Does empowerment matter? Perceptions of nursing leaders in Pakistan through qualitative approach.

Background: In a patriarchal society like Pakistan, where women are oppressed, women dominating professions like nursing is mostly seen as disempowered and requires considerable struggle to achieve its due recognition and respect. Aim: This study aims to explore the experiences of empowerment among the nursing leaders of Pakistan. Methods: This study uses a qualitative descriptive design. Total of twelve Pakistani Nursing leaders were interviewed using semi-structured interview guideline to explore their experiences of empowerment. Results: The study findings revealed five major categories which include: status of a nurse, nursing profession, power relationships, value-belief system, and leadership and management. Conclusions: Nurses’ empowerment is essential for enhancing the image and status of nursing profession in Pakistan. The study identified various personal and professional factors affecting nurses’ empowerment in the country and suggests various strategies, such as access to higher nursing education, development of enhanced nursing leadership competencies and understanding of power and politics of the organization, through which nurses can achieve empowerment

Female Institutional Directors on Boards and Firm Value

The aim of this research is to examine what impact female institutional directors on boards have on corporate performance. Previous research shows that institutional female directors cannot be considered as a homogeneous group since they represent investors who may or may not maintain business relations with the companies on whose corporate boards they sit. Thus, it is not only the effect of female institutional directors as a whole on firm value that has been analysed, but also the impact of pressure-resistant female directors, who represent institutional investors (investment, pension and mutual funds) that only invest in the company, and do not maintain a business relation with the firm. We hypothesize that there is a non-linear association, specifically quadratic, between institutional and pressure-resistant female directors on boards and corporate performance. Our results report that female institutional directors on boards enhance corporate performance, but when they reach a certain threshold on boards (11.72 %), firm value decreases. In line with female institutional directors, pressure-resistant female directors on boards also increase firm value, but only up to a certain figure (12.71 % on boards), above which they have a negative impact on firm performance. These findings are consistent with an inverted U-shaped relationship between female institutional directors and pressure-resistant female directors and firm performance

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

TELECOMMUNICATIONS,INFORMATION, and ECONOMIC DEVELOPMENT in INDIA

The paper deliberates on various indicators of development of telecommunication and information sector in India for socio economic development and makes projections for future

Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital

Faisal Gulzar,1,2 Muhammad Shoaib Akhtar,1 Rafshan Sadiq,3 Sajid Bashir,1 Sajida Jamil,2 Shahid Mahmood Baig4,5 1Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Punjab, Pakistan; 2Department of Pharmacology, Faculty of Pharmacy, The University of Lahore, Lahore, Punjab, Pakistan; 3Punjab Institute for Nuclear Medicines (PINUM) Cancer Hospital, Faisalabad, Punjab, Pakistan; 4Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Faisalabad, Punjab, Pakistan; 5Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Punjab, Pakistan Background: Delay in seeking health care by breast cancer patients is associated with advanced stage of disease at presentation and poor survival rates. This study aimed to identify the reasons for delayed presentation and their association with various sociodemographic variables. Methods: A total of 200 female patients with abnormal clinical findings, ie, lump or palpable mass, were consecutively invited for this study. Diagnostic delay was defined as a consultation with a health care provider more than 3 months from the appearance of the first symptoms. Sociodemographic variables, presenting symptoms, knowledge about diseases and its symptoms, time between seeking medical attention after appearance of symptoms and causes of delayed presentation were investigated. Chi-squared and logistic regression tests for significance and associations were used. Results:&nbsp;Among 125 women with breast cancer fulfilling the inclusion criteria, aged 24&ndash;75 years, 88.8% (n=111) presented late (&ge;3 months) and 59% presented with advanced stage of disease (stage III/IV). The majority (65.6%) were older than 40 years of age, 99.2% were married, 60.8% had &lt;8 years of education, 67.2% had poor social status, and 64.8% had a negative family history of any cancer type. Almost all patients (96%) complained about the presence of a painless lump in their breast. Ignorance of disease or the presence of painless lumps in the breast and low financial resources for therapy (81.1%) were the main variables associated with delayed presentation. Educational factors (P&lt;0.001, OR 4.682) and social status (P&lt;0.001, OR 1.8) were also associated with delayed presentation. Conclusion: Our study highlighted the variables associated with delayed presentation in Pakistani breast cancer patients. A significant number of patients presented late owing to misconceptions and poor knowledge about the disease and its symptoms, while illiteracy and poor social status were the major contributing factors for delayed presentation, resulting in an advanced presentation of disease and ultimately a decreased survival rate. Keywords: breast cancer, painless lump, social status, illiteracy, survival rat

Wear characteristics of patterned and un-patterned tetrahedral amorphous carbon film in the presence of synthetic and bio based lubricants

In this article, wear performance of patterned and non-patterned tetrahedral carbon thin film (ta-C) is compared in the presence of various lubricants. For this purpose, wear tests were conducted at temperatures (40 °C-125 °C) which are normally found during automotive engine operation. Wear test were conducted at 100 N load and 120 min. The results showed that bio-based lubricant show better wear performance at 40 and 80 °C compared to PAO lubricant for both laser patterned and non-patterned ta-C thin film. However, at the temperature of 125 °C, PAO showed better wear performance than palm based TMP ester. This can be because of unstable film formation at higher temperatures in case of bio-based lubricant. It was also found that patterned ta-C thin films shows higher wear resistance than non-patterned thin film. This can be because of micro pores which can provide lubricant, capture micro and nano wear particle and behave as micro hydrodynamic bearings