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)

A Charter on Medical Professionalism (CMA) has just recently been developed internationally, and the Canadian Medical Association is calling for public dialogue on medical professionalism now that reforms in the Canadian system of health care are imminent. We posit that good practices are at issue; we outline the essence of these in general and also specifically in the knowing, teaching and intervening components of practice. We also see challenges not to, but in, medical professionalism – first and foremost in the (...) profession's definition of good practices and the payer's confinement of insurance coverage to these. (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.

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)

The dissociation between the domains of knowledge continues to perpetuate the fragmentation of people’s health and healing experiences. Of particular significance are the polarities that have been created between the objective, subjective and spiritual dimensions of knowledge and human experience. This paper offers a consideration of how faith might serve as a pragmatic avenue towards assuaging the polarities between knowledges and enhancing nurses’ ability to attend to the complex and mulitdimensional nature of health and healing processes.

Benjamin Gregg’s Creating Human Nature: The Political Challenges of Genetic Engineering is a wide-ranging and controversial approach to the politics of genetic engineering. The book consists of thr...

These words were written by ethicist Jonathan Glover in his paper “Future People, Disability and Screening” in 1992. Whereas screening and choosing for a disability remained a theoretical possibility 16 years ago, it has now become reality. In 2006, Susannah Baruch and colleagues at John Hopkins University published a survey of 190 American preimplantation genetic diagnosis (PGD) clinics, and found that 3% reported having the intentional use of PGD “to select an embryo for the presence of a disability.” Even before, (...) in 2002, a controversy was generated by the case of Candace A. McCullough and Sharon M. Duchesneau, a lesbian and deaf couple from Maryland who set out to have a deaf child (then, Gauvin) by intentionally soliciting a deaf sperm donor. (shrink)

Background Several studies suggest that deviations from proper authorship practices are commonplace in medicine. The aim of this study was to explore experiences of and attitudes towards the handling of authorship in PhD theses at medical faculties in Denmark, Norway, and Sweden. Methods Those who defended their PhD thesis at a medical faculty in Scandinavia during the second half of 2020 were offered, by e-mail, to participate in an online survey. Survey questions dealt with experiences of violations of the first (...) three of the ICMJE authorship criteria and misuse of authorship order in the thesis articles, as well as respondents’ attitudes to these matters. Both questions with fixed response alternatives and questions with free-text responses were used. Quantitative data were analysed statistically using the Table functions in SPSS 25 and Chi-2 tests. Free-text responses were analysed qualitatively using manifest content analysis. Results 287 valid questionnaires were returned (response rate: 34.1%). Almost half (46.0%) of the respondents reported that the ICMJE authorship criteria were not fully respected in at least one of the papers in their thesis, while a vast majority (96.7%) found it important that authorship is handled according to the ICMJE authorship criteria. 24.4% reported inadequate handling of authorship order in at least one paper. The qualitative results provide a wide spectrum of examples of how the ICMJE authorship criteria are circumvented. Conclusion Despite increasing educational efforts to reduce deviations from good research practice at Scandinavian universities, the handling of authorship in medical papers remains problematic. (shrink)

Background Conducting ethically sound research is a fundamental principle of scientific inquiry. Recent research has indicated that ethical concerns are insufficiently dealt with in dissertations. Purpose To examine which research ethical topics were addressed and how these were presented in terms of complexity of reasoning in Swedish nurses' dissertations. Methods Analyses of ethical content and complexity of ethical reasoning were performed on 64 Swedish nurses' PhD dissertations dated 2007. Results A total of seven ethical topics were identified: ethical approval (94% (...) of the dissertations), information and informed consent (86%), confidentiality (67%), ethical aspects of methods (61%), use of ethical principles and regulations (39%), rationale for the study (20%) and fair participant selection (14%). Four of those of topics were most frequently addressed: the majority of dissertations (72%) included 3–5 issues. While many ethical concerns, by their nature, involve systematic concepts or metasystematic principles, ethical reasoning scored predominantly at lesser levels of complexity: abstract (6% of the dissertations), formal (84%) and systematic (10%). Conclusions Research ethics are inadequately covered in most dissertations by nurses in Sweden. Important ethical concerns are missing, and the complexity of reasoning on ethical principles, motives and implications is insufficient. This is partly due to traditions and norms that discount ethical concerns but is probably also a reflection of the ability of PhD students and supervisors to handle complexity in general. It is suggested that the importance of ethical considerations should be emphasised in graduate and post-graduate studies and that individuals with capacity to deal with systematic and metasystematic concepts are recruited to senior research positions. (shrink)

This book provides an invaluable overview of the reach of logic. It provides reference to some of the most important, well-established results in logic, while at the same time offering insight into the latest research issues in the area. It also has a balance of theory and practice, containing essays in the areas of modal logic, intuitionistic logic, logic and language, nonmonotonic logic and logic programming, temporal logic, logic and learning, combination of logics, practical reasoning, logic and artificial intelligence, abduction, (...) theorem proving and goal-directed reasoning. It will be invaluable reading for researchers and graduate students in logic and computer science, and a fabulous source of inspiration for research students in search of a topic for a PhD in logic and theoretical computer science. (shrink)

200 years ago, on August 5, 1802, Niels Henrik Abel was born on Finnøy near Stavanger on the Norwegian west coast. During a short life span, Abel contributed to a deep transition in mathematics in which concepts replaced formulae as the basic objects of mathematics. The transformation of mathematics in the 1820s and its manifestation in Abel’s works are the themes of the author’s PhD thesis. After sketching the formative instances in Abel’s well-known biography, this article illustrates two aspects of (...) the transformation which concern the introduction of concept based mathematics and the related shift in standards of mathematical rigor. Furthermore, the article outlines some of the many bicentennial celebrations in Norway and gives a short, thematic introduction to the literature on Abel and his work. (shrink)

Dag Svanæs is involved in the Norwegian public debate on how to handle the Corona pandemic. During the last year, he has written articles, participated in many debates and given lectures on the pandemic. He is the initiator of the website Coronakritikk.no, where they document the debate and present scientific knowledge about the pandemic. Svanæs is a professor at the Department of Computer Technology and Informatics at NTNU and studies the interaction between humans and technology. Svanæs received his Ph.D. in (...) Human-Computer Interaction from NTNU. His research over the last 15 years has been in the fields of HCI and Interaction Design. He has built up a full-scale usability laboratory that allows for simulation of use scenarios with multiple users and multiple devices in realistic settings – primarily for the medical domain. This allows for evaluations and empirical studies of embodied interaction. The basic theory that most inspires his work is the phenomenology of Maurice Merleau-Ponty and Martin Heidegger. This was also the topic of his 2000 PhD. This shows Svanæs’ interest in technology, philosophy, health and the ability to have knowledge to predict what could happen in the future. (shrink)