The purpose of this study is to explore the influence of consumers’ choice deferral behavior on their intertemporal choice preference. The empirical study shows that consumers’ choice deferral behavior can significantly affect their intertemporal decision preference through the level of hopefulness. Compared with non-choice deferral behavior, choice deferral behavior can improve the level of consumers’ sense of hopefulness, which then makes them prefer larger-longer interests in intertemporal decision-making. The effect of consumers’ sense of hopefulness on their intertemporal choice preference is (...) moderated by their perceived information integrity. When the perceived information integrity is low, the effect of hopefulness on intertemporal decision preference will be enhanced, but when the perceived information integrity is high, the effect of hopefulness on intertemporal decision preference will not be affected. In addition, the theoretical and practical significance of this study and the prospect of future research are also discussed. (shrink)

This study examines the effect of teaching ethics and the form of code of ethics on auditors’ ethical decision making. We draw upon Rest’s decision-making model and Hunt and Vitell’s theory of marketing ethics to assist us with this examination. We use accounting students as substitutes for auditors in this study to enhance its internal validity as students are “subjects who would not already have detailed knowledge and experience of the Code”. The research method includes a survey and an experiment (...) in the study. A between-subjects survey design with a sample of 271 students and a within-subjects experimental design with a sample of 146 students are used. A confirmatory factor analysis is conducted before other statistical methods are performed. Our results show that teaching codes of ethics improves accounting students’ awareness of audit independence issues and their ethical judgments and intentions. However, the form of a code of ethics does not make any significant difference in terms of the participants’ awareness of audit independence and their ethical judgments and intentions. Our study contributes to the debate on the effectiveness of principles-based versus rules-based codes of ethics and the importance of teaching ethics in non-Western economies. (shrink)

Over the past two decades, Victor and Cullen's (Adm Sci Q 33:101-125, 1988) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan's top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical climates. The results confirm the relationship between (...) these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

The sizes of individual data files have steadily increased along with rising demand for customized services, leading to issues such as low efficiency of web-based geographical information system -based data compression, transmission, and rendering for rich Internet applications in complicated visualization systems. In this article, a WebGIS-based technical solution for the efficient transmission and visualization of meteorological big data is proposed. Based on open-source technology such as HTML5 and Mapbox GL, the proposed scheme considers distributed data compression and transmission on (...) the server side as well as distributed requests and page rendering on the browser side. A high-low 8-bit compression method is developed for compressing a 100 megabyte file into a megabyte-scale file, with a compression ratio of approximately 90%, and the recovered data are accurate to two decimal places. Another part of the scheme combines pyramid tile cutting, concurrent domain name request processing, and texture rendering. Experimental results indicate that with this scheme, grid files of up to 100 MB can be transferred and displayed in milliseconds, and multiterminal service applications can be supported by building a grid data visualization mode for big data and technology centers, which may serve as a reference for other industries. (shrink)

Drawing on the transactional model of stress and leader-member exchange (LMX) theory, we examine the role of performance pressure in relation to unethical pro-organizational behavior (UPB). We propose that (1) employee perceived performance pressure and LMX interact to increase employees’ willingness to engage in UPB, and (2) employees’ threat appraisal mediates this interaction effect. The results from two studies based on samples of employees in the United States and China supported our theoretical model. We found that LMX moderated the relation (...) between performance pressure and the willingness to engage in UPB, such that the relation was stronger when LMX was high (Study 1). Moreover, the conditional indirect effect (i.e., performance pressure on UPB through threat appraisal with LMX as a moderator at the first stage) was also supported (Study 2). These findings highlight the role of performance pressure and LMX in inducing unethical work behaviors that are aimed at benefiting the organization (i.e., UPB). Theoretical and managerial implications are also discussed. (shrink)

This paper is motivated by a puzzling observation made when conducting a case study of ProCredit, a well-known social bank. The HR practices that this social enterprise adopted to cultivate mission identification were unfavorably impacting its retention rate. Building on prior research and our analysis of the case, we argue the need for SEs to embrace HRM systems that are both mission-identification proactive and employee-retention preemptive. It theorizes that these HRM systems should be attuned to the labor market conditions that (...) frame how SEs develop and sustain Person-Organization fit. Attuned HRM systems are adapted to labor market conditions and tuned to support SEs’ adeptness to operate against the grain of country and industry norms. (shrink)

The purpose of this study was to develop and empirically test a model for predicting the key factors affecting nurses’ behavioral intention to use mobile learning. We explored behavioral intention from users’ perspectives by applying an extended unified theory of acceptance and use of technology model with the addition of information quality, system quality, technostress, and satisfaction. We conducted a survey of the district and regional hospitals in central Taiwan. Data were derived from 434 respondents. Structural equation modeling was applied (...) to analyze the causal effects of 15 hypothesized predictive factors. We determined that satisfaction, social influence, performance expectancy, facilitating conditions, and effort expectancy positively impacted nurses’ behavioral intention to use m-learning. In addition, technostress was a negative antecedent of effort expectancy. Information quality and system quality had significantly positive effects on satisfaction, performance expectancy, and effort expectancy. This study provides hospital managers with a reference when assessing future developments and informs approaches to promote m-learning. (shrink)

Employee innovation is the cornerstone of the organization, and the motivation for employee innovative behavior largely depends on the leadership style of the leader. With the economic development of society, the traditional authoritative style of leadership can no longer adapt to the psychological characteristics of employees, who use new-era work concepts, techniques, and social rules (hereafter, new generation workers). Inclusive leadership is based on the concept of “fully inclusive and equitable” in traditional Chinese culture, and it can adapt to the (...) independent needs of new generation employees. At present, the research on the relationship between the traditional leadership style and employee innovative behavior is relatively extensive, but there is little research on the relationship between inclusive leadership style and employee innovative behavior, and this needs further exploration. This paper takes new generation employees as the sample and uses psychological capital as an intermediary variable to explore the influence of inclusive leadership style on the innovative behaviors of new generation employees. We found that inclusive leadership is significantly and positively related to new generation employees’ innovative behaviors. Theoretical and practical implications are discussed. (shrink)

Student–teacher relationships have been examined by many studies. However, an omission still exists, the existing scales are not appropriate for studying STRs in private colleges because of the special character of these schools. This paper presents the development and validation of Private-College Student–Teacher Relationship Scale, the first instrument to evaluate student–teacher relationships in private colleges. The PCSTRS has six dimensions: trust, interaction, intimacy, care, approval, and comfort. In our main study, the validity and reliability of the six-factor PCSTRS model were (...) demonstrated. The result of internal consistency coefficient indicated the high reliability of the scale, and the result of concurrent validity indicated the significant correlational relationships between the PCSTRS with other STR measures. In supplementary study, the PCSTRS was administered to 360 participants to confirm the applicability of PCSTRS and investigate the relation of STRs and students’ traits, performance, and wellbeing, as well as the differences between the private school and the public school in this relation; the analyses revealed that there were significant differences in trust, intimacy, and care between private and public colleges; positive correlations were found between STRs and self-esteem, self-efficacy, academic performance, extracurricular activity involvement, and subjective wellbeing. Present research firstly develops the PCSTRS, examined the reliability and validity, and provides the proposed nomological network among related constructs. (shrink)

Employees often experience ethical dilemmas throughout their service in an organization. This study utilized a multilevel standpoint to address employees’ differences in ethical reasoning. Hierarchical linear modeling was used to analyze responses from 40,485 full‐time employees across 54 countries. Drawing from Durkheim's concepts of the homo duplex, socialization process, and social conditions, this study found a positive relationship between employees’ income level and unethical reasoning. Furthermore, the results indicate that modern social regulation, technological advancement, economic development, and economic change moderate (...) the relationship between income and ethical judgment. The study findings contribute to the Durkheimian model by validating the effects of individual‐ and country‐level factors on employees’ ethicality. Considering that the results contradict Durkheim's initial propositions, another concept and theory are proposed, which may complement Durkheim's arguments. Practical implications for organizations and society are further discussed to reinforce employees’ ethics. (shrink)

Artificial intelligence (AI) systems are increasingly adopted to make decisions in domains such as business, education, health care, and criminal justice. However, such algorithmic decision systems can have prevalent biases against marginalized social groups and undermine social justice. Explainable artificial intelligence (XAI) is a recent development aiming to make an AI system’s decision processes less opaque and to expose its problematic biases. This paper argues against technical XAI, according to which the detection and interpretation of algorithmic bias can be handled (...) more or less independently by technical experts who specialize in XAI methods. Drawing on resources from feminist epistemology, we show why technical XAI is mistaken. Specifically, we demonstrate that the proper detection of algorithmic bias requires relevant interpretive resources, which can only be made available, in practice, by actively involving a diverse group of stakeholders. Finally, we suggest how feminist theories can help shape integrated XAI: an inclusive social-epistemic process that facilitates the amelioration of algorithmic bias. (shrink)

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

Several functional magnetic resonance imaging studies have demonstrated abnormalities in static intra- and interhemispheric functional connectivity among diverse brain regions in patients with major depressive disorder. However, the dynamic changes in intra- and interhemispheric functional connectivity patterns in patients with MDD remain unclear. Fifty-eight first-episode, drug-naive patients with MDD and 48 age-, sex-, and education level-matched healthy controls underwent resting-state fMRI. Whole-brain functional connectivity, analyzed using the functional connectivity density approach, was decomposed into ipsilateral and contralateral functional connectivity. We computed (...) the intra- and interhemispheric dynamic FCD using a sliding window analysis to capture the dynamic patterns of functional connectivity. The temporal variability in functional connectivity was quantified as the variance of the dFCD over time. In addition, intra- and interhemispheric static FCD patterns were calculated. Associations between the dFCD variance and sFCD in abnormal brain regions and the severity of depressive symptoms were analyzed. Compared to HCs, patients with MDD showed lower interhemispheric dFCD variability in the inferior/middle frontal gyrus and decreased sFCD in the medial prefrontal cortex/anterior cingulate cortex and posterior cingulate cortex/precuneus in both intra- and interhemispheric comparisons. No significant correlations were found between any abnormal dFCD variance or sFCD at the intra- and interhemispheric levels and the severity of depressive symptoms. Our results suggest intra- and interhemispheric functional connectivity alterations in the dorsolateral prefrontal cortex and default mode network regions involved in cognition, execution and emotion. Furthermore, our study emphasizes the essential role of altered interhemispheric communication dynamics in the DLPFC in patients with MDD. These findings contribute to our understanding of the pathophysiology of MDD. (shrink)

Increasing evidence suggests that corporate sustainability is paradoxical in nature, as corporates and managers have to achieve economic, social, and environmental goals, simultaneously. While a paradox perspective has been broadly incorporated into sustainability research for more than a decade, it has resulted in limited improvement in our understanding of corporate sustainability paradox management. In this study, the authors conduct a systematic review of the literature of corporate sustainability paradox management by adopting the Smith–Lewis three-stage model of dynamic equilibrium. The results (...) reveal the following: Both environmental and cognitive factors manifest tensions arising from the sustainability paradox. While both proactive and defensive strategies are adopted to manage the tensions embedded in the corporate sustainability, the proactive strategy is more extensively studied in the current literature. Management strategies of corporate sustainability paradox are characterized as multi-level, multi-stage, and dealing with multiple paradoxes. Proactive strategies enable organizations to enjoy short-term and long-term sustainability benefits. The authors call for further research explicitly addressing the following areas: the paradoxical nature of corporate sustainability management; corporate sustainability paradox management of for-profit organizations; the micro-foundations of corporate sustainability paradox management; defensive strategies and new proactive strategies; and a unified standard of sustainability outcomes. The practical implications of this review are then elaborated. In practice, the results imply that organizations would best manage the corporate sustainability paradox by understanding the paradox and its equilibrium stages. This review and proposed research agenda are expected to deepen interdisciplinary knowledge and set the stage for interested scholars to undertake in their future inquiries. (shrink)

To explore whether the generation of new protein folds could be linked to metallic cofactor recruitment, we identified the oldest examples of folds for manganese, iron, zinc, and copper proteins by analyzing their fold‐domain mapping patterns. We discovered that the generation of these folds was tightly coupled to corresponding metals. We found that the emerging order for these folds, i.e., manganese and iron protein folds appeared earlier than zinc and copper counterparts, coincides with the putative bioavailability of the corresponding metals (...) in the ancient anoxic ocean. Therefore, we conclude that metallic cofactors, like organic cofactors, play an evolutionary role in the formation of new protein folds. This link could be explained by the emergence of protein structures with novel folds that could fulfill the new protein functions introduced by the metallic cofactors. These findings not only have important implications for understanding the evolutionary mechanisms of protein architectures, but also provide a further interpretation for the evolutionary story of superoxide dismutases. (shrink)

Zhu Xi regarded the Chuci as highly as the Shijing. The author argues that Zhu’s positive reading of Chuci turned on the author Qu Yuan’s patriotic intent but neglected the cultural bac...

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)

An increasing number of users have been attracted by location-based social networks in recent years. Meanwhile, user-generated content in online LBSNs like spatial, temporal, and social information provides an ever-increasing chance to study the human behavior movement from their spatiotemporal mobility patterns and spawns a large number of location-based applications. For instance, one of such applications is to produce personalized point of interest recommendations that users are interested in. Different from traditional recommendation methods, the recommendations in LBSNs come with two (...) vital dimensions, namely, geographical and temporal. However, previously proposed methods do not adequately explore geographical influence and temporal influence. Therefore, fusing geographical and temporal influences for better recommendation accuracy in LBSNs remains potential. In this work, our aim is to generate a top recommendation list of POIs for a target user. Specially, we explore how to produce the POI recommendation by leveraging spatiotemporal information. In order to exploit both geographical and temporal influences, we first design a probabilistic method to initially detect users’ spatial orientation by analyzing visibility weights of POIs which are visited by them. Second, we perform collaborative filtering by detecting users’ temporal preferences. At last, for making the POI recommendation, we combine the aforementioned two approaches, that is, integrating the spatial and temporal influences, to construct a unified framework. Our experimental results on two real-world datasets indicate that our proposed method outperforms the current state-of-the-art POI recommendation approaches. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

The Iowa Gambling Task (IGT) simulates uncertain gains and losses in real life situations and thus is a good measure of uncertain decision making. The role of working memory (WM) in IGT performance still remains unclear. The present study aimed to examine the effect of WM on IGT performance. Three groups of participants matched on gender ratio were randomly assigned to no WM load, low WM load, and high WM load conditions. Initially the three groups did not show significant difference (...) in WM capacity. They finished a modified version of IGT and then their implicit learning effect and explicit cognition on IGT were assessed. Results indicated a linear increasing trend of IGT performance among high WM load, low WM load and no WM load groups; participants in the no WM load and low WM load groups revealed implicit learning effect, while participants in the high WM load group did not; all participants showed explicit cognition on IGT to the same level. These results suggested that participants in the high WM load group showed good explicit cognition to IGT but showed poor performance. This pattern is similar to frontal patients. Further studies should be conducted to explore this issue. (shrink)

Based on social cognitive theory, we theorize that collective efficacy plays a mediating role in the relationship between paternalistic leadership and organizational commitment and that this mediating role depends on team cohesion. The empirical results from a study of 238 employees from 52 teams at manufacturing companies show that benevolent leadership and moral leadership, both components of paternalistic leadership, are positively related to organizational commitment and further that collective efficacy mediates the moral leadership–organizational commitment relationship. We did not find a (...) relationship between authoritarian leadership and organizational commitment. Besides, it was found that team cohesion negatively moderates the relationship between moral leadership and collective efficacy and positively moderates the relationship between collective efficacy and organizational commitment. Explanations and directions for future research are discussed. (shrink)

The study of literature from the point of view of the search for archetypal images and the study of artistic creativity from the standpoint of structuralism are two important trends. Both of these trends have emerged in the contexts of different scientific paradigms. The origin of archetypal criticism is associated with the figure of Herman Northrop Fry, and the basis of archetypal criticism is psychology, namely the concept of psychoanalysis, founded by Sigmund Freud and Carl Gustav Jung. While the origin (...) of structuralism is associated with linguistics and the name of Ferdinand de Saussure, who first began to consider language as a system of signs in which each element defines other elements and is itself determined by them. With all the difference in origin, in general, both theories do not contradict each other - on the contrary, they complement each other. Archetypal literary criticism and structuralist theory of art have deep internal theoretical connections in several ways: both theories look for repetitive elements in literature, both consider literature as a space of memory about the past. Archetypal literary criticism and the structuralist theory of art direct the appeal to the psychology of man as the creator of works of art. Both directions are also largely based on the idea of binary oppositions: within the framework of the archetypal criticism of the pair, many archetypes are grouped into pairs, whereas within the framework of structuralism, the idea of structure itself is based on elementary concepts opposed to each other; finally, both methods have been criticized for the same shortcomings, such as the denial of author subjectivity and the denial of human progress. This article attempts to show that the theory of archetypes in literature and the structuralist theory of art complement each other, and how exactly this complementarity is achieved. (shrink)

Recent studies on the effects of mandatory online teaching, resulting from the COVID-19 pandemic, have widely reported low levels of satisfaction, unwillingness to continue online teaching, and negative impacts on the psychological well-being of teachers. Emerging research has highlighted the potential role of psychological need thwarting, in terms of autonomy, competence, and relatedness thwarting, resulting from online teaching. The aim of this study was to evaluate the immediate and delayed effects of PNT of online teaching on teachers’ well-being, intention to (...) continue online teaching, and job satisfaction. Moreover, data collected from both cross-sectional and longitudinal surveys allowed for a systematic validation of an important instrument in the field of teacher psychology, the Psychological Need Thwarting Scale of Online Teaching, in terms of longitudinal reliability and validity. The data reveal the usefulness of the construct of PNT in terms predicting and explaining teachers’ willingness to continue using online teaching as well as the degree of burnout after a period of 2 months, such that PNT is positively associated with burnout and negatively associated with willingness to continue online teaching. As such, the PNTSOT is recommended for future research evaluating the long-term psychological, affective, and intentional outcomes stemming from teachers’ PNT. Moreover, based on our findings that the impact from PNT of online teaching is persistent and long-term, we suggest that school leaders provide flexible and sustained professional development, model respectful and adaptive leadership, and create opportunities for mastery for the development of community of practice that can mitigate the thwarting of teachers’ autonomy, competence, and relatedness during times of uncertainty. Additionally, in terms of the psychometric properties of the PNTSOT instrument, our empirical findings demonstrate internal reliability, test–retest reliability, measurement invariance, and criterion validity based on cross-sectional and longitudinal data. (shrink)

Background “Crisis military deployment” was defined as a situation in which military personnel are suddenly ordered to duty to support an operation away from their home station and in a potentially dangerous environment. As a result of complex changes in the global political and economic landscape, military nurses are assuming an increasing number of crisis military deployment tasks. Moral distress has been widely studied among civilian nurses. However, little is known about the moral distress military nurses experience during military deployments (...) in crisis. Aim This review discussed the current state of research on the phenomenon, unique factors, specific sources, and measurement tools. Methods The scope of the study was defined using a framework developed by Arksey and O’Malley. Following English databases were searched: PubMed, CINAHL, Cochrane Library, Web of Science, and Embase, using MeSH terms and free word combinations; furthermore, Chinese databases: CNKI and CBMDisc, were explored using thematic terms from inception until January 20, 2023. Data were selected and defined by the inclusion and exclusion criteria and independently screened by two researchers. Ethical considerations The scoping review adhered to sound scientific practice and respected authorship and reference sources. Results Finally, 21 articles were included in the review. The moral distress of military nurses in crisis military deployments had unique and specific sources and reported positive aspects. The deployment environment and nature of the mission, responsibilities and obligations of military nurses, and the limited rights of patients were unique factors. Specific sources included third-party intervention, military triage, resource allocation, futile care, care of the enemy, and return to the battlefield. Military nurses in deployment reported positive aspects. They grow in their inner strength, build deep friendships and gain a greater sense of professional value. Conclusion It is important to understand the unique factors and specific sources of moral distress faced by military nurses in crisis military deployments and to identify the positive aspects. This research will help prepare military nurses for future deployments in advance by providing useful information to mitigate and eliminate moral distress. (shrink)

Shape memory alloy- based actuators are widely applied in the compliant actuating systems. However, the measured data of the SMA-based compliant actuating system reveal the input-output hysteresis behavior, and the actuating precision of the compliant actuating system could be degraded by such hysteresis nonlinearities. To characterize such nonlinearities in the SMA-based compliant actuator precisely, a Jiles-Atherton model is adopted in this paper, and a modified particle swarm optimization algorithm is proposed to identify the parameters in the Jiles-Atherton model, which is (...) a combination of several differential nonlinear equations. Compared with the basic PSO identification algorithm, the designed MPSO algorithm can reduce the local optimum problem so that the Jiles-Atherton model with the identified parameters can show good agreements with the measured experimental data. The good capture ability of the proposed identification algorithm is also examined through the comparisons with Jiles-Atherton model using the basic PSO identification algorithm. (shrink)

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)