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)

_Reasonable Risk_ examines the concept of risk as it applies to everyday life in general and to alcohol consumption specifically. The book addresses how we assess risks, and the strategies we use to manage them. It examines the elements that shape our perceptions of risk-cultural influences, social factors, and how we are presented with information about risk. The final chapter of the book focuses on the role of risk in policy formulation, examining in particular how alcohol policies are developed within (...) the context of individual and societal responsibility. (shrink)

Plagiarism is increasingly evident in business and academia. Though links between demographic, personality, and situational factors have been found, previous research has not used actual plagiarism behavior as a criterion variable. Previous research on academic dishonesty has consistently used self-report measures to establish prevalence of dishonest behavior. In this study we use actual plagiarism behavior to establish its prevalence, as well as relationships between integrity-related personal selection and workplace deviance measures. This research covers new ground in two respects: (a) That (...) the academic dishonesty literature is subject to revision using criterion variables to avoid self bias and social desirability issues and (b) we establish the relationship between actual academic dishonesty and potential workplace deviance/white-collar crime. (shrink)

Environmental ethics is the subject in philosophy that examines the moral relationship of human beings to the environment and its non-human species. It concerns human’s ethical relationship with the natural environment. The central question concerning environmental ethics is essentially – what is human being’s moral obligation concerning the natural environment? The paper will firstly provide a review of the ethical relations of humans and the environment, secondly examine how value-based education can assist in inculcating environmental ethics among learners.

I am an M.D/Ph.D. student and work as a research assistant for the director of a division of the school of medicine who is an M.D. He assigned me to research a certain topic and gave me no guidelines or guidance as to how to do it. Nevertheless, I did the research and wrote it up. My supervisor liked the report and said that he thought it was so good that “I would like to offer you the opportunity to publish (...) it and list you as the primary author.” Some bells went off when he so grandly offered to let me author the report for which I had done 100% of research and writing. I consulted some other people in the field and they said that, as long as I was the primary author, it was legitimate for him to list himself as secondary author if he did some editing later. After editing the abstract only, he e-mailed his revisions to me and in a note at the bottom he asked me what I thought of his revised author order. His name was first, mine second, and the name of his girlfriend was third. I was shocked by what seemed to be a case of unethical author attribution and confronted him asking why he changed the order when we had agreed that I was primary author. He said that he had put in several hours of work. (shrink)

Health care organizations are increasingly asked to show accountability about their performance. This paper proposes that accountability can best be achieved through evaluative methods that are based on evidence regarding the relationship between processes of care and expected outcomes. Root cause analysis (RCA) is used as an illustration of how a generic method of inquiring can be transformed into an ongoing monitoring, evaluation, user education and accountability strategy. The role of performance indicators, as well as patient and community expectations, is (...) discussed. (shrink)

In his recent work, ‘Sport, Aesthetic Experience, and Art as the Ideal Embodied Metaphor’, Tim L. Elcombe explores links between sport and art from a pragmatically informed conception of aesthetic experience. However, Elcombe's work does not highlight the role of the imagination in the interpretation of the aesthetic something Michael Polanyi claims to be the ‘cornerstone of aesthetic theory’. With the backdrop of an increased interest in the aesthetics, phenomenology, and epistemology of sport, this discussion essay seeks to defend the (...) usefulness and value of definitional demarcation debates between sport and art, to use Polanyi’s distinctions among technical, scientific and artistic problems to support the claim that sport is not art, and to offer an account of how sport contributes in its own way to human flourishing and why it is no less valuable experientially than art. (shrink)