Impact of Education and Employment on Women Empowerment

This study is an endeavor to examine the status of women and most importantly the impact of education and employment on women empowerment in Quetta. Balochistan, Pakistan’s most rich and undeveloped Province in which most of the women in particular are still kept deprived of the facilities such as education and work/ employment, to be economically and educationally strong. Cross section, descriptive, and empirical study was done using survey technique method to gather information from the educated and employed women of Quetta district. The result indicates that education and employment have high significant positive relationship with women empowerment in decision making, control over the resources and voice. Education helps women get employment and employment makes them financially independent and economically strong which then leads to their empowerment. When women are empowered they reach out and empower other women. Research findings will definitely help the future researchers to understand influence of education and employment on women residing in Quetta, Pakistan to improve their ability to make strategic life choice to attain the capability desired for them and her family members, moreover the finding also provides a view on the status of women residing in Quetta

Association of Beta-2 Adrenoreceptor Single Nucleotide Polymorphism with Risk of Type II Diabetes Mellitus

Objective: To determine the genotype of Arg16Gly & Gln27Glu polymorphism in type-2 diabetes mellitus and to find possible association of ADRβ2with type-2 diabetes mellitus. Methodology: A case control study was designed and a total of 192 subjects (98 in each group) were included. After formal approval, subjects were recruited from North West General Hospital (NWGH) Peshawar. After taking consent blood samples were collected from the participants and DNA analysis was done using commercially available kits by salting out protocols, while other biochemical parameters were analyzed using normal laboratory protocols for respective tests. Results: The comparative analysis of SNP rs1042713 indicates that allele G/A was 42(49.4%) in diabetic and 43(50.6%) in non-diabetic subjects. While GG was more frequent 22(59.5%) in diabetic as compare to non-diabetic 15(40.5%). Among AA allele, 19 (65.5%) were non-diabetic while 10(34.5%) were diabetic. However the difference was not statistically significant (p=0.22). In case of “rs1042714” gene the commonest allele was C/C 80 (41.7%) out of which, 47(58.8%) was found in diabetic and 33(41.2%) were non-diabetic. Similarly CG was second common allele out of which diabetics were 27(44.3%) while non-diabetics were 34(55.7%). Allele G/G was found only among 11 subjects (p=0.085). Conclusion: Based on the result of the present study, it is concluded that polymorphism in ADRB2 genes rs1042713 (Arg16Gly) and rs1042714 (Gln27Glu) is associated with susceptibility of T2DM through alteration in BMI & HbA1c

An updated checklist of Pteridophytes of district Mansehra, Khyber Pukhtunkhwa-Pakistan

Critical examination of the pteridophytes of District Mansehra based on our own field surveys and previous literature as well revealed the occurrence of total 130 taxa distributed in 34 genera and 17 families. Of these, 23taxa are new records for the study area, while Polystichum obliquum (D. Don) T. Moore  is reported for the first time for Pakistan. Nomenclatural reassessment of previously reported taxa suggests that 23 taxa are now synonyms. Habitat-wise, 68 taxa are terrestrial, while 54 are epilithic, 5exist as epiphytes and the remaining 3 are aquatic

Breach of Psychological Contract, Task Performance, Workplace Deviance: Evidence from Academia in Khyber Pukhtunkhwa, Pakistan

This study aims to examine the effects of breach of psychological contract on task performance, workplace deviance in higher educational institutions of Khyber Pakhtunkhwa, Pakistan. A conceptual framework has been developed based on previous findings examining the effect of breach of psychology contract on interpersonal and workplace deviance and ultimately on task performance. Survey data was collected from 225 faculty members of private sector universities in Khyber Pakhtunkhwa. It was found that there was a negative relationship between psychological contract breach and task performance. Further, organizational deviance has partially and interpersonal deviance has fully mediated the relationship between psychological contract breach and task performance. Findings, as usual have supported our expectations, but more so for interpersonal deviance and less so for organizational deviance. The present study is unique in many ways. On the basis of empirical analysis this study suggests that breach of psychological contract leads to low task performance. Few studies are conducted by examining these variables together. In addition, the present study has taken both interpersonal and organizational deviance as a mediator. Pakistan is under research country. This study has filled the gap by examining the effect of breach of psychological and its outcome in a novel culture of Pakistan

Prevalence and possible factors associated with anaemia, and vitamin B \u3csub\u3e\u3csub\u3e12\u3c/sub\u3e\u3c/sub\u3e and folate deficiencies in women of reproductive age in Pakistan: Analysis of national-level secondary survey data

Objective: To determine the prevalence and possible factors associated with anaemia, and vitamin B12 and folate deficiencies in women of reproductive age (WRA) in Pakistan.Methods: A secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels \u3c12 g/dL, vitamin B12 deficiency as serum vitamin B12 levels of \u3c203 pg/mL (150 pmol/L) and folate deficiency as serum folate levels \u3c4 ng/mL (10 nmol/L).Results: A total of 11751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12 deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95%CI 1.04 to 1.09)P\u3c0.00, food insecure with moderate hunger (RR 1.03; 95%CI 1.00 to 1.06)P=0.02, four or more pregnancies (RR 1.03; 95%CI 1.01 to 1.05)P\u3c0.00, being underweight (RR 1.03; 95%CI 1.00 to 1.05)P=0.02, being overweight or obese (RR 0.95; 95%CI 0.93 to 0.97)P\u3c0.00 and weekly intake of leafy green vegetables (RR 0.98; 95%CI 0.95 to 1.00)P=0.04. For vitamin B12 deficiency, a positive association was observed with rural population (RR 0.81; 95%CI 0.66 to 1.00)P=0.04, living in Khyber Pakhtunkhwa province (RR 1.25; 95%CI 1.11 to 1.43)P\u3c0.00 and living in Azad Jammu and Kashmir (RR 1.50; 95%CI 1.08 to 2.08)P=0.01. Folate deficiency was negatively associated with daily and weekly intake of eggs (RR 0.89; 95%CI 0.81 to 0.98)P=0.02 and (RR 0.88; 95%CI 0.78 to 0.99)P=0.03.Conclusions: In Pakistan, anaemia, and vitamin B12 and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12 and folate deficiencies among Pakistani women

Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data

Objective: To determine the prevalence and possible factors associated with anaemia, and vitamin B12 and folate deficiencies in women of reproductive age (WRA) in Pakistan. Methods: A secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels /dL, vitamin B12 deficiency as serum vitamin B12 levels of /mL (150 pmol/L) and folate deficiency as serum folate levels /mL (10 nmol/L). Results: A total of 11 751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12 deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95% CI 1.04 to 1.09) PConclusions: In Pakistan, anaemia, and vitamin B12 and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12 and folate deficiencies among Pakistani women

A mixed methods study to assess the effectiveness of food-based interventions to prevent stunting among children under-five years in districts Thatta and Sujawal, Sindh province, Pakistan: study protocol

Background: Maternal and child malnutrition is widely prevalent in low and middle income countries. In Pakistan, widespread food insecurity and malnutrition are the main contributors to poor health, low survival rates and the loss of human capital development. The nutritional status trends among children exhibit a continuous deteriorating with rates of malnutrition exceeding the WHO critical threshold. With the high prevalence of maternal and child malnutrition, it is important to identify effective preventative approaches, especially for reducing stunting in children under-five years of age. The primary aim of this study is to assess the effectiveness of food-based interventions to prevent stunting in children under-five years. Methods: A mixed methods study design will be conducted to evaluate the effectiveness of food-based interventions to prevent stunting among children under-five years in districts Thatta and Sujawal, Sindh Province, Pakistan. The study will include cross sectional surveys, a community-based cluster randomized controlled trial and a process evaluation. The study participants will be pregnant women, lactating mothers and children under-five years. The cross-sectional surveys will be conducted with 7360 study participants at baseline and endline. For the randomized control trial, 5000 participants will be recruited and followed monthly for compliance of food-based supplements, dietary diversity, pregnancy outcomes, and maternal and child morbidity and mortality. Anthropometric measurements and hemoglobin levels will be measured at baseline, quarterly and at endline. The interventions will consist of locally produced lipid-based nutrient supplement (Wawamum) for children 6–23 months, micronutrient powders for children 24–59 months, and wheat soya blends for pregnant and lactating mothers. Government lady health workers will deliver interventions to participants. The effectiveness of the project will be measured in terms of the impact of the proposed interventions on stunting, nutritional status, micronutrient deficiencies, and other key indicators of the participants. The process evaluation will assess the acceptability, feasibility and potential barriers of project implementation through focus group discussions, key informant interviews and household surveys. Data analysis will be conducted using STATA version 12. Discussion: There is considerable evidence on the effectiveness of food-based interventions in managing stunting in developing countries. However, these studies do not account for the local environmental factors and widespread nutrient deficiencies in Pakistan. These studies are often conducted in controlled environments, where the results cannot be generalized to programs operating under field conditions. The findings of this study will provide sufficient evidence to develop policies and programs aimed to prevent stunting in children 6–59 months and to improve maternal and child health and growth outcomes in poor resource setting

Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study

Background: Globally, clinical certification of the cause of neonatal death is not commonly available in developing countries. Under such circumstances it is imperative to use available WHO verbal autopsy tool to ascertain causes of death for strategic health planning in countries where resources are limited and the burden of neonatal death is high. The study explores the diagnostic accuracy of WHO revised verbal autopsy tool for ascertaining the causes of neonatal deaths against reference standard diagnosis obtained from standardized clinical and supportive hospital data. Methods: All neonatal deaths were recruited between August 2006 –February 2008 from two tertiary teaching hospitals in Province Sindh, Pakistan. The reference standard cause of death was established by two senior pediatricians within 2 days of occurrence of death using the International Cause of Death coding system. For verbal autopsy, trained female community health worker interviewed mother or care taker of the deceased within 2–6 weeks of death using a modified WHO verbal autopsy tool. Cause of death was assigned by 2 trained pediatricians. The performance was assessed in terms of sensitivity and specificity. Results: Out of 626 neonatal deaths, cause-specific mortality fractions for neonatal deaths were almost similar in both verbal autopsy and reference standard diagnosis. Sensitivity of verbal autopsy was more than 93 % for diagnosing prematurity and 83.5 % for birth asphyxia. However the verbal autopsy didn’t have acceptable accuracy for diagnosing the congenital malformation 57 %. The specificity for all five major causes of neonatal deaths was greater than 90 %.Conclusion: The WHO revised verbal autopsy tool had reasonable validity in determining causes of neonatal deaths. The tool can be used in resource limited community-based settings where neonatal mortality rate is high and death certificates from hospitals are not available

Immersive horizons: navigating ethical terrain and practical boundaries in the use of virtual reality for cancer symptom management – a comprehensive narrative review

Cancer is a significant healthcare problem. However, advancements in diagnostic procedures and therapeutic modalities have led to a decline in cancer mortality rates by 1% annually in most countries. Cancer patients often experience symptoms such as pain, cancer-related fatigue, anxiety, and lymphedema. To counter these side effects, there have been tremendous efforts. One such effort is the use of virtual reality (VR) technology, which is an interactive technology. VR has played a significant role in managing disorders such as phobias and anxiety disorders, and support for patients with cognitive and physical rehabilitation, acute and chronic pain management, and emotional support in different settings such as during hospitalizations. Our team conducted an extensive search for electronic literature on virtual reality in various databases, such as Medline, PubMed, Google Scholar, and Psych INFO, up to July 2023. We used keywords like "virtual reality," "cancer care," "depression," "cognition," "pain," "telemedicine," "rehabilitation care," "physical therapy," "radiotherapy," "telerehabilitation," "avatar," "video games," and "visual aid" as our search criteria. VR interventions for cancer patients include exposure therapy, psycho-education, and relaxation techniques, which have been shown to reduce symptoms significantly. VR distraction can also mitigate pain during medical procedures. Studies suggest that VR holds promise in rehabilitation and oncologic treatment, as it can improve function metrics, range of motion, and motivation for treatment. The review scrutinizes the use of digital information and virtual reality technology to alleviate cancer-related distress by providing remote care.

Effectiveness of unconditional cash transfers combined with lipid-based nutrient supplement and/or behavior change communication to prevent stunting among children in Pakistan: A cluster randomized controlled trial

Background: In Pakistan, the prevalence of stunting among children under-five years has remained above WHO critical thresholds (≥30%) over the last two decades.Objective: We hypothesized that an unconditional cash transfer (UCT) combined with lipid-based nutrient supplement (LNS) and/or social and behavior change communication (SBCC) will prevent stunting among children 6-23 months of age.Design: This was a four-arm, community-based cluster randomized controlled trial conducted in the district of Rahim Yar Khan, Pakistan. A total of 1729 children (UCT n = 434); (UCT+SBCC n = 433); (UCT+LNS n = 430) and (UCT+LNS+SBCC n = 432) were enrolled at 6 months of age and measured monthly for 18 months until the age of 24 months.Results: At 24 months of age, children who received UCT+LNS (rate ratio [RR], 0.85 [95% CI 0.74, 0.97]; P = 0.015); and UCT+LNS+SBCC (RR, 0.86 [95% CI 0.77, 0.96]; P = 0.007) had significantly lower risk of being stunted as compared to the UCT arm. No significant difference was noted among children who received UCT+SBCC (RR, 1.03 [95% CI 0.91, 1.16]; P = 0.675) in the risk of being stunted as compared to the UCT arm. The pooled prevalence of stunting among children 6-23 months was 41.7%, 44.8%, 38.5% and 39.3% in UCT, UCT+SBCC, UCT+LNS and UCT+LNS+SBCC, respectively. In pairwise comparisons, a significant impact on stunting among children in UCT+LNS (P = 0.029) and UCT+LNS+SBCC (P = \u3c0.001) was noted as compared to UCT arm.Conclusions: UCT combined with LNS and UCT+LNS+SBCC were effective in reducing the prevalence of stunting among children aged 6-23 months in marginalized populations. UCT+SBCC was not effective in reducing the child stunting prevalence.Clinical trial registration number: ClinicalTrials.gov NCT03299218