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)

The purpose of this study is to examine the effect of compassion experienced by low-cost carriers customers on their brand attitudes. Specifically, this study aims to unbox the mechanisms through how the customers’ experiences of compassion influence the formation of positive brand attitudes. Using the data from 423 low-cost carriers customers in South Korea, this study found that the more low-cost carriers’ customers experience compassion, the more positive their brand attitudes are toward the low-cost carriers. Notably, this study demonstrated that (...) the positive relationship between compassion and brand attitudes is serially mediated by positive emotion and positive brand image. The results from this study contribute to the literature on the airline industry by examining the roles of compassion, which is relatively new to the field, and also provide practical insights for a low-cost carrier to come up with competitive strategies to achieve a competitive advantage over its competitors in the industry. (shrink)

The concept of brain death — first defined decades ago — still presents medical, ethical, and legal challenges despite its widespread acceptance in clinical practice and in law. This article reviews the medicine, law, and ethics of brain death, including the current inconsistencies in brain death determinations, which a lack of standardized federal policy promotes, and argues that a standard brain death policy to be used by all hospitals in all states should be created.

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)

The concept of brain death evolved because advancements in medical science permitted unprecedented artificial maintenance of vital body functions by external means. Although the concept of brain death is accepted clinically, ethically, and legally in the United States, there is no national standard for the determination of brain death. There is evidence that variability and inconsistency in the process of determining brain death exist both in clinical settings and in State statutes. Several studies demonstrate that medical personnel determine brain death (...) in variable ways, and have variable understandings of the definition of brain death. The declaration of death has significant legal consequences such as probate proceedings and liability issues for wrongful death. Inconsistencies in the determination of death may therefore be medically, ethically, and legally problematic. (shrink)

Relational database management system is the most popular database system. It is important to maintain data security from information leakage and data corruption. RDBMS can be attacked by an outsider or an insider. It is difficult to detect an insider attack because its patterns are constantly changing and evolving. In this paper, we propose an adaptive database intrusion detection system that can be resistant to potential insider misuse using evolutionary reinforcement learning, which combines reinforcement learning and evolutionary learning. The model (...) consists of two neural networks, an evaluation network and an action network. The action network detects the intrusion, and the evaluation network provides feedback to the detection of the action network. Evolutionary learning is effective for dynamic patterns and atypical patterns, and reinforcement learning enables online learning. Experimental results show that the performance for detecting abnormal queries improves as the proposed model learns the intrusion adaptively using Transaction Processing performance Council-E scenario-based virtual query data. The proposed method achieves the highest performance at 94.86%, and we demonstrate the usefulness of the proposed method by performing 5-fold cross-validation. (shrink)

Storytelling is getting increasing attention as one of the effective strategies for revitalizing the local festivals and even regional economies. Yet, the mechanisms through how storytelling helps the success of local festivals are still relatively less known. Using the data from 322 individuals who participated in local festivals using storytelling, our results showed that local festival storytelling is positively related to tourists’ revisit intention. Furthermore, the positive relationship between local festival storytelling and tourists’ revisit intention was serially mediated by authenticity (...) and positive emotion. Theoretical and practical implications are discussed. (shrink)

There is a growing literature on corporate social responsibility, but few have focused on the implications of business groups for CSR. We examine the antecedents and outcomes of CSR behaviors of group firms in Korea. We find that group affiliation is associated with higher CSR overall and for its major societal and environmental components. However, the ownership disparity between cash flow and control by controlling inside shareholders is associated with lower CSR, consistent with opportunistic rent expropriation theory. We further find (...) that CSR initiatives can impact group firms positively in the event of bad events, consistent with insurance theory. This motive for CSR as a means of enhancing reputation capital to buffer the bad events is pronounced for group firms because of group-wide dissemination of negative reputational externality. (shrink)

This article provides a theoretical policy-making model of chemical sunset that gradually substitutes green alternatives for persistent toxic substances within a finite timeframe. The technological inflexibility of these substances is a tough obstacle to a chemical sunset, because a chemical sunset seeks to ultimately stop, within a short period of time, the risky businesses of these substances that are highly entrenched into our society. In wrestling with this obstacle, the intelligent precautionary “polluter pays” principle integrates three policy tools: a “precautionary (...) `polluter pays' principle,” “intelligent trial and error,” and democratic “regulatory negotiation.” It is designed to promote technological pluralism and strong democracy, as well as to create either trust or mutual adjustment among relevant groups. (shrink)