Maternal and newborn care: Practices and beliefs of traditional birth attendants in Sindh, Pakistan

Maternal mortality, infant mortality and neonatal mortality are high in Pakistan where maternal health services depend upon traditional birth attendants (TBAs). We examined the practices of TBAs in Dadu district in rural Sindh from September to November 1998 by interviewing and hosting focus group discussions with 17 TBAs. Health care personnel and other important members of the community were also interviewed. TBAs worked in areas demarcated by extended families, ethnicity or geographical access and a system of seniority was observed. Only one TBA was formally trained and antenatal and postnatal care concepts, cleanliness and equipment were inadequate. Communities trusted the TBAs and remunerated them according to factors particular to each birth. TBAs need training and to be linked with the formal health sector to effect change and to decrease maternal and neonatal mortality

Influence of Implemention of Government Accounting Standard and the Effectiveness of Government’s Internal Control System on the Quality of Local Financial Report and Its Impact Toward the Accountability of Regional Financial Management (A Research on G

This research is intended to examine the influence of implementing the of government accounting standard and the effectiveness of government’s internal control systems on the quality of local government financial report and its impact on the accountability of regional financial management in Aceh Government’s work units. The population in this research is finance administration officers on 48 work units (SKPA) in Aceh Government. This research uses census method. The data source of this research comes from the primary data which obtained from the respondents through distributed questionnaires. Analysis method used is path analysis. The result of this research shows the implementation of government accounting standards has a significant effect on the quality of local government’s financial reports, the effectiveness of government internal control system significantly affect the quality of local government financial reports, the Implementation of government accounting standards has an effect on the accountability of regional financial management either directly or indirectly, the effectiveness of government internal control system has a direct or indirect effect on the accountability of regional financial management, and the quality of local government’s financial reports significantly affect the accountability of  regional financial management. Keywords: Government Accounting Standard, Internal Control System, Quality of Financial Report, Accountability, and   Financial management. 1)       Lecturer of Magister of Accountancy, Graduate Program, University of  Kuala, Banda Aceh, Indonesia Main & Coresponding Author: Email: [email protected] 2)       Lecturer of Magister of Accountancy, Graduate Program, University of  Kuala, Banda Aceh, Indonesia Email: [email protected] 3)       Magister of Accountancy, Graduate Program, University of  Kuala Banda Aceh, Indonesia Email: [email protected]

Knowledge about hepatitis B and C among patients attending family medicine clinics in Karachi

Knowledge about hepatitis B and C was assessed in a cross-sectional study of 300 adults aged 18 or older attending family medicine clinics at The Aga Khan University Hospital, Karachi. Most knew that hepatitis B and C are viral diseases that primarily affect the liver, but knowledge about risk factors for disease transmission was poor. Approximately 70% knew that hepatitis B is vaccine preventable; 60% had the misconception that hepatitis C is also vaccine preventable. The majority incorrectly believed that people with hepatitis B or C should follow the diet \u27parhaiz\u27. Generally women knew more than men about the diseases. This study suggests that health education about these infections should be provided to the public. Family physicians can play an important role in educating people about the prevention of these diseases

Strukturna, elastična, elektronska i rešetkina svojstva legura GaPxAsySb1−x−y S rešetkama priležnim dvjema podlogama

Information on the energy band gaps, the lattice parameter and the lattice matching to available substrates is a prerequisite for many practical applications. A pseudopotential plane-wave method, as implemented in the ABINIT code, is used to the GaPxAsySb1−x−y quaternary alloy lattice matched to GaAs and InP substrates to predict their energy band gaps, elastic constants and lattice dynamic properties. The ranges of compositions for which the alloy is lattice-matched to GaAs and InP are determined. A very good agreement is obtained between the calculated values and the available experimental data of GaAs and GaAs0.5Sb0.5 parents. The compositional dependence of direct and indirect band gaps has been investigated. Note that a phase transition occurred at As composition of 0.018 and 0.576 for GaPxAsySb1−x−y within InP and GaAs substrates. The static and high-frequency dielectric constants and refractive index are indeed inversely proportional (proportional) to the fundamental band gap for GaPxAsySb1−x−y within InP (GaAs) substrates. We study the variation of elastic constants, the optical phonon frequencies (ωTO and ωLO) and the Born effective charge Z* with As concentration.Podaci o energijskim procijepima, parametrima rešetke i prileživanju na dostupne podloge je preduvjet mnogin primjenama. Rabimo metodu ravnih valova s pseudopotencijalom, primijenjenu u programu ABINIT, da bismo predvidjeli procijepe energijskih vrpci, elastične konstante i dinamička svojstva rešetaka legure GaPxAsySb1−x−y s četiri sastavnice, priležne na GaAs i InP podloge. Odredili smo područja sastava za koja rešetke priliježu na GaAs i InP. Postigli smo vrlo dobar sklad izračunatih vrijednosti s eksperimentalnim podacima za polazne legure GaAs i GaAs0.5Sb0.5. Istražili smo ovisnost izravnih i neizravnih procijepa vrpci o sastavu. Opaža se pojava faznog prijelaza za sadržaj As od 0.018 i 0.576 u GaPxAsySb1−x−y na InP i GaAs podlogama. Statičke i visokofrekventne dielektrične konstante te indeks loma su obrnuto razmjerni (razmjerni) širini osnovnog procijepa vrpci u GaPxAsySb1−x−y na InP and GaAs podlogama. Proučavamo promjene elastičnih konstanti, optičkih fononskih frekvencija (ωTO i ωLO) te Bornovog efektivnog naboja Z ∗ u ovisnosti o sadržaju As

Strukturna, elastična, elektronska i rešetkina svojstva legura GaPxAsySb1−x−y S rešetkama priležnim dvjema podlogama

Information on the energy band gaps, the lattice parameter and the lattice matching to available substrates is a prerequisite for many practical applications. A pseudopotential plane-wave method, as implemented in the ABINIT code, is used to the GaPxAsySb1−x−y quaternary alloy lattice matched to GaAs and InP substrates to predict their energy band gaps, elastic constants and lattice dynamic properties. The ranges of compositions for which the alloy is lattice-matched to GaAs and InP are determined. A very good agreement is obtained between the calculated values and the available experimental data of GaAs and GaAs0.5Sb0.5 parents. The compositional dependence of direct and indirect band gaps has been investigated. Note that a phase transition occurred at As composition of 0.018 and 0.576 for GaPxAsySb1−x−y within InP and GaAs substrates. The static and high-frequency dielectric constants and refractive index are indeed inversely proportional (proportional) to the fundamental band gap for GaPxAsySb1−x−y within InP (GaAs) substrates. We study the variation of elastic constants, the optical phonon frequencies (ωTO and ωLO) and the Born effective charge Z* with As concentration.Podaci o energijskim procijepima, parametrima rešetke i prileživanju na dostupne podloge je preduvjet mnogin primjenama. Rabimo metodu ravnih valova s pseudopotencijalom, primijenjenu u programu ABINIT, da bismo predvidjeli procijepe energijskih vrpci, elastične konstante i dinamička svojstva rešetaka legure GaPxAsySb1−x−y s četiri sastavnice, priležne na GaAs i InP podloge. Odredili smo područja sastava za koja rešetke priliježu na GaAs i InP. Postigli smo vrlo dobar sklad izračunatih vrijednosti s eksperimentalnim podacima za polazne legure GaAs i GaAs0.5Sb0.5. Istražili smo ovisnost izravnih i neizravnih procijepa vrpci o sastavu. Opaža se pojava faznog prijelaza za sadržaj As od 0.018 i 0.576 u GaPxAsySb1−x−y na InP i GaAs podlogama. Statičke i visokofrekventne dielektrične konstante te indeks loma su obrnuto razmjerni (razmjerni) širini osnovnog procijepa vrpci u GaPxAsySb1−x−y na InP and GaAs podlogama. Proučavamo promjene elastičnih konstanti, optičkih fononskih frekvencija (ωTO i ωLO) te Bornovog efektivnog naboja Z ∗ u ovisnosti o sadržaju As

Socio-economic and Demographic factors associated with injecting drug use among drug users in Karachi, Pakistan

Objective: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi. Methods: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing .Results: Multivariate analysis showed that the income generation via illegal modes [AOR 1.6, 95% CI 1.0-2.6], non-sharing of income with family [AOR 1.7, 95% CI 1.1-2.7] and presence of suicidal thoughts [AOR 2.0, 95% CI 1.1-3.8] were associated with the use of drugs through injections. Further, drug users from districts West, East and Central were more likely to use drug through injection as compared to drug users from district South. The history of genital herpes was also found to be associated with injecting drug use. One IDU was found seropositive for HIV. Conclusion: The high-risk behaviors, such as illegal modes of earning and presence of suicidal thoughts, among IDUs suggest that the group needs rehabilitation programme. Moreover, non-sharing of income suggest that IDUs are isolated from social network, therefore primary prevention activities with focus on improving socioeconomic conditions and social networking can reduce drug use through injections. Focused interventions on target districts would be helpful in reducing IDU (JPMA 53:511;2003)

Development of a stress scale for pregnant women in the South Asian context: the A-Z Stress Scale.

Stress in pregnancy can lead to low-birth-weight and preterm babies and to psychological consequences such as anxiety and depression during pregnancy and the puerperium. Previous scales to measure stress contain items that overlap with the symptoms of pregnancy. A stress scale was developed based on in-depth interviews with pregnant women in Pakistan. Construct validity, test-retest reliability and inter-rater reliability were carried out. Cronbach alpha was 0.82 for the 30 short-listed items, with item-total correlations of 0.2-0.8. Multidimensional scaling determined 2 dimensions: socioenvironmental hassles and chronic illnesses. This was the first scale developed for pregnant women based on stressors in a developing country in South Asia

Coverage and predictors of vaccination among children of 1-4 years of age in a rural sub-district of Sindh

OBJECTIVE: To estimate the proportion of children 1-4 years of age vaccinated in the first year of their life and determine socio-demographic factors associated with vaccination in the rural sub-district Khairpur, Sindh, Pakistan.STUDY DESIGN: Cross-sectional study.PLACE AND DURATION OF STUDY: The study was conducted in 9 Union Councils of sub-district Gambat, district Khairpur, Sindh, from August to October 2008.METHODOLOGY: A questionnaire based representative multi-stage cluster survey was conducted. A total of 549 children aged 1-4 years were assessed for coverage and predictors of vaccination. Univariate and multivariate analysis was done using logistic regression to determine the unadjusted and adjusted relationship between socio-demographic predictor and outcome (vaccination status).RESULTS: The coverage for complete vaccination was 71.9% (95%CI=68.1%-75.7%). Educational level of mother (p=0.042), father (p=0.001) and child birth at hospital (p=0.006) were significantly associated with the vaccination status. Mother\u27s educational level of intermediate and above was the strongest predictor (OR=12.19, 95%CI=1.57-94.3) for vaccination.CONCLUSION: Education of parents, particularly mother\u27s education was important determinant of vaccination status of the children. In addition, distance from taluka health facility and misconception of parents were among the main reasons of not getting the children vaccinated. There is a need to educate the parents especially mothers about the importance of vaccination and organize EPI services at Basic Health Unit level to improve the vaccination coverage in rural areas of Pakistan

Risk factors for cardiovascular disease in school children--a pilot study.

OBJECTIVE: To assess the frequencies of risk factors for cardiovascular disease in school children. The information may help in designing interventions aimed at modifying unhealthy lifestyle in children, which may reduce the later incidence of cardiovascular disease in adults. METHODS: A cross-sectional study was conducted on 206 students (ages 14-18 years), enrolled in higher secondary school. Students were interviewed about their lifestyles, family history of cardiovascular disease and its risk factors. Moreover, they were assessed for height, weight and blood pressure. RESULTS: Twenty nine percent of the children were physically inactive, 31% were taking unhealthy diet daily, 21% were overweight (BMI \u3e or = 25) and 6% were smokers. History of paternal smoking was reported by 36% of the children, and among them 76% of fathers smoked in the presence of their children. Family history of cardiac disease, hypertension and diabetes were positive in 4%, 23% and 16% of the children respectively. Overall, 58% of the children had at least one modifiable risk factor. CONCLUSION: Majority of the children had modifiable risk factors for cardiovascular disease. Prevention efforts are required early in life, using strategies for behavioral modification and health promotion