Acceptance rates and beliefs toward COVID-19 vaccination among the general population of Pakistan: A cross-sectional survey

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective

Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan: Results from two innovative birth spacing interventions

Background: Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--\u27Evidence for Innovating to Save Lives\u27, to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan.Methods: We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention models, (1) Suraj model (meaning \u27Sun\u27 in English), which uses social franchises (SF) along with a demand-side financing (DSF) approach using free vouchers, and (2) Community Midwife (CMW) model, in promoting the use of modern contraceptive methods compared to respective controls. Baseline and endline cross-sectional household surveys were conducted, 24 months apart, by recruiting 5566 and 6316 married women of reproductive age (MWRA) respectively. We used Stata version 8 to report the net effect of interventions on outcome indicators using difference-in-differences analysis. Multivariate Cox proportional hazard regression analysis was used to assess the net effect of the intervention on current contraceptive use, keeping time constant and adjusting for other variables in the model.Results: The Suraj model was effective in significantly increasing awareness about FP methods among MWRA by 14% percentage points, current contraceptive use by 5% percentage points and long term modern method--intrauterine device (IUD) use by 6% percentage points. The CMW model significantly increased contraceptive awareness by 28% percentage points, ever use of contraceptives by 7% percentage points and, IUD use by 3% percentage points. Additionally the Suraj intervention led to a 35% greater prevalence (prevalence ratio: 1.35, 95% CI: 1.22-1.50) of contraceptive use among MWRA.Conclusion: Suraj intervention highlights the importance of embedding subsidized FP services within the communities of the beneficiaries. The outcomes of the CMW intervention also improved the use of long-term contraceptives. These findings indicate the necessity of designing and implementing FP initiatives involving local mid-level providers to expand contraceptive coverage in under-served areas

Continuation rates and reasons for discontinuation of intra-uterine device in three provinces of Pakistan: Results of a 24-month prospective client follow-up

Background: Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as Suraj and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm.Methods: A total of 1,163 IUD users, 824 from Suraj and 339 from the CMW model, were enrolled in this 24-month prospective client follow-up. Participants were followed-up by female community mobilisers physically every second month to ascertain continued IUD usage and to collect information on associated factors, switching behaviour, reasons for discontinuation, and pregnancy occurrence. The probabilities of IUD continuation and the risk factors for discontinuation were estimated by life table analysis and Cox proportional-hazard techniques, respectively.Results: The cumulative probabilities of IUD continuation at 24 months in Suraj and CMW models were 82% and 80%, respectively. The difference between the two intervention areas was not significant. The probability distributions of IUD continuation were also similar in both interventions (Log rank test: χ(2) = 0.06, df = 1, P = 0.81; Breslow test: χ(2) = 0.6, df = 1, P = 0.44). Health concerns (Suraj = 57.1%, CMW = 38.7%) and pregnancy desire (Suraj = 29.3%, CMW = 40.3%) were reported as the most prominent reasons for IUD discontinuation in both intervention arms. IUD discontinuation was significantly associated with place of residence in Suraj and with age (15-25 years) in the CMW model.Conclusion: CMWs and private providers are equally capable of providing quality IUD services and ensuring higher method continuation. Pakistan\u27s National Maternal Newborn and Child Health programme should consider training CMWs and providing IUDs through them. Moreover, private sector mid-level providers could be engaged in promoting the use of IUDs

Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan: results from two innovative birth spacing interventions

Background: Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society - Pakistan implemented an operational research project - ‘Evidence for Innovating to Save Lives’, to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan. Methods: We conducted a quasi-experimental (pre - and post-intervention with control arm) study to assess the effectiveness of each of the two intervention models, 1) Suraj model (meaning ‘Sun’ in English), which uses social franchises (SF) along with a demand-side financing (DSF) approach using free vouchers, and 2) Community Midwife (CMW) model, in promoting the use of modern contraceptive methods compared to respective controls. Baseline and endline cross-sectional household surveys were conducted, 24 months apart, by recruiting 5566 and 6316 married women of reproductive age (MWRA) respectively. We used Stata® version 8 to report the net effect of interventions on outcome indicators using difference-in-differences analysis. Multivariate Cox proportional hazard regression analysis was used to assess the net effect of the intervention on current contraceptive use, keeping time constant and adjusting for other variables in the model. Results: The Suraj model was effective in significantly increasing awareness about FP methods among MWRA by 14 % percentage points, current contraceptive use by 5 % percentage points and long term modern method - intrauterine device (IUD) use by 6 % percentage points. The CMW model significantly increased contraceptive awareness by 28 % percentage points, ever use of contraceptives by 7 % percentage points and, IUD use by 3 % percentage points. Additionally the Suraj intervention led to a 35 % greater prevalence (prevalence ratio: 1.35, 95 % CI: 1.22–1.50) of contraceptive use among MWRA. Conclusion: Suraj intervention highlights the importance of embedding subsidized FP services within the communities of the beneficiaries. The outcomes of the CMW intervention also improved the use of long-term contraceptives. These findings indicate the necessity of designing and implementing FP initiatives involving local mid-level providers to expand contraceptive coverage in under-served areas

Effects of safety pattern, cabin ergonomics, and sleep on work-related stress and burnout of city and transit bus drivers in Lahore, Pakistan

The health and working environment of bus drivers is compromised in low-middle-income countries like Pakistan which leads to burnout and excessive Road Traffic Crashes. Hence, this study delves into factors affecting their safe operations from health and work environment perspectives and measures their associated stress and Burnout level. In a study of four hundred and ninety-nine (499), 86% city and 14% transit bus drivers are surveyed through a questionnaire. Stress is estimated for city and transit bus drivers, using the Effort/Reward Imbalance Model (ERI) of Siegrist, and burnout is calculated using the Copenhagen Burnout Inventory (CBI). For the determination of important determinants, descriptive and regression analyses are conducted. Findings show that stress has emerged as a negative factor for the physical and psychological health of city and transit bus drivers. Results based on bus drivers’ responses suggest that organisational awareness and emphasis on health and safety levels can significantly reduce driver stress and burnout

Graphene Based Functional Hybrids: Design and Technological Applications

Because of the versatile chemical, physical, and electrical properties, graphene as well as its nanocomposites are regarded as the backbone of engineering and scientific innovation. Different physical and chemical methods are used to create sustainable carbon materials. Furthermore, fabrication methods are employed in order to produce the composites, which are of constituents with desirable properties. Because of their biocompatibility, graphene nanomaterials have enormous potential for improving biology and drug delivery. The proposed chapter provides a variety of fabrication methods for sustainable graphene composites and highlights various applications of graphene. Furthermore, graphene nanocomposites are promising multifunctional materials with improved tensile strength and elastic modulus. Despite some challenges and the fact that carbon nanotube/polymer composites are sometimes better in some specific performance, graphene nanocomposites may have a wide range of potential applications due to their outstanding properties and the low cost of graphene. Because these graphene composites have a controllable porous structure, a large surface area, high conductivity, high temperature stability, excellent anti-corrosion properties, and composite compatibility, they can be used in energy storage as electrocatalysts, electro-conductive additives, intercalation hosts, and an ideal substrate for active materials. Meanwhile, the chapter summaries the graphene nanocomposites requirements for technological innovation and scientific applied research

Short-term behavioural responses to thermal stress by hawksbill turtles in the Arabian region

We present a previously unrecorded short-term behavioural response by hawksbill sea turtles to elevated sea surface temperatures in the Persian/Arabian Gulf. Surface waters typically exceed 30°C for sustained periods during the summer, and can be likened to a natural living laboratory for understanding thermoregulatory behaviour by marine species in the face of climate change and elevated global temperatures. We satellite-tracked 90 post-nesting hawksbill turtles between 2010 and 2013 as part of a larger programme to elucidate turtle foraging habitats and post-nesting behaviour. We used 66 of these datasets, where turtles clearly departed and returned to foraging grounds, for these analyses. Sea surface temperatures during the summer averaged 33.5°C and peaked at 34.9°C. During these elongated periods of elevated temperatures (June–August) the turtles temporarily migrated an average of 70km to deeper and cooler waters at northern latitudes, returning after 2–3months (September–October) back to original feeding grounds. Temperature differential T∆ between foraging and summer loop habitats was significantly different and approximated −2°C. Turtles undertaking summer migration loops generally moved in a north-easterly direction toward deeper water, returning in a south-westerly direction to the shallower foraging grounds. Swim speeds were significantly higher and orientation was less omnidirectional during the migrations than when foraging. The outbound migrations were significantly inversely correlated with temperature, but were not linked to chlorophyll-a, geostrophic currents or sea surface height. The turtles' preference for returning to the same foraging grounds suggests a lack of other substantial influences which might have precipitated the temporary summer migration loops. Our results indicate that Gulf hawksbills employ thermoregulatory responses which take them out of high temperature and potentially physiology-threatening conditions. These findings improve our overall understanding of hawksbill habitat use and behaviour in a climate-challenged environment, and support sea turtle conservation-related policy decision-making at national and regional levels.Emirates Wildlife Society—World Wild Fund for Nature Office. 7Days, Abu Dhabi Urban Planning Council, Bridgestone, CASP, College of the North Atlantic, Qatar, Deutsche Bank, Dubai Electricity & Water Authority, Dubai Festival City, Emirates Palace, Environment & Protected Areas Authority, Sharjah, Environment Agency—Abu Dhabi, Fairmont, Géant, Gulftainer, HSBC, Intercontinental, Dubai Festival City, Jebel Ali Golf Resort & Spa, Jumeirah Etihad Towers, Linklaters, Momentum Logistics, Mubadala, Murjan Marinas, Nokia, Sheikha Salama bint Hamdan Al Nahyan Foundation, The Club, TimeOut Dubai, and the Young Presidents Organisation

Identification of Important Sea Turtle Areas (ITAs) for hawksbill turtles in the Arabian Region

We present the first data on hawksbill turtle post-nesting migrations and behaviour in the Arabian region. Tracks from 90 post-nesting turtles (65 in the Gulf and 25 from Oman) revealed that hawksbills in the Arabian region may nest up to 6 times in a season with an average of 3 nests per turtle. Turtles from Qatar, Iran and the UAE generally migrated south and southwest to waters shared by the UAE and Qatar. A smaller number of turtles migrated northward towards Bahrain, Saudi Arabia and one reached Kuwait. Omani turtles migrated south towards Masirah island and to Quwayrah, staying close to the mainland and over the continental shelf. The widespread dispersal of hawksbill foraging grounds across the SW Gulf may limit habitat protection options available to managers, and we suggest these be linked to preservation of shallow water habitats and fishery management. In contrast, the two main foraging areas in Oman were small and could be candidates for protected area consideration. Critical migration bottlenecks were identified at the easternmost point of the Arabian Peninsula as turtles from Daymaniyat Islands migrate southward, and between Qatar and Bahrain. Overall, Gulf turtles spent 68% of the time in foraging ground with home ranges of 40–60km2 and small core areas of 6km2. Adult female turtles from Oman were significantly larger than Gulf turtles by ~11cm x¯=81.4CCL and spent 83% of their time foraging in smaller home ranges with even smaller core areas (~3km2), likely due to better habitat quality and food availability. Gulf turtles were among the smallest in the world x¯=70.3CCL and spent an average of 20% of time undertaking summer migration loops, a thermoregulatory response to avoid elevated sea surface temperatures, as the Gulf regularly experiences sustained sea surface temperatures >30°C. Fishery bycatch was determined for two of the 90 turtles. These spatio-temporal findings on habitat use will enable risk assessments for turtles in the face of multiple threats including oil and gas industries, urban and industrial development, fishery pressure, and shipping. They also improve our overall understanding of hawksbill habitat use and behaviour in the Arabian region, and will support sea turtle conservation-related policy decision-making at national and regional levels.Emirates Wildlife Society–World Wild Fund for Nature. 7Days, Abu Dhabi Urban Planning Council, Bridgestone, CASP, College of the North Atlantic-Qatar, Deutsche Bank, Dubai Electricity & Water Authority, Dubai Festival City, Emirates Palace, Environment & Protected Areas Authority, Sharjah, Environment Agency–Abu Dhabi, Fairmont, Géant, Gulftainer, HSBC, Intercontinental, Dubai Festival City, Jebel Ali Golf Resort & Spa, Jumeirah Etihad Towers, Linklaters, Momentum Logistics, Mubadala, Murjan Marinas, Nokia, Sheikha Salama bint Hamdan Al Nahyan Foundation, The Club, TimeOut Dubai, and the Young Presidents Organisation