The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before (...) and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. (shrink)

A positive connection has been established between personality traits and suicidal ideation. However, the possible mediation of resilience within this association has never been thoroughly discussed. In this study, we aimed to investigate this topic by using population-based cross-sectional survey data of 4,489 Chinese children and adolescents. A self-administered questionnaire was used to collect information from the participants. Univariate and multivariate logistic regression models were adopted to measure the crude and adjusted associations between personality traits, SI, and resilience. Path analysis (...) was performed to evaluate the mediation of resilience in the association between personality traits and SI. For 4,489 study subjects, the mean age was 13.4 years, ethnic minorities accounted for 71.8%, and over a half were middle school students. The reported prevalence rates for 1-week, 1-year, and lifetime SI were 27.6%, 35.5%, and 56.7%, respectively. Girls reported a significantly higher prevalence of SI than boys. Path analysis results revealed a prominent mediation of resilience; moreover, for different dimensions of personality traits, the proportion of mediation by resilience varied. Our major findings suggest that resilience-based intervention measures could be considered in preventing personality traits related to suicidal risk among youngsters. For children and adolescents, the measuring of personality dimensions may also be helpful in targeting key subpopulations of intervention priority. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

This study proposed a children’s digital art ability training system with artificial intelligence-assisted learning, which was designed to achieve the goal of improving children’s drawing ability. AI technology was introduced for outline recognition, hue color matching, and color ratio calculation to machine train students’ cognition of chromatics, and smart glasses were used to view actual augmented reality paintings to enhance the effectiveness of improving elementary school students’ imagination and painting performance through the diversified stimulation of colors. This study adopted the (...) quasi-experimental research method and designs the pre-test and post-test for different groups. The research subjects are the Grade 4 students of an elementary school in Taitung City, Taiwan. The test tools included an imagination test and an evaluation of painting performance ability. The test results of a total of 30 students before and after the experiment included the experimental group that received the children’s digital art ability training system with AI-assisted learning and 30 students in the control group that had not received the teaching were analyzed by covariance. These results were supplemented by the description and interpretation of student feedback, teachers’ reflection notes, and other qualitative data to understand the performance of the students in the experimental group in terms of imagination and painting performance. (shrink)

Member States of the United Nations proposed Seventeen Sustainable Development Goals (SDGs) in 2015, emphasizing the well-being of people, planet, prosperity, peace, and partnership. Countries are expected to work diligently to achieve these goals by the year 2030. The paths chosen to achieve the SDGs depend on each country’s specific needs, challenges, and opportunities. This contribution conducts a bibliometric study of selected SDG research related to hunger and climate change among countries of the North Asia Pacific region. A review of (...) literature related to the seventeen SDGs is provided to update the current research in SDGs as a background for the regional bibliometric search. The academic published literature related to this work were collected and text mined to create a research database for trend analysis. In this research, the natural language model KeyBERT and a text mining algorithm for normalized term frequency were used to extract key terminologies for bibliometric analysis. The study provides an overview of the seventeen SDGs in the literature review and then focuses on SDG 2 (zero hunger) and SDG 13 (climate action) publication trends. These two SDGs are in close alignment with sustainable food systems and agricultural development. The conclusion indicates that greater cooperation (SDG 17) is critical to improving the quality of life within the region and in building an ethical framework that restricts external exploitation of resources that benefit newly developed economies over developing economies. (shrink)

Chien-ming Chung-kuo che-hsueh shih [A Short History of Chinese Philosophy] compiled by Yang Yung-kuo is a good product of the Campaign to Criticize Lin Piao and Confucius and it is a book widely read by workers, peasants and soldiers. Philosophical struggle is closely linked to political struggle, a given philosophical thought is the theoretical basis of a given political line, and philosophy is a tool for class struggle. Ever since class society has existed, part of the history of philosophy has (...) simply been the reflection of the class struggle in philosophy in various historical periods. In the preface to the book, the compiler points out that "one of the common characteristics of the revisionist bosses within our Party has been to tamper with Marxism from the reactionary Confucian viewpoint for the sinister purpose of creating public opinion calling for the restoration of capitalism." An understanding of the many instances and the general laws of the philosophical struggles in Chinese history will help us thoroughly criticize the ideological origins and the ultrarightist nature of revisionism from a highly developed philosophical world view. One of the important characteristics of Confucian thought is that it uses eclecticism to camouflage its stubborn advocacy of old things and to oppose revolutionary dialectics and the philosophy of struggle. The unrepentant capitalist-roaders within the Party are using an eclectic strategem to carry out the revisionist line. Thus, reading this book on the history of philosophy by Yang Yung-kuo and acquainting ourselves with the sordid actions which Confucius took to carry out restoration and retrogression with the aid of eclecticism will benefit the present struggle against the Right-leaning wind of reversing decisions. (shrink)

全书选收辞条近700条,主要包括马克思主义哲学史上的基本理论、主要著作、有关人物、流派、事件等内容.

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

本书从时代特征出发,通过大量生动的事实,以及马克思、恩格斯、列宁、毛泽东、邓小平和江泽民同志的著作,论述了马克思主义不断发展的理论。.

In contemporary European policy discussion, “innovation“ is a term popularly used for finding responses to the pressure of global competition. In various forms of innovation, the accent is mainly given to technical and business innovation but less to social innovation. This article studies the issue of social innovation with reference to the local practice in Hangzhou city, which aims to strengthen the life quality of citizens in this city. These practices develop various forms of inter-sectoral collaboration, resulting in numerous “common (...) denominator subject“ (CDS) groups that are promoted by the local government. These practices follow the principles of cooperation and partnership, and thus develop a corporatist mechanism for urban development. Through discussion of these practices this article explores the nature and the features of these CDS groups, and evaluates its meaning for social innovation, local administration, life quality and social quality. (shrink)

Laws in China relating to HIV disclosure are inconsistent. After a patient has tested HIV‐positive, service providers struggle to decide who should be informed first: patients, family members, or both. To understand service providers' attitudes and practices regarding the HIV notification process in China, 1101 service providers from a southwestern province of China were surveyed. Opinions were gathered from providers at five different levels of health care facilities (provincial, city, county, township and village). A mixed methods approach was used to (...) analyze perceptions of informing family members of a patient's HIV status. Quantitative analysis was used to examine whether providers held a favorable attitude toward notifying family members first and qualitative analysis was used to explore the reasons and consequences of notifying family members first. Nearly half of service providers felt family members should be informed of a patient's HIV status first. Providers who were older, had contact with HIV patients, or had less medical education were more likely to agree with a family‐first notification practice. Psychological pressure, concern about protecting family members, the need for family support, and consideration for local regulations were cited as the main reasons for this practice. There is an immediate need to re‐examine HIV notification policies so that there are consistent guidelines and procedures for providers throughout China. (shrink)

The formation mechanism of innovation networks is one of the core issues in the current research of innovation networks, and proximity plays an important role in the formation and development of innovation networks; however, which proximity is more important and how different proximities interact remain to be further researched. This study conducts a social network analysis and adopts a spatial interaction model to examine innovation networks among 290 Chinese cities. The results reveal that, first, the hierarchical characteristics of Chinese cities’ (...) innovation networks reflect a core periphery structure and the spatial patterns of large dispersion and small agglomeration. Further, bound by the Hu line, the hierarchy is high in the east and low in the west. Second, geographical, institutional, and cognitive proximities positively affect Chinese cities’ innovation networking. Cognitive proximity, particularly, has the highest impact. Geographical proximity reinforces the effect of institutional proximity, and thus, their interactions are complementary. (shrink)

本书主要内容包括:中国刑事证据制度的改革、论刑事法庭审判中证据的判断与运用、关于《人民法院统一证据规定》调研报告、证明负担动态论研究、中国证据立法的理想与现实等.

What might it be to write a post-colonial social science? And how might the intellectual legacy of Chinese classical philosophy—for instance Sun Tzu and Lao Tzu—contribute to such a project? Reversing the more usual social science practice in which EuroAmerican concepts are applied in other global locations, this paper instead considers how a “Chinese” term, _shi_ might be used to explore the UK’s 2001 foot-and-mouth epidemic. Drawing on anthropological insights into mis/translation between different worlds and their alternative ways of knowing (...) and being, the paper explores that epidemic in three differently inspired _shi_-inflected “empirical” accounts. The first uses Sun Tzu’s strategic understanding of _shi_ to tell a conventionally representational story. The second resists the causes and background factors implied in standard social science by offering a “light” and _shi_-inflected form of knowing. And the third combines the referentiality of social science with a Lao Tzu-informed commitment to the paradoxes of normative epigram. This third narrative thus illustrates the possible features of a situated and _shi_-inflected social science that recognizes that it participates in the contexted and immanent flows and counterflows of things in the world. The paper concludes by noting that such a _shi_-inflected social science is experimental, and suggests that it is important to explore a range of ways of reversing the flow of concepts between EuroAmerica and other global locations. (shrink)

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)

Firms have been increasingly using social commerce platforms to engage with customers and support their brand value co-creation. While social commerce is now bringing a variety of benefits to business, it has also challenged marketing ethics surrounding online consumer privacy. Drawing on the trust-commitment theory, we develop a model that aims to create an ethical and trustworthy social commerce community for brand value co-creation by examining the impacts of online consumer privacy concerns and social interaction constructs on consumers’ psychological reactions. (...) Using an empirical study, we find that: privacy risk, privacy control, and collaborative norms significantly influence consumers’ trust; consumer-peer interaction and collaborative norms are positively related to relationship commitment; and relationship commitment and trust positively affect consumers’ brand value co-creation in the context of social commerce. Theoretical and practical implications are discussed. (shrink)

This study aimed to analyze the mediating effect of tolerance of uncertainty and trait anxiety on future self-continuity and intention to use Internet wealth management systems. A questionnaire survey was distributed online and a total of 388 participants completed questionnaire, The questionnaire included the following scales: Chinese version of the FSC, Intention to Use the Internet Wealth Management, TU, and TA. Pearson correlation was used to investigate the correlation coefficient between variables while the sequential regression method was used to analyze (...) relationship between variables. To analyze the collected data, the SPSS 26.0 was used. A two-step procedure was applied to analyze the mediation effect. Confirmatory factor analysis was conducted to test the measurement model. Afterward, the Maximum Likelihood method was used for path analysis, and the Bias-corrected Bootstrap method was used to investigate determine the estimated value and confidence interval of the mediating effect. To analyze the mediation effect, the Mplus 7.0 was used. The results showed that FSC positively predicted individuals’ Internet wealth management systems. Furthermore, TU and TA played complete serial multiple mediating roles between FSC and IUIWM. The role of TA and TU have negative impact on intention to use. This study provides a theoretical basis in personality psychology that Internet financial product suppliers can use to improve the attractiveness of their products. Product managers can subdivide users according to these personality traits to provide customized products. (shrink)

Confucians emphasizes and values morality, hence observers tended to regard moralities as politics so that the independent politics in the Confucian tradition has become implicit. Through a perusal of the Analects of Confucius, we can find that ethics and politics were separated from and independent of each other to Confucius, the primitive Confucian: he did not substitute ethics for politics.

Drowsy driving is a major cause of automobile accidents. Previous studies used neuroimaging based approaches such as analysis of electroencephalogram (EEG) activities to understand the brain dynamics of different cortical regions during drowsy driving. However, the coupling between brain regions responding to this vigilance change is still unclear. To have a comprehensive understanding of neural mechanisms underlying drowsy driving, in this study we use transfer entropy, a model-free measure of effective connectivity based on information theory. We investigate the pattern of (...) information transfer between brain regions when the vigilance level, which is derived from the driving performance, changes from alertness to drowsiness. Results show that the couplings between pairs of frontal, central, and parietal areas increased at the intermediate level of vigilance, which suggests that an enhancement of the cortico-cortical interaction is necessary to maintain the task performance and prevent behavioral lapses. Additionally, the occipital-related connectivity magnitudes monotonically decreases as the vigilance level declines, which further supports the cortical gating of sensory stimuli during drowsiness. Neurophysiological evidence of mutual relationships between brain regions measured by Transfer entropy might elucidate the understanding of cortico-cortical communication during drowsy driving. (shrink)