Safety of medical device users: A study of physiotherapists’ practices, procedures and risk perception

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Aims: To study practices and procedures with respect to electrotherapy in physiotherapy departments and to study physiotherapists’ perception of health risk, health consequences and protection of health from different risks including electromagnetic field emissions from electrotherapy devices. Methods: This cross-sectional study was conducted in three phases from June 2002 to December 2003. The first phase was an audit of the practices and procedures regarding electrotherapy in National Health Service physiotherapy departments (N = 46 including 7 departments in pilot study) located in 12 counties in the southeast and southwest of England including Greater London. The second phase comprised one observational visit to each of the same physiotherapy departments to characterise their occupational environment. The third phase was a questionnaire survey of 584 physiotherapists working in these departments. Variables concerned perception of health risk, health consequences and protection of health associated with different risk factors. Results: In the first two phases, the recruitment rate of the departments was 80.7% (46 out of 57) and response rate of those recruited was 100% (n=46). The response rate for the last phase of the study was 66.8% (390 out of 584). Results of the practices and procedures audit show that ultrasound was the most common form of electrotherapy while microwave diathermy was neither available nor used in these departments. Pulsed shortwave diathermy was used 4-5 days per week while continuous shortwave diathermy was used rarely. Electrotherapy was provided to up to 50% of patients per week in the departments. The observational visits to the departments revealed that there were metallic objects within close proximity of diathermy equipment and wooden treatment couches for treatment with PSWD and CSWD were rare. The risk perception survey showed that physiotherapists generally perceived a moderate health risk and health consequences (harm) from exposure to EMF emissions from electrotherapy devices. Protection from EMFs in physiotherapy departments was generally perceived as ‘usually’ possible. Conclusions: Physiotherapy departments report safe electrotherapy practices. Use of diathermy devices that use RF EMFs is declining. The key predictors of physiotherapists’ perception of health risk were perception of health consequences and vice versa. Gender was a significant predictor of the perception of health risks and health consequences. The main predictor of perception of protection against risk was the knowledge of environmental and health issues. Latent dimensions of perceptions of health risk, health consequences and protection from risk were identified and confirmed and their predictors were determined.Brunel Universit

Checklist of Medicinal Plants of Siran Valley, Mansehra, Pakistan

This study was carried in Siran Valley district Mansehra. (Pakistan). The method adopted for documentation of indigenous knowledge was based on questionnaire consisting of semi-structured interviews employing a checklist of questions and direct observations. The aim of the study was to collect indigenous knowledge of local inhabitants about the use of native plants, which were being utilized by the people for the treatment of different diseases. The ethnomedicinal uses of 80 plant species belonging to 49 families were recorded during field trips from the research area. The cultivated medicinal plants consists of 21 species. The checklist and ethnomedicinal inventory was developed alphabetically by botanical name, followed by local name, family, part used and ethnomedicinal uses. Plant specimens were collected, identified, preserved, mounted and voucher was deposited in the Department of Plant Sciences, Quaid-I-Azam University, Islamabad, for future references

Common Medicinal Folk Recipes of Siran Valley, Mansehra, Pakistan

The present studies were aimed to investigate ethnomedicinal folk recipes used to cure different diseases in the study area. Questionnaire method was adopted for documentation of folk indigenous knowledge. The interviews were carried out in local community, to investigate local people and knowledgeable persons (Hakims, Women and Herdsmen) who are the main user of medicinal plants. The ethnomedicinal data on 44 plant species belonging to 31 families were recorded during field trips from different villages of the area. The botanical name, followed by local name, family, part used and ethnomedicinal uses in different folk recipes was recorded. Plants were collected, pressed, dried, preserved, mounted and identified through the available literature (Nasir& Ali, 1971-2001) and were confirmed by the experts in Department of Biology, Quaid-I-Azam University, Islamabad. The specimens were deposited in the Herbarium, Department of Plant Sciences, and Quaid-I-Azam University, Islamabad, Pakistan (ISL)

Inter-industry Wage Differentials in Pakistan

The essential feature of a perfectly competitive labour market is that workers who accept jobs can expect to receive compensation equal to their opportunity cost. Firms pay a wage which is just sufficient enough, to attract workers of the quality they desire and no higher [Krueger and Summers (1988)]. Overall, the markets do not follow the law of one price, contradicting the competitive framework. This is where the problem of wage differentials across different industries needs to be assessed, and has also been the focus of many studies over the years, mainly in the industrialised countries, e.g. USA, European Countries. However, the issue of wage differentials has been addressed by very few studies in the developing countries [Arbache (2001) and Erdil, et al. (2001)]. Wage differentials analysis in developing countries should also have equal importance as in the industrialised countries, in order to gauge the effect of the corporate culture and centralisation/decentralisation on the different industries and labour market of those developing countries

Developing medical device technologies from users' perspectives: A theoretical framework for involving users in the development process

Objectives: The aim of this study was to suggest an acceptable and generic theoretical framework for involving various types of users in the medical device technology (MDT) development process (MDTDP).Methods: The authors propose a theoretical framework suggesting different routes, methods and stages through which various types of medical device users can be involved in the MDTDP.Results: The suggested framework comprises two streams of users' involvement in MDT development, that is, what might be called the end users' stream and the professional users' stream for involving these two groups respectively in the process of developing both simple and more complex and innovative medical devices from conceptualization through to the market deployment. This framework suggests various methods that can be used for users' involvement at different stages of the MDT lifecycle. To illustrate the application of the framework, several MDT development scenarios and device exemplars are presented.Conclusions: Development of medical devices from users' perspectives requires not only the involvement of healthcare professionals but also that of the ultimate end users, that is, patients, people with disabilities and/or special needs, and their caregivers. The evidence shows that such end users quickly discard devices that do not fulfill their personal expectations, even though both manufacturers and healthcare professionals may consider those end users' requirements met. Developers and manufacturers need to recognize this potent potential discrepancy between the parties involved, and involve end users and professional healthcare staff directly in the MDTDP. The framework, the authors contend, is a step forward in helping medical device manufacturers plan and make decisions about users' involvement at different stages of the MDTDP

Impact of Foreign Remittances on Financial Development of Pakistan

Purpose: Mostly developing countries are not receiving the remittances with same speed as compared to workers’ outflow. This cumbersome situation allows developing countries to go to external source of funding (debt) for economic and financial development-FD. Thus, the purpose of this paper is to investigate the nexus between FD and remittances in Pakistan for the period 1976-2015.   Design/Methodology/Approach: The study utilizes the time series annual data for the period 1976-2015. Data were taken from different sources like world bank data source and different economic surveys of Pakistan.  To evaluate the long run relationships between FD and remittances, Auto Regressive Distributed Lag (ARDL) strategy is utilized. Findings: The empirical results indicate that remittances have a significant positive impact on FD (M2/GDP) except for CPS/GDP measure of FD which has insignificant positive coefficient. Implications/Originality/Value: Most of previous literature measured FD with the ratio of money supply to GDP (M2/GDP) however, the current study measured with two indicators i.e. the ratio of money supply to GDP (M2/GDP) and the ratio of bank credit to GDP (CPS/GDP). This is the main contribution in the literature. The study recommends that remittances channelize financial segment of the country in augmented manner and government should encourage Pakistani expatriates to send the remittance through formal sources (e.g. banks). Financial institutions and intermediaries working in Pakistan should exaggerate the recruitment of remittances with the purpose to make them significant source for loanable funds. In addition to this, the concern department should simplify the procedure for sending remittances

Ethnobotanical study of some medicinal plants from tehsil BudhaL, District Rajouri, (Jammu and Kashmir)

An ethno-botanical survey was carried out in Tehsil Budhal of District Rajouri for documentation and information from local tribal communities (Gujjar and Bakerwals) about the ethno-medicines uses of plants. The indigenous knowledge of local uses of plants by these tribal communities was collected through personal interviews during field of this hilly and far flung Tehsil of Jammu and Kashmir. Most of the ethno-medicinal knowledge about the local uses of the plants was poorly known by the locals of this hilly area because of the elders of this region died along the traditional knowledge of the plants as they failed to document or communicate the same to their offspring due to lack of education and writing skill. I made extensive survey and trips to reach the head men and oldest persons of these communities in the different villages of this Tehsil for gathering the long-hidden indigenous knowledge. This study is one of its kinds in this hilly and remotest Tehsil of Jammu and Kashmir State. While interviewing the tribal, they got delighted in expressing their indigenous knowledge about the local uses of plants in this area