Stress levels and their risk/protective factors among MSc Public Health students

There is increasing evidence that university students are particularly susceptible to feelings of stress. Given that many post-graduate healthcare students work with patients, the negative outcomes associated with feelings of stress may also impact upon the patient population. This study investigated the prevalence and risk/ protective factors of self-perceived stress among 43 international public health post-graduate students. Results revealed that almost all participants scored in either the moderate or high stress level category, with South-Asian students scoring particularly high stress scores. Headache frequency, sleep duration and feeling the need for a holiday were the explanatory variables most strongly associated with stress. The results support and add to previous literature which suggests that international students are particularly susceptible to feelings of stress. Suggestions on the management and prevention of stress are proposed, while ideas for future research to build upon this study's findings are considered

The prevalence and under-reporting of needle-stick injuries among dental healthcare workers in Pakistan: a systematic review

Needlestick injuries (NSIs) are a major occupational health problem among dental healthcare workers (HCWs) in Pakistan, which places them at a significant risk of acquiring blood-borne infections. However, not all NSIs are reported, leading to an underestimation of the actual prevalence. The harmful impacts of NSIs on the healthcare delivery necessitate an urgent need to measure its actual prevalence. Objectives. The aim of this study was to review literature to estimate the prevalence and reporting rates of NSIs among dental-HCWs in Pakistan. Methods. 713 potentially relevant citations were identified by electronic databases and hand searching of articles. Nine primary studies were subsequently identified to be included in the review. Results. The results of the included studies indicate that the prevalence of NSIs among Pakistani dental-HCWs was between 30% and 73%. The rate of reporting of NSIs was between 15% and 76%, and the most common reason was found to be the lack of awareness regarding the reporting system, or of the need to report NSIs. Conclusion. It is evident from the review of the included studies that there is a significantly high prevalence and a low rate of reporting of NSIs among dental-HCWs in Pakistan, suggesting the need to setup an occupational health department in dental settings, for preventing, managing, recording, and monitoring NSIs

Community and individual identity of the Kashmiri community : a case study of Luton

A thesis submitted for the Degree of Doctor of Philosophy of the University of LutonThis thesis is the study of the relationship between individuals and communities in the context of racialised minorities in the United Kingdom. The research examines the ways in which individuals belonging to the Kashmiri community articulate and manifest 'Kashmyriat' in conditions of diaspora. Specifically, the research is an investigation of the core features of Kashmiri identity. These were selected as being identifications based on culture, religion and the territorial identification with the land of Kashmir, the nature of culture conflict between individuals and community and differences between generations of Kashmiris and the role of gender identity in 'Kashmyriat'. The central premise is that identity is constantly updated, multiple and redefined in relation to contextual changes through a process of enculturation. Results of the research suggest that culture, religion and territorial identification with the land of Kashmir are central core features of Kashmiri identity in Luton. The younger generation appear to be maintaining a distinct and separate identity based partly on shared culture, religion and terrirotial identification with the land of Kashmir with the older generation whilst they are redefining their identity in response to the contexts in which they have been born and brought up. Gender identities appear to be less significant as part of overall identity development. Theoretically the thesis is an exploration of identity and its relationship to cultural identity among migrants. In this thesis I rely on qualitative ethnographic work as well as the quantitative research methodology of Identity Structure Analysis (ISA) to try and draw a textured analysis of Kashmiri identity transformation in the wake of immigration to Luton. Using the notion of enculturation the thesis sets out to deepen and make this concept more academically rigorous. Enculturation is deployed as a means to understanding the process of identity transformation. Results of the research suggest that culture, religion and affiliation with the land of Kashmir. Whilst they share the first two with other South Asian ethnicised communities in the United Kingdom it appears that the territorial affiliation with the land of Kashmir which can be translated as political identity is currently their self-defined identity. This is marking the Kashmiris as a national community whose individuals and collectivities centre their identity on 'Kashmyriat'

Exploring factors contributing to low uptake of the NHS Breast Cancer Screening Programme among Black African women in the UK

Breast cancer is the most common cancer among women in the United Kingdom (UK) accounting for about 15% of cancer deaths. The National Breast Cancer Screening Programme in the UK was introduced in 1988 to assist with early detection and better management of breast cancer. Black and Minority Ethnic (BME) women however have a low uptake of the National Breast Screening programme when compared to their White counterparts. Within the BME group, Black African women have the lowest uptake of screening services and are more likely to have an advanced stage of the disease at diagnosis, leading to poorer survival rates than White women. This study aimed to explore the factors that lead to low uptake of the National Breast Cancer Screening Programme  among Black African women living in Luton and present action points to local breast cancer services. Using a qualitative research design, six focus groups were conducted with a total of twenty-five Black African women residing in Luton between May and June in 2013. Data was analysed thematically using the framework approach. Four main themes emerged across the focus group discussions: knowledge and beliefs about breast cancer and risk factors, prevention of breast cancer and awareness of the NHS breast screening service, delays in attending the NHS breast screening service and suggestions for improving information on breast cancer and the NHS breast cancer screening service. The findings from this study suggest the need for more targeted information on breast cancer and screening services for Black African women. This could help improve the uptake of the NHS breast screening service, promote early help-seeking behaviour and improve breast cancer outcomes for this ethnic group.

Risk Factors for Injury to Recurrent Laryngeal Nerve in Thyroid Surgeries - A Tertiary Care Centre Experience

Objective: To evaluate the risk factors of recurrent laryngeal nerve injury during thyroid surgery. Study Design: Descriptive study. Place And Duration Of Study: Department of Otorhinolaryngology-Head and Neck Surgery, Sindh Government Lyari General Hospital / Shaheed Mohatarma Benazir Bhutto Medical College and Dr Ruth K. M. Pfau Civil Hospital Karachi, Dow University of Health Sciences from   July 2014 to August 2018.  Methods: Every patient with goiter (multinodular / solitary nodule) admitted for primary or revision surgery with normal vocal cord movements were included in this study, while patients having hoarseness due to impaired vocal cords movements were excluded from this study. Results: Out of 120 Patients 28 (23.33%) were operated for Total Thyroidectomy, 4 (3.34%) had Near total thyroidectomy and 49(40.83%) for Right lobectomy with isthmusectomy, 35(29.17%) for Left lobectomy with isthmusectomy and 4(3.3%) cases operated for recurrent goiter. Transient unilateral vocal cord paralysis occurred in 5 cases, became permanent in 3 cases. Bilateral vocal cord paralysis was seen in revision thyroidectomy in 1 case. Conclusion: With this study we have tried to evaluate the relation of injury to RLN and type of surgery performed. It can be concluded that thyroid surgery, if performed by expert surgeons carries low risk of injury to RLN. Lobectomies have a slightly lower risk of nerve injury compared to total thyroidectomies. In revision surgeries RLN are at greater risk. Careful dissections of nerve make an important pillar in preservation of RLN during surgery. Keywords:  Thyroidectomy, Recurrent Laryngeal Nerve Palsy, Risk Factors

Complementary and alternative medicine in oncology nursing

Use of complementary and alternative medicine (CAM) has increased globally, particularly among oncology patients. This study investigated the knowledge, experience and attitudes of oncology nurses towards CAM. A quantitative study was conducted in tertiary care hospitals in Karachi, Pakistan, where 132 oncology nurses were surveyed. The survey revealed that more than 50% of nurses had never heard about many of the CAM therapies used in Pakistan. Approximately 65% of the nurses had knowledge about prayer and less than 30% had experience of CAM education or training. In addition, the majority of nurses had seen patients using CAM and felt that their health status could be enhanced with the use of CAM. This study showed that oncology nurses had a positive experience of and attitude towards CAM, although they needed to enhance their knowledge of it to maximise patient satisfaction and quality of care

Prevalence and factors associated with postpartum vaginal infection in the Khyber agency federally administered tribal areas, Pakistan

Objective: To estimate the prevalence and to identify the factors associated with vaginal infection among the married women between the ages of 15-49 years residing in the Khyber Agency (FATA), Pakistan.Methods: A cross-sectional study was conducted in the month of July 2005 on 1084 mothers by using random sampling strategy in Khyber Agency Pakistan by trained nurses. The descriptive and multivariate statistics were computed.Results: The multivariate analysis showed that the associated factors with vaginal infection were the use of unhygienic material to soak up the lochia [aOR=3.45, 95% CI (1.36, 8.75)], bathing after 40 days [aOR=2.10, 95% CI (1.55, 3.14)], and women who did not receive antenatal care [OR=3.87, 95% CI (1.93, 7.75)]. Also women who did not have medical facilities available [OR=2.45, 95% CI (1.23, 5.06)] reported of vaginal infection.Conclusions: This study concluded that there is considerable need for health education among women and the entire community for the maintenance of hygiene, safe delivery through medical personnel and improvement in the mobility of mothers and female education (JPMA 57:363:2007)

A signature-based data security and authentication framework for internet of things applications

Internet of things (IoT) is the next big revolution in modernized network technologies connecting a massive number of heterogeneous smart appliances and physical objects. Owing to these technologies' novelty, various issues are characterized by security concerns are the most prioritized issue. A review of existing security approaches highlights that they are very particular about the solution towards a specific attack and cannot resist any unknown attacker. Therefore, this manuscript presents a novel computational model that introduces a unique authentication process using a simplified encryption strategy. The simulated study outcome shows that the proposed system offers efficient security and efficient data transmission performance in the presence of an unknown adversary. Hence, the study outcome exhibits better effects than frequently used security solutions when implemented in a vulnerable IoT environment