S. S. Sharma

Medical tourism is the across-border travel for healthcare services by patients from various European and Asian countries. India is one of the preferred choices for medical treatments being the low-cost healthcare service provider along with the holistic quality care. Globalization and Liberalization are two important factors leading to the potential growth of the medical tourism market all over the globe.The current study undertakes the evaluation of potential factors for the growth of the medical tourism market in the country like cost benefits, qualified and expertise pool of medical staff, certification and accreditation and role of government in it. Based on these opportunities evaluation the strategy necessary for the exponential growth of the market is recommended. The medical tourism market is growing at a high pace of 30% yearly. The study aims to focus on the strategy to boost the economy of the country through the growing medical tourism market.Indian medical tourism market has been valued at US$ 2.89 billion in the year 2020 and the country has been ranked 10th out of world’s top 46 counties for medical tourism by the Medical Tourism Index 2020–2021. Thus, the paper highlights the in-depth analysis of growth drivers to boost the economy of the country through the exponential growth of medical tourism market.

India stands at a pivotal juncture in its pursuit of becoming a global power. Despite rapid economic growth and an expanding geopolitical presence, the nation faces deep-rooted structural and institutional barriers that constrain its transformation. This paper examines five interrelated dimensions—political governance, economic structure, infrastructure and technology, social demographics, and geopolitical strategy—to provide a comprehensive understanding of India’s developmental trajectory. The analysis reveals that bureaucratic inefficiency and limited institutional transparency undermine effective policy implementation. Economic growth, though driven by a robust service sector, is hindered by weak manufacturing foundations, persistent income inequality, and the mismatch between education and labor market demands. Infrastructure gaps, including unreliable power supply, inadequate transport systems, and digital divides, continue to slow industrial and digital transformation. Socially, India’s demographic dividend risks turning into a liability without inclusive education, gender equality, and rural healthcare reform. On the global stage, India’s geopolitical influence is constrained by regional rivalries, strategic ambivalence between alignment and autonomy, and challenges in asserting leadership within South Asia. The paper concludes that India’s ascent to great-power status requires an integrated national strategy that simultaneously strengthens governance, modernizes infrastructure, enhances human capital, and adopts pragmatic diplomacy. Only through comprehensive reform and coordinated execution can India effectively convert its demographic potential and strategic advantages into sustainable global influence.

Digital technology has enormous potential for infusing growth in an economy. With the exponential growth of digitalisation and the emergence of digital platforms, there are growing concerns related to the regulation of such ecosystems. Peculiar features of digital platforms facilitate winner takes all and thus, give rise to dominant entities, which are able to control the stakeholders and competition in that digital ecosystem. The government and regulators need to take a cautious approach to the regulation of dynamic digital markets as they are still in the evolutionary phase. Digital public goods and digital infrastructure have become key enablers in public service delivery in India in recent times. While the provision of digital infrastructure for service delivery is being applied to other sectors, one needs to be circumspect in applying this beyond public service delivery approaches. The chapter analyses two key sectors in cyber space viz. digital payments and digital commerce to analyse the application of emerging digital public infrastructure principles in these areas. The chapter further discusses various initiatives in India regarding digital public infrastructure and analyses the challenges in applying this approach to the e-commerce marketplace. It identifies challenges in applying this to digital e-commerce and examines regulating digital e-commerce through competition law principles. The study evaluates the approach to the regulation of digital e-commerce through a competition law framework and postulates that dynamic competition law principles can very well be evolved to regulate and ensure competition in the digital marketplace. Further, the chapter proposes that prerequisites like a well-designed big data regulatory regime and cyber law along with a proactive regulatory regime need to be established.

The resource-market level of competition has replaced end-product market level of competition in global integrated production systems where micro and small enterprises (MSEs) often perform activities that are of a low strategic value while large organizations focus on their core competencies. Resource-markets are markets at the level of resources or stages of production which, when aggregated, make up the value-chain of a production process. This article describes this current change in level of competition for MSEs and suggests a framework to help them strategically gain a superior competitive advantage in resource markets. The objective of this framework is to improve the terms of trade for MSEs integrated into larger production networks.

The paper presents the results of an empirical study in two parts: (a) Comparative case studies of seven organizations in the Canadian oil industry undertaken to develop a model of environmental responsiveness that centers on the impact of issue interpretations on strategic responses and identifies influential antecedent strategic leadership and organization design elements; (b) A questionnaire-based mail survey in the Canadian and U.S. oil industries that tests and confirms some elements of the framework generated in the first phase.

Environmental response in 7 Canadian oil and gas firms is discussed, based on an exploratory study from the grounded perspective. Environmental response of individual firms appeared to be determined by (a) the strategic vision of the executive leadership on environmental protection (b) managerial interpretations of environmental issues, impacted upon by managerial perceptions of corporate image and identity, stakeholders considered strategically important, and the significance accorded to relationship-building and managers' personal values, (c) structural variables such as the degree of flexibility in the strategic planning and budgeting process that allows for managerial discretion and learning on environmental issues, and commensurate performance evaluation systems. Environmental response in the oil and gas firms followed the following dominant patterns - (a) reactive, mediated by the size of the firm - regulatory compliance for smaller firms, risk and liability reduction for larger firms, and a case of transitional response through public relations, (b) proactive : strategic integration aimed at maintaining or enhancmg competitiveness.

Environment have been regarded as paramount and divine entities from ancient times. In the face of today’s pressing environmental conservation and sustainable development challenges, it is essential to revisit and adapt traditional knowledge to effectively shape modern practices. India has a long-standing tradition of valuing and safeguarding the environment. Scriptures and ancient Indian texts such as the Vedas and Arthashastra, along with other classical writings, offer insights into the principles of environmental conservation and maintaining a balanced ecosystem. By adhering to these teachings, Indians began to worship and cherish nature. This paper emphasizes on Vedas, the interconnectedness of all forms and the concept of Prakriti, Rita, Yajna, which fosters concern and reverence for the environment. Kautilya’s work Arthashastra underscores practical strategies for conserving resources, with a strong focus on water management and sustainable farming practices. His comprehensive guidance on resource utilization emphasizes the importance of a balanced approach, where economic growth is aligned with environmental responsibility. Regardless of religious teachings, most of the scriptures collectively promote living harmony with nature, respect for conservation and sustainable practices. This paper seeks to promote a better understanding of reciprocity of human and the environment and a sustainable future for generations to come.

Off-label uses of drugs are increasingly at the forefront of discussions both in the patients’ forum and also in the physician’s forum. Off-label drug use refers to the prescription of an approved and marketed medication in a manner that is different from what is approved on the label. The common types of off-label use are the use of a drug for a different indication, different dose, different duration, different route of administration, or different patient population. Off-label drug use is very common and accounts for one-fifth or 20% of all prescriptions and in some cases, it can be very high even up to 80%. When appropriately prescribed, off-label drug use has many advantages and can further the cause of science by discovering new innovative uses for existing drugs. It can also help the physician in providing optimum health care in many diseases/patient groups. However, inappropriate off-label use may expose the patient to a higher risk of adverse effects and potential harm. Off-label drug use demands a heightened standard of care and whenever a physician uses a drug in an off-label manner, the decision must be based on sound scientific evidence and the patient should be made a partner as part of the “shared decision making.”

Vaccines are a cornerstone of public health and have enabled the complete eradication of human diseases such as smallpox and control of conditions such as polio. Development of vaccines involves a multi-step process from foundational research and preclinical testing through to clinical trials, regulatory review, and post-marketing surveillance. The clinical trials of vaccines are done in several phases: Phase I is a study of small groups regarding safety and immune response; Phase II will include expanded diverse populations to evaluate the safety and immunogenicity of the vaccine; Phase III will determine efficacy and safety in larger cohorts, leading to the regulatory approval of vaccines. Phase IV continues to monitor post-marketing and post-distribution vaccines for their continued safety and effectiveness.Immunology, including innate and adaptive immunity, was identified as a key factor, so that it can interpret the immune response to vaccination with biomarkers of antibody levels and T-cell activity, providing valuable insights into its immunogenicity. Strong statistical methodologies, including randomization and careful sample size determination, help with the validity of trial results. Special populations present special ethical challenges: special considerations are made for informed consent and placebo use.In this respect, regulatory bodies like the FDA, EMA, and WHO are very instrumental in ensuring vaccine safety and effectiveness through expedited pathways such as Emergency Use Authorizations to help with these public health crises.These will involve state-of-the-art approaches, such as adaptive trial designs, integration of real-world data to improve efficiency of trials, and community trust. The forward direction for vaccine research includes personalized strategies for vaccination, next-generation vaccine platforms and universal vaccines, and use of artificial intelligence-machine learning in pinpointing optimization in trial processes. Regulatory framework adaptation and fostering global harmonization are going to hold the key for improving access to vaccines for populations across the world.

This chapter reviews the ethical structure underlying clinical testing. It describes the chronological development of this field, with the crucial milestones—the Nuremberg Code, the Declaration of Helsinki, and the Belmont Report—all of which recognize three basic principles: respect for persons, beneficence, and justice. These formative documents are required to protect participant rights and to maintain public trust in research.The chapter underlines informed consent, confidentiality, and privacy as being critically important, while it also mentions historical violations of ethics as a justification for rigorous oversight in research practices. It also looks at various regulatory frameworks, such as ICH GCP, guidelines by CIOMS, WHO standards, and roles of national regulatory authorities like FDA, EMA, and CDSCO.It discusses the complexities regarding informed consent, especially in vulnerable populations, ethical dilemmas around placebo use, and randomization of trials. It also addresses new trial designs, issues related to data privacy and post-trial obligations, with an emphasis on participant welfare and scientific integrity as imperatives.The modern-day challenges also include the use of artificial intelligence and patient-centric approaches, which raise very pertinent questions related to algorithmic bias and engagement of participants. Ethics committees and CABs are highlighted for their contributions toward culturally sensitive research practices.In the end, this chapter recommends continuous education in ethics and the elaboration of unified ethical standards internationally, while compliance with established guidelines is vital for participant protection and responsible medical knowledge acquisition.

“High Utility Itemset Mining” (“HUIM”) is a critical data mining technique aimed at identifying item combinations in transactional datasets that generate significant utility, such as profit or revenue. Traditional frequent itemset mining methods often fail to capture the value dimension, making HUIM essential for applications in retail, healthcare, and e-commerce. However, the computational complexity of HUIM presents challenges in handling large and dense datasets.This study introduces an Enhanced Swarm-Based Optimization Algorithm tailored for HUIM. The algorithm integrates the adaptive parameter tuning capabilities of “Particle Swarm Optimization” (“PSO”) with the pheromone-inspired mechanisms of Ant Colony Optimization (“ACO”). Key improvements include dynamic parameter adjustments to balance exploration and exploitation and hybridization strategies to overcome issues like premature convergence. The algorithm’s effectiveness is demonstrated on retail datasets, revealing high-utility itemsets that provide actionable insights for inventory management, marketing, and strategic decision-making.Compared to standard PSO, the enhanced algorithm achieves superior performance, including higher utility discovery, faster convergence, and improved scalability. This research bridges theoretical advancements in swarm intelligence with practical applications, offering a robust framework for mining valuable patterns in complex datasets. Future work aims to extend the algorithm to larger datasets, real-time data streams, and dynamic utility scenarios.

The fundamental difference regarding self and consciousness emerges from the Vedantic Ātman concept facing off against Buddhist Anattā doctrine. According to Vedānta philosophy Ātman presents a doctrine which describes the self as a permanent unchanging single thing which acts as the foundation of every being. According to the Anattā doctrine of Buddhism there exists no permanent core self whatsoever because all aspects compose an ongoing sequence of elements called Skandhas. This paper examines the philosophical system and textual basis while analysing scholarly interpretations of these two doctrines. Both philosophical perspectives use such perspectives to restructure larger metaphysical systems together with their epistemological and ethical perspectives. Modern philosophical discussions that reevaluate and reinterpret ancient arguments form the core subject of this research because they maintain current significance in contemporary philosophical scholarship. The paper mainly focuses on two philosophical systems presenting arguments based on the texts, Bṛhadāraṇyaka Upaniṣad together with Śaṅkara’s Brahmasūtra Bhāṣya on one side and the Majjhima Nikāya and Nāgārjuna’s Mūlamadhyamakakārikā on the other side to understand their approaches regarding self-existence. This paper investigates if a self-concept must be accepted as an essential metaphysical principle or if it emerges purely from linguistic and cognitive false perceptions. Vedānta, through the lens of Śaṅkara, argues that denying the self-undermines the very possibility of knowledge and liberation (mokṣa), while Buddhism asserts that clinging to a self is the root of suffering (dukkha), and true liberation (nirvāṇa) lies in letting go of that illusion. This comparative study ultimately argues that both traditions, while differing in metaphysical commitment, converge on the transformative goal of transcending egoic identity and realizing an unconditioned freedom beyond conceptual dualities.

Single women’s lives are important but marginalised. The care that they do is meaningful and can be radical. In this article, we argue that within neoliberal patriarchal capitalism, radical care work is care that emerges from the margins, is self-and-other regarding and envisions change through maintenance and small acts. This definition draws insights from an emerging body of literature that uses the term ‘radical care’ to explore its potential in empirical studies of care and interview data with UK single women in midlife (37–62 years old), with and without children and experiences of romantic relationships. We develop the concept of radical care through a reflexive thematic analysis of accounts of care performed by these women. The decisions they make about their relationships are in part made by the care that those relationships enact, and single status allows rationalities of care to emerge which are not driven or defined by the pervasive ‘couple-norm’ that marginalises them. We argue that this kind of care work, governed by pursuit of a life that is meaningful and self-sustaining, is radical because it pushes against the neoliberal edicts of self-advancement and competition and instead centres relationality, survival and world-repair. By foregrounding the common yet marginal status of female singlehood in midlife, this article develops a vantage point that advances debates about radical care.

The growing prominence of ChatGPT has sparked interest in its potential to improve both the quality and productivity of academic writing. This study aims to fill the knowledge gap regarding how research scholars perceive and engage with ChatGPT in the context of academic research writing. The primary objective was to assess scholars’ views on ChatGPT's efficiency, usefulness, and effectiveness in academic research writing, while also identifying possible improvements to better align with the scholars’ needs. A sequential explanatory mixed-methods approach was adopted, beginning with a quantitative phase and was subsequently followed by a qualitative phase involving semi-structured interviews. A sample of 317 research scholars drawn from diverse Indian higher education institutions. The findings reveal that research scholars generally perceive ChatGPT as moderately effective and useful in academic writing, though their perceptions of its usefulness vary. Although the overall user experience, certain ethical concerns were identified. Qualitative analysis showed that ChatGPT has the potential to enhance research writing, streamline processes, facilitate scholarly interactions, and support research writing challenges. However, areas needing improvement were also highlighted, including comprehensive topic coverage, cultural sensitivity, multilingual capabilities, and personalized support.

On the one hand, the environmental management literature argues that firms will not adopt minimum environmental standards unless they are subject to stringent command-and-control regulations and that stringent regulations stimulate innovation. On the other hand, it is argued that command-and-control regulations stifle innovation and that flexible regulations encourage proactive environmental strategies that lead to competitive benefits for organizations. This study comparing the environmental strategies and competitiveness of the oil and gas firms in two different regulatory contexts- the command-and-control based U.S. environmental context and the flexible collaborative Canadian context- found no significant differences in the degree to which firms in the two countries were more or less proactive in their environmental strategies and the competitive impact of these strategies.

Organizational sustainability requires the balancing of economic performance with impacts on ecosystem health and social equity. Knowledge required for integrating these seemingly conflicting objectives transcends organizational boundaries and is embedded in networks of stakeholders. As this knowledge is constantly evolving, only firms with a capability of stakeholder integration can harness sustainability knowledge from a variety of internal and extemal stakeholders. Stakeholder integration is a dynamic capability consisting of three sub-capabilities of boundary-spanning, higher-order learning and sustainability commitment. It leads to the development of organizational social capital that enables further stakeholder linkages and sustainability leaming. Via sustainability knowledge generation, this capability leads to improved sustainability performance, short-term benefits and long-term competitive imagination for creative destruction.

Bem Le Hunte was born in Kolkata to an Indian mother and an English father. She earned her BA in Social Anthropology and MA from the University of Cambridge, UK, in 1985 and 1987, respectively. She completed her doctoral degree in March 2007 from Cambridge University of Sydney, Sydney. Le Hunte believes in the power of sharing one’s gifts and the interconnectedness of all beings and is inspired by the works of Virginia Woolf, Lewis Hyde, Arundhati Roy, and Gabriel Garcia Marquez. She has written six novels, poems, and short stories and maintains a blog for sharing her insights and experiences. She has worked in the creative industries and the arts for three decades and is currently an Associate Professor at the University of Technology, Sydney, Australia. She founded the Bachelor of Creative Intelligence and Innovation program at the University. This transdisciplinary, future-focused degree teaches creativity across 25 disciplines and explores the permeable boundaries between areas, disciplines, and industries.

Alok Vaid-Menon is a gender non-conforming and transfeminine American author, poet, mixed-media performance artist, and activist. ALOK—used as a mononym—uses writing, live performance, and fashion as a way of expressing views on gender, sexuality, race, and ethnicity. Born to Indian immigrant parents, ALOK grew up—and was bullied on account of race and gender—in College Station, Texas, and later graduated with a bachelor’s and master’s degree in feminist, gender, and sexuality studies from Stanford University. Urvashi Vaid, an India-born American feminist, and LGBTQ+ rights activist, is Alok’s aunt. ALOK has been given the GLAAD Media Award and the Stonewall Foundation Visionary Award.

The Seduction of Silence (2000) is Bem Le Hunte’s trans-continental, generational story that is rowdy, quirky, ethereal, and sexual. It is a stunning tale spanning several generations, written tenderly and movingly. The novel reads gently, like a leisurely river meandering past sharp stones that, in the end, do not affect how the water flows. It tackles various spiritual and cultural ideas with humor. The novel is about family, life, death, and loss, and how these things interact tragically, magically, and finally, in ways beyond comprehension.