This paper presents an autobiographical narrative of two aspects of my history; two events that permeated my moral consciousness and influenced my political development and a sequence of changes in my dominant theoretical and epistemological perspectives. The two events were, as a teenager, the intense experience of briefly witnessing Apartheid culture and, as a young adult, becoming deeply engaged in feminist activism. My intellectual journey began in cognitive developmental theory and progressed to a cultural, discursive perspective in which the role (...) of affect is seen as integrated. The paper explores the intersection of these two strands of my moral and intellectual development and concludes with a preliminary model of action and engagement. (shrink)

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social (...) issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. (shrink)

Nowadays, many countries are promoting entrepreneurial education or the “innovation, entrepreneurship, and creativity” education. Entrepreneurial education can enhance a nation’s economic competitiveness and give rise to new business. At the moment, entrepreneurial courses are mostly designed by school teachers; however, while school teachers may possess business experience, they lack in entrepreneurial experience. Hence, entrepreneurial education courses call for experts with entrepreneurial experience to contribute to course designs and assist with course teachings. Entrepreneurial education not only improves a student’s entrepreneurial skills, (...) but also enables each student to explore their personal characteristics in order to advance the collaboration efficacy of the team as a whole. This study asked six experts with entrepreneurial experience in the information industry to work with school teachers in course design as well as teaching collaboration. The course design starts with three talk sessions given by professionals who share with students their thoughts and experiences in entrepreneurial products, team organization, fund raising, and profit calculation. Following that, each student is asked to share their own thoughts on entrepreneurial products and start searching for team members and planning their project. During the course, each team receives six individual advising sessions from the professionals, with topics ranging from product modeling, feasibility, product market estimation, fundraising methods, and profit calculation. The experts also provide each team member with personal trait analysis. Last but not least, the course invites five management-level industry professionals to play the role of venture capital investor and evaluate each team’s product modeling based on their presentation. This study reviews the grades given by the experts as well as the evaluations given by the three industry managers to assess whether the entrepreneurial education course’s student entrepreneur teams satisfy the industry’s expectations. (shrink)

Objects in the world usually have names at different hierarchical levels (e.g., beagle, dog, animal). This research investigates adults' ability to use cross‐situational statistics to simultaneously learn object labels at individual and category levels. The results revealed that adults were able to use co‐occurrence information to learn hierarchical labels in contexts where the labels for individual objects and labels for categories were presented in completely separated blocks, in interleaved blocks, or mixed in the same trial. Temporal presentation schedules significantly affected (...) the learning of individual object labels, but not the learning of category labels. Learners' subsequent generalization of category labels indicated sensitivity to the structure of statistical input. (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)

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan.

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)

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

This paper explores the linkage between electoral systems and candidate selection methods by analyzing two innovations of CSMs in Taiwan and Japan: polling primary and kobo, respectively. With an assumption that partiesno-finding’ conclusion in some previous large-N studies on the linkage between electoral systems and choices of CSMs. Additionally, our findings highlight the importance of institutional factors, such as electoral systems, in explaining CSM reforms in a comparative perspective.

In a recent study (Chen et al., 2018), we conducted a series of experiments that induced the “four-hand illusion”: using a head-mounted display (HMD), the participant adopted the experimenter’s first-person perspective (1PP) as if it was his/her own 1PP. The participant saw four hands via the HMD: the experimenter’s two hands from the adopted 1PP and the subject’s own two hands from the adopted third-person perspective (3PP). In the active four-hand condition, the participant tapped his/her index fingers, imitated by (...) the experimenter. Once all four hands acted synchronously and received synchronous tactile stimulations at the same time, many participants felt as if they owned two more hands. In this paper, we argue that there is a philosophical implication of this novel illusion. According to Merleau-Ponty (1945/1962) and Legrand (2010), one can experience one’s own body or body-part either as-object or as-subject but cannot experience it as both simultaneously, i.e., these two experiences are mutually exclusive. Call this view the Experiential Exclusion Thesis. We contend that a key component of the four-hand illusion—the subjective experience of the 1PP-hands that involved both “kinesthetic sense of movement” and “visual sense of movement” (the movement that the participant sees via the HMD)—provides an important counter-example against this thesis. We argue that it is possible for a healthy subject to experience the same body-part both as-subject and as-object simultaneously. Our goal is not to annihilate the distinction between body-as-object and body-as-subject, but to show that it is not as rigid as suggested by the phenomenologists. (shrink)

The importance of organizational ambidexterity was stressed in different fields of management. This study was using a distinct method to measure the differences in the degree of ambidexterity to bridge the gap with the previous studies and to provide more insights in the successful management of exploitation and exploration. This study surveyed Taiwanese small and medium-sized enterprises to test the hypotheses. We issued 1000 questionnaires in total and received 234 valid ones. Results indicate exploitative and explorative capabilities exerting non-linear effect (...) on performance. Likewise, ambidexterity and its interaction with market orientation have positive influence on firm performance. This study used structural equation modeling to analyze data, as this approach is known to be particularly advantageous for the exploratory nature of this study. We also used hierarchical regression analysis to test interaction and moderating effects. The study contributes to the literature in two ways. First, we offer a clearer understanding of the complete concept of social capital, including inter-firm and intra-firm social capital, and how contributes to improving and extending existing exploitative capabilities. Second, this study outlines how market orientation can have different effects on an ambidextrous strategy that is adopted to improve Taiwanese SMEs performance. (shrink)

Physicians play a substantial role in facilitating communication regarding life-supporting treatment decision-making including do-not-resuscitate in the intensive care units. Physician-related fact...

Self-location—the sense of where I am in space—provides an experiential anchor for one's interaction with the environment. In the studies of full-body illusions, many researchers have defined self-location solely in terms of body-location—the subjective feeling of where my body is. Although this view is useful, there is an issue regarding whether it can fully accommodate the role of 1PP-location—the sense of where my first-person perspective is located in space. In this study, we investigate self-location by comparing body-location and 1PP-location: using (...) a head-mounted display (HMD) and a stereo camera, the subjects watched their own body standing in front of them and received tactile stimulations. We manipulated their senses of body-location and 1PP-location in three different conditions: the participants standing still (Basic condition), asking them to move forward (Walking condition), and swiftly moving the stereo camera away from their body (Visual condition). In the Walking condition, the participants watched their body moving away from their 1PP. In the Visual condition, the scene seen via the HMD was systematically receding. Our data show that, under different manipulations of movement, the spatial unity between 1PP-location and body-location can be temporarily interrupted. Interestingly, we also observed a “double-body effect.” We further suggest that it is better to consider body-location and 1PP-location as interrelated but distinct factors that jointly support the sense of self-location. (shrink)

The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.

Two experiments were conducted to examine adult learners' ability to extract multiple statistics in simultaneously presented visual and auditory input. Experiment 1 used a cross‐situational learning paradigm to test whether English speakers were able to use co‐occurrences to learn word‐to‐object mappings and concurrently form object categories based on the commonalities across training stimuli. Experiment 2 replicated the first experiment and further examined whether speakers of Mandarin, a language in which final syllables of object names are more predictive of category membership (...) than English, were able to learn words and form object categories when trained with the same type of structures. The results indicate that both groups of learners successfully extracted multiple levels of co‐occurrence and used them to learn words and object categories simultaneously. However, marked individual differences in performance were also found, suggesting possible interference and competition in processing the two concurrent streams of regularities. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 58-59, August 2011.

Antoni Tàpies’ essays and interviews display how his conception of art is impregnated with an Oriental nondualistic aesthetics.1 I argue that, among them, the Chinese aesthetics of qi 氣 plays the most pivotal role and leaves an indelible imprint in his corpus. Tàpies’ encounter with this Asian thinking probably came through the translated writings of Laozi 老子, Confucius 孔子, Mencius 孟子, Zhuangzi 莊子, Mozi 墨子, and Lin Yutang 林語堂, among others, thanks to the publications of different Western-based Sinologists.2 However, instead (...) of the term qi, Tàpies was prone to using the words “energy” or “spirit” to designate this element, which he understood as a cosmological principle and force, as was mentioned... (shrink)

In this paper, we analyze how citizens evaluate their president, especially focusing on why voters lower their evaluations at an individual-level perspective. We assert that citizens raise their evaluations of a new president when their expectations are met and lower their opinions when his or her performance disappoints them. Furthermore, the evaluations of the president are not only affected by a government's economic and diplomatic performance, but are also influenced by individual awareness of salient political issues, the contents of the (...) news, and their own perceived influence on politics. We test the theoretical hypotheses using Taiwan's Election and Democratization Study panel survey data. The statistical results support our theoretical hypotheses and show that when President Ma's performance did not meet respondents media exposure and political efficacy are significantly associated with the change in their opinions of Ma. (shrink)

SummaryThis study estimates the effect of dysgenic trends in Taiwan by exploring the relationships among intelligence, education and fertility. Based on a representative adult sample, education and intelligence were negatively correlated with the number of children born. These correlations were stronger for females. The decline of genotypic intelligence was estimated as 0.82 to 1.33 IQ points per generation for the Taiwanese population.

Recent studies of the rubber hand illusion (RHI) have shown that the sense of body ownership is constrained by several factors and yet is still very flexible. However, exactly how flexible is our sense of body ownership? In this study, we address this issue by investigating the following question: is it possible that one may have the illusory experience of owning four hands? Under visual manipulation, the participant adopted the experimenter’s first-person perspective (1PP) as if it was his/her own. Sitting (...) face to face, the participant saw four hands—the experimenter’s two hands from the adopted 1PP together with the subject’s own two hands from the adopted third-person perspective (3PP). We found that: (1) the four-hand illusion did not occur in the passive four-hand condition. (2) In the active four-hand condition, the participants tapped their index fingers, imitated by the experimenter. When tactile stimulations were not provided, the key illusion was not induced, either. (3) Strikingly, once all four hands began to act with the same pattern and received synchronous tactile stimulations at the same time, many participants felt as if they had two more hands. These results show that the sense of body ownership is much more flexible than most researchers have suggested. (shrink)

Political scientists generally consider that the incentive for legislators to switch parties lies in their desire to be re-elected. While some scholars attribute defection to the legislators’ popularity and strong connections with their constituents which enable them to be re-elected without relying on party labels, others assert that legislators switch if they perceive that staying put might threaten their chances of re-election. In this paper, we find that the two assumptions, to some extent, contradict each other. More surprisingly, the two (...) contradictory hypotheses cohabit under the single non-transferable vote system. From an analysis of the switching in the Taiwanese Legislative Yuan, the empirical evidence shows that because of fierce intraparty competition in the multimember districts, not only barely elected but also top-ranked legislators switched party affiliation in order to avoid the loss in votes or even seats to their copartisans and to maximize their chances of re-election. (shrink)

Background Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. Methods This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, (...) 2013 were reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. Results We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Conclusion Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order. (shrink)

The American Journal of Bioethics, Volume 12, Issue 5, Page 40-41, May 2012.

Global climate change arouses people’s attention to environmental protection and, therefore, changes consumption habits. Food overconsumption not only produces extra waste but also pollutes the environment. Therefore, it is important to understand the factors that motivate people to eat green, an eco-friendly way to consume food. To keep the body in good shape, the fitnessers concern more about diet than the general people. This study explored intrinsic motivations, such as social recognition, environmental ethics, curiosity, joy of purchase, perceived usefulness, subjective (...) norm, and perceived behavior control as constructs that affect fitnesser’s green eating intention. All constructs except curiosity have significant impacts on behavior intention. The results demonstrate that social recognition and environmental ethics have significant effects on curiosity, joy of purchase, perceived usefulness, subjective norm, and perceived behavior control. The mediation effects between social recognition and behavior intention are not supported. The mediators between environmental ethics and behavior intention are joy of purchase, perceived usefulness, subjective norm, and perceived behavior control. (shrink)

Online music sharing, deemed illegal for invading intellectual property rights under current laws, has become a crucial issue for the music industry in the modern digital age, but few have investigated the potential costs and utilities for individuals involved in such online misbehavior. This study aimed to fill in this gap to predict consumers' intentions to engage in online music sharing and further consider consumers' online music sharing knowledge as a moderator in the research model. The results of repeated measures (...) analysis of variance of costs and utilities of online music sharing not only give more detailed information to grasp empirical implications but also provide some suggestions to the music industry in Taiwan. (shrink)

Working memory performance affects children’s learning. This study examined objective, subjective, and physiological cognitive load while children completed a spatial working memory complex span task. Frist, 80 Taiwanese 11-year-olds who participated in Experiment 1 confirmed the suitability of the materials. Then, 72 Taiwanese 11-year-olds were assigned to high and low complexity groups to participate in Experiment 2 to test the study hypothesis. Children had to recall at the end of a dual-task list and answer two questions regarding the difficulty and (...) mental effort involved in processing and storage. Their pupil diameters were recorded using an eye-tracker. Two-way mixed ANOVA found that the processing requirements and memory load reduced storage and aggravated the subjective CL of storage; the subjective CL of processing was higher under highly complex conditions. Stepwise regression analysis indicated that subjective CL of processing predicted memory performance in low CL conditions, and physiological CL of processing predicted it in high CL conditions. (shrink)

The experience of embarrassment was explored in two experiments comparing monolingual and bilingual speakers from cultures varying in the degree of elabo- ration of the embarrassment lexicon. In Experiment 1, narratives in English or Korean depicting three types of embarrassing predicaments were to be rated on their embarrassability and humorousness by Korean-English bilinguals, Korean monolinguals, and Euro-American monolinguals. All groups judged certain predicaments (involving social gaffes) to be the most embarrassing. However, significant group and language differences occurred in judgments of (...) the inten- sity of embarrassment and amusement judgments evoked. Euro-Americans ex- hibited higher overall levels of amusement than the two Korean groups who, in turn, reported higher levels of embarrassment, particularly for certain predica- ment types and contexts (ingroup members present). Further, for the bilinguals, inept performance predicaments in English were judged more embarrassing than those in Korean, whereas all predicament types were judged more amusing when framed with English emotion labels. Bilinguals also appeared to show a heightened embarrassability relative to both monolingual groups. Experiment 2 found lexical selection differences in open-ended responses to embarrassing predicaments depicted in each language, with Euro-Americans preferring to give justifications or use humor to minimize the embarrassment and Korean-English bilinguals preferring to give apologies or say nothing. The findings are interpret- ed to reflect the influence of culturally-mediated schemas guiding the activation and processing of emotion vocabulary. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

This study attempts to investigate the relationships among the ethical beliefs of Chinese consumers and orientations based on attitudinal attributes: materialism and moral philosophies (idealism and relativism). In addition, this study examines Chinese consumers' ethical beliefs in relation to five selected demographic characteristics (gender, age, religion, family income and education). Based on this exploratory study of 284 Chinese consumers, the following statistically significant findings were discovered. First, Chinese consumers regard that a passively benefiting activity is more ethical, but actively benefiting (...) from an illegal or a questionable activity is unacceptable. Second, the two dimensions of passively benefiting and no harm/no foul can be used to distinguish the consumers who endorse higher levels of idealism or relativism. Third, Chinese consumers with a high level of materialism are more likely to actively benefit from illegal and questionable activities, and the passively benefiting actions. Finally, the more ethical Chinese consumers seem to be younger, be religious, and have a lower family income. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (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)