The concept of brain death evolved because advancements in medical science permitted unprecedented artificial maintenance of vital body functions by external means. Although the concept of brain death is accepted clinically, ethically, and legally in the United States, there is no national standard for the determination of brain death. There is evidence that variability and inconsistency in the process of determining brain death exist both in clinical settings and in State statutes. Several studies demonstrate that medical personnel determine brain death (...) in variable ways, and have variable understandings of the definition of brain death. The declaration of death has significant legal consequences such as probate proceedings and liability issues for wrongful death. Inconsistencies in the determination of death may therefore be medically, ethically, and legally problematic. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...) end-of-life care and its consequential impacts. Research objectives To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design A qualitative descriptive approach was employed. Participants and research context Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings The moral distress-inducing factors and nurses’ perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. (shrink)

Modern schooling in Korea, which was officially established by law in 1949, is well known for its function as an engine of economic success in modern Korea. Although this fact seems to be world-wid...

Little is known about the Korean Peninsula before 12 th century, due to which potentially biased assessments of its social, cultural, and political history exist. This study attempted to unearth the history of the Korean Peninsula since the late 10th century through the Buddhist inscriptions. These inscriptions unveil the authentic social environment, religious beliefs, and political ecology of late Silla and delve into the political motives and life philosophies of Silla scholars who studied the Tang Dynasty, especially their approach of (...) 'interpreting Buddhism through Confucianism'. Based on empirical research grounded in documentary evidence, combined with literary-historical methods, this study examined the inscriptions of two great Silla scholars Choi Chi-Won and Choi Eun-Wee. Their works predominantly feature Confucian thought within Buddhist narratives. Politically, they used Confucian principles as the foundation for governance, interpreting them through Buddhist concepts to enlighten the masses and strengthen dynastic rule. Ideologically, while Choi Chi-Won fully implemented Confucian logic, Choi Eun-Wee demonstrated a stronger Buddhist inclination. This research enriches the understanding of the history, culture, and society of the Korean Peninsula, highlighting the significant role of blending Confucian and Buddhist elements in shaping its social and political structures. (shrink)

Temporal Changes in Ovarian Gonadotropin-Releasing Hormone mRNA Levels by Gonadotropins in the Rat Sung Ho Lee, Eun-Seob Song, Sun Kyeong Yu, Changmee Kim, Dae Kee Lee, Wan Sung Choi l and Kyungjin Kim* Department of Molecular Biofogy and SRC for Cell Differentiation, Seoul National University, Seoul 150-742, Korea; IDepartment of Anatomy, College of Medicine, Gyeongsanf; National University, Chinju 660-280, Korea (Recei·. cd on December 29, 1993) The present study examines whether gonadotropins are involved in the regulation of ovarian GnRH (...) gene expression and how ovarian GnRH gene expression temporalJy correlates with alterations in hypothalamic GnRH, pituitary LH~ gene expression in respons to gonadotropins. Hypothalamic and ovarian GnRH mRNA and pituitary LH~ mRNA levels were determined by respective RNA-blot hybridizations, and ovarian GnRH and estradiol contents and serum LH levels were measured by respective radioimmunoassays. Three animal models such as 1) PMSG-treated, 2) PMSG and heG-treated immature rats and 3) proestrous stage of adult rats were used. Immature rats (25-days old) were administered with PMSG (10 iu) at 10:00 hand 48 h later with heG (10 iu) to induce ovulation. In the PMSG-injected model, hypothalamic GnRH mRNA levels were markedly augmented about 9-fold at 50 h, and pituitary LH mRNA 3-fold at 52 h after PMSG administration. Serum LH levels were increased to the preovulatory surge levels at 56 h, and ovarian GnRH mRNA levels were augmented 4-fold at 60 h after PMSG injection. Administration of heG also induced a marked enhancement in ovarian GnRH mRNA levels in comparison to the values shown in both intact and PMSGtreated rats at 52 hand 54 h, respectively. In the proestrous stage of normal adult rats, pituitary LH~ mRNA levels were peaked at 16:00 h. The preovulatory LH surge was evident at 4 h before increment in ovarian GnRH mRNA levels as shown in PMSG-treated rats. The present study clearly showed the sequential increase in hypothalamic GnRH mRNA, pituitary LH~ mRNA and ovarian GnRH mRNA levels, indicating that ovarian GnRH may play a possible role in the control of follicular maturation and the ovulation process. (shrink)

Although Fair Trade has recently experienced rapid growth around the world, there is lack of consumer research that investigates what determines consumers' loyalty toward Fair Trade brands. In this research, we investigate how ethical consumption values (ECV) and two mediating variables, Fair Trade product beliefs (FTPB) and Fair Trade corporate evaluation, (FTCE) determine Fair Trade brand loyalty (FTBL). On the basis of two empirical studies that use samples from the U.S. and Korea, we provide evidence demonstrating that the manner in (...) which ECV influence FTBL differs in the U.S. and Korea. In the U.S., ECV determine FTBL only indirectly via FTPB, whereas in Korea they determine FTBL directly as well as indirectly via FTCE. We discuss theoretical and managerial implications of these findings. (shrink)

Background: Whenever there has been a worldwide contagious disease outbreak, there have been reports of infection and death of healthcare workers. Particularly because emergency nurses have contact with patients on the front line, they experience ethical problems in nursing while struggling with infectious diseases in an unfavorable environment. Objective: The objective of this study was to explore emergency nurses’ ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome–coronavirus in Korea. Design and sample: (...) For this cross-sectional study, a questionnaire survey was conducted with emergency nurses working in six hospitals selected through convenience sampling from the hospitals designated for Middle East respiratory syndrome–coronavirus patients in the capital area. Methods: Data were collected from 169 emergency nurses in Korea during August 2015. Ethical considerations: This research was approved by the Institutional Review Board of G University in Korea. Results: The findings of this study suggest that during the Middle East respiratory syndrome–coronavirus outbreak, emergency nurses experienced ethical problems tied to a mind-set of avoiding patients. Three factors were found to influence emergency nurses’ ethical problems (in order of influence): cognition of social stigmatization, level of agreement with infection control measures, and perceived risk. Conclusion: Through this study, we obtained information on emergency nurses’ ethical problems during the Middle East respiratory syndrome–coronavirus outbreak and identified the factors that influence them. As found in this study, nurses’ ethical problems were influenced most by cognitions of social stigmatization. Accordingly, to support nurses confidently care for people during future health disasters, it is most urgent to promote appropriate public consciousness that encourages healthcare workers. (shrink)

Role-based database management systems are most widely used for information storage and analysis but are known as vulnerable to insider attacks. The core of intrusion detection lies in an adaptive system, where an insider attack can be judged if it is different from the predicted role by performing classification on the user’s queries accessing the database and comparing it with the authorized role. In order to handle the high similarity of user queries for misclassified roles, this paper proposes a deep (...) metric neural network with strategic sampling algorithm that properly extracts salient features and directly learns a quantitative measure of similarity. A strategic sampling method of heuristically generating and learning training pairs through Monte Carlo search is proposed to select a training pair that can represent the entire dataset. With the TPC-E–based benchmark data trained with 11,000 queries for 11 roles, the proposed model produces the classification accuracy of 95.41%, which is the highest compared with the previous models. The results are verified through comparison of quantitative and qualitative evaluations, and the feature space modelled in the neural network is analysed by t-SNE algorithm. (shrink)

The purpose of this essay is to discuss Deleuze and Guattari's concept of the Third World. For Deleuze and Guattari, however, the Third World is not only a geographical term, but also one that denotes the linguistic zones, another term of the minority. The essay argues that the concept of the Third World is related to minor literature, the minor or intense use of language. This ‘transcendental exercise’ of writing is an opposition to the initial purpose of language, namely representation. (...) Language must escape from its normative usage, and then be liberated to a new spatio-temporality, in other words, the linguistic Third World zones. My conclusion is that the creation of Third World linguistic zones is the repetition of differences against the generalisation of representation, such as becoming non-human and non-European, not in imitation of the molar form of the animal or a non-continent extending terrestrial power into the ocean, but as the right way to invent the people missing in the Third World. Inventing the people of the Third World is the right condition in which alternative political subjects can be produced through desubjectification, not domestication, by capitalist axiomatics. In this way, Deleuze's political philosophy aims to use the virtual politics of the Third World to radicalise the actual representation of the existing Left. (shrink)

The zone of proximal development (ZPD) is defined as an overarching concept that integrates the main tenets of Vygotsky’s theory of human development. The conceptualization of the ZPD begins with its social, cultural, and historical context and traces its development as a spatial and temporal metaphor that reflects the sociogenetic root of all human mental functioning. Beyond the explication of sociogenesis, the ZPD is reconceptualized to include the notions of voice and dialogicality. The insights gained from the fields of semiotics (...) and discourse studies allow a broader understanding of the ZPD by bringing to light participant structures and institutional and historical forces that may not have been included in the dominant interpretations of the ZPD. (shrink)

This study examined influential factors of newspaper corporation social responsibility and evaluated corporate social responsibility using a newspaper corporate social responsibility index. Results of this study, which was conducted by survey, showed that arbitrative, essential, and cultural activities were influential factors comprised of newspaper corporate social responsibility. In addition, the findings indicated that higher corporate social responsibility index was not accompanied by Korean newspaper corporations with larger circulations.

En este artículo se realiza un periplo a lo largo de la historia de la península coreana a través de los caminos recorridos por las principales tradiciones religiosas presentes en ella. Analizaremos el papel que han tenido en el modo de entender las relaciones sociales y la creación de mecanismos de inclusión y exclusión dentro de la sociedad coreana. Las interrelaciones establecidas entre ellas como factor que ha contribuido al progreso de la sociedad y que diferentes grupos fueran aceptados o (...) rechazados a lo largo de la historia. Estudiamos como el pensamiento de estas tradiciones religiosas y el modo de entenderlo ha impulsado u obstaculizado los procesos de inclusión y liberación a lo largo de las diferentes etapas de la historia de Corea. (shrink)

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid levels and cerebral blood flow in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a (...) diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress, anxiety, fatigue, and sleep quality improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms. The prefrontal GABA levels decreased, while relative CBF increased after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention. The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress. (shrink)

This study aimed to explore the enabling context of the HIV care continuum as perceived by people living with HIV and healthcare professionals. This qualitative study involved in‐depth individual interviews with eight people living with HIV and group interviews with seven nurses and physicians. These interviews took place between March 5, 2021, and July 13, 2022. Thematic analysis was conducted. The main themes that emerged included “network of support and systems,” “personal gains from the care continuum,” “continuity and practicality of (...) healthcare services,” “presence of significant other(s),” and “social belonging.” These themes were structured within the five levels of the socio‐ecological model (system, individual, organizational, interpersonal, and community levels), and 10 subthemes were identified. With the integration of themes, the enabling context was compared to a “care orbit,” indicating that people diagnosed with HIV start treatment at the system level and continue HIV care at other levels. In addition to primary support at the system level, the enabling context also includes individual commitment to care and regular health habits, hospital services, support from significant others, and community culture. Together, the context helps guide people living with HIV into the “orbit” of the care system. (shrink)

Ce travail explore l’origine d’un malentendu vieux de cinq siècles concernant la foi justifiante. Dieu justifie-t-il le pécheur par la foi seule ( sola fide ) comme le disent les luthériens ou par la foi formée par la charité ( fide caritate formata ) comme le disent les catholiques? Il s’agit d’une des différences les plus débattues entre les deux traditions. Une étude précise des sources et une comparaison entre les textes de Thomas d’Aquin et de Martin Luther consacrés à (...) l’interprétation de la fides caritate formata permet de constater que, malgré la compréhension différente de la formule, ils ont en réalité la même idée de la foi justifiante en raison d’une même fidélité à l’Écriture. C’est en puisant à cette source commune qu’aujourd’hui encore, ils montrent aux Églises un chemin d’unité. (shrink)

Ideological indoctrination is explicit and pervasive in China, with the school curriculum used to mould the spirit and character of adolescents, fulfilling ideological and political purposes. But the exact content varies over time. Comparing two versions of textbooks published in 1997 and 2005, this paper depicts the continuities and change in the curricular discourses centred on the notion of ‘good citizen’. While keeping the official status of socialism and the Party leadership untouched, the new textbooks soften the presentation and packaging (...) of the ideological content, very much in tandem with the soft authoritarianism practised since the post‐Deng era when China has been deeply involved in the processes of marketisation, liberalisation and globalisation. The new textbooks also adopt a stance of greater reconciliation with human rights and global citizenship. While being granted more autonomy and rights, young citizens are still expected to shoulder the mission of national revival and socialist modernisation—very much derived from official policies. (shrink)

The central theme of this paper is the dispositional/categorical distinction that has been one of the top agendas in contemporary metaphysics. I will first develop from my semantic account of dispositions what I think the correct formulation of the dispositional/categorical distinction in terms of counterfactual conditionals. It will be argued that my formulation does not have the shortcomings that have plagued previously proposed ones. Then I will turn my attention to one of its consequences, the thesis that dispositional properties are (...) not susceptible to intrinsic finks. This thesis was first advanced by me and has ever since stirred up a big controversy, endorsed by some philosophers like Handfield, Bird, and Cohen but rejected by others like Clarke and Fara. Against this background, I will remedy my defense of the impossibility of intrinsically finkable dispositions and then refute some of apparently powerful criticisms of it. And so the upshot is that it is much more reasonable to hold on to the thesis that dispositions are intrinsically unfinkable. This will have the effect of putting the dispositional/categorical distinction on firmer and more secure ground. (shrink)

With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their end-of-life treatment preferences (ELTP) while they are physically and mentally able to do so. The purpose of this study was to explore ELTP among older adults and to compare those preferences in a subset of individuals who had reported their ELTP in a survey completed the previous year. This was a descriptive study of 191 older adults (...) living in a continuing care retirement community. Approximately half of the participants did not want cardiopulmonary resuscitation, to be put on a respirator, or to receive dialysis. The findings in this study suggest that many older adults do not want aggressive interventions at the end of life, but choose rather those measures that will keep them comfortable. Moreover, treatment choices may change over time. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in dictating their end-of-life care. (shrink)

The concept of emotion can be organized within a hypothetical space comprising a limited number of dimensions representing essential properties of emotion. The present study examined cultural influences on such conceptual structure by comparing the performance of emotion word classification between Japanese and Korean individuals. Two types of emotional words were used; central concepts, highly typical examples of emotion, and less typical peripheral concepts. Participants classified 30 words into groups based on conceptual similarity. MDS analyses revealed a three-dimensional structure with (...) valence, social engagement, and arousal dimensions for both cultures, with the valence dimension being the most salient one. The Japanese prioritized the social engagement over the arousal while the Koreans showed sensitivities to the arousal dimension. Although the conceptual structure was similar for the two countries, the weight of importance among the three dimensions seems to be different, reflecting each culture’s values and communication styles. (shrink)

The study aimed to examine the influence of personal characteristics on activity preferences using decision tree analysis and examine the effects of the variables using conventional approaches. A descriptive study was conducted with 251 nursing home residents with dementia in Korea to examine the relationship between their personal characteristics and activity preferences. Decision tree analysis was used to classify participants’ activity preferences, and preference levels were examined using logistic regression analysis. Activities were classified as either physical and social activities or (...) cognitive and affective activities. This model showed an accuracy rate of 85.7% for positively predicting physical and social activity preference and 30.3% for positively predicting cognitive and affective activity preference. Gender was the strongest determinant of activity preference. The odds of preferring physical and social activities were 3.179 times higher among women, while the odds for preferring cognitive and affective activities were 0.412 times higher among men. Notably, cognitive and affective activity preference increased to 58.8% for married male participants. This study’s findings can contribute to the development of programs to decrease behavioral and psychological symptoms among older people with dementia residing in nursing homes and provide scientific evidence for integrating these activities into long-term services for this population. (shrink)

In empiricism, there are only two answers for a question: black or white. Yet, subjective meanings of human behaviours and responses toward health and illness cannot be simply explained with black and white. Gray zones are needed because they are characterized by complexity and require a contextual understanding. In this paper, we present and suggest fuzzy logic as an example of theoretical bases that help transcend the conflicts between objectivity and subjectivity, respect gray zones between black and white answers for (...) questions, and provide a contextual understanding of complex nursing phenomenon. A historical review of fuzzy logic is followed by a definition of fuzzy logic. Then, fuzzy logic is discussed in terms of its compatibility with nursing epistemological views and philosophical thoughts. Fuzzy logic agrees with three categories of epistemological views of nursing, including correspondence, coherence and pragmatism. Fuzzy logic also agrees with four major philosophical thoughts in nursing, including postempiricism, pragmatism, feminism, and postmodernism. Based on the discussion, we propose that fuzzy logic be further explored, used and developed in research and practice in the nursing areas/situations/phenomena that are characterized by complexity, ambiguousness, and vagueness. (shrink)

The lack of attention to sustainability, as a concept with multiple dimensions, has presented a developmental gap in green marketing literature, sustainability, and marketing literature for decades. Based on the established premise of customer–corporate (C–C) identification, in which consumers respond favorably to companies with corporate social responsibility initiatives that they identify with, we propose that consumers would respond similarly to companies with sustainability initiatives. We postulate that consumers care about protecting and preserving favorable economic environments (an economic dimension of sustainability) (...) as much as they care about natural environments. Thus, we investigate how two sustainability dimensions (i.e., environmental and economic) and price can influence consumer responses. Using an experimental method, we demonstrate that consumers favor sustainability in both dimensions by giving positive evaluations of the company and purchase intent. In addition, consumers respond more negatively to poor company sustainability than to high company sustainability. In comparison, consumers respond more negatively to the company’s poor commitment to caring for the environment than to the company’s poor commitment to economic sustainability. We also find that consumers do not respond favorably to low prices when they have information about the firm’s poor environmental sustainability. Finally, we find support for an interaction effect between consumer support for sustainability and corporate sustainability; that is, consumers evaluate a company more favorably if the company shares the consumers’ social causes. Overall, we conclude, from our empirical study, support for the idea that consumers do respond to multiple dimensions of sustainability. (shrink)

The study reviewed 20 currently-available structured ethical decision-making models and developed an integrated model consisting of six steps with useful questions and tools that help better performance each step: (1) the identification of an ethical problem; (2) the collection of additional information to identify the problem and develop solutions; (3) the development of alternatives for analysis and comparison; (4) the selection of the best alternatives and justification; (5) the development of diverse, practical ways to implement ethical decisions and actions; and (...) (6) the evaluation of effects and development of strategies to prevent a similar occurrence. From a pilot-test of the model, nursing students reported positive experiences, including being satisfied with having access to a comprehensive review process of the ethical aspects of decision making and becoming more confident in their decisions. There is a need for the model to be further tested and refined in both the educational and practical environments. (shrink)