Determinants of overall knowledge and health behaviours in relation to hepatitis B and C among ever-married women in Pakistan: evidence based on Demographic and Health Survey 2017–18

Background: In 2019, around 5 million and 10 million people were affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) respectively in Pakistan. On World Hepatitis Day 2019, Pakistan's Government announced the Prime Minister's Plan to eliminate HBV and HCV from the country by 2030. In order to achieve this goal, adequate knowledge about HBV and HCV regarding mode of transmission, symptoms of the disease, and awareness about available treatments and vaccines is imperative. The present study aims to investigate the determinants related to overall knowledge about and behaviour in relation to HBV and HCV amongst married women in Pakistan. Methods: Secondary data analysis was carried out using the Pakistan Demographic and Health Survey (PDHS) 2017-18. A series of questions regarding women's knowledge about how to avoid HBV and HCV and their health behaviour in relation to HBV and HCV were posed to 12,364 ever-married women of reproductive age (15-49 years). Bivariate and multivariable logistic and linear regression was applied to examine the effects of sociodemographic characteristics and covariates on women's overall knowledge and health behaviour regarding HBV and HCV. Results: The findings highlight that the majority of women (88.3%) have heard of HBV and HCV. Nonetheless, only 34.8% had comprehensive knowledge about how to avoid HBV and HCV. Few women (11.3%) had been tested for HBV or HCV during the year preceding the survey. Furthermore, the results indicate that women living in urban areas, being older, and having more than 10 years of schooling, reported better knowledge and health behaviours regarding HBV and HCV. Conclusion: This study provides evidence that women's sociodemographic characteristics create differences in their overall knowledge about and attitudes towards HBV and HCV. This research emphasized that there is a need to create awareness about the causes and prevention of HBV and HCV in order to achieve the goal of eliminating these diseases in Pakistan by 2030

Binge-Watching as Behavioral Addiction: A Systematic Review

In the recent past, binge-watching has emerged as one of the most prevalent pursuits among adults. Being a relatively new phenomenon, there is a pressing need to examine the literature on the associations of binge watching with various psychological correlates such as cognitive processes, emotional regulation, moods and sleep patterns. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) model was employed for this systematic review. Relevant articles were collected using various databases including Google Scholar, Research Gate and PubMed. This resulted in a collection of 209 articles which were further screened based on the predefined inclusion and exclusion criteria. Out of these articles, 18 met the criteria and were included in the study. The findings revealed noteworthy associations between binge-watching behavior; particularly problematic patterns, and disruptions in mood and emotional dysregulation. The systematic review highlighted that the phenomenon of binge-watching as an addictive and problematic behavior has negative outcomes for individuals such as compromised executive functioning as well as cognitive deficits

Prestige and Nuclear Security of Iran: A Pakistani Perspective

The nuclear program of Iran has been fraught with controversies and it has faced several economic sanctions over the years. These controversies emerged and grew stronger with Iran refusing to provide the international experts access to controversial sites like Natanz where it is assumed that illegal activities relating to uranium enrichment are taking place. Iran assumes an important position in the region. However, it shares ideological and political differences with its neighboring Sunni majority Arab states. Iran considers United States and Israel as its main adversaries and, historically, there have been several exchanges of threats of war to each other. With these threats it is implied that Iran wants to develop nuclear weapons for; firstly, to have hegemonic position in the region; secondly, to make the threat to US and Israel more credible; and lastly, to have a greater say in the world affairs. Iran’s nuclear program has been a source of concern for its regional countries and Pakistan also, being a neighboring country. The relations between them may get complicated; however, the differences between Iran and Pakistan are not huge enough to result in the hot conflict

Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012

Iqbal S, Maqsood S, Zakar R, Zakria Zakar M, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Services Research. 2017;17(1): 189.Background Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012. Methods Secondary data analysis was performed on nationally representative data from the last two iterations of Pakistan Demographic and Health Survey (PDHS), conducted during 2006/07 to 2012/13. The analysis is limited to women of the reproductive age group (15–49 years) who gave birth during the last five years preceding both surveys. This leads to a sample size of 5,724 and 7,461 respondents from PDHS 2006/07 and 2012/13 respectively. The association between CoC and several factors, including individual attributes (reproductive status), family influences, community context, as well as cultural and social values was assessed in bivariate analyses in a first step. Furthermore, odds ratios and adjusted odds ratios with 95% confidence intervals using a binary and multivariable logistic regression were calculated. Results Our research presents the trends of a composite measure of CoC including antenatal care, delivery assistance and postpartum care. The largest gap in CoC was observed at antenatal care followed by delivery and postnatal care within 48 h after delivery. Results show that CoC completion rate has increased from 15% to 27% amongst women in Pakistan over time from 2006 to 2012. Women with high age at first birth, having less number of children, with higher education, belonging to richest quintile, living in Sindh province and urban areas, having high autonomy and exposure to mass media were most likely to avail complete CoC. Conclusions The findings show that women in Pakistan still lack the CoC. This calls for attention to develop and implement tailored interventions, focusing on the needs of women in Pakistan to provide CoC in an integrated manner, involving both public and private sectors by appropriately addressing the factors hindering CoC completion rates

Determinants of overall knowledge of and attitudes towards HIV/AIDS transmission among ever-married women in Pakistan: evidence from the Demographic and Health Survey 2012–13

Iqbal S, Maqsood S, Zafar A, Zakar R, Zakria Zakar M, Fischer F. Determinants of overall knowledge of and attitudes towards HIV/AIDS transmission among ever-married women in Pakistan: evidence from the Demographic and Health Survey 2012–13. BMC Public Health. 2019;19(1): 793.Background HIV/AIDS has emerged as a serious public health issue across the globe, and particularly in developing countries. Comprehensive knowledge and positive attitudes are cornerstones for the prevention, control and treatment of HIV/AIDS. However, there are various misconceptions associated with HIV/AIDS transmission, which lead to negative attitudes towards people living with AIDS. The present study aims to explore the effects of these determinants, related to socio-demographic characteristics and autonomy, on women’s overall knowledge and attitudes regarding HIV/AIDS in Pakistan. Methods Secondary data analysis was carried out using the national representative dataset of the 2012–13 Pakistan Demographic and Health Survey. A series of questions related to HIV/AIDS was asked of 13,558 ever-married women aged 15–49 years to assess respondents’ knowledge regarding modes of HIV/AIDS transmission and preventative measures, as well as their attitudes towards people living with HIV/AIDS. Descriptive and bivariate statistics were used to identify associations with socio-demographic and autonomy-related variables. Furthermore, bivariate and multivariate logistic regression analyses were performed to assess the association between multiple factors and overall HIV/AIDS knowledge as well as attitudes towards people living with AIDS. Results The results show that only 42% of Pakistani women have heard about HIV/AIDS. Amongst these women, the majority (68%) have good overall knowledge of HIV/AIDS and more than 55% have positive attitudes towards people living with AIDS. Furthermore, women residing in urban areas, having at least secondary-level education, with high autonomy, belonging to the richest wealth quintile and having exposure to mass media had high overall knowledge and positive attitudes towards people living with AIDS. Conclusion The findings of this research support the relevance of women’s autonomy, education and exposure to mass media, particularly in rural areas of Pakistan, to address the lack of knowledge and eliminate various myths and stigmatisation of people living with HIV/AIDS. Furthermore, it reveals a need to increase focused and targeted interventions to enhance women’s knowledge and positive attitudes towards people living with HIV/AIDS. In this regard, the media can play a proactive role to gauge wider audience in creating awareness and eradicating the myths and misconceptions regarding HIV/AIDS

Advanced Carbon Functional Materials for Superior Energy Storage

In the developing world, energy crisis is the main reason for less progress and development. Renewable and sustainable energy may be of bright future for scientific lagging and low-income countries; further, sustainability through smart materials got a huge potential; so, hereby keeping in view the energy crisis which the developing world is facing for many decades, we are proposing to write a chapter project for obtaining energy through cheap, sustainable, and functional advanced carbon materials. Carbon materials are the future of energy storage devices because of their ability to store energy in great capacity. The graphene is a material with amazing properties like no band gap, which turns graphene a wonderful candidate for use in the photovoltaic. Shortly, this chapter will discuss how superior energy storage may be obtained through various routes like using pyrrolic (N5) and pyridinic (N6) doping in advanced carbon functional materials, or superior energy by KOH activation in carbon materials, or through carbonization in organic matter, respectively. Further, for the advanced carbon functional materials, the superior energy storage using pyrrolic (N5) and pyridinic (N6) doping, or KOH activation, or through carbonization will be discussed one by one for lithium ion batteries, supercapacitors, and relevant energy devices, respectively

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

Change management in the information age: Approaches of academic library administrators in Pakistani Universities’ libraries

This study investigates the understanding of senior/head librarians towards change management, what areas they consider most important for change, how they are managing the change in work place in context of information technology, acquisition of new resources, negotiating change among top and bottom level management and skill development, The study involves the supervisor librarians of fifteen public sector university libraries of Islamabad (capital of Pakistan) and Rawalpindi region as a sample and data were gathered by questionnaire, based on quantitative research method

Stress-related growth of HIV/AIDS patients: role of religion and self-esteem in mitigating perceived discrimination

Objectives: Objectives of present research were to i) examine association between levels of religiosity, self-esteem, perceived discrimination and stress related growth among HIV/AIDS Patients and ii) find out the mediating effect of self-esteem on perceived discrimination and stress related growth among HIV/AIDS Patients. Methods: It was a cross sectional study. The respondents were registered in VCCT (Voluntary Confidential Counseling & testing) center at Civil Hospital of Jalal Pur Jattan, Gujrat. Total sample of 247 patients was selected on the basis of two stage stratified simple random sampling technique. After taking verbal consent from respondents, data was collected from HIV/AIDS patients by using a structured questionnaire. Analysis was performed by using SPSS version 21 Results: Results of descriptive analysis showed that majority of respondents belonged to age group 29-37 (39.5%). Educational attainment of majority of the respondents was 6-11 years (38.3%), whereas, 27.4% of the respondents had monthly household income between Rs.10001-20000. Conclusion: Results of correlation and regression analysis showed that level of religiosity and self-esteem had significant effects in reducing perceived discrimination among HIV/AIDS patients. The reduced perceived discrimination further assisted in improving the stress related growth among respondents. Based on the findings it is suggested that special programs for accelerating stress related growth among HIV/AIDS patients by enhancing their self-esteem may be arranged and most importantly this issue may be raised in the religious sessions to discuss it and for removing the related stigma. It would be helpful for HIV/AIDS patients to cope with the disease. Continuous..