Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)

With developed country governments and high resource institutions engaging in research in low- and middle-income countries, we argue that these entities have a moral obligation to help build and strengthen research infrastructure and capacity so local scientists and institutions can adequately conduct studies to understand and resolve the health burdens in low and middle income countries. We explore the moral justifications and motivations behind engaging in research capacity strengthening in the health sector in LMIC at multiple levels. In highlighting these (...) issues, this paper aims to initiate a global discourse around why capacity development in LMIC has a moral basis at the individual, institutional and system levels. (shrink)

There has been growing consensus to develop relevant guidance to improve the ethical review of global health policy and systems research and address the current absence of formal ethics guidance.

Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)

Currently, health systems research is reviewed by the same ethical standards as clinical research, which has recently been argued in the literature to be an inappropriate standard of evaluation. The issues unique to HSR warrant a different review by research ethics committees, as it does not impose the same risks to study participants as other types of clinical or public health research. However, there are limited tools and supporting documents that clarify the ethical considerations. Therefore, there is a need for (...) additional reflection around ethical review of HSR and their consideration by RECs. The purpose of this paper is to review, understand, and synthesize the current state of literature and practice to inform these deliberations and the larger discourse on ethics review guidelines for HSR. This paper presents a review of the literature on ethics of HSR in the biomedical, public health, and implementation research to identify ethical considerations specific to HSR; and to identify examples of commonly available guidance and/or tools for the ethical review of HSR studies. Fifteen articles were identified on HSR ethics issues, and forty-two international academic institutions were contacted, no institution had special ethical guidelines for reviewing HSR) about their HSR ethics review guidelines. There appears to be a clear gap in the current health research ethics discourse around health systems research ethics. This review serves as a first step towards a larger dialogue on the topic. (shrink)

1. Ḥāshīyat al-Ṣabbān ʻalá al-Sharḥ al-Ṣaghīr lil-Mullawī ʻalá al-Sullam al-murawnaq -- 2. Taqrīrāt Ḥasan ibn Riḍwān al-Ḥusaynī.

Vahyin akılla, bilimin dinle, benliğin yaratıcıyla, dünyanın ahiretle çeliştiğini düşünen Batı modernitesi en güçlü etkisini kendi yuvası Avrupa’da gösterdikten kısa bir süre sonra 18. yüzyılda komşu topraklara Afrika ve Asya’ya dünya görüşünü neşretmiştir. Napolyon’un Mısır işgali kuşkusuz bu etkinin Arap dünyası sathında kıvılcımı olmuştur. Başta Mısır insanı olmak üzere tüm Arap dünyası basın ve yayın yoluyla Batı tarzı yaşam tarzı ile tanışmış ve kendi geleneği aleyhinde olumsuz etkilenmiştir. Bu olumsuz etkiyi kendi toplumunda gören Menfalûtî, halkına karşı sorumluluk hisleriyle vaaz ve (...) irşat içerikli edebi eserler ortaya koymuştur. Ancak onun bu eserlerinde çoğu zaman karamsar bir üslup kullandığı ifade edilmiştir. Hikâyelerinde seçtiği karakterlerin başlarına gelen acı felaketlerin eserlerine melankolik bir hava kattığı belirtilmiştir. Bu makale yazarın bu karamsar üslubu benimsemesinin nedenlerinden biri üzerine duracaktır. (shrink)

Ways of Being Free: Introduction -- War Is Everything's Father: History and Death as Causes of Existential Angst -- Introduction: Causes of Existential Angst -- Change and Changelessness in Midnight's Children -- The Road of Existential Struggle in The Famished Road -- History and the "Nervous Condition" in The English Patient -- Death as a Drive to Meaningful Existence in Midnight's Children -- Becoming Dead-to-the-World in The English Patient -- Ideological Re-appropriation through Death in The Famished Road -- Authenticity -- (...) Authenticity: Introduction -- From Self-Sufficiency to Inoperative Community in The English Patient -- Revolution Revisited in The Famished Road -- From Communalism to the Comic Absurd in Midnight's Children. (shrink)

خلصت هذه الدراسة إلى دحض الادعاء بوجود فجوة تاريخية في تطور علم الاقتصاد، حيث تمكن الرواد الأوائل من الاقتصاديين المسلمين من وضع العديد من الأسس الفكرية لعلم الاقتصاد. تسلط هذه الدراسة الضوء على الفترة الزمنية التي تم تجاهلها قصداً أو جهلا لتكشف عن الجذور التاريخية لعلم الاقتصاد الإسلامي وتكشف عن الحلقة المفقودة في تطور علم الاقتصاد منذ القرن الهجري الأول إلى القرن الهجري الخامس، حيث سعت هذه الدراسة إلى نقض ادعاء الريادة الغربية لعلم الاقتصاد من خلال ما عرضته من إسهامات (...) للمفكرين المسلمين الذين سبقوا الاقتصاديين الغربيين بعدة قرون. لقد قام الاقتصاديون المسلمون بتدشين عدد من قواعد علم الاقتصاد، واستخدموا أساليب التحليل الاقتصادي في رصد بعض الظواهر الاقتصادية، وقد قاموا بتسليم إنجازاتهم هذه للبشرية من خلال الصروح العلمية في الأندلس. كذلك لا يزعم مُعدُّ هذه الدراسة أنّ العلماء المسلمين تناولوا جميع القضايا الاقتصادية ولا يدعي بانّهم وضعوا قواعد علم الاقتصاد جملة ولم يغفلوا عن شاردة أو واردة، بل يعترف بأنّ علماء المسلمين الاقتصاديين لم يتناولوا كثيرا من القضايا الاقتصادية المحدثة كالائتمان، والمشتقات المالية، والنقود الالكترونية وما شاكل من المستجدات. لكنه يؤكد إسهام العلماء المسلمين في تطوير الفكر الاقتصادي. (shrink)

Refusing consent to organ donation remains unacceptably high, and improving consent rates from family or next-of-kin is an important step to procuring more organs for solid organ transplantation in countries where this approval is sought. We have thus far failed to translate fully our limited understanding of why families refuse permission into successful strategies targeting consent in the setting of deceased organ donation, primarily because our interventions fail to target underlying cognitive obstacles. Novel interventions to overcome these hurdles, incorporating an (...) understanding of cognitive psychology and behavioral change therapy, may be beneficial. One potential intervention is to use the concept of nudge theory, where decision-making is influenced by encouraging positive reinforcement and indirect suggestion. Purposefully nudging families to given consent for organ donation by understanding, and then overcoming, their inherent cognitive biases is novel but also controversial. This article explores the roles of relatives in decisions about organ donation, how nudge theory translates to organ donation and discusses the arguments for and against its application. (shrink)

We show in this paper that the AGM postulates are too weak to ensure the rational preservation of conditional beliefs during belief revision, thus permitting improper responses to sequences of observations. We remedy this weakness by proposing four additional postulates, which are sound relative to a qualitative version of probabilistic conditioning. Contrary to the AGM framework, the proposed postulates characterize belief revision as a process which may depend on elements of an epistemic state that are not necessarily captured by a (...) belief set. We also show that a simple modification to the AGM framework can allow belief revision to be a function of epistemic states. We establish a model-based representation theorem which characterizes the proposed postulates and constrains, in turn, the way in which entrenchment orderings may be transformed under iterated belief revision. (shrink)

Despite the fact that in order to become a liveable space for humankind the world owes many things to the scientific point of view, to fill that space with meaning so that it can be our home, is only possible due to the aesthetic relation which man establishes with life. The meaning which is required so that man could make sense of this space can only be brought into this world through the fictional strength of language. Existence which in itself (...) alone is meaningless, indifferent and neutral can only become a stage where humanity dares to appear, thanks to the attributes that it gains through the act of making sense. By overlooking that point the theoretical approach which is symbolized by the Enlightenment destroys according to Nietzsche the basics of the relation between man and life. Today the scientific and technological Perspective which have become the forces of our culture and civilization have already withdrawn themselves from the question of the meaning of life to the point of ignoring its importance. On the other side, due to its natural mechanism, the advantage which the artistic approach possesses comes from the capacity to transform the reality through fiction. Hence, art is maybe one of the most important accomplishments which contributes to the creation of meaning so that man won't perish against this essential indifference of existence. (shrink)

Özgür istemeyi bir illüzyona dönüştüren deterministik öğelere sahip olan bir ideoloji içerisinde insan varoluşunun anlamsız ve saçma bir nitelik arz edeceğini düşünen Dostoyevski, Yeraltından Notlar’da kurguladığı yeraltı adamı karakteri aracılığıyla, doğa yasalarını temel alan ve Çernişevski gibi materyalist düşünürler tarafından savunulan toplumsal mühendislik fikrinin hiçbir şekilde uygulamaya konulmayacağını göstermek ister. Bunu gerçekleştirmek için dolaylı bir yol izleyen ve yeraltı adamı aracılığıyla determinist bir ideolojinin penceresinden dünyaya bakan bir karakter yaratan Dostoyevski, bu karakterin bakışından hareketle tüm insani edimlerin zorunlu bir nedensellik (...) tarafından belirlendiğini idrak eden bilincin verdiği irrasyonel, çelişkili ve bir anlamda saçma tepkileri gün yüzüne çıkarır. Karşıt olduğu öğretinin perspektifinden bir anlatı ortaya koyan Dostoyevski böylece materyalist bir determinizm ileri süren ideolojiyi adeta içeriden çürütmeye çalışır. Bu makalenin amacı Dostoyevski’nin Yeraltından Notlar’ını takip ederek, istemelerini, arzularını ve seçimlerini özgürce hayata geçiremeyeceğinin bilincine varan yeraltı adamının düştüğü çelişkili varoluşu irdelemek ve böylece determinist öğretilerin kabul edilmesi güç olan pratik sonuçlarını anlaşılır kılmaktır. (shrink)

The paper analyses the relations of the Communist authorities with religious communities in Montenegro in the period 1945 - 1955. The paper separately problematises specific features of each confessional community in Montenegro, and establishes a typology of the expansion of regime control. The Communist Party did not use violent methods in the process of marginalising the religious community, but new authorities in Montenegro managed to marginalise its influence. By taking over the executive authority in the state, the Party began the (...) process of marginalising the religious communities. The process of excluding religious communities from social life started. Their activity was limited to constitutional and legal provisions and later on prohibition of all forms of religious behaviour in public life. Results of the process of secularisation were much better than in other Yugoslav republics. Montenegro had 31.5% of the population atheists, and this was significantly more than the Yugoslavian average, which amounted for 12.5% of the population. (shrink)

Background: Observance of the patients’ bill of rights is one of the main features of moral codes in hospitals. In this regard, nurses bear great responsibility because they spend a long time with patients. Therefore, the continuous evaluation of the nurses’ performance and assessing their knowledge about the patients’ bill of rights are a need. Objectives: We aimed to determine the nurses’ awareness of the patients’ rights and measure their performance in this regard. Research design and participants: This cross-sectional study (...) was carried out in 2013. To measure the nurses’ knowledge and performance, 250 nurses and 300 patients were surveyed. The participants were selected randomly from five teaching hospitals in Tehran, Iran. Two questionnaires, one for nurses (17 questions) and the other for patients (11 questions), were applied. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The research protocol was submitted and approved by the research and ethics committees of the participating hospitals. Additionally, the consent of all of the participants was obtained before the study. Findings: The mean score of the nurses’ knowledge regarding the patients’ rights was acceptable (69.85 ± 11.7 of 85). Furthermore, the mean score of nurses’ performance in observing the patients’ rights was relatively acceptable (11.2 ± 4.6 of 22). More experienced and educated nurses had higher knowledge regarding the patients’ rights, and patients with higher education level or experience of being hospitalized were less satisfied with the nurses’ performance. Conclusion: Nurses’ knowledge of the patients’ bill of rights was acceptable; however, observance of the patients’ rights was not. It seems that notification of the patients’ bill of rights has increased the nurses’ awareness of the patients’ rights, although improvement of the nurses’ performance needs more extensive measures. (shrink)

Lex Mercatoria play a crucial role in resolving disputes arising from international trade contracts before arbitration bodies, thus establishing them as an independent legal system capable of regulating international commercial relations. This legal characteristic imposes a certain obligation on various arbitration bodies to apply them to the disputes brought before them, either based on the parties' intentions or based on the legal force inherent in those customs. Consequently, this research examines the extent of recognition of the binding force of commercial (...) customs before arbitration bodies, and based on that, it elucidates the authority of these bodies in applying them to international trade disputes. It is evident that these customs, due to their flexibility derived from the nature of commercial transactions and the customary practices of traders resorting to them, have become today an independent legal system that imposes itself on arbitration bodies even if the parties did not choose to apply those customs. This paper recommends the Jordanian legislator to explicitly adopt the application of these commercial customs in the Jordanian Arbitration Law texts, following the example of national and international comparative legislation. (shrink)

Recent work has shown that the input-output behavior of some common machine learning classifiers can be captured in symbolic form, allowing one to reason about the behavior of these classifiers using symbolic techniques. This includes explaining decisions, measuring robustness, and proving formal properties of machine learning classifiers by reasoning about the corresponding symbolic classifiers. In this work, we present a theory for unveiling the _reasons_ behind the decisions made by Boolean classifiers and study some of its theoretical and practical implications. (...) At the core of our theory is the notion of a _complete reason,_ which can be viewed as a necessary and sufficient condition for why a decision was made. We show how the complete reason can be used for computing notions such as sufficient reasons (also known as PI-explanations and abductive explanations), how it can be used for determining decision and classifier bias and how it can be used for evaluating counterfactual statements such as “a decision will stick even if...because....” We present a linear-time algorithm for computing the complete reasoning behind a decision, assuming the classifier is represented by a Boolean circuit of appropriate form. We then show how the computed complete reason can be used to answer many queries about a decision in linear or polynomial time. We finally conclude with a case study that illustrates the various notions and techniques we introduced. (shrink)

Several protective cellular mechanisms protect against the accumulation of reactive oxygen species (ROS) and the concomitant oxidative stress. Therefore, any reduction in glucose or fatty acid flux into cells leading to a decrease in the production of reducing equivalents would also lead to a decreased ROS production and protect cells against oxidative stress. In the presence of insulin, FOXO proteins are localized from the nucleus to the cytoplasm and degraded. An increase in cellular glucose uptake will lead to increased production (...) of ROS. This in turn activates the stress‐responsive Jun‐N‐terminal kinase (JNK), which promotes nuclear translocation of FOXO proteins, upregulating some important target genes including stress resistance. Consequently, insulin resistance should result in decreased cellular ROS production. For this reason, insulin resistance could be a physiological mechanism activated at the cellular level in response to conditions stimulating ROS production and leading to the prevention of oxidative stress, and extension of life. Concerning the whole organism, however, IR is a maladaptive process in the long term causing a diabetic state. BioEssays 29:811–818, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

_With the growth of the edutainment industry, developing countries in Asia have seen a significant increase in this sector in recent years. Although Pakistan has been a latecomer to this emerging industry, it faces challenges in effective marketing strategies, limiting its appeal to potential customers. The concept of edutainment is still relatively unknown, making it crucial to raise awareness of its potential benefits. Pakistan requires more initiatives to build children's confidence, enhance communication skills, foster cognitive growth, and support overall mental (...) development. This research focuses on Giggle Town, a newly established center in Karachi, Pakistan, and examines its digital marketing strategies to position itself favorably within the competitive entertainment industry. Giggle Town offers a unique learning environment that fosters children's curiosity, creativity, and exploration. However, the study reveals that the center's digital marketing efforts are disproportionately focused on entertainment, overlooking the critical educational components that make it unique. This study assesses the effectiveness of these existing digital marketing strategies and explores alternative approaches to enhance Giggle Town's market positioning and outreach. Through qualitative methods including interviews and observational data, we explored how parents and educators perceive these offerings. The center currently relies heavily on influencer marketing and referrals, lacking a comprehensive digital marketing strategy. The findings propose a comprehensive digital marketing strategy that equally emphasizes both educational and entertainment aspects, thus appealing to parents' desire for meaningful and engaging experiences for their children. This approach not only aims to boost Giggle Town's visibility but also sets a new standard for edutainment marketing._. (shrink)

Volume 20, Issue 5, June 2020, Page 67-69.

History in this age needs to record and analyze the events in the light of modern concept of contemporary world. When the historians narrate the brutal condition of Indo-Pak history, they never forget the work and services of Shaykh Ahmad Sirhindi to transform the society according to the current values. For his services, he is hailed as Mujaddid Alf-I-Thani. The Muslim society had degenerated when Mujaddid Alf-I-Thani appeared on the horizon. A number of Hindu customs and practices had become the (...) part of their creed. The commandments of Shariat and Sunnah were being floated. Moreover, the Mughal emperor Akbar had adopted controversial policies detrimental to the very existence of Muslim society. Mujaddid Alf -Thani made strenuous and constant efforts to turn the tide. When Mujadded-Alf-Thani started his social reform movement, he found that the Muslim society was embracing un-Islamic practices such as widespread belief in Karamat had developed under the influence of Hindu thinking. Moreover, the Islamic teachings had been vitiated by adopting customs and practices of other religions such as inter marriages between Hindus and Muslims and ban on cow slaughter etc. Shaykh Ahmad Sirhindi never entered into any political conflict directly. He endeavored to restore pure doctrine to Islamic thought and to compel the Muslims to follow Shariat and Sunnah in letter and spirit. He was a social reformer, great Alim, Sufi and Mujaddid. He initiated a process of social change, inspired by Islamic Ideal, in an age, which was becoming secular. This research paper is an attempt to mention the role of Shaykh Ahmad Sirhindi for saving the society from un-Islamic values and customs in the sub-continent and its impact on society. By utilizing the historical method, this paper aims at analyzing the effect of social reforms of Shaykh Ahmed Sirhindi on Muslim society. (shrink)

Moral distress is a fundamental problem in the nursing profession that affects nurses. Critical care nurses are more susceptible to this problem due to the nature of their work. Moral distress may, in turn, lead to several undesirable consequences. This study aimed to determine the relationship between moral distress and intention to leave the ward among critical care nurses. This descriptive-correlational study was conducted by census method on all eligible nurses who worked in Coronary Care Unit (CCU) and Intensive Care (...) Unit (ICU) of AhVaz hospitals, Iran. Data was collected by Corley’s moral distress questionnaire and a researcher-made questionnaire to investigate the intention to leave the ward. Questionnaires were completed through self-report and data were analyzed using a t-test and Pearson correlation coefficient. The results showed that there was a direct association between moral distress and intension to leave the ward in critical care nurses (P < 0.05). Also, the intensity of moral distress (P = 0.03) and the intention to leave the ward (P = 0.007) were significantly higher in ICU nurses. Given the high exposure of critical care nurses with moral distress and its association with leaving the ward, it seems that devising strategies to reduce or control moral distress and its negative consequences are necessary, particularly in ICU nurses. (shrink)

We present a survey of the recent applications of continuous domains for providing simple computational models for classical spaces in mathematics including the real line, countably based locally compact spaces, complete separable metric spaces, separable Banach spaces and spaces of probability distributions. It is shown how these models have a logical and effective presentation and how they are used to give a computational framework in several areas in mathematics and physics. These include fractal geometry, where new results on existence and (...) uniqueness of attractors and invariant distributions have been obtained, measure and integration theory, where a generalization of the Riemann theory of integration has been developed, and real arithmetic, where a feasible setting for exact computer arithmetic has been formulated. We give a number of algorithms for computation in the theory of iterated function systems with applications in statistical physics and in period doubling route to chaos; we also show how efficient algorithms have been obtained for computing elementary functions in exact real arithmetic. (shrink)