Ying Ru Li

As future providers of medical services, nursing students require strong ethical sensitivity to effectively manage clinical ethical dilemmas. However, studies have shown that they often exhibit lower ethical sensitivity than practicing nurses, which may hinder their ability to address ethical challenges competently. This systematic review aimed to comprehensively evaluate the effectiveness of educational interventions in enhancing the ethical sensitivity of nursing students. The findings will offer practical guidelines and a theoretical foundation for advancing nursing ethics education. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted comprehensive searches across nine databases (PubMed, Embase, Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Cochrane Library, Cumulated Index in Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), VIP (Chinese Science and Technology Journal Database), and Wanfang Data) to identify relevant studies published through December 2024. Two researchers independently performed the screening, data extraction, and quality assessment, with any disagreements resolved through discussion to reach a consensus. Twenty-one studies were included. The results indicated that current educational interventions primarily focus on two dimensions: teaching methods and curricular content. Among teaching methods, situational participatory learning was found to be more effective than traditional didactic instruction in enhancing nursing students’ ethical sensitivity. The curricular content was organized into a three-dimensional framework encompassing fundamental theories, clinical practice, and interdisciplinary integration, establishing a comprehensive knowledge system ranging from ethical principles to emerging technological ethics. This review confirmed that interactive teaching methods effectively enhance nursing students’ ethical sensitivity, although they require significant resources. Future nursing education should integrate cross-cultural competencies, spiritual care training, and emerging ethical issues while establishing comprehensive ethics curricula within clinical training. Such approaches will better prepare nurses for ethical challenges in practice.

The theory of embodied semantics holds that verbal metaphors are strongly grounded in sensorimotor experience. Many studies have proven that besides sensorimotor simulation, the comprehension of verbal metaphors also requires semantic abstraction. But the interaction between simulation and abstraction, as well as the time course of metaphorical meaning integration, is not well understood. In the present study, we aimed to investigate whether embodiment or abstraction, or both, is employed in the processing of Chinese verbal metaphor. Participants were asked to read subject-verb metaphorical, verb-object metaphorical, literal-concrete and literal-abstract sentences, and the target words were measured at the verb and the object of each sentence. The results revealed that a similar N400 effect was elicited by the target verbs in the verb-object metaphorical and the literal-concrete sentences, and a similar P600/LPC effect was induced by the target verbs in the subject-verb metaphorical and the literal-abstract sentences, reflecting that the verb-object metaphors trigger a simulation process, while the subject-verb metaphors trigger an abstraction process in the verb processing stage. Moreover, the subject-verb metaphors elicited a stronger P600/LPC effect by the target verbs than the verb-object metaphors, but there was no difference of the P600/LPC caused by the target objects between the two kinds of metaphors, revealing that the metaphorical meaning of a subject-verb metaphor is integrated in the verb processing stage, while that of a verb-object metaphor is reanalyzed in the object processing stage. These results suggest that a verbal metaphor is processed both by simulation and abstraction, and the metaphorical meaning is integrated immediately with the unfolding of the sentence meaning. The position where the semantic conflict lies in a sentence modulates the time course of metaphor sentence comprehension.

Privacy concerns are among the most critical ethical issues in applying generative artificial intelligence (GAI) tools in education. This study examines university students’ privacy concerns regarding GAI, investigating the causes, consequences, and educational implications of these concerns. We employed a qualitative research design featuring in-depth, semi-structured interviews with 15 university students, guided by the Antecedents-Privacy Concerns-Outcomes (APCO) macro model as our theoretical framework, while utilizing a combination of thematic analysis and grounded theory to identify emergent patterns and relationships within participants’ responses. Our research examined students’ privacy concerns regarding GAI usage, investigating influencing factors at both individual and social levels. At the individual level, we analyzed privacy experiences, optimistic bias, and privacy protection skills, while at the social level, we explored peer influence and perceived effectiveness of privacy policies. We also assessed how these privacy concerns ultimately impacted three crucial outcomes: students’ use of GAI tools, mental health, and educational inequality. This study addresses a significant research gap by examining privacy concerns among university students regarding GAI usage, a previously understudied area despite students being early adopters of emerging technologies, while simultaneously representing a vulnerable group regarding privacy risks.

In the Internet era, consumers prefer products with the attributes of social responsibility. Supply chain enterprises strengthen corporate social responsibility management for their own development. To improve CSR throughout the supply chain, it requires coordination and cooperation among the members of the supply chain. In this paper, we consider a three-tier supply chain system consisting of a supplier, a manufacturer, and a retailer and use stochastic differential game to study the CSR coordination of the supply chain. The following indicators are investigated under four decision situations, such as the optimal level of CSR effort for the supply chain members, the optimal value of profit for the supply chain members and the supply chain system, and the expectation and variance of CSR goodwill. Some important results are obtained. Compared with decentralized decision-making, the optimal level of CSR effort increases for the supplier and the manufacturer under local alliance decision-making without cost sharing, whereas the optimal level of CSR effort remains unchanged for the retailer. Compared with local alliance decision-making without cost sharing, the optimal level of CSR effort remains unchanged for the supplier and the manufacturer under local alliance decision-making with cost sharing. When the sum of the marginal profit for the supplier and the manufacturer is greater than half of the marginal profit for the retailer, the optimal level of CSR effort increases for the retailer. Compared with local alliance decision-making with cost sharing, the optimal level of CSR effort increases for the supply chain members under overall alliance decision-making. From decentralized decision-making to local alliance decision-making without cost sharing, to local alliance decision-making with cost sharing, and then to overall alliance decision-making, the optimal value of profit increases for the supply chain members and the supply chain system. Also, the expectation and variance of CSR goodwill increase.

In light of the dramatic growth of Chinese learners worldwide and a need for cross-linguistic research on Chinese literacy development, this study drew upon theories of visual complexity effect (Su & Samuels, 2010) and dual-coding processing (Sadoski & Paivio, 2013) and investigated a) the effects of character properties (i.e., visual complexity and radical presence) on character acquisition and b) the relationship between individual learner differences in radical awareness and character acquisition. Participants included adolescent English-speaking beginning learners of Chinese in the U.S. Following Kuo et al. (2014), a novel character acquisition task was used to investigate the process of acquiring the meaning of new characters. Results showed that a) characters with radicals and with less visual complexity were easier to acquire than characters without radicals and with greater visual complexity; and b) individual differences in radical awareness were associated with the acquisition of all types of characters, but the association was more pronounced with the acquisition of characters with radicals. Theoretical and practical implications of the findings were discussed.

At present, the market demand for forest health tourism is weak. The main purpose of this study is to investigate whether frugality inhibits the intention of forest health tourism and whether the positive effect of cognition on the intention of forest health tourism can compensate for the inhibition of frugality. Based on mental account theory and planned behavior theory, this study constructs a structural equation model with intermediary variables—health consumption mental account and forest health consumption attitude. According to the results of the path analysis of the data, which was collected through the questionnaire survey of urban residents, the positive influence of cognition can compensate for the inhibitory effect of frugality. On this basis, mediating effect analysis based on multigroup comparison is further carried out. This study verifies for the first time the inhibitory effect of frugality on the intention for forest health tourism, enriches the theoretical system of tourism consumer behavior, and provides a scientific basis for the market positioning of forest health and the formulation of marketing strategies.

BackgroundPublished data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China.MethodsWithdrawal of treatment for children in the pediatric intensive care unit of a regional children’s hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawal of treatment was categorized as medical withdrawal or premature withdrawal. The guardian’s self-reported reasons for abandoning the child’s treatment were recorded from 2011.ResultsThe incidence of withdrawal of treatment for children in the PICU decreased significantly; for premature withdrawal the 3-year average of 15.1% in 2006–2008 decreased to 1.9% in 2015–2017. The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children for whom treatment was withdrawn increased from 14.5 months in 2006 to 40.5 months in 2017. Among the reasons given by guardians of children whose treatment was withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved”. Only a few guardians ascribed treatment withdrawal to economic reasons.ConclusionsThe frequency of withdrawal of medical therapy has changed over time in this children’s hospital PICU, and parental decision-making has been a large part of the change.

In this article, we propose that giving in cash and non-cash differ in their relation with the giving firm’s future corporate financial performance and only cash giving is associated with future CFP. Using a novel dataset from ASSET4 that differentiates corporate giving over a sample period of 2002–2012, we examine three competing hypotheses: agency cost hypothesis that cash giving reflects agency cost and destroys value for shareholders, investment hypothesis that cash giving is an investment by management that aims for better future return, and information hypothesis that cash giving has informational value to shareholders as cash is a critical resource at a firm and giving is a decision by managers who are insiders. We find that indeed, only cash giving is positively associated with future CFP and firm value, measured by Fama–French five-factor abnormal risk-adjusted stock returns, future return on assets, and Tobin’s Q. In addition, we find that the positive association exists only between excess, i.e., unexpected, but not expected cash giving and future CFP. Our empirical findings support the information hypothesis, but neither the agency hypothesis nor the investment hypothesis, and are robust to a number of endogeneity tests, including orthogonalized cash giving, instrumental variable regression using geography-based instruments, and propensity score matching. Furthermore, we show that the positive association between future CFP and unexpected cash giving is only pronounced at firms with good governance and relatively higher sales growth where agency problems are less likely, and at firms with no alternative mechanisms to demonstrate the strength of cash flow. Additionally, we do not find evidence that suggests in-kind giving to possess any informational value.

This paper investigates the impact of diversity on corporate philanthropy. Compared to previous studies that have considered the influence of board diversity and CEO gender on corporate philanthropy, this study introduces the concept of operational diversity, which is the implementation of diversity programs at management, employee, and supply chain levels, and further, it explains why operational diversity influences corporate philanthropy, by using the premises of resource dependence theory. Second, this study also investigates the influence of board diversity on corporate philanthropy. Third, this study uses a large sample of U.S. firms over the period of 1991–2009 and tries to mitigate possible omitted variables and endogeneity problems that are often overlooked in previous research. We demonstrate that firms with operational diversity programs are likely more dependent on a broad variety of resources and give more to community as a strategic maneuver; hence, operational diversity is a better indicator for predicting future corporate giving than board diversity alone. However, having a woman or a member of a minority as a company’s chief executive officer is not sufficient to impact its charitable giving. A battery of robustness tests support our conclusion and confirm that our results are not driven by a firm’s general corporate social responsibility (CSR) score, gender or independence of board members, or firm ownership. This paper will assist researchers, practitioners, and other stakeholders in deepening their understanding of the predictors of corporate giving

ObjectiveTo investigate the attitudes of Chinese parents regarding the storage of dried blood spots collected for newborn screening (NBS) and their use in research.MethodsWe conducted a hospital-based survey of parents and examined parental attitudes regarding (a) allowing NBS sample storage, (b) permitting use of children’s NBS samples for research with parental permission, and (c) permitting use of children’s NBS samples for research without parental permission.ResultsThe response rate was 52 percent. Of parents surveyed, 68 percent would permit their infant’s NBS sample to be stored for at least some length of time. If permission is obtained, 69 percent of parents “strongly agreed” or “agreed” to permit use of the NBS sample for research. If permission is not obtained, only 14 percent of parents “strongly agreed” or “agreed.” There was no significant association between permitting use of NBS samples for research and parental gender, education, household income, number of children, or site of residence.ConclusionsThis is the first survey of Chinese parents regarding the use of NBS samples for different types of research, with results indicating that most parents would permit their infant’s sample to be stored and would support the use of NBS dried blood spots for research purposes

We aggregate different dimensions of corporate social responsibility (CSR) activities following the stakeholder framework proposed in Clarkson (Acad Manag Rev 20(1), 92–117, 1995) and present consistent evidence that CSR strengths targeting different stakeholders have their unique impact on firm risk and financial performance. Institutional CSR activities that target secondary stakeholders are negatively associated with firm risk, measured by total risk and systematic risk. Technical CSR that target primary stakeholders are positively associated with firm financial performance, measured by Tobin’s Q, ROA, and cash flow returns. Our results, based on a sample of S&P 500 component firms over the period of 1995–2009, are consistent with the risk management view of “altruistic” CSR activities and with the stakeholder salience theory. We also show that the impact of CSR activities on risk varies with the ethical climate, as proved in our subsample analyses on pre- and post-Sarbanes–Oxley periods. Our empirical analyses mitigate possible omitted variables and endogeneity concerns that are often overlooked in previous research. Our findings are robust to alternative CSR measures, to alternative risk and performance measures, and to alternative estimation methods.