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)

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.

本书共由五部分组成。第一部分是对当前现实中道德疼痛与尴尬问题的剖析与审视;第二部分是对伦理学领域中历史与现实的理论难点问题的思考和分析;第三部分是对未来中国道德前景的思考与瞻望;第四部分是谈话录;第五 部分是对一些经典著作和友人作品的评论。.

This study analyzes the influence of behavioral foundation factors and corporate strategic behavior on the formulation of corporate dividend policy. We use the Logit model and the OLS model for estimating the empirical model. The year- and industry-fixed effects are controlled in the model. We consider the behavioral foundations in three dimensions-ambiguity aversions, risk aversion, and loss aversion. The results show firms with high ambiguity or high risk infrequently pay dividends but firms with loss-averse behavior tend to pay dividends. This (...) paper also provides evidence that a firms’ business strategy influences its corporate dividend policy. Aggressive firms inhibit the payout of dividends. In additional tests, we find the results remain unchanged in those firms with high corporate governance or high growth opportunities. (shrink)

Body ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a (...) rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness. (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)

Product counterfeiting, a serious problem throughout the world, is particularly challenging for luxury brands, which often have simple designs and a value that depends largely on buyers' perceptions. This study incorporates the concept of customer value into an investigation of the anticounterfeiting strategies. Both hedonic and utilitarian values positively influence customer loyalty toward luxury brands. As a means to strengthen customer values, legal and product strategies positively influence customers' hedonic value, whereas communication and product strategies positively influence their utilitarian value. (...) The managerial implications of these findings and directions for further research are discussed. (shrink)

Ben shu gong you ba jiang zu cheng, fen bie shi sheng ren bi ke xue er zhi, Wang Yangming de xin xue ti xi, shi gong yu bing xue, wen xue si xiang yu shi wen chuang zuo, jiao yu si xiang yu shi jian, Yangming hou xue, Yangming xue zai jin xian dai de ying xiang, Yangming wen hua yu Guizhou lü you. Mei ge lun ti lun shu ji zhong, shen du shi zhong, xu shu xing yu (...) yan tong su liu chang, gu shi xing qiang, hen shi he da zhong du zhe yue du. wei qi fa du zhe si kao, zeng qiang yue du xiao guo, zai mei yi jiang zhi hou shi liang she zhi le yi xie ming ci jie shi, jian da tao lun ti. ling pei he xiang guan wen zi, she zhi le yi xie tu pian, bei ke he Yangming shu fa zuo pin deng, ju you ji jia de guan shang xing. (shrink)

Urban streetscapes are outdoor areas in which the general public can appreciate green landscapes and engage in outdoor activities along the street. This study tested the extent to which the degree of awareness of urban street trees impacts attention restoration and perceived restorativeness. We manipulated the degree of awareness of street trees. Participants were placed into four groups and shown different images: (a) streetscapes with absolutely no trees; (b) streetscapes with flashes of trees in which participants had minimal awareness of (...) the content; (c) streetscapes with trees; and (d) streetscapes with trees to which participants were told to pay attention. We compared the performance of 138 individuals on measures of attention and their evaluations of perceived restorativeness. Two main findings emerged. First, streetscapes with trees improved the performance of participants on attentional tests even without their awareness of the trees. Second, participants who had raised awareness of street trees performed best on the attentional test and rated the streetscapes as being more restorative. These findings enhance our knowledge about the role of an individual's awareness of restorative elements and have implications for designers and individuals who are at risk of attentional fatigue. (shrink)

First we show that the classical two-player semantic game actually corresponds to a three-valued logic. Then we generalize this result and give an n-player semantic game for an n + 1-valued logic with n binary connectives, each associated with a player. We prove that player i has a winning strategy in game G if and only if the truth value of φ is $t_i $ in the model M, for 1 ≤ i ≤ n; and none of the players has (...) a winning strategy in G if and only if the truth value of φ is $t_o $ in M. (shrink)

This study proposed and examined a conceptual framework on the influence of real estate brokers’ personalities, psychological empowerment, social capital, and knowledge sharing on their innovation performance, and used moral hazard as a moderating variable. We used structural equation modeling for data analysis and estimation. The participants were real estate brokers in Kaohsiung City. A total of 1,000 questionnaires were administered to 100 branch offices of real estate companies, 571 of which were later recovered from 80 branch offices. After removing (...) 52 for being invalid, we were left with 519 valid questionnaires, indicating a 51.9% recovery rate. The empirical results suggest that the real estate brokers’ personalities and psychological empowerment positively and significantly influence social capital; personality and psychological empowerment also positively and significantly influence their innovation performance; and social capital significantly influences knowledge sharing, which in turn positively and significantly influences the brokers’ innovation performance. In environments with higher levels of moral hazard, the influence of social capital on the brokers’ knowledge sharing is significantly diminished. (shrink)

Mo Tzu was active in ancient China's academic world during the late Spring and Autumn period and the early Warring States period when the slave system collapsed and the feudal system was gradually established. During this time of radical social change, class antagonism and struggle were acute, and ideological and theoretical struggles were fierce. According to the social classes to which they belonged, thinkers from different social classes and strata gave different answers for the existing social problems. As a result, (...) many schools of thought emerged, and "a hundred schools of thought contended." Among these schools of thought, advocates of Confucianism and followers of Mo Tzu were the most influential. Mutual repudiations developed between the advocates of Confucianism and the followers of Mo Tzu and between the followers of Mo Tzu and the advocates of Yang Tzu. Therefore, criteria for correct opinions became an important question in society. On this question, Mo Tzu voiced his views and conducted a thorough investigation. (shrink)

We associate the semantic game with chance moves conceived by Blinov with Blamey’s partial logic. We give some equivalent alternatives to the semantic game, some of which are with a third player, borrowing the idea of introducing the pseudo-player called Nature in game theory. We observe that IF propositional logic proposed by Sandu and Pietarinen can be equivalently translated to partial logic, which implies that imperfect information may not be necessary for IF propositional logic. We also indicate that some independent (...) quantifiers can be regarded as dependent quantifiers of indeterminate sequence, using the interjunction connective in partial logic. We conclude our paper by indicating some further research in a more general setting. (shrink)

Double 11 shopping carnival, celebrated by the most successful electronic-commerce Chinese company, Alibaba, has always been the online shopping festival with the highest turnover and involves the largest number of consumers and enterprises in China. This study integrates the elaboration likelihood model and stimulus-organism-response theory to study the dual-processing path of information, which drives customers’ behavioral intention on Double 11. There are 454 valid samples of data are collected, and the research model is tested using the partial least squares method. (...) Results show that in the Double 11 context, two different processing mechanisms affect consumers’ behavioral intention. Thereinto, consumers’ behavioral intention is more affected by the peripheral path than the central path. The affective experience affected by the information stimulus has a greater impact on the behavioral intention than cognitive experience. Furthermore, we find situational involvement have different moderating effects on the relationship between two experiences and behavioral intention. (shrink)

In 2016 the Chinese government initiated a nationwide campaign aiming to eliminate poverty in China by 2020. Over 20% of listed firms in China have made significant contributions to the campaign. Using hand-collected data on listed firms’ contributions to the campaign and multivariate analyses, we examine whether managers’ and politicians’ personal incentives play an important role in firms’ contributions to the campaign. The results show that firms are more likely to contribute if they are state-owned and managers are appointed by (...) governments, if managers have a higher risk of being targeted in a concurrent anti-corruption campaign, if the political leaders in their province are new or intend to seek promotion, and if managers or directors have experienced poverty in their early life. The results suggest that it is important to consider managers’ and politicians’ personal incentives in CSR activities that could have a grand social impact. (shrink)

This article explores intersections between critical theory, Buddhism, and film studies in what Jürgen Habermas characterizes as the current ‘post-secular society’. I use A...

Background Adherence to ethical guidelines and regulations and protecting and respecting the dignity and autonomy of participants by obtaining a valid informed consent form (ICF) prior to participation in research are crucial; The subjects did not add signatures next to the corrections made to signatures or dates on the ICF, Multiple signatures in other fields, ICF missing/missing signature, Incorrect ICF version Signed after modification, Correction tape used to correct signature, Impersonated signature, Non-research-member signature, however, ICFs are often not properly completed, (...) which must be addressed. This study analyzed ICF signing errors and implemented measures to reduce or prevent these errors. Methods We used the plan–do–check–act (PDCA) cycle to help improve the correctness and validity of ICF signing. Results Interim and final reports from January 2016 to February 2020 including 363 ICFs were studied. The total proportion of correct ICF signatures (200, 83.3%) following the PDCA intervention was significantly higher than that before the intervention (P < 0.05). Analysis of the types of signing error demonstrated that signature errors were significantly reduced after the intervention, particularly for subjects did not add signatures next to the corrections made to signatures or dates on the ICF (16, 6.7%) and impersonated signature (0; P < 0.05). Conclusions The proportions of other error types—multiple signatures in other fields, missing or unsigned ICF, incorrect signature order, incorrect ICF version, use of correction tape to correct signature, and non-medical profession members signing the ICF—did not differ significantly. (shrink)

The global impact of COVID-19 has seriously affected health and livelihood in every country or region, especially in terms of physical consumption behaviors. Hairdressing is an essential physical consumption behavior. To prevent infection, the consumption model for using the beauty industry matchmaking platform has been used during the pandemic. This study investigates the changes in the behavior of media app users in the beauty industry in the post-epidemic era of COVID-19. The COM-B model is the basis for a research framework (...) to study the factors that affect changes in behavior in the areas of Capability, Motivation, and Opportunity of the theoretical framework. A new dimension of fashion sense has expanded the application and validation of the COM-B model to determine the causal relationship between the ability to pursue beauty, motivation, fashion sense, and opportunities by using the platform and the dimension of user behavior. The study finds that fashion sense in the BIMP has a positive and significant impact on beauty care ability, self-motivation to pursue beauty and future cooperation opportunities. The ability, motivation and opportunity to act are all positively significant, which is in agreement with the theoretical framework of the COM-B model. There is no mediating effect for motivation between fashion sense and behavior. The results of this study show that increasing the sense of fashion for members using the BIMP will increases active behavior for members using the platform. This study also proposes practical suggestions for the operation of the BIMP based on the results. (shrink)

The American Journal of Bioethics, Volume 11, Issue 10, Page 11-13, October 2011.

This study investigates the role of religion in shaping the norms of citizenship from a cultural perspective for an East Asian country that exhibits fundamental differences in social contexts from Western advanced democracies. Using data drawn from the Taiwan Social Change Survey, we find that the Eastern religions of Buddhism, Taoism, and Folk Religions are important for explaining the formation of the concept of being a good citizen. This study further examines the relationships between citizenship norms and various conventional and (...) unconventional types of political participation. The empirical results herein suggest that duty-based citizenship and engaged citizenship have significant differences in their effects on political participation. (shrink)

The study of illiberal constitutions has recently generated enormous scholarly interests. Few, however, have focused on whether democracies may still embrace constitutionalism mixed with illiberal elements. This article explores mixed constitutions of South Korea and Taiwan, the two democracies with vibrant civil societies in East Asia. Three distinctive features in both constitutions have demonstrated illiberal elements, including duty clauses imposed upon citizens, directives requiring the State to enact laws to fulfill the goals of governance, and constitutional cultures that exhibit high (...) deference to political elites based on the Confucian tradition. This article further examines the impacts of such mixed constitutions on three challenging issues: managing pandemic crisis, applying artificial intelligence, and combating fake news. This article finds mixed features of illiberal and democratic constitutions in the two countries by giving their governments more space in managing urgent crises, showing higher deference to experts who are generally trusted by the public, and making compromises to individual rights for greater public good. However, this does not imply that the government is not made democratically accountable, or rights and freedoms are not asserted or valued by individuals. To the contrary, nongovernmental organizations and courts in the two countries continue to act as a counterbalancing force, challenging the government’s policies and decisions if not reasonably balanced, weakening the tendency of power concentration that has been seen in other countries where democratic backsliding or authoritarian governance is gradually revived. (shrink)

The Hygiene Hypothesis has been recognized as an important cornerstone to explain the sudden increase in the prevalence of asthma and allergic diseases in modernized culture. The recent epidemic of allergic diseases is in contrast with the gradual implementation of Homo sapiens sapiens to the present-day forms of civilization. This civilization forms a gradual process with cumulative effects on the human immune system, which co-developed with parasitic and commensal Helminths. The clinical manifestation of this epidemic, however, became only visible in (...) the second half of the twentieth century. In order to explain these clinical effects in terms of the underlying IgE-mediated reactions to innocuous environmental antigens, the low biodiversity of antigens in the domestic environment plays a pivotal role. The skewing of antigen exposure as a cumulative effect of reducing biodiversity in the immediate human environment as well as in changing food habits, provides a sufficient and parsimonious explanation for the rise in allergic diseases in a highly developed and helminth-free modernized culture. Socio-economic tendencies that incline towards a further reduction of environmental biodiversity may provide serious concern for future health. This article explains that the “Hygiene Hypothesis”, the “Old Friends Hypothesis”, and the “Skewed Antigen Exposure Hypothesis” are required to more fully explain the rise of allergy in modern societies. (shrink)

Photovoltaic power forecasting can provide strong support for the safe operation of the power system. Existing forecasting methods are ineffective for grid scheduling decisions or risk analysis. The novel multicluster interval prediction method is proposed to consider the volatility and randomness of PV power output. First, this method utilizes the sparse autoencoder and Bayesian regularized NARX network for point forecasting of PV power. Second, density peak clustering improved by kernel Mahalanobis distance is applied to classify the dataset into multiple clusters, (...) including forecasting error and meteorological factors. Finally, the joint probability density is established by multivariate kernel density estimation to accomplish the PV power interval prediction. The proposed hybrid method is applied for the interval prediction of PV power at Yulara, Australia. Comparative research of point forecasting is implemented to evaluate the machine learning and deep learning methods, with the proposed SAE-BRNARX under four different periods. Results shows that the average values of nRMSE, MRE, nMAE, and R2 for the four periods are 4.45%, 0.90%, −0.15%, 3.39%, and 95.93%, respectively. Moreover, the results of interval prediction obtained by the other interval prediction approaches are compared with the proposed KMDDPC-MKDE. It shows that the average values of PICP, PINAW, ACE, and nMPICD for four periods are 93.93%, 9.50%, 3.93%, and 7.10% at 90% confidence level, respectively. Outcomes demonstrate that the proposed method can obtain more accuracy, a higher coverage rate, narrower average bandwidth, and a closer distance between the middle of interval and actual value than other methods. (shrink)

COVID-19 began to spread worldwide in early 2020. Various governments have taken measures such as isolation, travel bans, and evacuation, mandating people to wear masks and go out less, in an attempt to prevent the spread of the virus. Governments also restrict human contact service industries, including beauty and hair salons. When the pandemic was very serious, consumers had great doubts about going for hairdressing so the beauty industry was greatly affected. This study designed and developed an app platform that (...) considers the COVID-19 and is used for the psychological role of consumer safety. The methodology of this research is a qualitative study. Based on the Capability, Opportunity, Motivation, Behavior model, and presenting the context of capabilities, opportunities, and motives of the theoretical framework, this study investigates the factors that identify the demand for the development of the platform for the beauty industry app matching mechanism. Four groups of people including consumers, beauty technicians, store managers, and application development engineers all conduct interviews based on their ability, opportunity, and motivation after experiencing the using application of OpenBeautiful. The results found that all groups of people already had the knowledge and ability to avoid infection in a pandemic, so it was possible to establish the need and feasibility of using the app platform. The use of the beauty industry app platform can bring new consumption patterns and career opportunities, and can trigger more business behavior activities. Therefore, this study starts from the COM-B model, and then explores the user needs of the platform according to the COM-B model framework, and proposes the mechanism and platform of app matching. Finally, based on the conclusion of the study, we propose practices and suggestions for the future operation of the app matching platform. (shrink)

Over the last half decade or so, Jürgen Habermas has increasingly employed the interview format, both as a means of presenting his changing views on philosophical topics in an accessible way, and as a means of debating current social and political issues. This new, expanded edition of Autonomy and Solidarity includes an additional five interviews in which Habermas discusses such themes as the history and significance of the Frankfurt School, the social and political development of post-war Germany, the moral status (...) of civil disobedience, the implications of the "Historians' Dispute," and the function of national identity in the modern world. Never before published autobiographical material covering Habermas' early years at the Frankfurt Institute for Social Research is followed by an extended philosophical interrogation of his latest thinking on the relations between ethics, morality and law. With an extended introduction by Peter Dews, exploring the status and prospects of Critical Theory in the light of the recent revolutionary transformations in Europe, Autonomy and Solidarity should be of interest and value both to newcomers and those already familiar with Habermas' thought. (shrink)

Over the last half decade or so, Jürgen Habermas has increasingly employed the interview format, both as a means of presenting his changing views on philosophical topics in an accessible way, and as a means of debating current social and political issues. This new, expanded edition of Autonomy and Solidarity includes an additional five interviews in which Habermas discusses such themes as the history and significance of the Frankfurt School, the social and political development of post-war Germany, the moral status (...) of civil disobedience, the implications of the "Historians' Dispute," and the function of national identity in the modern world. Never before published autobiographical material covering Habermas' early years at the Frankfurt Institute for Social Research is followed by an extended philosophical interrogation of his latest thinking on the relations between ethics, morality and law. With an extended introduction by Peter Dews, exploring the status and prospects of Critical Theory in the light of the recent revolutionary transformations in Europe, Autonomy and Solidarity should be of interest and value both to newcomers and those already familiar with Habermas' thought. (shrink)

The relationship between gender and ethics has been extensively researched. However, previous studies have assumed that the gender–ethics association is constant; hence, scholars have seldom investigated factors potentially affecting the gender–ethics association. Thus, using managers as the research target, this study examined the relationship between gender and ethics and analyzed the moderating effect of cultural values on the gender–ethics association. The results showed that, compared with female managers, their male counterparts are more willing to justify business-related unethical behaviors such as (...) bribery and tax evasion, and that the gender difference in ethics becomes more pronounced under the cultural dimensions of collectivism, humane orientation, performance orientation, and gender egalitarianism. This study used data obtained through surveying 2,754 managers in 27 nations. (shrink)

We investigate two issues about the subjective experience of one's body: first, is the experience of owning a full-body fundamentally different from the experience of owning a body-part?Second, when I experience a bodily sensation, does it guarantee that I cannot be wrong about whether it is me who feels it? To address these issues, we conducted a series of experiments that combined the rubber hand illusion (RHI) and the “body swap illusion.” The subject wore a head mounted display (HMD) connected (...) with a stereo camera set on the experimenter's head. Sitting face to face, they used their right hand holding a paintbrush to brush each other's left hand. Through the HMD, the subject adopted the experimenter's first-person perspective (1PP) as if it was his/her own 1PP: the subject watched either the experimenter's hand from the adopted 1PP, and/or the subject's own hand from the adopted third-person perspective (3PP) in the opposite direction (180°), or the subject's full body from the adopted 3PP (180°, with or without face). The synchronous full-body conditions generate a “self-touching illusion”: many participants felt that “I was brushing my own hand!” We found that (1) the sense of body-part ownership and the sense of full-body ownership are not fundamentally different from each other; and (2) our data present a strong case against the mainstream philosophical view called the immunity principle (IEM). We argue that it is possible for misrepresentation to occur in the subject's sense of “experiential ownership” (the sense that I am the one who is having this bodily experience). We discuss these findings and conclude that not only the sense of body ownership but also the sense of experiential ownership call for further interdisciplinary studies. (shrink)

Short-term motor practice leads to plasticity in the primary motor cortex. The purpose of this study is to investigate the factors that determine the increase in corticospinal tract excitability after motor practice, with special focus on two factors; “the level of muscle activity” and “the presence/absence of a goal of keeping the activity level constant.” Fifteen healthy subjects performed four types of rapid thumb adduction in separate sessions. In the “comfortable task” and “forceful task”, the subjects adducted their thumb using (...) comfortable and strong forces. In the “comfortable with a goal task” and “forceful with a goal task”, subjects controlled the muscle activity at the same level as in the C and F, respectively, by adjusting the peak electromyographic amplitude within the target ranges. Paired associative stimulation, which combines peripheral nerve stimulation and transcranial magnetic stimulation, with an inter-stimulus interval of 25 ms was also done. Before and after the motor tasks and PAS25, TMS was applied to the M1. None of the four tasks showed any temporary changes in behavior, meaning no learning occurred. Motor-evoked potential amplitude increased only after the FG and it exhibited a positive correlation with the MEP increase after PAS25, suggesting that FG and PAS25 share at least similar plasticity mechanisms in the M1. Resting motor threshold decreased only after FG, suggesting that FG would also be associated with the membrane depolarization of M1 neurons. These results suggest task-dependent plasticity from the synergistic effect of forceful muscle activity and of setting a goal of keeping the activity level constant. (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)

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)

This study examines the effects of leader emotional intelligence, leadership styles, organizational commitment, and trust on job performance. A questionnaire was administered to the participants, who were real estate brokers in Kaohsiung City. Of the 980 questionnaires administered, 348 valid responses were received, indicating an effective response rate of 35.5%. Structural equation modeling was used for the analysis. The results show that leader emotional intelligence has a significant and positive effect on trust in supervisors, and transformational leadership and trust within (...) a team have significant and positive effects on job performance. In addition, organizational commitment has a significant and positive effect on job performance. Trust within a team mediates the significant and positive effect of leader emotional intelligence on job performance. Although transactional leadership has no direct, positive, and significant effects on employee job performance, trust in the workplace shaped by a leader’s leadership style will empower a team’s spirit and boost their morale, thereby indirectly affecting their job performance in a positive manner. (shrink)