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)

Scholars are becoming increasingly interested in whether and how government use of Big Data will affect public policy outcomes. Despite such growing scholarly interests, however, little evidence exists on the role Big Data can play in improving government service. We undertake one of the first quantitative studies revealing the potential utility and limitations of “Big Data-based policymaking” by exploring its recent use by the Seoul Metropolitan Government. In 2013, the government introduced the “Owl Bus”—a late-night bus system—the routes of which (...) were selected based on government analyses of Big Data relating to citizens’ late-night taxi and mobile phone use. The findings suggest that the average number of passengers utilizing the Owl Bus routes was significantly greater than that on other daytime bus routes with comparable characteristics. That said, we also present the potential limitations of evidence-based policymaking in general, especially when politics and equity considerations are factored in. (shrink)

In the age of artificial intelligence, writing machines or robot authors have already begun to produce narrative texts in a variety of genres, including short stories and poetry, as well as journalistic articles. This article is based on the prospect that the narrative ecosystem is in a transitional period of decisive disconnection as it enters the era of artificial intelligence. The primary force driving this transition is the formidable execution of artificial intelligence algorithms, which fully automate narrative communication and narrative (...) works. This article attempts to lay the groundwork for building a new paradigm of post-narrativity through a critical examination of several detailed themes in narrative semiotics and non-anthropocentric narratology. The process of narrative creation based on artificial intelligence algorithms is a key condition that constitutes post-narrativity. This presupposes a non-anthropocentric view. In the landscape of post-narrativity, human writers, paper books, computer screens, and invisible narrative algorithms are all agents with equal influence. Automated narrative production by algorithms accelerates the repositioning of other existing media and actors, and changes the narrative ecosystem by incorporating new elements into activities such as production, distribution, and reception of narratives. (shrink)

Despite the prevailing discourses on the importance of top management ethical leadership, related theoretical and empirical developments are lacking. Drawing on institutional theory, we propose that top management ethical leadership contributes to organizational outcomes by promoting firm-level ethical and procedural justice climates. This theoretical framework was empirically tested using multi-source data obtained from 4,468 employees of 147 Korean companies from various industries. The firm-level analysis shows that top management ethical leadership significantly predicts ethical climate, which then results in procedural justice (...) climate that fully mediates the effects of top management ethical leadership on two organizational outcomes, namely, firm-level organizational citizenship behavior and firm financial performance. The present study provides a plausible theoretical account and empirical validation of a mechanism through which top management ethical leadership enhances organizational performance. (shrink)

Do liberals’ and conservatives’ brain processes differ in moral reasoning? This research explains these groups’ dissimilar moral stances when they face ethical transgressions in business. Research that explores the effects of ideological asymmetry on moral reasoning processes through moral foundations has been limited. We hypothesize two different moral reasoning processes and test them in the South Korean culture. Study 1 uses the neuroscientific method of event-related potentials to explore the dissociable neural mechanisms that underlie Korean liberals’ and conservatives’ moral reasoning (...) processes in business ethical transgressions. Liberals’ early frontal negative-going brain waves showed that they are quick to pass negative judgment by intuitively detecting violations of fairness, while conservatives’ temporoparietal positive-going brain waves showed that they have a higher motivation to respect authority. Both liberals’ and conservatives’ ERP components occur within the first second of the decision-making phase, suggesting the rapid and intuitive nature of moral reasoning processes. Study 2 tests a mediating process and confirms that Korean liberals exhibit the moral engagement strategy, through the fairness foundation. These findings from our interdisciplinary research deepen the knowledge of the complexity of human morality in business ethics research. (shrink)

Originally presented as the authors thesis (doctoral--Universiteat Freiburg i. Br., 1988) under the title: Der Widerspruch und das Urteilsproblem im platonischen Dialog "Parmenides.".

This study proposes two identification cuing factors (i. e., CSR associations and CSR participation) to understand how corporate social responsibility (CSR) relates to employees' identification with their firm.The results reveal that a firm's CSR initiatives increase employee-company identification (E-C identification).E-C identification, in turn, influences employees' commitment to their company. However, CSR associations do not directly influence employees' identification with a firm, but rather influence their identification through perceived external prestige (PEP). Compared to CSR associations, CSR participation has a direct influence (...) on E-C identification. On the basis of these findings, it is argued that CSR performance can be an effective way for companies to maintain a positive relationship with their employees. (shrink)

This study proposes two identification cuing factors to understand how corporate social responsibility relates to employees’ identification with their firm. The results reveal that a firm’s CSR initiatives increase employee–company identification. E–C identification, in turn, influences employees’ commitment to their company. However, CSR associations do not directly influence employees’ identification with a firm, but rather influence their identification through perceived external prestige. Compared to CSR associations, CSR participation has a direct influence on E–C identification. On the basis of these findings, (...) it is argued that CSR performance can be an effective way for companies to maintain a positive relationship with their employees. (shrink)

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

There is no consensus concerning how to understand the ‘two-step proof structure’ (§§15–20, 21–7) of the Transcendental Deduction in the B-edition of the Critique of Pure Reason. This disagreement invites a closer examination of what Kant might have meant by a ‘transcendental deduction’. I argue that the transcendental deduction consists of three tasks that parallel Kant’s broader project of a ‘critique’ of pure reason; first, an origin task to justify reason’s authority to use them; second, an analytical task that determines (...) the conditions under which this authority can be legitimately exercised; and third, a dialectical task to determine the conditions under which this authority cannot be legitimately exercised. So long as we continue to read the B-Deduction solely in terms of its two-step proof structure, we overlook how Kant’s notion of ‘critique’ constitutes the real grounds for his argumentative strategy there. (shrink)

아리스토텔레스와 헤어의 윤리이론에서 도덕적 가치 개념은 공통적으로 규정적 속성을 갖는 것으로 이해되지만, 문제의 ‘규정적 속성’을 바라보는 그들의 관점은 다소 상이하다. 헤어가 도덕적 기술(旣述)의 논리적 형태에 착안하여 도덕적 가치들이 규정적이라고 주장하는 반면, 아리스토텔레스가 바라보는 도덕적 가치의 규정적 속성은 주어진 상황 속의 도덕적 요건 및 변수들을 향한 ‘인간의 인지적 본성’에 기인한다. 따라서 사실상 우리가 오늘날 현대 윤리학에서 이해되는 바와 정확히 같은 의미로 아리스토텔레스를 규정주의자로 부를 수는 없을 지도 모른다. 그러나 이 글은 비록 아리스토텔레스와 헤어가 ‘도덕 가치의 규정성’에 대한 동일한 논증을 도출하지는 않는다고 (...) 하더라도, 도덕적 가치에 대한 개념적 이해나 도덕 판단을 바라보는 이 두 철학자들의 기본적 관점에는 우리가 주목할 만한 정도의 공통분모가 있다고 주장한다. 그리하여 우리는 이들 사이의 공통적 요소들을 보이면서, 도덕 판단에 대한 아리스토텔레스의 논의 역시 비록 다소 제한적 이긴 하지만, 여전이 의미 있는 방식으로 ‘규정주의적’이라고 논증할 것이다. (shrink)

Despite the wide and daunting array of cross-cultural obstacles that the formulation of a global policy on advance directives will clearly pose, the need is equally evident. Specifically, the expansion of medical services driven by medical tourism, just to name one important example, makes this issue urgently relevant. While ensuring consistency across national borders, a global policy will have the additional and perhaps even more important effect of increasing the use of advance directives in clinical settings and enhancing their effectiveness (...) within each country, regardless of where that country's state of the law currently stands. One cross-cultural issue that may represent a major obstacle in formulating, let alone applying, a global policy is whether patient autonomy as the underlying principle for the use of advance directives is a universal norm or a construct of western traditions that must be reconciled with alternative value systems that may place lesser significance on individual choice. A global policy, at a minimum, must emphasize respect for patient autonomy, provision of medical information, limits to the obligations for physicians, and portability. And though the development of a global policy will be no easy task, active engagement in close collaboration with the World Health Organization can make it possible. (shrink)

아리스토텔레스 윤리학의 다양한 논점과 개념들 중에서도 실천적 지혜(phronēsis)는 판이하게 다른 이해와 분석이 존재하는 것으로 악명이 높은 주제라고 할 수 있다. 그 논란을 대표하는 전통적인 두 입장을 소개하면 다음과 같다. 먼저, 혹자들은 이성은 정념의 노예’ 혹은 ‘이성의 불활성(inertness)’등의 흄(David Hume)의 사상에서 착안하여, 아리스토텔레스 버전의 실천이성인 ‘실천적 지혜’ 역시 ‘덕’과 ‘행복’에 관하여 다소 제한적 기능만을 갖고 있다는 해석을 제시한다. 이들은 아리스토텔레스의 실천적 지혜는 ‘목적 달성을 위한 도구들’에만 관여한다고 주장하면서, 마치 흄의 도구적 이성과 유사한 것으로 아리스토텔레스의 실천적 사유(dianoia pratike)를 이해하려 한다. 반면, 아리스토텔레스의 (...) 실천적 지혜는 ‘도구들에 대한 숙고’는 물론, 덕, 용기, 절제, 행복 등의 궁극적 목적들에 대한 개념적 사유를 바탕으로 인간의 감정과 욕구에 명령을 내리는 적극적 이성의 역할을 갖는다고 주장하는 연구자들도 있다. 전자의 경우, 실천적 지혜에 대한 ‘흄적 해석’ 혹은 ‘감정주의적(emotivist)’ 해석 등으로 불리고, 후자에 대해서는 ‘칸트적 해석’ 혹은 ‘주지주의적(intellectualist) 해석’ 등의 명칭이 주어지기도 한다. 이 글은 행복(eudaimonia)에 대한 실천적 지혜의 역할에 대해서는 다소 조심스럽게 접근해야 할 부분이 있기는 하지만, 전반적으로 ‘칸트적 해석’이 아리스토텔레스의 실천적 지혜에 대한 적절한 분석이라는 논증을 제시할 것이다. (shrink)

A recent paradigm shift in music research has allowed scholars to examine the macro- and micro-processes taking place within musical performance and underlying cognitive processes. Tying in with phenomenological theories of embodied perception and cognition, this paper focuses on bodily musical activity relevant to the acquisition of instrumental musical skills—the process of learning music. Dynamic interaction with musical instruments, accompanied by the interplay of action and passion, involves body image and body schema, whose status oscillates in different phases of the (...) acquisition of instrumental musical skills; this interaction allows humans to direct attention from their bodily states—the proximal—to the quality of musical sounds and a unity of musical experience—the distal. It is thus argued that shaping music by means of playing a musical instrument can be conceived of as an embodied process, of understanding the forms of one’s own experience as related to the musical world that is created by one’s bodily activity. (shrink)

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)

This longitudinal study examined how nursing students' moral judgment changes after they become qualified nurses working in a hospital environment. The sample used was a group of 80 nursing students attending a university in Suwon, Korea, between 2001 and 2003. By using a Korean version of the Judgment About Nursing Decisions questionnaire, an instrument used in nursing care research, moral judgment scores based on Ketefian's six nursing dilemmas were determined. The results were as follows: (1) the qualified nurses had significantly (...) higher idealistic moral judgment scores than the nursing students; (2) the qualified nurses showed significantly higher realistic moral judgment scores than the nursing students; and (3) when comparing idealistic and realistic moral judgment scores, both the qualified nurses and the nursing students had higher scores for idealistic moral judgment. Further study is recommended to examine changes in moral judgment. (shrink)

Over the past decade AIDS research has turned toward the use of pharmacology in HIV prevention, including pre-exposure prophylaxis (PrEP): the use of HIV medication as a means of preventing HIV acquisition in those who do not have it. This paper explores the contradictory reasons offered in support of PrEP—to empower women, to provide another risk-reduction option for gay men—as the context for understanding the social meaning of the experimental trials that appear to show that PrEP works in gay men (...) and heterosexual couples but not single women. The PrEP debates reveal the different ideas about “demedicalization” in the earlier gay health and women’s health movements and highlight the relationship between health activism and critique of research ethics in the context of a global pharmaceutical market. (shrink)

This paper elucidates and rationalizes the ethical governance system for healthcare AI research, as outlined in the ‘Research Ethics Guidelines for AI Researchers in Healthcare’ published by the South Korean government in August 2023. In developing the guidelines, a four-phase clinical trial process was expanded to six stages for healthcare AI research: preliminary ethics review (stage 1); creating datasets (stage 2); model development (stage 3); training, validation, and evaluation (stage 4); application (stage 5); and post-deployment monitoring (stage 6). Researchers identified (...) similarities between clinical trials and healthcare AI research, particularly in research subjects, management and regulations, and application of research results. In the step-by-step articulation of ethical requirements, this similarity benefits from a reliable and flexible use of existing research ethics governance resources, research management, and regulatory functions. In contrast to clinical trials, this procedural approach to healthcare AI research governance effectively highlights the distinct characteristics of healthcare AI research in research and development process, evaluation of results, and modifiability of findings. The model exhibits limitations, primarily in its reliance on self-regulation and lack of clear delineation of responsibilities. While formulated through multidisciplinary deliberations, its application in the research field remains untested. To overcome the limitations, the researchers’ ongoing efforts for educating AI researchers and public and the revision of the guidelines are expected to contribute to establish an ethical research governance framework for healthcare AI research in the South Korean context in the future. (shrink)

In light of the dramatic growth of Chinese learners worldwide and a need for cross-linguistic research on Chinese literacy development, this study drew upon theories of visual complexity effect (Su & Samuels, 2010) and dual-coding processing (Sadoski & Paivio, 2013) and investigated a) the effects of character properties (i.e., visual complexity and radical presence) on character acquisition and b) the relationship between individual learner differences in radical awareness and character acquisition. Participants included adolescent English-speaking beginning learners of Chinese in the (...) U.S. Following Kuo et al. (2014), a novel character acquisition task was used to investigate the process of acquiring the meaning of new characters. Results showed that a) characters with radicals and with less visual complexity were easier to acquire than characters without radicals and with greater visual complexity; and b) individual differences in radical awareness were associated with the acquisition of all types of characters, but the association was more pronounced with the acquisition of characters with radicals. Theoretical and practical implications of the findings were discussed. (shrink)

We used functional magnetic resonance imaging to examine the interactive effects of perceived competence and task interest on the cognitive and affective responses to negative feedback. Twenty-four undergraduates performed both interesting and uninteresting tasks and received failure feedback. The participants’ perceived competence in the task was manipulated between subjects prior to scanning with bogus feedback. The results showed that negative feedback processing was contingent upon both perceived competence and task interest. The most adaptive coping mechanism, indicated by activation in the (...) cognitive control network and attenuation in the negative affect region, was identified for the high-competence and high-interest combination. When either competence or interest was low, signals in the cognitive control network were weaker. The most detrimental activation patterns were observed for the combination of low-competence and high interest. Our results reveal the combination of task and learner characteristics that best harnesses the potential benefits of negative feedback and illustrate the neuroscientific mechanisms underlying this observation. (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)

To cope with economic globalization and improve the competitiveness of transnational start-ups, the impact of the work environment and innovation behavior on corporate performance of multinational new ventures is analyzed. First, a model of the interaction among environment, innovation behavior, and enterprise performance is proposed. Then, 296 transnational start-ups in coastal areas are surveyed, and the model results are analyzed. Finally, a series of results are obtained. The results show that from the perspective of psychology, work dynamic organizational learning environment (...) has a positive impact on enterprise performance, and resource environment has a significant positive impact on enterprise performance. Strategic environment also positively affects enterprise performance. Therefore, the working environment of multinational new ventures has a positive impact on firm performance, and the mediating function between the working environment and firm performance is firm innovation behavior. With the research to achieve enterprise innovation of multinational new ventures by improving their response to the dynamic environment, the corporate performance has been greatly promoted, and finally, the new ventures would participate in the international market competition. (shrink)

One of the most salient objections against paternalism is that it is motivated by a negative judgment about other people’s capacity to advance their own goals and interests. Such a negative judgment, according to this objection, is morally wrong because it denies others the status of moral equals who can rationally set and pursue their own conception of the good. Despite the popularity of this objection, I argue that it misfires because rendering a negative judgment about others’ capacities does not (...) deny them equal moral status when there is sufficient _evidence_ for that judgment. However, I argue that in order to determine if there is sufficient evidence of the agent’s incapacity, we must understand the agent’s reasons for action through a rational discursive exchange with them, instead of taking perceived facts about their behavior as sufficient grounds for a negative (or positive) judgment of their capacities. In fact, I argue that if the outcome of the discursive exchange supports a negative judgment of the agent’s capacities, there is a _pro tanto_ case in favor of paternalistic interference. (shrink)

This book engages in cross-tradition scholarship, investigating the processes associated with cultivating or nurturing the self in order to live good lives. Both Ancient Chinese and Greek philosophers provide accounts of the life lived well: a Confucian junzi, a Daoist sage and a Greek phronimos. By focusing on the processes rather than the aims of cultivating a good life, an international team of scholars investigate how a person develops and practices a way of life especially in these two traditions. They (...) look at what is involved in developing practical wisdom, exercising reason, cultivating equanimity and fostering reliability. Drawing on the insights of thinkers including Plato, Confucius, Han Fei and Marcus Aurelius, they examine themes of harmony, balance and beauty, highlight the different concerns of scepticism across both traditions, and discuss action as an indispensable method of learning and, indeed, as constitutive of self. The result is a valuable collection opening up new lines of inquiry in ethics, demonstrating the importance of philosophical ideas from across cultural traditions. (shrink)