Physicians play a substantial role in facilitating communication regarding life-supporting treatment decision-making including do-not-resuscitate in the intensive care units. Physician-related fact...

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

Ben shu cong da liang xi fang zhe xue de chuan bo fen fan xian xiang zhong xun chu ma ke si zhu yi zhe xue zai zhong guo cheng wei li shi fa zhan zhi bi ran, qi ta zhe xue si xiang dou zai zhong guo chuan bo guo, zhi you ma ke si zhu yi cai you wu bi qiang da de sheng ming li.

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)

This study investigated students? perceptions of their own and their peers? academic dishonesty (AD), their reasons for this dishonesty, their achievement goals, and their willingness to report AD (WRAD) within a Chinese cultural context. The results identified students? belief that their peers had a greater likelihood of engaging in AD and had more motivation to do so than did the students themselves. Gender and academic major did not affect students? WRAD. However, students were significantly more willing to report classmates than (...) friends. In terms of the participants? self-perceptions and peer perceptions concerning motivations for AD, more female students cited the lack of penalties as the reason for their own and their peers? AD, whereas male students more frequently cited their lack of attention to schoolwork as the reason for their own AD. In contrast to students in the social sciences, business students more frequently cited inadequate capabilities as the reason for their AD, and engineering students more frequently attributed their AD to self-interest. Multiple regression analysis demonstrated that three motivations for AD (opportunism, inadequacy, and self-promotion) could positively predict AD, whereas mastery-approach goals could negatively predict AD. (shrink)

BackgroundBreast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.MethodsA cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at (...) least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received and did not receive CHM treatment were enrolled. The incidence rate and hazard ratio citation for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.ResultsDuring the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation], and the adjusted HR remained significant at 0.74 in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.ConclusionFinding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials. (shrink)

Recent studies have found abnormal levels of brain-derived neurotrophic factor in a variety of central nervous system diseases. This suggests that BDNF may be involved in the pathogenesis of these diseases. Moreover, regulating BDNF signaling may represent a potential treatment for such diseases. With reference to recent research papers in related fields, this article reviews the production and regulation of BDNF in CNS and the role of BDNF signaling disorders in these diseases. A brief introduction of the clinical application status (...) of BDNF is also provided. (shrink)

This study is intended to create an innovative contextual English learning environment making use of the widely used communication software, LINE ChatBot, based on the Artificial Intelligence Markup Language, in order to improve speaking and listening ability among learners. A total of 73 students were invited to participate in learning activities involving a 4-week English conversation exercise including both speaking and listening. Additionally, in order to explore the influence of competition on language acquisition, we added competition characteristics to the learning (...) activities in the experimental group to enhance learning motivation and learning outcomes. The results showed that with the help of the LINE ChatBot contextual learning environment, the performance of both groups of students was slightly enhanced, but no significant differences were found. Meanwhile, extrinsic motivation in both the experimental and control group was improved if they spoke anonymously. That is, the contextual learning environment based on the LINE ChatBot significantly improved the learners’ English speaking and listening ability. In addition, the results showed that the addition of a competition element effectively enhanced the learners’ intrinsic motivation to learn English on the LINE ChatBot. (shrink)

The concept of work engagement has aroused the interest of many scholars. However, there has been limited academic research in examining how authentic leadership can influence WE, which consequently influences organizational citizenship behavior and task performance. In particular, this study divides WE into cognitive engagement, emotional engagement, and physical engagement to fully reflect the engagement theory. This study introduces three dimensions of WE and tests the theoretical model to validate cognitive engagement, emotional engagement, and physical engagement. Empirical testing using a (...) survey of 151 employees of retail travel agencies in Taiwan revealed that the AL can influence cognitive engagement, emotional engagement, and physical engagement, and also OCB and TP. These analysis results can assist vendors to implement OCB and TP through WE and AL. (shrink)

Piracy is the greatest threat facing the music industry worldwide today. This study developed and empirically tested a model examining the antecedents of consumer attitude and behavioral intention toward music piracy behavior. Two types of music piracy behavior, unauthorized duplication/download and pirated music product purchasing, were examined. Based on a field survey in Taiwan, the results showed that attributive satisfaction, perceived prosecution risk, magnitude of consequence, and social consensus are very important in influencing customers attitude and behavioral intention toward two (...) types of music piracy behavior. In addition, singer/band idolization can affect the attitude and behavioral intention in the case of pirated music product purchasing. Perceived proximity was found to affect the attitude and behavioral intention in the case of pirated music product purchasing. However, it only influenced behavioral intention in the case of unauthorized duplication/download. (shrink)

Adverse childhood experiences are known to have deleterious effects on individuals across the life span, but less is known about how they affect grit, a strong predictor of achievements and well-being. This study seeks to investigate the effect of ACEs on grit in a sample of Chinese college students during the COVID-19 pandemic. Data were collected from 1,871 students across 12 universities in China. Findings indicated a significant effect of ACEs on grit, particularly abuse and neglect dimensions of ACE. Since (...) grit is particularly important for professional success, those who have experienced abuse and neglect victimization may struggle throughout their education, and subsequently, in their careers. This calls for interventions to buffer the effects of ACEs on grit. (shrink)

BackgroundNurses working in the intensive care unit clung tenaciously to their job during the COVID-19 pandemic in spite of enduring stressed psychological and physical effects as a result of providing nursing care for the infected patients, which indicates that they possessed a high degree of professionalism and career calling. The aim of this study was to explain the associations between resilience, thriving at work, and ethical leadership influencing the calling of ICU nurses.MethodsFrom December 2020 to January 2021 during the COVID-19 (...) pandemic, a cross-sectional survey of 15 provinces in China was conducted using an online questionnaire. A total of 340 ICU nurses completed sufficient responses to be used in the study. Sociodemographic factors, job demographic factors, resilience, calling, thriving at work, and ethical leadership were assessed using the questionnaire. General linear modeling, hierarchical linear regression analysis, and generalized additive model were performed to examine all the considered research hypotheses.ResultsResilience was positively and significantly associated with calling. Moreover, thriving at work partially mediated the relationship between resilience and calling. The indirect effect of resilience on calling was 0.204, and the direct effect of resilience on calling through thriving at work was 0.215. The total effect of resilience on calling was 0.419. In addition, ethical leadership played a moderating role in the relationship between resilience and calling.ConclusionGreater resilience can positively predict increased calling among Chinese ICU nurses during the COVID-19 pandemic. Moreover, thriving at work is a mechanism that partly transmits the positive effects of resilience on calling. Overall, nurses possessing greater resilience tend to maintain thriving at work in the face of such adversity, further resulting in subsequently increased calling. Besides, findings suggest that there is stronger influence of resilience on calling among nurses working in an organization managed by an ethical leader. The current findings may offer two insights for nursing practitioners and policymakers in the postpandemic world. First, resilience training and intervention are necessary to foster nurses' sense of thriving at work in the nursing industry, further promoting career calling. Second, better training and effort on the development of ethical leadership for leaders in nursing practice are essential to encourage followers to engage in social learning of ethical behaviors and abiding by normatively appropriate conduct, further enacting prosocial values and expressing moral emotions. (shrink)

BackgroundThis study aimed to elucidate the influence of dementia etiologies on the degree of caregiver burden and determine which factors predict a high caregiving burden.MethodsThis 18-month retrospective cohort study enrolled 630 patients and their caregivers from the Dementia Center of Changhua Christian Hospital. The care team performed face-to-face interviews every 6 months, for 18 months from when a diagnosis of dementia was made. The primary outcome was the change in Zarit Burden Interview scores. Generalized estimating equations were used for the (...) longitudinal data analysis.ResultsParticipants with Lewy body disease had a significantly higher caregiving burden compared with those with Alzheimer's disease after adjusting for patient and caregiver features. Caregivers of mixed-type dementia and frontotemporal dementia experienced a greater burden than caregivers of AD, at 6- and 18-month follow-up. Patients with more severe dementia, neuropsychiatric symptoms, being cared for by more than two caregivers, or utilizing social resources were associated with higher ZBI scores; the depressive mood of caregiver also predicted higher ZBI scores.ConclusionThis longitudinal study demonstrated that caregiver burden was influenced by the underlying dementia etiology of patients. The dementia care team should provide personalized education and transfer patients and caregivers to appropriate resources, especially for high-risk populations. (shrink)

Assisted reproductive technology treatment tends to involve significant physical and emotional commitments that can impact maternal, infant, and family health and well-being. An in-depth understanding of experiences is necessary to provide adequate support for women and their families during pregnancy and transition to parenthood following ART treatment. The aim of this study was to explore first-time mothers’ experiences of pregnancy and transition to parenthood following successful ART treatment in Taiwan. Twelve first-time mothers who conceived and gave live birth using ART (...) treatment were purposively selected from a fertility centre in Taipei, Taiwan. Women’s experiences in pregnancy and in their transition to motherhood were explored using semi-structured in-depth interviews. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. The mothers’ accounts reflected three main themes: ‘being different from mothers who became pregnant naturally’, ‘ensuring health and safety of the foetus’, and ‘welcoming new lives with excitement’. The difference mothers felt about themselves was evident in four subthemes: becoming pregnant after a long wait, feeling vulnerable during pregnancy, relying on family’s assistance and support, and worrying about the impact of ART on health. The theme on ‘ensuring health and safety of the foetus’ encompassed three subthemes: activities to protect the unborn baby, monitoring foetal movement constantly to maintain peace of mind, and receiving foetal reduction for the sake of the pregnancy. Narratives around ‘welcoming new lives with excitement’ reflected four subthemes: overcoming hardship for worthwhile results, realising one’s life and dreams, proving to be fertile enough to give birth, and return to normal life track. Findings indicate the need for educational and psychosocial interventions to support women and their families physically and psychologically during ART treatment. The stigma related to infertility and the psychosocial support from family are aspects to consider while planning intervention programmes. (shrink)

As an excellent management tool, service guarantee can improve the competitive advantage of enterprises and allow consumers to obtain high-quality products and services. However, in the current Chinese context, this tool has not played its proper function. One important reason is the perception deviation of Chinese consumers. This research analyzes the main reasons for this deviation, puts forward related hypotheses and research models, and discusses the influence of disposition to trust of contract, perceived structural assurance, and subjective norm on service (...) guarantee perception. Also, this study discusses SGP of customers through perceived risk and quality. Through the verification of 574 sample data, the main conclusions are as follows: Disposition to trust of contract, subjective norms, and PSA significantly affect SGP positively; SGP positively affects customer value ; and SGP s are obviously different between people of different ages, education levels, and income levels. Hopefully, these conclusions can have the following enlightenment to enterprises serving Chinese consumers: in the designing stage of service guarantee, perception of customers of this guarantee should be a consideration; CUV can be a proper direction if an enterprise wish to lead the guarantee perception of the customer; Not all products need the same level of service guarantee; and The proper service guarantee level depends on various statistical characteristics of target customers of the service. (shrink)

Using Reidenbach and Robin’s Multidimensional Ethics Scale, this study designs three scenarios related to academic dishonesty dilemmas to explore students’ moral philosophies, behavioral intentions, and ethical judgments and further examines whether students with different individual factors have differences in the above variables. A total of 605 students from two areas, Taiwan and Mainland China, participated in this study. The results indicated that Taiwanese students had stricter moral equity, relativism, and contractualism philosophies in the duplicate submission scenario than Mainland China students. (...) They also had stricter moral equity and relativism philosophies in the incomplete citation scenario. Similarly, relatively harsh relativism and contractualism philosophies accompanied by a low level of willingness to be a perpetrator in the failure to cite research published in other countries scenario were found. In addition, females applied relatively harsh moral equity and utilitarianism to all scenarios, reporting that they and their peers were less likely to engage in all AD activities. Graduates had a stricter egoism attitude toward duplicate submission and had stricter moral equity, relativism, and contractualism philosophies toward the behavior of incomplete citation. Graduate students also had strict moral equity, relativism, egoism, and contractualism beliefs in the failure to cite the foreign research scenario. Finally, regression analysis showed that moral equity, contractualism, and self-behavioral intention are significant predictors of students’ ethical evaluations in the three scenarios. (shrink)

Drawing upon the massive redevelopment catalyzed by government-led urban renewal in Hong Kong in the past two decades, this book recharges the story of post-colonial Hong Kong through care, displacement, and how care is displaced in urban governance.

Business Ethics, the Environment &Responsibility, Volume 31, Issue 4, Page 999-1013, October 2022.

Reorienting the Political examines the reception of two controversial German philosophers, Carl Schmitt and Leo Strauss, in the Chinese-speaking world. This volume explores the powerful resonance of both thinkers in Chinese political thought from a cross-cultural and interdisciplinary perspective.

Ruyu HungNational Chiayi UniversityThis collective writing is intended to portray the contour of philosophy of education in contemporary Taiwan, resounding many beautiful counterparts in EPAT (Bies...

Piracy is the greatest threat facing the global music industry today. This study explores the effects of artist adoration and the perceived risk of being caught on the attitude and intention to engage in pirating a digital song among college students. The moderating effect of cultural environment factor is also examined. Experiments using between-group factorial designs were conducted in the United States and Taiwan. The results show that perceived risk of getting caught and cultural environment are important factors that can (...) significantly affect the attitude and intention toward downloading unauthorized music. In addition, a two-way (Perceived Risk ? Culture) and a three-way interaction in the model are also observed. (shrink)