ObjectiveThis pilot study aimed to evaluate the efficacy of a digital cognitive behavioral therapy in patients with cancer experiencing sleep problems.MethodsA total of 57 participants aged 25–65 years were randomly assigned to three groups—21 participants to a dCBT program, 20 participants to an app-based attentional control program, and 16 participants to a waitlist control group—and evaluated offline before and after the program completion. Of the 57 participants, there were a total of 45 study completers, 15 participants in each group. The (...) dependent variables were sleep quality scores, measured by the Pittsburgh Sleep Quality Index and health-related quality of life scores, measured using the Short-Form 36, and attentional bias scores from a dot-probe computer task.ResultsFor both the intention-to-treat and study-completers analyses, a significant increase supported by a large effect size was found in the quality of sleep score of the HARUToday Sleep group compared to both the app-based attentional control and the waitlist control group. However, no significant changes were found in the quality of life and attentional bias scores.ConclusionOur results suggest that the HARUToday Sleep app has the potential to serve as an intervention module to enhance the sleep quality of patients with cancer experiencing sleep problems. (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)

Given corporate lobbying’s double-edged nature, previous research has been interested in what motivates firms to engage in lobbying. In this study, we build on previous works to analyze how two types of aspiration, historical aspiration, which represents the level of performance firms aim to achieve given past self-performance, and social aspiration, which represents the level of performance firms aim to achieve given competitors’ achievements, shape corporate lobbying decisions. Our premise is that when a firm’s product market performance is below historical (...) aspirations, then the firm is motivated to engage in lobbying because the benefits of lobbying outweigh the potential costs. However, when a firm’s product market performance is below social aspirations, then decision-makers perceive that the potential challenges of lobbying outweigh the benefits and decide not to engage in lobbying. By examining automotive firms in the U.S. light vehicle market from 1998 to 2013, we find significant empirical support for our general premise. Using Tobit regression analysis, we find that automotive firms present diverging motivations for lobbying depending on whether they attend to historical or social aspirations for sales performance. (shrink)

We investigate what determines a multinational enterprise’s propensity to engage in lobbying and bribing in host countries where the overall institutional development for market exchanges is insufficient, and thus, their governance systems are relatively weak. We extend the current literature on institutional strategies by theorizing and showing the persistent and significant impacts of home country institutions on an MNE’s choice of influencing activities to address institutional constraints overseas. More specifically, our results demonstrate that the MNEs from a home country with (...) a stronger governance system are less involved in bribery, but have a higher tendency to lobby in transition economy countries, which have been characterized by relatively weaker institutional development, particularly in the area of governance. This tendency still holds even when these MNEs rely more on the local market for sales. We draw theoretical and practical implications from these observations. (shrink)

BackgroundThe Life Extension Medical Decision law enacted on February 4, 2018 in South Korea was the first to consider the suspension of futile life-sustaining treatment, and its enactment caused a big controversy in Korean society. However, no study has evaluated whether the actual implementation of life-sustaining treatment has decreased after the enforcement of this law. This study aimed to compare the provision of patient consent before and after the enforcement of this law among cancer patients who visited a tertiary university (...) hospital's emergency room to understand the effects of this law on the clinical care of cancer patients.MethodsThis retrospective single cohort study included advanced cancer patients aged over 19 years who visited the emergency room of a tertiary university hospital. The two study periods were as follows: from February 2017 to January 2018 (before) and from May 2018 to April 2019 (after). The primary outcome was the length of hospital stay. The consent rates to perform cardiopulmonary resuscitation (CPR), intubation, continuous renal replacement therapy (CRRT), and intensive care unit (ICU) admission were the secondary outcomes.ResultsThe length of hospital stay decreased after the law was enforced from 4 to 2 days (p = 0.001). The rates of direct transfers to secondary hospitals and nursing hospitals increased from 8.2 to 21.2% (p = 0.001) and from 1.0 to 9.7%, respectively (p < 0.001). The consent rate for admission to the ICU decreased from 6.7 to 2.3% (p = 0.032). For CPR and CRRT, the consent rates decreased from 1.0 to 0.0% and from 13.9 to 8.8%, respectively, but the differences were not significant (p = 0.226 and p = 0.109, respectively).ConclusionAfter the enforcement of the Life Extension Medical Decision law, the length of stay in the tertiary university hospital decreased in patients who established their life-sustaining treatment plans in the emergency room. Moreover, the rate of consent for ICU admission decreased. (shrink)

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...) end-of-life care and its consequential impacts. Research objectives To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design A qualitative descriptive approach was employed. Participants and research context Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings The moral distress-inducing factors and nurses’ perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. (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)

Temporal Changes in Ovarian Gonadotropin-Releasing Hormone mRNA Levels by Gonadotropins in the Rat Sung Ho Lee, Eun-Seob Song, Sun Kyeong Yu, Changmee Kim, Dae Kee Lee, Wan Sung Choi l and Kyungjin Kim* Department of Molecular Biofogy and SRC for Cell Differentiation, Seoul National University, Seoul 150-742, Korea; IDepartment of Anatomy, College of Medicine, Gyeongsanf; National University, Chinju 660-280, Korea (Recei·. cd on December 29, 1993) The present study examines whether gonadotropins are involved in the regulation of ovarian GnRH gene (...) expression and how ovarian GnRH gene expression temporalJy correlates with alterations in hypothalamic GnRH, pituitary LH~ gene expression in respons to gonadotropins. Hypothalamic and ovarian GnRH mRNA and pituitary LH~ mRNA levels were determined by respective RNA-blot hybridizations, and ovarian GnRH and estradiol contents and serum LH levels were measured by respective radioimmunoassays. Three animal models such as 1) PMSG-treated, 2) PMSG and heG-treated immature rats and 3) proestrous stage of adult rats were used. Immature rats (25-days old) were administered with PMSG (10 iu) at 10:00 hand 48 h later with heG (10 iu) to induce ovulation. In the PMSG-injected model, hypothalamic GnRH mRNA levels were markedly augmented about 9-fold at 50 h, and pituitary LH mRNA 3-fold at 52 h after PMSG administration. Serum LH levels were increased to the preovulatory surge levels at 56 h, and ovarian GnRH mRNA levels were augmented 4-fold at 60 h after PMSG injection. Administration of heG also induced a marked enhancement in ovarian GnRH mRNA levels in comparison to the values shown in both intact and PMSGtreated rats at 52 hand 54 h, respectively. In the proestrous stage of normal adult rats, pituitary LH~ mRNA levels were peaked at 16:00 h. The preovulatory LH surge was evident at 4 h before increment in ovarian GnRH mRNA levels as shown in PMSG-treated rats. The present study clearly showed the sequential increase in hypothalamic GnRH mRNA, pituitary LH~ mRNA and ovarian GnRH mRNA levels, indicating that ovarian GnRH may play a possible role in the control of follicular maturation and the ovulation process. (shrink)

The sociology of symbolic power, as put forth by Pierre Bourdieu, treats the relations between behavior and socio-cultural structure. Bourdieu comprehends culture as a form of capital that follows certain laws of accumulation, exchange, and operation, and emphasizes that its symbolic form plays an important role in establishing and maintaining power structures.1 Bourdieu’s concept of cultural capital comprises a variety of resources such as language capabilities, general cultural consciousness, aesthetic symbols, educational information, and level of education.2 His analysis of cultural (...) capital reveals three different processes of its formation.3 First, education fosters its formation, internalizing it through the.. (shrink)

This book is a critical attempt to approach world cinema in a new global frame that updates the national frame of territorial cinemas and the transnational frame of their interplay. The global frame implies the reintegration of border-crossing forces onto the postpolitical plane of troubled globalization with two ethical facets: the soft ethical inclusion of differences in multicultural, neoliberal systems and their hard ethical symptoms of fundamentalist exclusion and terror. Reflecting both, global cinema is formulated as staging crucial challenges that (...) today's globalism and its antinomies bring to the notions of subjectivity and community. Many films indeed depict the antagonism between the inclusive global system and its excluded remnants, allegorizing the impossible political change in various modes of catastrophe and nihilism. A global community often takes on a totalized network of sovereign violence and (counter)terror stuck in the impasse of utopian imagination. Yet some films suggest alternative ethics irreducible to collective politics when abject figures, deprived of social subjectivity and rights, become contingent agents of existential 'gift-giving' by fostering commonality without community, solidarity without unity. The psychoanalytic notion of abjection is redefined here as both the biopolitical mode of bare life and its potential for the ethical agency that opens atopian, if not utopian, networking on the edge of the global regime beyond the problematic 'soft/hard' ethics of tolerance/violence or pity/hate. This precarious yet precious abject agency is explored through a vast net of globally circulating contemporary films and a core cluster of political, ethical, and psychoanalytic philosophies. (shrink)

This work is the first English monograph on Franciscus Junius's (1545–1602) theology in more than 40 years, and also is the first monograph on Junius’s use of Thomistic moral concepts to date.

This study examined influential factors of newspaper corporation social responsibility and evaluated corporate social responsibility using a newspaper corporate social responsibility index. Results of this study, which was conducted by survey, showed that arbitrative, essential, and cultural activities were influential factors comprised of newspaper corporate social responsibility. In addition, the findings indicated that higher corporate social responsibility index was not accompanied by Korean newspaper corporations with larger circulations.

The study reviewed 20 currently-available structured ethical decision-making models and developed an integrated model consisting of six steps with useful questions and tools that help better performance each step: (1) the identification of an ethical problem; (2) the collection of additional information to identify the problem and develop solutions; (3) the development of alternatives for analysis and comparison; (4) the selection of the best alternatives and justification; (5) the development of diverse, practical ways to implement ethical decisions and actions; and (...) (6) the evaluation of effects and development of strategies to prevent a similar occurrence. From a pilot-test of the model, nursing students reported positive experiences, including being satisfied with having access to a comprehensive review process of the ethical aspects of decision making and becoming more confident in their decisions. There is a need for the model to be further tested and refined in both the educational and practical environments. (shrink)

Introduction -- the medium-interface -- The body-interface -- The surface of the object -- The face of the subject -- Image and subjectivity -- Conclusion.

The history of press freedom in South Korea has been characterized by periods of chaos. The major media companies in Korea have written a history of shame. Since Japanese colonial rule, freedom of the press has been more often restricted than protected by the laws and policies. There have been four main features of press freedom since 1910: severe restriction during the Japanese colonial rule; experiencing freedom with unstable democracy under the American military rule and the First and Second republics; (...) oppression of the military regimes; and the struggle with capital power since the advent of civilian government. Several decades of Japanese colonial rule, American military rule, and military dictators have influenced the Korean society and the media politically, economically, socially and culturally. (shrink)

The zone of proximal development is defined as an overarching concept that integrates the main tenets of Vygotsky’s theory of human development. The conceptualization of the ZPD begins with its social, cultural, and historical context and traces its development as a spatial and temporal metaphor that reflects the sociogenetic root of all human mental functioning. Beyond the explication of sociogenesis, the ZPD is reconceptualized to include the notions of voice and dialogicality. The insights gained from the fields of semiotics and (...) discourse studies allow a broader understanding of the ZPD by bringing to light participant structures and institutional and historical forces that may not have been included in the dominant interpretations of the ZPD. (shrink)

With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their end-of-life treatment preferences (ELTP) while they are physically and mentally able to do so. The purpose of this study was to explore ELTP among older adults and to compare those preferences in a subset of individuals who had reported their ELTP in a survey completed the previous year. This was a descriptive study of 191 older adults (...) living in a continuing care retirement community. Approximately half of the participants did not want cardiopulmonary resuscitation, to be put on a respirator, or to receive dialysis. The findings in this study suggest that many older adults do not want aggressive interventions at the end of life, but choose rather those measures that will keep them comfortable. Moreover, treatment choices may change over time. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in dictating their end-of-life care. (shrink)

When the Japanese invaded Joseon at the end of the sixteenth century, a Spanish Jesuit priest, Gregorio de Céspedes, S.J. , stayed in the Japanese fortress in Ungcheon with Japanese soldiers. While Céspedes is celebrated as the first European who allegedly came with an evangelical vision of proselytizing the native Koreans, previous scholarship has inadequately acknowledged Céspedes’ role without consideration of his concrete actions in the Japanese fortress and of the broader context of sixteenth–century Spanish colonial expansion. An examination of (...) the Jesuit mission to sixteenth-century Japan, the role of the Spanish chaplains and their activities in foreign expeditions, and Céspedes’ activities in Joseon indicate that Céspedes was not a missionary sent to Korea, but rather an active chaplain who played a role in the larger development of church and state collaboration under Spanish colonialism. (shrink)

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid levels and cerebral blood flow in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a (...) diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress, anxiety, fatigue, and sleep quality improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms. The prefrontal GABA levels decreased, while relative CBF increased after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention. The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress. (shrink)

Many clinical and psychological constructs are conceptualized to have multivariate higher-order constructs that give rise to multidimensional lower-order traits. Although recent measurement models and computing algorithms can accommodate item response data with a higher-order structure, there are few measurement models and computing techniques that can be employed in the context of complex research synthesis, such as meta-analysis of individual participant data or integrative data analysis. The current study was aimed at modeling complex item responses that can arise when underlying domain-specific, (...) lower-order traits are hierarchically related to multiple higher-order traits for individual participant data from multiple studies. We formulated a multi-group, multivariate higher-order item response theory (HO-IRT) model from a Bayesian perspective and developed a new Markov chain Monte Carlo (MCMC) algorithm to simultaneously estimate the (a) structural parameters of the first- and second-order latent traits across multiple groups and (b) item parameters of the model. Results from a simulation study support the feasibility of the MCMC algorithm. From the analysis of real data, we found that a bivariate HO-IRT model with different correlation/covariance structures for different studies fit the data best, compared to a univariate HO-IRT model or other alternate models with unreasonable assumptions (i.e., the same means and covariances across studies). Although more work is needed to further develop the method and to disseminate it, the multi-group multivariate HO-IRT model holds promise to derive a common metric for individual participant data from multiple studies in research synthesis studies for robust inference and for new discoveries. (shrink)

In empiricism, there are only two answers for a question: black or white. Yet, subjective meanings of human behaviours and responses toward health and illness cannot be simply explained with black and white. Gray zones are needed because they are characterized by complexity and require a contextual understanding. In this paper, we present and suggest fuzzy logic as an example of theoretical bases that help transcend the conflicts between objectivity and subjectivity, respect gray zones between black and white answers for (...) questions, and provide a contextual understanding of complex nursing phenomenon. A historical review of fuzzy logic is followed by a definition of fuzzy logic. Then, fuzzy logic is discussed in terms of its compatibility with nursing epistemological views and philosophical thoughts. Fuzzy logic agrees with three categories of epistemological views of nursing, including correspondence, coherence and pragmatism. Fuzzy logic also agrees with four major philosophical thoughts in nursing, including postempiricism, pragmatism, feminism, and postmodernism. Based on the discussion, we propose that fuzzy logic be further explored, used and developed in research and practice in the nursing areas/situations/phenomena that are characterized by complexity, ambiguousness, and vagueness. (shrink)

Ce travail explore l’origine d’un malentendu vieux de cinq siècles concernant la foi justifiante. Dieu justifie-t-il le pécheur par la foi seule ( sola fide ) comme le disent les luthériens ou par la foi formée par la charité ( fide caritate formata ) comme le disent les catholiques? Il s’agit d’une des différences les plus débattues entre les deux traditions. Une étude précise des sources et une comparaison entre les textes de Thomas d’Aquin et de Martin Luther consacrés à (...) l’interprétation de la fides caritate formata permet de constater que, malgré la compréhension différente de la formule, ils ont en réalité la même idée de la foi justifiante en raison d’une même fidélité à l’Écriture. C’est en puisant à cette source commune qu’aujourd’hui encore, ils montrent aux Églises un chemin d’unité. (shrink)

Hinging on a metaphysical examination of the concept of newness and Paul Guyer’s notion of the temporally extended self, this article analyzes what it means that we are a temporally extended being that is fashioned in time, which is none other than a transcendental object = newness, and argues that (fashioned) bodies can be things in themselves and mere phenomena simultaneously. Kant’s doctrine of self-positing assists us in decoding how the subject obtains an embodied experience while a thing in itself, (...) as well as how both a non-empirical affection and an empirical affection are at play, casually affecting the subject. By looking into how double affection is in operation, this article aims to broaden our understanding of Kant’s theory of self-consciousness. (shrink)

En este artículo se realiza un periplo a lo largo de la historia de la península coreana a través de los caminos recorridos por las principales tradiciones religiosas presentes en ella. Analizaremos el papel que han tenido en el modo de entender las relaciones sociales y la creación de mecanismos de inclusión y exclusión dentro de la sociedad coreana. Las interrelaciones establecidas entre ellas como factor que ha contribuido al progreso de la sociedad y que diferentes grupos fueran aceptados o (...) rechazados a lo largo de la historia. Estudiamos como el pensamiento de estas tradiciones religiosas y el modo de entenderlo ha impulsado u obstaculizado los procesos de inclusión y liberación a lo largo de las diferentes etapas de la historia de Corea. (shrink)

The study aimed to examine the influence of personal characteristics on activity preferences using decision tree analysis and examine the effects of the variables using conventional approaches. A descriptive study was conducted with 251 nursing home residents with dementia in Korea to examine the relationship between their personal characteristics and activity preferences. Decision tree analysis was used to classify participants’ activity preferences, and preference levels were examined using logistic regression analysis. Activities were classified as either physical and social activities or (...) cognitive and affective activities. This model showed an accuracy rate of 85.7% for positively predicting physical and social activity preference and 30.3% for positively predicting cognitive and affective activity preference. Gender was the strongest determinant of activity preference. The odds of preferring physical and social activities were 3.179 times higher among women, while the odds for preferring cognitive and affective activities were 0.412 times higher among men. Notably, cognitive and affective activity preference increased to 58.8% for married male participants. This study’s findings can contribute to the development of programs to decrease behavioral and psychological symptoms among older people with dementia residing in nursing homes and provide scientific evidence for integrating these activities into long-term services for this population. (shrink)

To effectively train ethical decision-making of nursing students, a case-based computer program was developed using Flash animation. Seven ethical cases collected from practicing registered nurses’ actual clinical experiences and a six-step Integrated Ethical Decision-Making Model developed by the author were employed in the program. In total, 251 undergraduate students from three nursing schools used the program in their nursing ethics course. The usability of the program and its usefulness in improving 11 abilities needed in ethical decision-making were measured; it scored (...) higher than 4 on a 5-point scale. Of the students, 82% recommended the program as a valuable complementary tool in the teaching of a nursing ethics course. A variety of encouraging and positive experiences were reported by the students. The computer program is likely to be usefully practical in the training of abstract skills to nursing students, though certain challenges remain, such as the precise understanding of cognitive or affective responses to ethical issues. (shrink)