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...

Mitigating response distortion in answers to sensitive questions is an important issue for business ethics researchers. Sensitive questions may be asked in surveys related to business ethics, and respondents may intend to avoid exposing sensitive aspects of their character by answering such questions dishonestly, resulting in response distortion. Previous studies have provided evidence that a surveying procedure called the randomized response technique is useful for mitigating such distortion. However, previous studies have mainly applied the RRT to individual dichotomous questions in (...) face-to-face survey settings. In this study, we focus on behavioral research examining the relationships between latent variables, which are unobserved variables measured by multiple items on Likert or bipolar scales. To demonstrate how the RRT can be applied to obtain valid answers from respondents answering a self-administered online questionnaire with Likert and bipolar scales, we build a behavioral model to study the effect of punishment severity on employees’ attitudes toward misuse of information systems resources in the workplace, which in turn influence misuse behavior. The survey findings meet our expectations. The respondents are generally more willing to disclose sensitive data about their attitudes and actual behavior related to misuse when the RRT is implemented. The RRT’s implications for causal modeling and the advantages and challenges of its use in online environments are also discussed. (shrink)

This paper aims to propose an improved learning algorithm for feature selection, termed as binary superior tracking artificial bee colony with dynamic Cauchy mutation. To enhance exploitation capacity, a binary learning strategy is proposed to enable each bee to learn from the superior individuals in each dimension. A dynamic Cauchy mutation is introduced to diversify the population distribution. Ten datasets from UCI repository are adopted as test problems, and the average results of cross-validation of BSTABC-DCM are compared with other seven (...) popular swarm intelligence metaheuristics. Experimental results demonstrate that BSTABC-DCM could obtain the optimal classification accuracy and select the best representative features for the UCI problems. (shrink)

In response to the growing needs of proficient English speakers, the Taiwan Ministry of Education officially included English in standard elementary school curriculum since 2001. English courses at elementary level were extended from the fifth grade to the third grade since the fall of 2005. It is significant to examine whether the educational reform has positively affected students? learning attitudes. Through focus group interviews and questionnaire survey at six elementary schools, this study explores students? attitudes towards learning English and ways (...) of instruction. Results indicate that students generally have strong interests in English?speaking people and desire to spend time in English?speaking places. A majority of students enjoy learning English through games, and compliments from teachers or parents boost their learning motivation. The finding also reveals that English education in Taiwan seems to have directed students towards a narrow viewpoint of foreign cultures since many students associate foreigners with English?speaking people only. Finally, many students experience learning English at cram schools, which indicates the important role cram schools play in students? extracurricular learning. (shrink)

Drawing on ancient and modern sources, "a lucid discussion of Taoism and the Chinese language [that's] profound, reflective, and enlightening." —Boston Globe According to Deepak Chopra, "Watts was a spiritual polymatch, the first and possibly greatest." Watts treats the Chinese philosophy of Tao in much the same way as he did Zen Buddhism in his classic The Way of Zen. Critics agree that this last work stands as a perfect monument to the life and literature of Alan Watts. "Perhaps the (...) foremost interpreter of Eastern disciplines for the contemporary West,... Watts begins with scholarship and intellect and proceeds with art and eloquence to the frontiers of the spirit."—Los Angeles Times. (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.

This paper demonstrated the influences of initiation, development, turn-down, and reinitiation of the dynamic capability of an entrepreneurial firm in the solar energy industry. The focus is on the impact of entrepreneurial hubris, which may affect the decision of ambidexterity that can vitalize dynamic capability. The findings indicate that, when the major decision maker has the trait of hubris, the decision-making process may be overly arbitrary, and a decision of being exploratory or exploitative alone is likely to be made. On (...) the contrary, when the founder entrepreneur is aware of the hubris and shares decisive power, the decision of being ambidextrous as a dynamic capability is more freely achieved. This paper contributes by discovery of the cognitive-based microfoundation of entrepreneurial ventures and linkage of such microfoundation to organizational ambidexterity. (shrink)

This study seeks to clarify the nature of linguistic synesthesia using a lexical-conceptual account. Based on a lexical analysis of Mandarin synesthetic usages, we find that linguistic synesthesia maps the metaphorical meaning between two domains; and linguistic synesthetic mappings and conceptual metaphoric mappings have similar behaviors when sense modalities are treated as conceptual domains that contain a set of mappings constrained by Mapping Principles. This lexical-conceptual account is designed to capture the fact that linguistic synesthesia involves mapping between lexicalized concepts (...) of sensory properties, instead of the real-time sensory input that is processed in neurological synesthesia. The incorporation of a lexical semantic view with the framework of Conceptual Metaphor Theory not only offers a coherent and comprehensive account for the nature of linguistic synesthesia, but also handles aspects of linguistic synesthesia previously only accounted for by non-metaphorical accounts. These design features make this proposal the most comprehensive account to fit the current data. Furthermore, by showing linguistic synesthesia as a type of metaphor, our study strengthens the role of conceptual metaphors as the link between the perceived world and our conceptualization of that world. (shrink)

The transition of gene switch induced by external noises and external signals is investigated in the genetic regulatory system. Results show that the state-to-state transition of gene switch as well as resonant behaviors, such as the explicit coherence resonance, implicit coherence resonance and control parameter coherence biresonance, can appear when noises are injected into the genetic regulatory system. The ECR is increased with the increase of the control parameter value when starting from the supercritical Hopf bifurcation parameter point, and there (...) exists a critical control parameter value for the occurrence of ECR. However, the ICR is decreased as the control parameter value is increased when starting from the subcritical Hopf bifurcation point. In particular, the coherence of ECR is higher and more sensitive to noise than that of ICR. When an external signal is introduced into the system, the enhancement or suppression of the CPCBR and the number of peaks strongly depend on the frequency and amplitude of the external signal. Furthermore, the gene regulation system can selectively enhance or decrease the noise-induced oscillation signals at preferred frequency and amplitude of an external signal. (shrink)

In 2016, Taiwan’s President Tsai Ing-wen officially apologised to the island’s indigenous peoples. This national apology not only plays a persuasive role in informing the general public about the historical wrongdoings inflicted on the Taiwanese aborigines, but also constitutes a therapeutic and restorative role in the process of reconciliation with the indigenous victims. This article provides a critical discourse analysis of President Tsai’s apology. In particular, it examines the power and ideology embedded in both the speech and the related ceremony, (...) and is supplemented with extracts from interviews with a cross-section of key stakeholders, such as a former Constitutional/supreme Court Justice, indigenous/tribal leaders and members/staff/advisers from the Presidential Office Indigenous Historical Justice and Transitional Justice Committee. The analysis reveals that, despite President Tsai’s apology and reconciliation policies, instead of facilitating reconciliation, the apology appears to exacerbate the long-standing latent tension between indigenous and non-indigenous groups. While the apology opens a window for reconciliation, a higher level of commitment is required to promote structural and systemic changes, such as land restitution, before the apology can be deemed adequate. (shrink)

This research on the ethics of meaningful work examined how types of job-related harm and their magnitude of consequences influenced components of ethical decision-making. The research also investigated the moderating effects of individual differences on the relation between the MOC and the ethical decision-making elements for each type of harm. Using a sample of 185 Chinese professionals, a between-subjects, fully crossed experimental scenario design revealed that physical and economic job-related harm were recognized as moral issues to a greater extent than (...) cognitive or emotional harm. Second, physical job-related harm stimulated a higher level of moral evaluations than economic and cognitive harm. Third, individuals intended to act ethically when MOC was high versus low. Finally, experience with layoffs and IMO helped explain the relations between MOC and moral evaluations for economic and cognitive job-related harm, respectively. Implications for research and management are discussed. (shrink)

Many studies of bribery acknowledge the important role of bribe-givers, but their true motives remain unclear. We propose that the likelihood of bribery depends on the willingness of an organization to affiliate with local parties or to be successful in a host country, or to have power over local parties. We further argue that different opportunities, either pervasive or arbitrary, facilitate different types of motives that affect the likelihood of bribery. In addition, we investigate the effect of perceived fairness on (...) the likelihood of bribery. We employ a 3 (motives: affiliation vs. achievement vs. power) × 2 (opportunities: pervasiveness vs. arbitrariness) × 2 (perceived fairness: high vs. low) factorial design in experimental settings among Executive MBA students in southern Taiwan. Our findings indicate that, when companies perceive a higher level of distributive fairness, high-achieving organizations are more likely to offer a bribe when the condition is pervasive. When they have a powerful motive, arbitrariness engenders a higher likelihood of bribery. When they perceive less distributive fairness, there are no significant differences between motive and opportunity. (shrink)

Mitigating response distortion in answers to sensitive questions is an important issue for business ethics researchers. Sensitive questions may be asked in surveys related to business ethics, and respondents may intend to avoid exposing sensitive aspects of their character by answering such questions dishonestly, resulting in response distortion. Previous studies have provided evidence that a surveying procedure called the randomized response technique is useful for mitigating such distortion. However, previous studies have mainly applied the RRT to individual dichotomous questions in (...) face-to-face survey settings. In this study, we focus on behavioral research examining the relationships between latent variables, which are unobserved variables measured by multiple items on Likert or bipolar scales. To demonstrate how the RRT can be applied to obtain valid answers from respondents answering a self-administered online questionnaire with Likert and bipolar scales, we build a behavioral model to study the effect of punishment severity on employees’ attitudes toward misuse of information systems resources in the workplace, which in turn influence misuse behavior. The survey findings meet our expectations. The respondents are generally more willing to disclose sensitive data about their attitudes and actual behavior related to misuse when the RRT is implemented. The RRT’s implications for causal modeling and the advantages and challenges of its use in online environments are also discussed. (shrink)

Adverse childhood experiences are known to have deleterious effects on individuals across the life span, but less is known about how they affect grit, a strong predictor of achievements and well-being. This study seeks to investigate the effect of ACEs on grit in a sample of Chinese college students during the COVID-19 pandemic. Data were collected from 1,871 students across 12 universities in China. Findings indicated a significant effect of ACEs on grit, particularly abuse and neglect dimensions of ACE. Since (...) grit is particularly important for professional success, those who have experienced abuse and neglect victimization may struggle throughout their education, and subsequently, in their careers. This calls for interventions to buffer the effects of ACEs on grit. (shrink)

Objects: To evaluate the feasibility and effectiveness of in-bed wearable elbow robot training for motor recovery in patients with early and late subacute stroke.Methods: Eleven in-patient stroke survivors received 15 sessions of training over about 4 weeks of hospital stay. During each hourly training, participants received passive stretching and active movement training with motivating games using a wearable elbow rehabilitation robot. Isometric maximum muscle strength of elbow flexors and extensors was evaluated using the robot at the beginning and end of (...) each training session. Clinical measures including Fugl-Meyer Assessment of upper extremity, Motricity Index for upper extremities, Modified Ashworth Scale were measured at baseline, after the 4-week training program, and at a 1-month follow-up. The muscle strength recovery curve over the training period was characterized as a logarithmic learning curve with three parameters.Results: At the baseline, participants had moderate to severe upper limb motor impairment {FMA-UE [median ]: 28 } and mild spasticity in elbow flexors {MAS [median ]: 0 }. After about 4 weeks of training, significant improvements were observed in FMA-UE and MI, and the improvements were sustained at the follow-up. The elbow flexors MVC significantly increased by 1.93 Nm and the elbow extensor MVC increased by 0.68 Nm. Muscle strength recovery curve showed that patients with severe upper limb motor impairment had a greater improvement rate in elbow flexor strength than those with moderate motor impairment.Conclusion: In-bed wearable elbow robotic rehabilitation is feasible and effective in improving biomechanical and clinical outcomes for early and late subacute stroke in-patients. Results from the pilot study suggested that patients with severe upper limb motor impairment may benefit more from the robot training compared to those with moderate impairment. (shrink)

The relationship between intuition and ethical decision-making has been researched extensively during the past two decades. This study aimed at exploring empirically observable associations between intuition and the moral intensity of ethical decision-making processes. A scenario-based quantitative approach was used to collect data from 157 practising professional spirit mediums. It was found that only collective universal intuition had a significant positive association with the moral intensity of ethical decision-making processes. Personal experience intuition and collective archetype intuition were not significantly associated (...) with moral intensity. This may explain why previous studies were unable to gauge the effects of intuition on ethical decision-making. The results suggest that a pure mind can improve one’s ability to make decisions. Thus, decision-makers would benefit by being more attuned to their sense of morality. (shrink)

We proposed a model to examine the relationship among different types of weight-related stigmas and their relationship to quality of life. We recruited 430 dyads of elementary school children [mean age = 10.07 years; nboy = 241 ; noverweight = 138 ] and their parents. Parents completed QoL instruments about their children assessing generic QoL and weight-related QoL. Children completed QoL instruments assessing generic QoL and weight-related QoL and stigma scales assessing experienced weight stigma, weight-related self-stigma, and perceived weight stigma. (...) Experienced weight stigma was significantly associated with perceived weight stigma, and in turn, perceived weight stigma was significantly associated with weight-related self-stigma. However, experienced weight stigma was not directly associated with weight-related self-stigma. In addition, experienced stigma was negatively associated with both child-rated and parent-rated QoL. Perceived weight stigma was associated only with parent-rated weight-related QoL but not child-rated QoL. Self-stigma was associated with child-rated QoL but not parent-rated QoL. Moreover, perceived weight stigma and weight-related self-stigma were significant mediators in the association between body weight and children's QoL; experienced weight stigma was not a significant mediator. The study findings can be used to inform healthcare providers about the relationship among different types of stigmas and their influence on child-rated and parent-rated QoL and help them develop interventions to address the global trend of overweight/obesity in youth and pediatric populations. (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 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)

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.

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)

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)

Differential tractography and correlation tractography are new tractography modalities to study neuronal changes in brain diseases, but their performances in detecting neuronal injuries are yet to be investigated in patients with mild traumatic brain injury. Here we investigated the white matter injury in mTBI patients using differential and correlation tractography. The diffusion MRI was acquired at 33 mTBI patients and 31 health controls. 7 of the mTBI patients had one-year follow-up scans, and differential tractography was used to evaluate injured fiber (...) bundles on these 7 patients. All subjects were evaluated using digital symbol substitution test and trail making test A, and the correlation tractography was performed to explore the exact pathways related to the cognitive performance. Our results showed that differential tractography revealed neuronal changes in the corpus callosum in all 7 follow-up mTBI patients with FDR between 0.007 and 0.17. Further, the correlation tractography showed that the splenium of the corpus callosum, combined with the right superior longitudinal fasciculus and right cingulum, were correlated with DSST in the acute mTBI patients. The cognitive impairment findings in the acute stage and the longitudinal findings in the corpus callosum in the chronic stage of mTBI patients suggest that differential tractography and correlation tractography are valuable tools in the diagnostic and prognostic evaluation of neuronal injuries in mTBI patients. (shrink)