Solid-organ transplantation remains the optimal therapeutic option for end-stage organ disease. Altruistic donation represents the ultimate sign of generosity and the most important gift of life. Currently, <10% of the global needs for transplant are fulfilled. Organ shortages result from an inability to provide an adequate organ supply to match demands. The recently observed stagnation in living kidney donations in the United States is related to a drop in all types of organ donations from living related donors, which has been paralleled with a steady and continuous increase in all living unrelated donations. Some forms of living unrelated donation represent a financially driven survival system within which wealthy recipients exploit poor donors. Low rates of altruistic donation are related to cultural barriers, religious obstacles, fear, and consequent distrust in the system. The low rate indicates a state of lack of societal solidarity, a consequence of the state of subconsciousness at the individual and collective levels that humanity is living in. Human domestication, the conditioning process that humans go through since birth and the primary facilitator of this subconscious state, is guarded through familial, social, cultural, religious, political, and mass media organizations, which are all under the influence of the monetary establishment. Acquired beliefs, mainly during the domestication process, influence our perception of the environment, our values, and ultimately our way of life. Unfortunately, this conditioning process is negatively enforced, leading to a stressful state. The powerful subconscious mind places humans in a permanent survival mode, resulting in loss of intelligence, indispensable for well-being and happiness. Altruistic donation requires a close cooperation between all parties involved in the donation process and necessitates a positive reprograming of our subconscious based on sharing, generosity, satisfaction, gratitude, trust, inner peace, and ultimately happiness, well-known constituents of unconditional love, which represents the peak of consciousness.

OBJECTIVE: The objective of this study was to investigate the newly graduated physicians\' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking.
METHODS: A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs. private) and the sex of the respondents.
RESULTS: Out of the participants, 61.8% believed that industry funding could support medical conferences and education, and 48.4% felt that small gifts and conference travel funding were acceptable. Conversely, 64.7% disagreed with industry-sponsored social events. Views on whether pharmaceutical representatives\' visits influenced prescriptions were divided. Statistically significant differences were observed between genders and medical school types, with men and private school graduates being more accepting of certain industry interactions.
CONCLUSIONS: The study highlights the nuanced attitudes of new doctors toward industry relationships, indicating the need for clearer ethical guidelines and education in medical schools to align practice with evolving societal values.

This paper investigates the influence of gifts - monetary and in-kind payments - from drug firms to US physicians on prescription behavior and drug costs. Using causal models and machine learning, we estimate physicians\' heterogeneous responses to payments on antidiabetic prescriptions. We find that payments lead to increased prescription of brand drugs, resulting in a cost rise of $23 per dollar value of transfer received. Paid physicians show higher responses when they treat higher proportions of patients receiving a government-funded low-income subsidy that lowers out-of-pocket drug costs. We estimate that introducing a national gift ban would reduce diabetes drug costs by 2%.

暂无摘要。

UNASSIGNED: Pharmaceutical companies invest greatly in promotional gifts to influence prescription of medications by physicians, yet there is limited published information evaluating its impact on healthcare.
UNASSIGNED: This study aimed to assess the beliefs and practices of physicians in Lebanon regarding promotional gifts and their interactions with representatives of pharmaceutical companies.
UNASSIGNED: This cross-sectional study was conducted between December 2019 and January 2020 through an email-based questionnaire sent to 5936 physicians of different specialties registered in the Lebanese Order of Physicians. Assessment was done using a validated tool and data analysis was conducted using SPSS version 26.0.
UNASSIGNED: Of the 268 respondents, 188 (70.4%) reported that physicians in Lebanon accepted gifts from representatives of pharmaceutical companies. Most of the physicians (31.7%) interacted with company representatives more than once a week. Medication samples (251 respondents) and stationary items (222 respondents) were the most common gifts accepted by physicians who admitted accepting gifts. Overall, 225 (84.9%) respondents believed that prescriptions by physicians in Lebanon were influenced by the gifts. Only 74 (40.0%) of those who accepted gifts from pharmaceutical companies believed that it was unethical, and around half did not know if the Lebanese Code of Medical Ethics allowed them to accept gifts from pharmaceutical companies.
UNASSIGNED: Although physicians in Lebanon were aware of the effect that gifts from pharmaceutical companies could have on their prescription behaviours, many of them still accepted the gifts. This study provides evidence to policymakers for decision-making regarding ethical guidance on interactions between physicians and pharmaceutical companies in Lebanon.
معتقدات الأطباء وممارساتهم في لبنان فيما يتعلق بالهدايا الترويجية وتفاعلاتهم مع شركات الأدوية.
عصام الشعراني، جيدا حاسبيني، ريم فرحات، نور صفاوي، جميل سليمان، آلاء قاسم حمود، تمارا فياض، دانة خزعل، عبيدة الخطيب، حسين برجاوي.
UNASSIGNED: تستثمر شركات الأدوية استثمارًا كبيرًا في الهدايا الترويجية للتأثير على وصف الأطباء للأدوية، إلا أن المعلومات المنشورة عن هذه الهدايا محدودة لتقييم تأثيرها على الرعاية الصحية.
UNASSIGNED: هدفت هذه الدراسة إلى تقييم معتقدات الأطباء وممارساتهم في لبنان فيما يتعلق بالهدايا الترويجية وتفاعلاتهم مع مندوبي شركات الأدوية.
UNASSIGNED: أُجريت هذه الدراسة المقطعية في المدة ما بين ديسمبر/ كانون الأول 2019 ويناير/ كانون الثاني 2020 من خلال استبيان قائم على البريد الإلكتروني أُرسلَ إلى 5936 طبيبًا من مختلف التخصصات، مُسجَّلين في نقابة أطباء لبنان. وأُجريَ التقييم بأداة متحقق منها، وحُلِّلت البيانات بالإصدار 26,0 من برنامج SPSS.
UNASSIGNED: من بين المشاركين في الاستبيان البالغ عددهم 268 طبيبًا، أفاد 188 منهم (70,4٪) بأن الأطباء في لبنان قبلوا الهدايا من مندوبي شركات الأدوية. وتفاعل معظم الأطباء (31,7٪) مع مندوبي الشركات أكثر من مرة في الأسبوع. وكانت عينات الأدوية (العدد = 251؛ 94,0٪) والأدوات القرطاسية (العدد = 222؛ 83,1٪) أكثر الهدايا شيوعًا التي حصل عليها الأطباء ممن اعترفوا بقبولهم للهدايا. وإجمالًًا، رأى 225 مشاركًا (84,9٪) أن الوصفات الطبية التي قدمها الأطباء في لبنان قد تأثرت بالهدايا. ورأى 74 فقط (40,0٪) ممن قبلوا هدايا من شركات الأدوية أنه أمر غير أخلاقي، ونحو نصف هؤلاء لا يعرفون هل تسمح مدونة الأخلاقيات الطبية اللبنانية لهم بقبول هدايا من شركات الأدوية أم لا.
UNASSIGNED: رغم أن الأطباء في لبنان كانوا على علم بتأثير قبول الهدايا من شركات الأدوية على سلوكياتهم في كتابة الوصفات الطبية، فما زال كثيرٌ منهم يقبل الهدايا. وتقدم هذه الدراسة دلائل لراسمي السياسات من أجل اتخاذ قرارات تتعلق بالإرشادات الأخلاقية بشأن التفاعلات بين الأطباء وشركات الأدوية في لبنان.
Croyances et pratiques des médecins au Liban concernant les cadeaux promotionnels et leurs interactions avec les laboratoires pharmaceutiques.
UNASSIGNED: Les laboratoires pharmaceutiques investissent des sommes importantes dans l\'offre de cadeaux promotionnels afin d\'influencer les prescriptions de médicaments par les médecins, mais les informations publiées déterminant l\'impact de ces pratiques sur les soins de santé sont limitées.
UNASSIGNED: La présente étude a pour objectif d\'évaluer les croyances et les pratiques des médecins au Liban concernant les cadeaux promotionnels et leurs interactions avec les représentants de laboratoires pharmaceutiques.
UNASSIGNED: La présente étude transversale a été menée entre décembre 2019 et janvier 2020 au moyen d\'un questionnaire envoyé par courriel à 5936 médecins de différentes spécialités inscrits à l\'Ordre des médecins libanais. L\'évaluation a été effectuée à l\'aide d\'un outil validé et l\'analyse des données a été réalisée au moyen du logiciel SPSS version 26.0.
UNASSIGNED: Sur les 26 8 répondants, 188 (70,4 %) ont indiqué que les médecins au Liban acceptaient des cadeaux de la part de représentants de laboratoires pharmaceutiques. La plupart d\'entre eux (31,7 %) communiquaient avec des représentants de laboratoires plus d\'une fois par semaine. Les échantillons de médicaments (251) et les fournitures de bureau (222) étaient les cadeaux les plus fréquemment acceptés par les médecins qui ont admis en avoir reçu. Dans l\'ensemble, 225 répondants (84,9 %) estimaient que les ordonnances prescrites par les médecins au Liban étaient influencées par les cadeaux reçus. Seuls 74 médecins (40,0 %) parmi ceux qui ont accepté des cadeaux de la part de laboratoires pharmaceutiques considéraient que cette pratique était contraire à l\'éthique, et près de la moitié ignoraient si le Code libanais de déontologie médicale leur permettait de les accepter.
UNASSIGNED: Bien que les médecins au Liban soient conscients des conséquences que les cadeaux offerts par les laboratoires pharmaceutiques pourraient avoir sur leurs habitudes de prescription, beaucoup d\'entre eux continuent de les accepter. La présente étude fournit des données probantes aux responsables de l\'élaboration des politiques pour la prise de décision concernant les directives éthiques régissant les interactions entre les médecins et les laboratoires pharmaceutiques dans le pays.

Gifts are a powerful way to acknowledge and strengthen interpersonal relationships. As with any relational space, gifting plays various roles in forming and maintaining relationships in political contexts, but its contribution to relationship-building has attracted little attention. This paper examines how politicians in Aotearoa New Zealand both engage with gifting and how they navigate the perceptions of others. Four current members of parliament (MPs) and six retired MPs participated in semi-structured interviews with questions on common practices and common understandings about political gifting. Their responses indicate their use of four different processes: formal processes are the guidelines provided by the government on gifting, but when these are insufficient, contextual processes regarding perceptions of the media, constituents or colleagues are used, or, alternatively, MPs rely on personal values or view gifting in terms of transactional processes with both parties receiving benefits. The paper explores perceptions and complexities of a sequence of gifts during events (event gifting). The authors recommend an improved awareness and understanding of the contribution of gifting practices to political relationship building.

OBJECTIVE: The purpose of this article is to guide the clinical nurse specialist in constructing a scorecard to track clinical outcomes and identify the associated financial impact.
UNASSIGNED: Creation of a scorecard highlighting the financial impact of the clinical nurse specialist team was used to disseminate financial outcomes to hospital executive stakeholders, allowing the clinical nurse specialist team to demonstrate its clinical and financial value.
RESULTS: During development and ongoing maintenance of the scorecard, the clinical nurse specialist team cultivated skills to identify the financial impact of projects. The team also utilized financial implications of individual and group projects to prioritize work. At the end of fiscal year 2022, the clinical nurse specialist team demonstrated revenue generation of $29 890 and cost avoidance of $2 854 807.30. The clinical nurse specialist scorecard was presented quarterly to the chief nursing officer, who shared with executive leadership.
CONCLUSIONS: Clinical nurse specialists are positioned to make significant and positive financial impact to organizations. A scorecard presented to executive leadership offers a clinical nurse specialist team a tool to capture and disseminate a clinical nurse specialist team\'s unique financial contribution at the system level.

UNASSIGNED: In accordance with South Africa\'s restrictions to mitigate the spread of COVID-19, some speech-language pathologists (SLPs) attempted to engage in novice teletherapy regimes to ensure continuity of care for children with cerebral palsy (CP). This study aimed to explore the experiences of caregivers of children with CP implementing SLP teletherapy during COVID-19 in South Africa. The goal was to shed light on how these families can be better supported and how teletherapy practices can be adjusted for this population.
UNASSIGNED: This study employed a qualitative phenomenological research design using in-person and virtual semi-structured interviews with 18 purposively sampled participants with children with CP who received speech and language teletherapy during COVID-19. The data was evaluated using an inductive thematic analysis approach whereby themes elicited from the caregivers\' narratives were analyzed.
UNASSIGNED: Interviews (n = 18) unveiled the significant understanding caregivers gained by becoming integral and active stakeholders in the provision of teletherapy. Caregivers were able to meaningfully communicate and bond with their children with CP. However, caregivers also assumed the burden that teletherapy placed on them, as they had to renegotiate their role during the pandemic in order to provide routine teletherapy.
UNASSIGNED: Findings indicated the need for person-centered SLP teletherapy interventions that utilize contextually and culturally responsive techniques and resources.

Pan-entertainment live streaming combines video with two-way communication and real-time viewer participation, allowing viewers to send virtual gifts to their favorite streamers. Drawing on social exchange theory, this study investigates the factors that influence viewers\' gift-giving intentions in live streaming from the perspectives of both viewers and streamers. It also explores the moderating role of streamers\' deceptive self-presentation. The theoretical framework is tested using AMOS and PROCESS Macro based on survey responses collected from 331 TikTok users in China. The results suggest that streamers\' attractiveness, expertise, parasocial interaction, and the viewers\' deceptive self-presentation significantly affect viewers\' gift-giving intention, and that streamers\' deceptive self-representation moderates the relationship between attractiveness, expertise, parasocial inter-action and the viewer\'s consumer intention. These findings contribute to social exchange theory by highlighting the importance of streamers\' deceptive self-presentation in moderating the effects of attractiveness, expertise, parasocial interaction, and the viewer\'s deceptive self-presentation on the viewer\'s gift-giving intention.

In this paper we report two high-powered and pre-registered experiments, testing the robustness and conceptual development of reciprocity and social norm appeals. Both experiments assessed both psychological processes for complying with these appeals and pro-environmental behavioral intention in tourism settings. In Experiment 1 (N = 2004), participants reported lower psychological reactance levels after learning that the hotel engaged in resource conservation (i.e., indirect homeomorphic reciprocity). No statistically significant effect was obtained for either obligatory motivation, prosocial motivation, skepticism, or behavioral intentions to reuse hotel towels. Importantly, high baseline intention of reusing hotel towels might have limited the effect of appeals. Therefore, we targeted meat consumption in Experiment 2 (n = 2540). Results first showed stronger obligatory and prosocial motivation for all three reciprocity appeals, compared to the standard appeal. No statistically significant results were found for either reactance or skepticism. Finally, after learning that the hotel had made a financial contribution to an environmental organization (i.e., indirect heteromorphic reciprocity) participants showed reduced meat consumption intentions compared to the standard appeal. Overall, the results provide initial evidence for conceptually refining the norm of reciprocity to encourage pro-environmental behaviors and for understanding the underlying psychological processes.