A Grounded Theory Case Study Examining the Impact on Policy Actors of their Engagement and Interactions with Educational Policy Implementation Processes.

In the field of Education there appears to be a gap in the literature examining policy implementation process from the viewpoint of educational stakeholders. This thesis attempts to address that gap by examining the impact on site based policy actors of the implementation of a policy in the form of a new mathematics curriculum. This dissertation endeavours to answer the question of how the interactions and engagement of policy actors with policy implementation processes are impacted by and impact such processes. The research approach adopted is that of a case study using a Classic Grounded Theory Methodology. This approach permits the data to be approached from a conceptually neutral position, allowing theoretical understanding to be built from the concepts that emerge from the analysis. The theoretical model developed from this grounded theory analysis is then filtered through two conceptual lenses, social cognition and affect/emotion, to determine an understanding of their theoretical relevance to the interactions and engagement of policy actors with policy processes. This study adds to the understanding of how policy processes unfold in a site based setting. In particular, it gives recognition to the affective responses of policy actors as they engage and interact with policy processes and how those responses may impinge on those processes

Impact of pregnancy on cancer survival: Experience at a tertiary care hospital

Objectives: To assess the overall survival of pregnant women diagnosed with cancer during pregnancy or became pregnant thereafter.Methods: A retrospective medical record review of 90 patients who were diagnosed with cancer when pregnant or who became pregnant thereafter between 1996 and 2015 in Aga Khan University Hospital, Karachi.Results: A total of 90 patients were analyzed. The malignancies that expectant mothers had were, breast cancer 38 (42.2%), hematological cancers 29 (32.2%), brain cancer 10 (11.1%), and other malignancies 13 (14.4%) that included thyroid cancers, gestational trophoblastic disease and synovial tumor of foot. We observed only four deaths out of 90 patients and mean survival time in pregnant patients with malignancies was 17.98 years [CI 16.35-19.31].Conclusions: The diagnosis of most cancer types before or during pregnancy does not influence on overall survival of patients

FORTHCOMING NEUROSURGICAL EVENTS

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International Neurosurgical Events

FORTHCOMING NEUROSURGICAL EVENTS Assistant Professor, Department of Neurosurgery, King Edward Medical University, Lahore 3rd Joint Scientific Meeting of RSSA & AIRP. Main Conference, 9th, 10th – 11th October 2018 Jeddah 1st EANS Trauma & Critical Care Update Meeting. December 13-14, 2018, Lund, Sweden Brainstorm on Brainstem. International Conference on Diagnostics and Treatment of Brainstem Lesions. The 2nd International Patient Experience Summit 2019. Shaping the Future of Health Care “Empathy + Culture”. 4th – 6th February, 2019. WFNS 2019. September 9 – 12, 2019 LINC International Neurovascular Course. Multimodality Management of Intracranial and Spinal AVMs. University of Thessaly School of Health Sciences, Department of Neurosurgery. March, 29 & 30, 2019

Metacognitive Awareness of Reading Strategies, Reading Practices and Academic Attainments of University Students

This study was conducted to examine the relationship between metacognitive awareness of reading strategies (MARS), and academic attainments (AA) of undergraduate business students. It also investigated the relationship between reading practices (RP) and MARS. There are three different categories of MARS – global, problem solving, and support reading strategies. The Metacognitive Awareness of Reading Strategies Inventory (MARSI), developed by Mokhtari and Reichard (2002) was used as the instrument for this study where the sample consisted of 571 male and female students of undergraduate business program from private and public universities of Karachi. The results showed Metacognitive Awareness of Reading Strategies significantly predicts academic attainments of university students. The findings suggest that conducting workshops or training sessions for promoting MARS may be helpful to enhance students’ concentration towards the reading process that may affect their learning. Keywords: academic attainments, metacognitive awareness of reading strategies, reading practices, undergraduate students

Improved clinical competence and patients satisfaction: Comparison of patient-centered, interdisciplinary collaborative round versus traditional post-partum round

The origin of the patient-centered interdisciplinary collaborative round, which involves health care members of all levels at a time, is an effective and emerging approach to offer inpatient healthcare. Traditionally, post-partum rounds at teaching hospitals consisted of separate visits from all members of the obstetric team that resulted in patient inconvenience, care insufficiencies, and communication gaps. The main objective of this study was to assess the patient\u27s satisfaction level from the traditional post-partum round versus the patient-centered collaborative care (PCCC) round. This study showed that in the traditional round, the patient\u27s satisfaction with the treatment was 95.1%; whereas, in PCCC rounds it was 96.9%. Patients were more satisfied with the treatment options discussed with them and the results of the medical tests explained to them. In conclusion, the survey showed that the implementation of the PCCC round improved patient satisfaction

Potential barriers amongst health care professionals of Pakistan in managing COVID-19 patients

Objectives: To evaluate basic knowledge of Health Care Professionals (HCPs) of Pakistan in managing COVID 19 patients. It includes information regarding infection control measures, administrative and professional support. This was followed by evaluation of psychological factor that can act as a barrier in effective management of these patients.Methods: The survey was conducted on line using Google Form. After approval from hospital ethical committee survey link was disseminated to HCPs using social media.Results: Four hundred fifteen HCPs were participated. Most of them were younger than 30 years and majority of them were postgraduate trainees. Results showed gaps in the knowledge about basic infection control measure like donning/doffing and understanding about high-risk procedures. On job training, professional and administrative support is compromising. Many of HCPs are anxious nowadays, having symptoms related to burn out with logical reasons behind. Even with all those hurdles they are committed and ready to volunteer themselves.Conclusion: The HCPs of Pakistan needs urgent attention for providing them Formal training regarding infection control measure. Administrative and professional support is required from institutions and scientific societies. Online teaching modules and webinar is a suitable option. The symptoms of burn out are significant and would increase with passage of time. This needs to be supported by occupational health committees

Course and outcomes of complicated gallstone disease in pregnancy: a single centre experience

Background: The incidence of acute abdomen during pregnancy is approximately 1 in 500 pregnancies. The incidence of symptomatic gallstone disease in pregnancy is reported in approximately 0.2-0.5 per 1,000 pregnancies. Symptoms are similar to those in the nonpregnant state. A delay in diagnosis may increase the risk of perforation. Treatment in most cases is conservative. However, recent trends, newer instrumentation and skilled personnel encourage arranging laparoscopic cholecystectomy at the time of diagnosis.Methods: This study was a retrospective study, included 117 pregnant patients with acute gallstone disease, who were treated and followed-up at Government Medical College, Srinagar, Department of General Surgery and Department of Gynae And Obstetrics, between January 2015 and April 2017.Results: The mean age of patients in our study was 28.6 years. Majority of patients 56 (47.86%) were in is trimester of pregnancy. Parity of the patients varied from 1 to 6, with a mean parity of 2.67. The presentation of majority of patients was colicky pain right upper abdomen,108 (92.30%). All patients had gallstones on USG scan.101(86.32%) patients had acute cholecystitis, while 8 (6.83%) patients had predominant features of acute pancreatitis,8(6.83%) patients had accompanying choledocholithiasis The average wall thickness of gallbladder in our patients was 4.62 mm. Majority 106 (90.59%) patients were managed conservatively. 8 (6.83%) patients underwent cholecystectomy in same admission, after failure of conservative management, 7 patients underwent laparoscopic cholecystectomy and one underwent open cholecystectomy. 3 patients (2.56%), who had features of cholangitis were managed by ERCP. The average length of hospital stay in our patient group was 8.61 days. There was one maternal death reported in our study, there were a total of 8 (6.83%) preterm deliveries.Conclusions: Symptomatic gallstone disease in pregnancy is a common surgical problem. Diagnosis during pregnancy can be difficult, majority of cases can be managed conservatively, intervention whenever indicated must be undertaken

A fatal case of gram negative bacterial sepsis associated with disseminated strongyloidiasis in an immunocompromised patient

We report a fatal case of disseminated strongyloidiasis in a patient with multiple myeloma receiving chemrotherapy. A fifty-seven years old man presented with severe diarrhoea and vomiting, fever, weight loss and dysphagia,due to mouth ulcers. Despite broad-spectrum intravenous antibiotics, albendazole (anti protozoal) and supportive treatment, the patient died of Gram-negative sepsis

Comparison of risk factors and survival of type 1 and type II endometrial cancers

Objective: To compare risk factors and progression free survival of type 1 & 2 endometrial cancers.Methods: A retrospective analysis of 149 patients with early stage endometrial carcinoma treated between 1997 and 2012 in Aga Khan University Hospital, Karachi was performed.Results: A total of 149 patients were analyzed. Type I tumors accounted for 92% of cases in the study while 8% were type II tumors. The mean age, BMI, parity, co-morbidities (hypertension & Diabetes), family history and history of polycystic disease were comparable in both groups. Overall better survival (113 Vs 24 months) was observed for type I endometrial cancer.Conclusion: Both types of endometrial cancer may share common etiologic factors. Despite the limitation of small numbers in one group this study confirms better survival in type 1 endometrial cancer