The Role of Fathers’ Expressed Emotions in Psychopathology and Social-Emotional Competence in Adolescents

Background: To study the role of fathers’ expressed emotions in psychopathology and social-emotional competence in adolescents. Methods: Through observational research design a study was conducted in the district Gujrat Pakistan from July 2020 to march 2021.As the inclusion criteria of the study was to include adolescents whose age range was 12 to 19 and the only fathers included whose children were adolescents. So the purposive sampling technique was used and five hundred adolescents were selected from different colleges and schools, five hundred fathers of same adolescents   approached from the community and their working places. For this purpose Parental Expressed Emotions Scale 1 was used and to assess the psychopathology (Social anxiety) and social-emotional competence in adolescents, Social Anxiety Scale,2 and Social Emotional-Competence Scale 3 were used and data was analyzed by using SPSS-21. Results: A total of 500 adolescents selected for study whose age range was from 12-19 years 4 and mean age of 16 years. In which 229 (46%) were boys and 271 (54%) were girls. Simple linear regression was used to see the effects of father expressed emotions in psychopathology and social-emotional competence in adolescents. Results showed significant difference in negative and positive expressed emotions of father. Father’ expressed emotions of critical comments caused 56%and hostility 64% predictor of social anxiety in adolescents. On the other hand father emotional -over involvement caused 11% warmth 37% and positive remarks 17% increase in social-emotional competence of adolescents. Conclusion: Father expressed emotions found to be significant predictor of social anxiety and social-emotional competence in adolescents

Oral Health Status Among Pregnant Women Attending Gynae OPD of Tertiary Care Hospital in Rawalpindi

Objective: The objectives of this study were to determine the oral health status and treatment needs using DMFT & CPITN indices in pregnant women attending Gynae OPD of tertiary care Hospital in Rawalpindi, to Determine Association of Oral health status using DMFT and CPITN with socioeconomic status and to determine oral health status of various trimesters of pregnancy Materials and methods: An analytical cross-sectional study was carried out to assess the oral health status and treatment needs among pregnant women at Tertiary Care Hospital, Rawalpindi from April’ 2020 to September’ 2020. Consecutive sampling was used to select the study participants. An adaptive version of WHO questionnaire was used. Results were presented in the form of frequency tables. Chi square test of statistics was applied to assess the association between categorical DMFT and CPITN with the sociodemographic characteristics of the participating females. Results: The mean DMFT score pregnant females was 2.41 + 2.30 and were belonged to a middle socioeconomic status 43.8% (n=173). About 61.8% (n=244) of participants had DMFT total score 1-7. Whereas, majority of the participants were reported bleeding gums on probing 30.6% (n=121) on assessment by CPITN. The participating pregnant females also depicted the worsening of periodontal tissues (P=0.00) and dentition status (P=0.02). Socioeconomic status was not significantly associated with dentition (P=0.39) and periodontal status (P=0.69). Conclusion: The study revealed that oral health status was deteriorated during pregnancy. Education and gestational period were strong indicator for oral health status among pregnant women. Bleeding gums were reported in majority of participants during second trimester of pregnancy. Socioeconomic status was not significantly associated with oral health status by CPITN and DMFT score

Depression, Anxiety and Stress in Female Doctors: A Cross Sectional Study from Rawalpindi

Introduction: Studies have shown that toiling in the medical field, especially in comparison to other professions is stressful. There is evidence that depression leads to reduced productivity in the workplace. Poor clinical judgement, increased chances of error in patient care and absenteeism all lead to reduced quality of work. Female doctors, in particular, are vulnerable to mental health issues owing to elements such as bullying, workplace sexual harassment, long working hours, frantic shifts, and domestic commitments. Materials and Methods: Over a six-month period (June 2020 to November 2020), we conducted a cross-sectional survey in three tertiary care hospitals in Rawalpindi, two of which were public sector and one private sector. We collected 328 samples by means of non-probability consecutive sampling. We used the Depression, Anxiety, and Stress Scale (DASS), a 42-item questionnaire via Lovibond and Lovibond with a Cronbach’s alpha of 0.89. Mean and SD of DASS total and subscale scores were compared for subjects stratified by age, marital status, designation, hospital status, and monthly household income via Student t-test and ANOVA. Results: The total mean DASS score reported by our participants was 31±26.92. Total mean DASS scores were significantly greater in House Officers and decreased as the designation rank increased (p=0.007). Mean DASS subscale scores showed that the junior female doctors were significantly more anxious (p=0.004) and depressed (p=0.041) compared to the senior doctors. However, there was no significant difference in stress scores, indicating that all the female doctors that participated were experiencing stress regardless of their designation. There was also no significant difference in DASS scores between private and public sector hospitals. Conclusion: Female doctors working in tertiary care hospitals of Rawalpindi reported depression, anxiety, and stress. Steps need to be taken to reduce risk factors for these mental health issues in order to boost workplace satisfaction and productivity

Depression, Anxiety and Stress in Young Female Doctors is Associated with High Sexual Harassment Scores

Background: Sexual harassment, a known cause of stress in females, makes them vulnerable to mental health issues and affects their professional performance. The objectives of the study were to assess the frequency of sexual harassment among female doctors based on age, designation, marital status, and household income, and to find out the association between sexual harassment and depression, anxiety, and stress in female doctors. Methods: A cross-sectional study was conducted at three tertiary care hospitals of Rawalpindi. on n=328 female doctors including House officers, Post Graduate Trainees, Senior Registrars, Assistants, Associates and Full Professors. We used the Sexual Harassment Experience Questionnaire and the Depression, Anxiety and Stress Scale to assess sexual harassment and depression, anxiety and stress scores, p-value <0.05 was considered statistically significant. Results: The mean age of 301 female doctors was 30.12±7.8 years, equally represented from public and private hospitals. Mostly were married 154 (51.2%), working as House Officers 126(41.9%), The mean score on the Sexual Harassment Experience Questionnaire was 48.23±14.84, with higher scores (52.83±16.2) in unmarried females (≤30 years), working in junior levels in public sector hospitals (p=0.001). A significant positive correlation (0.471) between the Sexual Harassment Experience Questionnaire and Depression Anxiety and Stress Scale scores was observed. Conclusion: The incidences of sexual harassment were seen more in younger, unmarried junior female doctors. Higher Depression, Anxiety and Stress were found positively associated with higher Sexual Harassment scores. Hospitals should develop policies to protect female healthcare workers especially junior doctors, to minimize workplace sexual harassment negativity on mental health. Keywords: Sexual Harassment; Depression; Anxiety; Female; Hospitals

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

sj-docx-2-obm-10.1177_1753495X241234961 - Supplemental material for Vascular endothelial growth factor/platelet ratio as a potential biomarker for preeclampsia: A study of angiogenic markers in Pakistani patients

Supplemental material, sj-docx-2-obm-10.1177_1753495X241234961 for Vascular endothelial growth factor/platelet ratio as a potential biomarker for preeclampsia: A study of angiogenic markers in Pakistani patients by Feriha Fatima Khidri, Yar Muhammad Waryah, Roohi Nigar, Zaib-Un-Nisa Mughal, Jawaid Ahmed Zai, Ali Raza Rao, Ikram Din Ujjan and Ali Muhammad Waryah in Obstetric Medicine</p

sj-jpg-1-obm-10.1177_1753495X241234961 - Supplemental material for Vascular endothelial growth factor/platelet ratio as a potential biomarker for preeclampsia: A study of angiogenic markers in Pakistani patients

Supplemental material, sj-jpg-1-obm-10.1177_1753495X241234961 for Vascular endothelial growth factor/platelet ratio as a potential biomarker for preeclampsia: A study of angiogenic markers in Pakistani patients by Feriha Fatima Khidri, Yar Muhammad Waryah, Roohi Nigar, Zaib-Un-Nisa Mughal, Jawaid Ahmed Zai, Ali Raza Rao, Ikram Din Ujjan and Ali Muhammad Waryah in Obstetric Medicine</p