BackgroundBreast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.MethodsA cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at (...) least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received and did not receive CHM treatment were enrolled. The incidence rate and hazard ratio citation for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.ResultsDuring the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation], and the adjusted HR remained significant at 0.74 in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.ConclusionFinding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials. (shrink)

To understand the impact of social, financial, cultural capitals, negative culture, and socioeconomic status of families on educational aspiration in the senior high school student athletes, it will be beneficial to promote their career developments. The purpose of this study is to explore the influence of ethnicity, year of sport experience family income, the educational expectations of significant others, and the three aforementioned types of capital on educational aspiration among the senior high school student athletes. This study was conducted with (...) a sample of 262 U-18 male baseball student athletes. Of the participants, 20.20% had attained the qualifications to play on the national team. The results showed that monthly family income positively affected social capital and positively indirectly affected educational aspirations through social capital, whereas monthly family income negatively affected negative culture and positively affected educational aspirations through negative culture. Moreover, social capital positively affected educational aspirations compared with negative culture negatively affected educational aspirations. The results serve as a reference for the formulation of educational policy as it relates to student athletes. (shrink)

Event-related potential components are sensitive to the processes underlying how questions are understood. We use so-called “covert” wh-questions in Mandarin to probe how such components generalize across different kinds of constructions. This study shows that covert Mandarin wh-questions do not elicit anterior negativities associated with memory maintenance, even when such a dependency is unambiguously cued. N = 37 native speakers of Mandarin Chinese read Chinese questions and declarative sentences word-by-word during EEG recording. In contrast to prior studies, no sustained anterior (...) negativity was observed between the cue word, such as the question-embedding verb “wonder,” and the in-situ wh-filler. SANs have been linked with working memory maintenance, suggesting that grammatical features may not impose the same maintenance demands as the content words used in prior work. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

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)

With Internet users constantly participating in online interactions, a wide range of novel usages have emerged, some of which involve multi-word expressions. The use of multi-word expressions in online discourses has not been fully explored. Therefore, this study sets out to investigate the Chinese word string bù shuō le ‘not talk anymore’, which occurs much more frequently in online discussion boards than in other written or spoken modes. In the corpus-based analysis, multiple contexts in which bù shuō le indicates a (...) reluctance to further elaborate are identified. The most common context is that the writer recounts a face-threatening experience and uses bù shuō le to bring the post to the conclusion, express a casual attitude toward that experience, and exert a humorous effect. This study contributes additional evidence that demonstrates how multi-word expressions fulfill textual, expressive, and interpersonal functions in online discourses. (shrink)

Body ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a (...) rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness. (shrink)

Facing the possibility of a surge of COVID-19-infected patients requiring ventilatory support in Intensive Care Units, the Singapore Hospice Council and the Chapter of Palliative Medicine Physicians forward its position on the guiding principles that ought to drive the allocation of ICU beds and its role in care of these patients and their families.

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 twenty-first century is arguably the century of computing. In such a world saturated by computing, Computational Thinking is now recognized as a foundational competency for being an informed citizen and being successful in STEM work. Nevertheless, how to effectively import different types of teaching methods in university courses is subjected to further evaluation. Currently, the arguments in favor of tangible robots including high interaction, great practicality, and specific operation results make themselves to be often used as a teaching medium (...) and tool for teaching activities between teachers and students. Hence, in addition to cultivating students with computational thinking ability, this paper discussed how to integrate tangible robots into project-based learning courses of thinking skills training to improve the learning performance of the computational thinking ability. This study conducted in one semester on the 105 students from three classes. Experimental results show that the project-based learning method integrated with the teaching material of robotic visual programs approach had significantly better effectiveness in improving students' learning achievements than the traditional teaching method integrated with paper practice teaching materials approach. Analysis of the questionnaire results showed that the proposed learning approach did not increase the students' cognitive burden. In sum, the proposed approach helps students' learning achievement and cognitive load. (shrink)

The pressure on companies to practice corporate social responsibility (CSR) has gained momentum in recent times as a means of sustaining competitive advantage in business. The pharmaceutical industry has been acutely affected by this trend. While pharmaceutical product recalls have become rampant and increased dramatically in recent years, no comprehensive study has been conducted to study the effects of announcements of recalls on the shareholder returns of pharmaceutical companies. As product recalls could significantly damage a company's reputation, profitability and brand (...) integrity, this paper investigates the effect on shareholder wealth and the extent to which the adoption of CSR practices by pharmaceutical companies in the United Kingdom (U.K.) and the United States (U.S.), the two largest markets for pharmaceutical products in the world, affected market reactions surrounding product recall announcements. The analysis of product recall announcements from 1998 to 2004 compiled from The Pharmaceutical Journal and U.S. Food and Drug Administration enforcement reports revealed marked differences in the way market participants in the two countries responded to news of product recalls. U.S. investors penalised firms according to the severity of product defects while U.K. investors were indifferent. While U.K. investors rewarded product recalls by firms which were not usually CSR-active, U.S. investors punished non-CSR active firms that performed recalls. These observations could pose strategic challenges to pharmaceutical firms operating in both countries. (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

Media guidelines on safe suicide-related reporting are within the suicide prevention armamentarium. However, implementation issues beleaguer real-world practice. This study evaluated the perspectives of the Malaysian media community, persons with lived experience of suicidal behavior, and mental health professionals on suicide-related reporting in terms of the impact, strategies, challenges, and the implementation of guidelines on safe reporting. Three focus group discussions of purposively sampled Malaysian media practitioners, PLE, and MHP were audio-recorded, transcribed, coded and thematically analyzed. Inclusion criteria were: English (...) fluency, no clinical depression or suicidal ideation, no recent previous suicide attempts or suicide bereavement. Three major themes emerged: Unsafe Reporting; Impact; and Safe Reporting. Most described current reporting as unsafe by being potentially triggering to media users and may contribute to contagion effect. Positive impacts identified included raised awareness toward suicide and its prevention. Unsafe reporting was attributed to inadequate awareness, knowledge, and guidance, lack of empathy and accountability, job-related factors, popularity-seeking, lack of monitoring and governance, and information source with unsafe content. Majority agreed on how suicide stories should be framed to produce a safe report. The media community diverged on how detailed a suicide story should be. Safe reporting challenges included difficulties in balancing beneficial versus harmful details, social media ubiquity and its citizen reporters. Participants suggested these safe reporting strategies: stakeholder engagement, educational approaches, improving governance and surveillance, and guidelines revision. Most acknowledged the relevance of guidelines but were unaware of the existence of local guidelines. Implementation challenges included the dilemma in balancing media industry needs vis-à-vis safe reporting requirements, stakeholder engagement difficulties and social media regulation. There is poor awareness regarding safe suicide-related reporting across all groups. PLE and MHP were negatively impacted by current unsafe messaging which aggravated trauma and grief reactions. Postvention support gaps for mental health professionals were highlighted. Safe reporting promotion strategies should include stakeholder engagement to increase awareness on minimizing Werther and maximizing Papageno effects. Strategic re-examination and dissemination of local media guidelines to address new media issues, and effective surveillance mechanisms, are crucial in sustainable improvement of safe reporting practices. (shrink)

The rapid development of digital technologies has transformed the world but can be a double-edged sword. We study the interaction of important variables that affect individual news reporters’ performance in which digital technology is the dominant feature. A multilevel model illustrates how transactive memory and job competence affect individual performance. The empirical study includes data from 19 teams of news reporters and 211 valid survey responses, applying hierarchical linear modeling to analyze the data. The results indicate that transactive memory and (...) technology competence help to improve a reporter’s job performance. More importantly, teamwork competence fully mediates the relationships. Our findings thus suggest that teamwork competence is the core skill. Neither technology competence nor transactive memory alone translates directly into enhanced individual performance. (shrink)

Creativity is so important for social and technological development that people are eager to find an easy way to enhance it. Previous studies have shown that mindfulness has significant effects on positive affect, working memory capacity, cognitive flexibility and many other aspects, which are the key to promoting creativity. However, there are few studies on the relationship between mindfulness and creativity. The mechanism between mindfulness and creativity is still uncertain. Meditation is an important method of mindfulness training, but for most (...) people who do not have the basic training, it’s difficult to master how to get into a state of mindfulness. Animation has been shown by many studies to help improve cognition and is often used as a guiding tool. Using animation as the guiding carrier of meditation is more convenient and easier to accept. Therefore, this study adopted the intervention method of animation-guided meditation, aiming to explore: the effect of animation-guided meditation on enhancing creativity; the role of flow and emotion in the influence of mindfulness on creativity. We advertised recruitment through the internal network of a creative industrial park, and the final 95 eligible participants were divided into two groups: animation and audio guided meditation. The animation group was given an animated meditation intervention, and the audio group was given an audio meditation intervention, both interventions were performed 3 times a week and last for 8 weeks. Results: Animation-guided meditation significantly increased participants’ mindfulness and creativity levels; Significantly reduced their cognitive load compared to audio-guided meditation. Mindfulness has a significant direct effect on creativity, and significant indirect effects on creativity; Flow and PA act as the mediating variable. Conclusion: Mindfulness, flow, and PA all helped to improve the subjects’ work creativity. In addition to the direct positive impact of mindfulness on creativity, mindfulness can also have an indirect positive impact on creativity through flow and PA. Compared with audio, animation can significantly reduce cognitive load and help improve users’ cognitive ability, which is more suitable for the guidance materials of mindfulness meditation to enhance the effect of meditation. (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)

We investigate two issues about the subjective experience of one's body: first, is the experience of owning a full-body fundamentally different from the experience of owning a body-part?Second, when I experience a bodily sensation, does it guarantee that I cannot be wrong about whether it is me who feels it? To address these issues, we conducted a series of experiments that combined the rubber hand illusion (RHI) and the “body swap illusion.” The subject wore a head mounted display (HMD) connected (...) with a stereo camera set on the experimenter's head. Sitting face to face, they used their right hand holding a paintbrush to brush each other's left hand. Through the HMD, the subject adopted the experimenter's first-person perspective (1PP) as if it was his/her own 1PP: the subject watched either the experimenter's hand from the adopted 1PP, and/or the subject's own hand from the adopted third-person perspective (3PP) in the opposite direction (180°), or the subject's full body from the adopted 3PP (180°, with or without face). The synchronous full-body conditions generate a “self-touching illusion”: many participants felt that “I was brushing my own hand!” We found that (1) the sense of body-part ownership and the sense of full-body ownership are not fundamentally different from each other; and (2) our data present a strong case against the mainstream philosophical view called the immunity principle (IEM). We argue that it is possible for misrepresentation to occur in the subject's sense of “experiential ownership” (the sense that I am the one who is having this bodily experience). We discuss these findings and conclude that not only the sense of body ownership but also the sense of experiential ownership call for further interdisciplinary studies. (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)

Loving-kindness meditation was first practiced by Buddhists and then developed by clinical psychologist. Previous studies on LKM have mainly focused on the impact of real person-guided meditation on depression, anxiety, and other negative psychology. During the COVID-19 pandemic, this study explored the effect and mechanism of media-guided LKM on the improvement of social presence, mindfulness, spirituality, and subjective wellbeing. From the viewpoint of positive psychology, this study compared the different media effects of animated pedagogical agent -guided LKM and audio-guided LKM. (...) A total of 82 flight attendants were recruited from airlines; then, they were randomly assigned to two groups: APA group and audio group, which both underwent an 8-week LKM training intervention. The aforementioned four main variables were measured pre and post the meditation experiment. The results indicated that both APA-guided meditation and audio-guided meditation significantly improved subjects’ spirituality and SWB. Compared with audio-guided meditation, APA-guided meditation significantly improved the subjects’ spirituality, SWB, and social presence. Audio-guided meditation has no significant effect on social presence. This study highlights APA-guided meditation has a positive effect on spirituality, SWB, and social presence, which may provide individuals with a simple and easy method to improve their mental health. (shrink)

Background:Suicide remains an important cause of premature deaths and draws much media attention. However, unsafe reporting and portrayal of suicides by the media have been associated with increased risk of suicidal behavior. Current evidence suggests that media capacity-building could potentially prevent suicide. However, there are still knowledge gaps in terms of a lack of data on effective strategies for improving awareness and safe reporting of suicide-related media content. This study aims to investigate the effectiveness of a workshop conducted with members (...) of the media community on the safe reporting of suicide-related content.Methods:An interventional single-arm pre and post pilot study was conducted on a sample of the Malaysian media community recruited through purposive and snowball sampling. The media safe reporting workshop was conducted by a suicide prevention expert with a media industry background. Thirty participants completed a self-reported evaluation questionnaire on their awareness and knowledge of reporting on suicide-related media content; before and after the interventional workshop.Results:There was a significant difference between the total scores before and after the intervention, with a large effect size. Post-intervention scores were significantly improved in 8 items, namely those related to the reporting of: (i) the content of any suicide note; (ii) headlines with methods of suicide; (iii) headlines with the location of suicide; (iv) cases of suspected suicide despite the unconfirmed cause of death; (v) suicide news to cater to readers’ interests; (vi) cause of suicide; (vii) details of the location of suicide; and (viii) the negative impact to media community when reporting suicide stories. In particular, there was an improvement in the majority of items for people from the media community with no lived experience of suicidal behavior.Conclusion:The media safe reporting workshop is a potentially effective intervention for improving awareness and knowledge measures relating to safe reporting on suicide among the media community, with a more pronounced effect in those without lived experience of suicidal behavior. Limitations in the sample size, generalizability, short-term evaluation, and lack of a control group warrant future larger, longer-term controlled, and more representative studies. (shrink)

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)

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)

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)

This paper traces the conception of “guarding the One” (shou yi 守一), an equivalent to “one-practice samādhi” from the East Mountain Teaching (dong shan fa men 東山法門) in early Chan Buddhism, back to the Zhuangzi《莊子》. “Guarding the One” and “nurturing the shen” (yang shen 養神) appear frequently in the context of Daoist spiritual training for longevity. In early medieval Chinese Buddhism, with the influence of the discourse of Daoist spiritual training and the karma theory from India, the concept of (...) shen 神 generally developed into a pure substance of the mind. This substance of the mind also echoes the theory of Buddha-nature, and played a significant role in “Fourth Patriarch” Daoxin’s interpretation of “guarding the One”. (shrink)

It was a common practice of the Chinese official historiographers to employ pseudo-historical, semi-fictional source materials alongside the factual, ascertainable data in their narratives for prescribed political or didactic purposes despite their commitment to the time-honored principles of truth and objectivity in the Confucian-oriented traditional historiography. The intrusion of these non-historical elements in the imperial historical records illustrates, therefore, the adaptability of the source materials representing the popular tradition of the masses for the uses of the great tradition, and the (...) propensity of the reciprocal exchanges between the expressions of the Confucian literati and the less cultured populace in historical compositions. Drawing on a textual analysis of the T'ai-tsu shih-lu, the reign chronicle of the Ming founder Chu Yüan-chang, who rose from a humble peasant to the imperial throne in 1368, this essay examines the historical circumstances and historiographical devices by which the factual records were commingled with the non-historical materials in the accounts of the dynasty founding. It shows how the historiographers synthesized the pseudo-historical expressions in the popular tradition with the deliberately fabricated falsehoods of their own doing to conjure up an inflated portrait of the Ming founder, transforming him from an illiterate, beggar mendicant monk and rebel leader into the topoi of a righteous hero, dynasty founder and exemplar ruler in traditional official historiography. It also shows that apart from the historiographers' penchant for conformity to the established conventions, the exaggerated portrait of the Ming founder in the T'ai-tsu shih-lu was a product of a historiographical revision undertaken on order of the third emperor Yung-lo, fourth son of T'ai-tsu, aiming at legitimizing his usurpation of the throne from his nephew the imperial successor Chien-wen in a palace rebellion of 1402. Lastly, it shows how the early Ming revision of the records of the rise of T'ai-tsu inspired a cycle of bizarre legends about the early years of the dynasty founding in later official and private writings, and how a case study of such historiographical process may add to our understanding of the continuous interactions between the expressions of the élite and mass heritages in the making of the Chinese intellectual and cultural traditions. (shrink)