Karo Kari : the murder of honour in Sindh Pakistan : an ethnographic study

This paper aims to discuss the wider context, in which honour murders occur, the social structures which contribute to the occurrence and perpetuation of the practice of honour murders. An ethnographic fieldwork was conducted in Jacobabad Sindh, Pakistan. The study found that honour murders were not solely driven by customs and traditions, but also by a feudal culture, male-dominated social structures, the complicit role of state institutions and law enforcement agencies and a web of vested interests. Therefore, honour murders may be prevented by reducing the influence and interference of feudal lords on state institutions, in particular law enforcement agencies, and by promoting education that challenges a patriarchal and feudal mind-set in the community

Effect of using performance-based approach for seismic design of tall building diaphragms

This paper presents how performance-based design (PBD) approaches can help to improve the structural performance and cost effectiveness in design of floor diaphragms of tall buildings under earthquakes. In contrast to the prescriptive design approaches, performance-based design provides a systematic methodology for assessing the performance capability of overall building system and its components. The performance-based design explicitly evaluates the response of the building under the potential seismic hazard, considering the probable site-specific seismic demands as well as the uncertainties in the post-yielding response and behaviour of the building under seismic events. Case study of 57-story reinforced concrete residential building with 4 basement levels is presented. The building was designed for Design Basis Earthquake (DBE) level in accordance with traditional code-based design procedures at the preliminary design stage. After preliminary design, the performance of the building was checked explicitly at Service Level Earthquake (SLE) (43-year return period) and Maximum Considered Earthquake (MCE) level (2475-year return period), using linear and nonlinear response history procedures. Diaphragm design forces at podium level and tower levels were explicitly checked at site-specific MCE level event rather than application of code-specified modification factors to estimate the forces and deformation under code-specified earthquake level. Cost effectiveness of the design was evaluated by comparison of the indicative quantities and parameters between the code-based design and the modified design based on PBD

Barriers and mechanisms to the development of palliative care in Aceh, Indonesia

The aim of this study was to identify barriers and mechanisms in the development of palliative care in the province of Aceh, North West Indonesia. Several factors, including an ageing population, have increased palliative care needs in the region; however, as with many low to middle income countries (LMICs), palliative care is not well established or integrated into mainstream health care services. Consequently, many people may experience serious health-related suffering (SHRS) at the end-of-life. Qualitative semi-structured interviews and focus groups were conducted with key stakeholders in Aceh, Indonesia and a semi-structured interview guide prompted an exploration of palliative care provision, including barriers and enablers. Interviews were digitally recorded, transcribed, and analysed using the principles of thematic analysis. Eight interviews and two focus groups were conducted with medics (n = 6), nurses (n = 7), hospital management (n = 1) and religious/cultural leaders (n = 2). The findings indicate that all participants recognise a need to reduce SHRS and a growing impetus to embed a culturally salient and sustainable model of palliative care within the Aceh healthcare system. The following four themes indicate key areas for further focus: (1) Local vision and leadership, (2) Prioritisation of palliative care policy and funding, (3) Access to palliative care in community and public services, and (4) supporting palliative care in the cultural context of Sharia law, family, and faith. Future expansion requires the identification of a culturally and socioeconomically salient package of palliative care which operates across rural community and acute care settings and is informed by further evaluation and evidence

Domestic Violence and Abuse screening in emergency department: A rapid review of the literature

Aim: The aim of the review was to identify intimate partner violence screening interventions used in emergency departments (ED) and to explore factors affecting intimate partner violence screening in EDs. Background: Intimate partner violence against women is now clearly recognised as a global health and societal issue. Nurses working in emergency and urgent care settings can play a crucial role in identification, prevention and management of intimate partner violence Research exploring optimal methods of IPV screening and factors affecting intimate partner violence screening in EDs is relatively limited. Design: Literature review: Rapid Evidence Synthesis. Methods: Literature published between 2000-2015 was reviewed using the principles of rapid evidence assessment. Six electronic databases: CINAHL Medline, EMBASE, Psych Info, the Cochrane Library and Joanna Briggs Library. Results: Twenty-nine empirical studies meeting the eligibility criteria were independently assessed by two authors using appropriate Critical Appraisal Skills Programme Checklists. IPV screening in EDs is usually performed using electronic, face to face or pen and paper based instruments. Routine or universal screening results in higher identification rates of IPV. Women who screen positive for IPV in EDs are more likely to experience abuse in subsequent months. Factors that facilitate PV screening can be classified as health care professionals related factors, organisational factors and patient related factors. Conclusion: EDs provide a unique opportunity for health care professionals to screen patients for IPV. Competence in assessing the needs of the patients appears to be a very significant factor that may affect rates of IPV disclosure

The impact of COVID-19 on work, training and well-being experiences of nursing associates in England: A cross-sectional survey

Aim To explore how the COVID-19 pandemic affected nursing associate work, training and well-being experiences. Design Cross-sectional survey. Methods A survey of trainee and newly qualified nursing associates was completed in July 2020. Closed responses were analysed using descriptive statistics with inferential comparisons made between community and secondary care settings. Open questions were analysed thematically. Results Sixty-four participants responded. Over half (53.2%) experienced an increased workload with 24.2% reporting extensions in their role. One third (32.3%) were redeployed, and a quarter (24.2%) did not feel safety concerns were adequately addressed when raised. Those working in the community reported significantly more concerns about staffing (p = .03), working overtime (p = .03), missed care (p = .02) and safety (p = .04). Despite this, many (75.8%) participants felt able to provide the same standards of care. Several spoke about enhanced teamwork, and the majority (96.8%) were not looking to leave their post

KARO KARI-THE MURDER OF HONOUR IN SINDH PAKISTAN: AN ETHNOGRAPHIC STUDY

ABSTRAC

Strategic Research Alliance Final Report : Review of Continuing Professional Development in Nursing

Continuing Professional Development (CPD) is important in generating and sustaining capability and in ensuring high quality, person-centred, safe and effective nursing care. In the UK, changes to models of funding for nursing CPD have raised concerns about the opportunities available for nurses to meet the requirements for revalidation of registration, their ability to provide adequate supervision of future students in relation to the new NMC standards of proficiency, and the potential impact of reductions in CPD access to nursing recruitment and retention. Contemporary evidence suggests that it is not only the opportunity to access CPD that is important to the provision of quality care, but also the ability to transform knowledge and skills learnt into practice within diverse practice settings. The purpose of CPD therefore is not only transformation of an individual’s practice but also transformation of workplace culture and context. For the purpose of this report, we follow Manley and Jackson (2020) in suggesting that transformation “implies radical ways of doing things to reflect the values aspired to; it is not about quick wins or key performance indicators.” There is then a need to understand the evidence about what factors maximise CPD impact at the individual, team, organisational and system level. Following initial scoping work, the Strategic Research Alliance (SRA) working group, in consultation with Professor Kim Manley and Carolyn Jackson, agreed to complete a rapid review to consider this evidence focusing on the specific question: "What are the factors that enable or optimise CPD impact for learning, development and improvement in the workplace at the individual, team, organisation and system level?

Monitoring and evaluation of irrigation and drainage facilities for pilot distributaries in Sindh Province, Pakistan. Volume 2 - Bareji Distributary, Mirpurkhas District. Interim report

Irrigation management / Monitoring / Evaluation / Irrigation canals / Distributary canals / Drainage / Maintenance / Land use / Irrigation practices / Basin irrigation / Furrow irrigation / Water distribution / Equity / Flow discharge / Watercourses / Water table / Groundwater / Water quality / Pakistan / Sindh Province / Mirpurkhas District / Bareji Distributary

T-regulatory cell modulation: the future of cancer immunotherapy?

T-regulatory cells suppress anti-tumour immunity in cancer patients and in murine tumour models. Furthermore, their activity is likely to have an effect on the effectiveness of immunotherapeutic treatments for cancer. Here we describe the current status of developing clinical strategies for modulating Treg activity in cancer patients