Cultural Adaptation and Validation of the Urdu Version of the Cognitive Emotion Regulation Questionnaire (CERQ) in Male Patients With Substance Use Disorders (SUDs) in Pakistan

Background Adults with substance use disorders (SUDs) often have co-occurring mental health problems. Emotion regulation may play a vital role in mental health problems. The Cognitive Emotion Regulation Questionnaire (CERQ) is a widely used measure for assessing cognitive emotion regulation. However, it has not been used in Pakistan on patients with co-occurring SUDs and mental health issues. The present study aims to translate and adapt the CERQ into the Urdu language and to determine its reliability and convergent validity in a sample of male patients with SUDs in Pakistan. Method Participants completed a demographic information form, the CERQ, the Depression, Anxiety, and Stress Scale Short Form [DASS-21)], and the Rosenberg Self-Esteem Scale [RSES)] in Urdu. Results Male participants (N = 237) 18–50 years of age (M = 29.8, SD = 8.1) were recruited from four substance use disorder treatment centers and hospitals in Karachi. The reliability of the Urdu version of the CERQ was based on an examination of its internal consistency reliability (Cronbach's α) and test–retest reliability for both the total scale and its subscales. Internal consistency for the CERQ total (α = 0.80) was adequate, as it was for subscales of self-blame, (0.76) acceptance (0.78), rumination (0.72), positive refocusing (0.79), focus on planning (0.89), positive reappraisal (0.81), putting into perspective (0.83), catastrophizing (0.73), and other blame (0.70). The 10–14 day test–retest reliability of the CERQ total score was 0.86. Higher CERQ scores were significantly (ps < 0.001) negatively associated with DASS-21depression (r = –0.24), anxiety (r = –0.23), and stress (r = –0.27) subscales, as well as the DASS-21 total score (r = –0.26) and positively associated with the RSES self-esteem score (r = 0.30). Conclusion The Urdu version of the CERQ is a reliable measure for investigating cognitive emotion regulation strategies related to mental health and SUDs in Pakistan

'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study. Methods: Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed. Results: The median time taken to make the decisions to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC and poverty, distance, transportation difficulties and decision making by male guardian were associated with slower access to EmOC. Conclusions: The intervention appeared to reduce the time taken to make the decision to access health care and time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community

Prevalence of Psychological Problems among Survivors of the Earthquake in Northern Areas of Pakistan

ABSTRACT The purpose of present study is to investigate the prevalence of psychological problems in the earthquake victims in Northern Areas of Pakistan. The sample of the present study consist of 200 earth quake victims (Mean age = 36.20; SD=16.78

Risk Factors Leading to Meconium Aspiration Syndrome in Meconium-Stained Amniotic Fluid

OBJECTIVES This study aimed to find out the risk factors leading to meconium aspiration syndrome in patients having meconium-stained amniotic fluid. METHODOLOGY This comparative study was conducted in the department of Obstetrics and Gynaecology at Hayatabad Medical Complex from January 2022- June 2022. All patients admitted to the labour ward with the diagnosis of meconium-stained liquor (MSL) were included in the study through a convenient sampling technique. Patients were divided into two groups, group 1 having only meconium-stained amniotic fluid (MSAF) without meconium aspiration syndrome while group 2 having babies with the diagnosis of meconium aspiration syndrome (MAS). Both groups were compared for different risk factors for the development of MAS. Differences in the risk factors between the two groups were analyzed using Pearson’s correlation with a p-value of &lt;0.05 considered significant. SPSS vs 20 was used for statistical analysis. RESULTS 84 patients were included in the study, i.e., 61 in group 1 and 23 in group 2. The mean age of the patients was 25± 3.45. The frequency of meconium-stained amniotic fluid was 3.83%. Meconium aspiration syndrome developed in 23 babies out of 84 MSAF deliveries (27.38%). Low APGAR score (&lt; 0.00), patients handled outside the hospital (&lt;0.001) and prolonged second stage (0.003) were significant risk factors for the development of MAS. CONCLUSION In the prolonged second stage, patients handled outside the hospital by unauthorized personnel and low APGAR score at birth were statistically significant risk factors for developing meconium aspiration syndrome

Potential Healing Powers with Jute Plant- A Review

Jute (Corchorus spp) can be a potential medicinal product for the treatment of many diseases. In traditional medicinal practices, it is used to treat constipation, demulcent, dysentery, worm, carminative anthalmitic, intestinal antiseptic, ascites, pain, piles, tumors, dysuria, febrifuge, stomachic, cystitis etc. Till now more than 80 compounds, including glycosides, triterpenes, ionones, phenolics, phytosterols, organic acids, lignins, alkaloids have been isolated and identified from jute plant. The main phytochemical compounds are cardiac glycosides, corchorin, corchotoxin, helveticoside, corchoroside A and B, olitoriside, erysimoside, straphatidol, glycoside, capsularinsteroids and many other secondary metabolites. Modern studies have revealed several biological activities such as acidic polysaccharide, cardiotonic, anti-obisity, gastroprotective, antidiabetcs, antioxidant, anti-inflammatory and cytotoxic activities. The present review deals to provide comprehensive knowledge on the phytochemistry and pharmacological activities of different plant extracts of jute based on the available scientific literature, provide a potential guide to highlight the available literature on jute plant with respect to ethnobotany, chemical constituents and summary of various pharmacological activities

Long - term conservation agriculture increases nitrogen use efficiency by crops, land equivalent ratio and soil carbon stock in a subtropical rice - based cropping system

Conservation Agriculture (CA) is still a relatively new approach for intensively cultivated (3 crops yr-1) rice-based cropping systems that produce high crop yield and amounts of residues annually. With the recent development of transplanting of rice into tilled strips on non-puddled soil, CA could become feasible for rice-based cropping patterns. However, the effect of increased retention of crop residues on crop response to nitrogen (N) fertilization rate in strip tilled systems with the transplanted rice and other crops grown in the annual rotation is yet to be determined. For nine years, we have examined the effects of soil disturbance levels - strip tillage (ST) and conventional tillage (CT), two residue retention levels –15% residue by height (low residue, LR) and 30% residue (high residue, HR) and five N rates (60%, 80%, 100%, 120%, and 140% of the recommended N fertilizer doses (RFD)) for a rice-wheat-mungbean cropping sequence. The 100% RFD was 75, 100 and 20 kg N ha-1for rice, wheat, and mungbean, respectively. Rice yields were comparable between the two tillage systems for up to year-6, wheat for up to year-3 but mungbean yield markedly increased in ST from year-1; however, the land equivalent ratio increased from year-1, principally because of higher mungbean yield. Introduction of ST increased land equivalent ratio by 26% relative to CT, N use efficiency and partial factor productivity. Nitrogen fertilizer demand for maximum yield in ST was increased by about 10% for rice and 5% for mungbean but decreased by 5% for wheat. Although fertilizer N demand had increased in ST system due to higher yield than CT, the N requirement declined by50–90% when the same yield goal is considered for ST as for CT. The soil organic carbon stock (0–15 cm) after 8 years increased from 21.5 to 30.5 t ha-1 due to the effect of ST plus high crop residue retention. Annual gross margin increased by 57% in ST over CT practice and 26% in HR over LR retention. In conclusion, after 9 years practicing CA with increased residue retention under strip tillage, the crops had higher N use efficiency, grain yield, land equivalent ratio and annual gross margin in the rice-wheat-mungbean cropping system while the N fertilizer requirement increased minimally

Competing biosecurity and risk rationalities in the Chittagong poultry commodity chain, Bangladesh

This paper anthropologically explores how key actors in the Chittagong live bird trading network perceive biosecurity and risk in relation to avian influenza between production sites, market maker scenes and outlets. They pay attention to the past and the present, rather than the future, downplaying the need for strict risk management, as outbreaks have not been reported frequently for a number of years. This is analysed as ‘temporalities of risk perception regarding biosecurity’, through Black Swan theory, the idea that unexpected events with major effects are often inappropriately rationalized (Taleb in The Black Swan. The impact of the highly improbable, Random House, New York, 2007). This incorporates a sociocultural perspective on risk, emphasizing the contexts in which risk is understood, lived, embodied and experienced. Their risk calculation is explained in terms of social consent, practical intelligibility and convergence of constraints and motivation. The pragmatic and practical orientation towards risk stands in contrast to how risk is calculated in the avian influenza preparedness paradigm. It is argued that disease risk on the ground has become a normalized part of everyday business, as implied in Black Swan theory. Risk which is calculated retrospectively is unlikely to encourage investment in biosecurity and, thereby, points to the danger of unpredictable outlier events

Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan : Evidence from two longitudinal cohort studies 15 years apart

Funding Information: Study 1 was funded through the Applied Diarrheal Disease Research Program at Harvard Institute for International Development with a grant from USAID (Project 936–5952, Cooperative Agreement # DPE-5952-A-00-5073-00), and the Aga Khan Health Service, Northern Areas and Chitral, Pakistan. Study 2 was funded by the Pakistan US S&T Cooperative Agreement between the Pakistan Higher Education Commission (HEC) (No.4–421/PAK-US/HEC/2010/955, grant to the Karakoram International University) and US National Academies of Science (Grant Number PGA-P211012 from NAS to the Fogarty International Center). The funding bodies had no role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript. Publisher Copyright: © 2020 The Author(s).Peer reviewedPublisher PD

Development and validation of a simplified algorithm for neonatal gestational age assessment - protocol for the Alliance for Maternal Newborn Health Improvement (AMANHI) prospective cohort study.

OBJECTIVE: The objective of the Alliance for Maternal and Newborn Health Improvement (AMANHI) gestational age study is to develop and validate a programmatically feasible and simple approach to accurately assess gestational age of babies after they are born. The study will provide accurate, population-based rates of preterm birth in different settings and quantify the risks of neonatal mortality and morbidity by gestational age and birth weight in five South Asian and sub-Saharan African sites. METHODS: This study used on-going population-based cohort studies to recruit pregnant women early in pregnancy (<20 weeks) for a dating ultrasound scan. Implementation is harmonised across sites in Ghana, Tanzania, Zambia, Bangladesh and Pakistan with uniform protocols and standard operating procedures. Women whose pregnancies are confirmed to be between 8 to 19 completed weeks of gestation are enrolled into the study. These women are followed up to collect socio-demographic and morbidity data during the pregnancy. When they deliver, trained research assistants visit women within 72 hours to assess the baby for gestational maturity. They assess for neuromuscular and physical characteristics selected from the Ballard and Dubowitz maturation assessment scales. They also measure newborn anthropometry and assess feeding maturity of the babies. Computer machine learning techniques will be used to identify the most parsimonious group of signs that correctly predict gestational age compared to the early ultrasound date (the gold standard). This gestational age will be used to categorize babies into term, late preterm and early preterm groups. Further, the ultrasound-based gestational age will be used to calculate population-based rates of preterm birth. IMPORTANCE OF THE STUDY: The AMANHI gestational age study will make substantial contribution to improve identification of preterm babies by frontline health workers in low- and middle- income countries using simple evaluations. The study will provide accurate preterm birth estimates. This new information will be crucial to planning and delivery of interventions for improving preterm birth outcomes, particularly in South Asia and sub-Saharan Africa

Environmentalism in the EU-28 context: the impact of governance quality on environmental energy efficiency

Environmental policies are a significant cornerstone of a developed economy, but the question that arises is whether such policies lead to a sustainable growth path. It is clear that the energy sector plays a pivotal role in environmental policies, and although the current literature has focused on examining the link between energy consumption and economic growth through an abundance of studies, it does not explicitly consider the role of institutional or governance quality variables in the process. Both globalization and democracy are important drivers of sustainability, while environmentalism is essential for the objective of gaining a “better world.” Governance quality is expected to be the key, not only for economic purposes but also for the efficiency of environmental policies. To that end, the analysis in this paper explores the link between governance quality and energy efficiency for the EU-28 countries, spanning the period 1995 to 2014. The findings document that there is a nexus between energy efficiency and income they move together: the most efficient countries are in the group with higher GDP per capita. Furthermore, the results show that governance quality is an important driver of energy efficiency and, hence, of environmental policies.University of Granad