Background:The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy.Objectives:To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory and kinaesthetic model, (...) three strategies were developed for determining the programme components and corresponding learning styles.Research design:This was a quasi-experimental study.Participants:A total of 234 junior-college student nurses participated in this study. All participants were aged 18–19 years.Ethical considerations:The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score.Results:The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies. Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning.Conclusion:This strategy was consistent with the student nurses’ preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge. (shrink)

We investigate whether air pollution harms business ethics from the perspective of earnings manipulation, which exerts a real effect on the economy and social welfare. Using a large sample and a comprehensive air quality index in China, we find that firms located in cities with more severe air pollution exhibit higher levels of discretionary accruals and are more likely to restate their financial statements, consistent with exposure to air pollution leading to more earnings manipulation. We further provide causal evidence using (...) propensity score matching and a discontinuity regression design exploiting the Qinling Mountain–Huai River Heating Policy Line, which exogenously leads to more air pollution to cities located immediately north of the Line but not those in the south. Our findings are robust to controlling for weather conditions and alternative samples and measures of air pollution and earnings manipulation. Overall, this study unveils how the ecological environment shapes business ethics. (shrink)

The practice of respecting patients’ autonomy is rooted in the healthcare professionals’ empathy for patients’ situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients’ experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi’s method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two major themes (...) emerged from the analyses: (a) a voluntary yet necessary alternative—to undergo a surgery and (b) alternatives compelled by the unalterable decision—the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel. (shrink)

In this research work, we have explored the physical and topological properties of the crystal structure of metal-insulator transition superlattice. In recent times, two-dimensional substantial have enamored comprehensive considerations owing to their novel ophthalmic and mechanical properties for anticipated employment. Recently, some researchers put their interest in modifying this material into useful forms in human life. Also, Metal-Insulator Transition Superlattice is useful in form of a thin film to utilize as two-dimensional transition metal dichalcogenides. Moreover, we have defined the computed-based (...) bond properties such as the degree constructed topological indices and their heat of formation for single crystal and monolayered structure of Ge-Sb-Te. Also, this structure is one of the most interesting composites in modern resources of science. (shrink)

This study investigated the differences between past and future temporal discounting in terms of neural activity in relation to temporal distance. Results show that brain regions are engaged differently in past and future temporal discounting. This is likely because past temporal discounting requires memory reconstruction, whereas future temporal discounting requires the processing of uncertainty about the future. In past temporal discounting, neural activity differed only when preferences were made between rewards received one hour prior and rewards received further in the (...) past. The peak amplitudes of P2 and P3 varied as the temporal distance increased from 2 weeks to 50 years. In future temporal discounting, neural activity differed only when preferences were evaluated between two delayed rewards. The delay conditions and had a significant influence on P2 and N2. Findings indicate the existence of different decision-making systems operating in past and future temporal discounting. (shrink)

Objectives: To investigate the current situation of completing the informed consent for do-not-resuscitate (DNR) orders among the competent patients with terminal illness and the ethical dilemmas related to it. Participants: This study enrolled 152 competent patients with terminal cancer, who were involved in the initial consultations for hospice care. Analysis: Comparisons of means, analyses of variance, Student’s t test, χ2 test and multiple logistic regression models. Results: After the consultations, 117 (77.0%) of the 152 patients provided informed consent for hospice (...) care and DNR orders. These included 21 patients (17.9%) who signed the consent by themselves, and 96 (82.1%) whose consent sheet was signed only by family members. The reasons why patients were not involved in the discussions toward the consent (n = 82) included poor physical or psychological condition (44.9%), concerns of the consultant hospice team (37.2%), and the family’s refusal (28.2%). On a multivariate analysis, patients’ awareness of their poor prognosis (odds ratio = 4.07, 95% confidence interval = 2.05 to 8.07) and their understanding of hospice care (2.27, 1.33 to 3.89) were two independent factors (p<0.01) that influenced their participation in the discussions or their personal signature in the informed consent. Conclusion: The family-oriented culture in Asian countries may violate the principles of the Patient Self-Determination Act and the requirements of the Hospice Care Law in Taiwan, which inevitably poses an ethical dilemma. Earlier truth-telling and continuing education of the public by hospice care workers will be helpful in solving such ethical dilemmas. (shrink)

Up till now, China has not enacted any legal mechanisms governing certification or supervision for ethics committees. This article analyses deficiencies in the protection of subjects in clinical drug trials under China’s current laws and regulations; it emphasizes that investigators, as practitioners who have direct contact with subjects, play significant roles in protecting and safeguarding subjects’ rights and interests. The paper compares the status quo in China in this area to that of other countries and discusses ways China might enhance (...) the protection of rights and interests of trial subjects, such as enhancing the ethical awareness of investigators through training, improving laws and regulations, and strengthening the communication between investigators and ethics committees. (shrink)

Silencing of tumor suppressor genes (TSGs), by DNA methylation, is well known in adult cancers. However, based on the “stem cell” theory of tumorigenesis, the early epigenetic events arising in malignant precursors remain unknown. A recent report1 demonstrates that, while pluripotent embryonic stem cells lack DNA methylation and possess a “bivalent” pattern of activating and repressive histone marks in numerous TSGs, analogous multipotent malignant cells derived from germ cell tumors (embryonic carcinoma cells) gain additional silencing modifications to those same genes. (...) These results suggest a possible mechanism by which aberrant differentiation, mediated by histone and DNA methylation, instigates tumor progression. BioEssays 29:842–845, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

The Protein Ontology (PRO) provides a formal, logically-based classification of specific protein classes including structured representations of protein isoforms, variants and modified forms. Initially focused on proteins found in human, mouse and Escherichia coli, PRO now includes representations of protein complexes. The PRO Consortium works in concert with the developers of other biomedical ontologies and protein knowledge bases to provide the ability to formally organize and integrate representations of precise protein forms so as to enhance accessibility to results of protein (...) research. PRO (http://pir.georgetown.edu/pro) is part of the Open Biomedical Ontologies (OBO) Foundry. (shrink)

Reasoning about what other people know is an important cognitive ability, known as epistemic reasoning, which has fascinated psychologists, economists, and logicians. In this paper, we propose a computational model of humans’ epistemic reasoning, including higher-order epistemic reasoning—reasoning about what one person knows about another person’s knowledge—that we test in an experiment using a deductive card game called “Aces and Eights”. Our starting point is the model of perfect higher-order epistemic reasoners given by the framework of dynamic epistemic logic. We (...) modify this idealized model with bounds on the level of feasible epistemic reasoning and stochastic update of a player’s space of possibilities in response to new information. These modifications are crucial for explaining the variation in human performance across different participants and different games in the experiment. Our results demonstrate how research on epistemic logic and cognitive models can inform each other. (shrink)

The emergence of new biological traits is landmarks of evolutionary progress. However, when, how, and why do they appear? We propose a universal mechanism, a Buffering Mechanism of Evolution to understand these questions. We speculate that all organisms possess this potential buffer capacity. This capacity would be triggered by the pressures, natural or artificial, to express the intrinsic potential variants. The potential buffer capacity of the organism increases for further selections as evolutionary progress occurs. The higher the evolutionary level of (...) the organism, the greater the potential buffer capacity, and importantly, the buffer capacity versus the pressures of selections will result. However, when the pressures are far more than the potential capacity of the targets, the natural or artificial pressures then compromise the genetic buffering system resulting in possible species extinction if the emergence of new traits fails. (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)

Critical types of infrastructure are provided by the state to maintain the people’s livelihood, ensure economic development, and systematic government operations. Given the development of ever more complicated critical infrastructure systems, increasing importance is being attached to the protection of the components of this infrastructure to reduce the risk of failure. Power facilities are one of the most important kinds of critical infrastructure. Developing an effective risk detection system to identify potential failure modes of power supply equipment is crucial. This (...) study seeks to improve upon prior approaches for risk assessment by proposing a hybrid risk-assessment model using the concepts of failure mode and effect analysis and multiple-criteria decision-making. The proposed model includes a cost-based factor for decision-makers. The subjectivity and uncertainty in FM assessment are adjusted through the rough number method. The original risk priority number can be expanded by including the entropy weights in the risk index. Furthermore, to rank the risk priorities in a rational manner, a modified technique for order preference by similarity to ideal solution is adopted. The applicability and effectiveness of the proposed method were demonstrated by considering an example of a turbine steam engine in a nuclear power plant. (shrink)

Sound-producing movements in percussion performance require a high degree of fine motor control. However, there remains a relatively limited empirical understanding of how performance level abilities develop in percussion performance in general, and marimba performance specifically. To address this issue, nine percussionists performed individualised excerpts on marimba within three testing sessions spaced 29 days apart to assess early, intermediate, and late stages of motor learning. Motor learning was quantified via analyses of both the temporal control of mallet movements, and the (...) spatial variability of upper-limb movements. The results showed that temporal control of mallet movements was greater in the intermediate compared to the early learning session, with no significant additional improvements revealed in the late learning session. In addition, spatial variability in the left and right elbows decreased within the intermediate compared to the early learning session. The results suggest that temporal control of mallet movements may be driven by reductions in spatial variability of elbow movements specifically. As a result, this study provides novel evidence for kinematic mechanisms underlying motor learning in percussion which can be applied towards enhancing musical training. (shrink)

ObjectiveTo explore the relations among perceived stress, fatigue, sleepiness, and the pathway of their effects on the ambulatory arterial stiffness index among medical staff.MethodsThis cross-sectional study was conducted at a tertiary hospital in Wuhan, China. Perceived stress, fatigue, and sleepiness were measured using the perceived stress scale, Fatigue assessment scale, and Epworth Sleepiness Scale, respectively. AASI was obtained from 24-h ambulatory blood pressure monitoring. Path analysis was used to clarify the relations among the PSS, FAS, and ESS scores, and their (...) relations to AASI values.ResultsA total of 153 participants were included herein. The PSS and FAS correlated with the ESS, and the PSS correlated with the FAS. In addition, the ESS correlated with the AASI. According to the path analysis results, the PSS and FAS had no direct effect on the AASI, but did have an indirect effect on this index by influencing the ESS.ConclusionSleepiness was a mediator of the effects of perceived stress and fatigue on AASI. (shrink)

BackgroundMental stress and imbalance of its two neural stress systems, the autonomic nervous system and the hypothalamic–pituitary–adrenal axis, are associated with chronic prostatitis/chronic pelvic pain syndrome and erectile dysfunction. However, the comprehensive analyses of psychological stress and stress systems are under-investigated, particularly in CP/CPPS patients complicated by lower urinary tract symptoms and ED.Materials and methodsParticipants were 95 patients in CP/CPPS+ED group, 290 patients in CP/CPPS group, 124 patients in ED group and 52 healthy men in control group. The National Institutes (...) of Health Chronic Prostatitis Symptom Index, the International Index of Erectile Function-5 and the International Prostate Symptom Score were used for assessing the disease severity of CP/CPPS, LUTS and ED. Psychometric self-report questionnaires including the Beck Anxiety Inventory, Perceived Stress Scale, Type A Personality Test and Symptom Checklist 90 were completed for distress from physical symptoms. Twenty-five subjects per group were randomly selected for further investigating the changes of the HPA axis and ANS. Saliva samples were taken on 3 consecutive days at 8 specific times with strict reference to time of morning awakening for evaluation of free cortisol. Heart rate variability as marker of the ANS was measured using 24 h electrocardiography, and time-and frequency-domain variables were analyzed.ResultsThe BAI and SCL-90 scores were significantly higher in the CP/CPPS+ED, CP/CPPS and ED groups compared with the control group. The PSS scores of both groups with ED were significantly higher than the control group. Compared with the CP/CPPS group, the differences of PSS, SCL-90 and TAPT scores were statistically significant in CP/CPPS+ED patients. The IPSS scores were shown to have significantly positive correlations with BAI, PSS and SCL-90 in the CP/CPPS patients. However, in all subjects, the IIEF-5 scores were shown to have significantly negative correlations with BAI, PSS, SCL-90 and quality of life score in NIH-CPSI. Cortisol awakening response parameters and diurnal cortisol levels did not significantly vary between the four groups. Time-dependent parameters of HRV also did not differ significantly across groups. In the frequency domain analysis, low frequency was significantly lower in ED patients when compared with CP/CPPS+ED patients and healthy controls, high frequency power was significantly higher in healthy controls compared to patients with ED, CP/CPPS and CP/CPPS+ED, and the CP/CPPS+ED group had significantly higher LF/HF ratio than the control group.ConclusionCP/CPPS and ED patients score exceedingly high on most psychosocial variables. The symptom scores of LUTS and ED positively correlate with the severity of psychological stress. Our findings also suggest that the ANS sympathovagal imbalance is associated with ED and LUTS in CP/CPPS, whereas HPA axis activity is not. (shrink)

Whether or not a public relations code of ethics should be enforced, among others, has become one of the most widely controversial topics, especially after the Hill and Knowlton case in 1992. I take the position that ethical codes should be enforced and address this issue from eight aspects: (a) Is a code of ethics an absolute prerequisite of professionalism? (b) Should problems of rhetoric per se in a code of ethics become a rationale against code enforcement? (c) Is a (...) code of ethics of any significance? (d) Is the ethical code is enforceable, (e) Would the licensure system interfere with the freedom of expression of the practitioners? (f) Do PR practitioners choose to be ethical (if they do) because they have to be or because they want to be? (g) Would the public interest be virtually assured as a result of a public relations? and (h) Can education in ethics overcome the ethical problems in public relations? (shrink)

This paper highlights the significance of popular astronomy lectures in British theatres during the first half of the nineteenth century. The popular astronomy lecturing trade inherited from Enlightenment natural philosophy discourses. A ‘theatrical turn’ developed in the late eighteenth century and became extensive by the 1820s. Lecturers moved astronomy displays into theatres and used theatrical facilities, which resulted in a distinct type of show blending scientific instruction with sensational amusement. Lent was especially high season for this business in a metropolitan (...) entertainment market. Pre–eminent cases of private entrepreneurs in this trade included William Walker, Deane Franklin Walker, George Bartley, and C. H. Adams. By exploring astronomy lectures in theatres, this paper also shows the spatial influence of the site on the format and style of the performance: the benefits and constraints of a theatre made a theatrical astronomy lecture distinct from others at a formal institution. (shrink)

Confucianism’s long historical association with despotism has cast doubts on its compatibility with democracy, and raise questions about its relevance in contemporary societies increasingly dominated by democratic aspirations. “Confucian democracy” has been described as a “contradiction in terms” and Asian politicians have appropriated Confucianism to justify resistance to liberalization and democratization. There has been a lively debate over the question of whether democracy can be found in Confucianism, from ancient texts such as the Analects and Mencius, to Confucian institutions such (...) as those recommended by Song dynasty Huang Zongxi. Philosophers have examined similarities and differences between Western ideas, such as autonomy, liberty, and rights, that are central to democratic theories on the one hand and Confucian ideas of virtue, ren, yi, li, zhi, exemplary person and authority. Scholars have studied the biographical accounts of prominent Confucians to understand the Confucian ideal person and society. Works arguing that there are elements of democracy in Confucianism, or that some Confucian ideas could provide the basis for a contemporary Confucian democracy, differ in the kind of democracy they choose as models. Liberal democracy was the model of earlier works; with increasing criticisms of liberal democracy in the past decades, a growing number of works arguing for Confucian democracy seek alternatives to liberal democracies, many proposing some kind of communitarian democracy as having affinity with the Confucian philosophical orientation. Besides conceptions of democracy that view it in terms of political systems, Dewey’s conception of democracy as the idea of community and primarily a moral ideal has also inspired attempts to reconstruct Confucian democracy. (shrink)

This book offers a definitive and wide-ranging overview of developments in behavioral finance over the past ten years. In 1993, the first volume provided the standard reference to this new approach in finance--an approach that, as editor Richard Thaler put it, "entertains the possibility that some of the agents in the economy behave less than fully rationally some of the time." Much has changed since then. Not least, the bursting of the Internet bubble and the subsequent market decline further demonstrated (...) that financial markets often fail to behave as they would if trading were truly dominated by the fully rational investors who populate financial theories. Behavioral finance has made an indelible mark on areas from asset pricing to individual investor behavior to corporate finance, and continues to see exciting empirical and theoretical advances. Advances in Behavioral Finance, Volume II constitutes the essential new resource in the field. It presents twenty recent papers by leading specialists that illustrate the abiding power of behavioral finance--of how specific departures from fully rational decision making by individual market agents can provide explanations of otherwise puzzling market phenomena. As with the first volume, it reaches beyond the world of finance to suggest, powerfully, the importance of pursuing behavioral approaches to other areas of economic life. The contributors are Brad M. Barber, Nicholas Barberis, Shlomo Benartzi, John Y. Campbell, Emil M. Dabora, Daniel Kent, François Degeorge, Kenneth A. Froot, J. B. Heaton, David Hirshleifer, Harrison Hong, Ming Huang, Narasimhan Jegadeesh, Josef Lakonishok, Owen A. Lamont, Roni Michaely, Terrance Odean, Jayendu Patel, Tano Santos, Andrei Shleifer, Robert J. Shiller, Jeremy C. Stein, Avanidhar Subrahmanyam, Richard H. Thaler, Sheridan Titman, Robert W. Vishny, Kent L. Womack, and Richard Zeckhauser. (shrink)

This article comments on some of Professor Huang’s theses by looking at ancient historiography. It deals with the significance of history in its respective cultural contexts; the kind of orientation that historical thinking and historiography provide; and the relationship between concrete examples and abstract rules in historical argumentation. Distinguishing between ancient Greece and Rome, it shows that Huang’s explicit and implicit East–West oppositions are more valid with respect to ancient Greece than to ancient Rome. On important points, the (...) situation of Rome is surprisingly close to that of China. Thus not only in China but also in Rome, tradition and history are highly important as a life-orienting force ; and not only in China but also in Rome the orientation that historical thinking and historiography provide is to a great extent moral . As to the relationship between concrete examples and abstract rules in historical argumentation, the paper takes up Professor Rüsen’s category of “exemplary meaning-generation,” but suggests a distinction between example in the sense of “case/instance” and example in the sense of “model/paragon.” Though the two corresponding modes of exemplary meaning-generation are mostly entwined, it appears that in Chinese and Roman historical works there is a tendency toward meaning-generation by example in the sense of “model/paragon,” whereas in Greek historiography the tendency is toward meaning-generation by example in the sense of “case/instance.”. (shrink)

ABSTRACTThis article comments on some of Professor Huang's theses by looking at ancient historiography. It deals with the significance of history in its respective cultural contexts; the kind of orientation that historical thinking and historiography provide; and the relationship between concrete examples and abstract rules in historical argumentation. Distinguishing between ancient Greece and Rome, it shows that Huang's explicit and implicit East‐West oppositions are more valid with respect to ancient Greece than to ancient Rome. on important points, the (...) situation of Rome is surprisingly close to that of china. thus not only in China but also in Rome, tradition and history are highly important as a life‐orienting force ; and not only in China but also in Rome the orientation that historical thinking and historiography provide is to a great extent moral. As to the relationship between concrete examples and abstract rules in historical argumentation, the paper takes up Professor Rüsen's category of “exemplary meaning‐generation,” but suggests a distinction between example in the sense of “case/instance” and example in the sense of “model/paragon.” Though the two corresponding modes of exemplary meaning‐generation are mostly entwined, it appears that in Chinese and Roman historical works there is a tendency toward meaning‐generation by example in the sense of “model/paragon,” whereas in Greek historiography the tendency is toward meaning‐generation by example in the sense of “case/instance.”. (shrink)