This article examines central tensions in cybernetics, defined as the study of self-organization, communication, automated feedback in organisms, and other distributed informational networks, from its wartime beginnings to its contemporary adaptations. By examining aspects of both first- and second-order cybernetics, the article introduces an epistemological standpoint that highlights the tension between its definition as a theory of recursion and a theory of control, prediction, and actionability. I begin by examining the historical outcomes of the Macy Conferences to provide a context (...) for cybernetics’ initial development for scientific epistemology, ethics, and socio-political thought. I draw extensively from Norbert Wiener, Heinz von Foerster, Ross Ashby, and Gregory Bateson, key figures of this movement. I then elaborate upon certain premises of cybernetics to further elucidate an intellectual history from which to begin to construct a cybernetic epistemology. I conclude by offering the second-order cybernetic concept of recursivity as a model and method for ethico-epistemological questioning that can account for both the constructive potential and the limitations of cybernetics in science and society. (shrink)

In Plato’s Republic, Socrates Famously argues that a just city has to have three distinct classes performing three distinct functions. The producer class is the largest of the three, with the job of taking care of the city’s material needs. It is widely accepted that individual producers in this class are appetitive—appetitive in the sense that they only value bodily and material goods as intrinsic goods and conduct their lives only to maximize those goods.1 In this paper, I want to (...) argue against this reading.The widely accepted picture of appetitive producers is closely tied to the question of what motivates the producers to do what they do. The argument goes something like this. Socrates argues that the soul .. (shrink)

Turnover is an important career decision that influences both individual employees and their organizations. While human resource management scholars have long sought to understand critical components of a workplace where employees want to stay, ethics has become a primary factor of interest in public sector turnover intention studies only in recent years. This article contributes to this growing line of research by investigating if and how ethical work environment influences public employees’ turnover intentions, and how this relationship is moderated by (...) an employee’s position of power measured by supervisory status. The findings suggest that ethical work environment is a critical determinant of public employees’ turnover intentions and that supervisory status can moderate this relationship. (shrink)

We analyze the use of Silbot – a “dementia-prevention robot” – in a regional health center in South Korea. From our on-site observation of the Silbot classes, we claim that the efficacy of the robot class relies heavily on the “strained collaboration” between the human instructor and the robot. “Strained collaboration” refers to the ways in which the instructor works with the robot, attempting to compensate for the robot’s functional limitation and social awkwardness. In bringing Silbot into the classroom setting, (...) the instructor employs characteristic verbal tones, bodily movements, and other pedagogical tactics. The instructor even talks over the robot, downplaying its interactional capacity. We conclude that any success of such robot programs requires a deeper understanding of the spatial and human context of robot use, including the role of human operators or mediators and also that this understanding should be reflected in the design, implementation, and evaluation of robot programs. (shrink)

This study aims to examine how service employees’ perceptions of corporate social responsibility affect their creativity at work and its mediated link through compassion at work and their intrinsic motivation. Working with a sample of 250 hotel employees in South Korea, structural equation modeling is employed to test research hypotheses. The results of this research suggest that employees’ perceptions of CSR are positively related to employee creativity. Second, compassion at work mediated the positive relationship between employees’ perceptions of CSR and (...) creativity. Third, employees’ intrinsic motivation also mediated the positive relationship between employees’ perceptions of CSR and employee creativity. Finally, the relationship between employees’ perceptions of CSR and employee creativity is sequentially and fully mediated by compassion at work and their intrinsic motivation. The theoretical and managerial implications of the results and limitations of the study are discussed, and future research directions are suggested. (shrink)

The goal of this thesis is to undo those assumptions about understanding and the doxastic and social relationships that are concomitant with those assumptions, while offering a different way of construing understanding that is conducive to allowing Christian religious educators to move forward in their work, especially as that work concerns intergenerational strife. This rewriting of our notions of understanding and relationship will be in a direction wherein thedistinctions between faith, knowledge, self-understanding, enculturation, and ethical choice are blurred. Accordingly, this (...) thesis finds the concern with many of those interdisciplinary approaches to the study of philosophy, theology, and education that have been influenced by both Korean Christian religious education and its radical, deconstructive re-positionings. The thesis also attempts to reflexively deploy such approaches throughout. (shrink)

Government-sponsored school lunch programs have garnered attention from activists and policymakers for their potential to promote public health, sustainable diets, and food sovereignty. However, across country contexts, these programs often fall far short of their transformative potential. It is vital, then, to identify policies and organizing strategies that enable school lunch programs to be redesigned at the national scale. In this article, we use document analysis of historical newspapers and government data to examine the motivating factors and underlying conditions that (...) allowed South Korea’s universal free, eco-friendly school lunch program to become a tool for advancing social justice and ecological goals at the national scale. We analyze the socio-historical evolution and current status of the Korean school lunch program, combining the multi-level perspective with insights from environmental sociology and critical food studies, in order to shed light on the factors that enabled the program to become an innovative niche and articulate the opportunities and challenges it now faces. We identify the state-sponsored creation of what we call “precautionary infrastructure” as a key anchoring mechanism between the school food niche and agri-food regime. Precautionary infrastructure includes new supply chains, certification standards, and sourcing policies that provide a stable market for eco-friendly farms and small-scale producers, while minimizing the environmental health risks of school lunch by delivering organic and pesticide-free ingredients to on-site kitchens that serve free lunches to all students. This analysis offers insight into how public school-lunch programs can become protected niches that help drive sustainability transitions within agri-food systems. (shrink)

Obstructive sleep apnea (OSA) severely impacts sleep and has long-term health consequences. Treating sleep apnea with continuous positive airway pressure (CPAP) not only relieves obstructed breathing, but also improves sleep. CPAP improves sleep by reducing apnea-induced awakenings. CPAP may also improve sleep by enhancing features of sleep architecture assessed with electroencephalography (EEG) that maximize sleep depth and neuronal homeostasis, such as the slow oscillation and spindle EEG activity, and by reducing neurophysiological arousal during sleep (i.e., beta EEG activity). We examined (...) cross-sectional differences in quantitative EEG characteristics of sleep, assessed with power spectral analysis, in 29 adults with type 2 diabetes treated with CPAP and 24 adults undergoing SHAM CPAP treatment (total n = 53). We then examined changes in spectral characteristics of sleep as the SHAM group crossed over to active CPAP treatment (n = 19). Polysomnography (PSG) from the CPAP titration night was used for the current analyses. Analyses focused on EEG frequencies associated with sleep maintenance and arousal. These included the slow oscillation (0.5–1 Hz), sigma activity (12–16 Hz, spindle activity), and beta activity (16–20 Hz) in F3, F4, C3, and C4 EEG channels. Whole night non-rapid eye movement (NREM) sleep and the first period of NREM spectral activity were examined. Age and sex were included as covariates. There were no group differences between CPAP and SHAM in spectral characteristics of sleep architecture. However, SHAM cross-over to active CPAP was associated with an increase in relative 12–16 Hz sigma activity across the whole night and a decrease in average beta activity across the whole night. Relative slow oscillation power within the first NREM period decreased with CPAP, particularly for frontal channels. Sigma and beta activity effects did not differ by channel. These findings suggest that CPAP may preferentially enhance spindle activity and mitigate neurophysiological arousal. These findings inform the neurophysiological mechanisms of improved sleep with CPAP and the utility of quantitative EEG measures of sleep as a treatment probe of improvements in neurological and physical health with CPAP. (shrink)

The dominant position of e-commerce is especially being articulated in the retailing industry once again due to several constraints that the world faces in the COVID-19 pandemic era. In this regard, this study explores the significant role of trust transfer and the moderating effect of consumers’ neurotic traits in the framework of trust-satisfaction-repurchase intention in the e-commerce context based on a survey with 406 Korean e-commerce consumers. Moreover, a prediction-oriented segmentation technique combined with structural equation models was utilized to reveal (...) consumers’ probable hidden heterogeneous characteristics. The outcomes of the global model SEM analysis indicate that offline-online trust transference occurs in e-commerce, and the conveyed trust significantly influences satisfaction and consumers’ repeat purchase intention through satisfaction. Neuroticism also has significant positive effects on trust transfer in the global model. However, results in three subgroups generated by POS show heterogeneous characteristics that considerably differed from the global model test results. The implications from this study will be beneficial to field practitioners in the e-commerce industry in addressing the importance of trust transfer, negative neurotic traits as well as heterogeneous aspects of consumers. (shrink)

We analyze the use of Silbot – a “dementia-prevention robot” – in a regional health center in South Korea. From our on-site observation of the Silbot classes, we claim that the efficacy of the robot class relies heavily on the “strained collaboration” between the human instructor and the robot. “Strained collaboration” refers to the ways in which the instructor works with the robot, attempting to compensate for the robot’s functional limitation and social awkwardness. In bringing Silbot into the classroom setting, (...) the instructor employs characteristic verbal tones, bodily movements, and other pedagogical tactics. The instructor even talks over the robot, downplaying its interactional capacity. We conclude that any success of such robot programs requires a deeper understanding of the spatial and human context of robot use, including the role of human operators or mediators and also that this understanding should be reflected in the design, implementation, and evaluation of robot programs. (shrink)

This paper examines the influence of CEO career horizon problems on corporate social responsibility. We assume that as CEOs are getting older, they tend to disengage in CSR due to their shorter career horizons. We further argue that high levels of industry-level discretion and blockholder ownership amplify the negative effects of CEO age on CSR. Using a panel sample of US-based firms over 2004–2009, we do not find the main effect of CEO age on CSR, but find support for the (...) moderating effects, such that CEO age is negatively associated with CSR when there are high levels of ILD and blockholder ownership. Therefore, results suggest that CEO career horizon problems matter for CSR when CEOs have sufficient discretion over the firm’s strategic decisions and outside blockholders put more pressure on CEOs to engage in financial earning management. (shrink)

Maximum likelihood (ML) estimation of categorical multitrait-multimethod (MTMM) data is challenging because the likelihood involves high-dimensional integrals over the crossed method and trait factors, with no known closed-form solution. The purpose of the study is to introduce three newly developed ML methods that are eligible for estimating MTMM models with categorical responses: Variational maximization-maximization (e.g., Rijmen and Jeon, 2013 ), alternating imputation posterior (e.g., Cho and Rabe-Hesketh, 2011 ), and Monte Carlo local likelihood (e.g., Jeon et al., under (...) revision). Each method is briefly described and its applicability for MTMM models with categorical data are discussed. (shrink)

This paper explores and defends the idea that mental properties and their physical bases jointly cause their physical effects. The paper evaluates the view as an emergentist response to the exclusion problem, comparing it with a competing nonreductive physicalist solution, the compatibilist solution, and argues that the joint causation view is more defensible than commonly supposed. Specifically, the paper distinguishes two theses of closure, Strong Closure and Weak Closure, two causal exclusion problems, the overdetermination problem and the supervenience problem, and (...) argues that emergentists can avoid the overdetermination problem by denying Strong Closure and respond to the supervenience problem by accepting the joint causation view. (shrink)

The overdetermination problem has long been raised as a challenge to nonreductive physicalism. Nonreductive physicalists have, in various ways, tried to resolve the problem through appeal to counterfactuals. This essay does two things. First, it takes up the question whether counterfactuals can yield an appropriate notion of causal redundancy and argues for a negative answer. Second, it examines how this issue bears on the mental causation debate. In particular, it considers the argument that the overdetermination problem simply does not arise (...) on a dependency conception of causation and shows why this idea, though initially appealing, does not address the real problem. As the essay shows, the idea derives its spurious plausibility from the fact that the dependency conception cannot even make sense of our pretheoretic idea of causal redundancy. The essay concludes by briefly discussing a possible picture of mental causation that suggests itself in light of these results. (shrink)

This paper examines the Fair Trade practices of Dure, a Korean consumer cooperative, through the extended cooperative enterprise citizenship framework. Extended cooperative citizenship means that cooperatives should replace citizenship and fill the gaps in the weakening public service sector. As dual-purpose business organizations, cooperatives have already played essential roles as extended corporate citizens. However, previous literature regarding CSR or cooperatives has not sufficiently explored the social responsibility of cooperatives. Furthermore, corporate citizenship is generally regarded as a singular and static concept. (...) Therefore, this paper analyses Dure’s Fair Trade practices through the newly developed framework. Significantly, this article clarifies how Dure collaborates with key stakeholders and upholds their civil, political, and social rights through Fair Trade. This paper also explains how cooperative enterprise citizenship has changed as Fair Trade practices have shifted. Two implications of this research are revealed. First, the paper develops a new analytical model to explain the dynamics of corporate citizenship and Fair Trade practices. Second, the research provides details about the social responsibility of Korean consumer cooperatives based on Fair Trade that will have practical applications for practitioners in the business sector. (shrink)

This integrative review aims to provide a synthesis of research findings of health-care professionals’ knowledge, attitudes and behaviours relating to patient capacity to consent to or refuse treatment within the general hospital setting. Search strategies included relevant health databases, hand searching of key journals, ‘snowballing’ and expert recommendations. The review identified various knowledge gaps and attitudinal dispositions of health-care professionals, which influence their behaviours and decision-making in relation to capacity to consent processes. The findings suggest that there is tension between (...) legal, ethical and professional standards relating to the assessment of capacity and consent within health care. Legislation and policy guidance concerning capacity assessment processes are lacking, and this may contribute to inconsistencies in practice. (shrink)

We explored the need for an ecosystem approach based on relational systems when conducting research on South Korea’s cultural industry. We used Mollard’s (2009. L’ingeniere culturelle. Paris: PUF) idea of the participants in the French cultural system as a key reference and extended it to the notion of the platform, which is the core concept of South Korea’s cultural industry ecosystem (CIE). We also utilized the idea of the “semiotic square of consumption values” from Floch to explicate each platform and (...) participant, which play a significant role in South Korea’s CIE. By defining a role rooted in the relationship and values for each subject (i.e., the production, consumption, authority, and intermediary subjects), we aimed to better understand the ecosystem of the cultural industry and focused on K-pop as a specific aspect of South Korea’s cultural sector by identifying the current identity of each participant. (shrink)

The author of this paper aimed to understand the early Buddhism community in its entirety by examining the individual episodes in the "Mahavagga". There is a remarkable experience of the psychic power between the Buddha and the Brahmins. They are both aware of coming across of psychic forces that entered the way to the Buddhist Community. Using the brahmins mythology as a instrument for missionary work, the early Buddhism brings people close to Buddha's community. The Buddha visited Uruvela-Kassapa and took (...) lodging for the night where the sacred fire was kept, in spite of Kassapa's warning that the spot was inhabited by a fierce Naga. The Buddha, by his magical powers, overcame, first this N ganad then another, both of whom vomited fire and smoke. Kassapabeing pleased with this exhibition of iddhi-power, undertook to provide the Buddha with his daily food. The Buddha spent the whole rainy season there, performing, in all, three thousand five hundred miracles of various kinds, reading the thoughts of kassapa, splitting firewood for the ascetic sacrifices, heating stoves for them to use after bathing in the cold weather, etc. Still Kassapa persisted in the thought, "The great ascetic is of great magic power, but he is not anarahant like me." Finally the Buddha decided to startle him by declaring that he was not an arahant, neither did the way he followed lead to arahantship. Thereon kassapa owned defeat and reverently asked for ordination. The Buddha asked him to consult with his pupils, and they cut off their hair and threw it with their sacrificial utensils into the river and were all ordained. Nadi Kassapa and Gaya Kassapa were ordained with their pupils. At Gay sisa the Buddha preached to them the Fire Sermon, and they all attained arahantship for the early Buddhist Community. The episode of Uruvela Kassaps in the Mahavagga text ultimately idealizes the power of psychic and the start of the community. It is probable, even at the time when the episode were written, that as a matter of fact every one, in ordinary daily life, spoke imply the vernaculars in a much more simple and natural state of society. It is the Mahavagga authors, when addressing a cultured public at a date when the vernaculars had become the paramount literary language. Another point is that though brahmins take part in the religious and philosophical conversations of those early tims, and in the accounts of them are always referred to with respect, and threaten with the same courtesy that they always themselves extended also to others, yet they hold no predominant position. The majority of the ascetic, and the most influential individuals among them, are not brahmins. That is only a matter of course will be the obvious subjection. The Mahavagga texts I quotes, if not the work of bitter opponents, were at leastcomposed under India bramins influence, and are prejudiced against the brahmins. (shrink)

BackgroundFor the patients receiving care in the operating room, it emphasizes that the ethical behavior and attitude of health professionals should be aligned with patients’ basic human rights. Surgical ethics may provide an ethical alternative in a specific operating room context. However, it is unclear how actively research is being conducted in this regard.AimThis study determines the direction of future research by identifying ethical issues experienced in the operating room.MethodThis scoping review is based on the methodological framework suggested by Arksey (...) and O’Malley in 2005. PubMed, CINAHL, EMBASE, WOS, Cochrane, KISS, and KMbase databases were searched from January 2012 to May 2022. Two researchers independently screened the searched articles by reviewing the titles, abstracts, and full texts. Consequently, 19 studies were selected.FindingsFive categories were identified: Professional ethics, Organizational ethics, Patients’ rights, Patient safety, and Allocating resources. The derived categories covered all the same content as the International Council of Nurses’ (ICN) code of ethics, with the exception of one element, that is, global health.ConclusionsThis study highlights ethical issues in the operating theatre and emphasizes the need for individual and organizational strategies aligned with the ICN code of ethics. Future research should cover a wider range of issues, employ diverse perspectives and methodologies, and enhance ethical practices to improve understanding and ethical practices in the field. (shrink)

This article situates Bong Joon-ho’s Parasite (2019) within the historical logics of the Washington Consensus. In this broad context, we might think of the film’s much-heralded class critique as not quite so domestically contained as may initially appear in a film staged primarily in the confines of a single household. Instead, it opens onto a global political economic framework, which it explores through a nested structure in which class dynamics are also mobilized to explore cold-war and trade-war logics, both of (...) which are revealed to be radically interconnected with domestic concerns. Parasite reveals then the inherent dissensus in the Washington Consensus, a dissensus that was always latent but eventually became more explicit. We might say more generally that stories of class difference take on a pointedly different tenor during periods of stagnation; the specific anxiety in Parasite then is not just over the moral fact of social inequality but also specifically about the material distribution of wealth in the face of diminishing resources. The fact of brutal competition emerges from a milieu that seems ostensibly defined by plentitude. (shrink)

This study analyzed the national data on life-sustaining treatment decisions from 2018 to 2020 to find out the characteristics of South Korea’s end-of-life procedure according to the decision-making approach and process. We collected the data of 84,422 patients registered with the National Agency for Management of Life-sustaining Treatment. We divided the patients into four groups (G1, G2, G3, and G4) according to the decision-making approach. A descriptive analysis of each group was conducted using indicators such as the patient’s age, status, (...) diagnosis, and content of forgoing life-sustaining treatment. Additionally, logistic regression analysis was performed by dividing the patients into self-determining (G1, G2) and non-self-determining patients (G3, G4). Cancer was the most common diagnosis for each group. The period from life-sustaining treatment decision to implementation was 10.76, 1.01, 0.86, and 1.19 days for G1, G2, G3, and G4, respectively. In the logistic regression analysis, the self-determination ratio was higher for 40–49 years old and lower for cardiovascular disease and gastrointestinal disease. Age was has a major impact on life-sustaining treatment decisions (LSTD), and with increase in age, the family, and not the patient, made the LSTD. The LSTD method also differed depending on the disease. The self-determination rates of patients with circulatory or digestive diseases were somewhat lower than that of those with neoplastic diseases. The period from decision-making to implementation is short for end-of-life care. (shrink)

This study examines how the corporate philanthropy decisions of group-affiliated firms in Korea are made. Based on the attention-based view, we argue that when corporate decision makers at group-affiliated firms focus their attention more on internal markets than external stakeholders because of the firm’s high reliance on intragroup transactions, the firm will decrease its level of corporate philanthropy. We further argue that the relationship will be stronger when governance mechanisms focus on the instrumental value of corporate philanthropy. Using a panel (...) sample of group-affiliated firms in Korea from 2011 to 2015, we find that as intragroup sales increase, the level of corporate philanthropy decreases, and such a negative relationship is stronger when outside director representation and foreign investor ownership are high. Our study suggests that internal dependence and corporate governance mechanisms jointly affect the level of corporate philanthropy at firms in a business group. Thus, this study contributes to the literature on corporate philanthropy, business group, and corporate governance. (shrink)

이 글은 의학교육에 전공 연계 글쓰기(WAC)를 적용할 수 있는 가능한 모형을 제시하고자 한다. 이것을 보이기 위해 먼저 의학교육에 WAC을 적용하고자 할 때 글쓰기와 연계할 수 있는 의학교육의 내용이 의료윤리와 전문직업성 교육이 될 수 있음을 보일 것이다. 다음으로 우리나라 의과대학이 가진 제약조건 아래서 의학교육에 적용할 수 있는 두 가지 유형의 WAC 모형을 재안하고, 그것의 교육 내용과 구성을 보이고자 한다. 첫째, ‘과제 연계형 글쓰기 집중’ 모형은 우리나라의 많은 대학에서 이미 적용하여 시행하고 있는 과제 연계형 글쓰기 교육과 글쓰기 집중(WI)을 융합한 형태의 글쓰기 교육이다. (...) 이것은 학술적 글쓰기의 〈요약-논평-에세이 쓰기〉의 일반적인 교육 절차를 따르고 있지만, 의료윤리, 의료법, 의료사회학 등의 의학 관련 주제에 초점을 맞추어 〈에세이 쓰기〉 과정을 강조한다. 둘째 ‘문제해결형 글쓰기’ 모형은 논리와 비판적 사고에 기초하여 의학과 의료에서 딜레마 상황 또는 두 입장이 충돌하는 사례를 분석하고 평가하는 글쓰기 교육이다. 이 모형은 ‘사고실험’과 ‘사례 보고서’로 구분할 수 있다. 전자는 철학과 윤리학에서 전통적으로 사용하고 있는 생각하는 기법이고, 후자는 의학의 임상 사례 분석과 유사한 형태의 분석과 평가의 기법을 가지고 있다. 마지막으로, 두 유형의 글쓰기 교육이 가진 장점과 한계를 제시하고 의학교육에 글쓰기 교육을 연계하기 위해 요구되는 사항들을 제시한다. (shrink)

Pathological gaming among adolescents has been reported to hamper the achievement of a balanced life and to threaten the development of social competencies. Despite the increasing social concerns on the adolescent users, however, the mechanism of gaming behavior of adolescents has not been sufficiently examined. This study explored the mechanism of pathological gaming among adolescents from 3-year longitudinal data of 778 Korean adolescent gamers, by analyzing the effects of negative affects on the degree of pathological gaming through the mediation variables (...) based on the stimulus-organism-response framework. Latent class analysis was used to uncover potential risk groups, and through partial least squares-structural equation modeling analysis, the mediation pathways to pathological gaming were compared between the risk group and the non-risk group. The results highlighted the key role of academic stress on the degree of pathological gaming. In the entire group, academic stress primarily increased pathological gaming through self-control. The mediation path of self-control was the most influential result in the risk group. Aggression was the key mediator between loneliness and pathological gaming in the non-risk group. The theoretical and practical implications of the results were discussed. (shrink)

RésuméLe but de cette recherche est de répondre qualitativement à la question de l’évolution de la culture de consommation et des valeurs culturelles associées au sein des cafés d’aujourd’hui de la société coréenne. Cette étude cherche à définir l’aspect synchronique, avec une analyse des comportements de consommation, les attitudes des consommateurs et des concepts d’espace dans les trois stades : le niveau discursif, le niveau sémio-narratif et niveau thématique. Nos travaux s’orientent vers le consommateur par l’utilisation du « parcours génératif (...) de signification » et nous aident à construire des images sur certains aspects de ce phénomène de la culture spatiale pour notre analyse. Ce processus en trois étapes de recherche a été appliqué en utilisant la méthode de l’observation, du questionnaire et de la sémiotique culturelle pour atteindre et trouver les valeurs culturelles fondamentales de cet espace. En fait, les comportements de consommation observés pourraient être interprétés suivants les valeurs /particuliers/ versus /communautaires/ et l’enquête-analyse des attitudes des consommateurs pourraient être définis par les valeurs /professionnels/ versus /sociabilités/ pris dans sa dimension sémantique. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Using an analogy in science and everyday life is a double-edged sword because they are accompanied by alternative ideas, in addition to scientific concepts. Schools and public education explain global warming by making a common analogy between this phenomenon and greenhouse effects. Unfortunately, this analogy sometimes produces various incorrect explanatory mental models. To construct a correct understanding of global warming, it is necessary: first, to investigate the attributes of analogical reasoning; second, to understand these features by restructuring the greenhouse analogy; (...) and third, to explore the problems and benefits of the greenhouse analogy. The characteristics of relations, rather than objects, must be mapped according to the principle of systematicity, but the public tends to preserve the attributes of the base domain, which is mapped relatively easily. In conclusion, certain facets of the prevailing greenhouse analogy cause a distorted public view of climate change. We must use the greenhouse analogy and yet simultaneously emphasize the relations and attributes highlighted and hidden in the analogy during evaluation. (shrink)

Culture provides people with rich, detailed, implicit, and explicit knowledge about associations and contingencies. These culture-based expectations allow people to get through their days without much systematic reasoning. Experimental designs that unpack these situated effects of culture on thinking, feeling, and doing can advance bias research and direct policy and intervention.