Disabilities and vulnerabilities

Persons with special needs and disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower levels of employment, and higher poverty rates. Disable or differently-able people are considered to be the most vulnerable or even in majority of countries as one of the neglected and marginalized segment of our society who are mostly at risk when there is any kind of emergency, disaster, pandemic (such as COVID-19) because of their vulnerability and being at risk. The purpose of the study is to refer and highlight the deprivations of people with disabilities (PWDs) have to face on continuous basis. Although conventions like Convention on the Rights of Persons with Disabilities (CRPD) focuses on the change of attitudes and approaches to persons with disabilities but still there are different disabilities who still do not have equal human rights and fundamental freedoms in the 21st century. We still overlook the needs of people with disabilities during such difficult situations to a large extent. As it is evident from our previous experience since the outbreak of this COVID-19, such pandemics have multidisciplinary problems and issues, especially from a disability perspective, because their effects are partly medical and partly socioeconomic and psychological, and when the end beneficiary or victim is disable then the repercussions are harmful and long-lasting, and such victims are traumatized and psychologically more impacted than the normal humans like us. In terms of responsibility state is the first actor who is responsible to act immediate and take an immediate and necessary measures to ensure the protection and safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies and 2 the occurrence of natural disasters. Furthermore, PWDs could be multiple challenges when on one hand they are physical/mentally challenged or on the other hand they are poor, uneducated, they sick and frail, and having disadvantages in society, and due to these factors they are at much greater risk when a pandemic arrives. Moreover, such pandemics are indiscriminatory in a sense that almost entire population globally was impacted equally, but again when it comes to cater the special needs of disabled people, we have stay one step ahead so they can feel equally valued and respected. Also, from another angel elderly people are also considered because of their age and dependency of others, as not all elderly people are disabled, but disability becomes more likely with the bodily deteriorations that age can cause. People with disabilities who live alone may suffer isolation and feel anxiety continuously. The elderly may have lost friends and partners, and they may suffer long-term deterioration in their health, leading to disability as a result thereof. Additionally, disabled people have many of the same fears and undergo the same stresses that are experienced by nondisabled people, but they may be dealing with the prospect of more serious consequences. In terms of methodology, content analysis as a qualitative tool was used to analyze different content and its features, such as international conventions and frameworks, evidence based info-graphics, Sustainable Development Goals PiCCWED15, 24 September 2022 Page 25 (SDGs) and charters. With regard to its significance, this research also focuses and considers recent observations and studies suggested and endorsed that that many people with disabilities are good at adapting to adversity and are well aware of the sources of help or emotional support. They may use religion, humour or acceptance to help them cope with such hardships. On the negative side, they may in some cases resort to denial, which enables them to escape from the harsh reality of pandemic restrictions. Other maladaptive coping mechanisms involve substance abuse, detachment, behavioral disengagement, selfblame, guilt and venting. Keywords: PWDs, disability, pandemic, emergency, psychology, anxiet

Impact of 10-valent pneumococcal conjugate vaccine (PCV10) on nasopharyngeal carriage in children 2 years of age: Data from a four-year time series cross-sectional study from Pakistan

The dataset described in this paper was collected for a time-series cross-sectional study exploring the impact of 10-valent Pneumococcal Conjugate Vaccine (PCV10) on nasopharyngeal (NP) carriage in children under 2 years of age from a rural population in Sindh, Pakistan. The study was carried out in two union councils of Matiari - Khyber and Shah Alam Shah Jee Wasi (Latitude 25.680298 / Longitude 68.502711). Data was collected on socio-demographics, clinical characteristics and vaccination status using android phone-based application. NP samples were collected using standard World Health Organisation (WHO) techniques, culture and serotyping was done using sequential Multiplex PCR described by Centre for Disease Control, USA. We looked at the carriage rate of vaccine type (VT) and non-vaccine type (NVT) serotypes over time in vaccinated and unvaccinated children. We additionally looked at the predictors for pneumococcal carriage. The uploaded dataset, available on Mendeley data repository (Nisar, Muhammad Imran (2021), Impact of PCV10 on nasopharyngeal carriage in children in Pakistan , Mendeley Data, V1, doi:10.17632/t79h6g97gr.1), has 3140 observations in CSV format. Additional files uploaded include a data dictionary and the set of questionnaires. The dataset and accompanying files can be used by other interested researchers to replicate our analysis, carry similar analysis under varying set of assumptions or perform additional exploratory or metanalysis

Direct and indirect effect of 10 valent pneumococcal vaccine on nasopharyngeal carriage in children under 2 years of age in Matiari, Pakistan

Background: Pakistan introduced Ten-valent pneumococcal-conjugate-vaccine PCV10 in 2012 as a 3 + 0 schedule without catch-up.Methods: Children \u3c2 years old in Matiari, Sindh provided nasopharyngeal swabs between 2014 and 2018, which were cultured for pneumococcus and serotyped through multiplex PCR at the Aga Khan University Hospital. Carriage rates over time for Vaccine-Type (VT) and Non-VT (NVT) serotypes were used to estimate direct, indirect, total and overall effects of vaccination. Regression analysis was used to determine factors associated with VT carriage.Results: Pneumococcus was detected in 2370/3140 (75%). VT carriage decreased overall, 16.1-9.6% (p-trend \u3c0.001); vaccinated (all 3 doses of PCV10 received) 11.3-8.1% (p-trend 0.031) and unvaccinated (no PCV10 dose received) 17.4-10.3% (p-trend 0.003) with a decline in serotypes 6B, 9V/9A and 19F. Immunization increased from 41.0% to 68.4% (p-trend 0.001). Direct effect of vaccine was 32.8% (95% CI 14.7-47.0%) and indirect effect 44.6%(95% CI 40.6-48.6%). Factors associated with decreased VT colonization were education 1-5 years (aOR 0.7, 95%CI 0.6-1.0), history of difficulty breathing (aOR 0.7, 95%CI 0.5-1.0), exposure to smoke (aOR 0.8, 95% CI 0.6-1.0), child fully immunized (aOR 0.7, 95%CI 0.5-1.0) and enrolled in 3rd (aOR 0.6, 95%CI 0.4-0.8) and 4th (aOR 0.6, 95%CI 0.5-0.9) year of the study whereas history of runny nose (aOR 1.5, 95% CI 1.2-1.9) was positively associated.Conclusions: Decrease in VT pneumococcal carriage in vaccinated and unvaccinated children indicates herd immunity. Sustained increase in vaccine coverage and close long-term surveillance is warranted

Pandemic 2019 - a harsh reality and its impact on the vulnerable

ABSTRACT In case of any emergency or calamity, there are a few segments and groups of our society who are considered vulnerable, marginalized, and neglected in terms of hardships and inequality. Even though as a pandemic COVID-19 treated everyone equally without any sort of discrimination such as marginalized population working in a non-formal industry or women-home based workers, women in post-war zones or conflict-affected areas, rural women, women and child migrants and ethnic minorities are more likely to suffer the most from limited movements and drastic decrease in their incomes (daily wagers, laborers for instance). The same is the case with COVID-19 and its continuous repercussions on human lives especially women, the elderly, differently-abled/PWDs, and children. This pandemic which is also referred to as a shadow pandemic limits and even stops economic growth and opportunities for many in different areas of life. This is the harsh reality one should admit that our health and overall system was not ready to deal with such threat which has multiple effects on the living beings and hence the non-agile response to the same risks the well-being of many. Considering the economic, emotional, societal, and psychological impact of the pandemic and the restrictions imposed, as a result, it was also observed that cases such as GBV or VAW were increased, as one in three women worldwide experience physical or sexual violence by someone they are close to or their partners. Since the outbreak of COVID-19, data and reports indicate that all types of violence against women and girls, particularly domestic violence, have increased and overall numbers of the affectees soared. The Covid-19 pandemic has also revealed the extent of exclusion that the most marginalized communities have experienced. But with threats and weaknesses, there are always opportunities that can be translated and served with the prospect of helping those who need us most

Pandemic 2019 - a harsh reality and its impact on the vulnerable

ABSTRACT In case of any emergency or calamity, there are a few segments and groups of our society who are considered vulnerable, marginalized, and neglected in terms of hardships and inequality. Even though as a pandemic COVID-19 treated everyone equally without any sort of discrimination such as marginalized population working in a non-formal industry or women-home based workers, women in post-war zones or conflict-affected areas, rural women, women and child migrants and ethnic minorities are more likely to suffer the most from limited movements and drastic decrease in their incomes (daily wagers, laborers for instance). The same is the case with COVID-19 and its continuous repercussions on human lives especially women, the elderly, differently-abled/PWDs, and children. This pandemic which is also referred to as a shadow pandemic limits and even stops economic growth and opportunities for many in different areas of life. This is the harsh reality one should admit that our health and overall system was not ready to deal with such threat which has multiple effects on the living beings and hence the non-agile response to the same risks the well-being of many. Considering the economic, emotional, societal, and psychological impact of the pandemic and the restrictions imposed, as a result, it was also observed that cases such as GBV or VAW were increased, as one in three women worldwide experience physical or sexual violence by someone they are close to or their partners. Since the outbreak of COVID-19, data and reports indicate that all types of violence against women and girls, particularly domestic violence, have increased and overall numbers of the affectees soared. The Covid-19 pandemic has also revealed the extent of exclusion that the most marginalized communities have experienced. But with threats and weaknesses, there are always opportunities that can be translated and served with the prospect of helping those who need us most

Disabilities and vulnerabilities

Persons with special needs and disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower levels of employment, and higher poverty rates. Disable or differently-able people are considered to be the most vulnerable or even in majority of countries as one of the neglected and marginalized segment of our society who are mostly at risk when there is any kind of emergency, disaster, pandemic (such as COVID19) because of their vulnerability and being at risk. The purpose of the study is to refer and highlight the deprivations of people with disabilities (PWDs) have to face on continuous basis. Although conventions like Convention on the Rights of Persons with Disabilities (CRPD) focuses on the change of attitudes and approaches to persons with disabilities but still there are different disabilities who still do not have equal human rights and fundamental freedoms in the 21st century. We still overlook the needs of people with disabilities during such difficult situations to a large extent. As it is evident from our previous experience since the outbreak of this COVID-19, such pandemics have multidisciplinary problems and issues, especially from a disability perspective, because their effects are partly medical and partly socioeconomic and psychological, and when the end beneficiary or victim is disable then the repercussions are harmful and long-lasting, and such victims are traumatized and psychologically more impacted than the normal humans like us. In terms of responsibility state is the first actor who is responsible to act immediate and take an immediate and necessary measures to ensure the protection and safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies and the occurrence of natural disasters. Furthermore, PWDs could be multiple challenges when on one hand they are physical/mentally challenged or on the other hand they are poor, uneducated, they sick and frail, and having disadvantages in society, and due to these factors they are at much greater risk when a pandemic arrives. Moreover, such pandemics are indiscriminatory in a sense that almost entire population globally was impacted equally, but again when it comes to cater the special needs of disabled people, we have stay one step ahead so they can feel equally valued and respected. Also, from another angel elderly people are also considered because of their age and dependency of others, as not all elderly people are disabled, but disability becomes more likely with the bodily deteriorations that age can cause. People with disabilities who live alone may suffer isolation and feel anxiety continuously. The elderly may have lost friends and partners, and they may suffer long-term deterioration in their health, leading to disability as a result thereof. Additionally, disabled people have many of the same fears and undergo the same stresses that are experienced by non-disabled people, but they may be dealing with the prospect of more serious consequences. In terms of methodology, content analysis as a qualitative tool was used to analyze different content and its features, such as international conventions and frameworks, evidence-based info-graphics, Sustainable Development Goals (SDGs) and charters. With regard to its significance, this research also focuses and considers recent observations and studies suggested and endorsed that that many people with disabilities are good at adapting to adversity and are well aware of the sources of help or emotional support. They may use religion, humour or acceptance to help them cope with such hardships. On the negative side, they may in some cases resort to denial, which enables them to escape from the harsh reality of pandemic restrictions. Other maladaptive coping mechanisms involve substance abuse, detachment, behavioral disengagement, selfblame, guilt and venting

The role of microbiome in preterm labor: Recent advances and future challenges

Background: Our current understanding of preterm labor is limited in the context of dysbiosis of microbiome. Human microbiome is comprised of trillions of microorganisms, residing on and within our bodies that are associated with the vital function of organs and systems. Few studies have highlighted the role of maternal gut microbiome dysbiosis as a contributing factor for metabolic syndrome and may be associated with risk of preterm labor. A clear understanding of dysbiosis in placenta or vagina with early ripening of cervix for initiation of preterm labor is not fully elucidated.Aim: Our aim is to contextualize the alteration in microbial community structure in maternal and fetal organs in association with risk of preterm labor.Methods: In this review, we summarized the studies published from 2000 to 2016 in the field of microbiome in association with preterm labor.Findings & Discussion: Evidence suggest that placental microbiome has promising correlation with preterm labor, while findings are equivocal for maternal gut and vaginal microbiome in inducing preterm labor. Similar alteration in fetal intestinal microbiome of meconium is supposed to evoke an inflammatory response that may lead to preterm labor.Conclusion: To understand the relationship of microbiome and preterm labor, both maternal and fetal microbiome should be studied in parallel to determine the causality. Dysregulation of immune response due to disturbance in normal or commensal flora might be an underlying cause of preterm labor

Streptococcus mutans carriage in the saliva of mothers and its association with dental caries and Streptococcus mutans carriage in the saliva of children between 6 and 30 months old in a low‐income setting in Karachi, Pakistan

Abstract Background Early childhood caries poses a significant health issue in children under 6 years old. It is determined that Streptococcus mutans is a primary etiological agent, likely to be transferred through maternal contact. Objectives To determine the association of maternal S. mutans counts with S. mutans counts in their children between 6 and 30 months of age, and to determine the maternal and child DMFT (decayed, missing, and filled teeth) indices. Material and Methods A community‐based cross‐sectional study was conducted in Karachi, Pakistan. A sample of 193 dyads of mother–children (6–30 months of age) was selected via purposive sampling. Saliva samples of the dyads were collected to assess S. mutans count. Caries assessment was performed for both using the DMFT index. A pretested questionnaire was used. The association of bottle‐feeding, oral hygiene measures, and other factors with S. mutans counts in children were also explored. Zero‐inflated negative binomial regression model at a 5% level of significance was applied using STATA version 12.0. Results Out of 193 children, 109 (56.47%) were males and 84 (43.52%) were females. The mean age of mothers and children was 29.4 ± 6.2 years and 19.54 ± 6.8 months, respectively. Maternal S. mutans counts were not statistically associated with child's S. mutans counts (Mean child's S. mutans count ratio: 1; 95% confidence interval [CI]: 1, 1.01; p = .882). Compared with children who were breastfed, S. mutans counts were higher in children who were bottle‐fed (mean S. mutans count ratio= 4.85 [95% CI: 1.53, 15.41], p = .007). Age of mother and present caries status of mothers was significantly associated with the child's S. mutans count. Conclusion No association between maternal S. mutans and child S. mutans was observed. However, maternal age, children who were breastfed, children who did not use pacifiers, and children with mothers who did not have caries, exhibited low S. mutans counts in their saliva

Psychological and emotional impact of harassment at workplace: a comprehensive examination of its consequences and remediation strategies

Harassment in the workplace is an acceptable action a prevalent issue that can deep impact considered far beyond on an individual as a victim as well as the organisation. Previous research and evidence of harassment further supplement the consequences of its harmful impact. Such evidence-based research is critical to understanding the pattern, consequences, and most importantly the mitigation strategies to prevent such heinous actions which could have a long-lasting psychological impact on someone’s soul, and also lead to a hostile, intimidating, and non-productive work environment, and eventually organization losses its ethics and core competencies which act the foundation of any organization. Sexual harassment in the workplace has been widely discussed in scientific literature and socio-political organizations for the past several years now. Multiple studies have focused on this aspect to support experimental research, dissemination, and preventive measures concerning sexual harassment in the workplace. This has led to a growing awareness among organizations and stakeholders on the significance of addressing and combating sexual harassment in the workplace. Although social scientists have documented a negative association between sexual harassment at the workplace and mental health (i.e., psychological, and emotional), limited research has been carried out on the psychological and emotional repercussions of workplace sexual harassment on women employees. By further probing into the distinct psychological and emotional outcomes of such experiences, this research intends to enhance the understanding of the multi-faceted consequences of sexual harassment on women employees. A survey research strategy was designed to derive the quantitative data through a questionnaire distributed through social media, e-mail, in-person distribution, and WhatsApp groups. Furthermore, the data collected from 256 respondents were then analysed using SPSS (Statistical Package for the Social Sciences) version 2019 including frequency, percentage, median, and standard deviation. The result indicated several consequences due to sexual harassment in the workplace such as fear and paranoia (58%), sleep disturbances (55%), anxiety (46%), low self-esteem (46%), depression (43%), decreased job satisfaction (39%), post-traumatic stress disorder (39%), and interpersonal difficulties (38%). Additionally, it is important to address such behaviours through effective remediation strategies to provide the victims with the needed assistance and coping mechanisms. The result revealed that the majority of the respondents prefer to talk to their family or friends with the highest percentage (29%), followed by seeking professional help (11%) and engaging in hobbies (8%). The results were expected to provide valuable insights into developing practical and evidence-based interventions that organizations can implement to create safer and healthier work environments, especially for women employees. Pre-emptive measures to avert harassment of any form do not make sure the organisation will be failed to foster a culture of respect, diversity, and inclusion in any workplace dynamics

Differential coverage for vaccines in the expanded program on immunization (EPI) among children in rural Pakistan

Background: Pakistan has a well-established Expanded Program on Immunization (EPI) however vaccine-preventable diseases still account for high infant and child mortality rates. This study describes the differential vaccine coverage and determinants of vaccine uptake in rural Pakistan.Methods: From October 2014 to September 2018, we enrolled children younger than 2 years of age from the Matiari Demographic Surveillance System in Sindh, Pakistan. Socio-demographic and vaccination history were collected from all participants. Vaccine coverage rates and timeliness were reported. Socio-demographic variables for missed and untimely vaccination were studied in multivariable logistic regression.Results: Of the 3140 enrolled children, 48.4 % received all EPI recommended vaccines. Only 21.2 % of these were age appropriate. Around 45.4 % of the children were partially vaccinated, and 6.2 % were unvaccinated. Highest coverage was seen for the first dose of pentavalent (72.8 %), 10-valent Pneumococcal Conjugate Vaccine (PCV10) (70.4 %) and Oral Polio Vaccine (OPV) (69.2 %) and the lowest coverage was for measles (29.3 %) and rotavirus (1.8 %) vaccines. Primary caretakers and wage earners with a higher level of education were protective against missed and untimely vaccination. Enrollment in the 2nd, 3rd and 4th study year was negatively associated with being unvaccinated whereas distance from a major road was positively associated with non-adherence to schedule.Conclusion: Vaccine coverage was low among children in Matiari, Pakistan, and majority received delayed doses. Parents\u27 education status and year of study enrollment was protective against vaccine dropout and delayed vaccination whereas geographical distance from a major road was a predictor. Vaccine promotion and outreach efforts may have had a beneficial impact on vaccine coverage and timeliness