The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social (...) issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. (shrink)

The existing scholarship has developed six main explanations to account for the success of the Chinese Revolution, which has been anomalous for major paradigms derived from cross-national comparisons. Methodologically, we use a social geographical approach to test these existing explanations systematically by constructing and analyzing a unique dataset of Communist growth in 93 counties in the three most contested provinces during its most pivotal period of ascendence. Theoretically, we advance and test an alternative perspective, based on the groundwork of Tocqueville (...) and Fei Xiaotong, that integrates the state-centric theory, elite theory, and cultural analysis. Our perspective emphasizes the interplay between state centralization and local elite structure, which leads to intensified state extraction and local elite fracturing, thus creating favorable conditions for revolution. The quantitative analysis strongly supports the importance of the Japanese invasion but provides limited support for many other conventional explanations. The analysis largely confirms the Tocqueville-Fei perspective on state centralization, elite fracturing, cultural change, and revolution. The findings are buttressed by a detailed case study of Lianshui County. The study unveils a common structural challenge that a modernizing state faces in an agrarian status society, to recreate its political legitimacy while disrupting local elite structure. It also sheds historical light on the evolution of state-society relationship through the Chinese Revolution. (shrink)

This study investigates the complexities in the relationship between perceptions of organizational politics and performance ratings by examining the moderating effect of impression management on that relationship. Expectancy theory was employed to better understand the moderating effect. We proposed that two kinds of impression management tactics occurred: supervisor-focused and job-focused, respectively. It was hypothesized that increased exercise of impression management would mitigate the negative effects of perceptions of organizational politics and performance ratings. Data were collected from 290 full-time employees of (...) ten state-owned enterprises in Taiwan. Hierarchical moderated regression analysis of data revealed that the job-focused tactics exerted a significant moderating effect on the relationship between perceptions of organizational politics and performance ratings. When perceptions of organizational politics are low, employees who engage in high levels of job-focused impression management tactics are more likely to gain better ratings than those who employ low-level tactics. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 58-59, August 2011.

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan.

The hukou system is a mandatory household registration system in China that assigns an individual either an urban/non-agricultural hukou or a rural/agricultural hukou based on one’s birthplace. This system favors urban residents and discriminates against rural residents in accessing state-owned resources such as employment, education, health care, and housing. To better understand how this institutionally imposed hukou identity impacts an individual’s sense of fairness in the ultimatum game, we conducted a field experiment in China using 9–12-year-old children and collected 672 (...) observations. Subjects played a one-shot ultimatum game to allocate 20 yuan in groups of two. We employed a 2 ×\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\times $$\end{document} 2 ×\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\times $$\end{document} 2 experiment design and used the strategic method ultimatum game. We primed our subjects with their hukou identity before they made their decisions in the experiment. Results of this study show that hukou salience mainly affects rural hukou subjects, who belong to the perceived less-favored social group. On one hand, when the hukou identity is made salient, rural hukou proposers decrease their amount offered regardless of their responder’s hukou type. On the other hand, rural hukou responders expect higher offers from their urban hukou proposers when the hukou identity is revealed. We interpret these results as that rural hukou subjects tend to seek compensations for their perceived hukou inferiority to achieve fair distributions. (shrink)

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)

This paper presents an autobiographical narrative of two aspects of my history; two events that permeated my moral consciousness and influenced my political development and a sequence of changes in my dominant theoretical and epistemological perspectives. The two events were, as a teenager, the intense experience of briefly witnessing Apartheid culture and, as a young adult, becoming deeply engaged in feminist activism. My intellectual journey began in cognitive developmental theory and progressed to a cultural, discursive perspective in which the role (...) of affect is seen as integrated. The paper explores the intersection of these two strands of my moral and intellectual development and concludes with a preliminary model of action and engagement. (shrink)

Transfer learning can improve the robustness of deep learning in the case of small samples. However, when the semantic difference between the source domain data and the target domain data is large, transfer learning easily introduces redundant features and leads to negative transfer. According the mechanism of the human brain focusing on effective features while ignoring redundant features in recognition tasks, a brain-like classification method based on adaptive feature matching dual-source domain heterogeneous transfer learning is proposed for the preoperative aided (...) diagnosis of lung granuloma and lung adenocarcinoma for patients with solitary pulmonary solid nodule in the case of small samples. The method includes two parts: (1) feature extraction and (2) feature classification. In the feature extraction part, first, By simulating the feature selection mechanism of the human brain in the process of drawing inferences about other cases from one instance, an adaptive selected-based dual-source domain feature matching network is proposed to determine the matching weight of each pair of feature maps and each pair of convolution layers between the two source networks and the target network, respectively. These two weights can, respectively, adaptive select the features in the source network that are conducive to the learning of the target task, and the destination of feature transfer to improve the robustness of the target network. Meanwhile, a target network based on diverse branch block is proposed, which made the target network have different receptive fields and complex paths to further improve the feature expression ability of the target network. Second, the convolution kernel of the target network is used as the feature extractor to extract features. In the feature classification part, an ensemble classifier based on sparse Bayesian extreme learning machine is proposed that can automatically decide how to combine the output of base classifiers to improve the classification performance. Finally, the experimental results (the AUCs were 0.9542 and 0.9356, respectively) on the data of two center data show that this method can provide a better diagnostic reference for doctors. (shrink)

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)

The American Journal of Bioethics, Volume 12, Issue 5, Page 40-41, May 2012.

We experimentally investigate whether donation motive attribution influences individual investors' judgments of the donating firm's future earnings prospects and whether individual moral orientation, that is, perceived importance of social goodwill (PISG), moderates this effect. We find that investors forecast higher future earnings per share (EPS) when the donation motive is believed to be altruistic or win–win rather than egoistic; the EPS forecasts for altruistic and win–win motives are not different. However, this motive attribution effect holds only for higher-PISG investors. A (...) further examination finds that when the donation motive is believed to be egoistic and/or when investors have lower PISG, doing good is no better than doing nothing, but no backfire effect occurs. Our findings indicate that the positive effect of corporate donation on investors' judgments is generated only when higher-PISG investors believe that the donation motive is not purely egoistic; corporate donation will not generate negative effects on investors' judgments even under less favorable conditions. (shrink)

This research adopted the unified theory of acceptance and use of technology to emphasize the use of the PX Pay mobile payment app for PX Mart, the most popular supermarket in Taiwan, and examine the degree of involvement as a moderator. The influence of factors related to PX Mart’s target customer groups on their shopping intentions and usage behaviors were discussed, with subsequent benefits and optimization directions. This study indicated the following results. First, performance expectations, ease-of-use expectations, and social impact (...) enhance consumers’ behavioral intention and behavioral intention significantly influence usage behavior. Second, gender has no significant moderating effect on the proposed model. Third, age has a moderating effect from performance expectations and ease-of-use expectations, social influence on behavioral intention. Fourth, use is more significantly affected by perceived stakeholders for customers over age 50 than for those age 30–39. Fifth, the degree of involvement significantly affects the relationship between behavioral intention and usage behavior in terms of social influence and facilitating conditions effects. Finally, we provided academic and practical implications and make contributions to both the online payment industry and academia. (shrink)

Judging similarities among objects, events, and experiences is one of the most basic cognitive abilities, allowing us to make predictions and generalizations. The main assumption in similarity judgment is that people selectively attend to salient features of stimuli and judge their similarities on the basis of the common and distinct features of the stimuli. However, it is unclear how people select features from stimuli and how they weigh features. Here, we present a computational method that helps address these questions. Our (...) procedure combines image-processing techniques with a machine-learning algorithm and assesses feature weights that can account for both similarity and categorization judgment data. Our analysis suggests that a small number of local features are particularly important to explain our behavioral data. (shrink)

The intracellular multiprotein complex β‐catenin destruction complex plays a key role in Wnt/β‐catenin signaling. Wnt stimulation induces the assembly of the receptor‐associated signalosome and the inactivation of the destruction complex, leading to β‐catenin accumulation and transcriptional activation of the target genes. The core components of the destruction complex include Axin, APC, GSK3β, CK1α and other proteins. Recent studies demonstrated that Axin and APC undergo liquid–liquid phase separation (LLPS), which is critical for their function to regulate Wnt/β‐catenin signaling. Here, we discuss (...) the possible roles of LLPS in Wnt/β‐catenin signaling and regulation of Axin LLPS by post‐translational modifications. (shrink)

Academic discourses regarding teacher motivation have been on-going for decades for those who teach in ethnic minority areas. Yet research findings failed to provide a consistent conclusion regarding if kindergarten teachers’ motivation pattern would vary based on a case-to-case scenario. Therefore, further studies are needed to probe the motivation patterns among this population. The study firstly examined kindergarten teachers’ motivational profiles based on Expectancy Value Theory, and then examined how teachers’ motivation related to outcome variables. Participants included 1,199 kindergarten teachers (...) from ethnic minority areas in China. Latent profile analysis identified three motivation profiles for teachers: low value-high cost, moderate all, and high value-low cost. Teacher with different motivation profiles had significant differences in work engagement, workplace wellbeing, and retention intention. In addition, chain mediation analysis revealed that work engagement and workplace wellbeing mediated the relationship between motivation profiles and retention intention. The implications of the findings for study are discussed. (shrink)

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

The stabilization problem of a macroeconomic dynamical system is considered in this paper. The main features of this system are that the system uncertainties may be unknown functions of state and time but with known bounds. Furthermore, the control inputs are subject to constraints, which is a salient feature in an economic control problem. To ensure that the controls are within the specified boundaries, in our control design procedure, a creative diffeomorphism, which converts bounded controls into unbounded corresponding signals by (...) choosing an appropriate transformation function, is proposed. For the uncertain system, a deterministic robust control is designed to render the practical stability: uniform boundedness and uniform ultimate boundedness. The range of the input bounds is related to the uncertainties and can be designed according to the actual situation. Numerical simulations are performed to verify the effectiveness of the stabilization policy. (shrink)

A hybrid preference framework is proposed for strategic conflict analysis to integrate preference strength and preference uncertainty into the paradigm of the graph model for conflict resolution (GMCR) under multiple decision makers. This structure offers decision makers a more flexible mechanism for preference expression, which can include strong or mild preference of one state or scenario over another, as well as equal preference. In addition, preference between two states can be uncertain. The result is a preference framework that is more (...) general than existing models which consider preference strength and preference uncertainty separately. Within the hybrid preference structure, four kinds of stability are defined as solution concepts and a post-stability analysis, called status quo analysis, which can be used to track the evolution of a given conflict. Algorithms are provided for implementing the key inputs of stability analysis and status quo analysis within the extended preference structure. The new stability concepts under the hybrid preference structure can be used to model complex strategic conflicts arising in practical applications, and can provide new insights for the conflicts. The method is illustrated using the conflict over proposed bulk water exports from Lake Gisborne in Newfoundland, Canada. (shrink)

Orphans and vulnerable children fall under the category of children who are at risk of exposure to more stressful circumstances and receive less social assistance compared to other children. This study aims to investigate the impact of group counseling based on social intervention and psychological therapy on social support and the perceived stress growth of orphans and vulnerable children. In one special educational needs school in Nanning, China, the SSGPC was developed and implemented. Using the social support and post-stress growth (...) scales, the researchers investigated the effects of SSGPC on orphans and vulnerable children. Twenty-seven orphans and vulnerable children between the ages of nine and 12 were arbitrarily assigned to the experimental and control groups. A pre-test post-test method of quasi-experimental design was applied, with 13 participants in the experimental group and 14 in the control group. The results revealed that the intervention group had significantly higher scores for social support and post-stress growth than the control group. The SSGPC had significantly improved the levels of social support for orphans. The findings indicated that the SSGPC provided an effective way to improve social support and post-stress growth of orphans and vulnerable children. (shrink)