Awareness about Workplace Harassment among Female Nursing Students and Nursing Staff of a Teaching Hospital in Lahore

Background: Harassment of working women is a common social and human rights problem and healthcare settings are no exception. This unacceptable situation has many avoidable determinants that need preventive measures to ensure, safe and secure working environment for nurses. Objectives: To assess the knowledge and understanding among female nursing students and nursing staff about workplace harassment in a tertiary healthcare facility. Methods: It was a cross-sectional study conducted at Tertiary care hospital Lahore from July to September 2018. Convenient sampling technique was used to collect data. Verbal informed consent of voluntary participants was taken. Anonymity and confidentiality was assured. SPSS version 21 was used for data analysis. The participants (n=80) comprised of senior female nurses students (62.5%) and senior nursing staff (37.5%), aged 18 to 46 years. Results: Awareness about common harassment forms was adequate (81.3%). Adverse effects included mental health problems (83.8%) and low self-esteem (72.5%). A large percentage of nurses (62.5%) intended to report such personal incident to institutional head and 72.5% were willing to accompany victims for such reporting. 77.5% desired arranging informative sessions and holding counseling for victims (78.8%) at workplace. Only 22.5% had vague idea about official protective legal frameworks. Conclusions: Workplace harassment of female workers is quite prevalent but under-reported phenomena in Pakistan. All organizations and institutions must have a harassment policy to protect the females.

Statistical optimization of zinc oxide nanorod synthesis for photocatalytic degradation of methylene blue

In this work, synthesis process parameters of Zinc Oxide nanorods (ZnO NRs) photocatalyst is optimized using Taguchi Method to obtain the highest degradation rate of Methylene Blue dye, MB. The Taguchi L27 (38) orthogonal array technique was used to determine the optimum conditions for the synthesis of the nanostructured photocatalyst. Eight important synthesis process parameters were chosen in the analysis while the effects of the parameters were studied using signal-to-noise (S/N) ratio analysis using minitab-16. The ZnO NRs photocatalyst was synthesized via solution process route based on the parameters obtained from the layout of the orthogonal arrays. The optimized synthesized nanorods was then characterized using field emission scanning electron microscope (FESEM), X-ray diffraction (XRD), photoluminescence (PL), ultraviolet-visible near-infrared (UV-VIS-NIR), and Raman spectroscopies while the photodegradation of MB was determined by UV-VIS spectrum analysis under ultraviolet light irradiation. The results show that ZnO NRs with hexagonal wurtzite structure and bandgap energy of 3.25 eV have been obtained. The Taguchi analysis based on simulated experimental runs predicted the highest MB degradation percentage of 17.12% that can be achieved under optimum process conditions. Meanwhile, experimental photocatalytic degradation of MB using ZnO NRs synthesized under the same optimum condition achieved a degradation percentage of 17.27%, which deviates only 0.88% from the predicted value. This analysis could give an approach to optimize the synthesis process to ensure the good performance of nano-photocatalyst for the photodegradation of organic contaminations in industrial wastewater in a short time and cost-effective process

The Transit Phase of Migration: Circulation of Malaria and Its Multidrug-Resistant Forms in Africa

In the third article in a six-part <I>PLoS Medicine</I> series on Migration & Health, Cally Roper and Caroline Lynch use a case study of migration and anti-malarial drug resistance in Uganda to discuss the specific health risks and policy needs associated with the transit phase of migration

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

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

Construction of Positivity in Indian Scenario

Abstract- Positivity refers to the degree to which something is positive or the quality or state of being positive. Positivity is that which accepts the world as it is, takes inspiration from it and sees the brighter side of it. Positive Psychology, a newly developed branch of Psychology, is an evolving branch of psychology developed by Martin Seligman and Mihaly Csikszenmihalyi in 1998. It was developed in order to get an insight and understanding in to various dimensions of the concept of positivity. The aim of this branch of psychology was summed up by its authors in the following words: “We believe that a psychology of positive human functioning will arise that achieve a scientific understanding and effective interventions to build thriving in individuals, families and communities.” Positive psychologists seek to find and nurture genius and talent and to make normal life more fulfilling rather than treating mental illness. The paper deals with a study carried out on Indian adults (both young and middle-aged males and females) to understand what constitutes as ‘positive ’ in their lives with respect to their country, culture, education, family and relationships, life-style and changing trends, personal experiences, technology and sports. Open ended personal interviews of the sample were taken. The sample comprised of 80 subjects with the age group of youngsters ranging between 18-25, while that of the older group between 40-55 years. The content analysis of the interviews was done to understand the positivity in Indian perspective. The above study yielded a pleasantly surprising result—the common perception that we as a society are extremely negative and cynical in our attitude was found out to be completely untrue

The utility of pre-procedural COVID-PCR testing for dental aerosol generating procedures is questionable

Objectives: To compare the number of aerosol-generating procedures performed and the number of coronavirus disease-2019-positive workers in dental practice. Method: The audit study was conducted in May 2021 at the Aga Khan University Hospital, Karachi, and comprised data from April 1, 2020, to March 31, 2021, which was retrieved from dental clinics at the main hospital and its Clifton branch as well as in three secondary care hospitals in Garden, Kharadar, Karimabad areas of Karachi, and one in Hyderabad, Pakistan. Data of individuals who followed mandatory pre-procedural polymerase chain reaction testing in addition to using personal protective equipment in the main hospital and Clifton branch was placed in group A, and of those using personal protective equipment only at the 4 satellite clinics with no testing was placed in group B. Dental charts of patients who underwent dental aerosol-generating procedures were analysed. Number of dental clinics affected by coronavirus disease-2019 and number of dental patients who were reported positive on pre-procedural polymerase chain reaction testing were evaluated. Data was analysed using SPSS 23. Results: Of the 63 dental healthcare workers, 44(69.8%) were in group A and 19(30.2%) were in group B. In group A, 19(43.2%) were affected by coronavirus disease-2019 compared to 2(11%) in group B (p=0.01). Among 782(67.8%) patients who underwent polymerase chain reaction testing, 26(3.3%) turned out positive for coronavirus disease-2019. Due to the mandatory testing imposed on patients, 371/1153(32.2%) refused to get the desired dental treatment. Conclusion: The benefit of pre-procedural testing in dentistry remained uncertain

The utility of pre-procedural COVID-PCR testing for dental aerosol generating procedures is questionable

Objective: To compare the number of aerosol-generating procedures performed and the number of coronavirus disease-2019-positive workers in dental practice.Methods: The audit study was conducted in May 2021 at the Aga Khan University Hospital, Karachi, and comprised data from April 1, 2020, to March 31, 2021, which was retrieved from dental clinics at the main hospital and its Clifton branch as well as in three secondary care hospitals in Garden, Kharadar, Karimabad areas of Karachi, and one in Hyderabad, Pakistan. Data of individuals who followed mandatory pre 20 procedural polymerase chain reaction testing in addition to using personal protective equipment in the main hospital and Clifton branch was placed in group A, and of those using personal protective equipment only at the 4 satellite clinics with no testing was placed in group B. Dental charts of patients who underwent dental aerosol-generating procedures were analysed. Number of dental clinics affected by coronavirus disease 25 2019 and number of dental patients who were reported positive on pre-procedural polymerase chain reaction testing were evaluated. Data was analysed using SPSS 23.Results: Of the 63 dental healthcare workers, 44(69.8%) were in group A and 19(30.2%) were in group B. In group A, 19(43.2%) were affected by coronavirus disease-2019 compared to 2(11%) in group B (p=0.01). Among 782(67.8%) patients who underwent polymerase chain reaction testing, 26(3.3%) turned out positive for coronavirus disease-2019. Due to the mandatory testing imposed on patients, 371/1153(32.2%) refused to get the desired dental treatment.Conclusions: The benefit of pre-procedural testing in dentistry remained uncertain

Molarity Effects of Fe and NaOH on Synthesis and Characterisation of Magnetite (Fe₃O₄) Nanoparticles for Potential Application in Magnetic Hyperthermia Therapy

In this study, the effect of molarity on the structural, magnetic, and heat dissipation properties of magnetite nanoparticles (MNPs) was investigated to optimise the parameters for potential application in magnetic hyperthermia therapy (MHT). MHT works based on the principle of local temperature rise at the tumour site by magnetic iron oxide nanoparticles (MIONPs) with the application of an alternating magnetic field. MHT is a safe method for cancer treatment and has minimal or no side effects. Magnetite (Fe3O4) is the best material among MIONPs to be applied in local MHT due to its biocompatibility and high saturation magnetisation value. MNPs were prepared by co-precipitation at varying molarity. Structural characterisation was performed via X-ray powder diffraction (XRD) for crystalline structure analysis and field-emission scanning electron microscopy (FESEM) for morphology and particle size analysis. Measurement of the magnetic properties of the as-synthesised MNPs was carried out using a vibrating sample magnetometer (VSM). Power loss (P) was determined theoretically. The increase in molarity resulted in significant effects on the structural, magnetic, and heat dissipation properties of MNPs. The particle size and saturation magnetisation (Ms) decreased with the gradual addition of base but increased, together with crystallinity, with the gradual addition of iron source. M3 recorded the smallest crystalline size at 3.559 nm. The sample with the highest molarity (M4) displayed the highest heat generation capacity with a p value of up to 0.4056 W/g. High p values at the nano-scale are crucial, especially in local MHT, for effective heat generation, thus proving the importance of molarity as a vital parameter during MNP synthesis