The study aims to identify the efficiency of the university education performance from the perspective of postgraduate and undergraduate students in international and Palestinian universities. The analytical descriptive approach was used for this purpose and the questionnaire was used as a main tool for data collection. The study community consists of: post graduate students, (23850) graduate students and (146355) undergraduate students. The sample of the study was 378 graduate students and 383 undergraduate students. The random stratified sample was used. The (...) Statistical Package of Social Sciences (SPSS) was also used for data analysis. The study reached a number of results, the most important of which are: The level of efficiency of educational performance in Palestinian and international universities from the point of view of postgraduate and undergraduate students was high. And that there are significant differences between the average views of the sample of the study on the efficiency of educational performance in Palestinian and international universities attributed to the University and to the benefit of international universities. The study concluded many recommendations, the most important of which is the necessity of continuing to develop e-learning strategies that affect the efficiency of educational performance and research commensurate with the university's position in the local and international community, which puts it on the best classification between local and international universities through e-learning. (shrink)

The study aimed to identify E- Learning strategies and their relation to the efficiency of research performance in foreign and Palestinian universities (University of Ottawa, Munster, Suez Canal, Al-Azhar, Islamic, Al-Aqsa). The analytical descriptive approach was used for this purpose, and relying on the questionnaire as a main tool for data collection. The study society is from the senior management, where the number of senior management in the universities in question is 206. The random stratified sample was selected and (SPSS) (...) was used for statistical data analysis. The study found a significant relationship between E- Learning strategies and the efficiency of research performance in universities. It also reached the participation of senior management in the research that develops the university performance in the Palestinian universities. The senior management indicated that they do not care to follow the policies of implementing the development of scientific research. While the senior management in foreign universities indicated that they are interested in following up the policies of implementing the development of scientific research. The study also showed that senior management in Palestinian universities does not care about providing the appropriate budget for E- Learning. The study recommended that the senior management of Palestinian universities should provide an E- Learning budget and encourage employees to continue using E- Learning strategies. The administration in the Palestinian universities should adopt and support outstanding research, and the need to encourage interest in the implementation of policies for the development of scientific research. (shrink)

The study aimed to identify Design Thinking and its use in NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in the Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. The overall inventory of the possible study community (...) was based mainly on the use of the SPSS in processing and analyzing the data obtained through the survey tool. Smart-PLS was also used to construct the structural equation model (SEM) Analyzing the relationship between study variables. The study found that Design Thinking mediates the relationship between the management of process design and decision making with a holistic effect. The study showed the interest of local NGOs in creating a good mental image in the local community. And the ownership of local NGOs to the expertise and technical skills required to implement the projects, and showed the adoption of local NGOs in their activities to meet the needs of the beneficiaries and their wishes, and local NGOs analyze the problem, and causes, through data relevant to the decision, based on reference data for decision-making. The main recommendations of the study are: The need for senior management in the local NGOs in Gaza Strip to adopt the methodology of design thinking because of its impact on the sustainability of the projects, design the technical feasibility study and meet the wishes of the beneficiaries. (shrink)

The study aimed at identifying the personal variables and their effect in promoting job creation in Gaza Strip through business incubators. The researchers used the descriptive analytical approach to achieve the study objectives. The study population consisted of 92 of the pilot projects benefiting from the three business incubators in Gaza Strip (Palestinian Information Technology Incubator, UCAS Technology Incubator and Business and Technology Incubator). The study reached a number of results, the most important of which are the existence of statistically (...) significant differences on entrepreneurship attributed to each age as most of them are between the ages of 22-30, Gender for males, business incubator, scientific qualification for the specialties of information technology and engineering, and years of experience. Based on the findings, the researchers recommend focusing on university students in guiding them towards entrepreneurship and helping new graduates to start entrepreneurship. And to guide students to scientific disciplines that help them in entrepreneurship after graduation, whether starting a small business or self-employment, support females to entrepreneurship as most of the entrepreneurs are male, in addition to stimulating males as well. (shrink)

The study aimed to identify the reality of decision-making in the local NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. A Census Method of the possible study community (...) was adopted, and the use of the Statistical Package for Social Sciences (SPSS) was mainly based on the analysis and analysis of the data obtained through the survey tool. The study reached a set of results, the most important of which are: NGOs follow a decision-making mechanism. NGOs examine the problems and causes of the organization. Organizations are less concerned with stakeholder participation. Make decision. The main recommendations of the study are: To promote systematic methods of decision-making in NGOs in Gaza Strip: Local NGOs in Gaza Strip should continue to develop their competencies in order to make sound and correct decisions and encourage them to follow the scientific methodologies in the mechanism of taking Decisions. (shrink)

Studies on end-of-life care reveal different practices regarding withholding and/or withdrawing life-sustaining treatments between countries and regions. Available data about physicians’ practices regarding end-of-life care in ICUs in Egypt is scarce. This study aimed to investigate physicians’ attitudes toward end-of-life care and the reported practice in adult ICUs in Ain Shams University Hospitals, Cairo, Egypt. 100 physicians currently working in several ICU settings in Ain Shams University Hospitals were included. A self-administered questionnaire was used for collection of data. Most of (...) the participants agreed to implementation of “do not resuscitate” orders and applying pre-written DNR orders, while only 13% almost always/often order DNR for terminally-ill patients. 52% of the participants agreed to usefulness of limiting life-sustaining therapy in some cases, but they expressed fear of legal consequences. 47% found withholding life-sustaining treatment is more ethical than its withdrawal. 16% almost always/often withheld further active treatment but continued current ones while only 6% almost always/often withdrew active therapy for terminally-ill patients. The absence of legislation and guidelines for end-of-life care in ICUs at Ain Shams University Hospitals was the main influential factor for the dissociation between participants’ attitudes and their practices. Therefore, development of a consensus for end-of-life care in ICUs in Egypt is mandatory. Also, training of physicians in ICUs on effective communication with patients’ families and surrogates is important for planning of limitation of life-sustaining treatments. (shrink)

Topological indices are of incredible significance in the field of graph theory. Convex polytopes play a significant role both in various branches of mathematics and also in applied areas, most notably in linear programming. We have calculated some topological indices such as atom-bond connectivity index, geometric arithmetic index, K-Banhatti indices, and K-hyper-Banhatti indices and modified K-Banhatti indices from some families of convex polytopes through M-polynomials. The M-polynomials of the graphs provide us with a great help to calculate the topological indices (...) of different structures. (shrink)

Background Although methods proposed for the conduct of ethics consultation tend to be viewed as competing approaches, they may in fact function in a complementary manner. Methods We describe the experience of ethics consultation in two ethics committees at the University Hospitals of Geneva, Switzerland. Results Both committees provide case consultation by a multi-disciplinary team of committee members, but with different processes. These differences in process do not necessarily lead to differences in outcome. Discussion Different methods of ethics consultation are (...) not mutually exclusive, and can co-exist within the same institution. The practical application of one method of ethics consultation can lead to substantial variations in process between different groups of consultants. Conclusion Despite the importance of clarifying theoretical groundings, and consultation and deliberation processes, in ethics consultation, choosing between different processes may not be pressing. To assist these choices, exploration of the practical strengths and weaknesses of different methods will be necessary to assist clinical ethicists, and clinical ethics committees, in acquiring a flexible and evidence-based set of approaches to their work. (shrink)

Despite broad agreement that the vulnerable have a claim to special protection, defining vulnerable persons or populations has proved more difficult than we would like. This is a theoretical as well as a practical problem, as it hinders both convincing justifications for this claim and the practical application of required protections. In this paper, I review consent-based, harm-based, and comprehensive definitions of vulnerability in healthcare and research with human subjects. Although current definitions are subject to critique, their underlying assumptions may (...) be complementary. I propose that we should define vulnerability in research and healthcare as an identifiably increased likelihood of incurring additional or greater wrong. In order to identify the vulnerable, as well as the type of protection that they need, this definition requires that we start from the sorts of wrongs likely to occur and from identifiable increments in the likelihood, or to the likely degree, that these wrongs will occur. It is limited but appropriately so, as it only applies to special protection, not to any protection to which we have a valid claim. Using this definition would clarify that the normative force of claims for special protection does not rest with vulnerability itself, but with pre-existing claims when these are more likely to be denied. Such a clarification could help those who carry responsibility for the protection of vulnerable populations, such as Institutional Review Boards, to define the sort of protection required in a more targeted and effective manner. (shrink)

Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...) (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

Although rationing by clinical judgment is controversial, its acceptability partly depends on how it is practiced. In this paper, rationing by clinical judgment is defined in three different circumstances that represent increasingly wider circles of resource pools in which the rationing decision takes place: triage during acute shortage, comparison to other potential patients in a context of limited but not immediately strained resources, and determination of whether expected benefit of an intervention is deemed sufficient to warrant its cost by reference (...) to published population based thresholds. Notions of procedural justice are applied along with an analytical framework of six minimal requisites in order to facilitate fair bedside rationing: (1) a closed system that offers reciprocity, (2) attention to general concerns of justice, (3) respect for individual variations, (4) application of a consistent process, (5) explicitness, and (6) review of decisions. The process could be monitored for its applicability and appropriateness. (shrink)

Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the ‘Swiss model’ for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the ‘Swiss model’ using the framework of Hohfeldian rights as modified by Wenar. After (...) outlining this framework, we dissect the rights involved in suicide assistance in Switzerland, and compare it with the situation in England and Germany. Based on this approach, we conclude that in Switzerland, claim rights exist for those requesting suicide assistance, and for those who are considering providing such assistance, even though no entitlements exist toward suicide assistance. We then describe the implementation of the ‘Swiss model’ and difficulties arising within it. Clarifying these issues is important to understand the Swiss situation, to evaluate what features of it may or may not be worth correcting or emulating, and to understand how it can impact requests for suicide assistance in other countries due to ‘suicide tourism’. It is also important to understand exactly what sets Switzerland apart from other countries with different legislations regarding suicide assistance. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. (...) -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the ‘Swiss model’ for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the ‘Swiss model’ using the framework of Hohfeldian rights as modified by Wenar. After (...) outlining this framework, we dissect the rights involved in suicide assistance in Switzerland, and compare it with the situation in England and Germany. Based on this approach, we conclude that in Switzerland, claim rights exist for those requesting suicide assistance, and for those who are considering providing such assistance, even though no entitlements exist toward suicide assistance. We then describe the implementation of the ‘Swiss model’ and difficulties arising within it. Clarifying these issues is important to understand the Swiss situation, to evaluate what features of it may or may not be worth correcting or emulating, and to understand how it can impact requests for suicide assistance in other countries due to ‘suicide tourism’. It is also important to understand exactly what sets Switzerland apart from other countries with different legislations regarding suicide assistance. (shrink)

Fair resource allocation in humanitarian medicine is gaining in importance and complexity, but remains insufficiently explored. It raises specific issues regarding non-ideal fairness, global solidarity, legitimacy in non-governmental institutions and conflicts of interest. All would benefit from further exploration. We propose that some headway could be made by adapting existing frameworks of procedural fairness for use in humanitarian organizations. Despite the difficulties in applying it to humanitarian medicine, it is possible to partly adapt Daniels and Sabin's ‘Accountability for reasonableness’ to (...) this context. This would require: (1) inclusion of internally explicit decisions and rationales; (2) publicity to donors, local staff, community leaders and governments, as well as frank answers to any beneficiary—or potential beneficiary—who asked for clarification of decisions and their rationale; (3) a consistent reasoning strategy to weigh conflicting views of equity in specific situations; (4) advocacy within the organization as a mechanism for revision and appeals; and (5) internal regulation according to publicly accessible mechanisms. Organizations could generate a common corpus of allocation decisions from which to draw in future similar cases. Importantly, the complexity of these challenges should encourage, rather than hinder, broader discussion on ethical aspects of resource allocation in humanitarian medicine. CiteULike Connotea Del.icio.us What's this? (shrink)

Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient inclusion. Results Justifications were provided for 59% of DNAR orders and included (...) severe comorbidity, patients and families’ resuscitation preferences, patients’ age, or poor prognosis or quality of life. Reasons to include patients in CPR/DNAR decisions were provided in 96% and 84% of cases, and were based on respect for autonomy, clinical assessment of the situation as not too severe, and the view that such inclusion was required. Reasons for not including patients were offered in 84% of cases for CPR and in 70% for DNAR. They included absent decision-making capacity, a clinical situation viewed as good (CPR) or offering little hope of recovery (DNAR), barriers to communication, or concern that discussions could be emotionally difficult or superfluous. Decisions made earlier in the patient's management were infrequently viewed as requiring revision. Residents reported a variety of introductions to discussions with patients. Conclusions These results provide better understanding of reasons for CPR/DNAR decisions, reasons for patient inclusion or lack thereof, and ways in which such inclusion is initiated. They also point to potential side-effects of implementing CPR/DNAR recommendations without in-depth and practical training. This should be part of a regular audit and follow-up process for such recommendations. (shrink)

Which inequalities in longevity and health among individuals, groups, and nations are unfair? And what priority should health policy attach to narrowing them? These essays by philosophers, economists, epidemiologists, and physicians attempt to determine how health inequalities should be conceptualized, measured, ranked, and evaluated.

The Philosophers' Library features the most important philosophy manuscripts and books as stepping stones to take your through the history of philosophy. By cataloguing the history of philosophy via its key works, this book reflects the physical results of human thinking and endeavour; brilliant thought manifested in titles that literally changed the course of knowledge, sometimes by increments, and sometimes with revolutionary impact. This is a unique book of books, all as beautiful as they are important, whether they be ancient, (...) modern or those in-between"--Publisher's description. (shrink)

Sometimes physicians lie to third-party payers in order to grant their patients treatment they would otherwise not receive. This strategy, commonly known as gaming the system, is generally condemned for three reasons. First, it may hurt the patient for the sake of whom gaming was intended. Second, it may hurt other patients. Third, it offends contractual and distributive justice. Hence, gaming is considered to be immoral behavior. This article is an attempt to show that, on the contrary, gaming may sometimes (...) be a physician's duty. Under specific circumstances, gaming may be necessary from the viewpoint of the internal morality of medicine. Moreover, the objections against gaming are examples of what we call the idealistic fallacy, that is, the fallacy of passing judgments in a nonideal world according to ideal standards. Hence, the objections are inconclusive. Gaming is sometimes justified, and may even be required in the name of beneficence. (shrink)

Health care costs have been rising steadily in most industrialized countries. These increases are driven primarily by technological advances and, to a lesser degree, by aging of the population. Many factors make it unlikely that market forces alone will limit increases in the costs of health care. These unremitting increases make health care rationing appear both necessary and inevitable.One of the least controversial mechanisms for rationing could be to allow patients to make their own choices as to which kinds of (...) care they would be willing to forgo. This is appealing because it preserves individual freedom of choice regarding health care in a way that other rationing mechanisms often do not. Rationing by patient choice, however, can only happen if patients recognize that resources are limited and need to be conserved, and are willing to forgo marginal benefits. (shrink)

The religions of the world preserve the knowledge and protect the secrets of ancient powerful mantras. At the heart of world religion, and among the most powerful mantras in the history of religion, is the Navkar mantra, or Trimantra. In the book “Trimantra”, Gnani Purush (embodiment of Self knowledge) Dada Bhagwan explains the Trimantra, its mantra meaning, and the extraordinary benefits of its recitation. Whether wishing to live with no worry while facing problems in everyday life, wondering how to get (...) inner peace, or on a spiritual quest seeking spiritual enlightenment (self realization), utilizing Trimantra provides that – and more. Among the many spiritual books available today, Dadashri’s spiritual guidance about the value of Trimantra, and how to best access its spiritual power, is invaluable. (shrink)

The American Journal of Bioethics, Volume 11, Issue 12, Page 46-47, December 2011.

Quelles sont les principales problématiques en émergence dans l’éthique de la santé publique ces 10 prochaines années? Se hasarder à prédire l’avenir nécessite toujours une certaine dose d’autodérision, mais les fondements des enjeux sur une échéance aussi proche sont en grande partie déjà présents. Ils peuvent être décrits à différents niveaux d’observation. Le premier de ces niveaux est technique : la santé publique recouvre toute une série d’interventions, dont la mise en œuvre rencontre des obstacles qui, pour certains, ont une (...) résonance éthique. Le deuxième niveau est philosophique et politique : la dimension collective des interventions de santé publique mobilise les débats généraux concernant la liberté individuelle d’une part, et la justice distributive d’autre part. Le troisième niveau est systémique : la santé de la population peut en effet être considérée comme une ressource faisant l’objet de tensions politiques dont la visibilité est pour le moment variable. Certes, l’idée que la santé du peuple est une richesse pour la nation remonte au Siècle des lumières (1). Néanmoins, prise dans les débat centrés sur l’individu et la collectivité, l’éthique de la santé publique peine davantage à concevoir parmi ses objets les tensions à l’œuvre entre différentes collectivités, certaines seulement comptant parmi leurs tâches la protection des biens communs dont fait partie la santé publique. (shrink)

One of the most striking findings of the study by Foglia and colleagues (2009) was that clinicians and managers were most concerned with limited resources while ethics committee chairpersons focuse...

The American Journal of Bioethics, Volume 12, Issue 1, Page 10-11, January 2012.

Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

As pressures increase to contain growing healthcare expenditures, there is currently a prominent rise in the shift of healthcare costs to patients in the form of deductibles, co-pays, and co-insurance. Rising co-payments are part of a larger picture of increasing overall out-of-pocket healthcare expenditures. From 1990 to 2000, per capita out-of-pocket payments for healthcare reached $707 in the United States, and doubled in several European countries with universal health insurance, reaching $396 in Denmark, $290 in Germany, and $466 in Italy (...) in 2000. (shrink)

The American Journal of Bioethics, Volume 12, Issue 5, Page 37-38, May 2012.