Rationale, aims and objectives To compare the pharmacotherapeutic approaches to diabetic hypertension of family physicians (FPs) and general practitioners (GPs). Methods A retrospective prescription-based study was conducted in 15 out of a total of 20 health centres, involving 115 primary care physicians – 77 FPs and 38 GPs, representing 74% of the primary care physicians of Bahrain. Prescriptions were collected during May and June 2000 to comprise a study population of 1266 diabetic-hypertensive patients. Results As monotherapy, angiotensin-converting enzyme (ACE) inhibitors (...) (37.9%) and β-blockers (38.3%) were the most commonly prescribed classes of antihypertensives by FPs and GPs, respectively. Calcium channel blockers (CCBs) were ranked third by both categories of physicians. For two-drug combinations, a β-blocker and an ACE inhibitor was the combination of choice for both physician categories. Patients managed by the FPs were more likely to receive a β-blocker–CCB combination (17.4 vs. 14.9%) or a diuretic–ACE inhibitor combination (16.7 vs. 11.4%) and less likely to receive a β-blocker–diuretic combination (11.8 vs. 16.7%) than those managed by the GPs. The proportion of patients receiving antihypertensive combinations was 40.6 and 38.5% for FPs and GPs, respectively. While the GPs prescribed CCB as a monotherapy to the elderly most often, the FPs choice was a β-blocker. Diuretics were less preferred by both FPs and GPs. β-Blocker–ACE inhibitor was again the most preferred combination of both FPs and GPs. FPs prescribed CCB–β-blocker combinations more often than GPs (P = 0.01), whereas CCB–ACE inhibitor combinations were less preferred (P = 0.09). A trend towards excessive use of short-acting nifedipine as monotherapy for elderly patients, both by FPs and by GPs, was noticed. Glibenclamide, alone or in combination with metformin, was the foremost antidiabetic drug prescribed by FPs and GPs. Middle-aged (45–64 years) patients seen by GPs were more likely to receive glibenclamide than those treated by FPs (P = 0.001) and less likely to receive gliclazide (P = 0.01). Combinations of a β-blocker with either glibenclamide or insulin were prescribed considerably more often by GPs.Conclusions Within the same practice setting, a substantial difference was observed between FPs and GPs in terms of preference for different classes of drugs in the management of diabetic hypertension. The compliance of both FPs and GPs was suboptimal; overall, the compliance of the FPs was closer to the recommended guidelines, however. Educational programmes should specifically address these inadequacies in order to improve the quality of health care. (shrink)

Drawing upon rational choice and investor attention theories, we examine how accusations of corporate bribery and subsequent investigations shape market reactions. Using event study methodology to measure loss in firm value for public firms facing bribery investigations from 1978 to 2010, we found that total market penalties amounted to $60.61 billion. We ran moderated multiple regression analysis to examine further the degree to which the unique characteristics of bribery explain variations in market penalties. Companies committing bribery in less corrupt host (...) countries and with the involvement of compromised executives experienced greater market penalties than did other companies. After partitioning share value losses into components for regulatory penalties, class action settlements, and loss to reputation, we found that reputational penalties account for 81.8¢ of every dollar of share value loss. Omission of reputational penalties in rational choice calculus underestimates bribery costs by 4.5 times. The results suggest that firms should not underestimate the importance of market-imposed reputational penalties by merely considering regulator-imposed fines and sanctions. (shrink)

We examine how corporate bribery is impacted by cultural distance between multinational enterprises home and host countries, and organizational distance to core values between MNE entry modes and MNE headquarters. Tension between external and internal legitimacy helps to explain why cultural and organizational distances will affect MNE bribery. The empirical analysis used data from cross-border transactions by MNEs that were sanctioned by US regulatory officials between 1978 and 2011. We find statistical support for all hypotheses capturing main and moderating effects (...) and suggest that MNEs may be seriously risking their legitimacies from transactions in corruption-prone host countries. (shrink)

Artificial intelligence (AI)-based virtual influencers are now frequently used by brands in various categories to engage customers. However, little is known about who the followers of these AI-based virtual influencers are and more importantly, what drives the followers to use AI-based virtual influencers. The results from a survey support the notion that compensatory mechanisms and the need to belong play important roles in affecting usage intentions of AI-based virtual influencers. Specifically, the study finds that usage intentions are mediated and moderated (...) by compensatory mechanisms that arise from the perception of AI-based virtual influencers’ functional benefits and existential threats to human identity. Furthermore, the need for belonging moderates the effects of the following status (following versus non-following) on perceived personalization benefits of AI-based virtual influencers and behavioral intentions to use AI-based virtual influencers. This study provides important implications for academia delving into the social, cultural, and philosophical implications of AI-based virtual influencers for human societies as well as for brands that plan to use AI-based virtual influencers and gain a better understanding of their customers in AI-driven digital marketing. (shrink)

This article provides an Austrian overview of the inflation versus deflation debate which has captured the attention of the economics profession in the years following the US housing bust. Much of the Austrian analysis of this debate has focused on the massive expansion of the Federal Reserve’s balance sheet and attendant creation of new reserves. Several Austrian economists have predicted that the creation of new reserves will cause a massive increase in inflation. The money multiplier theory, on which these predictions (...) are based, is criticized and an overview of the Austrian business cycle theory is provided to explain why banks are reluctant to issue new credit. Finally, an analysis of the politics of deflation is provided and a class theory is presented to explain why a policy of controlled credit deflation is more likely than a policy that would result in mass inflation or hyperinflation. (shrink)

As Acharya Vidyanand writes in the Foreword of Samayasara, it is the ultimate conscious reality. The enlightened soul has infinite glory. It has the innate ability to demolish the power of karmas, both auspicious as well as inauspicious, which constitute the cycle of births and deaths, and are an obstacle in the path of liberation of the soul. Samayasara is an essential reading for anyone who wishes to lead a purposeful and contented life. It provides irrefutable and lasting solutions to (...) all our problems, concerning worldly ways as well as spiritual curiosities and misgivings. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

The Ganadbharvad is a philosophical work in which there are profound discussions of eleven salient doctrines. In each of the discussions, one vital Tattva is taken up; and Lord Mahavir discusses it in great detail and clears the doubt of each Ganadhar with the result that each Ganadhar is fully convinced of the truth of the Lord`s argument and becomes his disciple. This book has been written so that people may read it and understand the meaning of the tattvas relating (...) to the soul, the karmas, the five elements, next birth, bondage, deliverance etc. and so that they may realise the true phenomenon of this Universe, may cultivate the trust and may make endeavours to attain the liberations from samsar. (shrink)

This article responds to Terry Eagleton's claim that Spivak's latest book, A Critique of Postcolonial Reason, works against the intent of postcolonial criticism. Reading the work as a search for a just representational strategy, we explore the implications of Spivak's engagement with philosophy - Kant, Hegel, and Marx. As a disciplinary machine, philosophy produces Western subjects who are engendered by simultaneously including and excluding the other. Working through this production of the double location of the 'other' we suggest that systematic (...) thought is inhabited by an absence that is present within, a disturbing otherness that ultimately questions authority and stability, and opens up the question of politics and representation. Drawing Spivak into the representational problematic opened up by Lyotard, we suggest that a responsible postcolonial intervention can be performed in the difficult exergue between representability and unrepresentability. In this account, representation is open to invention, to finding new idioms for articulating otherness. (shrink)

This study examines how meritocracy as a collective social imaginary promoting social justice and fairness reproduces class and caste inequalities and fosters ethical violence. We interrogate discourse of merit in the narratives of the professional–managerial class-in-making at an Indian business school. Empirically, we draw on interviews, full-text responses to a qualitative questionnaire, and a student’s poem. We describe how business school students articulate merit as a neoliberal ethic, emphasizing prudential, enterprising attitudes, and responsibility. However, this positive, aspirational façade of merit (...) masks practices of ethical violence, wherein individuals invoke an ethical principle as grounds for moral condemnation and linguistic injuries. These practices of ethical violence desubjectify disadvantaged students and result in silence as a form of inequality. We contribute to organizational research on inequalities by foregrounding ethical violence and desubjectification. We detail the possibilities of discursive agency in contesting and interrupting ethical violence. (shrink)

This essay deals with the manner in which Salman Rushdie’s works engage with the heterogeneous logics of ethics and aesthetics. Drawing upon the work of Jacques Rancière it is argued that Rushdie neutralizes the two by introducing what Rancière calls a dissensus in the ethical-aesthetic hierarchy. The dissensus works on a principle of ‘excess’ so that within the domain of aesthetics the ethical is pushed to its limits. The order of desire (aesthetics) and the order of knowledge (ethics) are no (...) longer seen as hierarchical and mutually exclusive categories. By examining two versions of an unpublished novel by Rushdie (‘Madame Rama’) it is suggested that Bollywood cinema functions as a mode in which the two orders come together. In this early and mercifully unpublished novel, one finds the beginnings of Rushdie’s belief that works of art are sites of ideological and ethical contestations. (shrink)

In this age of “free-sex”, gurus, Hare-Krishna chanters and transcendental meditation teachers J. Кrisimamurti stands almost alone as a non-guru of outstanding grandeur. His lecture tours in major centers of the world remind one of the historical Buddha who reversed the Upanishadic tradition of teaching in a forest hermitage to a select few by travelling on foot from village to village in North-Eastern India to carry his message of love, compassion and understanding to the masses regardless of caste, color or (...) sex. But historical comparisons are never complete. Whereas the Buddha used the local dialect, adapted his message to the intellectual level of his audience and made free use of stories and parables, Krishna-multi lectures in the English language in his intense analytic style to rapt audiences without any such aid. No wonder the Buddha's appeal and impact historically has been infinitely wider than that of Krishnamurti. And yet, both eschewed dogma, tradition and metaphysical subtleties, and deliberately refused to offer any sugar-coated pills and panaceas for overcoming the pervasive human condition of suffering. They endeavoured to make people “see” and “understand” the human condition in an act of total awareness so as to take them to the very brink of that “creative emptiness”, ultimate freedom and radical change which alone is conducive to the attainment of transcendent peace. In other words, the doctrine of Krishnamurti as that of the Buddha is not for the weak and effeminate who need “crutches” of all kinds but for those who have the courage to help themselves by an act of understanding the way things are without being entangled in theories and conceptual puzzles. It is the intention of this paper to analyze, understand and critically evaluate Krishamurti's concepts of self, action and freedom. (shrink)

In the Appendix to the Treatise of Human Nature, Hume famously recants his position on personal identity. There he confesses: “upon a strict review of the section concurring personal identity I find myself involv’d in such a labyrinth that... I neither know how to correct my former opinions, nor how to render them consistent.” By his own admission, then, something has gone wrong in Hume’s account of personal identity, something that, at least to his eyes, did not go wrong in (...) his accounts of body and necessary connection. For those accounts were not grossly inconsistent or patently absurd. The case is different, however, with personal identity. There his philosophical enterprise suffers shipwreck, and it is important to understand why. Unfortunately, however, Hume confesses that he finds his former opinions false as well as inconsistent, but neglects to specify how or why he came to this conclusion. This paper is an attempt to address just that question. (shrink)

Most of us know of God only as "Our Father in Heaven". However, there is the other view, which declares that "I and my Father are one." That is a very bold view, which only the daring dare to embrace. Proclaimed by fearless thinkers in all ages, this professed Godhood is no one person's exclusive domain, as some would have you believe, but the common property of one and all. Whatever be your station in life, truth remains that you are (...) God. Everything else that you hold yourself to be is pure ignorance. This book is the bold wake-up call to make you realize who you are. Like a distant thunder, we hear a voice rolling down from the past "Never forget the glory of human nature. We are the Greatest God, that ever was, or ever will be. Christs and Buddhas are but waves, on the boundless ocean which I am"; but its sound is getting dimmer; its echoes lost in the din and clutter of fanaticism and materialism. This book is the clarion call that resounds the bugle of that age-old theme once again and with a vengeance. A vengeance that stems from rationality, reasons, and the added weight of discoveries in modern sciences; discoveries, which are all found to resonate with that grand ancient truth. Unlike anything that you may have read, this book questions your most fundamental concepts. Be prepared to abandon all preconceived notions that you may hold about the Self and the Universe. This iconoclastic book shatters all delusions, and will truly revolutionize the way your perceive yourself and the world. (shrink)

By examining the systematic integration of theology, ethics, and teleology in Aristotle’s Nicomachean Ethics, I address four key interpretational aporiai: the apparently illogicality of the opening lines, the apparent contradiction between practical virtue and contemplation being the highest good, the “dominant” v. “inclusivist” views of eudaimonia, and the immanence v. transcendence of God. I show how proper attention to the link between Aristotle’s conception of the Good as “that at which all things aim” and God as the prime unmoved mover, (...) as well as an appreciation of the overall “aristocratic” context of Aristotelian philosophy, provides a new way of dealing with these aporiai that renders them less perplexing and problematic, while avoiding un-Aristotelian, anachronistic readings. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

The category “music” as used in this area of science is inconsistent and unstable, and its logical relationship to the word “musicality” – used by scientists to denote the human capacity for music – is circular. Therefore, rather than pursue the question, “Why did music evolve?” let us ask more inclusively, “What experiences in humankind's deep past might have felt like music?”.

Despite growing evidence of the benefits to a firm of improving corporate social performance (CSP), many firms vary significantly in terms of their CSP activities. This research investigates how the characteristics of the stakeholder landscape influence a firm’s CSP breadth. Using stakeholder theory, we specifically propose that several factors increase the salience and impact of stakeholders’ demands on the firm and that, in response to these factors, a firm’s CSP will have greater breadth. A firm’s CSP breadth is operationalized as (...) the number of different sub-domains of CSR for which a firm has taken positive actions and is captured using a unique dataset from Kinder, Lydenburg, and Domini (KLD). This data set includes positive and negative firm actions across more than 35 different dimensions of socially responsible behavior. Findings based on a longitudinal, multi-industry sample of 447 US firms during the period from 2000 to 2007 demonstrate that firms which: (1) have greater sensitivity to stakeholder needs as a result of the firm’s strategic emphasis on marketing and/or value creation, (2) face greater diversity of stakeholder demands, and (3) encounter a greater degree of scrutiny or risk from stakeholder action have a greater breadth of CSP in response to the stakeholder landscape that they face. (shrink)

Around 96 percent of children with hearing loss are born to parents with intact hearing, who may initially know little about deafness or sign language. Therefore, such parents will need information and support in making decisions about the medical, linguistic, and educational management of their child. Some of these decisions are time-sensitive and irreversible and come at a moment of emotional turmoil and vulnerability (when some parents grieve the loss of a normally hearing child). Clinical research indicates that a deaf (...) child’s poor communication skills can be made worse by increased level of parental depression. Given this, the importance of reliable and up-to-date support for parents’ decisions is critical to the overall well-being of their child. In raising and educating a child, parents are often offered an exclusive choice between an oral environment (including assistive technology, speech reading, and voicing) and a signing environment. A heated controversy surrounds this choice, and has since at least the late 19th century, beginning with the International Congress on the Education of the Deaf in Milan, held in 1880. While families seek advice from many sources, including, increasingly, the internet, the primary care physician (PCP) is the professional medical figure the family interacts with repeatedly.The present article aims to help family advisors, particularly the PCP and other medical advisors in this regard. We argue that deaf children need to be exposed regularly and frequently to good language models in both visual and auditory modalities from the time hearing loss is detected and continued throughout their education to ensure proper cognitive, psychological, and educational development. Since there is, unfortunately, a dearth of empirical studies on many of the issues families must confront, professional opinions, backed by what studies do exist, are the only option. We here give our strongly held professional opinions and stress the need for improved research studies in these areas. (shrink)

This journal's well-intentioned consideration of the arts has turned out to be quite the Pandora's box. As soon as we broach the subject of aesthetics, we are already in the realm of ideology; as soon as we impose the frame of scientific inquiry upon any subject, we invoke another kind of ideology. The previous issues in this series have depicted the unfolding of an ideological clash of cultures between sciences and the humanities, enough to make C.P. Snow blush. For the (...) time being, this is an unavoidable condition; yet the more we remain aware of it, the further we may push our insights. (shrink)

The COVID-19 pandemic has resulted in more than 524 million cases and 6 million deaths worldwide. Various drug interventions targeting multiple stages of COVID-19 pathogenesis can significantly reduce infection-related mortality. The current within-host mathematical modeling study addresses the optimal drug regimen and efficacy of combination therapies in the treatment of COVID-19. The drugs/interventions considered include Arbidol, Remdesivir, Interferon and Lopinavir/ritonavir. It is concluded that these drugs, when administered singly or in combination, reduce the number of infected cells and viral load. (...) Four scenarios dealing with the administration of a single drug, two drugs, three drugs and all four are discussed. In all these scenarios, the optimal drug regimen is proposed based on two methods. In the first method, these medical interventions are modeled as control interventions and a corresponding objective function and optimal control problem are formulated. In this framework, the optimal drug regimen is derived. Later, using the comparative effectiveness method, the optimal drug regimen is derived based on the basic reproduction number and viral load. The average number of infected cells and viral load decreased the most when all four drugs were used together. On the other hand, the average number of susceptible cells decreased the most when Arbidol was administered alone. The basic reproduction number and viral load decreased the most when all four interventions were used together, confirming the previously obtained finding of the optimal control problem. The results of this study can help physicians make decisions about the treatment of the life-threatening COVID-19 infection. (shrink)

The aim of this paper is to explore the roles of religion and culture in how firm-stakeholder relationships evolve and are managed. It uses an ‘embeddedness’ framework (Granovetter, 1983; Uzzi, 1997, 2003) as its theoretical frame of reference to study how and why culture and religion can influence the varying types of ties that constitute firmstakeholder relationships.

The authors explore the relation between the way different family firms are named, and the shareholder value impact of these firms’ new product introductions. Using an event study of 1,294 product introduction announcements of 107 publicly listed U.S. family firms, the authors find that the presence of the founding family’s name as part of a family firm’s name acts as a valuable firm resource, increasing the abnormal stock returns surrounding the firm’s new product introductions. Superior returns to family-named firms’ new (...) product introductions are partially mediated by these firms’ history of ethical product-related behavior: family-named firms, particularly those with corporate branding, and those wherein a founding family member holds the CEO or chairman position, are more likely to exhibit a history of avoiding such product-related controversies as product safety issues, and deceptive advertising. The authors highlight the managerial and theoretical contributions of this research. (shrink)

The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)