Can People Be Managed through Fear? An Enquiry into Arab Culture.

This research scrutinises the fear-driven management of Arabs. It conceptualises fear as a structural component of Arab society through a sociological lens and, by drawing upon the reflections of 28 Arab experts, philosophises on the potential of fear to develop into a well-configured managerial system ('feararchy') that regulates public and private lives. This research finds this system to rest upon a foundation of three forms of fear: ontological (the normalisation of fear), epistemological (the utilisation of fear to shape knowledge) and axiological (the influence of fear on acceptability). This article makes five contributions. First, it shows how, through turning fear into a collective status, Arab managers exploit fear for social control. Second, it demonstrates the institutional nature of Arabs' fear, making it worthy of attention from the field of management. Third, it investigates fear as an individually internalised, socially constructed feeling that is psychologically manipulative. Fourth, it presents fear as not merely a natural psychological sensation but a managerially distorted contextual frame within which current (and future) members think and operate. Fifth and finally, it exposes the contextuality of fear: sources of fear in one context may not be sources of fear in another.

"The pandemic of distance learning": How Arab high school students see online-learning during Covid-19.

Emergency transition to online due to the coronavirus disease 2019 (Covid-19) pandemic has created unprecedented challenges in schooling. There is a dearth of information on the perception of Arab high school students and parents regarding the negative effects of online learning during Covid-19. Qualitative analysis of data from a multisite ethnographic-centered study collected in nine Arab countries. Data presented are only the ones recorded from students and parents. Raw data were abstracted using a mind-mapping software and coded using words. The perceived negative effects of students and parents on several aspects of the transition to online learning such as the needed technical adjustments, impact on parents, perceptions of learning online versus face to face, pedagogical drawbacks, and psychological effects are described and discussed in light of results of previous studies. In spite of cultural differences, Arab high school students and parents face the same challenges and difficulties reported in other parts of the world. The overarching theme that emerges both for parents and children is the perceived superiority of face-to-face learning in the structured environment of the school for a more holistic learning and socialization experience of students and for better long-term outcomes.

Coronian Education: Perceptions of Educational Changes during the COVID-19 Pandemic in Arab Countries.

This article tackles the question: To what domains did education go when it left school buildings due to the coronavirus pandemic? To answer this question, 1184 observations of online activity, 1132 observations of face-to-face activity, 118 focus groups and 1110 individual interviews were undertaken. In addition, 1290 witticisms were collected, utilising humour to inform research. Data analysis reveals the relocation of education to three domains: the domestic, digital and political. Its relocation to the domestic domain has meant increased familial responsibility, fuelling domestic tensions and conflicting with home-based distractions. Its relocation to the digital domain has involved reduced physical interaction, rituality, social merit, mobility and student health. Its relocation to the political domain has given rise to issues of participation and reshaped the power, institutional fabrication and societal support of education. The conclusion introduces the concept of "coronian education"-a hybrid of the domestic, digital and political domains. Whereas pre-coronian education was limited to a single domain, the school, coronian education is fragmented across three domains. Although coronian education research is feasible in the digital and political domains, it is challenging to conduct such research in the domestic domain, as an enquiry into domesticity entails invading the private spaces of homes.

From Symptoms to Diagnosis: An Observational Study of the Journey of SLE Patients in Saudi Arabia.

Background and Objectives: Early diagnosis and treatment is associated with improved outcomes in patients with systemic lupus erythematosus (SLE). Studying the journey of SLE patients in Saudi Arabia is essential to direct future health-care plans. Patients and Methods: This is a cross-sectional, multicenter study. Eligibility criteria included a diagnosis of SLE that was confirmed by a rheumatologist. Patients younger than 18 at the time of interview were excluded. Primary objectives were to determine time from first symptoms to initial physician visit (Lag 1), time from initial physician visit to encounter with rheumatologist (Lag 2), time from first visit to a rheumatologist to diagnosis of SLE (Lag 3), and time from diagnosis to start of treatment (Lag 4). Secondary objectives were to determine the number and specialty of physicians seen by patients, the speciality type that confirmed the diagnosis, first symptoms experienced, and age at first diagnosis of SLE. Results: Three hundred patients (92.3% women) with SLE were evaluated. Mean age at diagnosis was 29.92 years. Mean disease duration was 8.1 years. The majority were college educated (43.0%). The most common initial symptom was joint pain (68%), followed by skin rash (23%), and fever (3.7%). Lag 1 was less than one month in 68.2% of patients. Lag 2 was less than one month in 33.4% of patients and exceeded one year in 25.8%. Lag 3 was less than 1 month in 68.7% of patients. Lag 4 was less than one month in 94.4% of patients. The diagnosis of SLE was made most frequently by rheumatologists (80%). Evaluation by primary care, orthopedic and dermatology physicians were associated with delays in diagnosis. Conclusion: Delay was marked in Lag 2. Causes of delay included evaluation by non-specialists and visiting higher numbers of physicians before diagnosis confirmation.

Phenomenological Qualitative Methods Applied to the Analysis of Cross-Cultural Experience in Novel Educational Social Contexts.

The qualitative method of phenomenology provides a theoretical tool for educational research as it allows researchers to engage in flexible activities that can describe and help to understand complex phenomena, such as various aspects of human social experience. This article explains how to apply the framework of phenomenological qualitative analysis to educational research. The discussion within this article is relevant to those researchers interested in doing cross-cultural qualitative research and in adapting phenomenological investigations to understand students' cross-cultural lived experiences in different social educational contexts.

Expert recommendations on early diagnosis and referral of axial spondyloarthritis in the Kingdom of Saudi Arabia.

Axial spondyloarthritis is a chronic inflammatory disorder that primarily involves the axial skeleton (sacroiliac joints and spine), causing stiffness, severe pain and fatigue. In some patients, definitive structural damage of sacroiliac joints is visible on imaging and is known as radiographic axial spondyloarthritis. Some patients do not have a clear radiographic damage of the sacroiliac joints, and this subtype is known as non-radiographic axial spondyloarthritis. Early diagnosis is important for reducing the risk of irreversible structural damage and disability. Management of axial spondyloarthritis is challenging in Saudi Arabia because of inadequate disease knowledge and the unavailability of local guidelines. Therefore, this expert consensus is intended to provide recommendations, including the referral pathway, the definition of remission and the treat-to-target approach, to all healthcare professionals for the management of patients with axial spondyloarthritis. A Delphi technique of consensus was developed by involving an expert panel of 10 rheumatologists, 1 dermatologist and 1 general physician. The experts offered consensus-based recommendations based on a review of available scientific evidence and clinical experience for the referral, screening and management of patients with axial spondyloarthritis.

Consensus-based recommendations on the diagnosis, referral and clinical management of patients with psoriatic arthritis.

Psoriatic arthritis (PsA) is a highly heterogeneous disease with complex manifestations. Limited understanding of the disease and non-availability of local guidelines pose challenges in the management of PsA in Saudi Arabia. Therefore, this expert consensus is aimed to provide recommendations on the management of patients with PsA, including referral pathway, definition of remission and treat-to-target (T2T) approach. A Delphi technique of consensus development was used involving an expert panel comprised of 10 rheumatologists, one dermatologist and one family physician. Based on the review of available published evidence and the opinions of clinical experts, key recommendations were developed. A consensus was achieved in defining the following: management guideline adaptable for Saudi Arabia, most useful screening tool, laboratory investigations, imaging tests and criteria for referring suspected PsA patients to a rheumatologist. In addition, an agreement was achieved in defining the T2T strategy and remission for the clinical management of PsA. Overall, these recommendations provide an evidence-based framework for the management of PsA patients in Saudi Arabia.

Efficacy and Safety of Tofacitinib in Rheumatoid Arthritis (RA): A Retrospective Study From Two Centers in Jeddah, Saudi Arabia.

BACKGROUND: Tofacitinib is the first Janus kinase (JAK) inhibitor approved for treating rheumatoid arthritis (RA). Several clinical trials have evaluated the safety and effectiveness of tofacitinib in adult patients with moderately to severely active RA. Real-world studies provide invaluable insights into routine clinical practice. We aim to assess the clinical efficacy and safety of RA patients. METHODS: Over a period of two years, we included 50 consecutive RA patients who were treated with tofacitinib. Clinical disease activity, assessed by disease activity score (DAS) 28 - erythrocyte sedimentation rate (ESR), as well as adverse events (AEs) were evaluated. RESULTS: A total of 50 patients (84% female) were enrolled in the study. The mean age at initiation of tofacitinib was 48.54 ± 15.97 years. The mean time of treatment with tofacitinib was 18.06 ± 2.04 months. Patients were treated with tofacitinib 5 mg BID with 32% receiving tofacitinib as monotherapy. A total of 74% of the patients had been prescribed at least one biological treatment. The treatment target was achieved in 42 patients (82%). Baseline characteristics and previous treatment regimens did not predict clinical response to tofacitinib. Fifteen patients discontinued the treatment: seven due to ineffectiveness, four due to pregnancy, and five due to adverse events. The most common infectious adverse event was herpes zoster (4%) while the most common observed laboratory abnormalities were elevation in low density lipoprotein (LDL) and high density lipoprotein (HDL) in 6% and 8% of the patients, respectively. CONCLUSION: Our results indicate that tofacitinib is effective in real-world settings even as monotherapy. The treatment target was attained by 82% of the patients on tofacitinib. The safety profile of tofacitinib was generally consistent with previous studies.

A Case Report on the Atypical Presentation of Hypertrophic Cardiomyopathy (HOCM) in a 19-Year-Old Female.

Atypical hypertrophic cardiomyopathy (HOCM) is a relatively rare genetic disorder that can affect the left ventricular system. HOCM can lead to various cardiac issues such as sudden cardiac death (SCD). We report a case of a 19-year-old female who was referred to a cardiology clinic after presenting with bi-ventricular hypertrophy on an echocardiogram (ECHO). Results from screening tests for infiltrative diseases and an iron panel came negative. The patient was asymptomatic, with no functional limitations and no family history of any cardiac disease or sudden death. In conclusion, HOCM can present with an atypical pattern, such as biventricular hypertrophy, and has been linked to SCD; therefore, it is important to be aware of this condition and take the necessary precautions to prevent it.

Future Directions of Rheumatology Training According to Saudi Vision 2030: Recommendations From a Saudi Experts Meeting.

BACKGROUND: Worldwide research anticipates that a current shortage of rheumatologists will exacerbate over the next decade, whereas the need for arthritis specialists will continue to escalate. Saudi Arabia (SA) also encounters a limited geographical distribution of rheumatologists and rheumatology fellowship training centres. OBJECTIVE: Reporting the Saudi rheumatologists' advisory meeting conducted in Makkah, SA in January 2020 with the aim to discuss the "Saudi Vision 2030" for rheumatology training programs. MATERIALS AND METHODS: A meeting of Saudi rheumatology experts and consultants was conducted to address the future directions, challenges, and recommendations of rheumatology training. The 10th Rheumatology Practice Symposium was organised by Alzaidi Chair of Research in Rheumatic Diseases (ZCRD), and conducted in Makkah Commerce Chamber, Makkah, SA on January 28, 2020. More than 30 consultants and rheumatology fellows with five Saudi experts in the field of rheumatology assembled to form 10 recommendations that tackle rheumatology training challenges in SA. RESULTS: The meeting recommendations shed light on the clinical practice of rheumatology training in SA; challenges and opportunities in rheumatology fellowship programs; efforts of the Saudi Commission for Health Specialties (SCFHS) to design and implement a competent postgraduate rheumatology training; and challenges with trainers, trainee, and within training centres. CONCLUSION: To address rheumatology challenges in SA, rheumatology consultants and fellows assembled to form 10 recommendations. The recommendations tackled the challenges of rheumatology fellowship programs and the efforts to implement a competent postgraduate rheumatology training. These recommendations are expected to lead us successfully to fulfil our ambition in the "Saudi Vision of 2030".

Pneumomediastinum as a Manifestation of Granulomatosis with Polyangiitis.

A 38-year-old hypertensive male with a smoking history presented to the emergency room with significant hemoptysis, arthritis, and a purpuric rash. Other findings included a dropping hemoglobin and acute kidney injury with microscopic hematuria. The pulmonary computed tomography was significant for alveolar hemorrhage and a rarely reported pneumomediastinum. Along with this constellation of findings, a positive antiproteinase 3 helped to confirm this patient's diagnosis of granulomatosis with polyangiitis. Treatment commenced with sessions of plasma exchange and pulse steroids along with cyclophosphamide infusions. The patient had since improved and made a full recovery. This case report highlights the rarely described pneumomediastinum in association with vasculitides.

Case report: Prostatic abscess caused by community acquired methicillin resistant Staphylococcus aureus.

Prostatic abscess is declining disease because of widespread using of antibiotic in management of early prostatitis and urinary tract infections. Causing pathogenic factors usually gram-negative organisms. In lack of a guidelines, diagnosis and management sometimes is a challenge.

Understanding the public temper through an evaluation of rumours: an ethnographical method using educational technology.

The power of rumours is that they can be broadly exchanged, generating a 'public temper' (which is everybody's temper without being anybody's temper in particular). This article, therefore, describes an approach to measuring the public temper, examining particularly the public temper of an Arab society, namely Saudi Arabia. It addresses the following research question: is it possible to analyse existing (scholarly) rumours to see if they can be used as informants of the public temper of the culture in which they exist? This question is answered ethnographically by analysing 579 Arabic online rumours collected by students as part of their critical engagement with educational technology. Having analysed the data, four categories emerged: the concerns, interests, attitudes and values of Saudi Arabia. According to the literature, these four categories, taken together, constitute the emotional domain (i.e., the public temper) of a society. Thus, a theoretical proposition (and contribution to the existing literature regarding sociology) is that rumours mirror the public temper of a culture, reflecting a range of emotions from simple to complex (from concerns, interests and attitudes to values). Simpler emotions (e.g., concerns) appear to be more easily affected by rumours than more complex emotions (e.g., values). An implication of this study is that rumours have 'biographies', which detail public tempers across space and time. Rumours are 'records' of public tempers that should be read in the same way archaeologists read landscapes and remains. Although rumours entail ill-defined information, it is feasible to well define society through such ill-defined information, meaning that something can come out of its opposite. This study offers ethnographers a new method of understanding public tempers through rumours, alongside conventional meaning-making symbols (e.g., poems).

The theory of multiple stupidities: education, technology and organisation in Arabia.

Traditional perspectives have envisaged intelligence as one entity dominated by a single set of abilities (i.e. cognitive abilities), whereas modern perspectives have defined intelligence in various shapes (e.g. linguistic, musical and interpersonal intelligences). By the same token, traditional perspectives have examined stupidity as one set of inabilities (i.e. cognitive inabilities). However, it is not clear whether modern perspectives have discussed whether stupidity exists in various forms-in the same way as they have envisaged intelligence. To address this limitation, 257 university members were asked to share what they perceived as being stupid educational and technological practices in their institutions. Analysis of the data suggested three concepts were important to the members: moral, spatial and administrative stupidities. That is, stupidity is perceived to come in the form of failing to meet certain moral, spatial and administrative values. This implies that modern perspectives may conceptualise stupidity differently from traditional perspectives, seeing it as going beyond cognitive inabilities and viewing it as existing in various forms (e.g. moral, spatial and administrative stupidities). Thus, there are multiple stupidities as there are multiple forms of intelligence. A strength of this research is that it views stupidity through an organisational and qualitative lens, although some may traditionally expect such a topic to be examined quantitatively through psychometric and biological approaches.