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)

The emphasis on evidence based medicine (EBM) has placed increased focus on finding timely answers to clinical questions in presence of patients. Using a combination of natural language processing for the generation of clinical excerpts and information theoretic distance based clustering, we evaluated multiple approaches for the efficient presentation of context-sensitive EBM excerpts.

Public figures’ transgressions attract considerable media attention and public interest. However, little is understood about the impact of celebrity endorsers’ transgressions on associated brands. Drawing on research on moral reasoning, we posit that consumers are not always motivated to separate judgments of performance from judgments of morality or simply excuse a wrongdoer. We propose that consumers also engage in moral coupling, a distinct moral reasoning process which allows consumers to integrate judgments of performance and judgments of morality. In three studies, (...) we demonstrate that moral coupling is prevalent and has unique predictive utilities in explaining consumers’ evaluation of the transgressor. We also show that transgression type has a significant impact on consumers’ choice of moral reasoning strategy. Finally, we demonstrate that consumers’ support for a brand endorsed by a transgressor is a direct function of moral reasoning choice. Findings suggest that public figure’s immoral behavior and its spillover to an extended brand is contingent on consumers’ moral reasoning choices. (shrink)

The present study develops an artificial agent that plays the iterative chicken game based on a computational model that describes human behavior in competitive social interactions in terms of fairness. The computational model we adopted in this study, named as the self-concept fairness model, decides the agent’s action according to the evaluation of fairness of both opponent and self. We implemented the artificial agent in a computer program with a set of parameters adjustable by researchers. These parameters allow researchers to (...) determine the extent to which the agent behaves aggressively or cooperatively. To demonstrate the use of the proposed method for the investigation of human behavior, we performed an experiment in which human participants played the iterative chicken game against the artificial agent. Participants were divided into two groups, each being informed to play with either a person or the computer. The behavioral analysis results showed that the proposed method can induce changes in the behavioral pattern of human players by changing the agent’s behavioral pattern. Also, we found that participants tended to be more sensitive to fairness when they played with a human opponent than with a computer opponent. These results support that the artificial agent developed in this study will be useful to investigate human behavior in competitive social interactions. (shrink)

A controversy of the Perception is focused on the Mind-Nature relation by Confucian Scholars in 18th century Joseon Dynasty. Chang-Hyup Kim [金昌協], especially, asserted that the Perception should be the unique side of Mind, because the Wise [智: the Mind of Judgment, remarkably about the righteous or not] is one aspect of the Nature. He needs to define the category of Wise and Perception, because the existing definition of Wise as an unprocurable activity of Mind. That might bring a confusion (...) of concepts though The Mind and Nature, in his view. More over he added the essential aspect of Perception to real activity of Perception, and in this point of view, the position of Mind is important to the process of consolidating into Nature. Therefore he asserted that we should perceive the Nature, the essence, in the side of Mind [卽心指性]. This vision of the aim to Nature in the point of Mind, which was reinvestigation of Neo-Confucianism and this was succeeded to the general with academic traditional of Nak School [洛學]. (shrink)

There are two main paradigms for brain-related science, with different implications for brain-focused intervention or advancement. The paradigm of homeostasis (“stability through constancy,” Walter Cannon), originating from laboratory-based experimental physiology pioneered by Claude Bernard, shows that living systems tend to maintain system functionality in the direction of constancy (or similitude). The aim of physiology is elucidate the factors that maintain homeostasis, and therapeutics aim to correct abnormal factor functions. The homeostasis paradigm does not formally recognize influences outside its controlled experimental (...) frames and it is variable in its modelling of neural contributions. The paradigm of allostatic orchestration (PAO) extends the principle of allostasis (“stability through change”) as originally put forth by Peter Sterling. The PAO originates from an evolutionary perspective and recognizes that biological set points change in anticipation of changing environments. The brain is the organ of central command, orchestrating cross-system operations to support optimal behavior at the level of the whole organism. Alternative views of blood pressure regulation and posttraumatic stress disorder illustrate differences between the paradigms. For the PAO, complexities of top-down neural effects and environmental context are foundational (not to be “factored out”), and anticipatory regulation is the principle of their interface. The allostatic state represents the integrated totality of brain-body interactions. Health itself is an allostatic state of optimal anticipatory oscillation, hypothesized to relate to the state of criticality, a mathematical point of poise between phases, on the border between order and disorder (or the “edge of chaos”). Diseases are allostatic states of impaired anticipatory oscillations, demonstrated as rigidifications of set points across the brain and body (disease comorbidity). Conciliation of the paradigms is possible, with “reactive homeostasis” resolved as an illusion stemming from anticipation of environmental monotony. Considerations are presented with respect to implications of the two paradigms for brain-focused intervention or advancement; the hypothesis that the state of criticality is a vehicle for evolutionary processes; concordance with a philosophy of freedom based on ethical individualism as well as self-creativity, non-obsolescence, empowerment, and citizenship; and concluding reflections on the science and ethics of the placebo, and the potential for virtuous cycles of brain-Anthropocene interactions. (shrink)

This research examines how one’s construal level of a crisis differs by crisis type, and how the interplay of crisis type and apology appeal type impacts the effectiveness of apology messages in a corporate crisis context. Findings indicate that one’s mental construal toward a crisis varies by crisis type, with a self-threatening crisis leading to a lower level of construal than a society-threatening one. Findings further suggest that in a society-threatening crisis condition, an informational apology was more effective than an (...) emotional one. However, in a self-threatening crisis condition, there was no significant difference between two different message types. These findings offer valuable guidelines for developing effective crisis response strategy. (shrink)

In the age of artificial intelligence, writing machines or robot authors have already begun to produce narrative texts in a variety of genres, including short stories and poetry, as well as journalistic articles. This article is based on the prospect that the narrative ecosystem is in a transitional period of decisive disconnection as it enters the era of artificial intelligence. The primary force driving this transition is the formidable execution of artificial intelligence algorithms, which fully automate narrative communication and narrative (...) works. This article attempts to lay the groundwork for building a new paradigm of post-narrativity through a critical examination of several detailed themes in narrative semiotics and non-anthropocentric narratology. The process of narrative creation based on artificial intelligence algorithms is a key condition that constitutes post-narrativity. This presupposes a non-anthropocentric view. In the landscape of post-narrativity, human writers, paper books, computer screens, and invisible narrative algorithms are all agents with equal influence. Automated narrative production by algorithms accelerates the repositioning of other existing media and actors, and changes the narrative ecosystem by incorporating new elements into activities such as production, distribution, and reception of narratives. (shrink)

All of the world's religions refer to death in some way. Everyone is somewhat familiar with stories about where we go or what happens to us after death. From an early age, we have all heard stories of heaven or hell or some other version of paradise. Many of us believed such stories, and a great number of us still do. When considering that such stories manage to persist in modern times, an age of science and logic, we can be (...) sure that death is an issue to which humans attach great importance. In a sense, the idea of an afterlife can be a great source of comfort to those whose death is imminent, as well as to their loved ones. Those who have led especially difficult lives can look forward to a more pleasant world, while those who have enjoyed happiness and abundance have the chance to experience more good fortune. To those left behind, the idea of an afterlife presents the chance to meet a loved one again. We may not be conscious of it, but such hopes and expectations stay with us throughout our lives. If such an afterlife does exist, then there is no reason to avoid or fear death. Moreover, if we believe that another life awaits us, then we would believe that we are only separated from our loved ones temporarily before being reunited with them later on. (shrink)

This book examines green management practices among top-performing companies operating on the Chinese mainland. It begins with the question: what constitutes a "green" company? Is this definition different when we consider China's sustainability efforts? Taken into consideration are such aspects as green management vision, supplier management programs, resource usage and investment in the environment. Through in-depth interviews with sustainability leaders and top executives, this Green Management Book will reveal how to systematically create or improve existing green management strategies in China. (...) It uses actual case studies from domestic and foreign companies to highlight these practices. Over 2 years of extensive research - working with the research board of the Fortune China CSR rankings and China-based CSR strategy platform InnoCSR - contribute to a comprehensive list of companies that are leading the way towards a greener China. (shrink)

We used functional magnetic resonance imaging to examine the interactive effects of perceived competence and task interest on the cognitive and affective responses to negative feedback. Twenty-four undergraduates performed both interesting and uninteresting tasks and received failure feedback. The participants’ perceived competence in the task was manipulated between subjects prior to scanning with bogus feedback. The results showed that negative feedback processing was contingent upon both perceived competence and task interest. The most adaptive coping mechanism, indicated by activation in the (...) cognitive control network and attenuation in the negative affect region, was identified for the high-competence and high-interest combination. When either competence or interest was low, signals in the cognitive control network were weaker. The most detrimental activation patterns were observed for the combination of low-competence and high interest. Our results reveal the combination of task and learner characteristics that best harnesses the potential benefits of negative feedback and illustrate the neuroscientific mechanisms underlying this observation. (shrink)

We seek to understand how third-party observers respond to allegations of sexual transgressions, whether their responses vary and if so why, how they determine perpetrator sanctions, who is more forgiving of them, and what is the psychological mechanism underlying this preference. We draw on one dimension of Hofstede's theory of cultural orientations—power distance belief, and one dimension of Haidt's work on moral reasoning—moral decoupling. Results from three studies on recent real-life cases—those pertaining to Harvey Weinstein, Brett Kavanaugh, and Peter Martins—reveal (...) interesting, consistent, and dramatic findings pertaining to these research questions. Specifically, compared to observers who endorse a low power distance belief, high PDB observers selectively suspend judgments of culpability and express higher evaluations of the alleged perpetrators, are significantly more forgiving of them, convey a lower preference for naming and shaming them, and consider the alleged transgressions as less serious. These outcomes are predicated on the psychological mechanism of moral decoupling. Both high and low PDB respondents decouple the perpetrators’ competence and morality. However, high PDB observers gauge the actions of the perpetrators by emphasizing competence, while low PDB observers gauge their actions by emphasizing morality. (shrink)

The initial online publication contained a typesetting mistake. The original article has been corrected.

DNA damage repair within telomeres are suppressed to maintain the integrity of linear chromosomes, but the accidental activation of repairs can lead to genome instability. This review develops the concept that mechanisms to repair DNA damage in telomeres contribute to genetic variability and karyotype evolution, rather than catastrophe. Spontaneous breaks in telomeres can be repaired by telomerase, but in some cases DNA repair pathways are activated, and can cause chromosomal rearrangements or fusions. The resultant changes can also affect subtelomeric regions (...) that are adjacent to telomeres. Subtelomeres are actively involved in such chromosomal changes, and are therefore the most variable regions in the genome. The case of Caenorhabditis elegans in the context of changes of subtelomeric structures revealed by long‐read sequencing is also discussed. Theoretical and methodological issues covered in this review will help to explore the mechanism of chromosome evolution by reconstruction of chromosomal ends in nature. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

This study focuses on CEO hubris and its detrimental effect on corporate financial performance along with an examination of critical corporate governance contingencies that may moderate the negative effect. From 654 observations of 164 Korean firms over the years 2001–2008, we found that CEO power exacerbated the negative effect of CEO hubris on corporate financial performance, whereas board vigilance mitigated it. This study provides empirical evidence that entrenchment problems arising from CEO hubris would be exacerbated as CEOs become more powerful, (...) but weakened as board of directors become more vigilant. Theoretical contributions and practical implications will be discussed. (shrink)

Company–cause fit has been one of the major issues in the domain of corporate social responsibility. This study tries to expand the perspective from company–cause to company–non-profit organization (NPO) fit, and it gives implications to firms looking for long-term collaboration with an NPO. Specifically, it suggests three types of fit, i.e., familiarity, business, and activity fit and investigates the potential effects of these fits in social alliances between companies and the partnering NPOs on consumer attributions of the firms’ motives for (...) the alliances. An experiment that used scenarios revealed that consumers perceive high-fitted alliances on the dimensions of the familiarity and activity fit as being more public-serving than low-matched ones. However, the consumers’ attribution of the motive is not different between the high and low business fit. The implications of the research results are discussed from an academic and practical standpoint. (shrink)

Cheating in the undergraduate classroom is not a new problem, and it is recognized as one that is endemic to the education system. This paper examines the highly normative behavior of using unauthorized assistance (e.g., a solutions manual or a friend) on an individual assignment within the context of an upper division undergraduate course in engineering mechanics. The findings indicate that there are varying levels of accepting responsibility among the students (from denial to tempered to full) and that acceptance of (...) responsibility can lead to identification of learning and necessary behavioral changes. The findings have implications for institutions and engineering faculty, in particular the need for consistent academic integrity education and the teaching of professional integrity and ethics. (shrink)