladaptive functioning in life. Survivors in the second pattern showed intrusive behaviors and appeared to be adaptive in relationships with friends. Finally, survivors in the third pattern showed aggressive behaviors and reported poor partner relationships while showing good relationships with friends. The practical implications of the interventions are also discussed. (shrink)

BackgroundElectronic cigarettes as substitute devices for regular tobacco cigarettes have been increasing in recent times. We investigated neuronal substrates of vaping e-cigs and smoking r-cigs from r-cig smokers.MethodsTwenty-two r-cig smokers made two visits following overnight smoking cessation. Functional magnetic resonance imaging data were acquired while participants watched smoking images. Participants were then allowed to smoke either an e-cig or r-cig until satiated and fMRI data were acquired. Their craving levels and performance on the Montreal Imaging Stress Task and a 3-back (...) alphabet/digit recognition task were obtained and analyzed using two-way repeated-measures analysis of variance. Regions-of-interest were identified by comparing the abstained and satiated conditions. Neuronal activation within ROIs was regressed on the craving and behavioral data separately.ResultsCraving was more substantially reduced by smoking r-cigs than by vaping e-cigs. The response time for the 3-back task was significantly shorter following smoking r-cigs than following vaping e-cigs = 5.3, p = 0.035). Neuronal activations of the right vermis, right caudate, and right superior frontal gyrus were significantly correlated with the RT for the 3-back task only for smoking r-cigs.ConclusionOur findings suggest that insufficient satiety from vaping e-cigs for r-cigs smokers may be insignificant effect on working memory function. (shrink)

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...) end-of-life care and its consequential impacts. Research objectives To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design A qualitative descriptive approach was employed. Participants and research context Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings The moral distress-inducing factors and nurses’ perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. (shrink)

This work is the first English monograph on Franciscus Junius's (1545–1602) theology in more than 40 years, and also is the first monograph on Junius’s use of Thomistic moral concepts to date.

Background: Infectious disease outbreaks such as COVID-19 and MERS pose a major threat to healthcare workers' physical and mental health. Studies exploring the positive changes gained from adapting to traumatic events, known as post-traumatic growth, have attracted much attention. However, it is unclear which factors or experiences lead to PTG among HCWs. The purpose of this mixed-method study was to investigate factors associated with PTG among HCWs who experienced the MERS outbreak in South Korea, and fully describe their experience of (...) developing PTG.Methods: Quantitative data from 78 participants were collected using psychometric tools for Psychological distress, Resilience, and Support for coping, and Post-traumatic growth. Qualitative interviews were conducted with seven nurses. Data were analyzed using the qualitative content analysis method according to the sub-themes of resilience, which was the main factor associated with PTG.Results: We found resilience to have a significant impact on PTG. Thus the qualitative interviews were analyzed using the core concepts of resilience. Qualitative interviews with nurses illustrated how participants experienced the development of resilience in terms of its sub-factors: hardiness, persistence, optimism, and support.Conclusion: HCWs who endured the MERS outbreak showed high levels of PTG, and the analysis of the interview data provided a fuller understanding on the experience of remaining resilient and developing PTG. These results provide practical and pragmatic information helpful for developing intervention strategies and protocols that can help HCWs transform adversity into growth and development. (shrink)

In this collection of writings drawn from Jonathan Edwards’s essays and topical notebooks, the great American theologian deals with key Christian doctrines including the Trinity, grace, and faith. The volume includes long-established pieces in the Edwards canon, newly reedited from the original manuscripts, as well as documents that have never before been published and that in some cases reveal new aspects of his theology.

The current study is a conceptual replication of Wang using a pretest-posttest design and an online sample through Amazon’s Mechanical Turk. Seventy-one Asian-Americans recalled a recent memory before and after being primed as either Asian or American. On pre-prime memories, conditions did not significantly differ. However, on post-prime memories, participants primed as American recalled more self-focused memories than relationally focused memories and those primed as Asian recalled more relationally focused memories than self-focused memories. In addition, memories of Asian-Americans primed as (...) American consisted of a smaller proportion of social interaction instances than those primed as Asian. In total, 6 of the 8 effects found in Wang were replicated. We discuss the implications that the current results and past studies have on our understanding of how culture influences memory encoding and retrieval. (shrink)

Social enterprises, promising organizations for solving societal problems with innovative approaches, rely upon their members’ active roles for workplace innovation. However, we still have a limited understanding about how social enterprises can foster employees’ endeavors for innovation. By focusing on employee learning and innovative behavior, we investigate the influences of perceived social mission, value congruence, and human resource management (HRM) practices in social enterprises. We conducted two complementary studies to answer our research questions. In Study 1, with a survey of (...) 369 employees from 68 social enterprises, we examined a multilevel moderated mediation model with firm‐level and individual‐level data. We found that perceived social mission promoted learning and innovative behavior by increasing value congruence, and that commitment‐based HRM practices enhanced the overall process from mission to employee efforts for innovation. In Study 2, with 300 daily surveys from 60 employees participating in an experience sampling study, we found that those with high‐value congruence showed a significantly more stable pattern with less variance in innovative behavior than in learning behavior. Our study adds novel implications to the underdeveloped literature on employee innovation and HRM in social enterprises by uncovering the positive effects of social mission and value facets for boosting learning and innovative behaviors. Our research also suggests that social enterprises should benefit from pursuing and emphasizing the social mission and commitment‐based HRM bundle together, which will promote the prosperity and well‐being of business and society. (shrink)

Business Ethics, the Environment &Responsibility, Volume 31, Issue 3, Page 702-717, July 2022.

While social interaction and play in a VR environment are becoming ever more popular, little is known about how social VR games affect users. The purpose of this study was to elucidate the role of several contingent factors in social VR games by modeling the relationships between involvement, well-being, depression, self-esteem, and social connectedness. A conditional process-moderated mediation model of the measured variables was analyzed with 220 pieces of collected data. The result showed that: the direct effect of involvement on (...) well-being was significant, and the index of moderated mediation involving depression, self-esteem, and social connectedness was significant. We conclude that high levels of involvement in social VR games by socially isolated users with low self-esteem can negatively affect their well-being. The findings of this study contribute in several ways to our understanding of the effect of social VR games upon users and provide important practical implications. (shrink)

Social enterprises are hybrid organizations that primarily pursue social missions while also seeking economic gains. Drawing on workplace diversity and conflict theories, this article addresses recent calls for further research to explore how employees within social enterprises experience internal conflicts arising from the organizational pursuit of dual, competing missions (i.e., social and economic), and how social enterprises manage, and potentially overcome, these challenges. In the context of Korean social enterprise, we conducted a quantitative study that built on an initial explorative (...) qualitative study. Our research examined whether perceived participatory human resource management practices and diversity climate increase employees’ affective commitment by reducing their relational conflict. We further explored a boundary condition, perceived social impact, which strengthened this mediation relationship. Our results offer significant insights into social enterprise, business ethics, and broader management literature. Implications for future research and practice are also discussed. (shrink)

Green consumers are those who seek to fulfill economic responsibility with their choices of environment-friendly products. Previous research found that it is not easy to identify green consumers by using traditional demographic or psychographic measurements due to the instability of moral attitude and actual behavior. The frontal theta brain waves of 19 right-handed respondents were recorded and analyzed in a choice task between an environment-friendly (green) product and a conventional product. Product information, which was provided to the respondents, included written (...) descriptions as well as the price of each product without visual depiction. Based on the respondents’ choice, they were classified into two groups: green (GR) consumers who chose an environment-friendly product option and non-green (Non-GR) consumers who chose the option of a conventional product. While processing the green product message, we discovered that frontal theta activations were significantly higher among GR consumers than Non-GR consumers. On the contrary, the frontal theta waves of GR consumers were not differentiated from Non-GR consumers while processing the price information. Therefore, theta activations in the frontal area may potentially be a unique neural indicator of GR consumers’ cognitive engagement with environment-friendly product messages. (shrink)

Although access to medicines is a vital feature of the right to the highest attainable standard of health (“right to health”), almost two billion people lack access to essential medicines, leading to immense avoidable suffering. While the human rights responsibility to provide access to medicines lies mainly with States, pharmaceutical companies also have human rights responsibilities in relation to access to medicines. This article provides an introduction to these responsibilities. It briefly outlines the new UN Guiding Principles on Business and (...) Human Rights and places the human rights responsibilities of pharmaceutical companies in this context. The authors draw from the work of the first UN Special Rapporteur on the right to the highest attainable standard of health, in particular the Human Rights Guidelines for Pharmaceutical Companies in Relation to Access to Medicines that he presented to the UN General Assembly in 2008, and his UN report on GlaxoSmithKline (GSK). While the Guiding Principles on Business and Human Rights are general human rights standards applicable to all business entities, the Human Rights Guidelines for Pharmaceutical Companies consider the specific human rights responsibilities of one sector (pharmaceutical companies) in relation to one area of activity (access to medicines). The article signals the human rights responsibilities of all pharmaceutical companies, with particular attention to patent-holding pharmaceutical companies. Adopting a right-to-health “lens,” the article discusses GSK and accountability. The authors argue that human rights should shape pharmaceutical companies' policies, and provide standards in relation to which pharmaceutical companies could, and should, be held accountable. They conclude that it is now crucial to devise independent, accessible, transparent, and effective mechanisms to monitor pharmaceutical companies and hold them publicly accountable for their human rights responsibilities. (shrink)

The Constitution of the World Health Organization affirms that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.” The Universal Declaration of Human Rights lays the foundations for the international framework for the right to health. This human right is now codified in numerous national constitutions, as well as legally binding international human rights treaties, such as the International Covenant on Economic, Social and Cultural Rights.Although medical care and access to (...) medicines are vital features of the right to health, almost two billion people lack access to essential medicines, leading to immense avoidable suffering. Improving access to essential medicines could save 10 million lives each year, four million of them in Africa and South-East Asia alone. Gross inequity is a shocking feature of the world pharmaceutical situation. (shrink)

This book demonstrates the originality and coherence of Jonathan Edwards' philosophical theology using his dynamic reconception of reality as the interpretive key. The author argues that what underlies Edwards' writings is a radical shift from the traditional Western metaphysics of substance and form to a new conception of the world as a network of dispositions: active and abiding principles that possess reality apart from their manifestations in actions and events. Edwards' dispositional ontology enables him to restate the Augustinian-Calvinist tradition in (...) theology in a strikingly modern philosophical framework. A prime example of Edwards' innovative reconstruction in philosophical theology is his conception of God as both eternal actuality and a disposition to repeat that actuality within God and also through creation. This view is a compelling alternative to the traditional Western doctrine of God as changeless actuality, on the one hand, and the recent process theologians' excessive stress on God's involvement in change, on the other. Edwards' achievement was that he saw dynamic movement as essential to God's own life without compromising the traditional Christian tenets of God's prior actuality and transcendence. The author of this volume also explicates the way in which Edwards' dynamic reconception of reality informs his theories of imagination, aesthetic perception, the knowledge of God, and the meaning of history. This expanded edition includes a new preface and a new appendix titled "Jonathan Edwards on Nature.". (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

ObjectivePrevious research has shown that adolescents in single-mother households are at heightened risk for adjustment problems. However, limited studies have investigated the mechanisms leading to adolescent problem behaviors in single-mother households. To address this research gap, this study applied the Family Stress Model to examine how single mothers’ material hardship is linked to adolescent problem behaviors, focusing on the mediating roles of mothers’ depression and mother-adolescent closeness. The moderating role of adolescent school connectedness in the relationships between mother-adolescent closeness and (...) school connectedness and between mothers’ depression and school connectedness was also investigated.Materials and methodsThe study analyzed data from 1,384 adolescents and their single mothers who participated in the Fragile Families and Child Wellbeing Study at Wave 6. The associations between study variables were analyzed using structural equation modeling by decomposing the direct, indirect, and total effects of material hardship on adolescent problem behaviors. School connectedness’s interactions with mother-adolescent closeness and mothers’ depression were also examined.ResultsResults showed a significant indirect relationship between material hardship and adolescent problem behaviors through sequential mediation of mothers’ depression and mother-adolescent closeness. Mothers’ depression also significantly mediated the relationship between material hardship and problem behaviors. Lastly, school connectedness moderated the relationship between mother-adolescent closeness and adolescents’ internalizing behaviors. The association between mother-adolescent closeness and adolescents’ internalizing behavior was weaker for adolescents with higher levels of school connectedness.ConclusionThe results indicate the important indirect effect of economic strain on adolescents’ problems behaviors in single-mother households, which has been less emphasized compared to the effects in earlier childhood. High rates of material hardship and adolescent problem behaviors in single-mother families call for multifaceted interventions focusing on family processes and protective factors, including school environment. (shrink)

Tumor‐infiltrating lymphocyte (TIL) therapy is a promising approach for treating refractory or advanced solid cancers by using autologous TILs harvested from cancer tissues. Despite the heterogeneity of cancer, TIL therapy can potentially produce a positive therapeutic response, including complete remission.After decades of research on lymphocyte functions, culture/expansion methods, therapeutic protocols, and multiple clinical trials, TIL therapy has finally reached a stage where it can be formally approved for clinical use.TIL therapy is expected to hold a unique position among anti‐cancer therapeutic (...) options as a standard intervention. To successfully introduce TIL therapy into clinical settings, there is a need to expand therapeutic indications and set up the best protocols for cancer tissue sampling and manufacturing, and related clinical trials. Moreover, studies on next‐generation TIL therapy have already begun, and post‐approval real‐world data will promote and support further research. (shrink)