Reasons for betel quid chewing amongst dependent and non-dependent betel quid chewing adolescents: a school-based cross-sectional survey

Background: Betel quid (BQ) chewing in children is initiated in their adolescence. It is pivotal to understand adolescents’ reasons behind chewing BQ. In this study, we aimed to evaluate the reasons for BQ chewing amongst adolescents using reasons for betel quid chewing scale (RBCS) and their associated dependency on it. Methods: This is a cross-sectional school based survey. Out of 2200 adolescents from 26 schools of Karachi, 874 BQ chewers were assessed for their reasons of BQ chewing and dependency on it. Regression analyses were employed to report crude and adjusted (after adjusting for all reasons of BQ chewing) effect sizes with 95% confidence interval and P-value was set significant at < 0.05. Results: Students who believed that BQ chewing relaxes them (stimulation construct) were twice as likely to be dependent on BQ (OR = 2.36, 95% CI (1.20–4.65) as compared with others. Participants who thought it eases their decision making (stimulation construct), were sizably more likely to be dependent on BQ (OR = 9.65, 95% CI (4.15–22.43) than those who did not consider ease in decision making important. Adolescents who considered not chewing as rude (social/cultural construct), were thrice more likely to be dependent on BQ (OR = 2.50, 95% CI (1.11–5.63) than others. Conclusions: Stimulation remained fundamental chewing reason followed by social/cultural trigger amongst adolescents. Any future intervention may get favorable results if it addresses ways to overcome stimulation and social/cultural barriers that are strongly associated with BQ chewing and dependency

Maternal education, empowerment, economic status and child polio vaccination uptake in Pakistan: a population based cross sectional study

Objectives: To explore the association of maternal education and empowerment with childhood polio vaccination using nationally representative data of Pakistani mothers in a reproductive age group. Design: Cross-sectional. Setting: Secondary analysis of Pakistan Demographic and Health Survey (PDHS), 2012–2013 data was performed. Participants: Of the 13 558 mothers included in the survey sample, 6982 mothers were able to provide information regarding polio vaccinations. Main outcome measures: Polio vaccination coverage among children aged up to 5 years was categorised as complete vaccination (all four oral polio vaccine (OPV) doses), incomplete vaccination, and no vaccination (zero OPV dose received). Mothers' empowerment status was assessed using standard ‘Measure DHS’ questions regarding their involvement in decision-making related to health, household possessions and visits among family and friends. Education was categorised as no education, primary, secondary and higher education. Results of multinomial regression analyses were reported as adjusted OR with 95% CI. We adjusted for age, wealth index, urban/rural residence, place of delivery, and antenatal and postnatal visits. Results: Only 56.4% (n=3936) of the children received complete polio vaccination. Women with no education had significantly higher odds of their child receiving no polio vaccination (OR 2.34, 95% CI 1.05 to 5.18; p<0.01) and incomplete vaccination (OR 1.40, 95% CI 1.04 to 1.87; p<0.01). Further, unempowered women also had significantly higher odds of not taking their child for any polio vaccination (OR 1.58, 95% CI 1.17 to 2.12; p<0.01) and incomplete vaccination (OR 1.18, 95% CI 1.00 to 1.41; p=0.04). Conclusions: Illiteracy, socioeconomic status and empowerment of women remained significant factors linked to poorer uptake of routine polio vaccination

Health professional students’ perceptions regarding their role in tobacco control: findings from the Global Health Professional Students Survey, Pakistan, 2011

Background: An important way of reducing tobacco use is to train the health professional (HP) students to assist in tobacco cessation by educating patients and public. In order to shape their thoughts for the desired role, it is vital to understand their existing perceptions regarding HP’s role in tobacco control. Thus, the aim of our study was to find out the perceptions of Pakistani HP students regarding their future role in tobacco control, and examine factors associated with negative perceptions.<p></p> Methods: Secondary data analysis of the Global Health Professional Students Survey, Pakistan, 2011 was performed. Study population included 3445 health professional students in third year of graduate level programs. The dependent variable (perceptions of HP students), was developed using four questions from the survey. Students who did not regard HP’s role in tobacco control were labeled as having negative perceptions. Logistic regression analyses were conducted to analyze association between HP students’ perceptions and various socio-demographic, attitudinal and knowledge related factors; and were reported as adjusted odds ratios with 95% confidence interval.<p></p> Results: We found that 44.8% (n = 1542) of students do not regard HPs as role model for their patients and public, and perceive that HPs do not play an important part in patient’s quitting tobacco use. These negative perceptions were associated with male sex (OR = 1.25, 95% CI 1.02 – 1.53, p value 0.028), and poor knowledge about tobacco cessation techniques (OR = 1.32, 95% CI 1.12 – 1.55, p value < 0.001). Negative perceptions were also associated with their attitudes towards ban on: tobacco advertisements (OR = 1.67, 95% CI 1.13 – 2.48, p value 0.010); and tobacco use at public places (OR = 1.60, 95% CI 1.26 – 2.03, p value < 0.001).<p></p> Conclusion: The role of HPs for tobacco control is fairly under-perceived by HP students, and the undesired negative perceptions are associated with male sex, poor knowledge about tobacco use cessation techniques and negative attitudes towards legislative control. A comprehensive approach, focusing on these aspects should be adopted to train HPs, in order to utilize them as an effective manpower for tobacco control

Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: secondary analysis of Global Youth Tobacco Survey

Background: Susceptibility to smoke has been recognized as a strong predictor of smoking experimentation and taking up regular smoking habit. The identification of smoking susceptible individuals and its determinants is important in the efforts to reduce future smoking prevalence. The aims of this study are to estimate prevalence of susceptibility to smoke among adolescents, and identify factors associated with it.<p></p> Methods: Cross sectional data was obtained from Global Youth Tobacco Survey conducted in three cities of Pakistan in year 2004. Study population consisted of students in grades, 8th, 9th, and 10th; aged 13 to 15 years. Secondary analysis using univariate and multivariate logistic regression analyses were performed to estimate the associations between smoking susceptibility and co-variates. Descriptive statistics were reported in proportions, and adjusted odds ratios with 95% confidence interval were used to report logistic regression analyses.<p></p> Results: Approximately 12% of nonsmoking students were found susceptible to smoking. Students, who were females (OR = 1.53, 95% CI [1.24-1.89]); whose parents (OR = 1.64, 95% CI [1.35-1.99]); or close friend smoked (OR = 2.77, 95% CI [2.27- 3.40]) were more susceptible to cigarette smoking. Students who had good knowledge about harmful effects of smoking (OR = 0.54, 95% CI [0.43-0.69]); and had access to anti-smoking media (OR = 0.73, 95% CI [0.59-0.89]) were less likely to be susceptible to smoking.<p></p> Conclusion: Students who were females, had smoking parents, friends or exposure to newspaper/magazines cigarette marketing, were more susceptible to cigarette smoking among Pakistani adolescents. While knowledge of harmful effects of smoking and access to anti-smoking media served as protective factors against susceptibility to smoking.<p></p&gt

Betel quid dependency and associated intrapersonal, interpersonal, and environmental factors among adolescents: a school-based cross-sectional survey

Background: Betel quid (BQ) is one of the fourth most commonly used substance globally. Though BQ is a psycho-active substance, yet little has been explored regarding dependency on it particularly among adolescents. Objectives: Therefore, in this study, we aimed to determine adolescents' dependency on BQ, along with their intrapersonal, interpersonal and environmental determinants of dependency. Methods: This cross-sectional study focused on 2200 school-going adolescents of Karachi, Pakistan in 2016. Primary outcome was dependency on BQ among adolescents. Both univariate and multivariate regressions were used to estimate crude and adjusted odds ratios (after adjustments for all intrapersonal, interpersonal, and environmental factors) with 95% confidence level. Results: Out of 2200 students, 874 (39.7%) were found to be BQ users amongst whom 69 (7.9%) were dependent on BQ. Comparing the groups with only areca nut users as reference category, betel quid with tobacco additives chewers were considerably dependent (OR = 14.08, 95% CI 3.64–54.16). The individuals who chewed >5 chews per day (OR = 1.87, 95% CI 1.08–3.29) and chronic users (>1year) (OR = 2.02, 95% CI 1.09–3.74) were more likely to be dependent. Older students (>12 years) (OR = 2.12, 95% CI 1.06–4.23), and who studied in government schools were significantly dependent (OR = 3.32, 95% CI 1.80–6.10) than those who studied in private schools. Conclusions: In conclusion, intrapersonal characteristics like more than 5 chews per day, chronic chewers of more than a year, BQ with tobacco chewers, older adolescents and children studying in government schools were significantly associated with BQ dependency

Individual, social and environmental determinants of smokeless tobacco and betel quid use amongst adolescents of Karachi: a school-based cross-sectional survey

Background: With 600 million people using betel quid (BQ) globally, and smokeless tobacco (SLT) use being more wide-spread; the duo is an uphill public health concern in South Asian countries. SLT and/or BQ use increases the risk for morbidity and mortality from oral cancer. Because SLT and/or BQ use is initiated during adolescence, it renders this group more vulnerable; and particular attention is needed to curb SLT and/or BQ use to reduce related disease burden. We aimed to observe the differential individual, social and environmental features amongst SLT and/or BQ users to determine the key influencers of its use in adolescents. Methods: This study was a cross-sectional survey of 2140 adolescents from secondary schools of Karachi, Pakistan. The main outcome measure was SLT and/or BQ use based on their consumption in the past 30 days. Univariate and multivariate regression binary logistic analyses were employed while reporting results in both crude form and adjusted odds ratio (after adjusting for all remaining individual, social and environmental level variables) with 95% confidence level. A p-value of < .05 was considered significant for all analyses. Results: The overall prevalence of SLT and/or BQ use was 42.6% (n = 912) of the total sample. The SLT and/or BQ consumer group had more males than females. A significant proportion of user (n = 558, 61.2%) was found in co-education schools. Students whose peers (OR = 6.79, 95% CI 4.67–9.87, p-value <0.001) and/or either of the parents (OR = 2.16, 95% CI 1.73–2.65, p-value <0.001) used SLT and/or BQ, alongside, adolescents who had not attended knowledge based sessions in schools regarding harmful effects of SLT and/or BQ were more likely to consume it. It’s availability with outside school hawkers increased the odds of its use by 6 times, as indicated by both univariate and multivariate models after adjusting for the remaining variables. Conclusion: In conclusion, students studying in co-education, parents and peers use, lack of knowledge based sessions on harmful health effects of SLT and/or BQ, and easy availability of the product from hawkers outside school all contribute towards enhanced risk of SLT and/or BQ use in adolescents

THE EFFECT OF COMMITMENT AND MOTIVATION ON HUMAN TALENT AND ITS CONTRIBUTION TO ORGANIZATIONAL PERFORMANCE

Human Capital has received major attention in present era research. Talent can be any individual who is committed, motivated and performs effectively. The successful utilization of individual capabilities can contribute positively to performance and enhance organizational image. It is very challenging to retain talent with in organization and keep them motivated. Most importantly they are one of the sources of competitive advantage. Talent drain and executive theft is the major challenge faced by the HR managers throughout the corporate world. Therefore it is important to retain them by keeping them motivated and committed to the organization. This research studies the effect of commitment and motivation on individual and how that contributes towards organizational performance. If employees perceive that their efforts are recognized by the organization they feel motivated and level of commitment will rise. Paper is based on conceptual study. In future empirical study will be conducted to test the conceptualized model.commitment, individual performance, motivation, organizational performance, talent.

Microbial dynamics during various activities in residential areas of Lahore, Pakistan

Bioaerosols are ubiquitous in the atmosphere with their levels affected by a variety of environmental factors as well as type of activities being carried out at any specific time. The present study investigated how indoor activities influence bioaerosol concentrations in five residential houses of Lahore. Agar coated petri plates were exposed face upwards for twenty minutes in kitchens and living rooms during activity and non-activity periods. The temperature and relative humidity levels were noted as well. The bioaerosol concentrations in kitchens during the activity time ranged between 1022 to 4481 cfu/m3 and in living rooms from 1179 to 3183 cfu/m3 . Lower values were observed during non-activity periods. A paired-t test revealed a significant difference in bacterial loads during activity and non-activity times in both micro-environments (p = 0.038 in kitchen and p = 0.021 in living room). The predominant species identified were Micrococcus spp., Staphylococcus spp., and Bacillus spp. which are a common constituent of the indoor environment and are known to be opportunistic pathogens as well

Measurement of NO2 indoor and outdoor concentrations in selected public schools of Lahore using passive sampler

Higher levels of NO2 are a danger to human health especially for children. A seven day study was carried to find out the ambient concentrations of NO2in 27 schools of Lahore with the help of passive samplers. In each school three sites were selected, viz: laboratory, corridor and outdoors. After 7 days exposure the tubes were subjected to spectrophotometric analysis. Results showed that the maximum values measured in laboratory, outdoor and corridors were 376µg/m3 , 222µg/m3 and 77µg/m3 . Minimum values for laboratory, outdoor and corridors were 10µg/m3 , 20µg/m3 and 8µg/m3 . Factors affecting these values were laboratory activities and proximity to main roads. These values were significantly higher than the standard values defined by EPA. Therefore children in schools were at risk of developing health complications

Impact of Continuing Medical Education on Health Care Provider Performance in a Medical University, Karachi, Pakistan.

Introduction: Basic life support (BLS), is the chain of survival and decreases the rate of cardiac arrest; health care professionals should know at least how to perform BLS individually as they may encounter such emergency very often. In the developed world, sudden cardiac death represents the single largest cause of natural death accounting for 12–18% of total mortality and 50% of cardiac mortality. Objectives: To determine the level of awareness regarding Basic Life Support and knowledge of involved skills and its practice among medical and non-medical personnel. Methodology: A retrospective study conducted by using valid questionnaire regarding Basic Life Support by 323 personnel. The results were analyzed with SPSS version 16. Results: Twenty-five questions were used to assess the level of knowledge/awareness and skills after BLS training. The percentage of correct answer varied from 33.1% to 95.7% for knowledge related items; and for skills items, it was varied from 35.3% to 68.4%. Conclusion: We recommend that Cardio Pulmonary Resuscitation/Basic Life Support should be a basic skill across all medical and non-medical personnel. Key words: Cardio-pulmonary resuscitation, Basic Life Support, KAP