The Shrine of ʿAbd al-Qādir al-Jīlānī in Baghdad & the Shrine of ʿAbd al-ʿAzīz al-Jīlānī in ʿAqra: Mapping the multiple orientations of two Qādirī Sufi shrines in Iraq

This thesis charts the stakeholder communities, physical environment and daily life of two little studied Qādiriyya Sufi shrines associated with Shaikh ʿAbd al-Qādir al-Jīlānī (1077 – 1165 AD), a 12th century Ḥanbalī Muslim theologian and the posthumous founder of one of the oldest Sufi orders in Islam. The first shrine is based in Baghdad and houses his burial chamber; and the second shrine, on the outskirts of the city of ‘Aqra in the Kurdish region of northern Iraq, is that of his son Shaikh ʿAbd al-ʿAzīz (died 1206 AD). The latter was also known for lecturing in Ḥanbalī theology in the region, and venerated for this as well as his association with Shaikh ʿAbd al-Qādir. Driven by the research question “What shapes the identity orientations of these two Qādiriyya Sufi shrines in modern times?” the findings presented here are the result of field research carried out between November 2009 and February 2014. This field research revealed a complex context in which the two shrines existed and interacted, influenced by both Sufi and non-Sufi stakeholders who identified with and accessed these shrines to satisfy a variety of spiritual and practical needs, which in turn influenced the way each considered and viewed the two shrines from a number of orientations. These overlapping orientations include the Qādirī Sufi entity and the resting place of its patron saint; the orthodox Sunnī mosque with its muftī-imams, who are employed by the Iraqi government; the local Shīʿa community’s neighbourhood saint’s shrine and its destination for spiritual and practical aid; and the local provider of welfare to the poor of the city (soup kitchen, funeral parlour and electricity-generation amongst other services). The research findings also revealed a continuously changing and adapting Qādirī Sufi scene not immune from the national and regional socio-religio-political environments in which the two shrines exist: a non-Sufi national political class vying to influence and manipulate these shrines for their own purposes; and powerful national sectarian factions jostling to do the same. The mixture of stakeholders using and associating with the two shrines were found to be influential shapers of these entities, both physically and spiritually. Through encountering and interacting with each other, most stakeholders contributed to maintaining and rejuvenating the two shrines, but some also sought to adapt and change them driven by their particular orientation’s perspective.

A study of ignorance: suffering and freedom in early Buddhist teachings and parallels in modern neuroscience

What might early Buddhist teachings offer neuroscience and how might neuroscience inform contemporary Buddhism? Both early Buddhist teachings and cognitive neuroscience suggest that the conditioning of our cognitive apparatus and brain plays a role in agency that may be either efficacious or non-efficacious. Both consider internal time to play a central role in the efficacy of agency. Buddhism offers an approach that promises to increase the efficacy of agency. This approach is found in five early Buddhist teachings that are re-interpreted here with a view to explaining how they might be understood as a dynamic basis for ‘participatory will’ in the context of existing free will debates and the neuroscientific work of Patrick Haggard (et al.). These perspectives offer Buddhism and neuroscience a basis for informing each other as the shared themes of: (1) cognition is dynamic and complex/aggregate based, (2) being dynamic, cognition lacks a fixed basis of efficacy, and (3) efficacy of cognition may be achieved by an understanding of the concept of dynamic: as harmony and efficiency and by means of Buddha-warranted processes that involve internal time.

An exploration of treatment burden and patient capacity in people with stroke

Background and aims: Advances in modern medicine have led to improved outcomes after stroke, yet an increased treatment burden has been placed on patients. Treatment burden is the workload of health care for people with chronic illness and the impact that this has on functioning and well-being. Those with comorbidities are likely to be particularly burdened. Excessive treatment burden can negatively affect outcomes. Individuals are likely to differ in their ability to manage health problems and follow treatments, defined as patient capacity. The aim of this thesis was to explore the experience of treatment burden for people who have had a stroke and the factors that influence patient capacity. Methods: There were four phases of research. 1) A systematic review of the qualitative literature that explored the experience of treatment burden for those with stroke. Data were analysed using framework synthesis, underpinned by Normalisation Process Theory (NPT). 2) A cross-sectional study of 1,424,378 participants >18 years, demographically representative of the Scottish population. Binary logistic regression was used to analyse the relationship between stroke and the presence of comorbidities and prescribed medications. 3) Interviews with twenty-nine individuals with stroke, fifteen analysed by framework analysis underpinned by NPT and fourteen by thematic analysis. The experience of treatment burden was explored in depth along with factors that influence patient capacity. 4) Integration of findings in order to create a conceptual model of treatment burden and patient capacity in stroke. Results: Phase 1) A taxonomy of treatment burden in stroke was created. The following broad areas of treatment burden were identified: making sense of stroke management and planning care; interacting with others including health professionals, family and other stroke patients; enacting management strategies; and reflecting on management. Phase 2) 35,690 people (2.5%) had a diagnosis of stroke and of the 39 co-morbidities examined, 35 were significantly more common in those with stroke. The proportion of those with stroke that had >1 additional morbidities present (94.2%) was almost twice that of controls (48%) (odds ratio (OR) adjusted for age, gender and socioeconomic deprivation; 95% confidence interval: 5.18; 4.95-5.43) and 34.5% had 4-6 comorbidities compared to 7.2% of controls (8.59; 8.17-9.04). In the stroke group, 12.6% of people had a record of >11 repeat prescriptions compared to only 1.5% of the control group (OR adjusted for age, gender, deprivation and morbidity count: 15.84; 14.86-16.88). Phase 3) The taxonomy of treatment burden from Phase 1 was verified and expanded. Additionally, treatment burdens were identified as arising from either: the workload of healthcare; or the endurance of care deficiencies. A taxonomy of patient capacity was created. Six factors were identified that influence patient capacity: personal attributes and skills; physical and cognitive abilities; support network; financial status; life workload, and environment. A conceptual model of treatment burden was created. Healthcare workload and the presence of care deficiencies can influence and be influenced by patient capacity. The quality and configuration of health and social care services influences healthcare workload, care deficiencies and patient capacity. Conclusions: This thesis provides important insights into the considerable treatment burden experienced by people who have had a stroke and the factors that affect their capacity to manage health. Multimorbidity and polypharmacy are common in those with stroke and levels of these are high. Findings have important implications for the design of clinical guidelines and healthcare delivery, for example co-ordination of care should be improved, shared decision-making enhanced, and patients better supported following discharge from hospital.

Blood donor motivation and recruitment : a comparative study in West of Scotland and the Sudan

In modern society, blood donor motivation and recruitment is a fundamental part of health care delivery. Well defined and documented programmes exist throughout the world but new ideas are always welcome. The situation in the Sudan is different and much remains to be done by way of comparison with elsewhere. This thesis outlines the objectives of a study, how it was supported, sponsored and achieved. It describes briefly the geography of the Sudan, the source of Sudanese economy, climate, culture and historical backgrounds. The problems of existing services in the Sudan are reviewed and a brief account of the demographic characteristics of the Sudanese population is given. Two surveys done in West of Scotland and in the Sudan are described in detail. This work discloses and compares the positive motives that enhances giving of blood and the negative motives that hinders its donation. The comparison is between an Eastern Society with a voluntary motivation not fully activated because of lack of understanding and awareness of the need to give blood voluntarily for strangers and Western Society with a well established voluntary system of donation. An addition to this research was the investigation into the immunity to tetanus and hepatitis in the Sudanese population. An estimate of the percentage of individuals with detectable levels of hepatitis A and B antibodies and tetanus antibodies is included since there is a need to establish a plasmapheresis programme as part of a good Blood Transfusion Service for the procurement of specific immunoglobulin's. This work has revealed major differences between the West of Scotland and the Sudan and suggestions are made for their resolution. The main conclusion and comparison are summarised in Chapter 7. It is hoped that many of the suggestions in this thesis can be introduced in the Sudan at an early date.

Braid groups, mapping class groups, and Torelli groups

This thesis discusses subgroups of mapping class groups of particular surfaces. First, we study the Torelli group, that is, the subgroup of the mapping class group that acts trivially on the first homology. We investigate generators of the Torelli group, and we give an algorithm that factorizes elements of the Torelli group into products of particular generators. Furthermore, we investigate normal closures of powers of standard generators of the mapping class group of a punctured sphere. By using the Jones representation, we prove that in most cases these normal closures have infinite index in the mapping class group. We prove a similar result for the hyperelliptic mapping class group, that is, the group that consists of mapping classes that commute with a fixed hyperelliptic involution. As a corollary, we recover an older theorem of Coxeter (with 2 exceptional cases), which states that the normal closure of the m-th power of standard generators of the braid group has infinite index in the braid group. Finally, we study finite index subgroups of braid groups, namely, congruence subgroups of braid groups. We discuss presentations of these groups and we provide a topological interpretation of their generating sets.