Background: Patients with a traumatic injury often require intensive care for life-saving treatments. Physical suffering and emotional stress during critical care can be alleviated by ethical caring provided by nurses. The relationship between body and self are fundamentally inseparable. Nurses need to understand the impacts of traumatic injury on a patient’s body and self. Aim: To understand the meaning of traumatic injury for body and self for patients receiving intensive care. Research design: A qualitative descriptive study using Giorgi’s phenomenological approach. (...) Participants and research context: Patients receiving intensive care for physical trauma were selected by purposive sampling (N = 15) from a medical center in Taiwan. Individual in-depth, face-to-face audiotaped interviews, guided by semi-structured questions, were used to collect data. Each interview lasted 30–60 min. Audiotaped interviews were transcribed and analyzed. Ethical considerations: This study was approved by the Institutional Review Board of the medical center. Findings: The impact of the experience of traumatic injury on participants’ body and self was described by three main themes: (1) Searching for the meaning of the injured body, (2) Feeling trapped in the bed, and (3) The carer and the cared-for. Discussion and conclusion: The implications of the three themes described in the findings are as follows: Trauma as a source of meaning; Body and self are mutually limiting or mutually enabling; and Ethical relationships. The experience of needing intensive care following a traumatic injury on the body and self was dynamic and mutual. The experience of the injury changed the relationship between body and self, and gave new meaning to life. Nurses play a crucial role in continuity of care by understanding the meaning of a traumatic injury for patient’s body and self that facilitates ethical care and recovery from injury. (shrink)

Background: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse–patient relationships. Aim: This study aimed to understand the experience of nurses who cared for burn victims (...) of the color-dust explosion and the meaning of ethical relationships between nurse and patient. Research design: A qualitative descriptive study using a phenomenological approach. Participants and research context: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi’s method. Ethical considerations: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. Findings Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths. Conclusions: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient–nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving. (shrink)

Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to (...) interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress. (shrink)

Background Ethical dilemmas that arise in the clinical setting often require the collaboration of multiple disciplines to be resolved. However, medical and nursing curricula do not prioritize communication among disciplines regarding this issue. A common teaching strategy, problem-based learning, could be used to enhance communication among disciplines. Therefore, a university in southern Taiwan developed an interprofessional ethics education program based on problem-based learning strategies. This study described tutors’ experience teaching in this program. Aim To explore the phenomenon of teaching and (...) learning in interprofessional ethics education for medical and nursing students from the perspectives of tutors. Design Phenomenological qualitative research. Methods Medical and nursing students completed a 6-week interprofessional ethics education program moderated by either physician or nurse tutors. At the conclusion of the ethics education program, all 14 tutors were invited to participate in focus group interviews. Among them, six tutors (three nursing tutors and three physician tutors) participated in additional individual interviews. All of the contents from the focus group interviews and individual interviews were recorded and transcribed. Using the phenomenological approach, the phenomenon of teaching and learning in interprofessional ethics education were generated. Ethical consideration The study was approved by the Institutional Review Board. Findings Three themes emerged from the tutors' teaching perspectives, including the instructor’s motivation to teach, the use of narrative case scenarios, and the emphasis on improving interprofessional ethics communication. Discussion Problem-based learning creates an interprofessional communication platform in interprofessional ethics education. The phenomenon of value convergence between tutors and students, between different students’ professions, and between different students’ professional maturities is observed. Conclusion Problem-based learning is an effective teaching strategy for creating a communication platform for interprofessional ethics education. Ethic curriculum should emphasize motivating instructor, use narrative case scenarios, and focus on interprofessional communication. (shrink)

Research on the unrepresentability of death in Samuel Beckett’s oeuvre abound in Beckett scholarship, but little attention has been given to the artist’s representation of caregiving to the dying in his plays. With reference to Martin Heidegger’s concept of _care_ and Albert Camus’s idea of the _absurd_, this article analyzes _Endgame_ (1957) and _Footfalls_ (1976) by attending to Beckett’s dramatic representation of caregiving as undergirded by a sense of its absurdity. The almost 20-year gap between the writing of both plays (...) highlights the development of an understanding that this sense of absurdity is never about the caregiver’s questioning of one’s obligation to the dependent but about how one chooses to respond to caregiving as an absurd predicament. The pertinence of such a representation of caregiving by Beckett lies in its poignant articulation of a complex experience that is often left unexpressed by caregivers who prioritize their dependent loved ones over themselves. (shrink)

Globalization has expanded its influence since the early 1980s hugely since Reagan and Thatcher were in power and devoted themselves to advocating its key ideas, such as deregulation and privatizat...

It has been argued that globalization assists the USA to gain a hegemonic position, allowing it to export its culture. Because this exportation leads to the domination by American culture of the local cultures of importing countries, which are the key element in sustaining their citizens’ national identity, citizens of these countries are unable to protect state sovereignty from this cultural invasion. In order to prevent a political crisis arising from such an invasion, these countries will adopt the strategy of (...) cultural localization. However, this top-down approach overestimates the influence of hegemonic cultures and, thus, overlooks the dynamic nature of cultural development that is generated by people’s agency. This essay rejects this top-down model by arguing that texts cannot dominate people, and that people influence their existence and value. (shrink)

Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; (...) and factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the stress of the COVID-19 pandemic, 12.3% of frontline healthcare workers in general hospitals reported having mental distress and perceived lower social adaptation status compared with those working in psychiatric hospitals. Christians/Catholics perceived better psychological well-being, and Buddhists/Taoists were less likely to experience mental distress. The results at 6 weeks of follow-up showed that the perceived lower social adaptation status of general hospital healthcare workers was temporary and improved with time. Christian/Catholic religion and time had independent positive effects on psychological well-being; however, the interaction of Christian/Catholic religion and time had a negative effect.Conclusions: Collectivism and individualism in the cultural context are discussed with regard to alexithymic trait and Buddhist/Taoist and Christian/Catholic religious faiths. Early identification of mental distress and interventions should be implemented to ensure a healthy and robust clinical workforce for the treatment and control of the COVID-19 pandemic. (shrink)

Some of the authors of the essays on Chinese philosophers prefer the pin yin system of romanization for Chinese names and words, while others prefer the Wade‐Giles system. Given that both systems are in wide use today, important names and words are given in both their pin yin and Wade‐Giles formulations. The author's preference is printed first, followed by the alternative romanization within brackets.

Preparative and analytical methods developed by separation scientists have played an important role in the history of molecular biology. One such early method is gel electrophoresis, a technique that uses various types of gel as its supporting medium to separate charged molecules based on size and other properties. Historians of science, however, have only recently begun to pay closer attention to this material epistemological dimension of biomolecular science. This paper substantiates the historiographical thread that explores the relationship between modern laboratory (...) practice and the production of scientific knowledge. It traces the historical development of gel electrophoresis from the mid-1940s to the mid-1960s, with careful attention to the interplay between technical developments and disciplinary shifts, especially the rise of molecular biology in this time-frame. Claiming that the early 1950s marked a decisive shift in the evolution of electrophoretic methods from moving boundary to zone electrophoresis, I reconstruct various trajectories in which scientists such as Oliver Smithies sought out the most desirable solid supporting medium for electrophoretic instrumentation. Biomolecular knowledge, I argue, emerged in part from this process of seeking the most appropriate supporting medium that allowed for discrete molecular separation and visualization. The early 1950s, therefore, marked not only an important turning point in the history of separation science, but also a transformative moment in the history of the life sciences as the growth of molecular biology depended in part on the epistemological access to the molecular realm available through these evolving technologies. (shrink)

Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung (...) Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses. (shrink)

Young migrants have been the major migrant labor force in urban China. But they may be more vulnerable in quality of life and mental health than other groups, due to their personal characteristic and some social/community policies or management measures. It highlights the need to focus on psychological wellbeing and probe driving and reinforcing factors that influence their mental health. This study aimed to investigate the influence of subjective/objective status and possible pathways of young migrants’ life satisfaction and psychological distress. (...) Data on 9838 young migrants in the China Migrants Dynamic Survey were analyzed by LISREL 8.8. A total of 94.03% migrated for jobs or business. Subjective status, including subjective socioeconomic status, social adaptation, and psychological integration, had positive effects on life satisfaction, whereas social adaptation and psychological integration negatively affected psychological distress. Objective status, including objective socioeconomic status and health insurance, had adverse effects on life satisfaction, whereas they positively affected psychological distress. Social participation and city belonging had only significant positive mediating roles on life satisfaction. It is essential to increase social adaptation and decrease integration stress according to younger internal migrants’ practical needs. It is also necessary to enhance community/social resources and activities in the context of developing sustainability in the community to assist in mental health promotion. (shrink)

Corporate social responsibility involvement and disclosure has been becoming increasingly popular among US public firms, including those that qualify as real estate investment trusts. This paper aims to discover the relationship between CSR involvement and potential determinants such as growth opportunities, profitability, visibility, and agency costs. Types of CSR involvement are assessed in terms of environmental, community, and governance disclosures and are quantified using word count from the company’s voluntary disclosure. Our results support the hypothesis that CSR has a strategic (...) element and that REITs have greater CSR involvement when they have greater growth and investment opportunities. When the type of disclosure is broken into subcategories, the results show that not all dimensions of CSR are alike: environmental, community, and governance CSR disclosures appear to be motivated by different sets of incentives and reasons. (shrink)

This study considers the role of epistemic turning points in the historiography of sexuality. Disentangling the historical complexity of scientia sexualis, I argue that the late 19th century and the mid-20th century constitute two critical epistemic junctures in the genealogy of sexual liberation, as the notion of free love slowly gave way to the idea of sexual freedom in modern western society. I also explore the value of the Foucauldian approach for the study of the history of sexuality in non-western (...) contexts. Drawing on examples from Republican China (1912—49), I propose that the Foucauldian insight concerning the emergence of a ‘homosexual identity’ in the West can serve as a useful guide for thinking about similar issues in the history of sexuality and the historical epistemology of sexology in modern East Asia. (shrink)

Historians and philosophers of science have furnished a wide array of theoretical-historiographical terms to emphasize the discontinuities among different systems of knowledge. Some of the most famous include Thomas Kuhn’s “paradigm”, Michel Foucault’s “episteme”, and the notion of “styles of reasoning” more recently developed by Ian Hacking and Arnold Davidson. This paper takes up this theoretical-historiographical thread by assessing the values and limitations of the notion of “style” for the historical and philosophical study of science. Specifically, reflecting on various methodological (...) and theoretical concerns prompted by sexuality, translation, and East Asian studies, this paper argues that the heretofore ways in which historians and philosophers of science have used the notion of “style” are severely restricted in terms of its mere applicability to the intellectual history of Western science. The particular example of the translation of “homosexuality” into Chinese during the May Fourth era reveals that the notion of “style” has the potential of carrying a much more dynamic conceptual weight, as when used in “styles of argumentation”. The paper also engages briefly with the historiography of scientific “national styles” and ends with some concluding remarks on the limitations of “social histories from below” and the under appreciated importance of “epistemological histories of possibilities”. (shrink)

Philosophy is presented in a wide range of forms, none of which can be convincingly claimed to be the “genuine” one. Historically speaking, there is not one “proper” way of doing philosophy, evidencing what may be called the social contingency of philosophy. This paper aims to provide a “critical” philosophy of today, in the Kantian sense of a philosophy that reflects on the conditions of its possibility, and thereby acknowledges the limitations they impose. Conceptually, our approach is grounded in Niklas (...) Luhmann’s social systems theory, in which “functional differentiation” and “second-order observation” are two crucial characteristics of modern society. The paper discusses how presentations of philosophy align themselves with the second-order observation mechanisms of the specific social systems in which they are “hosted.” This paper deals in particular with two such systems: academics and social media. These forms of presenting philosophy produce two different kinds of philosophy presenters: the expert and the influencer. (shrink)

Followership is an important but understudied domain. This study adopted a follower-centric perspective to examine the internal process by which followership affects creative performance via work autonomy and creative self-efficacy. The study employed a 3-wave survey of 341 employees of a Taiwanese university to achieve the research purpose. This study showed that effective followership is positively associated with employees’ work autonomy and creative self-efficacy. Work autonomy and creative self-efficacy mediate the relationship between effective followership and creative performance. This study’s empirical (...) findings provide an improved way of measuring followership and broaden our understanding of how followership triggers intrinsic motivation to facilitate creative performance. (shrink)

A great deal of progress has been made on information ethics. Which portion is not sufficient? That might be the comparison from countries to countries. The purpose of this study was closely examined using the cross-cultural method for comparison. To determine the ethics cognitions and behaviors of the students, a comprehensive survey was distributed. The questionnaire for the study used Mason’s four essential factors in information ethics that included Privacy, Accuracy, Property and Accessibility (PAPA). The samples were comprised of Kaohsiung (...) Taiwan and Nanjing China, junior high school students in 2006. The sample and the survey were obtained from two stages of random sampling that was conducted using an Internet website. Students could read the online questionnaire in the computer laboratory and then send immediate feedback to the website server. The result of the experiment showed the divergence of information ethics in cognition and behavior between Kaohsiung and Nanjing school children. The effects of background and correlation are from cognition and behavior between two regions. (shrink)

The significance of the discovery of half of Dewey’s most important China lecture series notes, “Social and Political Philosophy,” cannot be overestimated. These newly-discovered lecture notes provide us with a unique opportunity to conduct a translation case study in both directions: first, to check Hu Shi’s translation against Dewey’s lecture notes; and second, to check John Dewey: Lectures in China, 1919-1920, “back translations” in the terminology of translation studies, both against Hu’s translation and against Dewey’s original notes that the back (...) translators tried to reconstruct. More important, by treating translations as re-writes and as products of cultural and ideological manipulations, this case study enables us to analyze how Hu Shi appropriated Dewey’s ideas to advance his own cultural and political agenda while acting as the latter’s interpreter. (shrink)

ABSTRACTThis study explores how sexual orgasm is conceptualized in 27 languages and proposes an ideal cognitive model for sexual desire. Specifically, the study has identified that the conceptual metaphors, conceptual metonymies, and related concepts manifested in the terms and announcements for orgasm can be categorized into orgasm as a physiological response, orgasm as a psychological state, and orgasm as an ideal goal. We also observed that languages tend to conceptualize orgasm as a physiological response in the terms for orgasm; whereas (...) more languages are inclined to conceptualize orgasm as an ideal goal in the announcements for orgasm. Depending on whether the focus is on the physiological, psychological, and ideal aspects during sex, native speakers of their various languages may conceptualize orgasm with the conceptual metaphors ORGASM IS A PEAK, ORGASM IS FIRE, ORGASM IS DEATH, ORGASM IS A DESTINATION, and ORGASM IS THE RELEASE OF FORCE/SUBSTANCE IN A CONTAINER; conceptual metonymies (i.e., EXCIT... (shrink)

This study explores the ethical attitudes, behaviors, and perceptions of a sampling of political science students in Taiwan. It investigates their intentions toward observing ethics in the area of digital rights, on topics such as the freedom of expression, freedom of association, equal access to information, confidentiality, security, and protection of intellectual property while using computers. Based on preliminary studies, a questionnaire was designed and distributed to 660 political science and public administration students throughout colleges in Taiwan. Data collected from (...) 440 valid samples have been analyzed using structural equation modeling to test the three sets of hypotheses made by the researchers in the framework of the theory of planned behavior. Findings show attitude, subjective norm, and perceived behavior control of the respondents all have positive impacts on the personal observation of information ethics. In this regard, altruism, the secondary group, and the sense of security have greater influence than egoism, the primary group, and the consideration of self-efficacy. Implications of these findings and recommendations for cultivating computer ethics in Taiwan and elsewhere are discussed. (shrink)

Gene therapy approaches have great promise in the treatment of neurodegenerative disorders and malignant brain tumors. Neuwelt et al. review available viral-mediated gene therapy methods and their blood-brain-barrier (BBB) disruption delivery technique, briefly mentioning nonviral mediated gene therapy methods. This commentary discussed the BBB disruption delivery technique, viral and nonviral mediated gene therapy approaches to Parkinson's disease, and the potential use of antisense oligo to suppress malignant brain tumors.