Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...) of medical decisions of adults. Objective The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual’s relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers’ dominant voice hampers the demonstration of relational autonomy. Conclusions Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual’s values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual’s values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. (shrink)

Community-Based Tourism (CBT) has been presented as an alternative to sustain tourism development in developing countries. This tourism model offers local residents an opportunity to manage natural and cultural resources in order to promote local economy and generate greater benefits. The objective of the study is to investigate the benefits, challenges of CBT and solution to address identified shortcomings by studying Muen Ngoen Kong community in Chiang Mai, Thailand. In order to achieve these objectives, qualitative methods; field observation and interview (...) were employed and qualitative data were analyzed by thematic analysis. The results of field observation and interview data from local residents were reported, analyzed, and discussed. To practice CBT, the findings indicated that several challenges; conflict over resource ownership and benefit leaking, financial issues, and problems of community participation had been experienced in implementation of CBT. However, abundance of tourism resources and security related concerns were identified as benefits of CBT in the area. In close collaboration with government agency, product development was recommended to create a unique condition for CBT and address shortcoming. It is crucial to involve local residents, empower the local community, conserve and cultivate cultural resources, and finally, maintain the sustainability of overall tourism resources. (shrink)

The purpose of the current study was to explore how effectively journal author guides communicate with graduate students learning English as a foreign language (EFL) in Taiwan. A 10-item three-tier test was developed to explore the participants’ (1) confidence level in their reading comprehension of excerpts from author guides, (2) their actual comprehension, and (3) their understanding, if any. The test consisted of 10 excerpts from author guides that covered a variety of topics related to plagiarism. The test was administered (...) to 46 EFL graduate students. The findings revealed that the selected excerpts from the author guides caused confusion, which led to misunderstanding by the readers. Among the 10 types of plagiarism, citation issues and copying of methods sections were the the most understood, whereas self-plagiarism was the least understood type. (shrink)

Background Ethical dilemmas that arise in the clinical setting often require the collaboration of multiple disciplines to be resolved. However, medical and nursing curricula do not prioritize communication among disciplines regarding this issue. A common teaching strategy, problem-based learning, could be used to enhance communication among disciplines. Therefore, a university in southern Taiwan developed an interprofessional ethics education program based on problem-based learning strategies. This study described tutors’ experience teaching in this program. Aim To explore the phenomenon of teaching and (...) learning in interprofessional ethics education for medical and nursing students from the perspectives of tutors. Design Phenomenological qualitative research. Methods Medical and nursing students completed a 6-week interprofessional ethics education program moderated by either physician or nurse tutors. At the conclusion of the ethics education program, all 14 tutors were invited to participate in focus group interviews. Among them, six tutors (three nursing tutors and three physician tutors) participated in additional individual interviews. All of the contents from the focus group interviews and individual interviews were recorded and transcribed. Using the phenomenological approach, the phenomenon of teaching and learning in interprofessional ethics education were generated. Ethical consideration The study was approved by the Institutional Review Board. Findings Three themes emerged from the tutors' teaching perspectives, including the instructor’s motivation to teach, the use of narrative case scenarios, and the emphasis on improving interprofessional ethics communication. Discussion Problem-based learning creates an interprofessional communication platform in interprofessional ethics education. The phenomenon of value convergence between tutors and students, between different students’ professions, and between different students’ professional maturities is observed. Conclusion Problem-based learning is an effective teaching strategy for creating a communication platform for interprofessional ethics education. Ethic curriculum should emphasize motivating instructor, use narrative case scenarios, and focus on interprofessional communication. (shrink)

Community-Based Tourism offers local residents opportunities to manage local tourism resources while sustaining their lifestyle at the same time. The research objective of the study was to explore the process and experience of communities in Northern Thailand which are known as elephant habitats, how these communities strive for stimulating the local economy without jeopardizing the way of life. The study was qualitative in nature. Qualitative data collection methods such as field observations and in-depth interviews were employed. The qualitative data were (...) further analyzed with thematic analysis. In practicing CBT, the findings identified positive factors, negative factors, and suggestions. The study found that the communities took pride in their cultural as well as natural resources and they are willing to commercialize these resources to a certain degree, i.e. founding elephant themed facilities, as has evidently been indicated. Consequently, as many issues factor into the practice of CBT, the study concluded that community participation and government support should have played a crucial role in maintaining new balance of overall local lifestyle sustainability and commercialization during and after the pandemic. (shrink)

The meshed control theory assumes that cognitive control and automatic processes work together in the natural attention of experts for superior performance. However, the methods adopted by previous studies limit their capacity to provide in-depth information on the neuromotor processes. This experiment tested the theory with an alternative approach. Twelve skilled golfers were recruited to perform a putting task under three conditions: (1) normal condition, with no focus instruction (NC), (2) external focus of attention condition (EC), and (3) internal focus (...) of attention condition (IC). Four blocks of 10 putts each were performed under each condition. The putting success rate and accuracy were measured and electroencephalographies (EEGs) were recorded. The behavioral results showed that the NC produced a higher putting success rate and accuracy than the EC and IC. The EEG data showed that the skilled golfers’ attentional processes in the NC initially resembled those in the EC and then moved toward those in the IC just before putting. This indicates a switch from more automatic processes to cognitive control processes while preparing to putt. The findings offer support for the meshed control theory and indicate the dynamic nature of neuromotor processes for the superior performance of athletes in challenging situations. (shrink)

The domestic situation of the past few years shows the practices of employees’ unpaid leave and layoffs and the constant drain on capital, talent, and technologies in hospitality. Owners expect to reduce the losses to as low as possible by saving on human costs. Nevertheless, in face of such a changing environment, hospitality has to accumulate high-quality human capital through systematic investment, sensitive development, and continuous learning and growth to discover competitive advantages through the cultivation of human capital. The pre-service (...) education of new employees could accelerate their familiarity with the operations of the company and their understanding of their job role and duties. More importantly, with good planning, it could make employees feel emphasized with and respected with the result of largely changing their thoughts and working habits. Aiming at supervisors and employees in hospitality in Zhejiang as the research objects, a total of 420 copies of our questionnaire are distributed, and 357 valid copies were retrieved, with a retrieval rate of 85%. According to the results to propose discussions, it is expected to generate systematic and proper education methods for the pre-service education in hospitality, promote the education effectiveness, and promote employees’ capability and organizational performance. (shrink)

While political scientists generally see Taiwan as a success state because of its economic modernization and political democratization, this book reinterprets Taiwan's success from the Confucian and postcolonial perspectives. Democracy uncovers the hegemonic construction of the myth of the "success state" and challenges political scientists to abandon both the liberal-centrism and state-centrism prevailing in the literature of democratization.

IntroductionThis paper employs Confucianism to illustrate a kind of differential or benevolent love, which people give in accordance with their relations and roles. In this sense, Confucian benevolent love is more of a duty to create mutual belonging than an emotion of solidarity.1 This benevolent love contrasts with the universal love of liberalism and the resultant solidarity that those who express this form of love feel for one another—these people often being the distant and unacquainted—whose presence would puzzle Confucian leaders (...) in terms of their roles and duties. Confucian roles are, in comparison, contextual, evolving, and reciprocal in order to cope with encountered strangeness. The liberal belief in everyone being ontologically equal and free de-emphasizes the relevance of experiencing the other’s strangeness. As a result of this, a Confucian’s and liberal’s love for one another may ironically cause, in both, a moral outrage qua deprived belonging.2. (shrink)

Co-creativity focuses on how individuals produce innovative ideas together. As few studies have explored co-creativity using standardized tests, it is difficult to effectively assess the individual’s creativity performance within a group. Therefore, this study aims to develop a platform that allows two individuals to answer creativity tests simultaneously. This platform includes two divergent thinking tasks, the Straw Alternative Uses Test and Bottle Alternative Uses Test, and Chinese Radical Remote Associates Test A and B, which were used to evaluate their open-and (...) closed-ended creative problem-solving performance. This platform has two modes: single-player mode and paired-player mode. Responses from 497 adults were collected, based on which the fluency, flexibility, and originality of divergent thinking were measured. This study also developed a computer scoring technique that can automatically calculate the scores on these creativity tests. The results showed that divergent thinking scores from computer-based calculation and manual scoring were highly positively correlated, suggesting that the scores on a divergent thinking task can be calculated through a system that avoids time-consuming, uneconomical manual scoring. Overall, the two types of tests on this platform showed considerable internal consistency reliability and criterion-related validity. This advanced application facilitates the collection of empirical evidence about co-creativity. (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.

Delineation of the subthalamic nuclei on MRI is critical for deep brain stimulation surgery in patients with Parkinson’s disease. We propose this retrospective cohort study for quantitative analysis of MR signal-to-noise ratio, contrast, and signal difference-to-noise ratio of the STN on pre-operative three-dimensional stereotactic MRI in patients with medication-refractory PD. Forty-five consecutive patients with medication-refractory PD who underwent STN-DBS surgery in our hospital from January 2018 to June 2021 were included in this study. All patients had whole-brain 3D MRI, including (...) T2-weighted imaging, T2-weighted fluid-attenuated inversion recovery, and susceptibility-weighted imaging, at 3.0 T scanner for stereotactic navigation. The signal intensities of the STN, corona radiata, and background noise were obtained after placing regions of interest on corresponding structures. Quantitative comparisons of SNR, contrast, and SDNR of the STN between MR pulse sequences, including the T2WI, FLAIR, and SWI. Subgroup analysis regarding patients’ sex, age, and duration of treatment. We used one-way repeated measures analysis of variance for quantitative comparisons of SNR, contrast, and SDNR of the STN between different MR pulse sequences, and we also used the dependent t-test for the post hoc tests. In addition, we used Mann–Whitney U test for subgroup analyses. Both the contrast and SDNR were highest on FLAIR. The SNR was highest on SWI, and both the SNR and SDNR were lowest on T2WI. Subgroup analyses demonstrated significantly lower SDNR on SWI for patients receiving medication treatment for ≥13 years. In conclusion, on 3D stereotactic MRI of medication-refractory PD patients, the contrast and SDNR for the STN are highest on FLAIR, suggesting the optimal delineation of STN on FLAIR. (shrink)

Protein disulfide isomerase (PDI) is one of the most abundant and critical protein folding catalysts in the endoplasmic reticulum of eukaryotic cells. PDI consists of four thioredoxin domains and interacts with a wide range of substrate and partner proteins due to its intrinsic conformational flexibility. PDI plays multifunctional roles in a variety of pathophysiological events, both as an oxidoreductase and a molecular chaperone. Recent studies have revealed that the conformation and activity of PDI can be regulated in multiple ways, including (...) posttranslational modification and substrate/ligand binding. Here, we summarize recent advances in understanding the function and regulation of PDI in different pathological and physiological events. We propose that the multifunctional roles of PDI are regulated by multiple mechanisms. Furthermore, we discuss future directions for the study of PDI, emphasizing how different regulatory modes are linked to the conformational changes and biological functions of PDI in the context of diverse pathophysiologies. (shrink)

We are of the opinion that there is also identity between erroneous thinking and existence. Our opinion is based on the following facts.

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)

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)

This study analyzes the influence of behavioral foundation factors and corporate strategic behavior on the formulation of corporate dividend policy. We use the Logit model and the OLS model for estimating the empirical model. The year- and industry-fixed effects are controlled in the model. We consider the behavioral foundations in three dimensions-ambiguity aversions, risk aversion, and loss aversion. The results show firms with high ambiguity or high risk infrequently pay dividends but firms with loss-averse behavior tend to pay dividends. This (...) paper also provides evidence that a firms’ business strategy influences its corporate dividend policy. Aggressive firms inhibit the payout of dividends. In additional tests, we find the results remain unchanged in those firms with high corporate governance or high growth opportunities. (shrink)

This study examines the effects of leader emotional intelligence, leadership styles, organizational commitment, and trust on job performance. A questionnaire was administered to the participants, who were real estate brokers in Kaohsiung City. Of the 980 questionnaires administered, 348 valid responses were received, indicating an effective response rate of 35.5%. Structural equation modeling was used for the analysis. The results show that leader emotional intelligence has a significant and positive effect on trust in supervisors, and transformational leadership and trust within (...) a team have significant and positive effects on job performance. In addition, organizational commitment has a significant and positive effect on job performance. Trust within a team mediates the significant and positive effect of leader emotional intelligence on job performance. Although transactional leadership has no direct, positive, and significant effects on employee job performance, trust in the workplace shaped by a leader’s leadership style will empower a team’s spirit and boost their morale, thereby indirectly affecting their job performance in a positive manner. (shrink)

The financial crisis of 2007–2008 and the COVID-19 pandemic have caused many enterprises to suffer great losses. Thus, companies have to take measures such as pays cut, furloughs, or layoffs, which caused dissatisfaction among employees and triggered labor disputes. Therefore, this study explores the service-oriented organizational citizenship behavior based on the decomposed theory of planned behavior in order to understand the behavioral intentions of employees through their mental states, job attitudes, subjective norms, and perceived behavioral control. This study conducted questionnaire (...) surveys for employees in different industries, collected 281 valid questionnaires, and applied Structural Equation Model for the analysis. The results show: employees believe organizational justice in the organization is important, and when they feel treated fairly, their job attitudes and beliefs are enhanced. Employees’ job attitudes and beliefs support service-oriented organizational citizenship behavior, in other words, they have positive job attitudes and beliefs and will actively provide better service to customers. When employees are treated reasonably and fairly by the organization and have positive job attitudes and perceived behavior control, their spontaneous service-oriented organizational citizenship behavior is stimulated, thus increasing organizational development. (shrink)

Many studies assume a significant relationship between intention and behavior. However, the data do not always support this assumption. This study used a modified version of social cognitive theory with self-evaluations as an intermediate variable to explore and resolve the problems associated with applying the theory of planned behavior to explain students’ adoption of technology for self-directed learning. We surveyed 285 college students who enrolled in an e-book publishing course using multifaceted technological learning tools. We found that, as an intermediate (...) variable, self-evaluation enhanced the influence of intentions on behavior and improved the accuracy of predictions of college students’ adoption of technology for self-directed learning. Students’ attitudes and perceived behavioral control were important factors influencing their adoption of technology for self-directed learning through their effects on intention; subjective norms were not important in this respect. (shrink)

本书详细追溯了方以智晚年的活动和他最后自沉于惶恐滩,通过他在明亡后的生活与思想,试图揭开当时遗民士大夫的精神世界的一角。.

This study employs fMRI to examine the neural substrates of response to cognitive training in healthy old adults. Twenty Japanese healthy elders participated in a 4-week program and practiced a verbal articulation task on a daily basis. Functional connectivity analysis revealed that in comparison to age- and education-matched controls, elders who received the cognitive training demonstrated increased connectivity in the frontotemporal regions related with language and memory functions and showed significant correlations between the behavioral change in a linguistic task and (...) connectivity in regions for goal-oriented persistence and lexical processing. The increased hippocampal connectivity was consistent with previous research showing efficacious memory improvement and change in hippocampal functioning. Moreover, the increased intra-network connectivity following cognitive training suggested an improved neural differentiation, in contrast to the inter-network activation pattern typical in the aging brain. This research not only validates the relationship of functional change in the frontal and temporal lobes to age-associated cognitive decline but also shows promise in turning neural change toward the right direction by cognitive training. (shrink)