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)

Online consumer reviews are increasingly being written on and posted from mobile devices such that some platforms have started to indicate when this is the case with cues such as “via mobile”. Reviews from mobile devices differ from those from non-mobile devices; for example, reviews from mobile devices are more likely to include typographical errors. For this study, a web-based experiment was conducted to investigate viewers’ evaluation and adoption of online reviews in regard to a mobile cue and typographical errors. (...) The results indicate an interaction effect between the presence of a mobile cue and typographical errors. When a review did not include typographical errors, the presence of a mobile cue negatively affected the evaluation and adoption of information. However, the effects of a mobile cue were not significant for a review with typographical errors. Further, the results suggest that the viewer’s perception of the review writing effort and the review’s information usefulness are sequential mediators explaining the information adoption mechanism. The findings provide interesting insights into consumers’ perceptions of online reviews in the current media landscape in which the large-scale adoption of mobile devices is a well-recognized phenomenon. (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)

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 article looks closely at one of Paul Cézanne’s portraits of Vallier painted the last year of his life to examine how his (“fugitive”) vision works through his use of colors. The French philosopher Maurice Merleau-Ponty, who in his phenomenology views the body as the primary locus of having and therefore knowing the world, emphasizes the vital role of the body of the artist that must be offered to the world in order to truly manifest the world in painting. It (...) is no wonder that Cézanne’s artwork and thought are stitched into the structure of Merleau-Ponty’s aesthetics in his essay “Eye and Mind,” for Cézanne’s painting bears witness to his own account of aesthetic experience. Merleau-Ponty’s emphasis on the lived vision that seeks the depth of Being, the lived qualities of the visible world, takes Cézanne’s vision manifested in his portrait of Vallier further to see where the painting as well as Cézanne himself stand in relation to the visible world. (shrink)

Despite the prevailing discourses on the importance of top management ethical leadership, related theoretical and empirical developments are lacking. Drawing on institutional theory, we propose that top management ethical leadership contributes to organizational outcomes by promoting firm-level ethical and procedural justice climates. This theoretical framework was empirically tested using multi-source data obtained from 4,468 employees of 147 Korean companies from various industries. The firm-level analysis shows that top management ethical leadership significantly predicts ethical climate, which then results in procedural justice (...) climate that fully mediates the effects of top management ethical leadership on two organizational outcomes, namely, firm-level organizational citizenship behavior and firm financial performance. The present study provides a plausible theoretical account and empirical validation of a mechanism through which top management ethical leadership enhances organizational performance. (shrink)

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self-reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self-Confidence, and Korean Bioethics and Biosafety Action restriction perception. (...) The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. (shrink)

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self‐reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self‐Confidence, and Korean Bioethics and Biosafety Action restriction perception. (...) The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. (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)

모리스 메를로-퐁티의 신체 주체론이 함축하고 있는 인격 개념은 새로운 윤리를 보여주고 있는 메를로-퐁티의 도덕적 주체의 진면목을 보다 분명하게 드러내 준다. 익명성의 층위를 내포하는 메를로-퐁티적인 인격은 절대적 자기동일성의 견고함 속에서 수련을 통한 인격적 고양으로 도덕성을 실현하는 그러한 인격이 아니다. 인격이 익명성의 층위를 내포한다는 것은 인격이라는 말 자체가 전제하고 있는 이분화 혹은 불일치를 내부로 흡수한다는 것이고, 이것은 인격이 타자와의 관계 속에서 형성되는 것임을 뜻한다. 이를테면 메를로-퐁티의 인격 개념은 인격의 원래 의미인 페르소나에 가깝다. 페르소나가 타자와의 관계에 따르는 것처럼 메를로-퐁티의 인격은 자기 자신과의 불일치를, (...) 즉 익명성을 내포하면서 타자와의 관계 속에서 만들어지는 것이다. 관계주의적 윤리학의 모습을 보여주고 있는 메를로-퐁티 윤리학은 오늘날 그 중요성이 더욱 강조되고 있는 공동체 정신 함양에 도움이 될 것이다. (shrink)

The recent resurgence of knitting is an ambiguous social phenomenon because it has pre-industrial connotations in late modern society. Knitting is inherently an ambiguous practice which blurs the boundary between production and consumption, the material and the mental and subject and object. This paper explores Korean knitting practice from the angle of social practice. An examination of knitting practice in Korea revealed that the inherent heterogeneity is intricately intertwined with the complex landscape of knitting practice, which is dispersed in a (...) range of different forms of subgroups. Also, the multifaceted aspect of these subgroups which combines consumption, production, education and socialization, refers to the complicated and contrasting aspects of contemporary consumption and consumers. This paper particularly pays attention to the role of practical understanding as a form of skill, know-how and knowledge in the formulation and transformation of knitting practice. It also examines the emotional landscape of knitting practice, which is constructed and mediated in close interconnection with the material dimensions of the practice. (shrink)

Background: An association between gaming disorder and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs.Methods: Five representative GD instruments were chosen based on recommendations by the previous systematic review study to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on (...) either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized.Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 and a mean test-retest estimate of 0.86. Estimated effect sizes of correlation between GD and the variables were as follows: 0.33 with depression, 0.29 with anxiety, 0.30 with aggression, –0.22 with quality of life, 0.29 with loneliness, 0.56 with internet addiction, and 0.40 with game playtime, respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented.Discussion and Conclusion: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies.Limitations: The current study did not include gray literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42020219781]. (shrink)

Most new democracies face a challenge of reshaping the political culture to support the new democratic political order. This can often be a long-term process, complicated by the Realpolitik of governing in a new political (and often economic) system. One of the mechanisms of cultural change is generational change. New generations socialized after a democratic transition are presumably educated into the political norms of the new democratic regime. However, one can also imagine that the young lack clear political cues (...) because they grow up under a system in transition, or even reject the new order if it is accompanied by widespread social dislocation. The study of generational change in new democracies thus provides insights into the processes transforming a nation's political culture. We analyze generational change in the new democracies of East Asia using the Second Wave of the East Asian Barometer. We examine support for a democratic/authoritarian regime and the citizenship norms that underlie a democratic process (such as the rule of law and political tolerance). Our results yield evidence of significant generational change in regime norms in these new democracies, which suggests that the political culture is gradually being transformed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Global Health Careers:Serving the Navajo CommunityMaricruz Merino, Jonathan Iralu, and Sonya ShinGallup Indian Medical Center (GIMC) sits on a hilltop in Gallup, New Mexico, a town of 20,000 in the four corners region of the Southwestern United States. From its third story windows one can see the red cliffs of the nearby Navajo Nation, a 27,000 square mile reservation that reaches into Arizona, northern New Mexico, and the southern (...) edges of Utah. It is a vast, rural landscape that houses more than 350,000 Navajos. For many on the reservation, healthcare is provided by Indian Health Service hospitals such as GIMC."Are you going to stay?" is a common question for new doctors at GIMC. The Navajo know that their geographic location, while beautiful and attractive to many young providers, will also be the reason they leave. It is hard for doctors to be away from their own homelands. Aging parents get sick, [End Page 86] educational opportunities arise, and children who need to be near extended family are born. But to the Navajo, the story of an individual provider is not so important or memorable. All they know is that providers come and go."Are you here to experiment on us?" is yet another question. Years of exploitation and efforts to destroy traditional ways and language have made many Navajo wary of healthcare providers, no matter how genuine their intentions. Many are so fearful of the hospital—they regard it as "the place to go die."Yet despite this initial suspicion, the Navajo are welcoming people at heart, and tend to develop relationships of trust with their providers. Parents will begin to talk about their grief over a son that has committed suicide or a daughter who died from alcoholic cirrhosis. The elderly will tell you how they care for their five orphaned grandchildren while they can barely take care of their own diabetes. A carpenter tells you he has not worked in a year and feels worthless. An HIV-positive woman will tell you she has been sleeping in a dry river bed because she has no place to go. It quickly becomes apparent that as a physician you will be treating patients with enormous social challenges in addition to complex medical conditions.The origins of the Federal Government's involvement in the healthcare of American Indians and Alaskan Natives (AI/ANs) in the 19th century arose out of both legal obligation and concern for self- preservation. Health services were promised to AI/ ANs in exchange for land, settlements, and agreements. In addition, infectious diseases endemic on reservations as a consequence of crowding and abject poverty, including smallpox and tuberculosis, were seen as a major public health concern. The responsibility of Native American health was first granted to the War Department, then to the Bureau of Indian Affairs, and finally to the Public Health Service in 1955 under the heading of the IHS, or Indian Health Service (U.S. Commission on Civil Rights, 2004; National Library of Medicine, 1994).Since then, the IHS has had many successes. Vaccination rates have gone up, and rates of pneumonia and tuberculosis have gone down significantly. Maternal and infant mortality have declined, and life expectancy has increased (Indian Health Services, 1999). Nonetheless, these improvements remain overshadowed by glaring health disparities among AI/ANs across a broad spectrum of diseases, both communicable and non-communicable, acute and chronic. Native Americans experience higher rates of obesity, diabetes, and cardiovascular disease than the general United States population. They are also more likely to die from alcohol-related causes and in accidents. Life expectancy remains more than five years less than that of the general U.S. population (U.S. Commission on Civil Rights, 2004; U.S. Department of Health and Human Services, 2000).Underlying these health indicators is the continued impoverished status of most AI/ANs. In Navajo, almost half of the population lives below the poverty line. According to the Navajo Nation, the current unemployment rate is 42% (Navajo Nation Department of Economic Development, 2011). Many Navajo on the reservation do not have running water or electricity. They heat with wood, which they chop and haul themselves—regardless... (shrink)

By examining the stories of Asian American Dreamers, or Asian American young adults with Deferred Action for Childhood Arrivals (DACA) status, this essay investigates how these undocumented young adults cultivate virtuous imagination to transcend the violence of uncertainty and radically imagine new paths toward flourishing. The aversive state of structural uncertainty leads them to experience narrative foreclosure and the violent disruption of the pursuit of the good life. This essay subsequently proposes two kinds of stories as moral resources (...) for empowering Asian American Dreamers to cultivate imaginative excellence in order to dream new paths toward flourishing and to resist the toxic internalization of the “model minority” myth: (1) religious stories demonstrating their steadfast commitment to God’s goodness and (2) stories of solidarity co-authored with their suffering neighbors. (shrink)

This essay explores small “ordinary” experiences of moral harm as problems of social injustice. Starting with two stories, we first argue against a dominant framework of personal responsibility that assigns responsibility to particular blameworthy agents. Instead we sketch an account of why structural responsibility for social harm must be considered, drawing on the work of Iris Marion Young and Pierre Bourdieu. Finally, drawing on Margaret Walker’s notion of moral repair and Christopher Marshall’s interpretation of the parable of the Good (...) Samaritan, we sketch an account of Christian moral responsibility grounded in restorative justice that seeks to address daily experiences of moral harm through the moral repair work of neighbor-love. (shrink)

When making decisions, people tend to overweigh the impact of losses compared to gains, a phenomenon known as loss aversion. A moderate amount of LA may be adaptive as it is necessary for protecting oneself from danger. However, excessive LA may leave people few opportunities and ultimately lead to suboptimal outcomes. Despite frequent reports of elevated LA in specific populations such as patients with depression, little is known about what psychological characteristics are associated with the tendency of LA. Based on (...) the neurobiological studies of LA, we hypothesized that positive psychological wellbeing may be negatively associated with people's tendency of LA. In the present study, we set out to test this hypothesis in a sample of young adults. We evaluated LA using a decision-making task in which subjects were asked to decide whether to accept or reject a series of coin-toss gambles. Our results revealed that individuals with more advanced personal growth as assessed by the Ryff's Psychological Well-being Inventory showed reduced LA. To our knowledge, this is the first report demonstrating an association between positive psychological wellbeing and LA. These findings suggest that personal growth might be employed as interventional targets for correcting excessive LA in vulnerable populations. (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 paper attempts to identify a principle of equal treatment that gives specific structure to our widely shared judgments about the circumstances in which we have moral reason to object to the differential adverse treatment of others. I formulate what I call a “substantive” principle of equal treatment (to be distinguished from principles of formal equality) that describes a moral constraint on the reasons we can have for picking out individuals for differentially adverse action. I argue that this constraint is (...) violated when an action, in view of its rationale, expresses lesser respect for the moral status of an individual under some differentiating description, compared to the respect reserved to another class of individuals who are not picked out by that description. I show that this substantive demand of equal treatment is not morally otiose and reveal the fallacy underlying accounts that have concluded otherwise. (shrink)

A key aspect of Oliver O’Donovan's approach to ethics and theology is the notion of Scripture's ‘authorisation’ of concepts. Authorisation is an organic process of concepts and Scripture illuminating each other, where Scripture has ultimate authority over concepts. That is, while concepts from various disciplines can illuminate biblical texts, the biblical texts in return shape those concepts. Here concepts are formed organically guided by the Spirit. Such a notion of authorisation lies dormant in O’Donovan's earlier political theology, The Desire of (...) the Nations, and comes to fuller expression in his relatively recent Ethics as Theology. (shrink)

法に対して合理的で批判的な姿勢を吹き込もうとする試み。ハート=ドゥオーキン論争以降の「法実証主義の現代的展開」を描き出す。本書ではとくに、ハートの理論的継承者であるラズおよびマーモーの議論に注目する。 .

What are the sensory individuals of audition? What are the entities our auditory system attributes properties to? We examine various proposals about the nature of the sensory individuals of audition, and show that while each can account for some aspects of auditory perception, each also faces certain difficulties. We then put forward a new conception of sensory individuals according to which auditory sensory individuals are composite individuals. A feature shared by all existing accounts of sounds and sources is that they (...) postulate sensory individuals that are non-composite. They identify the sensory individual of sound hearing or source hearing with one type of entity in the environment, be they sound waves, vibrations, or interactions. We question this assumption and argue that our perceptual systems represent two or more aspects of the environment as a single sensory individual. Finally, we show that taking auditory individuals to be composite sensory individuals allows for an account of audition that is less problematic than its existing alternatives. (shrink)

During the last years the demand for regionally and culturally harmonised machine design is increasingly on the agenda. The problem of localising products like machine tools instantly poses the question for new procedures that allow including the regional and cultural adaptations into the design processes of machine tool companies. How to transform the general insight into the necessity of culture- and region-adapted technologies and how to embed it into a design procedure comprising applicable design attributes is the crucial problem addressed. (...) The paper shows in an exemplary way how ambiguous design attributes can eventually be embodied in a prototype design. (shrink)