Patient communication in radiology: current status of breaking bad news among radiologists and radiology trainees in Pakistan

Breaking bad news can be an intimidating task for any physician. The aim of this study was to record the practices of breaking bad news to the patients by Pakistani radiologists and trainees. The radiologists and trainees attending the 26th National Radiological Conference in October 2010 in Karachi, Pakistan, were surveyed. The response rate was 76%. The respondents included residents (51%), private practicing radiologists (28%), academic radiologists (13%), and other trainees (8%). Most of the academic radiologists communicated with their patients. The daily frequency of breaking bad news by residents was noted, which was highest in the public teaching hospitals (71%). For severe abnormalities such as malignancy, 50% residents, 55% of the academic radiologists and 74% of the private practicing radiologists were very uncomfortable in disclosure of results. Differences in frequency of communication with patients were noticed with both different training levels, and different settings of practice in a developing country

Volume Conduction Effects on Wavelet Cross-Bicoherence Analysis

Cross-bicoherence analysis is one of the important nonlinear signal processing tools which is used to measure quadratic phase coupling between frequencies of two different time series. It is frequently used in the diagnosis of various cognitive and neurological disorders in EEG (Electroencephalography) analysis. Volume conduction effects of various uncorrelated sources present in the brain can produce biased estimates into the estimated values of cross-bicoherence function. Previous studies have discussed volume conduction effects on coherence function which is used to measure linear relationship between EEG signals in terms of their phase and amplitude. However, volume conduction effect on crossbicoherence analysis which is quite a different technique has not been investigated up to now to the best of our knowledge. This study is divided into two major parts, the first part deals with the investigation of VCUS (Volume Conduction effects due to Uncorrelated Sources) characteristics on EEG-cross-bicoherence analysis. The simulated EEG data due to uncorrelated sources present in the brain was used in this part of study. The next part of study is based upon investigating the effects of VCUS on the statistical analysis of results of EEG-based cross-bicoherence analysis. The study provides an important clinical application because most of studies based on EEG cross-bicoherence analysis have avoided the issue of VCUS. The cross-bicoherence analysis was performed by detecting the change in MSCB (Magnitude Square CrossBicoherence Function) between EEG activities of change detection and no-change detection trials. The real EEG signals were use

Adaptation of Grid Tied Photovoltaic (GT-PV) System as Retrofit Renewable Energy Model for Single-Family House in UAE

Gulf Cooperation Countries (GCC) governments are encouraging advances in renewable energy and its deployment to reform domestic energy market policy. GCC countries including United Arab Emirates (UAE) all have begun to explore renewable energy technologies. This research intended to develop a framework model to use Grid Tied photovoltaic renewable energy (GT-PV) in the housing design of the GCC region particularly in UAE. In this regard, research has analyzed the various types of housing plans and worked out the possibilities of retrofit design to adapt renewable energy model to implement (GT-PV) in existing housing for their energy needs.  This study has determined the total energy need of each type of house, data of energy need was statically analyzed, and renewable energy output was calculated. The end result of research has surfaced a comprehensive model to design a grid-tied photovoltaic renewable energy system to cater the need for private housing in UAE

Factors That Influence Travelers’ Willingness to Adopt Bus Rapid Transit (Green Line) Service in Karachi

peer reviewedBus rapid transit (BRT) system is a sustainable mode choice alternative and traffic management method for traffic congestion problems in urban areas. As an extent of total demand management, BRT has broadly been implemented in many countries. BRT has proven to be progressive in alleviating traffic congestion and the difficulty of finding parking spaces in city centers. Currently, people driving their automobiles to work cause traffic congestion along Karachi’s main corridors. People cannot be persuaded to use public transit until their travel patterns are understood. Therefore, the disparity between public and private transportation must be addressed. This research aimed to develop a model to shift car travelers toward Karachi’s Green Line BRT and investigate the factors that influence car travelers’ decisions. A questionnaire-based survey was carried out on single-occupant vehicle (SOV) users in the Green Line corridor of Karachi. This study investigated the elements that influence SOV users’ willingness to adopt the BRT system and studied the possible ways of attracting car drivers to BRT. Data were examined using descriptive-analytic techniques such as the contingency table approach in conjunction with a Chi-square test of the independence/association model in SPSS. Furthermore, binary logistic regression was applied to the highly mediated associated variables. The research’s outcomes were geared at the imposition of parking fees at workplaces to deter individuals from parking their automobiles there. SOV travelers can be diverted to BRT services using this strategy. The research findings will assist policymakers and serve as a foundation for scientific investigations on the travel demand model for the BRT system.11. Sustainable cities and communitie

Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia:a Multinational Point Prevalence Study of Hospitalised Patients

Pseudornonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients

Wavelet Coherence Analysis of Change Blindness

Change blindness is the incapability of the brain to detect substantial visual changes in the presence of other visual interruption. The objectives of this study are to examine the EEG (Electroencephalographic) based changes in functional connectivity of the brain due to the change blindness. The functional connectivity was estimated using the wavelet-based MSC (Magnitude Square Coherence) function of ERPs (Event Related Potentials). The ERPs of 30 subjects were used and were recorded using the visual attention experiment in which subjects were instructed to detect changes in visual stimulus presented before them through the computer monitor. The two-way ANOVA statistical test revealed significant increase in both gamma and theta band MSCs, and significant decrease in beta band MSC for change detection trials. These findings imply that change blindness might be associated to the lack of functional connectivity in gamma and theta bands and increase of functional connectivity in beta band. Since gamma, theta, and beta frequency bands reflect different functions of cognitive process such as maintenance, encoding, retrieval, and matching and work load of VSTM (Visual Short Term Memory), the change in functional connectivity might be correlated to these cognitive processes during change blindness

The Relationship between Emotional Intelligence and Work Commitment: The Moderating Role of Organizational Culture

Purpose: The objective of this study is to investigate the relationship between emotional intelligence and work commitment through the moderating role of organizational culture. Design/Methodology/Approach: A sample of 351 teachers was randomly selected from public sector universities of Punjab, Pakistan. The data was acquired using a self-administered questionnaire. The study used the structural equational modeling technique (PLS-SEM) to test the hypothesized relationships. Findings: The result showed a differential impact of all the dimensions of emotional intelligence on work commitment.  The results showed a significant positive relationship between the interpersonal dimension and work commitment and a significant negative relationship between the adaptability dimension and work commitment. The remaining dimensions of emotional intelligence were found to have an insignificant relationship. However, hierarchy culture moderated the relationship between emotional intelligence and work commitment. Implications/Originality/Value: The results highlight the significance of emotional intelligence and hierarchy culture for university teachers. The study suggests university authorities to invest in organizational culture to develop and improve emotional intelligence competencies among university teachers to enhance work commitment

Acute appendicitis: Diagnostic accuracy of Alvarado scoring system

Objective: To evaluate the usefulness of the Alvarado scoring system in reducing the percentage of negative appendectomy in our unit. Materials and methods: A cross-sectional study was conducted, comprising 110 patients, admitted to Surgical Unit I, Civil Hospital, Karachi, in 2011 with a preliminary diagnosis of acute appendicitis. Patients of both sexes and all age groups except younger than 10 years were included in the study and their Alvarado scores calculated, on the basis of which patients were divided into two groups: Group A (Alvarado score <6) and Group B (Alvarado score ≥6). The signs, symptoms, laboratory values, surgical interventions, and pathology reports of each patient were evaluated. Diagnosis was confirmed by histopathological examination. Sensitivity, specificity, and positive and negative predictive values were calculated. Results: Out of 110 cases (79 males, 31 females), 31 belonged to Group A (28.2%) and 79 belonged to Group B (71.8%). Surgical procedures were performed in 98.2% of cases, along with conservative treatment. Final diagnosis by histopathology was confirmed in 77 cases (71.3%). The overall negative appendectomy rate was 28.7% (males: 28.2%, females: 30%). Sensitivity and specificity of the Alvarado scoring system were found to be 93.5% and 80.6% respectively. Positive and negative predictive values were 92.3% and 83.3%, respectively, and accuracy was 89.8%. Conclusion: Alvarado score can be used effectively in our setup to reduce the incidence of negative appendectomies. However, its role in females was not satisfactory and needs to be supplemented by other means

Acute appendicitis: Diagnostic accuracy of Alvarado scoring system

To evaluate the usefulness of the Alvarado scoring system in reducing the percentage of negative appendectomy in our unit. A cross-sectional study was conducted, comprising 110 patients, admitted to Surgical Unit I, Civil Hospital, Karachi, in 2011 with a preliminary diagnosis of acute appendicitis. Patients of both sexes and all age groups except younger than 10 years were included in the study and their Alvarado scores calculated, on the basis of which patients were divided into two groups: Group A (Alvarado scor