Perceptions of intensive care nurses and physicians regarding interprofessional collaboration in intensive care unit of a tertiary care hospital in Karachi: An exploratory qualitative study

Background: Interprofessional Collaboration (IPC) is crucial in healthcare, particularly in intensive care units (ICUs). Effective Interprofessional Collaboration between physicians and nurses in patient care can reduce hospital stays, improve the quality of care, and enhance the health outcomes of patients. It has been determined that Interprofessional Collaboration (IPC) is a key policy method foming healthcare personnel and patient safety challenges and improving the healthcare organization.Purpose: This study aims to explore the perceptions of ICU nurses and physicians regarding IPC in a tertiary care hospital in Karachi, Pakistan. It also investigates the factors that facilitate and limit IPC, thereby impacting patient care quality.Methodology: An exploratory qualitative study was conducted using semi-structured interviews with 10 nurses and 08 physicians from a tertiary care hospital ICU. The study employed purposive sampling, with participants chosen for their direct involvement in patient care. Interviews were conducted in both Urdu and English, lasting 40-50 minutes each. Data analysis followed systematic text condensation, focusing on thematic analysis to identify key patterns and themes.Results: The analysis revealed three main themes: 1) Perception of healthcare professionals toward IPC, highlighting its importance on improved patient outcomes and opportunities for improved collaboration; 2) Promoting factors for effective IPC, emphasizing the importance of effective communication, mutual respect and trust, and professional experience and knowledge; 3) Limiting factors for effective IPC, identifying challenges like lack of organizational support, power dynamics, increased workload, and system-based factors. Participants acknowledged the substantial benefits of IPC in improving patient outcomes, stressing the need for collaborative, respectful, and well-informed practices among healthcare professionals. It also recommends the need to emphasize its integration in education and research practices.Conclusion: This study contributes considerable insights into the dynamics of IPC in a developing country\u27s healthcare setting. It emphasizes the essential role of IPC in enhancing patient outcomes and the need for systemic changes to promote a collaborative healthcare culture

Climatic Changes and Their Effect on Wildlife of District Dir Lower, Khyber Pakhtunkhwa, Pakistan

Climatic changes and their impact are increasingly evident in Pakistan, especially in the mountainous regions. Mountain ecosystems are considered to be sensitive indicators of global warming; even slight variations in temperature can lead to significant shifts in local climate, which can, in turn, drastically affect the natural environment, subsequently altering people’s lifestyle and wildlife habitats. The targeted area for the present research was Lower Dir District, Pakistan. The study gathered the required information from primary and secondary sources. Secondary data on temperature and precipitation were obtained from various sources, i.e., local CBO, including WWF Pakistan. Based on information gathered on climate change and wildlife, a detailed questionnaire was designed. Results showed that no regular pattern of the increase was found in temperature from 2010 to 2018; the same was noticed in the rainfall decrease pattern. Results also showed that the leading causes behind climatic changes are an increase in greenhouse gases due to pollution by industries, vehicles, crushing plants, deforestation, and some natural phenomena such as floods. The study showed that more than 80% of the respondents agreed that climatic effects have a significant impact on wildlife, i.e., the existence of wildlife falls in danger due to climatic changes as it may lead to habitat change, making it difficult for the survival and adaptation of the wildlife. Hence, in consequence, it leads to migration, low growth rate, an increase in morbidity and mortality rate, and finally leading to the extinction of the species or population. It is concluded from the study that people are severely noticing the climatic change and its leading causes are greenhouse gases and deforestation. To control climatic changes and wildlife extinction, we need an appropriate policy for forest conservation, wildlife conservation, prevent hunting, industrial pollution control, vehicle pollution control, increase in plantation, awareness of policy for the control of climatic changes, etc

New Onset Refractory Status Epilepticus as an Unusual Presentation of a Suspected Organophosphate Poisoning

New onset refractory status epilepticus (NORSE) is a new entity in medical literature. It has different infectious and noninfectious etiologies showing a devastating impact onto the clinical outcome of patients. Therapy with anaesthetic and antiepileptic agents often fails to improve the condition, unless the primary cause is rectified. Here is presented the case of a young female with a history of depression who after a recent bereavement came to the Emergency Department of Aga Khan University Hospital with complaints of drowsiness that lasted for few hours. Though she had no history of organophosphate poisoning, her physical examination and further investigations were suggestive of the diagnosis. During her hospital stay, she developed refractory status epilepticus. Her seizures did not respond to standard antiepileptic and intravenous anesthetic agents and subsided only after intravenous infusion of atropine for a few days. Organophosphate poisoning is a very common presentation in the developing world and the associated status epilepticus poses a devastating problem for emergency physicians. In patients with suspected organophosphate poisoning with favoring clinical exam findings, the continuation of atropine intravenous infusion can be a safe option to abate seizures

Insurance Demand in Emerging Asian and OECD countries: A Comparative Perspective

Purpose: In this paper we aim to assess insurance demand across selected Asian and OECD countries during the period of the global financial crisis. Methodology: We collected data from 55 emerging Asian and OECD countries during the period of the global financial crisis. Our methodology relies on panel regressions. Separate models are run for the Asia/OECD economies and a follow-up distinction between high/low income regions is also made. Findings: We find that global financial crisis affects negatively the general insurance demand particularly in high-income region. Higher dependency ratio in Asia tends to decrease insurance demand, whereas Education in case of Asia positively influences insurance demand indicating that higher literacy rate can be helpful to capture the potential customers. Our results further reveal that life insurance is an important driver for insurance demand in OECD countries whereas general insurance demand is higher in the Asian economies. Research Limitation: A limitation of this study is that data sets employed do not differentiate between different life and general insurance products. Practical Implications: This study is helpful for regulators, policy makers and insurance providers to evaluate, assess and monitor insurance demand in relevant countries. Originality: This is one of the pioneering studies that have assessed insurance demand among emerging Asian and OECD countries during the period of the global financial crisis

Enhancing Wheat Yield and Phosphorus use Efficiency through Foliar Application in Calcareous Soil

The experiment was conducted at Agricultural Research Farm of Khyber Pakhtunkhwa Agricultural University, Peshawar during 2011-12 to evaluate the effect of foliar P on growth, yield and P uptake by wheat crop, respectively.. Soil P was applied in the form of TSP while foliar P was applied in the form of KH2PO4 with maximum concentrations of 1% P equally applied in three split doses at tillering, boot and anthesis stage of wheat crop c.v. Atta Habib. The foliar application of P showed significant effect on grains spike-1, thousand grain weight, grain yield, biological yields and plant P and K and post harvest soil P. The grain yield increased from 2.12 to 2.60 t ha-1 with 2 kg foliar P ha-1 but further increases in P levels showed decreasing trend. Combination of soil and foliar application showed the supplemental effect in increasing the grain yield. Application of 20 kg soil + 2 kg foliar applied P ha-1 increased the grain yield from 2.57 t ha-1 to 2.92 t ha-1 showing increase of 13.67 and 37.73 % over alone soil applied control, respectively. The biological yield showed 12.94 % increase over control with 2.0 kg foliar P but further increases in P doses again failed to do so. The post harvest soil P, and plant [P] and [K] at both boot and anthesis stage improved with foliar application of P. The comparatively higher performance by 20 kg soil+2 kg foliar P ha-1 suggested that this could be the optimum level for wheat under the prevailing soil and climatic condition. However, such studies on diverse soil, crop and climatic condition should be conducted for confirmation of results and widespread recommendation. Keywords: Wheat, Yield Foliar spray of KH2PO

Effect of Deficit Irrigations and Sowing Methods on Mung Bean Productivity

A field experiment was designed to study the response of Mungbean to deficit irrigation levels and sowing methods. Randomized Complete Block Design (RCBD) with split plot arrangement replicated three times. Water treatments were controlled at I0 (zero percent irrigation), I33 (33% of full irrigation), I67 (67% of full irrigation) and I100 (full irrigation). Full irrigation was determined on the basis of 65% management allowed deficit (MAD). Results shows that I67 and I100 not significant for pods plant-1 while these were highly significant for the sowing methods. The pods per plant are highly significant for I0 and I33 levels. The sowing methods and irrigation levels both have significant impact on grain yield and biological yield. The biological yields continuously and consistently increase with the increase in irrigation levels. The harvest index of Mungbean and its water productivity both increase in irrigation levels certain level. The maximum irrigation applied at 65% MAD substantially decreases the Mungbean water productivity when compared to the harvest index. It was concluded that Mungbean MAD in semi-arid region of Peshawar may be exploited further; more moisture contents may be further extracted before applying next irrigation in raised bed technique in special and as usual in flat beds. Keywords: Deficit irrigation, Irrigation levels, Sowing method, Growth attributes, Mung bean

Effect of Deficit Irrigations and Sowing Methods on Mung Bean Productivity

A field experiment was designed to study the response of Mungbean to deficit irrigation levels and sowing methods. Randomized Complete Block Design (RCBD) with split plot arrangement replicated three times. Water treatments were controlled at I0 (zero percent irrigation), I33 (33% of full irrigation), I67 (67% of full irrigation) and I100 (full irrigation). Full irrigation was determined on the basis of 65% management allowed deficit (MAD). Results shows that I67 and I100 not significant for pods plant-1 while these were highly significant for the sowing methods. The pods per plant are highly significant for I0 and I33 levels. The sowing methods and irrigation levels both have significant impact on grain yield and biological yield. The biological yields continuously and consistently increase with the increase in irrigation levels. The harvest index of Mungbean and its water productivity both increase in irrigation levels certain level. The maximum irrigation applied at 65% MAD substantially decreases the Mungbean water productivity when compared to the harvest index. It was concluded that Mungbean MAD in semi-arid region of Peshawar may be exploited further; more moisture contents may be further extracted before applying next irrigation in raised bed technique in special and as usual in flat beds. Keywords: Deficit irrigation, Irrigation levels, Sowing method, Growth attributes, Mung bean

Impact of Community Orgnizations (CO’S) on Rice Productivity in District Malakand Khyber Pukhtunkhwa, Pakistan

The research study was conducted in selected villages of district Malakand to study the impact of Community Organizations (CO’s) on rice productivity. A total of 70 respondents having different characteristics were interviewed. The main dependent variable was rice productivity which was studied in relation to other variables, inputs and in their application. Contact with various government departments and private sector by (CO’s) to the respondents. The results of the research study show that 7% of the farmers stated the problem of low productivity due to insect/pest attack, reasons were increase cost of the of the insecticides and pesticides. Majority of the respondents as 42.9 % purchased their seed for growing rice crop while the second dominant group was those with their own seed numbered about 32.9 %. Some of the respondents were those who used to grow seed of their own as well they also purchased some of the seed from market, were about 22.9 %. Majority of the sample respondents stated that their source of information regarding various inputs was (CO’s) following by Agri. Extension and fellow farmers. The satisfaction level of the sampled respondents was 81.4 % while 82.9 % sampled respondents stated that their production was increased due to the assistance and credit provided to them by (CO’s). The statistics of the paired T-test shows that the result was highly significant at the rate of 5% sample size and the production was increased by 10.39 % which show the effectiveness of (CO’s) activities in the area. It was concluded from the study that majority of respondents were literate, got proper technical assistance from (CO’s), agricultural extension departments and private companies. On the basis of findings it was recommended that all type of farmers should be involved in such activities and state should encourage the organizations to increase the productivity of various crops, the same techniques of assistance and credit should be adopted for other regions of the country. Keywords: Community Organizations, Rice productivity, variables, statics, technical assistance

Corporate Governance and Environmental Reporting in Pakistan

The focus of the present study is to investigate the association between environmental reporting and corporate governance traits in Pakistan. The prior studies related to the association between environmental disclosure and corporate governance characteristics show fickle findings. This study fills the gap by using cross sectional data of 100 randomly selected firms registered at Karachi Stock Exchange for the year 2015. The results of the present research showed a positive association between the level of environmental disclosure and fraction of independent directors on the board. Negative relationship was found between environmental disclosure and institutional investors. The result shows a positive association between the level of environmental reporting and board size. It confirms a positive association. The analysis revealed a lack of association between level of environmental reporting and fraction of female directors on a board. In case of control variables, positive relationship was found between firms’ profitability and level of environmental disclosure, whereas, no correlation was found between firm size and the level of environmental reporting. Moreover, the results of incremental regression indicate that ownership concentration is the most important independent variable among all the independent variables in the model

Virtual Pseudonym-Changing and Dynamic Grouping Policy for Privacy Preservation in VANETs

Location privacy is a critical problem in the vehicular communication networks. Vehicles broadcast their road status information to other entities in the network through beacon messages to inform other entities in the network. The beacon message content consists of the vehicle ID, speed, direction, position, and other information. An adversary could use vehicle identity and positioning information to determine vehicle driver behavior and identity at different visited location spots. A pseudonym can be used instead of the vehicle ID to help in the vehicle location privacy. These pseudonyms should be changed in appropriate way to produce uncertainty for any adversary attempting to identify a vehicle at different locations. In the existing research literature, pseudonyms are changed during silent mode between neighbors. However, the use of a short silent period and the visibility of pseudonyms of direct neighbors provides a mechanism for an adversary to determine the identity of a target vehicle at specific locations. Moreover, privacy is provided to the driver, only within the RSU range; outside it, there is no privacy protection. In this research, we address the problem of location privacy in a highway scenario, where vehicles are traveling at high speeds with diverse traffic density. We propose a Dynamic Grouping and Virtual Pseudonym-Changing (DGVP) scheme for vehicle location privacy. Dynamic groups are formed based on similar status vehicles and cooperatively change pseudonyms. In the case of low traffic density, we use a virtual pseudonym update process. We formally present the model and specify the scheme through High-Level Petri Nets (HLPN). The simulation results indicate that the proposed method improves the anonymity set size and entropy, provides lower traceability, reduces impact on vehicular network applications, and has lower computation cost compared to existing research work