A Study of Government Reform (Change) Initiatives in the Khyber-Pakhtunkhwa Region of Pakistan

Whilst change management theories have significantly influenced profit-oriented organisations, their adoption by the public sector is less understood, particularly in developing countries (Kooskora, 2016). Reform failure rates in such countries are excessive compared with developed countries; a serious issue as such countries typically have limited resources to create public good. In response to this issue, this study aims to investigate key factors that enable or hinder employees' acceptance of recent change initiatives in the public organisations of Pakistan. The main objective of this research was to identify the challenges, barriers and opportunities hindering or supporting the adoption of public reforms in developing countries, with a specific focus on the KPK region of Pakistan. A review of the literature led to the development of a preliminary conceptual framework based on a robust Technology-Organisation-Environment (TOE) model developed by Tornatzky and Fleischer (1990), which provided a basis for further empirical research. The data was collected in two phases: (1) quantitative data was collected in the first phase to test the TOE-based framework using a survey questionnaire (300 public employees); and (2) qualitative data was gathered in the second phase via semi-structured interviews (three state ministers) and through public documents. While results indicated that two variables, legal and IT infrastructure, were found to be the most influential predictor of ‘employees’ intention to adopt change’ and ‘level of reform’s success’, economy was the least influential factor that affected the dependent variables. Moreover, demographic variables such as age, level of education and pay grade proved to be influential in determining employees’ intention to adopt/implement change in Pakistan. Low status groups with lower levels of education showed a reduced propensity to adopt change, and resistance was found to be more salient in junior employees. Overall, the results of the current study show that the proposed model has a good explanatory power and is therefore robust in predicting change (reform) adoption/implementation in Pakistan. This study will contribute to the literature on change management in public organisations, particularly for developing countries such as Pakistan, and may assist the public managers, change leaders and practitioners of human resources management in assessing, designing, initiating and evaluating new or existing programmes for change (reform)

"Systematic Analysis of the Factors That Impact upon the Mindset of Knowledge Sharing Behaviour (KSB) for Individuals within Academia"

The aim of this study is to provide an examination of the factors that have a bearing on KSB, based upon attitudes amongst academics in developing countries, using a particular focus upon academics within the University of Baghdad. With the research study, structural equation modelling was undertaken by using a questionnaire survey for examination of attitudes to microfoundations with regard to KSB amongst a total of 326 academics based at the University of Baghdad. With regard to KSB, it was found that three of the hypothesised factors (anticipation of extrinsic rewards, anticipation of reciprocal relationships and perception of reciprocal benefits) were significantly and positively related. No significant relationship, however, was found to exist between KSB and interpersonal interactions. Based upon the results, a refined, valid model succeeds in exhibiting good explanatory power for the prediction of the intentions for the KSB of academics. Furthermore, it was suggested by the results that academics who were less educated had a greater willingness for knowledge sharing than those who were more highly educated. Based upon the unprecedented data, the paper makes a contribution to growing KSB-theory-related research, particularly with respect to the planned model of behaviour, and puts forward empirical evidence in support of the relationship between attitude and the KSB of academics

Effects of Neem (Azadirachta indica) seed and Turmeric (Curcuma longa) rhizome extracts on aphids control, plant growth and yield in okra

The use of synthetic pesticides to control pests and increase crops yield is a common practice, but they cause several environmental and health problems. Therefore, there is a need to explore alternative approaches to reduce the sole dependence on synthetic pesticides. The present study was conducted to screen the extracts of Neem seed and Turmeric rhizome for pesticidal activities against okra pests (aphids). Experiments were conducted in field with four plots. One plot was kept as a control (unsprayed) and one was sprayed with synthetic pesticides, one with Neem seeds extract and one with Turmeric rhizome extract. The effect on number of pests, plant growth and yield was observed at regular intervals. A significant reduction in pests was recorded in all treatments as compared to the control. Neem seed extract was more effective than Turmeric rhizome extract as revealed by a 73% decrease in aphids by Neem extract in comparison to 54% by Turmeric extract after last application. Both the extracts were found to be more effective than the synthetic pesticides in controlling okra pests. Both the extracts had stimulatory effects on okra growth and yield. For example, the total yield of plots sprayed with Neem (53.3 kg plot-1) and Turmeric extract (47.7 kg plot-1) was higher than the yield of control plot (33.8 kg plot-1) and plot sprayed with synthetic pesticides (39 kg plot-1). It is concluded that Neem and Turmeric extracts can be used as alternative of synthetic pesticides for controlling pests attacks in okra

The influence of the accessory genome on bacterial pathogen evolution

Bacterial pathogens exhibit significant variation in their genomic content of virulence factors. This reflects the abundance of strategies pathogens evolved to infect host organisms by suppressing host immunity. Molecular arms-races have been a strong driving force for the evolution of pathogenicity, with pathogens often encoding overlapping or redundant functions, such as type III protein secretion effectors and hosts encoding ever more sophisticated immune systems. The pathogens’ frequent exposure to other microbes, either in their host or in the environment, provides opportunities for the acquisition or interchange of mobile genetic elements. These DNA elements accessorise the core genome and can play major roles in shaping genome structure and altering the complement of virulence factors. Here, we review the different mobile genetic elements focusing on the more recent discoveries and highlighting their role in shaping bacterial pathogen evolution

Hepatocellular carcinoma in Pakistan: where do we stand?

Context: From the 1970s till the mid 1990s, hepatitis B was the most common etiological factor for hepatocellular carcinoma (HCC) in Pakistan. Afterwards, a shift in HCC etiology was observed with a steady rise in hepatitis C virus (HCV) related HCC cases. HCV-3a, which is the most prevalent genotype, is also most frequent in HCV related HCC. There was an increase in the proportion of non-B non-C (NBNC) HCC cases as well, which might be attributed to an increase in non-alcoholic fatty liver disease. Evidence Acquisition: The age-standardized rate for HCC is 7.64/100 000 in males and 2.8/100 000 in females. Male to female ratio is 3.6:1. Usual age of presentation is in the fifth and sixth decade. Most patients present with advanced disease, as they are not in a regular surveillance program. This is more so for patients with NBNC chronic liver disease. As many sonologists in Pakistan are practicing without sufficient training to pick up early lesions, alpha-fetoprotein is still recommended to compliment ultrasound in the surveillance of HCC. Results: Majority of HCC patients present with nonresectable disease. Interventions such as transarterial chemoembolization, radiofrequency ablation, resection and chemotherapy including sorafenib are available in selected centers. Pakistan appears to be in an area of intermediate endemicity for HCC. There is a need for population based epidemiological studies to estimate the exact disease burden. Conclusions: Measures to prevent the spread of hepatitis C and B can slow down the epidemic rise in the incidence of HCC in the coming decades. There is a need to implement a proper surveillance program to identify HCC cases at an early stage

Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

<p>Abstract</p> <p>Background</p> <p>Physicians are encouraged to counsel obese patients to lose weight, but studies measuring the quality of physicians' counseling are rare. We sought to describe the quality of physicians' obesity counseling and to determine associations between the quality of counseling and obese patients' motivation and intentions to lose weight, key predictors of behavior change.</p> <p>Methods</p> <p>We conducted post-visit surveys with obese patients to assess physician's use of 5As counseling techniques and the overall patient-centeredness of the physician.. Patients also reported on their motivation to lose weight and their intentions to eat healthier and exercise. One-way ANOVAs were used to describe mean differences in number of counseling practices across levels of self-rated intention and motivation. Logistic regression analyses were conducted to assess associations between number of 5As counseling practices used and patient intention and motivation.</p> <p>Results</p> <p>137 patients of 23 physicians were included in the analysis. While 85% of the patients were counseled about obesity, physicians used only a mean of 5.3 (SD = 4.6) of 18 possible 5As counseling practices. Patients with higher levels of motivation and intentions reported receiving more 5As counseling techniques than those with lower levels. Each additional counseling practice was associated with higher odds of being motivated to lose weight (OR 1.31, CI 1.11-1.55), intending to eat better (OR 1.23, CI 1.06-1.44), and intending to exercise regularly (OR 1.14, CI 1.00-1.31). Patient centeredness of the physician was also positively associated with intentions to eat better (OR 2.96, CI 1.03-8.47) and exercise (OR 26.07, CI 3.70-83.93).</p> <p>Conclusions</p> <p>Quality of physician counseling (as measured using the 5As counseling framework and patient-centeredness scales) was associated with motivation to lose weight and intentions to change behavior. Future studies should determine whether higher quality obesity counseling leads to improved behavioral and weight outcomes.</p

Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics.</p> <p>Methods</p> <p>We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor.</p> <p>Results</p> <p>The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factors–<it>Physician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy</it>, and <it>Negative Outcome Expectancy</it>. Competency and reported percent of patients who lose weight were most strongly associated with the <it>Physician Success/Self Efficacy </it>attitude factor. Greater skill in patient assessment was associated with less <it>Physician Discomfort/Bias</it>. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty.</p> <p>Conclusion</p> <p>Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.</p

Botany, chemistry, and pharmaceutical significance of Sida cordifolia: a traditional medicinal plant

Sida cordifolia Linn. belonging to the family, Malvaceae has been widely employed in traditional medications in many parts of the world including India, Brazil, and other Asian and African countries. The plant is extensively used in the Ayurvedic medicine preparation. There are more than 200 plant species within the genus Sida, which are distributed predominantly in the tropical regions. The correct taxonomic identification is a major concern due to the fact that S. cordifolia looks morphologically similar with its related species. It possesses activity against various human ailments, including cancer, asthma, cough, diarrhea, malaria, gonorrhea, tuberculosis, obesity, ulcer, Parkinson’s disease, urinary infections, and many others. The medical importance of this plant is mainly correlated to the occurrence of diverse biologically active phytochemical compounds such as alkaloids, flavonoids, and steroids. The major compounds include β-phenylamines, 2-carboxylated tryptamines, quinazoline, quinoline, indole, ephedrine, vasicinone, 5-3-isoprenyl flavone, 5,7-dihydroxy-3-isoprenyl flavone, and 6-(isoprenyl)- 3-methoxy- 8-C-β-D-glucosyl-kaempferol 3-O-β-D-glucosyl[1–4]-α-D-glucoside. The literature survey reveals that most of the pharmacological investigations on S. cordifolia are limited to crude plant extracts and few isolated pure compounds. Therefore, there is a need to evaluate many other unexplored bioactive phytoconstituents with evidences so as to justify the traditional usages of S. cordifolia. Furthermore, detailed studies on the action of mechanisms of these isolated compounds supported by clinical research are necessary for validating their application in contemporary medicines. The aim of the present chapter is to provide a detailed information on the ethnobotanical, phytochemical, and pharmacological aspects of S. cordifolia