Effect of on-the-job coaching on management trainees performance: a post merger case study of Glaxo-Smith-Klein Pakistan

This paper has identified the relationship between on-the-job coaching and job performance by considering the external forces involved in this relationship. The framework of the study illustrates the relationship between on the job coaching and job performance. The research has used quantitative design by application of case study technique. The data was collected through questionnaires from Marketing Sales Executives (MSEs) in the Rawalpindi/Islamabad regions of Glaxo-Smith-Kline (GSK). The paper has identified several variables which constitute coaching and it was found by the results that job performance has a positive relationship with on-the-job coaching. Furthermore the variables of coaching like coach ability, team coordination, action learning, and flexibility of the coach are also positively related with Job Performance. The paper suggests that at GSK, coaches need to lead from the front and use action learning techniques more often and they should perform what they deliver to the employees. Several rewards can also be given to trainees who perform well during the session. Sometimes a pat on the back can increase motivation immensely which in turn increases their performance on the job

Venoarterial PCO2 difference: a marker of postoperative cardiac output in children with congenital heart disease

OBJECTIVE: To determine the relationship between venoarterial carbon dioxide gradient (DeltapCO2) and central venous oxygen saturation (ScvO2) in children after cardiac surgery. STUDY DESIGN: A cohort study. PLACE AND DURATION OF STUDY: The Paediatric cardiac intensive care unit of the Aga Khan University Hospital, Karachi, from June 2006 to May 2007. METHODOLOGY: All children admitted in the paediatric cardiac intensive care after complete repair of congenital heart defect using cardiopulmonary bypass were included in the study. Simultaneous arterial and central venous blood gas samples were obtained from a catheter placed in the artery (either radial or femoral) and superior vena cava respectively. Linear regression analysis was performed between ScvO2 and DeltapCO2. RESULTS: Fifty seven children aged from 5 days to 14 years were included and 272-paired simultaneous arterial and central venous samples were analyzed. Mean venous pCO2 was 47.82+/-9.03 mmHg and mean arterial pCO2 was 40.50+/-9.06 mmHg. One hundred seventy four samples had ScvO2 \u3e 70% with mean DeltapCO2 of 5.44+/-2.55 mmHg and 98 samples had ScvO2 \u3c 70% with mean DeltapCO2 of 9.07+/-3.90 mmHg. With ScvO2 \u3c 70%, 77 samples had DeltapCO2 of \u3e 6 mmHg while only 21 samples had DeltapCO2 of \u3c 6 mmHg (p \u3c 0.001). On the contrary with ScvO2 \u3e 70%, 71 samples had DeltapCO2 of \u3e 6 mmHg and 103 samples had DeltapCO2 of \u3c 6 mmHg. Coefficient of correlation (R2) between 0.340 was ScvO2 and DeltapCO2. CONCLUSION: Elevated DeltapCO2 is practical and can be utilized as a useful adjunct to low ScvO2 in the assessment of low cardiac output syndrome in children after cardiac surgery

Antimicrobial Susceptibility Pattern among Patients Presenting with Acute Exacerbation of COPD

Background: The irrational use of antibiotics in outpatient as well as indoor patients without studying the culture and sensitivity patterns may have led to resistance in common organisms causing acute exacerbation of chronic obstructive pulmonary disease. The objective of this study was to determine the culture and sensitivity patterns of bacteria in the sputum of patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) in our population.Material and Methods: This cross-sectional study was conducted in the Medicine Department, Jinnah Hospital Lahore from 1st January 2018 to 25th June 2018. A total of 215 patients with acute exacerbation of COPD were collected through non-probability consecutive sampling technique. COPD was diagnosed on the basis of history, examination, chest X-ray and spirometry. Acute exacerbation was taken as an acute rise in one or more of the following; sputum volume and/or purulence, frequency and severity of cough and dyspnea. Two sputum samples were collected from each patient. Antimicrobial susceptibility testing was done as per CLSI guidelines. Data was analyzed by SPSS version 21.0. with p-value ≤ 0.05 considered as statistically significant.Results: Among 215 selected cases, 118 (54.88%) were males and 97 (45.12%) were females. A total of 110 (51.16%) cultures were positive and 105 (48.84%) were negative for bacterial growth. Klebsiella pneumoniae (n=69; 62.72%) was the most frequent microorganism in patient’s sputum followed by Pseudomonas aeruginosa (n=21; 19.1%) and Staphylococcus aureus (n=20; 18.2%). Regarding sensitivity pattern, amikacin was found to be the most sensitive antibiotic against these organisms followed by gentamicin and ciprofloxacin.Conclusions: Klebsiella pneumoniae was the most common microorganism in the sputum of patients presenting with acute exacerbation of COPD, while amikacin was reported to be most sensitive antibiotic against the microorganism.Key words: Acute exacerbation, Antimicrobial susceptibility pattern, COP

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Service Quality of Higher Education Digital Library (DL) and Loyalty Behaviors: Testing the Mediating Role of Student Satisfaction

Higher academic institutions are now focusing on capturing the behaviors of the postgraduate students towards digital libraries. It depends on the conditions of assessing the psychological needs of both parties in which service-provider provides services to recipient and recipient reciprocate service-provider in turn to their services. Drawing from service-encounter needs theory (SENT), this study measures the service quality of the digital library of the Pakistan higher education commission (HEC) and student behaviors using the digital library. Interestingly, this study tests the service quality of the HEC digital library in the sight of postgraduate students of the public and private Universities in Punjab, Pakistan. By collecting data from 403 postgraduate students, the study uses a convenient sampling approach using designed survey questionnaires. Out of 403, 305 survey questionnaires were valid and reliable so, the response rate was 75.68%. By testing the 2nd order measurement model, the study supported the direct significant and positive impact of service quality on student satisfaction. Interestingly, satisfaction is a psychological indicator of enhancing loyalty behaviors (Zhang and Bloemer, 2008). Furthermore, this study supported the mediating role of student satisfaction between service quality and student loyalty behaviors: intention to revisit (IRT), words of mouth (WOM), and willingness to pay more (WPM) and to extend the literature of loyalty behaviors. The results showed that there was a partially significant mediating relationship between overall service quality and among RPI, WOM, and WPM. Interestingly, student satisfaction had the highest mediating link between service quality and WOM. This research guides and recommends higher education commission (HEC) provide the database structure and equipment for searching research articles and books to the postgraduate students so, that they can easily achieve literature studies on the same subject. Moreover, the research provides the research limitations and future directions

Carer Empowerment Is Key to Reduce Dementia Care Inequalities in the Middle East

Dementia represents a significant problem in the Middle East. Sociocultural and political factors that shape conceptions of health and care tend to stifle research and the dissemination of knowledge throughout the Middle East. These socio-political challenges concerning engagement with individuals living with dementia and their carers include language barriers, stigmatization, logistical constraints, lack of informal support outside of hospitals, and over-dependence on clinicians for dementia information. There is an urgent need in the Middle East to increase care and support for adults with dementia and their carers, enhance research efforts and improve the dissemination of information related to dementia in the region. One possible way to do so is to begin to promote a knowledge-based culture throughout the Middle East. This can be achieved by aligning traditional deterministic and spiritual perspectives of mental health with more Western, scientific, and evidence-based models. We suggest employing practical, multidimensional approaches to deal with the stated challenges, both at individual and societal levels. Doing so will improve knowledge of dementia and allow health and social care systems in the Middle East to begin to address a growing problem

Peristaltic transport of Carreau-Yasuda fluid in a curved channel with slip effects.

The wide occurrence of peristaltic pumping should not be surprising at all since it results physiologically from neuro-muscular properties of any tubular smooth muscle. Of special concern here is to predict the rheological effects on the peristaltic motion in a curved channel. Attention is focused to develop and simulate a nonlinear mathematical model for Carreau-Yasuda fluid. The progressive wave front of peristaltic flow is taken sinusoidal (expansion/contraction type). The governing problem is challenge since it has nonlinear differential equation and nonlinear boundary conditions even in the long wavelength and low Reynolds number regime. Numerical solutions for various flow quantities of interest are presented. Comparison for different flow situations is also made. Results of physical quantities are interpreted with particular emphasis to rheological characteristics

Understanding the Antecedents of Use of E-Commerce and Consumers’ E-Loyalty in Saudi Arabia Amid the COVID-19 Pandemic

Customer loyalty is a critical factor for any business’ long-term profitability and growth. Despite the rapid expansion and prominence of e-commerce, businesses still face challenges in attaining customers’ e-loyalty. The objective of this paper is to uncover the numerous factors that have an impact on e-loyalty. The data were gathered from 334 students from various universities in Saudi Arabia. With the aid of structural equation modeling (SEM), the hypotheses were examined. The findings support the links between effect expectation, social influence, and facilitating conditions on the use of e-commerce (UEC). However, the linkage between perceived risk and performance expectations on the UEC is not supported. In addition, the UEC predicts e-commerce satisfaction, and e-commerce satisfaction predicts e-loyalty. The paper also supports the UEC and e-commerce satisfaction as mediators. Importantly, the e-commerce experience is supported as a moderator of the connection between e-commerce satisfaction and e-loyalty. The paper recommends that online businesses assess the three constructs of effect expectation, social influence, and facilitating condition that are positively associated with the UEC. Various implications, both theoretical and practical, are highlighted

Slip effects on mixed convective peristaltic transport of copper-water nanofluid in an inclined channel.

Peristaltic transport of copper-water nanofluid in an inclined channel is reported in the presence of mixed convection. Both velocity and thermal slip conditions are considered. Mathematical modelling has been carried out using the long wavelength and low Reynolds number approximations. Resulting coupled system of equations is solved numerically. Quantities of interest are analyzed through graphs. Numerical values of heat transfer rate at the wall for different parameters are obtained and examined. Results showed that addition of copper nanoparticles reduces the pressure gradient, axial velocity at the center of channel, trapping and temperature. Velocity slip parameter has a decreasing effect on the velocity near the center of channel. Temperature of nanofluid increases with increase in the Grashoff number and channel inclination angle. It is further concluded that the heat transfer rate at the wall increases considerably in the presence of copper nanoparticles