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)

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)

This study is based on the situation of Taiwan listed companies as derivative financial products from 2015 to 2017, analyzing the relationship between the hedging of derivative financial products and characteristics of enterprises and the factors that affect the hedging decision-making of companies. It is found that even after the announcement of Taiwan’s No. 34 and No. 36 bulletins, there are still some problems that are needed to improve in the disclosure of derivative financial product investment information by Taiwan’s listed (...) companies, at least in the disclosure of the reasons for this conduct which is still insufficient. In this study, two-stage regression analysis method is applied to empirical analysis, and it is found that hedging activities are related to corporate characteristics, such as expected financial crisis costs, corporate size, equity issues, growth investment opportunities, and information asymmetry. In the investment of derivative financial products, enterprises should evaluate their own financial characteristics as a reference for the risk avoidance decision. At the same time, it is necessary to investigate different natures of hedging tools used in appropriate risk categories, so as to fully achieve the hedging effect and maximize the hedging benefits. This study also found that companies with higher growth investment opportunities, larger size, and higher financial crisis costs will tend to use derivative financial products for hedging. As for the impact of other industries, it is found that the electronic and electrical machinery industries are more active than other industries in hedging behaviors of undertaking derivative financial products’ transaction. (shrink)

COVID-19 began to spread worldwide in early 2020. Various governments have taken measures such as isolation, travel bans, and evacuation, mandating people to wear masks and go out less, in an attempt to prevent the spread of the virus. Governments also restrict human contact service industries, including beauty and hair salons. When the pandemic was very serious, consumers had great doubts about going for hairdressing so the beauty industry was greatly affected. This study designed and developed an app platform that (...) considers the COVID-19 and is used for the psychological role of consumer safety. The methodology of this research is a qualitative study. Based on the Capability, Opportunity, Motivation, Behavior model, and presenting the context of capabilities, opportunities, and motives of the theoretical framework, this study investigates the factors that identify the demand for the development of the platform for the beauty industry app matching mechanism. Four groups of people including consumers, beauty technicians, store managers, and application development engineers all conduct interviews based on their ability, opportunity, and motivation after experiencing the using application of OpenBeautiful. The results found that all groups of people already had the knowledge and ability to avoid infection in a pandemic, so it was possible to establish the need and feasibility of using the app platform. The use of the beauty industry app platform can bring new consumption patterns and career opportunities, and can trigger more business behavior activities. Therefore, this study starts from the COM-B model, and then explores the user needs of the platform according to the COM-B model framework, and proposes the mechanism and platform of app matching. Finally, based on the conclusion of the study, we propose practices and suggestions for the future operation of the app matching platform. (shrink)

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

The global impact of COVID-19 has seriously affected health and livelihood in every country or region, especially in terms of physical consumption behaviors. Hairdressing is an essential physical consumption behavior. To prevent infection, the consumption model for using the beauty industry matchmaking platform has been used during the pandemic. This study investigates the changes in the behavior of media app users in the beauty industry in the post-epidemic era of COVID-19. The COM-B model is the basis for a research framework (...) to study the factors that affect changes in behavior in the areas of Capability, Motivation, and Opportunity of the theoretical framework. A new dimension of fashion sense has expanded the application and validation of the COM-B model to determine the causal relationship between the ability to pursue beauty, motivation, fashion sense, and opportunities by using the platform and the dimension of user behavior. The study finds that fashion sense in the BIMP has a positive and significant impact on beauty care ability, self-motivation to pursue beauty and future cooperation opportunities. The ability, motivation and opportunity to act are all positively significant, which is in agreement with the theoretical framework of the COM-B model. There is no mediating effect for motivation between fashion sense and behavior. The results of this study show that increasing the sense of fashion for members using the BIMP will increases active behavior for members using the platform. This study also proposes practical suggestions for the operation of the BIMP based on the results. (shrink)

Most neuroimaging research in stroke rehabilitation mainly focuses on the neural mechanisms underlying the natural history of post-stroke recovery. However, connectivity mapping from resting-state fMRI is well suited for different neurological conditions and provides a promising method to explore plastic changes for treatment-induced recovery from stroke. We examined the changes in resting-state functional connectivity (RS-FC) of the ipsilesional primary motor cortex (M1) in 10 post-acute stroke patients before and immediately after 4 weeks of robot-assisted bilateral arm therapy (RBAT). Motor performance, (...) functional use of the affected arm, and daily function improved in all participants. Reduced interhemispheric RS-FC between the ipsilesional and contralesional M1 (M1-M1) and the contralesional-lateralized connections were noted before treatment. In contrast, greater M1-M1 functional connectivity and disturbed resting-state networks were observed after RBAT relative to pre-treatment. Increased changes in M1-M1 RS-FC after RBAT were coupled with better motor and functional improvements. Mediation analysis showed the pre-to-post difference in M1-M1 RS-FC was a significant mediator for the relationship between motor and functional recovery. These results show neuroplastic changes and functional recoveries induced by RBAT in post-acute stroke survivors and suggest that interhemispheric functional connectivity in the motor cortex may be a neurobiological marker for recovery after stroke rehabilitation. (shrink)

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice and protocol compliance in clinical research. However, they are laborious, time consuming, and require expertise. Therefore, we developed a simple auditing process and (...) evaluated its feasibility and effectiveness. The screening audit was developed using a routine audit checklist based on the Severance Hospital’s Human Research Protection Program policies and procedures. The measure includes 20 questions, and results are summarized in five categories of audit findings. We analyzed 462 studies that were reviewed by the Severance Hospital Human Research Protection Center between 2013 and 2017. We retrospectively analyzed research characteristics, reply rate, audit findings, associated factors and post-screening audit compliance, etc. Investigator reply rates gradually increased, except for the first year. The studies were graded as “critical,” “major,” “minor,” and “not a finding”, based on findings and number of deficiencies. The auditors’ decisions showed fair agreement with weighted kappa values of 0.316, 0.339, and 0.373. Low-risk level studies, single center studies, and non-phase clinical research showed more prevalent frequencies of being “major” or “critical”. Inappropriateness of documents, failure to obtain informed consent, inappropriateness of informed consent process, and failure to protect participants’ personal information were associated with higher audit grade. We were able to observe critical GCP violations in the routine internal audit results of post-screening audit compliance checks in “non-responding” and “critical” studies upon applying the screening audit. Our screening audit is a simple and effective way to assess overall GCP compliance by institutions and to ensure medical ethics. The tool also provides useful selection criteria for conducting routine audits. (shrink)

In this article, the researchers explore the following question. Can corporate social responsibility (CSR) and the corporate reputation of a firm lead to its brand equity in business-to-business (B2B) markets? This study discusses CSR from customers' viewpoints by taking the sample of industrial purchasers from Taiwan small-medium enterprises. The aims of this study are to investigate: first, the effects of CSR and corporate reputation on industrial brand equity; second, the effects of CSR, corporate reputation, and brand equity on brand performance; (...) and third, the mediating effects of corporate reputation and industrial brand equity on the relationship between CSR and brand performance. Empirical results support the study's hypotheses and indicate that CSR and corporate reputation have positive effects on industrial brand equity and brand performance. In addition, corporate reputation and industrial brand equity partially mediate the relationship between CSR and brand performance. (shrink)

In this study, we examined the role of culture on early adolescents’ social reasoning about peer exclusion. A total of 80 U.S. and 149 Taiwanese early adolescents independently completed a social reasoning essay about peer exclusion. Analyses of the essays based on social-moral theories showed that U.S. students tended to reason about peer exclusion based on social conventional thinking whereas Taiwanese students were more attentive to personal and moral issues. Despite this difference, both groups of students referred to some common (...) social-moral concepts while reasoning about peer exclusion, including consideration of personal benefit, harming others’ welfare, personal concern, and punishment. The use of social reasoning strategies was similar across the two groups of students except that Taiwanese students relied more on judgment whereas U.S. students generated more alternative hypotheses. (shrink)

Although current literature demonstrates how parents benefit from parent empowerment programs, the development of a quantitative measure of parent empowerment has garnered limited attention in parenting research. The goal of this research was therefore to develop and validate a quantitative measure for the assessment of practitioners’ attitudes and competence in parent empowerment. In the process of item generation, the qualitative findings derived from four studies in relation to the perceived outcomes and experiences in parent empowerment were synthesized in the first (...) stage. In the second stage, a list of narratives that articulated different themes of parent empowerment was generated, which resulted in an item pool containing 28 items. In the third stage, the research team converted the 28 items into a survey instrument. In the fourth stage, a first-scale validation study was conducted to explore the factor structure of the initial 28-item questionnaire. The exploratory factor analysis on the first sample of 366 practitioners yielded a twofold factor structure with 17 items, including practitioners’ attitudes in parent empowerment and practitioners’ competence in parent empowerment. In the final stage, a second-scale validation study was undertaken to verify the fit of the twofold factor structure. A confirmatory factor analysis on the second sample of 170 practitioners demonstrated a good model fit. The results of reliability tests for the whole scale and two subscales also indicate satisfactory internal consistency. The Parent EmpowermentviaTransformative Learning Questionnaire (PETLQ) was thus developed and confirmed as a scale with sufficient factorial validity and internal consistency to be used for assessing parenting practitioners’ attitudes and competence in parent empowerment and for evaluating the effectiveness of parent empowerment programs. (shrink)

As the figures for wife abuse cases in Hong Kong continue to rise, the author questions the effectiveness of current law in controlling domestic violence. It is argued that the present law, which punishes abusers by putting them into jail, can neither change their violent behavior nor repair the personal/familial relationships of the parties involved. It is within this context that the author proposes the adoption in Hong Kong of ``court-mandated counseling'', a scheme that has been practiced not only in (...) the United States, but also in Mainland China, and Taiwan. It is, however, noted that such a counseling programme must be sensitive to the gendered legal politics and the local cultural discourse, as, otherwise, the scheme will operate to (re-)strengthen both the male dominating structure and the postcolonial hegemony. (shrink)

Background and aimDuring the COVID-19 pandemic, an Internet-Mindfulness-Based Stress Reduction program was delivered and may be better than an in-person approach. Our study evaluated the effects of iMBSR intervention on mental health, self-efficacy, and body image in women with breast cancer in Taiwan.Materials and methodsSixty-seven women with breast cancer were allocated to a 6-week iMBSR program or a waitlist control group, without heterogeneity between group characteristics. Patients from both groups were measured at baseline and postintervention using three scales: Depression, Anxiety, (...) and Stress Scale, General self-efficacy scale, and Body Image Scale. Descriptive dataset analysis, paired t-test, and Student’s t-test were used to evaluate the data.ResultsAlthough iMBSR did not significantly improve depression and stress between groups, iMBSR could improve anxiety with medium effect sizes. Significant benefits were found for body image and self-efficacy, with large effect sizes.ConclusionOur preliminary study supports iMBSR as a program that can improve mental health, body image, and self-efficacy in women with breast cancer. During the COVID-19 pandemic, medical professionals can use Internet-based clinical health education. (shrink)

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)

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)