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Paper mulberry pollen, declared a pest in several countries including Pakistan, can trigger severe allergies and cause asthma attacks. We aimed to develop an algorithm that could accurately predict high pollen days to underpin an alert system that would allow patients to take timely precautionary measures. We developed and validated two prediction models that take historical pollen and weather data as their input to predict the start date and peak date of the pollen season in Islamabad, the capital city of Pakistan. The first model is based on linear regression and the second one is based on phenological modelling. We tested our models on an original and comprehensive dataset from Islamabad. The mean absolute errors (MAEs) for the start day are 2.3 and 3.7 days for the linear and phenological models, respectively, while for the peak day, the MAEs are 3.3 and 4.0 days, respectively. These encouraging results could be used in a website or app to notify patients and healthcare providers to start preparing for the paper mulberry pollen season. Timely action could reduce the burden of symptoms, mitigate the risk of acute attacks and potentially prevent deaths due to acute pollen-induced allergy. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to identify and comprehend the challenges experienced by the undergraduate medical and dental students in enrolled in public sector in Pakistan while conducting research. Methodology: A cross-sectional study was carried out from April to June of 2023 among undergraduate students at public sector medical and dental schools in Khyber Pakhtunkhwa, Pakistan. A customized questionnaire was developed to gather information on the challenges faced by students when undertaking research. The survey was circulated online using Google Forms, and participation was entirely optional. Descriptive statistics were used to analyse the responses. Results: Participants in the study were 58 male and 139 female students who were enrolled in the Bachelor of Medicine & Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS) programs. The analysis found that 47% of students cited a lack of knowledge and research skills as a major barrier, while 40% cited time restrictions as a major issue. Mentorship and training issues were cited as major barriers by 51% of students, while a lack of institutional support was cited as a significant issue by 53% of students. Language issues made it difficult to produce research papers for 14% of students, while finding research opportunities was challenging for 38% of students. Conclusion: According to the research, undergraduate medical and dentistry students in the public sector encountered a number of challenges when conducting research. It was suggested that these issues be resolved by include research projects in the curriculum, providing specific interventions for enhancing research skills, establishing mentorship programs, and allocating funds for research activities. [ABSTRACT FROM AUTHOR]

This paper investigates the long-run and short-run relationship between money supply and inflation in Pakistan, utilizing annual data spanning from 1981 to 2021. The key objective is to assess the impact of monetary policy, specifically money supply, on inflation dynamics in the country. To achieve this, the Autoregressive Distributed Lag (ARDL) bounds testing approach is employed, which is suitable for analyzing cointegration among variables with mixed integration orders. The results reveal both short and long-run cointegration between inflation, money supply, unemployment, and interest rates. Notably, unemployment demonstrates a negative correlation with inflation, while money supply and interest rates exhibit a positive relationship. These findings underscore the importance of dedicated policy measures to manage inflation effectively. The paper concludes by recommending the establishment of a policy implementation body and collaboration between the government and the central bank to ensure financial stability and control inflation through well-calibrated monetary and fiscal policies. [ABSTRACT FROM AUTHOR]

The banking sector serves as a nudge between increased financial investments and reduced environmental impacts in the modern era of sustainability thus, integrating the social, environmental, and economic dimensions. This paper aims to explore the practices and ongoing activities on account of sustainable banking which is being practised in the Pakistani Banking Sector. A mixed methods approach using a survey with a sample size of (n = 250) and in-depth interviews of (n = 25) provides significant evidence for the research. SmartPLS4.0 was used for hypotheses testing and to ascertain the path coefficient association within the constructs. This research fills the gap in existing literature by testing and implying the mediating role of Stakeholders' Influence on the relationship between Green Banking Practices and the Bank's Performance. The results of the quantitative analysis show a positive association between variables, highlighting the role of stakeholders and their need to partake efficiently, in the countrywide execution of green banking. The qualitative analysis portrays that; green banking is currently the partial focus of the banking sector in the developing economy of Pakistan whereas, approaches like financing green projects, investments in renewable energy, in-house greening of the banking sector, and provision of easy lending facilities to encourage and support environmental initiatives are some commonly practised accomplishments of the banking sector. [ABSTRACT FROM AUTHOR]

The Internet has become the fastest-growing way to sell luxury products. Purchase intention for luxury products in online stores has taken attention in the last few years since the sector has proliferated. The primary objective of this study is to examine the impact of various factors such as Product knowledge, Price consciousness, Perceived enjoyment, Perceived ease of usage, and usefulness on online luxury purchase intention in developing countries like Pakistan. Data was collected from 267 luxury fashion customers in Pakistan through an online questionnaire, and the results were analyzed using Smart PLS-SEM. In addition, the paper investigates the moderating effect of Perceived risk, Brand awareness and Web Atmospheric on the link between the Attitude and Online Luxury Purchase Intentions of the consumer to buy luxury fashion products online. The framework of this study is validated by structural equation modelling (SEM). The findings of this study show that perceived enjoyment, price consciousness, and Perceived ease of use significantly and positively impact online luxury purchase intention. Additionally, the findings indicated that brand awareness, perceived risk, and web atmospherics each intervened as moderators in the relationship between attitudes toward purchasing luxury products and online luxury purchase intentions. Product knowledge is not directly related to online purchase intention, but Attitude plays a mediating role in the relationship between product knowledge and online luxury buying purpose. In the context of luxury product intention, this study is one of the first to investigate the moderating effect that brand awareness, perceived risk, and web atmospherics play. It will help luxury brands develop the right tactics for selling luxury goods online in developing countries like Pakistan. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic showed distinct waves where cases ebbed and flowed. While each country had slight, nuanced differences, lessons from each wave with country-specific details provides important lessons for prevention, understanding medical outcomes and the role of vaccines. This paper compares key characteristics from the five different COVID-19 waves in Pakistan. Methods: Data was sourced from daily national situation reports (Sitreps) prepared by the National Emergency Operations Centre (NEOC) in Islamabad. We use specific criteria to define COVID-19 waves. The start of each COVID-19 wave is marked by the day of the lowest number of daily cases preceding a sustained increase, while the end is the day with the lowest number of cases following a 7-days decline, which should be lower than the 7 days following it. Key variables such as COVID-19 tests, cases, and deaths with their rates of change to the peak and then to the trough are used to draw descriptive comparisons. Additionally, a linear regression model estimates daily new COVID-19 deaths in Pakistan. Results: Pakistan saw five distinct waves, each of which displayed the typical topology of a complete infectious disease epidemic. The time from wave-start to peak became progressively shorter, and from wave-peak to trough, progressively longer. Each wave appears to also be getting shorter, except for wave 4, which lasted longer than wave 3. A one percent increase in vaccinations decreased deaths by 0.38% (95% CI: -0.67, -0.08) in wave 5 and the association is statistically significant. Conclusion: Each wave displayed distinct characteristics that must be interpreted in the context of the level of response and the variant driving the epidemic. Key indicators suggest that COVID-19 preventive measures kept pace with the disease. Waves 1 and 2 were mainly about prevention and learning how to clinically manage patients. Vaccination started late during wave 3 and its impact on hospitalizations and deaths became visible in wave 5. The impact of highly virulent strains Alpha/B.1.1.7 and Delta/B.1.617.2 variants during wave 3 and milder but more infectious Omicron/B.1.1.529 during wave 5 are apparent. [ABSTRACT FROM AUTHOR]

The majority (40%) of the world's under-five mortality burden is concentrated in nations like Nigeria (16.5%), India (16%), Pakistan (8%), and the Democratic Republic of the Congo (6%), where an undetermined number of under-five deaths go unrecorded. In low-resource settings throughout the world, the Verbal Autopsy-Social Autopsy (VASA) technique may assist assess under-five mortality estimates, assigning medical and social causes of death, and identifying relevant determinants. Uncertainty regarding missing data in high-burden nations like Pakistan necessitates a valid and reliable VASA instrument. This is the first study to validate Child Health Epidemiology Reference Group-CHERG's VASA tool globally. In Pakistan, data from such a valid and reliable tool is vital for policy. This paper reports on the VASA tool in Karachi, Pakistan. Validity and reliability of the CHERG VASA tool were tested using face, content, discriminant validation, and reliability tests on one hundred randomly selected mothers who had recently experienced an under-five child death event. Data were computed on SPSS (version-21) and R software. Testing revealed high Item-content Validity Index (I-CVI) (>81.43%); high Cronbach's Alpha (0.843); the accuracy of between 75–100% of the discriminants classifying births to live and stillbirths; and I-CVI (>82.07% and 88.98% respectively) with high accuracy (92% and 97% respectively) for assigning biological and social causes of child deaths, respectively. The CHERG VASA questionnaire was found relevant to the conceptual framework and valid in Pakistan. This valid tool can assign accurate medical and non-medical causes of child mortality cases occurring in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) is a major source of disease burden worldwide, with an estimated 296 million individuals living with infections worldwide. Although vaccine programs exist to control infections, certain sub-populations around the world continue to have very high prevalence of HBV infection. Methods: A systematic search of studies of HBV published after 2010 was conducted for India, Pakistan, Bangladesh, Nepal, Sri Lanka and Bhutan. Each paper was independently screened for risk of bias and inclusion. Data were extracted from included studies before being analysed to estimate pooled prevalence, and to conduct sub-group analyses. Random-effects models were used for estimating summary prevalence due to a high level of heterogeneity between studies, and funnel plots were combined with Egger's test to assess publication bias. Meta-regression was conducted to investigate sources of between-study heterogeneity. Results: The pooled prevalence of HBV across all studies was 3% (95% CI 0.02, 0.05). For countries with multiple studies, the pooled prevalence in India was 3% (95% CI 0.02, 0.04), in Pakistan 6% (95% CI 0.03, 0.09), in Bangladesh 5% (95% CI of 0.02, 0.12), and in Nepal 1% (95% CI 0.00, 0.08). There was some evidence of publication bias, and a high level of heterogeneity across studies. Risk of bias analysis found most studies to be of fair or moderate quality. Conclusions: The prevalence of HBV among countries in the sub-continent was higher than the global average, but was not as high as some other regions. Countries with greater numbers of displaced persons had higher prevalence of HBV, with a wide range of prevalence between subpopulations likely reflecting differential uptake, and implementation, of vaccination programs. [ABSTRACT FROM AUTHOR]

The market for the halal food and beverage industry sector has experienced rapid growth in recent years, which indicate excellent investment opportunities. This paper examine the effect of Technical Efficiency (TE) on firm value in 5 selected influential countries in halal food and beverage sector based on Global Islamic Economy Report 2020. Two steps estimation was used to run the data, using the Stochastic Frontier Analysis (SFA) model to determine the company's TE and panel data to test the effect of TE through firm value. The results show that Indonesia has the highest score for TE (62%), followed by Pakistan (59%), South Africa (57%), Malaysia (55%), and Singapore (52%), which means, in general, there is inefficiency in allocating resources over 38% up to 48% and needs to be improved by halal food and beverage companies in. Regarding panel data, all countries sample except Pakistan highlight that TE significantly affect company value. It indicates that the crucial part of managing efficiency can be a sign in stock market performance. The result shows that company managers should set efficiency strategies to their business process for creating sustainability and increase their value in the capital market. As for investors, this TE can be used as an indicator before choosing company stocks; if the company is efficient, then it is worthy of being one of the portfolio assets. Form the government side, the finding can help them to set appropriate policy setting to boost halal food and beverages industry such as giving subsidy or incentive to increase the efficiency ability of halal food and beverage companies and identify the industry's strength by comparing the result of TE between 5 countries. [ABSTRACT FROM AUTHOR]

Food insecurity is a major concern for the developing world and around 37% of the population of Pakistan is food insecure. This paper utilizes the Food Insecurity Experience Scale (FIES) to assess the population prevalence of food insecurity and to identify their risk factors and determinants at the household level in Pakistan. This study employs a multi-level random coefficient model, using the Pakistan Panel Household Survey (PPHS-2010) dataset; representative data from 4,130 households. Factors like; income of the household, gender, education, household size, land ownership, and shocks of food insecurity allow the incidence of idiosyncratic shocks (injuries and/or casualties) at the community level, which affects the food insecurity situation of the community, rather differently were included. The study confirms a statistically significant inverse relationship between household income, household size, and household head education with food insecurity and a positive association of shocks and inflation with food insecurity at the household level. Specifically, with increasing per capita income of the household, food insecurity declines (coefficient: -0.083, statistically significant at 1%) and food insecurity increases with shocks (coefficient: 0.058, statistically significant at 1% significance level). The study also reveals a significant heterogeneity at a one percent significance level in the determinants of food insecurity at the district, community, and household levels. The income of the household, household head gender and education level, household size, household assets, shocks, injuries, and inflationary pressure are important determinants of food insecurity in Pakistan. [ABSTRACT FROM AUTHOR]

Poverty is a big threat to prosperity in developing countries like Pakistan. Alleviating poverty needs concerted efforts including how to measure and analyze poverty. Therefore, this paper employs synthetic panel technique and uses repeated cross-sections household survey dataset (Household Integrated and Economic Survey (HIES)) of Pakistan for 2010–11 and 2015–16, to derive poverty bounds for Pakistan. The findings of the paper suggest that 17% of population still remains in poverty in 2015–16 as they were in 2010–11. They don't move in or out of poverty. In the same periods 19% population affected by poverty. The 2.5% poor's of 2010–11 moves out of poverty in 2015–16. This constitutes the first attempt to provide an insight into poverty dynamics in Pakistan using the available survey data. [ABSTRACT FROM AUTHOR]

Background: Population growth in Pakistan necessitates the implementation of comprehensive family planning (FP) initiatives. The adoption of modern contraceptives, especially long-acting reversible contraceptives (LARC), and permanent family planning methods in the country is challenging and has yet to reach an optimal level. These challenges are deeply rooted in the lack of informed decision-making, as well as demographic and maternal obstetric history. Interventions tailored according to women's needs can address the challenges faced by FP programs. This paper presents the findings of the implementation of a client-centered counseling and facilitation approach in an urban slum in Karachi, Pakistan. Such an approach has the potential to inform women and help them make better decisions regarding their health. Methods: In Rehri Goth, a slum located in Karachi, client-centered counseling along with facilitation at the facility was implemented to encourage the adoption of any modern contraceptive methods, with a specific emphasis on promoting the use of LARCs and permanent methods (where needed) among married women of reproductive age (MWRA). This approach was integrated into the existing Maternal, Neonatal, and Child Health (MNCH) services established in 2014. During the routine delivery of services, data were collected on various aspects including demographic characteristics, obstetric history, motivation to adopt LARCs, and reasons for refusal. Results: A total of N = 3079 eligible MWRA received client-centered counseling, and 60.3% accepted modern contraceptive methods after counseling. Furthermore, 32.5% of these MWRA adopted LARCs or permanent methods. Factors explaining reluctance to adopt any method by MWRA despite specialized counselling were: age >25 years (AOR:1.28, 95% CI:1.08–1.51), no formal education (AOR:1.58, 95% CI:1.36–1.89), having no decision making role at household (AOR:1.60, 95% CI:1.36–1.89), the desire of female or male progeny (AOR:1.86, 95% CI:1.59–2.25) and age of youngest alive ≥3 years (AOR:1.50, 95% CI:1.22–1.84). Factors explaining adoption of short-term methods instead of LARCs or permanent method were: being resident in high under-five mortality clusters (AOR:1.56, 95% CI:1.14–2.14), maternal age > 25 years (AOR:1.88, 95% CI: 1.47–2.40), no decision-making role (AOR:11.19, 95% CI:8.74–14.34), no history of abortions (AOR:2.59, 95% CI:1.79–3.75), no female child (AOR:1.85, 95% CI:1.30–2.65) and ≤ 2 children (AOR:1.74, 95% CI:1.08–2.81). Conclusion: Considering the obstacles mothers face when it comes to accessing extended contraception, public health officials can devise effective strategies that empower MWRA to make well-informed and empowered choices regarding their families and reproductive health. [ABSTRACT FROM AUTHOR]

Introduction: Poor psychosocial support and lack of respectful care for women during childbirth are commonplace in health facilities in low- and middle-income countries. While WHO recommends providing supportive care to pregnant women, there is a scarcity of material for building the capacity of maternity staff to provide systematic and inclusive psychosocial support to women in the intrapartum phase, and prevent work stress and burnout in maternity teams. To address this need we adapted WHO's mhGAP for maternity staff to provide psychosocial support in labour room settings in Pakistan. Mental Health Gap Action Programme (mhGAP) is an evidence-based guidance which provides psychosocial support in resource-limited health care settings. This paper aims to describe the adaptation of mhGAP to develop psychosocial support capacity building materials for maternity staff to provide support to maternity patients, and also to staff, in the labour room context. Methods: Adaptation was conducted within the Human-Centered-Design framework in three phases: inspiration, ideation, and implementation feasibility. In inspiration, a review of national-level maternity service-delivery documents and in-depth interviews of maternity staff were conducted. Ideation involved a multidisciplinary team to develop capacity-building materials by adapting mhGAP. This phase was iterative and included cycles of pretesting, deliberations, and revision of materials. In implementation feasibility, materials were tested via the training of 98 maternity staff and exploring system feasibility via post-training visits to health facilities. Results: Inspiration phase identified gaps in policy directives and implementation and formative study identified limited understanding and skills of staff to assess patients' psychosocial needs and provide appropriate support. Also, it became evident that staff themselves needed psychosocial support. In ideation, team developed capacity-building materials comprising two modules: one dedicated to conceptual understanding, the other to implementing psychosocial support in collaboration with maternity staff. In implementation feasibility, staff found the materials relevant and feasible for the labour room setting. Finally, users and experts endorsed usefulness of the materials. Conclusion: Our work in developing psychosocial-support training materials for maternity staff extends the utility of mhGAP to maternity care settings. These materials can be used for capacity-building of maternity staff and their effectiveness can be assessed in diverse maternity care settings. [ABSTRACT FROM AUTHOR]

Leadership plays a significant role in the performance of individuals and organizations. This paper investigates the impact of leadership styles on the innovative performance of female leaders in Pakistani Universities using a survey approach. This paper aimed to (a) discover a leadership style practiced by females and (b) discover the relationship between leadership style and the innovative performance of female leaders. Several female leaders, including faculty members, heads of departments, deans, coordinators, and directors, from public and private universities of Punjab (a province of Pakistan), were involved in this study. A sample of one hundred female leaders was selected using a multistage sampling method. In the first stage, five public and five private sector universities were selected through a simple random method. In the second stage, ten female leaders (five from each of the social science and basic science departments) were selected from each university through a purposive sampling method. The researchers adopted a reliable instrument to collect the survey data. The collected data were analyzed using SPSS (Version 26). Mean scores and Pearson correlation coefficients were used to discover the relationship between various variables. The investigation revealed that most female leaders practice the transactional leadership style in their universities. This study also discovered a moderate positive relationship between both leadership styles, namely transactional and transformational, and innovative performance. The study recommends that various workshops and seminars may be conducted to increase the practices of both leadership styles to enhance innovation in Pakistani Universities. [ABSTRACT FROM AUTHOR]

This paper explores the perceptions and attitudes of married couples which prevent them from using modern contraceptive for purpose of family planning, based on semi-structured interviews with 16 married couples from rural Pakistan. This study, with married couples, not using any modern contraceptives, discussed issues of spousal communication and religious norms using qualitative methods. Despite near universal knowledge of modern contraceptives among married Pakistani women, the use continues to be low, with high unmet need. Understanding the couple context about reproductive decision making, pregnancy and family planning intentions is imperative to helping individuals fulfil their reproductive desires. Married couples may have varying intentions and desires about family size; a lack of alignment between partners may lead to unintended pregnancies and affect uptake and use of contraception. This study specifically explored the factors which prevent married couples from using LARCs for family planning, despite their availability, at affordable prices in the study area of rural Islamabad, Pakistan. Findings show differences between concordant and discordant couples regarding desired family size, contraceptive communication and influence of religious beliefs. Understanding the role that male partners play in family planning and use of contraceptives is important in preventing unintended pregnancies and improving service delivery programmes. This study also helped identify the challenges married couples, particularly men have in understanding family planning and contraceptive use. The results also show that while men's participation in family planning decision making is limited, there is also a lack of programs and interventions for Pakistani men. The study findings can support development of appropriate strategies and implementation plans. [ABSTRACT FROM AUTHOR]

Background: COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multicomponent, community health-worker (CHW)-led hypertension management program, has been shown to be effective in rural communities in South Asia. This paper presents the acceptability of COBRA-BPS multicomponent intervention among the key stakeholders. Methods: We conducted post-implementation interviews of 87 stakeholder including 23 community health workers (CHWs), 19 physicians and 45 patients in 15 rural communities randomized to COBRA-BPS multicomponent intervention in in Bangladesh, Pakistan, and Sri Lanka. We used Theoretical Framework for Acceptability framework (TFA) with a focus on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy. Results: COBRA-BPS multicomponent intervention was acceptable to most stakeholders. Despite some concerns about workload, most CHWs were enthusiastic and felt empowered. Physicians appreciated the training sessions and felt trusted by their patients. Patients were grateful to receive the intervention and valued it. However, patients in Pakistan and Bangladesh expressed the need for supplies of free medicines from the primary health facilities, while those in Sri Lanka were concerned about supplies' irregularities. All stakeholders favoured scaling-up COBRA-BPS at a national level. Conclusions: COBRA-BPS multicomponent intervention is acceptable to the key stakeholders in Bangladesh, Pakistan and Sri Lanka. Community engagement for national scale-up of COBRA-BPS is likely to be successful in all three countries. [ABSTRACT FROM AUTHOR]

Among other diseases, Covid 19 creates a critical situation around the world. Five layers have been recorded so far, resulting in the loss of millions of lives in different countries. The virus was thought to be contagious, so the government initially severely forced citizens to keep a distance from each other. Since then, several vaccines have been developed that play an important role in controlling mortality. In the case of Covid-19 mortality, the government should be forced to take significant steps in the form of lockdown, keeping you away or forcing citizens to vaccinate. In this paper, modeling of Covid-19 death rates is discussed via probability distributions. To delineate the performance of the best fitted model, the mortality rate of Pakistan and Afghanistan is considered. Numerical results conclude that the NFW model can be used to predict the mortality rate for Covid-19 patients more accurately than other probability models. [ABSTRACT FROM AUTHOR]

International Financial Reporting Standards (IFRS) 's adoption increased attention to International Accounting Standard Regulations worldwide. It has opened the door for empirical analysis having different perceptions of mandatory IFRS adoption. This paper's main objective is to examine the impact of accounting quality and IFRS adoption on Pakistan's banking sector efficiency. We have employed the Malmquist productivity index, Roychowdhury's Earnings Management, and modified learner index to conduct the empirical analysis. The results mean how much banking sector efficiency is affected by accounting quality and IFRS adoption. The results demonstrate that the banking sector efficiency significantly increases through accounting quality and IFRS. Furthermore, it can be seen that the foreign banks' efficiency in Pakistan is less than other banks compared to public or private banks. Additionally, more earnings timeliness has been noted in large banks than medium and small banks in Pakistan. Preferably, the practice of quality accounting relies on disclosed information through financial statements. In contrast, the organizations may evade the losses once the information quality is precise and appropriate. The study provides valuable information to managers and other stakeholders. [ABSTRACT FROM AUTHOR]

Small and Medium Enterprises (SMEs) are considered as the fundamental tool for economic growth, nevertheless, they face continuous financing challenges. SMEs are a major source for generating employment, creation of wealth and alleviating poverty from the rural regions in developing countries. Their access to finance is key to the expansion of this sector. The paper aims to discover the intervening role of "access of SMEs to finance" in the link between SME's evolution and rural development, in the context of Pakistan. In total 338 entrepreneurs operating SMEs in rural areas completed a survey for the study. Through a multi-stage stratified random sampling technique, entrepreneurs were selected from three districts. Confirmatory factor analysis and structural equation modeling were used to test hypotheses. This study shows that SME's evolution has a positive and optimistic influence on rural development. Further, the study also reveals that on SME's progress a positive influence happens by the "access of SMEs to finance". Particularly, the study finds that "access of SMEs to finance" significantly mediated the effect of SME's evolution on rural development. The findings of this paper hold significant implications for both the research society and loan-issuing institutions and departments. [ABSTRACT FROM AUTHOR]

Inherent uncertainties in demand and supply make it problematic for supply chains to accomplish optimum inventory replenishment, resulting in loss of sales or keeping excessive inventories. To cope with erratic demands, organizations have to maintain excessive inventory levels, sometimes taking up to one-third of an organization's annual budget. The two most pressing concerns to handle in inventory management are: how much to order and when to order. Therefore, an organization ought to make the correct and timely decisions based on precise demand information to avoid excessive inventory accumulation resulting in enhanced competitive advantage. Owing to the significance of inventory control and analysis, this paper reports on developing and successfully implementing a hybrid framework for optimum level inventory forecasting in Technical Services Organizations. The proposed framework is based on a case study of one of Pakistan's leading Technical Services Organization. The paper presents a statistical analysis of historical data and a comprehensive fault trend analysis. Both these analyses set a solid foundation for the formulation of a comparative analysis matrix based upon price and quantity based analysis of inventory. Finally, a decision criterion (Forecasting Model) is proposed using three primary forecasting techniques with minimum error calculations. The study's finding shows a forecast error of 142.5 million rupees in the last five years, resulting in the accumulation of more than 25 thousand excessive inventory stock. Application of price and quantity based analysis identifies that 65% of the annual budget is significantly dependent upon only 9% (in terms of quantity) of "High Price and Small Quantity" Items (HS). These HS items are forecasted through three different forecasting methods, i.e., Weighted Moving Average, Exponential Smoothing, and Trend Projection, with Minimum Absolute Deviation to significantly reduce the forecasting error while predicting the future required quantity. The research work aims to contribute to the inventory management literature in three ways. First, a new comparative analysis matrix concept for identifying the most critical items is introduced. Second, a Multi-Criteria Forecasting Model is developed to capture a wide range of operations. Third, the paper suggests how these forecasting criteria can be integrated into a single interactive DSS to maintain optimum inventory level stock. Even though the DSS framework is based on data from a single organization, the application is expected to manage inventory stock in a wide range of manufacturing and services industries. This study's proposed hybrid framework is the first of its kind that encapsulates all four dimensions of inventory classification criteria, forming a multi-criteria hybrid model within a DSS framework. [ABSTRACT FROM AUTHOR]

This paper demonstrates the application of hybrid energy system (HES) that comprises of photovoltaic (PV) array, battery storage system (BSS) and stand-by diesel generator (DGen) to mitigate the problem of load shedding. The main work involves techno-economic modelling to optimize the size of HES such that the levelized cost of electricity (LCOE) is minimized. The particle swarm optimization (PSO) algorithm is used to determine the optimum size of the components (PV, BSS). Simulations are performed in MATLAB using real dataset of irradiance, temperature and load shedding schedule of the small residential community situated in the city of Quetta, Pakistan. The LCOE for the HES system under study is 8.32 cents/kWh—which is lower than the conventional load shedding solution, namely the uninterruptable power supply (UPS) (13.06 cents/kWh) and diesel and generator system (29.19 cents/kWh). In fact, the LCOE of the HRES is lower than the grid electricity price of Pakistan (9.3 cents/kWh). Besides that, the HES alleviates the grid burden by 47.9% and 13.1% compared to the solution using the UPS and generator, respectively. The outcomes of the study suggests that HES is able to improve reliability and availability of electric power for regions that is affected by the load shedding issue. [ABSTRACT FROM AUTHOR]

This paper aims to analyze the divergent perspectives of Indian and Pakistani English print media on opening the Kartarpur corridor. It is a four-kilometer-long cordoned-off strip from the Indo-Pak international border to the Gurdwara Darbar Sahib Kartarpur located in Pakistan. The basic purpose of establishing this corridor is to give easy access to the Indian Sikh community. The initiative was taken into account in August 2018, which resulted in the appearance of a vast quantity of contemplations in the national print media of both countries, especially until the opening of the corridor in November 2019. Print media plays a key role in building knowledge and framing the general public's opinion through interpreting an issue. The data were taken from Dawn, The News International (Pakistan), The Times of India, and Hindustan Times (India) from August 2018 to March 2020 using Lexus Nexus Library. The corpus analysis was carried out by applying the lexical study of Natural Language Processing (NLP) through its Latent Dirichlet Allocation (LDA) tool to find out the general patterns or topics in the print media of both countries. It was found that Pakistani print media terms the Kartarpur corridor as a sign of regional peace, religious tourism, mediation, and diplomatic efforts. In contrast, Indian print media focuses on apprehensions related to traveling modalities, pilgrimage facilities, and tensions between the two states. [ABSTRACT FROM AUTHOR]

Introduction: Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women's empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan. Methods: We used Pakistan Demographic and Health Survey 2017–18 (PDHS) data which comprises of 6,602 currently married women aged between 15–49 years who had a live birth in the past five years preceding the survey. Our exposure variables were three-dimensional measures of women empowerment (social independence, decision making, and attitude towards domestic violence), and our outcome variables were quality of antenatal coverage [i.e. a composite binary measure based on skilled ANC (trained professional), timeliness (1st ANC visit during first trimester), sufficiency of ANC visits (4 or more)] and quality of ANC consultation (i.e. receiving at least 7 or more essential antenatal components out of 8). Data were analysed in Stata 16.0 software. Descriptive statistics were used to describe sample characteristics and binary logistic regression was employed to assess the association between empowerment and quality of antenatal care. Results: We found that 41.4% of the women received quality ANC coverage and 30.6% received quality ANC consultations during pregnancy. After controlling for a number of socio-economic and demographic factors, all three measures of women's empowerment independently showed a positive relationship with both outcomes. Women with high autonomy (i.e. strongly opposed the notion of violence) in the domain of attitude to violence are 1.66 (95% CI 1.30–2.10) and 1.45 (95% CI 1.19–1.75) and times more likely to receive antenatal coverage and quality ANC consultations respectively, compared with women who ranked low on attitude to violence. Women who enjoy high social independence had 1.87 (95% CI 1.44–2.43) and 2.78 (95% CI 2.04–3.79) higher odds of quality antenatal coverage and consultations respectively, as compared with their counterparts. Similarly, women who had high autonomy in household decision making 1.98 (95% CI 1.60–2.44) and 1.56 (95% CI 2.17–1.91) were more likely to receive quality antenatal coverage and consultation respectively, as compared to women who possess low autonomy in household decision making. Conclusion: The quality of ANC coverage and consultation with service provider is considerably low in Pakistan. Women's empowerment related to social independence, gendered beliefs about violence, and decision-making have an independent positive association with the utilisation of quality antenatal care. Thus, efforts directed towards empowering women could be an effective strategy to improve utilisation of quality antenatal care in Pakistan. [ABSTRACT FROM AUTHOR]

This paper is based on qualitative research carried out in a diabetic retinopathy (DR) programme in three districts of Pakistan. It analyses the organisation and delivery of DR services and the extent to which the interventions resulted in a fully functioning integrated approach to DR care and treatment. Between January and April 2019, we conducted 14 focus group discussions and 37 in-depth interviews with 144 purposively selected participants: patients, lady health workers (LHWs) and health professionals. Findings suggest that integration of services was helpful in the prevention and management of DR. Through the efforts of LHWs and general practitioners, diabetic patients in the community became aware of the eye health issues related to uncontrolled diabetes. However, a number of systemic pressure points in the continuum of care seem to have limited the impact of the integration. Some components of the intervention, such as a patient tracking system and reinforced interdepartmental links, show great promise and need to be sustained. The results of this study point to the need for action to ensure inclusion of DR on the list of local health departments' priority conditions, greater provision of closer-to-community services, such as mobile clinics. Future interventions will need to consider the complexity of adding diabetic retinopathy to an already heavy workload for the LHWs. [ABSTRACT FROM AUTHOR]

The province of Sindh reported the first COVID-19 case in Pakistan on 26th February 2020. The Government of Sindh has employed numerous control measures to limit its spread. However, for low-and middle-income countries such as Pakistan, the management protocols for controlling a pandemic are not always as definitive as they would be in other developed nations. Given the dire socio-economic conditions of Sindh, continuation of province-wise lockdowns may inadvertently cause a potential economic breakdown. By using a data driven SEIR modelling framework, this paper describes the evolution of the epidemic projections because of government control measures. The data from reported COVID-19 prevalence and google mobility is used to parameterize the model at different time points. These time points correspond to the government's call for advice on the prerequisite actions required to curtail the spread of COVID-19 in Sindh. Our model predicted the epidemic peak to occur by 18th June 2020 with approximately 3500 reported cases at that peak, this projection correlated with the actual recorded peak during the first wave of the disease in Sindh. The impact of the governmental control actions and religious ceremonies on the epidemic profile during this first wave of COVID-19 are clearly reflected in the model outcomes through variations in the epidemic peaks. We also report these variations by displaying the trajectory of the epidemics had the control measures been guided differently; the epidemic peak may have occurred as early as the end of May 2020 with approximately 5000 reported cases per day had there been no control measures and as late as August 2020 with only around 2000 cases at the peak had the lockdown continued, nearly flattening the epidemic curve. [ABSTRACT FROM AUTHOR]

In pan Pamir Plateau countries, Peste des petits ruminants (PPR) has brought huge losses to the livestock industry and threaten the endangered wildlife. In unknown regions, revealing PPRV transmission among countries is the premise of effective prevention and control, therefore calls for quantified monitoring on disease communication among countries. In this paper, a MaxEnt model was built for the first time to predict the PPR risk within the research area. The least cost path (LCP) for PPR transboundary communication were calculated and referred to as the maximum available paths (MAP). The results show that there are many places with high-risk in the research area, and the domestic risk in China is lower than that in foreign countries and is mainly determined by human activities. Five LCPs representing corridors among Kazakhstan, Tajikistan, Pakistan, India and China were obtained. This study proves for the first time that there is the possibility of cross-border transmission of diseases by wild and domestic animals. In the future, it will play an important role in monitoring the PPR epidemic and blocking-up its cross-border transmission. [ABSTRACT FROM AUTHOR]

The increase of social media (SM) has led to continuous deviations in how day-to-day entrepreneurial activities can be carried out. Additionally, studies devoted to SM entrepreneurship and SM are relatively limited and fragmented in their focus. However there is growing interest from scholars, practitioners and academia for upcoming studies and exploration within small and medium-sized enterprises (SMEs) context. This research explores the impact of entrepreneurial orientation (EO) on SM adoption and SME performance in developing countries. We employed the resource-based view (RBV) as the foundation for developing the conceptual framework The present study employed a closed-ended questionnaire to collect data from SMEs located in Pakistan. Partial-least-squares-structural equation-modeling (PLS-SEM) was utilized for the analysis of 423 responses. The results proved a direct positive link between EO–SMEs performance, EO–SM adoption, SM adoption–SMEs performance, innovation capabilities (IC), and SME performance. Partial mediation was found between EO and SME performance, and the significant moderation effect of IC was found between SM adoption and SME performance. This paper has implications for practitioners and researchers regarding SM adoption in the SMEs. It builds an empirical, multi-dimensional hypothesized model, including mediating and moderating roles affecting the relationships. [ABSTRACT FROM AUTHOR]

The current study describes ethnobotanical (EB) and traditional ethnomedicinal (TEMs) uses of medicinal plants (MPs) of Tehsil Samahni area of Azad Jammu and Kashmir, Pakistan. Indigenous inhabitants of the area mostly reside in remote mountainous areas and depend on wild plants for life necessities and treatment of different diseases. This paper presents first quantitative ethnobotanical study describing the popularity level of MPs in indigenous communities by using relative popularity level (RPL) and rank order of priority (ROP) indices. The data of TEMs and EB uses were collected from 200 interviewees consisting of traditional herbal practioners (110) and farmers (90) from study area using structured and semi-structured interview methodology during year 2019. It was found that illiterate peasants have more knowledge and practice of TEMs than other people. A total of 150 plant species belonging to 58 families with botanical and local names, parts used, mode of recipes preparation, administration mechanism and TEMs uses were documented in systematic manner. It was explored that highest number (7.69%) of plants of Moraceae were used in TEMs and followed by species of Asteraceae (6.29%). The ethnobotanical data was analyzed by using quantitative ethnobotanical tools viz: informant consensus factor (ICF), fidelity level (FL), relative frequency of citation (RFC), use value index (UVI), relative importance of plants (RIP), relative populatiry level (RPL) and rank order of popularity (ROP). The leaf ranked first (36.49%) and fruit 2nd (12.07%) being used in TEMs while prevalent use-form was decoction (29.28%), followed by tea (23.05%) and preferably taken as oral (46.66%). ICF analysis proved that diabetes, hypertension, rabies, snake sting and joint pains were the most prevalent occurring infirmities. The highest RFC (0.95) was found for Acacia modesta, followed by Boerhavia procumbens (RFC:0.87) and Berberis lycium (RFC:0.85). The relative importance of MPs was calculated by using UVI and Moringa oleifera showed highest (1.38), followed by Zanthoxylum armatum (1.25) and Withania somnifera (1.24) use-values. High UVI of plants depicts that these species are predominantly used in local health care system. The plants Phyllanthus emblica, Morus macruora, Justicia adhatoda and Melia azedarach depicted high values (1.00) of FL and RPL proving that these taxa are commonly used in indigenous medicines by local inhabitants and have better potential for drug discovery by ethnopharmacological analysis. Out of total, 26 species had more than 50% ROP index and Phyllanthus emblica and Flacourtia indica (ROP = 100) followed by Morus macruora (ROP: 97) were used to cure 'hypertension and hyperlipidemia' and 'cough, chest infection', respectively. It was found that 30% of total species were previously reported as medicinal while 70% plants were first time reported to be used in TEMs and authenticated by using of quantitative ethnobotanical tools. Ethnopharmacological potential of indigenous plants was confirmed by RIP and RPL indices which had been used to cure one or more body systems and were promulgated in the local herbal medicine system. The research provides clues to screen these plant species by using latest phytochemical and pharmacological analysis for novel drug discovery. This study will also be useful for conservation of bioculture traditional knowledge of indigenous communities and the most important is to conserve medicinal plants of the study area for future generations. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) infection is one of the most common bloodborne viral infections reported in Pakistan. Frequent dialysis treatment of hemodialysis patients exposes them to a high risk of HCV infection. The main purpose of this paper is to quantify the prevalence of HCV in hemodialysis patients through a systematic review and meta-analysis. Methods: We systematically searched PubMed, Medline, EMBASE, Pakistani Journals Online and Web of Science to identify studies published between 1 January 1995 and 30 October 2019, reporting on the prevalence of HCV infection in hemodialysis patients. Meta-analysis was performed using a random-effects model to obtain pooled estimates. A funnel plot was used in conjunction with Egger's regression test for asymmetry and to assess publication bias. Meta-regression and subgroup analyses were used to identify potential sources of heterogeneity among the included studies. This review was registered on PROSPERO (registration number CRD42019159345). Results: Out of 248 potential studies, 19 studies involving 3446 hemodialysis patients were included in the meta-analysis. The pooled prevalence of HCV in hemodialysis patients in Pakistan was 32.33% (95% CI: 25.73–39.30; I2 = 94.3%, p < 0.01). The subgroup analysis showed that the prevalence of HCV among hemodialysis patients in Punjab was significantly higher (37.52%; 95% CI: 26.66–49.03; I2 = 94.5, p < 0.01) than 34.42% (95% CI: 14.95–57.05; I2 = 91.3%, p < 0.01) in Baluchistan, 27.11% (95% CI: 15.81–40.12; I2 = 94.5, p < 0.01) in Sindh and 22.61% (95% CI: 17.45–28.2; I2 = 78.6, p < 0.0117) in Khyber Pukhtoonkhuwa. Conclusions: In this study, we found a high prevalence (32.33%) of HCV infection in hemodialysis patients in Pakistan. Clinically, hemodialysis patients require more attention and resources than the general population. Preventive interventions are urgently needed to decrease the high risk of HCV infection in hemodialysis patients in Pakistan. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the impact of risk and competition on the profitability of the Pakistani banking industry. Data are retrieved from the annual statements of banks, the Ministry of finance Pakistan and the World Bank covering the period of (2007–2017). Two steps Generalized Method of Moments (GMM) with the collapse command is used as an estimation technique to overcome endogeneity, unobserved heterogeneity and autocorrelation problems. The results of the study showed that the liquidity risk has positive while credit risk, insolvency risk and competition hurt negatively the profitability of Pakistani banks. The results of the study also revealed that capitalization, size, taxation and GDP growth rate positively affect the Banks' profits while banking sector development and infrastructure negatively affect banking profitability in Pakistan. The operational cost management positively affects net interest margins but negatively affects ROA and PBT in the Pakistani banking industry. [ABSTRACT FROM AUTHOR]

Using abandoned gas wells as geothermal resources for energy production is an effective way to extract geothermal energy from geological formations. These abandoned wells have the potential to significantly contribute in the rising global demand for energy without requiring the land disruption resulting from deep drilling or digging, processes necessary for energy extraction from geological formations via more traditional methods. In this paper, a method to extract geothermal energy from abandoned gas wells is proposed. The method offers an efficient, economical, and environmentally-conscious way to generate electricity. A mathematical model of a thermal and hydraulic coupling process is constructed, and a 3D numerical model is generated to study the process of geothermal energy extraction by retrofitting an abandoned gas reservoir into a geothermal reservoir. Using the model, heat extraction and fluid flow are analyzed over a period of 50 years. The heat production, electricity generation, and thermal recovery over the lifetime of the reservoir indicate that a commercially viable geothermal dual well system can produce geothermal energy effectively. Dual-well systems contain at least one injection well and one production well. They are composed of a two-way flow system in which the fluid flows into the reservoir via an injection well and returns from the production well having absorbed thermal energy from the surrounding rocks. Sensitivity analysis of the main parameters controlling the average outlet temperature of the fluid from the sedimentary geothermal system reveals that abandoned gas wells are a suitable source of geothermal energy. This energy can be harvested via a method whose use of reservoir fluids differs from that of the traditional method of closed-loop circulation via a borehole heat exchanger. Here, it is demonstrated that abandoned oil and gas fields can be repurposed to be geothermal energy sources that provide low-cost electricity and are economically sustainable. [ABSTRACT FROM AUTHOR]

Adult illiteracy is a major problem worldwide especially in developing countries. Adult Basic Education (ABE) programs working in this context are not very effective due to lack of motivation for the people who are not literate. The reason is inadequate learning content and content delivery methods. This situation calls for developing novel learning content and a learner-directed content delivery approach. This paper presents an exploratory study investigating the use of the Environmental Print Material (EPM) as learning content for the non-literate population of Pakistan. The EPM content is presented to the adult non-literate population in two ethnographic studies. The most frequently recognized content is selected and utilized as learning content in a Computer Assisted Learning (CAL) application. An empirical study is conducted upon two groups with 107 participants to compare the EPM-based learning content with Traditional Learning Content (TLC). As many as 54 participants participated in the experimental group (presented with EPM-based learning content), whereas 53 participants took part in the control group (presented with TLC content). The results reveal that the experimental group performed significantly better compared to the control group in recognition, pronunciation, and recall of the presented content. The meta-analysis of the results shows a large effect size of (1.05) with confidence interval in the range (0.798–1.315). The results claim that the EPM has potential to be considered as learning content in the ABE programs. [ABSTRACT FROM AUTHOR]

The red palm weevil Rhynchophorus ferrugineus (Olivier) is an important pest of date palms in many regions of the world. This paper reports the first survey of insecticide resistance in field populations of R. ferrugineus in Pakistan which were collected from seven date palm growing areas across Punjab and Khyber Pakhtunkhwa (KPK) provinces, Pakistan. The resistance was assessed by the diet incorporation method against the formulated commonly used chemical insecticides profenophos, imidacloprid, chlorpyrifos, cypermethrin, deltamethrin, spinosad, lambda-cyhalothrin and a fumigant phosphine. Elevated levels of resistance were recorded for cypermethrin, deltamethrin and phosphine after a long history of insecticide use in Pakistan. Resistance Ratios (RRs) were 63- to 79-fold for phosphine, 16- to 74-fold for cypermethrin, 13- to 58-fold for deltamethrin, 2.6- to 44-fold for profenophos, 3- to 24-fold for chlorpyrifos, 2- to 12-fold for lambda-cyhalothrin and 1- to 10-fold for spinosad compared to a susceptible control line. Resistant R. ferrugineus populations were mainly found in southern Punjab and to some extent in KPK. The populations from Bahawalpur, Vehari, Layyah and Dera Ghazi Khan were most resistant to chemical insecticides, while all populations exhibited high levels of resistance to phosphine. Of the eight agents tested, lower LC50 and LC90 values were recorded for spinosad and lambda-cyhalothrin. These results suggest that spinosad and lambda-cyhalothrin exhibit unique modes of action and given their better environmental profile, these two insecticides could be used in insecticide rotation or assist in phasing out the use of older insecticides. A changed pattern of both insecticides can be used sensibly be recommended without evidence of dose rates and frequencies used. [ABSTRACT FROM AUTHOR]

In response to the low levels of skilled birth attendance in rural Pakistan, the government introduced a new cadre of community midwives (CMWs) in 2006. Assessments to-date have found that these CMWs have yet to emerge as significant providers for a number of sociocultural, geographic and financial reasons. However, a small number of CMWs have managed to establish functional practices in the private sector in conservative, infrastructure-challenged rural contexts. With an objective to highlight “what are the successful CMWs doing right given their context?” this paper adopts an asset-based approach to explore the experiences of the Pakistani CMWs who have managed to overcome the barriers and practice. We drew upon ethnographic data that was collected as part of a larger mixed methods study conducted in 2011–2012 in districts Jhelum and Layyah, Pakistan. Thirty eight CMWs, 45 other health care providers, 20 policymakers, 78 women, 35 husbands and 23 older women were interviewed. CMW clinics and practices were observed. Our data showed that only eight 8 out of 38 CMWs sampled were active providers. Poverty as a push factor to work and intrinsic individual-level characteristics that enabled the CMWs to respond successfully to the demands of the midwifery profession in the private sector emerged as the two key themes. Household poverty pushed the CMWs to work in this perceived low-status occupation. Their families supported them since they became the breadwinners. The successful CMWs also had an intrinsic sense of what was required to establish a private practice; they exhibited professionalism, had strong business sense and provided respectful maternity care. The study provides insight into how the program might improve its functioning by adapting its recruitment criteria to ensure selection of right candidates. [ABSTRACT FROM AUTHOR]

Background: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with under- and over-weight categories of BMI among Pakistani women. Methods: We analyzed data on 4,767 women ages 15-49 years enrolled in a nationally representative Pakistan Demographic Health Survey (PDHS) conducted in 2012-13 that employed a multistage, stratified cluster sampling design. We assessed the association of urbanicity, household and community SEP derived from household assets and utilities, with categories of body mass index (BMI) using multinomial regression analysis where normal weight (BMI 18.6-22.5) was the reference category. Results: Thirteen percent of women were underweight (BMI <18.5), 15% pre-overweight (BMI: 22.6-24.9), 25% overweight (BMI: 25.0–29.9) and 14% were obese (BMI≥30). Pre-overweight, overweight and obesity among women increased across household wealth quintiles (HWQs) in a graded fashion whereas there was no significant difference in underweight by household wealth. Women in urban areas were more likely to be obese. There was a pronounced increase in adjusted odds ratios (aORs) for overweight/obesity across HWQs within urban areas compared to rural areas. There was a steeper gradient in aORs for obesity from 1st to 5th HWQs in high income communities compared to the middle- and low income communities. In community-level analyses, communities in urban areas were more likely to have higher levels of obesity while in rural areas, especially in Sindh, more communities were more likely to have a higher level of underweight. Conclusion: A shift to higher overweight and obesity than underweight in Pakistan is associated with high household and community wealth as well as living in urban areas. Clustering of obesity and underweight in distinct communities afford opportunity for tailored intervention programs. [ABSTRACT FROM AUTHOR]

This article considers ethnomedical knowledge and practices among parents related to contraction of acute gastroenteritis among children in Peshawar, Pakistan. Research methods included analysis of the Emergency Pediatric Services’ admission register, a structured interview administered to 47 parents of patients seen in the Khyber Medical College Teaching Hospital, semi-structured interviews of 12 staff, and four home visits among families with children treated at the hospital. The use of native research assistants and participant observation contributed to the reliability of the findings, though the ethnographic, home-visit sample is small. Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition. Various misconceptions propagate the recurrence or perserverance of acute gastroenteritis including assumptions about teething leading to poor knowledge of disease etiology, rehydration solutions leading to increased severity of disease, and diaper usage leading to the spread of disease. In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient’s parents leading to possible propagation of disease. These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts. [ABSTRACT FROM AUTHOR]

In recent years, progress in information and communication technology (ICT) has caused many structural changes such as reorganizing of economics, globalization, and trade extension, which leads to capital flows and enhancing information availability. Moreover, ICT plays a significant role in development of each economic sector, especially during liberalization process. Growth economists predict that economic growth is driven by investments in ICT. However, empirical studies on this issue have produced mixed results, regarding to different research methodology and geographical configuration of the study. This paper examines the impact of Information and Communication Technology (ICT) use on economic growth using the Generalized Method of Moments (GMM) estimator within the framework of a dynamic panel data approach and applies it to 159 countries over the period 2000 to 2009. The results indicate that there is a positive relationship between growth rate of real GDP per capita and ICT use index (as measured by the number of internet users, fixed broadband internet subscribers and the number of mobile subscription per 100 inhabitants). We also find that the effect of ICT use on economic growth is higher in high income group rather than other groups. This implies that if these countries seek to enhance their economic growth, they need to implement specific policies that facilitate ICT use. [ABSTRACT FROM AUTHOR]

Background: Secondary infertility in developing countries is mostly attributable to blockage of the fallopian tubes due to adhesions caused by reproductive tract infections. There is a dearth of information on the prevalence and causes of secondary infertility from Pakistan. This paper presents results on factors associated with secondary infertility among married women in Karachi, Pakistan. Methods: A matched case-control study was conducted. Cases were women aged 15-35 years with history of at least one previous conception and currently seeking treatment for secondary infertility. Controls were women residing in the neighborhood of cases with at least one live birth and not taking treatment for secondary infertility. The age of controls was matched by ±5 years to that of cases. Data was collected from June to August 2003. Conditional logistic regression was used to determine crude and adjusted odds ratios (OR) with corresponding 95% confidence intervals (CI) for factors associated with secondary infertility. Results: The final multivariate logistic regression model revealed that after adjusting for age, cases were more likely to be the housewives (AOR = 2.6, 95% CI:1.5-4.4), had used inappropriate material to absorb blood during menstruation (AOR = 9.0, 95% CI: 5.0-16.4), and at their last delivery, had a birth attendant who did not wash hands with soap and water (AOR = 3.0, 95% CI: 1.4-5.7). Moreover, women with secondary infertility were more likely to report current or past history of having STI symptoms (AOR = 3.6, 95% CI: 2.4-5.6) and use of intra-vaginal indigenous medicines during their last postpartum period (AOR = 3.1, 95% CI: 1.6-5.7). Conclusion: We recommend health education and awareness messages for safe practices during menstruation, delivery, and the postpartum period for women in general. Additionally, sanitary napkins should be made available at an affordable cost, and safe delivery kits should contain educational/pictorial brochures for appropriate hand washing skills. [ABSTRACT FROM AUTHOR]