In Bulgaria, integrating technology and innovation is crucial for advancing sustainable healthcare disaster management, enhancing disaster response and recovery, and minimizing long-term environmental and social impacts. The purpose of the study is to assess the impact of modern technological innovations on the effectiveness of disaster management in health care in Bulgaria with a focus on Health Information Systems (HIS), Telemedicine, Telehealth, e-Health, Electronic Health Records, Artificial Intelligence (AI), Public Communication Platforms, and Data Security and Privacy. These innovations, when integrated (...) effectively, can significantly strengthen Bulgaria's preparedness and response capabilities, improving efficiency and reducing the environmental footprint of disaster interventions. Collaboration with technology experts, research institutions, and international organizations is essential for successful implementation. The research aims to assess how these technologies can enhance disaster management efficacy, adopting a methodical approach using Systematic Literature Reviews (SLRs). Systematic Literature Reviews (SLRs) utilize precise criteria for research selection and evaluation to reduce bias, systematically compiling and analyzing data from various studies to offer evidence-based insights. They are crucial for uncovering research gaps, indicating areas needing further exploration. Findings highlight the transformative potential of technology integration in streamlining communication, data management, and operational efficiency. The study underscores the urgent need for an integrated approach and a culture of innovation within the healthcare sector, emphasizing ongoing assessment and adaptation of technology-based strategies. While acknowledging limitations and calling for further research, the study provides valuable insights into Bulgaria's healthcare disaster management strategies and sets the stage for future investigations to refine and expand upon these strategies. It advocates for a strategic framework guiding the efficient integration of technology into disaster management, aiming for resilient and patient-centric healthcare systems. (shrink)

The paper discusses the possibility that the benefits of pharmacogenomics will not be distributed equally and will create orphan populations. I argue that since these inequalities are not substantially different from those produced by ‘traditional’ drugs and are not generated with the intention to discriminate, their production needs not be unethical. Still, the final result is going against deep-seated moral feelings and intuitions, as well as broadly accepted principles of just distribution of health outcomes and healthcare. I thus propose (...) two provisos that would prevent the most offensive outcomes and moderate the scope of the produced inequalities. The first proviso rejects pharmacogenomics innovations that worsen existing group inequalities and aggravate the disadvantage of communities with a history of discrimination. The second proviso requires that there is a strategy in place to even out as much as possible the distribution of benefits in the future and that a system of compensations is in place for pharmacogenomic orphans. Given that only one moral problem generated by pharmacogenomics has been tackled, the list of provisos might be expanded when other issues are considered. (shrink)

The goal of referent tracking is to create an ever-growing pool of data relating to the entities existing in concrete spatiotemporal reality. In the context of Electronic Healthcare Records (EHRs) the relevant concrete entities are not only particular patients but also their parts, diseases, therapies, lesions, and so forth, insofar as these are salient to diagnosis and treatment. Within a referent tracking system, all such entities are referred to directly and explicitly, something which cannot be achieved when familiar concept-based (...) systems are used in what is called “clinical coding”. In this paper we describe the components of a referent tracking system in an informal way and we outline the procedures that would have to be followed by healthcare personnel in using such a system. We argue that the referent tracking paradigm can be introduced with only minor – though nevertheless ontologically important – technical changes to existing EHR infrastructures, but that it will require a radically different mindset on the part of those involved in clinical coding and terminology development from that which has prevailed hitherto. (shrink)

Bribing doctors for preferential treatment is rampant in the healthcare system of developing countries like Vietnam. Although bribery raises the out-of-pocket expenditures of patients, it is so common to be deemed an “envelope culture.” Given the little understanding of the underlying mechanism of the culture, this study employed the mindsponge theory for reasoning the mental processes of both patients and doctors for why they embrace the “envelope culture” and used the Bayesian Mindsponge Framework (BMF) analytics to validate our reasoning. (...) Analyzing responses from 1042 Vietnamese patients, we discovered that bribing doctors can help patients reduce the destitution risk induced by treatment. Such effect of doctor bribery remains consistent among patients that have to pay high daily costs (e.g., accommodation and subsistence fees) regardless of their employment status. Nevertheless, for patients with no or unstable jobs, their risks of destitution increase if they have to pay more thank-you money. These findings suggest that doctor bribery is an adaptive strategy for patients in an environment where the healthcare supply cannot meet the actual demand. Moreover, healthcare equity is greatly exacerbated due to the envelope culture, as vulnerable individuals are exposed to a greater threat of poverty. At the same time, those with good economic conditions get preferential treatment by paying a higher amount of thank-you money. Healthcare workers’ ethics must be the top priority for an equitable and proper healthcare system. (shrink)

The need for innovative development of healthcare institutions is determined by the necessity to increase the efficiency of organizational processes based on the formation of new models of cooperation, which will make it possible to get access to new technologies and knowledge. The goal of the study is to determine the parameters of the impact of innovative open cooperation strategy and the strategy of innovative closed cooperation of healthcare institutions on the effectiveness of their organizational structure in the (...) context of dissemination and the use of knowledge. Simulation modeling was applied to generate the most effective organizational management structure in the context of innovative cooperation and knowledge exchange within the organizational processes “Inside-out” and “Inside-in”. It is substantiated that the strategies of innovative cooperation “Open Innovation/Closed Innovation” have a significant impact on the organizational structure of management of healthcare institutions in terms of the “degree of centralization” (Dci), “degree of mediation” (Dii), and “degree of centralization of powers” (Dpi). The values of the selected criteria range from 25,52% to 61,50% in the case of Dii, and from 34,53% to 52,63% in the case of Dci, which indicates a higher efficiency of organizational knowledge exchange processes in healthcare institutions, which adhere to the Open Innovation strategy of innovative cooperation. Therefore, there are significant differences in the effectiveness of the management’s organizational structure depending on the degree of openness of innovative cooperation of healthcare institutions. The strategy of innovative openness allows increasing the number and quality of connections in the context of knowledge exchange between the subjects (actors, agents) of the organizational structure (in a broad sense, considering internal and external levels of externality) of healthcare institutions, regardless of the distance between them and the level of similarity. (shrink)

Previously proposed strategies for tackling hermeneutical injustices take for granted the interests people have in certain things about them being intelligible to them and/or to others, and seek to enable them to satisfy these interests. Strategies of this sort I call interests-as-given strategies. I propose that some hermeneutical injustices can instead be tackled by doing away with certain of these interests, and so with the possibility of their unfair non-satisfaction. Strategies of this sort I call interests-in-question (...) strategies. As a case study in when such an interests-in-question strategy ought to be pursued, I look at how to tackle hermeneutical injustices arising in the context of gender-affirming healthcare as provided to adults by the National Health Service in the UK. I argue that considerations of trust, privacy, and respect all support pursuing such a strategy. One way to do so, I suggest, would be by replacing the existing gatekeeping model with an informed consent model for the provision of gender-affirming healthcare. Considerations of hermeneutical justice can hence be added to the already-impressive case for undertaking this shift. (shrink)

The COVID-19 pandemic put immense pressure on healthcare systems globally, including those of highly developed countries like the United States and United Kingdom. During the pandemic, professional nursing organizations were the first to call attention to the disproportionate pandemic-related deaths among Filipino nurses. These organizations played a central role in addressing the various crises Filipino nurses faced due to their vulnerabilities as frontliners, ethnic minorities, and migrants in their host countries. Using the Volatile, Uncertain, Complexity, and Ambiguous (VUCA) framework, (...) this monograph assesses the pandemic-response actions and strategies of PNAA and PNAUK, two Filipino nursing associations in the US and UK. The major themes suggest that the two organizations are multifunctional entities with the capacity to act as lobbyists, research organizations, and decision-makers when adapting, strategizing, and coping with VUCA conditions. These findings corroborate previous findings on the potentiality of diasporic nursing organizations in addressing the gaps in government support for migrant workers in the healthcare industry. (shrink)

Introduction: There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation. -/- Methods: The main documents discussing the two (...) class='Hi'>strategies are examined with a qualitative content analysis. The ethical values reasonableness, openness and transparency, inclusiveness, responsiveness and accountability serve as categories for our ethical analysis. -/- Results: We observed that the decision-making processes in a legal solution to expand access to vaccines would be more transparent than in COVAX initiative, would be more inclusive, especially of nation states, and the values responsiveness and accountability could be easily incorporated in the development of a new regulation. -/- Discussion: A legal strategy that offers incentives to the pharmaceutical industry in return for global distribution of vaccines according to the Fair Priority Model is an innovative way to achieve global and equitable access to vaccines. However, in the long term, achieving the Sustainable Development Goals will require from all nations to work in solidarity to find durable solutions for global vaccine research and development. Interim solutions, such as our proposed legal strategy for equitable access to vaccines, and efforts to find long-term solutions must be advanced in parallel. (shrink)

The authors of the scientific monograph have come to the conclusion that ensuring sustainable development and security of economic systems in the new geostrategic realities requires the use of mechanisms for state protection of national economic interests, innovative outsourcing and digital technologies, and environmental protection. Basic research focuses on assessment the economic security of insurance companies, logistics processes, farms, healthcare organisations, retail and e-commerce, and tourist destinations. The research results have been implemented in the different decision-making models in the (...) new geostrategic realities, human resource management, environmental and international security, use of artificial intelligence, and city branding. The results of the study can be used in the developing policies, programmes and strategies for public-private partnerships, post-crisis recovery of Ukraine, and decision-making at the level of ministries and agencies that regulate the processes of managing sustainable development and security. The results can also be used by students and young scientists in the educational process and conducting scientific research on sustainable development and security of economic systems. (shrink)

MERC Global’s International Journal of Management (MERC Global’s IJM) is an international peer-reviewed, open access quarterly journal of management science, being brought out with a view to facilitating effective dissemination of the latest thinking and research with regard to various management issues and problem solving methodology relevant for practicing executives as well as for academicians and researchers working in the field of management around the globe. -/- MERC Global’s IJM publishes articles, research papers, abstracts of doctoral dissertations, book reviews, case (...) studies, short communications and bibliography that are interdisciplinary in nature as well as those within the major disciplines, including: marketing, OB/HR, entrepreneurship, production, operations, accounting, finance, business economics, international business, information technology management, social sector management, public sector management, healthcare management, management strategy, research methods etc. (shrink)

Background: Use of patients’ medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform ethical (...) and privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party’s competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data. (shrink)

One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. (...) In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. (shrink)

In this paper, I consider practical strategies for resolving the epistemic injustice that ill persons face when seeking medical treatment. My arguments will expand upon those initially made by Havi Carel and Ian James Kidd in “Epistemic Injustice in Healthcare: A Philosophical Analysis.” My approach to this problem is twofold. First, I will demonstrate how the phenomenological toolkit, as it currently stands, emphasizes the patient’s experience and leaves the doctor’s experience unadjusted. After this, I will explain how the (...) toolkit can be improved to include the doctor’s perspective. (shrink)

Competition for funding has prompted nonprofit Organizations (NPOs) to adopt marketing and other business-oriented practices to survive. Although certain NPOs have begun to implement marketing strategies, long-term sustainability continues to be a problem. This paper explores the degree to which NPOs in the healthcare industry use marketing strategies to attain sustainability. The data collection and analysis were carried out qualitatively. Data gathering methods included a literature study, in-depth interviews, and focus group discussions. Thematic and content analysis were (...) used to analyze the data. According to the findings, nonprofits cannot successfully implement marketing strategies and business methods due to a lack of marketing know-how, expertise, and donor funding. This paper may benefit NPOs, donors, and stakeholders who support the operations of NPOs. Nonprofit organizations will, for instance, have a better understanding of the significant and positive impact marketing strategies have on their organizations’ growth and sustainability. Furthermore, the paper recommends measures that NPOs can take to address the limiting factors and improve sustainability. The article ends by outlining further research options that will assist other academics engaged in this field. (shrink)

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally. They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them. Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable.

COVID-19 began in China in December 2019. As of January 2021, over a hundred million instances had been reported worldwide, leaving a deep socio-economic impact globally. Current investigation studies determined that artificial intelligence (AI) can play a key role in reducing the effect of the virus spread. The prediction of COVID-19 incidence in different countries and territories is important because it serves as a guide for governments, healthcare providers, and the general public in developing management strategies to battle (...) the disease. The prediction proved beneficial in the early months of 2020 to alert nations and territories in danger of an outbreak, allowing them to take preventative measures. Despite the fact that the COVID-19 outbreak has expanded to practically every location on the planet, the prediction has value in terms of monitoring the intensity of the spread and recovery, as well as determining the likelihood of a sequel or tertiary epidemic. COVID-19, like influenza, could become a seasonal or recurring epidemic in the future. COVID-19 activity must so be predicted and monitored now and in the future. (shrink)

Gerontology together with its subfields, such as social gerontology, geragogy, educational gerontology, political gerontology, environmental gerontology, and financial gerontology, is still a relatively new academic discipline that is currently intensively developing, expanding research fields and combining various theoretical and practical perspectives. The interdisciplinarity, transdisciplinarity, and multidisciplinarity of research on ageing and old age, despite its vast thematic, methodological and theoretical diversity, have a common denominator, which is the focus of research work on improving the quality of life of older people. (...) It is the concern for the components of quality of life such as welfare and well-being as well as focus on learning about phenomena conditioning successful ageing that has become motivators and premises hidden or visible in many texts included in the Research Topic “Perspectives and Theories of Social Innovation for Ageing Population.” The Research Topic that we are presenting to our readers is unique not only because of its size but above all because of its novelty and social involvement, visible in the content of individual chapters. The presented collection includes 17 articles prepared in total by 76 authors from the following countries: China, Finland, Germany, Ghana, Hungary, Ireland, Israel, Italy, Japan, the Netherlands, Poland, Portugal, Slovenia, Spain, Sweden, the United Kingdom, and the United States. Two journals were combined with this Research Topic: “Frontiers in Public Health” and “Frontiers in Sociology.” The presented Research Topic contains seven types of articles covering: two community case studies, eight original research articles, two perspective articles, one hypothesis and theory paper, one policy and practice review, one methods article, and two book reviews. The rationale to start work on this set of texts was the desire to continue and deepen the research analyses of the editors of this set, which concern the development of social innovations for the ageing population as well as changes of public policy on ageing. This Research Topic deals with topics covering issues such as social learning, intergenerational transmission, senior entrepreneurship, creative content creation by older adults, care services, raising the independence of older people in their living environments, dementia challenges, the image of the older generation in local social policies, new trends in qualitative research on old age, strategies for dealing with chronic diseases, the use of digital tools in health education, the silver economy/longevity economy, age-friendly environments, the diversity of structures and social services, preparation for old age, and food safety. The wide variety of submitted texts shows several selected and, according to the authors, current challenges that contemporary seniors have to face. The articles comprising this Research Topic are organized according to five themes. (shrink)

The idea of personalised medicine (PM) has gathered momentum recently, attracting funding and generating hopes as well as scepticism. As PM gives rise to differing interpretations, there have been several attempts to clarify the concept. In an influential paper published in this journal, Schleidgen and colleagues have proposed a precise and narrow definition of PM on the basis of a systematic literature review. Given that their conclusion is at odds with those of other recent attempts to understand PM, we consider (...) whether their systematic review gives them an edge over competing interpretations. We have found some methodological weaknesses and questionable assumptions in Schleidgen and colleagues’ attempt to provide a more specific definition of PM. Our perplexities concern the lack of criteria for assessing the epistemic strength of the definitions that they consider, as well as the logical principles used to extract a more precise definition, the narrowness of the pool from which they have drawn their empirical data, and finally their overlooking the fact that definitions depend on the context of use. We are also worried that their ethical assumption that only patients’ interests are legitimate is too simplistic and drives all other stakeholders’ interests—including those that are justifiable—underground, thus compromising any hope of a transparent and fair negotiation among a plurality of actors and interests. As an alternative to the shortcomings of attempting a semantic disciplining of the concept we propose a pragmatic approach. Rather than considering PM to be a scientific concept in need of precise demarcation, we look at it as an open and negotiable concept used in a variety of contexts including at the level of orienting research goals and policy objectives. We believe that since PM is still more an ideal than an achieved reality, a plurality of visions is to be expected and we need to pay attention to the people, reasons and interests behind these alternative conceptions. In other words, the logic and politics of PM cannot be disentangled and disagreements need to be tackled addressing the normative and strategic conflicts behind them. (shrink)

This research aims to investigate managing information and planning for the participation of health charities. With the Covid-19 outbreak, it was important to use information systems to optimize health management. The correct processing of information is the basis for better use of health charities’ participation. Using the snowball technique, and semi-structured interviews, 47 experts and non-experts in Fars province were asked for their opinions. Next, based on the fuzzy network analysis, important factors were prioritized. Four categories and 8 important criteria (...) were identified. To prioritize the effective aspects of the participation of health charities in Fars province, a network analysis technique was used via MATLAB software. Strategy and programs with a normal weight of 0.34 showed the highest priority. Research and education with a normal weight of 0.26 received the second priority. Laws and regulations with a normal weight of 0.24 were placed as the third priority. Based on the obtained results, creating strategy and planning, training and building cultural in this field, ease of rules and regulations as well as planning of financial resources play an important role in managing the participation of health donors. With precise planning of health programs, donors see the transparency of decisions. They check the part that needs financing and equipment completion. Because the quality of plans and programs, effectiveness and efficiency of strategies, and the quality of results depend on the decisions made by donors. (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a (...) qualitative approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

Brain tumors pose significant challenges in modern healthcare, with accurate and timely diagnosis crucial for determining appropriate treatment strategies. Artificial intelligence has made significant advancements in recent years. Rule-based expert systems (if-then rule-based systems) have emerged as a promising approach for clinical decision-making in brain tumor diagnosis. In this paper, we present "A CLIPS-Based Expert System for Brain Tumor Diagnosis," which leverages a set of 14 if-then rules to diagnose brain tumors with three possible outcomes: 1) Confirm the (...) diagnosis of a brain tumor, 2) Consider the possibility of a brain tumor that has metastasized, and 3) Consider the possibility of a brain tumor. Our expert system offers a user-friendly interface, enabling users to select symptoms and receive a diagnosis based on the provided information. This paper discusses the expert system's development, implementation, and evaluation, highlighting its potential to facilitate brain tumor diagnosis and decision-making in clinical settings. Additionally, we provide a literature review that contextualizes our expert system within the broader landscape of rule-based expert systems for brain tumor diagnosis, examining their effectiveness, limitations, and challenges. (shrink)

Introduction. The medical sphere is constantly evolving, requiring improved approaches to its organisation and functioning. Advances in medical technology, observable changes in patient needs and growing competition challenge medical institutions to improve their strategies and approaches. Marketing technologies are becoming one of the key tools for achieving strategic goals. Purpose. This article is aimed at studying the peculiarities of the use of marketing technologies in the medical field. The main purpose of the study is to analyse the impact of (...) marketing tools on the development and success of medical institutions. Method (methodology). The methodological approach involves the use of an analytical approach to studying current trends in marketing and their impact on the healthcare sector. The study uses methods of data analysis and comparative analysis of marketing practices in medical institutions. Results. The study found that the use of targeted marketing strategies allows healthcare facilities to attract more patients, increase customer satisfaction and ensure an excellent reputation. The results of the study show a positive impact of the use of marketing tools on changing the perception of medical services by patients. Conclusions. The scope of application of the results is the practical activities of medical institutions seeking to improve their strategy of promotion and interaction with customers. The findings of the study can be used by marketers and managers of healthcare organisations to develop and implement effective marketing strategies. In summary, this article reveals the importance of using marketing technologies in the healthcare sector and provides practical recommendations for their successful implementation. The study emphasises that marketing in the healthcare industry is necessary to increase competitiveness and ensure quality medical care. (shrink)

Health tourism occurs when people around the world travel across international borders to access various health and wellness treatment and at the same time touring the country they are visiting. It is one of the growing industries in South Africa, as people are constantly coming to South Africa in search of health care services. Health tourism is imperative for economic growth and development and has recently assumed the status of one of the most important contributors to employment, infrastructural and services (...) development, and generating an economic return. Due to these significant contributions, it is vital to have sustainable health care services in countries attracting health tourists. Making use of the traditional literature method, this paper presents an overview of health tourism, the importance of healthcare in South Africa, discussing the sustainability issues faced by health care providers and the impact thereof to health tourism. More importantly, we drew lessons from the three overlapping circle model as well as the four capital model. to further the discussion on sustainable strategies for health tourism NPOs. (shrink)

This article develops a civic republican approach to medical ethics. It outlines civic republican concerns about the domination that arises from subjection to an arbitrary power of interference, while suggesting republican remedies to such domination in healthcare. These include proposals for greater review, challenge and pre-authorisation of medical power. It extends this analysis by providing a civic republican account of assistive arbitrary power, showing how it can create similar problems within both formal and informal relationships of care, and offering (...) strategies for tackling it. Two important objections to civic republican medical ethics—that it overvalues independence and political participation in healthcare—are also considered and rebutted. (shrink)

Low back pain (LBP) carries a high risk of chronicization and disability, greatly impacting the overall demand for care and costs, and its treatment is at risk of scarce adherence. This work introduces a new scenario based on the use of a mobile health tool, the Dress-KINESIS, to support the traditional rehabilitation approach. The tool proposes targeted self-manageable exercise plans for improving pain and disability, but it also monitors their efficacy. Since LBP prevention is the key strategy, the tool also (...) collects real-patient syndromic information, shares valid educational messages and fosters self-determined motivation to exercise. Our analysis is based on a comparison of the performance of the traditional rehabilitation process for non-specific LBP patients and some different scenarios, designed by including the Dress-KINESIS’s support in the original process. The results of the simulations show that the integrated approach leads to a better capacity for taking on patients while maintaining the same physiotherapists’ effort and costs, and it decreases healthcare costs during the two years following LBP onset. These findings suggest that the healthcare system should shift the paradigm towards citizens’ participation and the digital support, with the aim of improving its efficiency and citizens’ quality of life. (shrink)

Henry Shevlin’s paper—“How could we know when a robot was a moral patient?” – argues that we should recognize robots and artificial intelligence (AI) as psychological moral patients if they are cognitively equivalent to other beings that we already recognize as psychological moral patients (i.e., humans and, at least some, animals). In defending this cognitive equivalence strategy, Shevlin draws inspiration from the “behavioral equivalence” strategy that I have defended in previous work but argues that it is flawed in crucial respects. (...) Unfortunately—and I guess this is hardly surprising—I cannot bring myself to agree that the cognitive equivalence strategy is the superior one. In this article, I try to explain why in three steps. First, I clarify the nature of the question that I take both myself and Shevlin to be answering. Second, I clear up some potential confusions about the behavioral equivalence strategy, addressing some other recent criticisms of it. Third, I will explain why I still favor the behavioral equivalence strategy over the cognitive equivalence one. (shrink)

Equipped with the ultimate query answering system, computers would finally be in a position to address all our information needs in a natural way. In this paper, we describe how Language and Computing nv (L&C), a developer of ontology-based natural language understanding systems for the healthcare domain, is working towards the ultimate Question Answering (QA) System for healthcare workers. L&C’s company strategy in this area is to design in a step-by-step fashion the essential components of such a system, (...) each component being designed to solve some one part of the total problem and at the same time reflect well-defined needs on the prat of our customers. We compare our strategy with the research roadmap proposed by the Question Answering Committee of the National Institute of Standards and Technology (NIST), paying special attention to the role of ontology. (shrink)

In the following paragraphs, I will describe ten strategies through which we can show the weaknesses of every form of theism based on the "One God", while postulating that the Trinity is a good solution. This approach follows up on Swinburne’s claims about the existence of a priori and a posteriori proofs for the existence of the Trinity (his proofs are part of the sixth strategy). Clearly, these strategies are not “new”: they have been advocated by many thinkers (...) in the past and in the present. I merely revived them, and brought them together in a kind of cumulative reasoning: the strength of them arises when these strategies are considered together, showing that the Trinity is a reasonable hypothesis even though it is contradictory. The proposed strategies lead to the conclusion that there must exist in God something similar to what we call ‘real relations’ and ‘multiplicity’; and in order for God to be relational, there must exist in Him some “distincts” that relate to one another. This is postulated by philosophical reasoning, not just by Revelation, and regardless of the choice to support a process metaphysics. As Trinitarian theology contains the mystery of eternal generation, the strategies do account for the fact that in philosophy we contemplate the mystery of eternal self-distinction and of all the other ‘self-actions’ of the One. The eternal generation remains mysterious, but it is the idea that best helps us describe how God is (One and Triune) and how he creates the world. God must be Triune in every theistic system. The One God is, as One, also Triune. The Unity-Trinity of the Principle is the only apophatic point that we can reach from many quarters. Once autonomous paths of reason have established that God is a Person and Persons, One-Multiple, Creator (communicated), Free, Relational and Infinite possibility, it therefore emerges that our most reliable hypothesis is that of the Trinitarian God. (shrink)

It has been argued that ethical frameworks for data science often fail to foster ethical behavior, and they can be difficult to implement due to their vague and ambiguous nature. In order to overcome these limitations of current ethical frameworks, we propose to integrate the analysis of the connections between technical choices and sociocultural factors into the data science process, and show how these connections have consequences for what data subjects can do, accomplish, and be. Using healthcare as an (...) example, attention to sociocultural conversion factors relevant to health can help in navigating technical choices that require broader considerations of the sociotechnical system, such as metric tradeoffs in model validation, resulting in better ethical and technical choices. This approach promotes awareness of the ethical dimension of technical choices by data scientists and others, and that can foster the cultivation of 'ethical skills' as integral to data science. (shrink)

In her short story “Stable Strategies for Middle Management,” Eileen Gunn imagines a future in which Margaret, an office worker, seeks radical genetic enhancements intended to help her secure the middle-management job she wants. One source of the story’s tension and dark humor is dramatic irony: readers can see that the enhancements Margaret buys stand little chance of making her life go better for her; enhancing is, for Margaret, probably a prudential mistake. This paper argues that our positions in (...) the real world are sufficiently similar to Margaret’s position in Gunn’s fictional world that we should take this story seriously as grounding an argument from analogy for the conclusion that radical genetic enhancements are, for us, probably a prudential mistake. The paper then defends this method. When the question at hand is one of speculative ethics, there is no method better fit to the purpose than argument from analogy to speculative fiction. (shrink)

This paper looks at an argument strategy for assessing the epistemic closure principle. This is the principle that says knowledge is closed under known entailment; or (roughly) if S knows p and S knows that p entails q, then S knows that q. The strategy in question looks to the individual conditions on knowledge to see if they are closed. According to one conjecture, if all the individual conditions are closed, then so too is knowledge. I give a deductive argument (...) for this conjecture. According to a second conjecture, if one (or more) condition is not closed, then neither is knowledge. I give an inductive argument for this conjecture. In sum, I defend the strategy by defending the claim that knowledge is closed if, and only if, all the conditions on knowledge are closed. After making my case, I look at what this means for the debate over whether knowledge is closed. (shrink)

The increasing complexity and scale of modern computing needs have led to the development and adoption of cloud computing as a ubiquitous paradigm for data storage and processing. The hybrid cloud model, which combines both public and private cloud infrastructures, has been particularly appealing to organizations that require both the scalability offered by public clouds and the security features of private clouds. Various strategies for configuring and managing resources have been developed to optimize the hybrid cloud environment. These (...) class='Hi'>strategies aim to balance conflicting objectives such as cost-efficiency, performance optimization, security, and compliance with regulatory standards. This exploratory research focused on evaluating the efficiency and limitations of different configuration strategies in hybrid cloud environments. Findings indicate that each approach presents distinct advantages. Improving resource utilization and automating governance processes are significant advantages of Policy-based Resource Management, which leads to costeffectiveness. Intelligent routing of traffic is a feature of Cross-cloud Load Balancing, resulting in optimized performance and higher service availability. By centralizing control, the Hybrid Cloud Service Mesh allows for secure and streamlined cross-service communication. A notable feature of Cross-cloud Container Orchestration is its ability to simplify the migration of applications across diverse cloud environments. For immediate threat detection and regulatory compliance, real-time monitoring is facilitated by Log Management and Analytics. However, Policy-based Resource Management can be complex and inflexible. Extra costs for data transfer between different cloud providers are a drawback of Crosscloud Load Balancing. Additional network hops create latency issues in Hybrid Cloud Service Mesh configurations. If configured incorrectly, Cross-cloud Container Orchestration could expose the system to security risks. Finally, Log Management and Analytics require both ample storage and advanced analytical capabilities. (shrink)

Disrespect in health care often persists despite firm commitments to respectful service provision. This conceptual paper highlights how the ways in which respect and disrespect are characterised can have practical implications for how well disrespect can be tackled. We stress the need to focus explicitly on disrespect (not only respect) and propose that disrespect can usefully be understood as a failure to relate to people as equals. This characterisation is consonant with some accounts of respect but sometimes obscured by a (...) focus on respecting people’s autonomy and dignity. Emphasising equality is consistent with connections patients draw between being (dis)respected and (in)equality. It readily accommodates microaggressions as forms of disrespect, helping to understand how and why experiences of disrespect may be unintentional and to explain why even small instances of disrespect are wrong. Our view of disrespect with an emphasis on equality strengthens the demand that health systems take disrespect seriously as a problem of social injustice and tackle it at institutional, not just individual levels. It suggests several strategies for practical action. Emphasising relational equality is not an easy or short-term fix for disrespect, but it signals a direction of travel towards an important improvement ambition. (shrink)

As detailed in The Evolutionary Manifesto and Evolution’s Arrow, an understanding of the large-scale processes that govern the evolution of life is capable of making sense of human existence. This evolutionary worldview is revealing that we are not just meaningless accidents in a universe that is indifferent to our existence. Instead it shows that humanity has a critical role to play in the future evolution of life on this planet and in the universe. -/- But what specifically do we need (...) to do to advance the evolutionary process and ensure that humanity successfully fulfils its role in the future evolution of life? This paper uses the direction of evolution to answer this fundamental question. It identifies the next great steps in evolution on Earth, and devises strategies that will help actualize those steps. (shrink)

It is common for theorists, drawing on P. F. Strawson, to account for morally responsible agency in terms of the nature of the emotions and feelings that characterize our responsibility practices, in terms of the nature of the so-called “reactive attitudes.” Here, I argue against this attitude-based Strawsonian strategy, and I argue in favor of an alternative, which I call the “concern-based Strawsonian strategy.” On this alternative, rather than account for morally responsible agency in terms of the nature of the (...) reactive attitudes, one accounts for such agency in terms of the concern that leaves us susceptible to those attitudes in the first place. This, I believe, is a more promising way to develop the Strawsonian approach than the attitude-based strategy. The concern-based strategy allows us to better countenance the number and variety of the reactive attitudes that characterize our responsibility practices; it shares the attitude-based strategy’s virtues; and it seems to position us to better understand the distinctive social and moral significance associated with being and being regarded as a morally responsible agent. (shrink)

Some how-possibly explanations have epistemic value because they are epistemically possible; we cannot rule out their truth. One paradoxical implication of that proposal is that epistemic value may be obtained from mere ignorance. For the less we know, then the more is epistemically possible. This chapter examines a particular class of problematic epistemically possible how-possibly explanations, viz. *epistemically opaque* how-possibly explanations. Those are how-possibly explanations justified by an epistemically opaque process. How could epistemically opaque how-possibly explanations have epistemic value if (...) they result from a process about which we lack knowledge or understanding? This chapter proposes three different strategies to salvage epistemic value from epistemic opacity, namely salvaging value from 1) functional transparency, 2) modal operator interpretation, and 3) pursuitworthiness. It illustrates using cases from deep neural network modeling. (shrink)

Grounded theory methodology is perceived as challenging due to its systematic and rigorous process. However, this is because most people do not realize that the strategies used in the grounded theory data analysis process are used by laypeople and professionals regularly, if not daily. This article aims to help others interested in grounded theory with a background in qualitative data analysis feel comfortable engaging in the methodology and constructing multiple theories in the same study. It shares my latest experience (...) incorporating various data analysis strategies with the constructivist approach: holistic and systems thinking, situational analysis, dramaturgical analysis, perspective taking, and abstraction. The examples remove the mystery from abstraction and abductive reasoning. (shrink)

The integration of biomedical terminologies is indispensable to the process of information integration. When terminologies are linked merely through the alignment of their leaf terms, however, differences in context and ontological structure are ignored. Making use of the SNAP and SPAN ontologies, we show how three reference domain ontologies can be integrated at a higher level, through what we shall call the OBR framework (for: Ontology of Biomedical Reality). OBR is designed to facilitate inference across the boundaries of domain ontologies (...) in anatomy, physiology and pathology. (shrink)

Self-identification strategy is presented so that a being identify itself wherein a subject is not an outer observer. A being is able to observe as a subject and be observed as an object. Thus, self-identification could be realized because a being acts to observe and be observed. A being is supposed to consist of spatio and temporal identities. They are considered to provide a basis of respective a spatio object to be observed and a temporal subject to observe. Two thought (...) experiments are presented for self-identification. In the first place, self-identification is explained by using the Out-of-Boddy experiences in no time flows. Secondly, a dream in a dream is provided to reveal a self-identification strategy in time flows. For this, dream is described by bi-directional movements in time flows. A teleological philosophy from the Aristotelian paradigm insists that the future decides the past which is thought to be the source of potentiality. Accordingly, the Aristotelian paradigm is modified to include the concept of a dream between the future and the past so that the reason why versatile a priori being such as Schrödinger's cat is created is explained and how they are distinguished among ontological potentiality by a teleological causation. (shrink)

Standard theories of scope are semantically blind. They employ a single logico-syntactic rule of scope assignment quantifying in Quantifier Raising, storage, or type change etc which roughly speaking prefixes an expression \aplha.

The authors of the book have come to the conclusion that it is necessary to effectively use modern approaches to developing and implementation strategies of sustainable socio-economic development in order to increase efficiency and competitiveness of economic entities. Basic research focuses on economic diagnostics of socio-economic potential and financial results of economic entities, transition period in the economy of individual countries and ensuring their competitiveness, assessment of educational processes and knowledge management. The research results have been implemented in the (...) different models and strategies of supply and logistics management, development of non-profit organizations, competitiveness of tourism and transport, financing strategies for small and medium-sized enterprises, cross-border cooperation. The results of the study can be used in decision-making at the level the economic entities in different areas of activity and organizational-legal forms of ownership, ministries and departments that promote of development the economic entities on the basis of models and strategies for sustainable socio-economic development. The results can also be used by students and young scientists in modern concepts and mechanisms for management of sustainable socio-economic development of economic entities in the condition of global economic transformations and challenges. (shrink)

William Smith’s recent article criticises the so-called orthodox approaches to the normative analysis of healthcare resource allocation, associated to the requirement that decision-makers should abide by strictly procedural principles of legitimacy defining a deliberative democratic process. Much of the appeal of Smith’s argument goes down to his awareness of real-world processes and, in particular, to the large gap he identifies between well-led democratic deliberation and the messiness of the process through which the intuitively legitimate Affordable Care Act (ACA) was (...) created. This reply aims to demonstrate that the ACA provides no counterexample to orthodox views, seizing this opportunity to explore the specific space that the procedural principles populating orthodox accounts are meant to regulate. Neither general questions of healthcare justice concerning, for example, universal access nor, relatedly, the activity of elected politicians falls within the natural scope of application of such principles, revealing a much more complex picture of the interactions between justice and legitimacy as well as substantive and procedural considerations than acknowledged by Smith. In the end, orthodox accounts of healthcare resource allocation turn out to provide a precious fund of theoretical resources for the normative study of administrators, which might be useful well beyond bioethics and health policy. (shrink)

The following article will examine three argumentative strategies to address a recent topic of debate in the philosophy of religion known as the "Gap Problem." It aims to study the "Stage II" of cosmological arguments, where the goal is to establish the theistic properties or attributes that identify the first cause or necessary being with the concept of God. The unique contribution of this study lies in the formalized and systematic presentation of the various solutions proposed by authors in (...) the philosophical field, synthesizing their central ideas and presenting them in the form of arguments. (shrink)

Abstract: The field of life extension is full of ideas but they are unstructured. Here we suggest a comprehensive strategy for reaching personal immortality based on the idea of multilevel defense, where the next life-preserving plan is implemented if the previous one fails, but all plans need to be prepared simultaneously in advance. The first plan, plan A, is the surviving until advanced AI creation via fighting aging and other causes of death and extending one’s life. Plan B is cryonics, (...) which starts if plan A fails, and assumes cryopreservation of the brain until technical capabilities to return it to life appear. Plan C is digital immortality in the sense of collecting data about the person now so future AI will be able to recreate a model of a person. Plan D is the hope based on some unlikely scenarios of infinite survival, like so-called “quantum immortality”. All these plans have personal and social perspective. The personal aspect means efforts of the increasing chances of personal survival via taking care about one’s own health, signing cryocontract or collecting digital immortality data. The social aspect means the participation in collective work towards creation and increase of the availability of life extension technologies, which includes funding scientific research, promotion of life extension value and direct performing of research and implementation, as well as preventing global catastrophic risk. All plans converge at the end, as their result is the indefinite survival as an uploaded mind inside an ecosystem, created by a superintelligent AI. (shrink)

This study aimed to determine the sustainable marketing strategies for micro, small, and medium enterprises (MSMEs) amidst the COVID-19 pandemic. In this research technique, a quantitative descriptive survey was utilized to examine 363 MSMEs in designated cities and municipalities in Pangasinan, such as Binmaley, Calasiao, Dagupan City, Mangaldan, San Carlos City, Santa Barbara, and Urdaneta City, all registered with the Department of Trade and Industry (DTI). According to the findings, manufacturing is the primary industry for most respondents; they are (...) sole proprietorships with less than PhP3 Million in assets, have 1-9 employees, and have been in operation for less than three years. The sustainable marketing strategies implemented by the MSMEs in terms of product, place, price, promotion, physical evidence, people, and process are considered extremely important. The level of effectiveness in sustaining marketing strategies of MSMEs is considered very effective. The respondents assessed the problems encountered by the MSMEs in sustaining marketing strategies as extremely serious. It can be concluded that the majority of the respondents were in the manufacturing business, a single type of business organization, and, capitalization comprises not more than 3 million. Most of them have a minimal number of employees and operate for a short time. For the sustainable marketing strategies implemented by the MSMEs product, place, price, physical evidence, people and process are extremely important while promotions are very important. The effectiveness of 7ps of marketing is considered very effective. The respondent’s problems encountered by the MSMEs in sustaining marketing strategies as extremely serious. (shrink)

Abstract: The COVID-19 pandemic has posed unprecedented challenges to global healthcare systems, necessitating accurate and timely forecasting of cases for effective mitigation strategies. In this research paper, we present a novel approach to predict COVID-19 cases using Artificial Neural Networks (ANNs), harnessing the power of machine learning for epidemiological forecasting. Our ANNs-based forecasting model has demonstrated remarkable efficacy, achieving an impressive accuracy rate of 97.87%. This achievement underscores the potential of ANNs in providing precise and data-driven insights into (...) the dynamics of the pandemic. However, this paper underscores the critical importance of a comprehensive evaluation beyond accuracy, including metrics such as sensitivity, specificity, and the area under the ROC curve (AUC-ROC), to assess the model's performance robustness. The research paper offers detailed insights into the architecture of the ANN model, encompassing critical hyperparameters, data preprocessing techniques, and regularization strategies employed to optimize model accuracy. Ethical considerations surrounding data privacy and potential biases within the COVID-19 dataset are also addressed. While the achieved accuracy is a significant milestone, this study underscores the dynamic and evolving nature of the pandemic, necessitating continuous model refinement and validation. Furthermore, it emphasizes the importance of considering false positives and false negatives in the context of public health decision-making. In conclusion, this research contributes to the arsenal of tools available for pandemic management by showcasing the potential of ANNs in COVID-19 case forecasting. It encourages ongoing exploration and adaptation of predictive models to enhance their applicability in real-world public health scenarios, ultimately contributing to more effective pandemic control and response efforts. (shrink)

Teachers' pedagogical strategy in teaching reading comprehension cannot be neglected because when learners fail to comprehend text and give meaning to it, they experience difficulties understanding other subjects taught. This study, therefore, examined reading comprehension strategies adopted by teachers to enhance reading comprehension among primary school learners. This study adopted a qualitative research method with an interpret visit paradigm. Ten (10) teachers were purposively selected for the study one each from ten (10) primary schools. Data was collected the selected (...) participants using semi-structured interview. The researchers ensured the trustworthiness of the interview through disclosure and corroboration. The data collected were transcribed for the purpose of analysis using the atlasti software and the thematic data analysis technique. Findings indicate that some teachers did not understand the various strategies to optimise reading comprehension. Teachers also lacked knowledge of the different learners learning preferences to plan their reading comprehension lessons. Furthermore, the lack of appropriate reading material and differentiated reading exercises for slow learners were highlighted among the challenges that hampered reading comprehension. The study recommends capacity-building programmes to provide strategies for differentiated teaching, to learn to accommodate slow learners and to provide appropriate resources by the education department. (shrink)

'Bao wei quan' 保位權 (‘Preservation of position and power’) (hereinafter: BWQ) is an essay advising rulers on how to preserve their position of power and maintain control over the bureaucracy. It is a part of one of the most authoritative premodern Chinese texts, the Chunqiu fanlu 春秋繁露 (The Luxuriant Dew of the Spring and Autumn Annals), which is traditionally ascribed to pivotal Han dynasty scholar Dong Zhongshu 董仲舒 (c. 195–115 BCE). This paper argues that the BWQ establishes a type of (...) naturalistic approach to rulership. In this vision, the state and its social and political order is rooted in the constitution of human nature, and is perceived as a place where human tendencies can be followed and fulfilled, but also controlled. In addition, the BWQ’s political discourse and its view of government is built around complementary processes, such as reward/punishment, political power/moral power, non-action/action, actuality/fam etc. The art of rulership thus consists of keeping these opposites in balance. (shrink)

This study was designed to explore career-related strategies for strengthening poverty reduction programmes in Nigerian communities. Using a phenomenological framework and interpretive paradigm, the study used a qualitative research design. The participants of this study consisted of five key officers working in the Federal Ministry of Humanitarian Affairs and Poverty Alleviation (FMHAPA) in Nigeria and five counsellors working in Nigerian secondary schools. The participants were selected through a purposeful sampling process. Data collection measures include interviews, focus group discussion, and (...) document analysis. All participants were interviewed to collect data, which was analyzed using thematic analysis. To identify themes and patterns in the responses provided by the participants, the interviews were recorded and transcribed. In accordance with the findings of this study, career-related strategies for strengthening poverty reduction programmes in Nigerian communities include employability skills development, access to quality education, job creation and entrepreneurship, supportive networks, social justice and corporate responsibilities, and appropriate work policy. A major contribution of this study is the identification of career-related strategies to help strengthen poverty reduction programmes in Nigerian communities. Another contribution is the implications that can be drawn for career counselling. (shrink)