ABSTRACT Ethical leaders can influence followers’ ethical behaviors by establishing an ethical climate. However, followers’ responses to an ethical climate may also differ according to the amount of attention they devote to moral questions. This study analyzes whether moral attentiveness augments the positive effect of an ethical climate on employees’ ethical behaviors, as well as the indirect effect of ethical leadership on employee ethical behavior through an ethical climate. Data from 270 employees in the Malaysian manufacturing industry indicate that the (...) positive impact of an ethical climate on ethical behavior is greater among employees who exhibit high rather than low moral attentiveness; this moderating role also applies to the relationship between ethical leadership and employee ethical behavior through the ethical climate. This study thus sheds new light on the notable role of moral attentiveness in ensuring that ethical leadership and ethical climate enhance ethical behavior in the workplace. (shrink)

At the forefront of critically examining the effects of colonization on the Middle East is Edward Said’s magnum opus, Orientalism. In the broadest theoretical sense, Said’s work through deconstructing colonial discourses of power-knowledge, presented an epistemologico-methodological equation expressed most lucidly by Aimé Césaire, colonization=thingification. Said, arguing against that archaic historicized discourse, Orientalism, was simply postulating that colonialism and its systems of knowledges signified the colonized, in Anouar Abdel-Malek’s words, as customary, passive, non-participating and non-autonomous. Nearly four decades later, Said’s (...) contribution has become tamed and domesticated to an extent that most heterodoxic critical endeavours in the field have become clichéd premeditated anti-Orientalist tirades. At best, these critiques are stuck at analysing the impact of power at the macro-level, polemically regurgitating jargons like “hegemony”, “misrepresentation” and “Otherness”. At worst... (shrink)

Soon after the 2013 military coup, state-sponsored violence and human rights abuses have begun to shake Egyptian society. The regime of president Abdel Fattah al-Sisi has attempted to rationalize them, claiming that this is the only path to save the most populous Middle Eastern country from civil unrest, terrorism, and economic decay. Al-Sisi, the former army chief during the 2013 coup, initially portrayed his ascendency to power as the only way to restore security and end the threat of (...) terrorism. Egypt’s generals have also recognized that they cannot rely only on the promise of restoring security to justify ending of the democratic opening and their heavy-handed ruling techniques. Therefore, they have also been using a web of alternative narratives to justify their approach and have been spreading these narratives using security-controlled public and private media institutions. Conspiracy theories, defamation campaigns, and hate speech against voices of dissent have assumed central positions... (shrink)

This eighth volume of Collected Papers includes 75 papers comprising 973 pages on (theoretic and applied) neutrosophics, written between 2010-2022 by the author alone or in collaboration with the following 102 co-authors (alphabetically ordered) from 24 countries: Mohamed Abdel-Basset, Abduallah Gamal, Firoz Ahmad, Ahmad Yusuf Adhami, Ahmed B. Al-Nafee, Ali Hassan, Mumtaz Ali, Akbar Rezaei, Assia Bakali, Ayoub Bahnasse, Azeddine Elhassouny, Durga Banerjee, Romualdas Bausys, Mircea Boșcoianu, Traian Alexandru Buda, Bui Cong Cuong, Emilia Calefariu, Ahmet Çevik, Chang Su Kim, (...) Victor Christianto, Dae Wan Kim, Daud Ahmad, Arindam Dey, Partha Pratim Dey, Mamouni Dhar, H. A. Elagamy, Ahmed K. Essa, Sudipta Gayen, Bibhas C. Giri, Daniela Gîfu, Noel Batista Hernández, Hojjatollah Farahani, Huda E. Khalid, Irfan Deli, Saeid Jafari, Tèmítópé Gbóláhàn Jaíyéolá, Sripati Jha, Sudan Jha, Ilanthenral Kandasamy, W.B. Vasantha Kandasamy, Darjan Karabašević, M. Karthika, Kawther F. Alhasan, Giruta Kazakeviciute-Januskeviciene, Qaisar Khan, Kishore Kumar P K, Prem Kumar Singh, Ranjan Kumar, Maikel Leyva-Vázquez, Mahmoud Ismail, Tahir Mahmood, Hafsa Masood Malik, Mohammad Abobala, Mai Mohamed, Gunasekaran Manogaran, Seema Mehra, Kalyan Mondal, Mohamed Talea, Mullai Murugappan, Muhammad Akram, Muhammad Aslam Malik, Muhammad Khalid Mahmood, Nivetha Martin, Durga Nagarajan, Nguyen Van Dinh, Nguyen Xuan Thao, Lewis Nkenyereya, Jagan M. Obbineni, M. Parimala, S. K. Patro, Peide Liu, Pham Hong Phong, Surapati Pramanik, Gyanendra Prasad Joshi, Quek Shio Gai, R. Radha, A.A. Salama, S. Satham Hussain, Mehmet Șahin, Said Broumi, Ganeshsree Selvachandran, Selvaraj Ganesan, Shahbaz Ali, Shouzhen Zeng, Manjeet Singh, A. Stanis Arul Mary, Dragiša Stanujkić, Yusuf Șubaș, Rui-Pu Tan, Mirela Teodorescu, Selçuk Topal, Zenonas Turskis, Vakkas Uluçay, Norberto Valcárcel Izquierdo, V. Venkateswara Rao, Volkan Duran, Ying Li, Young Bae Jun, Wadei F. Al-Omeri, Jian-qiang Wang, Lihshing Leigh Wang, Edmundas Kazimieras Zavadskas. (shrink)

This twelfth volume of Collected Papers includes 86 papers comprising 976 pages on Neutrosophics Theory and Applications, published between 2013-2021 in the international journal and book series “Neutrosophic Sets and Systems” by the author alone or in collaboration with the following 112 co-authors (alphabetically ordered) from 21 countries: Abdel Nasser H. Zaied, Muhammad Akram, Bobin Albert, S. A. Alblowi, S. Anitha, Guennoun Asmae, Assia Bakali, Ayman M. Manie, Abdul Sami Awan, Azeddine Elhassouny, Erick González-Caballero, D. Dafik, Mithun Datta, Arindam (...) Dey, Mamouni Dhar, Christopher Dyer, Nur Ain Ebas, Mohamed Eisa, Ahmed K. Essa, Faruk Karaaslan, João Alcione Sganderla Figueiredo, Jorge Fernando Goyes García, N. Ramila Gandhi, Sudipta Gayen, Gustavo Alvarez Gómez, Sharon Dinarza Álvarez Gómez, Haitham A. El-Ghareeb, Hamiden Abd El-Wahed Khalifa, Masooma Raza Hashmi, Ibrahim M. Hezam, German Acurio Hidalgo, Le Hoang Son, R. Jahir Hussain, S. Satham Hussain, Ali Hussein Mahmood Al-Obaidi, Hays Hatem Imran, Nabeela Ishfaq, Saeid Jafari, R. Jansi, V. Jeyanthi, M. Jeyaraman, Sripati Jha, Jun Ye, W.B. Vasantha Kandasamy, Abdullah Kargın, J. Kavikumar, Kawther Fawzi Hamza Alhasan, Huda E. Khalid, Neha Andalleb Khalid, Mohsin Khalid, Madad Khan, D. Koley, Valeri Kroumov, Manoranjan Kumar Singh, Pavan Kumar, Prem Kumar Singh, Ranjan Kumar, Malayalan Lathamaheswari, A.N. Mangayarkkarasi, Carlos Rosero Martínez, Marvelio Alfaro Matos, Mai Mohamed, Nivetha Martin, Mohamed Abdel-Basset, Mohamed Talea, K. Mohana, Muhammad Irfan Ahamad, Rana Muhammad Zulqarnain, Muhammad Riaz, Muhammad Saeed, Muhammad Saqlain, Muhammad Shabir, Muhammad Zeeshan, Anjan Mukherjee, Mumtaz Ali, Deivanayagampillai Nagarajan, Iqra Nawaz, Munazza Naz, Roan Thi Ngan, Necati Olgun, Rodolfo González Ortega, P. Pandiammal, I. Pradeepa, R. Princy, Marcos David Oviedo Rodríguez, Jesús Estupiñán Ricardo, A. Rohini, Sabu Sebastian, Abhijit Saha, Mehmet Șahin, Said Broumi, Saima Anis, A.A. Salama, Ganeshsree Selvachandran, Seyed Ahmad Edalatpanah, Sajana Shaik, Soufiane Idbrahim, S. Sowndrarajan, Mohamed Talea, Ruipu Tan, Chalapathi Tekuri, Selçuk Topal, S. P. Tiwari, Vakkas Uluçay, Maikel Leyva Vázquez, Chinnadurai Veerappan, M. Venkatachalam, Luige Vlădăreanu, Ştefan Vlăduţescu, Young Bae Jun, Wadei F. Al-Omeri, Xiao Long Xin.‬‬‬‬‬‬. (shrink)

This eleventh volume of Collected Papers includes 90 papers comprising 988 pages on Physics, Artificial Intelligence, Health Issues, Decision Making, Economics, Statistics, written between 2001-2022 by the author alone or in collaboration with the following 84 co-authors (alphabetically ordered) from 19 countries: Abhijit Saha, Abu Sufian, Jack Allen, Shahbaz Ali, Ali Safaa Sadiq, Aliya Fahmi, Atiqa Fakhar, Atiqa Firdous, Sukanto Bhattacharya, Robert N. Boyd, Victor Chang, Victor Christianto, V. Christy, Dao The Son, Debjit Dutta, Azeddine Elhassouny, Fazal Ghani, Fazli Amin, (...) Anirudha Ghosha, Nasruddin Hassan, Hoang Viet Long, Jhulaneswar Baidya, Jin Kim, Jun Ye, Darjan Karabašević, Vasilios N. Katsikis, Ieva Meidutė-Kavaliauskienė, F. Kaymarm, Nour Eldeen M. Khalifa, Madad Khan, Qaisar Khan, M. Khoshnevisan, Kifayat Ullah,, Volodymyr Krasnoholovets, Mukesh Kumar, Le Hoang Son, Luong Thi Hong Lan, Tahir Mahmood, Mahmoud Ismail, Mohamed Abdel-Basset, Siti Nurul Fitriah Mohamad, Mohamed Loey, Mai Mohamed, K. Mohana, Kalyan Mondal, Muhammad Gulfam, Muhammad Khalid Mahmood, Muhammad Jamil, Muhammad Yaqub Khan, Muhammad Riaz, Nguyen Dinh Hoa, Cu Nguyen Giap, Nguyen Tho Thong, Peide Liu, Pham Huy Thong, Gabrijela Popović‬‬‬‬‬‬‬‬‬‬, Surapati Pramanik, Dmitri Rabounski, Roslan Hasni, Rumi Roy, Tapan Kumar Roy, Said Broumi, Saleem Abdullah, Muzafer Saračević, Ganeshsree Selvachandran, Shariful Alam, Shyamal Dalapati, Housila P. Singh, R. Singh, Rajesh Singh, Predrag S. Stanimirović, Kasan Susilo, Dragiša Stanujkić, Alexandra Şandru, Ovidiu Ilie Şandru, Zenonas Turskis, Yunita Umniyati, Alptekin Ulutaș, Maikel Yelandi Leyva Vázquez, Binyamin Yusoff, Edmundas Kazimieras Zavadskas, Zhao Loon Wang.‬‬‬‬. (shrink)

Plastic consumption is an important aspect of contemporary living, and studies that systematically examine consumers’ plastic waste recycling intentions from an ethical perspective are scarce. Considering the severity of plastic waste recycling problems globally based on the stimulus-organism-response paradigm, this study analyses how the information publicity influences consumers’ plastic waste recycling intentions from an ethical perspective in an emerging market economy. We investigate this link by focusing on the indirect effect of perceived social pressure and the moderating role of media (...) disposition (i.e., media richness and content trustworthiness). Data from a three-wave field survey of 469 household consumers from China showed that social pressure mediated the positive relationship between information publicity and ethical recycling intentions. Additionally, media richness and content trustworthiness moderate the link between information publicity and consumers’ perceptions of social pressure. These findings provide encouraging evidence for applying the SOR paradigm to explain the ethical recycling intention of consumers. The findings may assist policymakers in motivating consumers to think ethically about plastic waste recycling. (shrink)

After his refutation of the doubts concerning Proposition I.7, Ibn al-Haytham mentions three possible ways in which circles may intersect, submitting them to the following “intuitive” argument: one part of one of the two circles is situated inside of the other circle, and its other part is situated outside of it. One is therefore tempted to believe that the commentator accepts the principle of continuity in the case of circles, since his argument has the following meaning: if a circle is (...) divisible into two parts, one of which is situated inside the other circle, and the other outside of it, then the two circles cut one another. The author of this article proposes to establish the limits of this belief, on the basis of the following reflections: 1). It will be noted first of all that what could be called the ‘principle of the intersection of circles’ does not constitute ipso facto a principle in the mind of Ibn al-Haytham: no allusion is made to it in the commentary on Proposition I.1, among others. 2) It will be established later on that if one accepts that a line is the result of the movement of a point, the principle of continuity should be considered by him as something which is obvious by itself, without being stated. This conclusion will be based on an analysis of the notion of continuity in its classical meaning, and on Ibn al-Haytham’s commentary on Proposition X.1. 3) On the other hand, we should note the presence of a ‘sketch’ of topological language, which Ibn al-Haytham develops for the notion of a circle : one could say in this context that his reflection constitutes an important, if not principal, stage in the process which was to lead to the explicit formulation of the principle of continuity. (shrink)

Sporadic efforts have been made to introduce computational thinking methods into K-12 education in Palestine, but these have been held back by the challenging educational environment. However, a recent in-service training initiative, funded and organized by the Ministry or Education of Palestine, constitutes a significant effort to embed computational thinking in K-12 practice. The middle school teachers who participated in the training course were invited to participate in the present study, and 38 did so. A qualitative approach involving both interviews (...) with teachers and classroom observations was used in data collection. All the teachers agreed to be observed in their classrooms, while 20 of the 38 also agreed to participate in the interviews. The findings showed that teachers of a range of topics, including social sciences and languages, employed computational thinking skills in teaching their students, but they were confronted by a number of challenges, including technical infrastructure and support, and a lack of time to prepare CT classes and space in the curriculum to deliver them. The results indicate that the most appropriate action to support teachers’ delivery of CT would be to provide peer exchanges and expert coaching in the integration of CT in the curriculum. (shrink)

Abdel-Hakim Ourghi's Reform of Islam is an open indictment of prevailing conservative Islam which insists on the absolute subjugation of the body and mind of all Muslims. The author seeks a humanist understanding of Islam and aims to interpret Islam in today's terms. He argues against the historical alienation and transfiguration that still shape the collective consciousness of Muslims in the 21st Century. Using critical analysis and logic, the author aims to reveal the true core of Islam. His 40 (...) Theses include: The freedom of the individual to interpret the Qur'an No scholars as mediators between God and man Islam does not claim to possess the absolute truth Only a reformed and open Islam is a religion of peace The Qur'an as the basis of a contemporary humanist ethics. (shrink)

This book is at once unique, strikingly bold and far-ranging. It is unique in being the only Indian approach to academic scholarship that has seriously attempted to undertake the swarajist programme of considering modern Western civilization in its entirety from an independent, decolonized Indian perspective.

The aim of this study is to explore social media marketing activities and their impact on consumer intentions. This study also analyzes the mediating roles of social identification and satisfaction. The participants in this study were experienced users of two social media platforms Facebook and Instagram in Pakistan. A self-administered questionnaire was used to collect data from respondents. We used an online community to invite Facebook and Instagram users to complete the questionnaire in the designated online questionnaire system. Data were (...) collected from 353 respondents, and structural equation modeling was used to analyze the data. Results show that SMMAs have a significant impact on the intentions of users. Furthermore, social identification mediates the relationship between social media activities and satisfaction, and satisfaction mediates the relationship between social media activities and the intentions of users. This will help marketers how to attract customers to develop their intentions. This is the first novel study that used SMMAs to address the user intentions with the role of social identification and satisfaction in the context of Pakistan. (shrink)

This article aims to highlight the healthcare issues raised by COVID-19 in Pakistan’s scenario. Initially, Pakistan lacked “standard operating procedures,” and the government had to ship testing kits from China and Japan. Moreover, due to violations of the lockdown and standard operating procedures (SOPs), the rapidly increasing number of cases created a burden on the healthcare system. More and more, this pandemic and its impact have grown. As vaccine development has not been successful yet, “herd immunity” can only be achieved (...) if about three quarters of the population contract the virus—requiring immuno￾compromised citizens to be sacrificed for the sake of the country. Moreover, Pakistan has limited testing capacity, so most COVID-19 tests are missing their mark even as the virus spreads. The current scenario is also raising several concerns about the capacity of the government to tackle the prevailing healthcare crisis. In this regard, healthcare professionals suggest that the government must act responsibly to ensure better security provided to healthcare professionals. Identifying suspected cases, introducing personal protective equipment, and taking administrative measures to ensure that better security is provided to healthcare professionals are the needs of the hour to improve outcomes of COVID-19 patients. Testing, tracking, and lockdowns must be focused on areas where clusters are detected. The healthcare professionals must be given utmost protection before this pan￾demic could wreak havoc in terms of fatalities. Investing in the chronically underfunded healthcare system is needed, so that Pakistan can build capacity to fight the pandemic. (shrink)

In this paper, Taylor series is used to solve neutrosophic multi-objective programming problem (NMOPP). In the proposed approach, the truth membership, Indeterminacy membership, falsity membership functions associated with each objective of multi-objective programming problems are transformed into a single objective linear programming problem by using a first order Taylor polynomial series. Finally, to illustrate the efficiency of the proposed method, a numerical experiment for supplier selection is given as an application of Taylor series method for solving neutrosophic multi-objective programming problem (...) at end of this paper. (shrink)

Research on the base-of-the-pyramid (BoP) approach and the associated business case for deprived participants in informal markets now appears frequently in a range of business ethics and management-related journals. The present analysis of how supply chain management (SCM) and sustainable supply chain management (SSCM) concepts are habitually used in base-of-the-pyramid research serves to strengthen the theoretical foundation of BoP research by addressing the related business case. Based on a content analysis of BoP papers published in English-speaking peer-reviewed journals between 2000 (...) and 2014 from the Web of Science database, this literature review comprehends existing research in the context of established SCM and SSCM frameworks, using both frequency and contingency analyses. The frequency analysis indicates that supply chain management and sustainable supply chain management [(S)SCM] constructs regularly discussed in the BoP literature include supplier integration, strategic purchasing, decommoditization, long-term relationship and enhanced communication among supply chain actors. The identified contingencies reflect linkages between BoP research and (S)SCM constructs. The highest number of links was found between the SCM constructs of strategic purchasing and long-term relationship and the SSCM constructs of supplier integration and communication and coordination with suppliers. These can be regarded as the most crucial (S)SCM constructs in the BoP business environment. This analysis facilitates the development of future research propositions at this intersection, including the use of tools from (S)SCM theories to evaluate BoP propositions and projects. Granted the limited range of BoP-related papers analyzed, the findings provide a coherent understanding of (S)SCM practices crucial to the functioning of BoP markets and why they matter, so contributing to the related ethical rationale. These findings will be of use to researchers and practitioners alike for the formulation of business development strategies and their subsequent implementation in informal market economies. (shrink)

In this paper, we propose a new hybrid neutrosophic multi criteria decision making (MCDM) framework that employs a collection of neutrosophic analytical network process (ANP), and order preference by similarity to ideal solution (TOPSIS) under bipolar neutrosophic numbers. The MCDM framework is applied for chief executive officer (CEO) selection in a case study at the Elsewedy Electric Group, Egypt. The proposed approach allows us to assemble individual evaluations of the decision makers and therefore perform accurate personnel selection. The outcomes of (...) the proposed method are compared with those of the related works such as weight sum model (WSM), weight product model (WPM), analytical hierarchy process (AHP), multiobjective optimization based on simple ratio analysis (MOORA) and ANP methods to prove and validate the results. (shrink)

Using intelligent software agents in the world of e-commerce may give rise to many difficulties especially with regard to the validity of agent-based contracts and the attribution of liability for the actions of such agents. This paper thus critically examines the main approaches that have been advanced to deal with software agents, and proposes the gradual approach as a way of overcoming the difficulties of such agents by adopting different standards of responsibility depending whether the action is done autonomously by (...) an unattended software, or whether it is done automatically by an attended software. Throughout this paper, it is argued that the introduction of “one size” regulation without sufficient consideration of the nature of software agents or the environments in which they communicate might lead to a divorce between the legal theory and technological practice. It is also concluded that it is incorrect to deal with software agents as if they were either legal persons or nothing without in any way accounting for the fact that there are various kinds of such agents endowed with different levels of autonomy, mobility, intelligence, and sophistication. However, this paper is not intended to provide the final answer to all problematic questions posed by the emergence of intelligent software agents, but is designed to provide some kind of temporary relief until such agents reach a more reliable and autonomous level whereby law begins to regard them, rather than their users, as the source of the relevant action. (shrink)

Our study explores the relationship between psychological contract (fulfillment/violations) and voice behavior (promotive/prohibitive). The study encourages promoting the development of positive voice behavior since the promotive voice behavior of employees would help the organization to grow and improve as per industry standards especially during the upcoming hi-tech era. If the knowledge workers do not show positive voice behavior, it is difficult for organizations to compete and sustain in such an era of digitalization. A cross-sectional survey was conducted for the assessment/validation (...) of the model. Data was collected through a single self-reported questionnaire, filled out by the 89 employees of two private banks, working in 8 different branches. Further, the relationships among variables have been analyzed using structure equation modeling. Results show a strong and positive relationship between psychological contract fulfillment and promotive voice behavior whereas a negative relationship is indicated upon the violations and breach of psychological contract. Job satisfaction/dissatisfaction was also tested as mediators between these variables. Future researchers may test the same in different geographical locations and demographic conditions, whereas various personality traits may also be tested since voice behavior is an individual decision. The study represents the first of its kind on the said topic especially in the Pakistani context. (shrink)

This study provides an innovative approach to neutrosophic algebraic structures by introducing a new structure called Neutrosophic Soft Cubic T-ideal (NSCTID), which combines T-ideal (TID) and neutrosophic Soft Cubic Sets (NSCSs) within the framework of PS-Algebra. Within the already-existing neutrosophic cubic structures, the addition of soft sets with the characteristics of TID makes this structure more desirable. The theoretical development of the proposed structure includes the application of fundamental ideas as union, intersection, the Cartesian product, and homomorphism. We also introduce (...) the notions of NSCTID-translation and NSCTID-multiplication to further enhance the structure of NSCTID. By applying the idea of translation and multiplication, we offer improved algorithm for neutrosophic cubic sets to deal with different parameters that are satisying the TID’s distinctive characteristics. Through this thorough research, we offer an elementary understanding of NSCTID and its capabilities, providing the way to new algebraic structures. (shrink)

This paper unravels an unprecedented interplay between board gender diversity (BGD) and corporate environmental, social, and governance (ESG) disputes among Chinese A-share-listed nonfinancial companies from 2017 to 2021. Framed within a knowledge-based and sensemaking perspective of institutional frameworks, the research not only illuminates the profound impact of internal (corporate governance ratings) and external (regional institutional development) institutional factors on this intricate relationship but also brings to light a paradigm-shifting revelation. The study employed a diverse set of empirical tests, ranging from (...) ordinary least squares regression to advanced methods such as the generalized method of moments, two-stage least squares, and propensity score matching, providing a nuanced and comprehensive analysis. The findings highlight the pivotal role of female directors in significantly mitigating ESG disputes. A mechanism analysis further uncovers that internal and external institutional quality are potent positive moderators in shaping the BGD–ESG dispute dynamic. This research has profound implications, providing valuable insights for stakeholders, policymakers, and scholars, offering a comprehensive understanding of how gender diversity fosters sustainability while unravelling the intricate tapestry of internal and external institutional dynamics that shape ESG outcomes. (shrink)

In his recent work, Jürgen Habermas signals the abandonment of his earlier claims to justify human rights and universalist morality. This paper explains the above shift, arguing that it is the inescapable result of his attempts in recent years to accommodate pluralism. The paper demonstrates how Habermas’s universal pragmatic justification of modern normative standards was inextricably tied to his consensus theory of validity. He was compelled by the structure of that argument to count on the current or future availability of (...) a unified framework within which all can potentially articulate their needs and interests. With his abandonment of the justification Habermas has rid discourse theory of this controversial assumption. In weakening its defense of human rights and universalist morality against the charge of ethnocentrism, he has strengthened his theory’s foothold in the lived pluralist world. Key Words: argumentation • ethnocentrism • Habermas • human rights • justification • legitimacy • pluralism • rational consensus • Rehg. (shrink)

En el presente escrito se estudian varias piezas hasta ahora inéditas tanto al corpus de precintos producidos durante el períodod inicial de al-Andalus, como al de los ponderales realcionados con las emisiones monetarias de épocas diversas en la historia andalusí.

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)