Determinants of never users of contraception-results from Pakistan demographic and health survey 2012-13

Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan.Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that non-users if convinced to adopt lactational amenorrhea method can shift to long term methods in future. Research shows that if non users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multi-collinearity, confounding and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years) were more prone to be never users as compared to those who were \u3e 30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children(\u3e 4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be non-users in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries

Client satisfaction: does private or public health sector make a difference? results from secondary data analysis in Sindh, Pakistan

{Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset (Sindh province) on a total of 3133 Married Women of Reproductive Age (MWRA) aged 15-49 years. Source of family planning (public/private sector) was the main exposure variable. Outcome variable was client satisfaction judged by ten different dimensions of client satisfaction. Means and standard deviations were calculated for continuous variable while for categorical variable frequencies and percentages were computed. For univariate analysis, Chi-square/Fisher Exact test was used to find an association between clients’ satisfaction in public and private sectors. Ten different multivariate models were made. Variables were checked for multi-collinearity, confounding and interaction, and then advanced logistic regression was used to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92,95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care (follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29

Altered platelet activating factor metabolism in insulin dependent diabetes mellitus

Diabetes mellitus is associated with several abnormalities of platelet function. Recent studies have shown that the blood level of platelet activating factor (PAF), a potent inducer of platelet aggregation, is elevated in insulin dependent diabetes mellitus (IDDM) and remains unchanged in non-insulin dependent diabetes mellitus (NIDDM) patients. However, the mechanism of this increase in PAF levels has not been determined. In this study we have measured the activity of plasma PAF acetylhydrolase (an enzyme that regulates PAF levels) and lipoprotein levels in control subjects and diabetic patients. The data presented show that plasma PAF acetylhydrolase activity is significantly decreased in IDDM and is not altered in NIDDM patients. The lipoprotein levels were similar in control and diabetic subjects and there was no correlation between lipoprotein levels and PAF acetylhydrolase activity. These results suggest that the elevated levels of PAF in IDDM patients could be due to a decrease in plasma PAF acetylhydrolase activity

Students' perceptions of the instructional quality of district hospital-based training.

Background: An innovative, three-year training programme, the Bachelor of Clinical Medical Practice (BCMP), for mid-level medical healthcare workers was started in 2009 by the Department of Family Medicine, University of Pretoria. Aim: To measure the students’ perceptions of the instructional quality of district hospitalbased training. Setting: Training of students took place at clinical learning centres in rural district hospitals in the Mpumalanga and Gauteng provinces. Methods: A survey using the MedEd IQ questionnaire was performed in 2010 and 2011 to measure BCMP second- and third-year students’ perceptions of instructional quality of district hospital-based training. The MedEd IQ questionnaire is composed of four subscales: preceptor activities, learning opportunities, learner involvement and the learning environment. Composite scores of instructional quality were used to present results. Results: The preceptor activities, learning opportunities and the learning environment were considered by second- and third-year BCMP students to be of consistently high instructional quality. In the area of learner involvement, instructional quality increased significantly from second to third year. Conclusion: Overall, instructional quality of district hospital-based training was high for both second- and third-year BCMP students, and the instructional quality of learner involvement being significantly higher in third year students. The MedEd IQ tool was a useful tool for measuring instructional quality and to inform programme quality improvement. Keywords: clinical associates, evaluation of medical education, mid-level healthcare workers, rural learning centres, rural medical education, student satisfaction

Data on electrical energy conservation using high efficiency motors for the confidence bounds using statistical techniques

In this article, we describe details of the data used in the research paper “Confidence bounds for energy conservation in electric motors: An economical solution using statistical techniques” [1]. The data presented in this paper is intended to show benefits of high efficiency electric motors over the standard efficiency motors of similar rating in the industrial sector of Pakistan. We explain how the data was collected and then processed by means of formulas to show cost effectiveness of energy efficient motors in terms of three important parameters: annual energy saving, cost saving and payback periods. This data can be further used to construct confidence bounds for the parameters using statistical techniques as described in [1]

Investigating Deep Learning Methods for Detecting Lung Adenocarcinoma on the TCIA Dataset

Lung cancer, one of the deadliest diseases worldwide, can be treated, where the survival rates increase with early detection and treatment. CT scans are the most advanced imaging modality in clinical practices. Interpreting and identifying cancer from CT scan images can be difficult for doctors. Thus, automated detection helps doctors to identify malignant cells. A variety of techniques including deep learning and image processing have been extensively examined and evaluated. The objective of this study is to evaluate different transfer learning models through the optimization of certain variables including learning rate (LR), batch size (BS), and epochs. Finally, this study presents an enhanced model that achieves improved accuracy and faster processing times. Three models, namely VGG16, ResNet-50, and CNN Sequential Model, have undergone evaluation by changing parameters like learning rate, batch size, and epochs and after extensive experiments, it has been found that among these three models, the CNN Sequential model is working best with an accuracy of 94.1% and processing time of 1620 seconds. However, VGG16 and ResNet50 have 95.0% and 93% accuracies along with processing times of 5865 seconds and 9460 seconds, respectively

Investigating Deep Learning Methods for Detecting Lung Adenocarcinoma on the TCIA Dataset

Lung cancer, one of the deadliest diseases worldwide, can be treated, where the survival rates increase with early detection and treatment. CT scans are the most advanced imaging modality in clinical practices. Interpreting and identifying cancer from CT scan images can be difficult for doctors. Thus, automated detection helps doctors to identify malignant cells. A variety of techniques including deep learning and image processing have been extensively examined and evaluated. The objective of this study is to evaluate different transfer learning models through the optimization of certain variables including learning rate (LR), batch size (BS), and epochs. Finally, this study presents an enhanced model that achieves improved accuracy and faster processing times. Three models, namely VGG16, ResNet-50, and CNN Sequential Model, have undergone evaluation by changing parameters like learning rate, batch size, and epochs and after extensive experiments, it has been found that among these three models, the CNN Sequential model is working best with an accuracy of 94.1% and processing time of 1620 seconds. However, VGG16 and ResNet50 have 95.0% and 93% accuracies along with processing times of 5865 seconds and 9460 seconds, respectively

A CNN Based Automated Activity and Food Recognition Using Wearable Sensor for Preventive Healthcare

Recent developments in the field of preventive healthcare have received considerable attention due to the effective management of various chronic diseases including diabetes, heart stroke, obesity, and cancer. Various automated systems are being used for activity and food recognition in preventive healthcare. The automated systems lack sophisticated segmentation techniques and contain multiple sensors, which are inconvenient to be worn in real-life settings. To monitor activity and food together, our work presents a novel wearable system that employs the motion sensors in a smartwatch together with a piezoelectric sensor embedded in a necklace. The motion sensor generates distinct patterns for eight different physical activities including eating activity. The piezoelectric sensor generates different signal patterns for six different food types as the ingestion of each food is different from the others owing to their different characteristics: hardness, crunchiness, and tackiness. For effective representation of the signal patterns of the activities and foods, we employ dynamic segmentation. A novel algorithm called event similarity search (ESS) is developed to choose a segment with dynamic length, which represents signal patterns with different complexities equally well. Amplitude-based features and spectrogram-generated images from the segments of activity and food are fed to convolutional neural network (CNN)-based activity and food recognition networks, respectively. Extensive experimentation showed that the proposed system performs better than the state of the art methods for recognizing eight activity types and six food categories with an accuracy of 94.3% and 91.9% using support vector machine (SVM) and CNN, respectively

Ventilator associated pneumonia in neonatal intensive care unit: Occurrence and risk factors

Objectives: To examine the occurrence of pneumonia linked with a ventilator in the neonatal intensive care unit and to determine the related risk factors.Purpose of study: To better identify the associated morbidity and mortality, pathophysiology, and recommended measures to avoid this disease, paediatric VAP diagnosis methods must become more standardized and exact.Study design: A cross-sectional studyPlace and Duration: This study was conducted at Aga Khan University hospital from May 2021 to May 2022Methodology: This study includes a total of 70 participants admitted in neonatal intensive care unit. All the patients were put under the ventilator for more than 2 days. At the time of admission, the X-ray of the chest was performed, and it was also performed every day. When certain organisms were present on the tracheal aspirate, ventilator-associated pneumonia (VAP) was diagnosed. After 2 days of ventilation, microbial analysis and gram staining were done for tracheal aspirates. They were later examined to determine the occurrence of nosocomial pneumonia and what are the risk factors linked with it. A Chi-square test and t-test were conducted to examine all the data. A confidence level of 0.05 was set.Results: Pneumonia associated with the ventilator occurred in 31.4% of the participants where a large number had developed it between 4-14 days after intubation. There were certain risk factors that were determined in our research. They include the use of H2 blockers, invasive lines, low PaO2/FiO2, and re-intubation. There were two things (use of steroids and enteral feeding through nasogastric) that were not linked with the occurrence of this pneumonia. The patients who were in the group of ventilator-associated pneumonia were having a longer time period of stay and mechanical ventilation.Practical implication: In newborn and paediatric intensive care units, VAP continues to be a significant and unresolved problem. The results of this study will highlight the numerous elements that significantly contribute to ventilator-associated pneumonia.Conclusion: The occurrence of pneumonia associated with ventilators is high. Those patients who were having above mentioned risk factors should require pay special attention towards prevention

UDC: 614.876:621.039.572:539.1.074

Mon i tor ing of ra di a tion lev els in and around the nu clear re search re ac tors is es sen tial to safe-guard ing life and the en vi ron ment. Back ground ra di a tion mon i tor ing at the Pa ki stan In sti tute of Nu clear Sci ence & Tech nol ogy (PINSTECH) has been car ried out since the early six ties, be-fore the crit i cal ity of the 5 MW Pa ki stan Re search Re ac tor, so as to con firm the safe op er a tion of PINSTECH nu clear fa cil i ties. In the pres ent study, am bi ent dose rate lev els were mea sured around PINSTECH by us ing TLD–200 (G-2 cards) in stalled at 15 dif fer ent lo ca tions over a five year pe riod (1998-2002). The mean dose rates for in di vid ual lo ca tions in the said pe riod ranged from 0.14 � 0.01 to 0.19 � 0.03 µSv/h, with a mean value of 0.16 � 0.03 µSv/h. The cu-mu la tive av er age an nual ef fec tive dose equiv a lent spread over 5 years was 204.4 � 17 µSv. The data were com pared with the world and av er ages in other coun tries. It was con cluded that, from the health haz ard point of view, the op er a tion of re search re ac tors and other nu clear fa cil i-ties at PINSTECH pres ents no risk to pub lic health. Key words: en vi ron men tal ra di a tion, am bi ent dose rate, an nual ef fec tive doses, sea sonal vari a tion, re search re ac tors, thermoluminescence do sim e ter IN TRO DUC TIO