This study explored the effect of learning strategies in a student organization on cake art creativity. The participants were 27 student members of a cake decorating art club from one central university in Taiwan. A quasi-experimental pretest-posttest design was adopted, with 90 h of experimental teaching over 16 weeks. The results, which included the use of a questionnaire, classroom observation, and in-depth interviews, suggest that in terms of creativity, the group participating in flipped classroom learning significantly outperformed the group using (...) traditional learning strategies. Furthermore, flipped classroom learning promoted learner motivation and satisfaction. (shrink)

Reading Medieval Chinese Poetry: Text, Context, and Culture. Edited, with an introduction, by Paul W. Kroll. Sinica Leidensia, vol. 117. Leiden: Brill, 2014. Pp. vi + 310. €126, $164.

This study proposed a children’s digital art ability training system with artificial intelligence-assisted learning, which was designed to achieve the goal of improving children’s drawing ability. AI technology was introduced for outline recognition, hue color matching, and color ratio calculation to machine train students’ cognition of chromatics, and smart glasses were used to view actual augmented reality paintings to enhance the effectiveness of improving elementary school students’ imagination and painting performance through the diversified stimulation of colors. This study adopted the (...) quasi-experimental research method and designs the pre-test and post-test for different groups. The research subjects are the Grade 4 students of an elementary school in Taitung City, Taiwan. The test tools included an imagination test and an evaluation of painting performance ability. The test results of a total of 30 students before and after the experiment included the experimental group that received the children’s digital art ability training system with AI-assisted learning and 30 students in the control group that had not received the teaching were analyzed by covariance. These results were supplemented by the description and interpretation of student feedback, teachers’ reflection notes, and other qualitative data to understand the performance of the students in the experimental group in terms of imagination and painting performance. (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 utterance model is a popular basis for theories of interpretation in the contemporary analytic philosophy of literature. This model suggests that interpretation should be constrained by a work's identity‐relevant factors in its context of production because a work, like an utterance, acquires its identity and content in part from its relations with that context. From a descriptive point of view, I argue that the implied author account of interpretation best describes critical practice following the current positions based on the (...) utterance model. That is, people who interpret in accordance with these positions end up interpreting an implied author. (shrink)

Under the background of global cross-border mobile commerce integration, the importance of cross-border payment research is becoming increasingly prominent and urgent. The important value of this study is to empirically research the influence power of key elements in using two different mobile payment platforms in Korea. The extended unified theory of acceptance and use of technology has been widely applied in various studies because of its strong interpretive power. In Korea, there are a few empirical studies on Chinese users. Based (...) on a survey of 908 Chinese participants in Korea, this study is one application extending UTAUT2 by incorporating multi-group and multi-model constructs: UTAUT2, information system success model, and an initial trust model, considering a multi-group analysis with some mediating variables. By comparing the two different payment platforms’ characters, this manuscript provides a set of targeted measures to ensure Chinese WeChat Payment platform decision-makers create effective long-term strategic policies for cross-border m-payments in Korea, and eventually, benefit cross-border m-commerce and economic cooperation in Southeast Asia. (shrink)

This project was undertaken to ascertain the perceptions of a group of Taiwan’s fourth-year bachelor of science in nursing (BSN) students regarding death and help expected from nurses during the dying process. Within the Chinese culture, death is one of the most important life issues. However, in many Chinese societies it is difficult for people to reveal their deepest feelings to their significant others or loved ones. It was in this context that this project was developed because little is known (...) about how Taiwan’s nursing students perceive death and the dying process. Using an open-ended, self-report questionnaire, 110 senior BSN students recorded their thoughts on: (1) their fears before physical death; (2) afterlife destinations; and (3) the help they would expect from nurses when dying. The data were analyzed using a three-layer qualitative thematic analysis. The students’ reported needs during the dying process were directed towards three main goals: (1) help in reaching the ‘triple targets of individual life’; (2) help in facilitating in-depth support so that both the dying person and significant others can experience a blessed farewell; and (3) help in reaching a destination in the afterlife. The results support the belief of dying as a transition occurring when life weans itself from the mortal world and prepares for an afterlife. (shrink)

In this paper I test major analytic theories of interpretation, including anti-intentionalism, the value-maximizing theory, actual intentionalism, and hypothetical intentionalism, against Li Shang-yin’s poem ‘The Ornamented Zither’. I argue that, based on the results of the test, all of these theories face grave difficulties. If their supporters want their accounts to be sustained in the debate over interpretation, they need to address the worries I raise.

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

In contemporary analytic philosophy of art, the intentionalist debate is about whether the author’s intention is relevant to the interpretation of her work. Various positions have been proposed, and in this paper I defend what I call hypothetical author-hypothetical intentionalism, the position that interpretation is based on the intention attributed to the author constructed from the work. There are three aims to achieve: (1) to give a general account of hypothetical author-hypothetical intentionalism; (2) to present a moderate version of hypothetical (...) author-hypothetical intentionalism; (3) to defend the moderate version of hypothetical author-hypothetical intentionalism against actual intentionalism and actual author-hypothetical intentionalism. Against the current trend that focuses on actual authors, I hope to show that the hypothetical author account is still a sustainable contender in the intentionalist debate. (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)

We obtained an exact solution for a uniformly accelerated Unruh–DeWitt detector interacting with a massless scalar field in (3 + 1) dimensions which enables us to study the entire evolution of the total system, from the initial transient to late-time steady state. We find that the conventional transition probability of the detector from its initial ground state to excited states, as derived from time-dependent perturbation theory over an infinitely long duration of interaction, is valid only in the transient stage and (...) is invalid for cases with proper acceleration smaller than the damping constant. We also found that, unlike in (1 + 1)D results, the (3 + 1)D uniformly accelerated Unruh– DeWitt detector in a steady state does emit a positive radiated power of quantum nature at late-times, but it is not connected to the thermal radiance experienced by the detector in the Unruh effect proper. (shrink)

Ths historical legacy inherited by thinkers of the Ch'un-ch'iu period comprised, briefly speaking: a religious world outlook characterized by ancestor worship; the ethical concept of filial piety and brotherliness, which was linked to ancestor worship, or derived therefrom; the concept of a ritual system; the conditions of aristocratic politics and scholar bureaucracy. These were things shaped on the basis of the blood ties in a patriarchal and racial society, and they were passive, from the standpoint of progress, being the obstacle (...) that hindered people from making big strides forward. Next, there were the tendency toward simple materialism and dialectics, which was born from the bowels of religious world outlook; the materialist philosophy of complaint against and hatred and cursing of Heaven; the belief in things and in laws; and Shih Po's doctrine of "Things are produced when matter combines." These were positive things, especially the last three, which emerged at a time when the slave system had begun to collapse, and which formed the premise of their ideological advance. Who among the thinkers of the Ch'un-ch'iu period would inherit and develop these things, what questions would be raised, probed, discussed, or argued on the common basis of their traditional thought, and what specific forms would be used to answer these questions had to be determined by their class stand and by the characteristics of the period in which they lived. (shrink)

The philosophical thought of the Ch'un-ch'iu period was derived and developed from the thought of the Yin dynasty and the Western Chou , there being an inseparable relationship of succession and transformation between them. Thus, in studying the philosophical thought of the Ch'un-ch'iu period, it is necessary to refer back to Yin-Chou thought. The courage and resolve evidenced by an attitude of so-called "cutting off the miscellaneous streams" in order to start with Lao Tzu or Confucius is really a very (...) awkward way of dissecting history. (shrink)

Modest actual intentionalism is a major position on interpretation in contemporary analytic aesthetics. The position consists of a disjunctive formulation according to which work-meaning is determined by the author’s intention when such intention succeeds or by non-intentionalistic factors when it fails. I challenge the disjunctive view by presenting a constructive dilemma, the conclusion being that modest actual intentionalism ends up either making non-intentionalistic factors idle or making authorial intent superfluous.

Monroe C. Beardsley has been interpreted by many theorists as advocating antiexternalism with respect to an artwork's aesthetically relevant properties, typically its meaning. According to this orthodox interpretation, the meaning of a work is not established by external or contextual factors but by what is internally present in the work. This acontextual account of meaning is challenged by contextualism, which claims that a work's identity and meaning are in part determined by contextual factors. However, a close look at textual evidence (...) shows that Beardsley actually leans toward contextualism. In particular, his speech act theory of literature compels him to hold an explicit contextualist position with respect... (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)

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)

Given the widespread acceptance of computational thinking in educational systems around the world, primary and higher education has begun thinking about how to cultivate students' CT competences. The artificial intelligence of things combines artificial intelligence and the Internet of things and involves integrating sensing technologies at the lowest level with relevant algorithms in order to solve real-world problems. Thus, it has now become a popular technological application for CT training. In this study, a novel AIoT learning with Augmented Reality technology (...) was proposed and explored the effect of CT skills. The students used AR applications to understand AIoT applications in practice, attempted the placement of different AR sensors in actual scenarios, and further generalized and designed algorithms. Based on the results of the experimental course, we explored the influence of prior knowledge and usage intention on students' CT competence training. The results show that proposed AIoT learning can increase students' learning intention and that they had a positive impact on problem solving and comprehension with AR technology, as well as application planning and design. (shrink)

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

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)

Some theorists on literary interpretation have suggested a connection between Monroe C. Beardsley’s anti-intentionalism and hypothetical intentionalism based on an implied author. However, a full exploration has never been attempted. I undertake this task in this paper. A close reading of Beardsley reveals that he assumes something very similar to the implied author in interpretation. I distinguish five types of fictional works in terms of their narrative mode and show that my claim stands in at least four of the five (...) types. The significance of my argument lies in exposing the above version of authorism in anti-intentionalism. -/- Beardsley is generally perceived as advocating the irrelevance of authorial intention to literary interpretation. The common interpretation of his theory is that work-meaning is generated by linguistic conventions, with intention playing no role in meaning-determination. All the interpreter needs is knowledge of public, linguistic conventions in order to recover textual meaning. -/- Nevertheless, when dealing with the problem of interpretation, Beardsley explicitly talks about attributing textual meaning to a fictional speaker. Although he does not elaborate on the nature of this speaker, clues scattered in his writings point to the striking similarity of this theoretical apparatus to an implied author. The key lies in his presumption that every fictional work must have an ultimate speaker to whom meaning inferred from the text should be attributed. This claim is almost the core of an implied author theory of interpretation. -/- A difficulty in classifying Beardsley’s view as a version of the implied author position is that his characterization of the story’s presenter might apply better to the story’s narrator than to its implied author. To test this, I examine different types of narrative modes to see whether the fictional speaker merges with the implied author in each of these scenarios. -/- The first factor to consider for classifying narrative modes is whether the narrator’s presence is explicit or implicit. The narrative scenario in which the narrator is implicit can be further divided into two sub-types: either the story is told from an omniscient viewpoint or centers on the experience of a third-person character. In either case, the story is not told by any of the characters in the story; rather, it is told by an implicit speaker whose words the work purports to be. It seems reasonable to identify this fictional speaker with the implied author, for both function as the subject to which textual meaning is attributed. -/- As for the narrative mode in which the narrator is explicit, this involves first-person narratives. In these, either the narrator is reliable or unreliable. When the narrator is unreliable, a transcendental perspective is required in determining the text’s meaning, because what is said ultimately in the work is not equivalent to what is literally said by the unreliable narrator. It follows that an implicit speaker has to be assumed and she again coincides with the implied author. -/- Where the narrator is reliable but textual meaning transcends what is literally expressed, an implicit speaker is at play again. This narrative scenario is thus better classified as a case in which the narrator’s presence is implicit. This leaves us with the narrative scenario in which the narrator is a reliable spokesperson for the implied author. -/- The identification of the narrator with the implied author in the case last mentioned is controversial. The crucial difference between them is that the former is dramatized in the story while the latter is not. I accept that the narrator here is not happily called an implied author, though I also point out several similarities between the two. -/- Finally, I discuss four complications to my argument. The first concerns multiple points of view in a story. To accommodate this kind of narrative, Beardsley could argue that an implicit narrator is needed to explain the definite meaning concealed behind what is literally said by different characters. The second complication is about the ontological status accorded to the narrator and the implied author. It might be objected that the two reside in different fictional worlds and this is what makes their merging impossible. But it is questionable whether this is a definitional feature of the implied author; moreover, the interpreter can take the implied author to be an instrumentalist concept and hence avoid talk about the ontological status of fictional entities. The third complication claims that versions of the implied author position developed by philosophers tend to be based on a contextualist ontology of literature; however, Beardsley’s account is acontextual. This is not true, for Beardsley has exhibited contextualist leanings in his writings. Finally, it has been objected that the formalist resources Beardsley has are not enough to guarantee a single right interpretation. But if Beardsley is actually a contextualist, contextual constraints will come into play and raise the chance of getting a single right interpretation. -/- The article concludes by reflecting on the significance of the misrepresentation of anti-intentionalism: it is the intention of the actual author which anti-intentionalism is against. The position in question is actually developed in an intentionalist framework based on the implied author. (shrink)

This paper attempts to revive interest in the speech act theory of literature by looking into Monroe C. Beardsley's account in particular. Beardsley's view in this respect has received, surprisingly, less attention than deserved. I first offer a reconstruction of Beardsley's account and then use it to correct some notable misconceptions. Next, I show that the reformulation reveals a hitherto unnoticed discrepancy in Beardsley's position and that this can be explained away by a weak version of intentionalism that Beardsley himself (...) actually tolerates. Finally, I assess the real difficulty of Beardsley's theory and its relevance today. (shrink)

Interpretation in art refers to the attribution of meaning to a work. A point on which people often disagree is whether the artist’s or author’s intention is relevant to the interpretation of the work. In the Anglo-American analytic philosophy of art, views about interpretation branch into two major camps: intentionalism and anti-intentionalism, with an initial focus on one art, namely literature. -/- This article elaborates on variations on these theories of interpretation and considers their notable objections. The debate about interpretation (...) covers other art forms in addition to literature. The theories of interpretation are also extended across many of the arts. This broad outlook is assumed throughout the article, although nothing said is affected even if a narrow focus on literature is adopted. (shrink)

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)

Background The Patient Right to Autonomy Act (PRAA), implemented in Taiwan in 2019, enables the creation of advance decisions (AD) through advance care planning (ACP). This legal framework allows for the withholding and withdrawal of life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) in situations like irreversible coma, vegetative state, severe dementia, or unbearable pain. This study aims to investigate preferences for LST or ANH across various clinical conditions, variations in participant preferences, and factors influencing these preferences among urban (...) residents. Methods Employing a survey of legally structured AD documents and convenience sampling for data collection, individuals were enlisted from Taipei City Hospital, serving as the primary trial and demonstration facility for ACP in Taiwan since the commencement of the PRAA in its inaugural year. The study examined ADs and ACP consultation records, documenting gender, age, welfare entitlement, disease conditions, family caregiving experience, location of ACP consultation, participation of second-degree relatives, and the intention to participate in ACP. Results Data from 2337 participants were extracted from electronic records. There was high consistency in the willingness to refuse LST and ANH, with significant differences noted between terminal diseases and extremely severe dementia. Additionally, ANH was widely accepted as a time-limited treatment, and there was a prevalent trend of authorizing a health care agent (HCA) to make decisions on behalf of participants. Gender differences were observed, with females more inclined to decline LST and ANH, while males tended towards accepting full or time-limited treatment. Age also played a role, with younger participants more open to treatment and authorizing HCA, and older participants more prone to refusal. Conclusion Diverse preferences in LST and ANH were shaped by the public’s current understanding of different clinical states, gender, age, and cultural factors. Our study reveals nuanced end-of-life preferences, evolving ADs, and socio-demographic influences. Further research could explore evolving preferences over time and healthcare professionals’ perspectives on LST and ANH decisions for neurological patients.. (shrink)

Monroe C. Beardsley's unavailability argument is one of the most underrated anti‐intentionalist arguments in the philosophy of interpretation. The main idea of this argument is that, since independent evidence of authorial intent is normally unavailable, the literary interpreter should focus on what a text means rather than on what the author intends it to mean. In this article I propose a revised version of the argument to show that the unavailability of authorial intent suffices to make actual intentionalism untenable as (...) a recommendation for finding out textual meaning. (shrink)

Normal 0 0 2 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:????; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Amis, one of the Austronesian languages, is spoken by the largest indigenous minority on the island of Taiwan. The population is estimated to be 140,000. The Amis language is spoken mainly in Hualien and Taitung, the eastern part of Taiwan. In 1990s, a Japanese linguist Tsuchida (1989) provided a set of categorization for the Amis language: 1. Sakizaya dialect 2. Northern dialect (Nansi Amis) 3. TavaLong-Vataan dialect 4. Central dialect (Coastal and other Soukuzun Amis) 5. Southern Amis (Puyuma Amis and Hanchan Amis) From the categorization above, Sakizaya belonged to a subcategory of Amis. At the same time, this categorization also reflected that from the “Takobowan Incident” in 1878 the exiled Sakizaya, in order to escape the ethnic cleansing by Qing government, living among the Amis, were simply a subgroup of the larger ethnic group, and so Sakizaya were classified as Amis from then on. The Sakizaya, as a distinct ethnic group, officially did not exist. However, not only historical materials show the term Sakizaya were known to the Spanish and to the Dutch East India Company during the 17th century (Hsu, Liao and Wu, 2001), but also the language data collected in this paper show there are differences between Sakizaya and Amis. (Both Nansi Amis and Sakizaya are spoken mainly in northern Hualien. This paper will further make examples of the phonological, morphological and syntactic differences between Sakizaya and Nansi Amis.) However, it is still difficult to define whether Sakizaya is not a dialect of Amis, but a language. In January of 2007, Sakizaya was officially recognized as Taiwan’s 13 th Indigenous Group in Taiwan and one of the most important claims used by the Sakizaya elite s in the process of ethnic reconstruction was the language. It seems to me that this ethnic reconstruction is motivated rather by the current Taiwan political environment than the ethnic group itself. It follows that it may occur that the language has been only an instrument to achieve political ends, but - no matter whether true or not - a much more in-depth study is still necessary to determine the status of the language and its relation to other languages, such as Amis, to make a final judgment on the whole process of ethnic reconstruction – Sakizaya case. (shrink)

The authors aim to explore a better fitting leadership style that is designed for the sustainable era in believing and committing to work for cherishing resources and developing the organization toward a new sustainable direction. This study developed the questionnaire items of the Resource-Dilemma-Handling-Leadership scale, representing a new sustainable era's new leadership style, and then to compare it with the transformational leadership style in order to highlight the importance of RHDL for sustainable development. This study took companies, which have more (...) than 100 employees in Taiwan as research samples. Those companies were selected because they were socially tagged as being operating continuously for more than 20 years and identifying themselves with the operational orientation of social responsibility as their business philosophy and core values for management. A total of 532 valid questionnaires were collected, with a 90.6% valid return rate, and tested with the SEM method. Consistent with the authors' inferences from the literature, the test results suggest that CSR plays the role of full mediator between RDHL and OC. CSR itself is like a sense of responsibility, giving employees a sense of mission, to complete meaningful sustainability-relevant tasks in the organization. RDHL, compared with TL, has a better prediction power on CSR and OC. Theoretically, this study implies that the impact of leadership of the organization on OC in the aspects of sustainable development should be going through the influence of the ELB system in the form of CSR to promote the organization's internal and external organizational CSR performance, with added internal strengthening power from OC. Practically, the new RDHL concepts brought up by this study include the training and enhancement of leadership skills based on the content of the scale items being explored. The new RDHL scale contains a comprehensive description of the spirit of the new sustainable era's leadership style. Also, the future applications of RDHL ideas in the form of human resource development should help the realization of the ideally sustainability behavioral patterns of leaders and employees in the organizations. (shrink)