Preferential Treatment Impacts Organizational Commitment: Evidence from Public Universities of Pakistan

Preferential treatment is detrimental. Keeping in view this important perspective, this study intends to capture the impact of preferential treatment via favoritism, nepotism, and cronyism on employee commitment in Public Universities of Pakistan. To seek the objectives of the study 400 questionnaires were distributed to employees of different Public Universities. The findings of the study revealed the negative impact of favoritism, nepotism, and cronyism on employees’ commitment. The results of the study confirmed the moderating role of LMX in the relation between favoritism-organizational commitment as well between nepotism-organizational commitment relation whereas, contrary to expectations LMX did not moderate the relation between cronyism and organizational commitment. Practical implications, limitations as well future directions are discusse

Interventional Study on Adherence to Pharmacotherapy and Drug Pattern in Elderly Patients at Civil Hospital of Badin, Pakistan

Background: To assess the contributing factors to adherence of pharmacotherapy and perception of elderly patients. Methods: This prospective cross-sectional study was conducted in the outpatient clinic of Civil Hospital Badin, Pakistan from January to June 2019. A total of 300 samples were selected to analyze the results. A self-designed proforma (prescribing indicator form) was used for collecting data including patient demographics, diagnosis, and the current medications prescribed for each patient. Results: Of the 300 selected participants, 221(73.7%) were male, while 79 (26.3%) were female. Majority of the subjects in the age group of 60–69 (52%) and 70–79 years (27%) followed by those aged >79 (21%). Antibiotics were prescribed to 17.2% and vitamins to 14.7%. Patients’ responses related to nonadherence factor were 92.7% for the cost, 32.7% for the long treatment duration, and 24% for the lack of knowledge. Out of the total patients, 28% were forgetful, 26.7% complained about complex therapy, 26.3% blamed financial problems, 19.7% patients had side effects, and 14.3% were negligent in taking the medication. Conclusion: Patient conformity can be enhanced by dropping polypharmacy and simplifying complex management, use of extended formulations, rate of medications, and by creating awareness among elderly patients. Keywords: elderly, polypharmacy, pharmacotherapy, adherenc

Assessment of Knowledge, Qualification, Experience, and Medication Dispensing Practices in South Karachi, Pakistan

Background: Drug stores in Pakistan are run by dispensers with varied knowledge, qualification, and experience. The current study was sought to explore the knowledge, qualification, experience, and dispensing practices among dispensers working in drugstores in South Karachi, Pakistan. Methods: A cross-sectional survey was carried out using a structured questionnaire. Data were collected from medical stores in South Karachi which were then categorized, coded, and analyzed using SPSS version 23. Relationship among different study variables with pharmacist’s availability and personal experience was assessed using statistical non-parametric Chi-square test. A total of 385 samples obtained using a simple random sampling method were included in the study. However, only 210 responses on questionnaire were complete which were then selected for study analysis between October and December 2018. Results: Of the 210 surveyed drugstores, 9% of their staff had studied only till primary school, 5.7% till the eighth grade, 25.2% up to secondary school level, 26.7% till higher secondary school level, 15.7% had non-professional education, and 8.1% were professional graduate. Only 9% of them had a degree in Pharm. D or B. Pharm, while 0.5% had a post-graduation qualification. Furthermore, 44.8% of pharmacies had a valid pharmacy license but the pharmacist was physically absent in 91% of the drugstores. Majority of pharmacies did not maintain appropriate temperature (refrigerator and/or room temperature). Majority of dispensers did not review prescription particulars before dispensing medications and also dispensed medications on older prescriptions as well as without prescription. Conclusion: In conclusion, the overall knowledge and practices of dispensers working in drugstores was poor. However, the presence of pharmacist was associated with good dispensing practices to a certain extent

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

The Relationship Between Corporate Diversification and Tax Avoidance: Empirical Evidence from the Emerging Economy of Pakistan

Tax avoidance are the strategies that firms use to avoid their tax payments and rise their after-tax income. Recently, tax avoidance increase consideration in the modern research literature. In developing countries like Pakistan, taxes are a most important element to support the country’s budget and revenues. Therefore, this study tries to find the impact of corporate diversification on tax avoidance of listed firms in Pakistan stock exchange. For sample selection study use the 22 different sectors and select 129 companies based on availability of data. The time horizon of this study is 13 years started from 2006 to 2018 on annual basis. Study uses GAAPETR (tax expense / pre-tax income) to measure the tax avoidance besides entropy-index use for corporate diversification. To identify the long-term relationship between corporate diversification and tax avoidance study apply Johnson and Julius (1990) multivariate co-integration analysis. The results of Johnson and Julius (1990) approach shows that co-integration exist between corporate diversification and tax avoidance. Besides study use firm characteristics as control variables like leverage, firm profitability, ratio of capital expenditure and market to book ratio.  Finally, study has policy implication for government, policy makers, regularity bodies, tax authority’s, investors and other stakeholders in Pakistan

Environmental Disclosures and Environmental Management Strategies – A study of Pakistani Listed companies

The main purpose of this paper is to understand the environmental disclosure by listed companies of Pakistan in the light of legitimacy theory. Furthermore, it highlights the environmental management strategies pursued by them. This research used a content analysis research method to codify the reported information in the annual reports into the environment related themes. The data analysis results revealed that the sampled companies appear to give little importance to environmental issues. The companies which have disclosed mainly reported about ‘environmental pollution’, ‘energy’, and ‘conservation of natural resources’ themes; and provided declarative types of disclosure about them. As for as environmental strategies are concerned only a few non-financial companies have followed proactive environmental strategies and made real efforts to address environmental issues. These results seem to reflect that the companies have disclosed environment related information in the annual reports in order to legitimize their existence. &nbsp

Lean Six Sigma DMAIC Approach to Improve Delivery Performance: Lean Six Sigma to Improve Performance

Today each and every thing is available just on one click. On-time delivery, quality and cost are the globally recognized foremost business drivers. Instant delivery of quality products with reasonable price is the first priority of today’s customers and business is distinguished to fulfill this expectation of customer. Advancement in technology is growing day by day. Amazon Prime offers quick delivery of One Day to its global customers. Such type of trend has urged manufacturing industry to make fast manufacturing with high quality and low price. Defects and wastages reduction is the first move to compete on globally. Quick or On-time delivery, quality and reduced costs are attainable by reducing cycle time and eliminating defects and wastages from manufacturing processes. The aim of this study is to improve on-time delivery performance by reducing cycle time with the minimization of rejection faults of washing and dyeing processes by implementing Lean Six Sigma DMAIC approach. Through the five phases of DMAIC, different tools and techniques of six sigmas were exercised. Define phase helped to elucidate the problem, measure phase computed the frequency of rejection defects and process sigma level, analyzed phase used pareto analysis to identify vital few and fishbone diagram to find root cause of vital few, to generate possible solutions and implement best one, brainstorming and KAIZEN events were used in improve phase, and control phase devised monitoring mechanism to sustain the results .DMAIC was applied in Washing department for washing and dyeing processes. Conspicuous results were found with successful application of DMAIC. The rejection rate was reduced from 5% to 0.9% and delivery performance was improved from76% to 94%. Sigma level was enhanced from 4.1 to 4.7 and FPY was upgraded from 95% to 99%. Company saved $24593 and$73778 on monthly and quarterly basis respectively

Interventional Study on Adherence to Pharmacotherapy and Drug Pattern in Elderly Patients at Civil Hospital of Ba

Background: To assess the contributing factors to adherence of pharmacotherapy and perception of elderly patients.Methods: This prospective cross-sectional study was conducted in the outpatient clinic of Civil Hospital Badin, Pakistan from January to June 2019. A total of 300 samples were selected to analyze the results. A self-designed proforma (prescribing indicator form) was used for collecting data including patient demographics, diagnosis, and the current medications prescribed for each patient.Results: Of the 300 selected participants, 221(73.7%) were male, while 79 (26.3%) were female. Majority of the subjects in the age group of 60–69 (52%) and 70–79 years (27%) followed by those aged >79 (21%). Antibiotics were prescribed to 17.2% and vitamins to 14.7%. Patients’ responses related to nonadherence factor were 92.7% for the cost, 32.7% for the long treatment duration, and 24% for the lack of knowledge. Out of the total patients, 28% were forgetful, 26.7% complained about complex therapy, 26.3% blamed financial problems, 19.7% patients had side effects, and 14.3% were negligent in taking the medication.Conclusion: Patient conformity can be enhanced by dropping polypharmacy and simplifying complex  management, use of extended formulations, rate of medications, and by creating awareness among elderly patients