Attitudes towards child restrains and seat belts usage in the learned population of Karachi, Pakistan.

BACKGROUND: Motor vehicles crashes (MVCs) are the leading cause of injury relatedmorbidity and mortality in developed countries. Recent evidence proves that properly used child seat belts can dramatically reduce the risk of severe and life-threatening injury from MVCs. There are rarities of thought and inspiration regarding the use of child seat belts in our society and region, therefore we lack of data regarding factors and paucity of usage of child seat belts in motor vehicles.This study aimed to assess the knowledge and attitudes of child seat belt usage among the educated population in Karachi, Pakistan. METHODS: Altogether 304 employees were investigated. They were employees of Aga Khan University who were using their cars and having children younger than 10 years old. A cross sectional observational study was designed, and a 36-item questionnaire in English was used to collect data on participants\u27 demographic details, designation, educational level, economic status, validity of driving license, number of children and cars, availability of adult seat belts and child seat belts along with their functionality, awareness, knowledge and attitude toward its use, and reason of not using these devices. SPSS version 20 for Windows was used to analyze the data and the Chi-square test was used. RESULTS: Totally 290 participants were recruited with a response rate of 72% (212). Of 212 participants, 126 (59%) were male. 154 (72.6%) participants had valid driver licenses, and 154 (72.6%) had adult seat belts in their vehicles. Only 32 (15%) reported regular use of adult seat belts. Although 168 (79.2%) participants had some knowledge about child restrains (CRs), only 65 (22%) had CRs in their cars. Eighty-two (38.7%) participants got the knowledge about CRs and seat belts from media. Mothers were more concerned about the use of CRs than fathers. Only 14 (6.6%) parents were found to use both adult and child seat belts all the time. Of the 157 parents who did not us use CRs, 42 considered unnecessary, 35 lacked relevant knowledge. But 15 parents used CR against their children\u27s wills. CONCLUSIONS: The pattern of CR usage among the employees at Aga Khan University, Karachi is dictated by the unavailability of CR, followed by ignorance, inconvenience, and nonacceptance by their children. The important issue of CR has consistently been ignored over the years and it has never gained enough popularity in Pakistan

Hazard of pesticides on the hearing of farmers.

Introduction: As the population of world is increasing there is increased use of pes-ticides to enhance the crop production. Farmers are trying different types of chemi-cals to kill harmful germs, but they are exposing themselves to different hazards. Throughout the world insecticides are used to kill insects that harm crops. These insecticides are usually neurotoxic. They have a lethal effect on the nervous trans-mission. Peoples who are exposed to these poisons are also at great risk of neuro-toxic effects .Objective: To study the effects of pesticides on the hearing of the farmers. It was a retrospective and descriptive type of study which was conducted in the department of physiology in association with department of ENT.Methodology: This retrospective study done between Mar 2019 to Aug 2019 at ENT department of Liaquat University Hospital Hyderabad. 100 subjects (50 study group having exposure to pesticides for at least five years, while 50 subjects as controls having no history of exposure to pesticides during last 5 years) were selected. The selected participants were subjected to a detailed otoscopic examination and if no other cause e.g. conductive deafness was found, the selection was finalized. The finalized participants were undergone through a comprehensive audiometric evalu-ation.Results: showed pesticide damages the hearing (P= .003). There was no link be-tween the age of farmers and hearing loss (1.00). It was found that as the duration of exposure increased the intensity of hearing loss increased (.001). It was also de-tected that that hearing loss was more frequent in nonprofessional than in profes-sionals (.001).Conclusion: This study revealed that pesticide affects sense of hearing in humans. Keywords: Pesticide, hearing loss, Farmers

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

The importance of actual use in defining and measuring innovative behaviour: Comparison of e-book reader users and non-users

This study introduces the concept of personal innovative behaviour and demonstrates its validity in the context of e-book reader adoption and use. Personal innovative behaviour, unlike measures of consumer innovativeness, amalgamates decisions about product adoption with reports of the product’s actual use. Quantitative methodology was used, and probability proportional stratified sampling technique was used to obtain the proportionate sample. Items to measure personal innovative behaviour for e-book readers were included in a questionnaire distributed to students at a Malaysian university. Of the 386 participants, 79% used the e-book reader, half of them for academic purposes. Confirmatory factor analysis using Amos tested the concept of personal innovative behaviour for both users and non-users. The results indicated that the underlying dimensions, (intended Adoption Behaviour and actual Use Behaviour), could be measured and combined in a structural model only for users, i.e. innovators. Good model fit confirmed the validity and reliability of the framework. The redefined construct and scale validation will be helpful to researchers to measure the individual personal behaviour in terms of their final decision to adopt and actual usage of the novel product. The personal innovative behaviour scale presented here can be used by researchers and practitioners to measure adoption and use of personal information products and devices. The two dimensional conceptualization of personal innovative behaviour (intended Adoption Behaviour and actual Use Behaviour) reconciles similarities and differences between the decision and action variables in innovation diffusion theory and the technology acceptance model

Perceived learning outcomes from Moodle: An empirical study of intrinsic and extrinsic motivating factors

This study explores the intrinsic and extrinsic features of Moodle learning managements system and how these features motivate students to use an e-learning portal, which subsequently influences their perceived learning effectiveness and academic performance. Theoretical underpinning of motivation theory, self-determination theory (SDT), and cognitive evaluation theory (CET) is used to design the framework. The quantitative empirical research to test the hypothesized relationships was conducted on 276 online students in Pakistan who use Moodle for online learning. By analysing the responses using AMOS, the findings reveal that both the intrinsic motivators (communication module features, course content module features and course delivery module features) and extrinsic motivator (assignment module feature) significantly influence the students’ perceived learning effectiveness, which results in improve academic performance

Ecology and management of range edge populations : the case of toothfish species at the South Sandwich Islands

Current theory suggests that the life history of a species will vary in a predictable way from the range centre where habitat is likely to be optimal, to range peripheries where it is not. Moving towards cold water, high-latitude range edges, life history theory contends that individuals should exhibit reduced growth rates to an increased average maximum length, with delayed maturation and reduced somatic condition. In addition, increased recruitment variability should be observed towards range edges. Toothfish species Dissostichus eleginoides and D. mawsoni are large deep-water finfish predators of the Southern Ocean region. Both are found at the South Sandwich Islands in the South Atlantic Ocean, where they are situated on the edge of their distributional range. In this study, data collected on board commercial fishing vessels were used to describe the ecology, life history and dispersal patterns of range-edge toothfish populations, compared with those of range centre populations (South Georgia D. eleginoides and Ross Sea D. mawsoni). Two main research questions were addressed: 1. What limits the distribution of toothfish species populations at the South Sandwich Islands and how do range edge life history and population dynamics differ from those of range centre populations? 2. How can we use this information to more effectively manage the toothfish fishery at the South Sandwich Islands and other fisheries on range edge populations? A bioregional analysis made use of commercial longline data to resolve the position of the ecotone between the Antarctic and Subantarctic bioregions at the South Sandwich Islands. An abrupt transition was observed between the two bioregions around Saunders Island and this was spatially coincident for finfish and invertebrate communities, indicating a dramatic change in habitat type at this location. A correlative modelling analysis suggested that the formation of toothfish species range edges is influenced by the extent of sea ice cover and winter seawater temperature near the surface. However, differences between threshold values of ice and temperature at the South Sandwich Islands and the Ross Sea suggest that regional patterns in hydrography and topography may lead to the formation of range edges that do not necessarily correspond with niche requirements, with implications for studies evaluating species redistributions in response to climate change. Some, though not all of the hypothesised high latitude range edge life history traits were observed in South Sandwich Islands D. eleginoides. Increased maximum size was observed, though initial growth rates were similar to those of individuals at South Georgia and growth is clearly not a factor limiting productivity towards the high latitude range edge. There was no evidence at all for gonad maturation to spawning condition and this appears to relate to improved somatic condition, which would not normally be expected in range edge individuals. Highly episodic recruitment, also assumed to be a feature of range edge populations, was observed in South Sandwich Islands D eleginoides population and this is unlikely to be self-sustaining. This appears to be confirmed by an analysis of the otolith chemistry of D. eleginoides, where a similar chemical signature was observed at the cores of otoliths extracted from individuals captured at South Georgia and South Sandwich Islands. In addition a mark-recapture model was developed to estimate the migration rates of postrecruitment D. eleginoides between South Georgia and the South Sandwich Islands. Sexbiased migration of males away from the cold water range limit were also evident from an analysis of the sex ratio of the South Sandwich Islands population and have a considerable impact on resident population age structure. Accounting for the emigration of males greatly improved the accuracy of estimates from a CASAL assessment of the South Sandwich Islands D. eleginoides population. However the episodic nature of recruitment negatively impacted on the sustainable yield that could be taken according to CCAMLR harvest decision rules, which do not appear to be appropriate for this and other range edge toothfish stocks. Some aspects of range edge life history, including decreased growth rates, delayed maturation and episodic recruitment will impact on the productivity of a population such that it will be increasingly vulnerable to the impacts of exploitation. Where generalised patterns in range position effects on life history can be discerned, this information can be used to make predictions about the life history of exploited stocks that are otherwise data poor and also will allow for improved predictions as to how species will respond to changes in the environment such as those arising from climate change.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Faculty willingness for continuing online teaching-post COVID-19 pandemic in Pakistan

Objective: To determine faculty willingness for continuing online education after coronavirus disease-2019 in Pakistan, and to correlate it with perceived gain in experience in online teaching during the pandemic. Method: The cross-sectional study was conducted at Aziz Fatimah Medical and Dental College, Faisalabad, Pakistan, from January to July 2021, and comprised medical faculty with teaching experience of at least 2 years. Data was collected using an online questionnaire though Google Forms. Multiple regression analysis was done to determine faculty willingness with perceived experience levels in online education. Data was analysed using SPSS 25. Results: Of the 100 subjects approached, 68(68%) responded; 51(75%) females and 17(25%) males. Of the total, 30(44.1%) participants were aged 33-40 years, 25(37%) were from  Basic Sciences, 27(39.7%) from Clinical Sciences, 16(23.5%) from Allied Health Sciences, and 39(57.4%) had teaching experience <5 years.. Overall, 39(57.4%) participants were willing to continue online education post-pandemic, 20(29.4%) agreed partially and 9(13.2%) did not agree. A positive linear relationship was found between willingness to continue online education and increase in perceived experience level in teaching online (p=0.021). Conclusion: There was a significant difference between perceived experience level in online teaching before and after the coronavirus disease-2019 pandemic. Those with increase in perceived experience level were willing to continue online education. Key Words: Online education, Post-COVID-19, Faculty, Willingness

Understanding perceptions and factors involved in do not resuscitate (DNR) decision making in the emergency department of a low-resource country: A mixed-methods study protocol

Introduction: Do not resuscitate (DNR) decision making is an integral component of emergency medicine practice. There is a paucity of data, protocols and guidelines regarding the perceptions and barriers that are involved in the interactions among healthcare professionals, patients and their caregivers regarding DNR decision making. The aim of this study is, therefore, to explore the perceptions and factors influencing DNR decision making in the emergency department and to evaluate the use of a context-based protocol for DNR decision making.Methods and analysis: This will be a sequential mixed method study beginning with qualitative research involving in-depth interviews (IDIs) with patient family members and focus group discussion with healthcare professionals. The consensual qualitative approach will be used to perform a thematic analysis to the point of saturation. The expected outcome will be to identify key themes that suggest perceptions and factors involved in DNR decision making. After piloting, the derived protocol will then be used with a different group of individuals (150 healthcare professionals) who meet the eligibility criteria in a quantitative cross-sectional study with universal sampling. Data will be analysed using NVIVO in the qualitative phase and SPSS V.19 in the quantitative phase. The study findings will support the development of a standardised protocol for DNR decision making for healthcare professionals in the emergency department.Ethics and dissemination: The proposal was reviewed by the ethics review committee (ERC) of the institution (ERC # 2020-1551-7193). The project is an institution SEED grant recipient PF139/0719. The results will be disseminated among participants, patient communities and healthcare professionals in the institution through seminars, presentations, brochures and emails. The findings will be published in a highly accessed peer-reviewed medical journal and will be presented at international conferences

Real-time loop-mediated isothermal amplification (LAMP) of mgc2 gene of Mycoplasma gallisepticum

Introduction:Mycoplasma gallisepticum is considered the most pathogenic and economically significant avian Mycoplasma spp. for the worldwide poultry industry. The aim of this study was to develop a novel and sensitive real-time loop-mediated isothermal amplification (LAMP) assay based on the amplification of its mgc2 gene sequence for its rapid molecular detection in poultry