Breaking bad news (BBN) to parents whose newborn has a major disease is an ethical dilemma. In Saudi Arabia, BBN about newborns is performed according to the parental preferences that have been reported from non-Arabic/non-Islamic countries. Saudi mothers' preferences about BBN have not yet been studied. Therefore, we aimed to elicit the preferences of Saudi mothers about BBN concerning newborns. We selected a convenience sample of 402 Saudi mothers, aged 18-50 years, who had no previous experience with BBN. We selected (...) them via a simple number-randomization scheme from the premises of a level III Saudi hospital between October of 2009 and January of 2011. We used a hypothetical situation (BBN about trisomy 21) to elicit their preferences about BBN concerning newborns via a structured verbal questionnaire composed of 12 multiple-choice questions. We expressed their preferences as percentages (95% confidence interval), and we used the Kendall's W test (W) to assess the degree of agreement in preferences. The Saudi mothers preferred that BBN be conducted with both parents together (64% [60-69]), albeit with weak levels of agreement (W = 0.29). They showed moderate agreement in their preferences that BBN should be conducted early (79% [75-83], W = 0.48), in detail (81% [77-85], W = 0.52), in person (88% [85-91], W = 0.58), and in a quiet setting (86% [83-90], W = 0.53). With extremely weak agreement, they preferred to have a known person present for support during BBN (56% [51-61], W = 0.01), to have close bodily contact with their babies (66% [61-70], W = 0.10), and to have no another patients present (64% [59-68], W = 0.08). They showed moderate levels of agreement in their desires to detail, in advance, their preferences about process of BBN by giving a reversible, written informed consent that could be utilized for guidance, if needed (80% [76-84], W = 0.36). In our experience, Saudi mothers' preferences about BBN concerning newborns are varied, suggesting that a "one-size-fits-all" approach is inappropriate. A reversible, written informed consent detailing their preferences about BBN that would be kept in their medical records and utilized for guidance, if needed, may be the best solution, given this level of diversity. These findings merit further study. (shrink)

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)

Ḥanafī, Ḥasan; views on Islamic philosophy; Islam; doctrines.

Secularism; Arab countries; Islam and state.

This work is about the deceptive nature of psychotherapy. In particular, it is about those therapies that claim to provide the client with insight and self-knowledge when in practice they are a means of social control absorbing clients into socially acceptable norms. Through a philosophical analysis of key concepts such as knowledge, insight, and subjectivity, and through an examination of mechanisms intrinsic to psychotherapeutic practice, such as power, interpretation, and suggestion, this monograph unveils how psychotherapy deludes clients into believing they (...) have discovered their true self. Rather than gaining self-knowledge and insight into their true or core self, clients are subtly reconstructed and reconfigured along prevailing social values. Furthermore, the very epistemological and metaphysical world-view clients are deceived into believing is highly suspect and founded upon a fascistic understanding of knowledge. As an alternative to such domination, psychotherapy needs to reconstruct itself along Nietzschean-Deleuzian lines where the focus is on multiple identities, difference, and creativity. Rather than focusing on an analysis of past memories to alleviate symptoms such as anxiety or depression, therapeutic intervention should aim for a non-repressive conception of self-knowledge and insight based upon a creative future and not a regretful past. This entails a different understanding of knowledge and reality that is not based on subjugating the world to what we know about it, but on immersing ourselves within reality in all of its concrete richness. And such an approach is preferable not because it is “true” but because it is more liberating. (shrink)

A large number of scholars have argued that a) Islamic architecture is hidden, in the sense that its interior is not articulated on the basis of its exterior; b) the form of Islamic buildings neither expresses nor embodies its function; and c) Islamic architecture is not tectonic or structural, but iconic in character. In this paper, we use Ernst Grube’s analysis of these three claims and focus our attention on the design of the congregational mosques. This paper presents informed arguments (...) against these claims. We begin the discussion with a clarification of the meaning of ‘form follows function’. A clear understanding of the relationship between these two concepts is indispensable for evaluating the claims that Grube makes in his analyses. Then we argue that the form of the congregational mosque embodies its function in a significant manner. Finally, the paper explains in some detail how the function of a mosque is the basis on which its formal structure is designed. The proposition that we defend in this paper is that Islamic architecture exists and expresses the spirit of Islamic culture. (shrink)

The human being is the most wonderful creation of God and the highest sign of his infinite power. Humanity is capable of achieving all divine perfections. God created them to reach the position of God’s closeness and God’s successor on Earth, and this path will not be realised except by the correct education. A human is a divine being who has settled in this earthly world, and correct education is the only way to achieve that sacred truth. Divine prophets have (...) come to prepare the Earth for this great transformation in human existence and guide them to the light of divine teachings. There is no doubt that if human beings are not educated according to divine standards, they will remain at the level of animality. The Holy Qur’an, as the most precious Islamic divine book, presents the best way of education based on the knowledge of the truth of humanity and their needs. In addition, it is appropriate to discuss the role of behavioural gentleness in the education of people, and in this regard, the Qur’anic verses have been reviewed carefully. Therefore, the aim of this manuscript is to study the Islamic teachings in education with an emphasis on behavioural gentleness.Contribution: If curriculum planners and educators in general pay attention to Qur’anic teachings in education and base their curriculum and educational programs on Qur’anic teachings and according to characteristics and abilities and appropriateness of methods, and if the contents are paid attention to and educational programs are produced based on the will and authority of the educators, we will definitely witness progress and development in educational systems on the one hand and development and progress in all levels of life. (shrink)

Machiavelli, Niccolò, 1469-1527; political views; political science; international relations; philosophy.

On the propagation and preaching in Islam against evil deeds and on the process of accountability in Islam.

Islamic sects; Islam; doctrines; Islamic philosophy.

Comparative analysis of Koranic ethics and those of the Prophet Muḥammad recorded in Hadith literature.