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According to a plethora of research and publications, the volume and amount of pollution are largely attributable to human-made emissions. Even during the recently ended Covid-19 outbreak, there was a notable decrease in global pollution, particularly in Pakistan's heavily populated cities. Due to the current situation, it is strategically important to safeguard the environment, and there are many criteria and predictors that should be used to encourage green behavior. This study examines green banking as a means of demonstrating ecologically responsible conduct in a developing nation. A survey questionnaire was used to collect information from 280 respondents via human contact and an internet platform. Software called SmartPLS3.0 was used to analyze the structural relationships between the study's variables. The results show that customers' adoption of green banking practices is statistically significantly influenced by their level of environmental consciousness and attitude. Similarly, green culture exhibits a substantial mediating influence between the independent variables and green behavior as well as a positive significant effect on green behavior. However, it is established that the consumer's apparent behavioral control is negligible. Particularly, the cognitive connection between behavior and culture is weak and insufficient to forecast behavior. For policymakers, especially those working in the field of green education, this study has many real-world applications., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This paper analyzes the risks to child development and school readiness among children under age 6 in Pakistan. Drawing on a nationally representative telephone survey conducted in the midst of a global pandemic, between December 2021 and February 2022, we present the first nationally representative estimates of child development for children under 3 years of age and school readiness for children 3-6 years of age, using internationally validated instruments. The paper examines how risk factors that were exacerbated due to the COVID-19 pandemic, such as parental distress, lack of psychosocial stimulation, food insecurity, low maternal education, no enrollment in early childhood education, and living in a rural area, are associated with children's outcomes. The data indicate that more than half (57 percent) of parents with children under age 3 were distressed and that 61 percent of households reported cutting down on the size of or skipping meals since the start of the pandemic. The data reveal that over half of parents fail to engage in adequate psychosocial stimulation with their child and enrollment in early childhood education is very low (39 percent). The paper finds that child development outcomes decline rapidly as the number of risks increase. Specifically, for children under 3 years, lack of psychosocial stimulation at home and higher levels of parental distress were most significantly associated with lower child development levels. For a child aged 3-6 years, early childhood education enrollment and the amount of psychosocial stimulation the child received at home had the strongest association with school readiness scores.

Workers in informal employment suffered significant out-of-pocket healthcare expenditures (OOPHEs) due to their low earnings and a lack of a social safety net or health insurance. There is little or no evidence of impoverishment caused by OOPHEs in the context of labor market categorization. Therefore, this study examines the economic burden of OOPHEs and its associated consequences on households, whose members are in informal employment. This study estimates the incidence of catastrophic health expenditures (CHEs) and impoverishment across the households in formal and informal employment and their key determinants in Pakistan by employing the data from the two rounds of the Household Integrated Economic Survey (2015-16, 2018-19). For measuring CHEs and impoverishment, the budget share and capacity-to-pay approaches are applied. Various thresholds are used to demonstrate the sensitivity of catastrophic measures. We found a higher incidence of catastrophic healthcare payments among the informal workers, that is, 4.03% and 7.11% for 2015-16 and 2018-19, respectively, at a 10% threshold, while at a 40% threshold, the incidence of CHEs is found to be 0.40% and 2.34% for 2015-16 and 2018-19, respectively. These OOPHEs caused 1.53% and 3.66% of households who are in informal employment to become impoverished, compared with their formal counterparts. The study demonstrates that the probability of incurring CHEs and becoming impoverished is high among informal workers, compared with their formal counterparts. This result has clear policy implications, in which to protect the informal workers, it is necessary to expand the insurance coverage, particularly during the COVID-19 response and recovery efforts., (© 2023 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Purpose: The pandemic's health and social issues have significantly altered the character and manner of teaching and learning in higher education across the country. The use of technology to replace or integrate face-to-face learning with online learning has become a necessary requirement for promoting and continuing learning processes. Furthermore, integrating technology is a goal of Sustainable Development Goal 4 (SDG 4) to make teaching and learning more innovative and sophisticated. This paper is based on a systematic review grounded in a synthesis of research papers and documents analyzing the current status of teachers' pedagogy through online learning modes in the context of Pakistan. Design/methodology/approach: Through content analyses of academic studies in higher education and reflection on the online teaching experiences, this study discusses how students' learning is associated with teachers' teaching approaches in the modern era of digitalization and innovation. Findings: The review and analysis suggest that online teaching is not viewed as an innovative phenomenon; rather, teachers simply teach their traditionally designed face-to-face courses through the use of technology. The paper suggests that transforming teachers' pedagogical insight to make online learning sustainable is an urgent need for higher education. Originality/value: The analysis provides a basis for consideration of teacher learning and quality education (SDG #4) to fulfill the nation's agenda for sustainable development. The analysis helps educators and administrators in higher education institutions reflect on their policies and practices that have short- and long-term effects on students' learning outcomes.

The study aims to understand the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic. The study adopts the PRISMA approach to screening the selection of journal articles and review papers according to the research aims and the inclusion criteria. The journal articles and review papers were extracted and stored in Microsoft Excel and Google Scholar, Academic. Microsoft, Semantic Scholar, Elsevier, and Emerald Insight databases searched relevant documents using formulated keywords. A statistical technique was applied using the M.S. Excel analysis tool (PivotTable and an independent t-Test) to analyze data and determine the differences between teachers and students. The review revealed the evidence that the majority of the studies were primarily focused on the individual developing countries and results from other developing countries were not considered. In addition, the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic were inadequate skills and training, inadequate Internet/Infrastructure, lack of supporting resources and lack of online student engagement and feedback. Finally, the independent t-test reveals there is no statistically significant difference in challenges in the transition to online teaching and learning during the COVID-19 pandemic. Both teachers and students encounter similar challenges. The systematic review raised concerns that higher learning needs to effectively implement long term strategies and support teachers and students in getting into online teaching and learning.

Introduction: Coronavirus Disease 2019 (COVID-19) is a cluster of acute respiratory illnesses with unknown etiology, which firstly appeared in Wuhan, Hubei Province, China, in December 2019. All educational institutes of Pakistan were completely closed from March 13, 2020, to August 15, 2020. This condition disturbs the daily routines of children with mental health needs. This sudden closure limited their physical activities in their routine life. This study aims to observe the depression associated with COVID-19 and its impact on the physical activities of young adults of Pakistan. Materials and Methods: A web-based cross-sectional study was conducted on 384 young adults. A modified depression scale was used to assess depression, and the revised physical activity questionnaire was used to evaluate the physical activity of Pakistani young adults in the past month. Results: About 57.8% of the samples were sometimes sad; 44.5% sometimes felt grouchy in the mood; 43.8% never felt hopeless about the future. Also, 32.6% sometimes slept less or more than usual, 35.9% sometimes had difficulty concentrating on their work, 48.7% slept 6-8 hours per day. Besides, 49% engaged 1-3 hours in work or study per day; 43.2% watched TV, sat quietly, or listened to music for 1-3 hours. About 57.8% engaged less than 1 hour per week in light physical activities. Also, 77.9% engaged for less than 1 hour per week in moderately strenuous activities. Conclusion: Depression could be highly associated with the COVID-19 outbreak, and it might affect the physical activities of young adults. [ABSTRACT FROM AUTHOR]

The paper examines quantitative and qualitative aspects of research on Moringa oleifera, based on global publications output (3187 publications), as covered in Scopus database during 1935-2019. The publications on Moringa oleifera registered annual average growth of 16.18% and cumulative growth of 3594.0% and averaged to 17.69 citations per paper. Bulk of global publications output (76.72%) and the global citations (68.06%) in the field emanates from top 10 countries. The paper further provides an insight into qualitative performance of research on Moringa oleifera in terms of relative citation index, citations per paper, highly cited papers, besides analyzing the top 25 global organizations and authors in the field, the distribution of publications by broad subjects, the identification of the most significance keywords, the most productive journals and the analysis of higher-cited papers in the field. The study found that Universidade Estadual de Maringa, Brazil (72 papers), National Research Centre, Giza, Egypt (66 papers) and University of Agriculture, Faisalabad, Pakistan (65 papers) were the most productive organizations and University of Agriculture, Faisalaba, Pakistan (38.35 and 2.17), University of Karachi, Pakistan (35.23 and 1.99) and Mahidol University, Thailand (27.35 and 1.55) were the most significant organizations in terms of citation per paper and relative citation index. Similarly, R. Bergamasco. (65 papers), P.M.G. Paiva. (36 papers) and L.C.B.B Coelho (34 papers) were the most productive authors and F. Anwar. (124.21 and 7.02), J. Beltrán-Heredia (36.07 and 2.04) and J. Sánchez-Martín (34.69 and 1.96) were the leading authors in terms of citation per paper and relative citation index. South African Journal of Botany (62 papers), Journal of Ethnopharmacology (61 papers) and Desalination and Water Treatment (44 papers) were the leading journals contributing to the field. [ABSTRACT FROM AUTHOR]

This paper aims to have a critical evaluation of an online training module among pre-service and in-service teachers in Pakistan. The aim of this study was to provide a thorough examination of the various aspects that contribute to both satisfaction and dissatisfaction with the training module. This evaluation is critical in the process of facilitating the accommodation of the synchronous and asynchronous online models that have established a permanent mark in education years after the COVID-19 pandemic lockdowns. A total of thirty educators who registered for the online training module were selected as participants for the study, in which open-ended online questionnaires were employed as the primary method of data collection. This research employed Braun and Clarke's technique, which involves a six-step theme analysis process. The results revealed the mixed feelings of satisfaction and dissatisfaction with adopting training modules. The motivation behind satisfaction stemmed from several factors, including the pertinence of content structure, adaptability, proficient utilization of media, and a determined attitude. Conversely, dissatisfaction was driven by the inadequacy of the content in addressing issues they thought were pertinent for teachers in the 21st century. The study underlined the crucial role of content design in online instruction, highlighting the need for robust planning to create accessible, engaging, and flexible modules compatible with standard devices like smartphones. The study proposes the ongoing adjustment of online modules to cater to the requirements of learners in the 21st century. This is because online modules have great potential for establishing a permanent position in the training of pre-service and in-service teachers.

The pandemic of coronavirus disease 2019 (COVID-19) has disrupted immunization programs around the globe, potentially increasing life-threatening vaccine-preventable diseases. Pakistan and Afghanistan are the only countries, which are still struggling to eradicate wild poliovirus. All vaccination campaigns in Pakistan were suspended in April due to the COVID-19 outbreak, leading 40 million children to miss out on polio vaccination. Like the climate crisis, the COVID-19 pandemic could be regarded as a child-rights crisis because it could have life-threatening impact over children, who need immunization, now and in the long-term. Delays in polio vaccination programs might not have immediate impact but, in the long-term, the increase in polio cases in Pakistan could result in the global export of infections. Therefore, healthcare authorities must intensify their efforts to track and vaccinate unvaccinated children in countries like Pakistan and Afghanistan. Polio vaccination campaigns need to resume immediately, so we suggest applying social distancing measures along with standard operating procedure to flatten the transmission curve of COVID-19. Furthermore, the concurrent emergence of cVDPV2 means that tOPV should temporarily be used for primary immunization. In the current review, we have discussed delays in polio vaccination, surveillance of polio viruses, reported cases in Pakistan along with recommendations to overcome interrupted immunization., (© 2020 John Wiley & Sons Ltd.)

Pandemics always create dreadful effects not only on human life but also drastically influence businesses and industries. Historical evidence has apparently indicated that the outbreak of Spanish flu, SARS, MERS, and Ebola viruses, all created radical impacts on businesses around the globe, leaving behind the economic structures into miseries and deprivations. Similar is the case of COVID-19 outbreak which instigated from China and dispersed all over the globe. In Pakistan, the first case was reported in March 2020 and since then the government has relentlessly tried to impose lockdown and social distancing in order to avert the harm. It has been substantiated that the public isolations and lockdowns have not only yielded negative impacts on the economy but also on different forms of business and employment. Therefore, this study is aimed to analyze potential impacts of COVID-19 on different forms of industries in Pakistan through gathering the public opinion as the source of data. The study is one of the preliminary studies therefore it is based on descriptive design in order to show perceived impact of outbreak of virus. Results indicated that the pandemic is harmful and affecting most of the business in negative manner however there are some businesses which are burgeoning on opportunities emerged from the pandemic and attaining growth due to the spread of the virus. [ABSTRACT FROM AUTHOR]

Purpose: This article aims to explore the areas of misalignment between the public financial management (PFM) and health financing during the COVID-19 pandemic in Pakistan., Originality/value: To the best of our knowledge, it is the first study on South Asian countries to adopt a framework and bring forward the dominant themes that cause the misalignment between PFM and health financing. The timing of the research was excellent as the world was facing the biggest health challenge in the form of COVID-19 which has put pressure on the PFM and has seriously hampered health service delivery. Therefore, the findings of the study are helpful for the ministry of health to draft policies to improve health allocations and move towards Universal Health Coverage., Design/methodology/approach: In-depth semi-structured interviews of 15 participants were used to explore the areas of misalignment between PFM and health financing. Based on qualitative data, thematic content analysis has been carried out., Findings: The findings of the study can be divided into five clusters and their explanations. First overall budget allocation has an impact on the health sector budget. For example, the budget for priority health interventions is not reflected in the budget allocation process. Further, the budget is classified by inputs rather than disease and finally, the budget is not released by the health priorities. The second cluster was the devolution of health to provinces which is unfinished agenda. Under this cluster fiscal decentralisation has been found to cause problems for the provinces as they have not provided fiscal autonomy to spend the money and there is a lack of coordination between the federal and provincial authorities. The third cluster was donor funding, and it was observed that it is not aligned with the government policies and priorities. Forth cluster was procurement and it was discovered that it is a lengthy process and caused delays in procuring the essential health equipment. The fifth cluster was an organisational culture that is not conducive to the health sector. Under this cluster, the attitude, knowledge, and practices of departments responsible for the health sector require complete revamping., (© 2023 John Wiley & Sons Ltd.)

The global COVID-19 pandemic has led educational institutions to shut down and adopt e-learning practices through computer-mediated communication. An unanticipated switch of online classes from face-to-face classes isolates students from social groups and teachers, causing online disinhibition. Therefore, this paper investigates factors influencing university students' toxic disinhibition behavior in online classrooms, WhatsApp groups, and Telegram groups. Also, social isolation has been used as a moderating variable to identify whether social isolation strengthens or weakens the proposed association. The research holds the basis of "Social Cognitive Theory" and "Theory of Planned Behavior." The data from 506 university students have been collected for analysis. The proposed framework and research hypotheses have been assessed via PLS-SEM using Smart PLS software. Findings from the study show that toxic behavior victimization, attitude, subjective norms, and behavioral control are factors that positively & significantly affect toxic disinhibition online. Furthermore, motives and self-efficacy showed an insignificant influence on toxic disinhibition. Additionally, toxic disinhibition significantly & positively affects toxic behavior. At last, social isolation is likely to have a moderation effect on the variables. Hence, the research yields guidance on reducing toxic disinhibition online. Further, implications and recommendations are discussed at the end of the study.

This paper examines the extent to which refugee girls and young women were able to access learning during COVID-19 education closures in Pakistan, and the role that EdTech played in their learning access. It is based on findings from a survey with 403 Afghan refugee students, along with in-depth interviews with six young female refugees. The research shows that, while the majority of female refugee students were able to continue accessing education in some form during school closures, learning access was nevertheless limited, and a sizable minority were not engaged in any learning during this time. Teacher and institutional support was either absent or inadequate for many students, and infrastructure and devices that serve to support remote learning were not always reliable or accessible. Although male respondents were less likely than females to engage in independent study during the closures, refugee girls and young women were significantly less likely than their male counterparts to own the devices they needed for learning. The findings demonstrate how targeted investment in specific types of EdTech and teacher professional development, as well as supporting educational institutions in the establishment of remote learning opportunities, could help sustain learning during future periods of educational restriction.

Pakistan is included in top 50 countries which are estimated to face serious agriculture and food deficiency related challenges due to the worldwide pandemic coronavirus 2019 (COVID-19). The aim of this study was to evaluate the effects of COVID-19 on food supply chain and agriculture in Punjab, Pakistan, by using space-time scan statistic (STSS). A survey was conducted at 720 points in different districts of the province. The STSS detected "active" and emerging clusters that are current at the end of our study area-particularly, 17 clusters were formed while adding the updated case data. Software ArcGIS 10.3 was used to find relative risk (RR) values; the maximum RR value was found to be 42.19 and maximum observed cases 53,265 during June 15-July 1, 2020. It was not always necessary that if the number of active cases in Punjab increased, there should be higher relative risk for more number of districts and vice versa. Due to the highest number of cases of COVID-19 and RR values during July, mostly farmers faced many difficulties during the cultivation of cotton and rice. Mostly farmers (72%) observed increase in prices of inputs (fertilizers and pesticides) during lockdown. If the supply chain of agriculture related inputs is disturbed, farmers may find it quite difficult to access markets, which could result in a decline in production and sales of crops and livestock in study area. It is suggested that to protect the food security and to decrease the effect of the lockdown, Punjab government needs to review food policy and analyse how market forces will respond to the imbalanced storage facilities and capacity, supply and demand and price control of products. The findings of this study can also help policy-makers to formulate an effective food security and agriculture adaptation strategy., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study aims to explore the factors that affect consumers' behavior in adaptation and use of internet-based services (IBS) during the COVID-19 crisis. In this study, technology acceptance model (TAM) was applied to predict the behavioral intention of active social media users among the Pakistan population based on the revised model of the TAM model. And the data of external factors facilitating conditions (FC), social impact (SI), and task technology fit (TTF) were collected from active social media users of Pakistan by using structured questionnaires. After performing Pearson's correlation and linear regression on the collected data, findings have shown that the outcome variable, i.e., behavioral intention, exhibited significant correlation with all variables except for perceived ease of use (PEoU). Further analysis revealed mixed results wherein FC and TTF can make a significant influence on perceived usefulness (PU) and PEoU, respectively. In addition, PU can significantly affect attitude (ATT) towards the use of IBS while the use of IBS has been affected by behavioral INT during the outbreak of COVID-19 in Pakistan., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In the current digital era, Massive Open Online Courses (MOOCs) are considered as an educational revolution specifically in the current situation of COVID-19. Although students from all over the globe register for MOOCs, only a small proportion of participants complete the online courses. MOOCs at present encounter the problem of low retention rates, thus providing numerous research gaps. This paper investigates the impact of critical factors such as the instructor's role, course relevancy, learning outcomes on MOOCs retention. This study also analyzes the mediating role of IT (Social Media) between critical factors and MOOCs retention and provides feasible solutions for the improvement of MOOCs retention rates. Data were collected from Pakistani participants who attended, registered, or completed any MOOC. The findings of this study indicate that critical factors such as the instructor's role, course relevancy, learning outcomes have a positive impact on MOOC participants' retention. The results also confirm the important mediating role of IT (Social Media). The universities and the instructors who offer MOOCs should consider these critical factors when offering an online course. These critical factors can enhance MOOCs participants' retention leading them to take the courses until certification.

Purpose: This paper aimed to examine the psycho-social aspects of coronavirus disease 2019 (COVID-19) in Pakistan. The study was conducted in Pakistan by using an online survey technique. The rationale to opt for this method was mainly based on the country's lock-down situations, social distancing and for the care of respondents. Design/methodology/approach: A total of 1,536 individuals participated from different parts of the country. An attitudinal scale was administered consisting of statements to measure (dis)agreement of the individuals facing the current situations of COVID-19. The ethical considerations and confidentiality of the respondents were opted by describing the purpose of research on the first page of the questionnaire. Findings: The study findings showed that the cost of personal protective equipment (PPE), social isolation and loss of intimacy have favourable positive effects on the psychological problems of individuals through the mediation of fake news and misinformation during COVID-19. Furthermore, the study findings were interpreted as per the effects of current situations of epidemic, i.e. COVID-19 on the psycho-social life of individuals. Research limitations/implications: This paper is purely limited to the quantitative approach including variables, i.e. COVID-19, risk of infection, social distancing, cost of PPE, social isolation, fake news and psychological problems. Practical implications: The present research will enhance the awareness and knowledge regarding psychological problems faced by the individuals during COVID-19. It will be a significant addition to the existing body of knowledge in the field of health and well-being. It will also provide guidelines to students, research scholars, policymakers and academicians to develop policies in future to improve the health of people during epidemics such as COVID-19 and similar nature of outbreak in the future. Originality/value: This paper focused on an important gap in the research on COVID-19 in the country in the context of COVID-19, risk of infection, social distancing, cost of PPE, social isolation, fake news and psychological problems.

Background: The global scientific community has been quick to respond to health crisis unleashed by Covid-19 pandemic with intensified investments in R&D and thereby it gave new impetus to Covid-19 research. The world has come to witness unprecedented increase in research publications on control and treatment of Covid-19 pandemic. Like any other region in the world, South Asia too has been the worst-hit region and it too witnessed increase in Covid-related research studies. Systematic reviews of such literature and bibliometric studies are used nowadays as tools to identify and analyze key and significant South Asian contribution to the subject. The present study aims to assess and quantify the contribution and impact of Covid-19 research made by a group of select four South Asian countries. Methods: Publications data on Covid 19 covering the period between December 2019 and 8.7.2021 was sourced from the Scopus database. VOSviewer 1.6.14 software was applied to generate network maps, assess hot topics in the area and describe collaboration patterns in research between different countries. Results: A total of 18,64,275 publications reflecting the global research output on Covid-19 were retrieved from the Scopus database. The publications data of select four South Asian countries - Pakistan, Bangladesh, Nepal and Sri Lanka - was also retrieved. Comparatively the data size of select four South Asian countries was small, limited to 4012 documents, and accounting for a 2.15% share of the global research output on Covid-19 virus. Pakistan published the most number of Covid-19 publications (n = 2246, 55.58%), followed by Bangladesh (n = 1203, 29.99%), Nepal (n=512, 12.76%) and Sri Lanka (n=202, 5.03%). The United States as the collaborating partner in most number of publications contributed by South Asian countries (n = 609, 25.41%), followed by the United Kingdom (n = 496, 20.69%), China (n=453, 18.90%), Saudi Arabia (n=441, 18.40%) and India (n=426, 17.77%). Covid-19 treatment type was the most studied topic in the contributions made by South Asian countries accounting for a 16.45% share, followed by epidemiology (15.63%), risk factors (5.835), clinical studies (4.81%), etc. Conclusion: This paper finds that the quantity and quality of research pursued by a select group of four South Asian countries in the domain of Covid 19 studies has so far been small and insignificant. There is an urgent need on the part of select group of South Asian counties to improve their productivity and qualitative performance at the national, institutional, and individual author level. [ABSTRACT FROM AUTHOR]

Coronavirus pandemic has changed the existing norms of life all over the world. Among other areas of life, the pandemic has also hit the education sector, where recent statistics show that around 500 Million students worldwide were unable to access remote learning. In developing countries like Pakistan, which is amongst the top-twenty countries impacted by the pandemic, and where around 23 million children were already out of school, much of the progress made over the years has reversed. Drawing on 'Faucet Theory,' this paper questions the inclusiveness of online higher education and argues that the stories of successful shifting to online education seem to be unexclusive, representing only privileged students, while neglecting the underprivileged students. Exclusions faced by the under-privileged students, including those related to technological, financial, and social, have been highlighted through the present research, emerging from a close analysis of informal conversations with approximately 90 female students of undergraduate level in Pakistan. The study recommends further in-depth research unveiling the stories and implications for those left out in online education during the Coronavirus pandemic.

A strengths intervention, The Good Life, was developed for this study to augment Pakistani university students' PERMA-oriented well-being. The intervention strategy focused on all 24 strengths, observing strengths in others, and developing the lesser strengths based on the dominant ones. Intervention best practices from positive, vocational, and educational psychology were also implemented to support greater learning capabilities among participants. Additionally, fidelity to training was observed to ensure intervention integrity. In this three-wave longitudinal study, participants were randomly assigned to an experimental group (n = 91) and a wait-list/no-treatment control group (n = 91). Quantitative results revealed that the experimental group reported greater well-being than the control group immediately after the intervention and 6 months later. Qualitative findings shed light on the character strengths demonstrated by the experimental group to build each PERMA dimension during Time 2 and Time 3. Findings also provided insights into how the experimental group experienced well-being during Time 2 and Time 3. Together, the quantitative and qualitative findings provide encouraging evidence regarding the long-term efficacy of the intervention in Pakistan's collective society. Implications for offering future strengths interventions amid the COVID-19 pandemic and recommendations for improving the Good Life intervention are also discussed., (© 2021 The International Association of Applied Psychology.)

This article delineates the process through which a quantitative study in the context of Pakistan was adapted into emergent mixed methods research due to COVID-19-related complexities. The in-process data collection was halted abruptly as schools were closed and lockdowns were imposed across Pakistan in the early 2020s due to COVID-19. In response, the quantitative research design was adapted to adjust the research design by adding further research questions and introducing qualitative interviews. COVID-19 increased the complexity in the research context. We argue that mixed methods offer adaptive approaches in disruptive situations which help to deal with the complexities. The paper further suggests that disruption during research occurs in various forms and adaptive procedures should be described as part of the research rather than ignoring them. This article provides a practical example for researchers on using adaptive approaches to mixed methods in a developing country context where the possibilities of disruptions are more rampant.

The inevitable COVID-19 global pandemic has severely affected Pakistan's fragile healthcare system. The system was already facing a significant burden of noncommunicable and other infectious diseases, and the pandemic further exacerbated the disease and the healthcare burden in Pakistan. In such a situation, people who live in geographically challenged areas with limited healthcare infrastructure and resources are more vulnerable to the impacts of a pandemic. The authors share the experience of the development of emergency response centres (ERCs) in the rural remote mountainous regions of Pakistan-Chitral, an initiative that the Government of Pakistan and Aga Khan Health Service Pakistan (AKHSP) implemented to manage the increasing rates of COVID-19 cases in these areas. The authors outline the processes that need to be undertaken to develop such healthcare facilities in a short period of time and discusses the challenges of establishing and operating these centres and the lessons learnt during and after the development of these centres in the remote mountainous regions of Pakistan., (© 2021 John Wiley & Sons Ltd.)

This paper presents a compilation of personal reflections from 66 contributors on the impact of, and responses to, COVID-19 in accounting education in 45 different countries around the world. It reveals a commonality of issues, and a variability in responses, many positive outcomes, including the creation of opportunities to realign learning and teaching strategies away from the comfort of traditional formats, but many more that are negative, primarily relating to the impact on faculty and student health and well-being, and the accompanying stress. It identifies issues that need to be addressed in the recovery and redesign stages of the management of this crisis, and it sets a new research agenda for studies in accounting education.

Objective: High maternal and neonatal mortality rates in developing regions like Pakistan are linked to low rates of institutional deliveries. One way to improve rates of institutional deliveries is through improving institutional delivery service satisfaction in women. The aim of this research is to identify which factors influence delivery service satisfaction during the period of COVID-19 and which socio-demographic characteristics of women are associated with greater fear of catching COVID-19 during institutional deliveries., Methods: A total of 190 women who had given birth between May to June, 2020, were sampled from two private and two public sector hospitals in Lahore, Pakistan. A standardized tool was modified for use and a combination of descriptive statistics and multivariate regression was applied., Results: The results reveal that a majority of women, at 74.7%, are afraid of contracting COVID-19; specifically, women delivering at public hospitals, those who are illiterate or semi-literate, with more than four children, with low household income, and who are unemployed. Regression models are used to identify factors related to higher satisfaction, including the following: (i) pre-delivery care (explanatory power of R 2  = 0.651); (ii) during delivery care (R 2  = 0.716); (iii) after delivery care for women (R 2  = 0.525); and (iv) after delivery care for newborn (R 2  = 0.780). The main areas which influence satisfaction include the following: service quality of staff and administration; maintenance of hygiene and sanitation; involvement in decision-making; provision of necessary information; and advice for breastfeeding, immunization and family planning., Conclusions for Practice: Based on our findings, we recommend improved regulation of delivery services in both public and private hospitals and increased protection for disadvantaged women groups to maintain service quality during the pandemic.

Stories and narratives are part of our human sociocultural history, which are always preserved in what I call "societal memory." We construct stories to weave meanings that help us make sense of our lifeworlds. Like stories, rumors and conspiracy theories can offer deep meanings when analyzed in specific contexts. Such narratives become most prominent in times of looming uncertainties, anxieties, and fears. Thus, the challenging coronavirus disease 2019 (COVID-19) pandemic has become surrounded by plentiful rumors and conspiracy theories. These narratives reveal geopolitics when they code the pandemic as "bioengineered." They also demonstrate local concerns, as in Pakistan, people started drinking "miraculous" tea as a form of prevention, shaving their heads, and/or praying to God to undo his "punishment." Some conceptualized the pandemic as an invented "plot." These narratives seem to empower individuals to make sense of this pandemic and to deal with its multidimensional effects: they allow them to feel confident enough to go outside and earn their livelihood. In this chapter, the author builds on his long-term ethnographic fieldwork on infectious diseases, recent telephone interviews, and content analysis of the media to discuss narratives revolving around COVID-19 in Pakistan. The author argues that these rumors and conspiracy theories are social phenomena pregnant with multiple meanings that deserve to be thoroughly explored, especially by anthropologists. A dearth of understanding about COVID-19 and narratives surrounding it would substantially impede the strategies to deal with this ongoing pandemic.

Novel COVID-19 caused turmoil in every domain of life around the globe. To halt the further spread of virus, preventive measures such as social and physical distancing has led the temporal cessation of all education institutions in numerous countries. To minimize disruption of teaching and learning process during epidemic, the Higher Education Commission (HEC) of Pakistan directed universities transition to an online learning system. The research paper explores deeply the problems faced by students in the current online education system introduced by various universities. A survey research method was employed and the data were collected through convenience sampling. The link of the semi-structured questionnaire was shared with 550 students enrolled in public and private universities in Lahore, Pakistan. The study brought to light the diversified problems such as lack of internet facility, load shedding, financial issues, ear pain due to prolong use of hand free/Bluetooth and unreliable results in assessments.

More than 200 countries across the globe, including Pakistan, have closed educational institutions (schools, colleges, universities and "madrassas") to contain the spread of coronavirus (COVID-19 pandemic). These closures have disrupted the learning of more than 1.7 billion learners (representing 91 per cent of the total enrolled students) across the world. It attempts to critically examine how schools' closures in Pakistan perpetuate and reproduce inequalities in education. We have attempted to explore and explain inequalities in education during COVID-19 pandemic lockdown and bring the issue of public school students' learning loss into public debate. The paper is based on qualitative primary data and is analysed and interpreted vis-à-vis the social reproduction theories. We deduce that unequal schools, unequal parenting and geographical location have further inflamed education inequalities in Pakistan during COVID-19 pandemic.

Purpose: This paper aims to report insights from the planning and execution phase of an interactive radio instruction (IRI) intervention envisioned as a medium-term response plan to address school closures amidst the global Coronavirus pandemic. The project has been envisioned by a local development agency in the province of Balochistan for adolescent out-of-school (OOS) girls. Design/methodology/approach: This study reports respondents' academic achievement through the one-group pretest-posttest design method across numeracy, literacy, civic education and indigenous crafts. Participating adolescent girl respondents were randomly selected from six districts of Balochistan and the results assert a positive impact of IRI intervention. Thus, showcasing IRI as a promising approach to address protracted challenges of educational accessibility in remote areas of Pakistan. Findings: The mean score comparison of pre-test-post-test across four curriculum subjects indicates the greatest gains in numeracy and civic education. Results also highlight the significance of the pedagogical capacity of IRI developers and the quality of supplementary educational kits paired with IRI during this intervention. Research limitations/implications: The findings of this study focus on design and implementation phases eliminating the analysis of learners' behaviour, environmental factors and family support. Further research is suggested to identify gaps in related dimensions for the success of IRI in Pakistan. Originality/value: This study contributes data-driven findings from a pioneer on-going IRI project in Balochistan, a hard-to-reach province where the ratio of OOS adolescent girls exceeds 78%. This study also proposes vital steps for the longevity of IRI to solve protracted educational crises in Pakistan.

Purpose: This paper aimed to examine the sources of information and use of personal protective equipment (PPE) during the COVID-19 pandemic in the province of Punjab, Pakistan. The COVID-19 pandemic affected at a large level of all social institutions including the healthcare system of the countries. Design/methodology/approach: The study was conducted in Pakistan by using an online survey technique. The rationale to opt for this method was based on the country's lockdown situations, social distancing and the care of the respondents. A total of 847 individuals from different parts of the Punjab province participated in the study. An attitudinal scale was administered, which consisted of statements to measure (dis)agreement among the individuals on current situations of the COVID-19 pandemic. The ethical considerations and confidentiality of the respondents were opted by describing the purpose of research on the first page of the questionnaire. Findings: The study findings revealed that peer group, signs and symptoms of COVID-19 pandemic and causes and consequences of COVID-19 pandemic had favourable positive effects on the use of PPE by individuals through the mediation of fear of infection during COVID-19 pandemic. Furthermore, the study findings were interpreted as per the effects of current situations of COVID-19 on the sources of information and the use of PPE by individuals. Originality/value: This study focused on an important gap in the research on COVID-19 pandemic in the country in terms of mass media, health practitioners, peer group, fear of infection and use of PPE.

During the COVID-19 pandemic, it was crucial for the healthcare sector to detect and classify the virus using X-ray and CT scans. This has underlined the need for advanced Deep Learning and Machine Learning approaches to effectively spot and manage the virus's spread. Indeed, researchers worldwide have dynamically participated in the field by publishing an important number of papers across various databases. In this context, we present a bibliometric analysis focused on the detection and classification of COVID-19 using Deep Learning and Machine Learning techniques, based on X-Ray and CT images. We analyzed published documents of the six prominent databases (IEEE Xplore, ACM, MDPI, PubMed, Springer, and ScienceDirect) during the period between 2019 and November 2023. Our results showed that rising forces in economy and technology, especially India, China, Turkey, and Pakistan, began to compete with the great powers in the field of scientific research, which could be seen from their number of publications. Moreover, researchers contributed to Deep Learning techniques more than the use of Machine Learning techniques or the use of both together and preferred to submit their works to Springer Database. An important result was that more than 57% documents were published as Journal Articles, which was an important portion compared to other publication types (conference papers and book chapters). Moreover, the PubMed journal Multimedia Tools and Applications' tops the list of journals with a total of 29 published articles. [ABSTRACT FROM AUTHOR]

Background: Health policy and systems research (HPSR) can strengthen health systems and improve population health outcomes. In the Eastern Mediterranean Region (EMR), there is limited recognition of the importance of HPSR and funding remains the main challenge. This study seeks to: (1) assess the reporting of funding in HPSR papers published between 2010 and 2022 in the EMR, (2) examine the source of funding in the published HPSR papers in the EMR and (3) explore variables influencing funding sources, including any difference in funding sources for coronavirus disease 2019 (COVID-19)-related articles. Methods: We conducted a rapid scoping review of HPSR papers published between 2010 and 2022 (inclusively) in the EMR, addressing the following areas: reporting of funding in HPSR papers, source of funding in the published HPSR papers, authors' affiliations and country of focus. We followed the Joanna Briggs Institute (JBI) guidelines for conducting scoping reviews. We also conducted univariate and bivariate analyses for all variables at 0.05 significance level. Results: Of 10,797 articles screened, 3408 were included (of which 9.3% were COVID-19-related). More than half of the included articles originated from three EMR countries: Iran (n = 1018, 29.9%), the Kingdom of Saudi Arabia (n = 595, 17.5%) and Pakistan (n = 360, 10.6%). Approximately 30% of the included articles did not report any details on study funding. Among articles that reported funding (n = 1346, 39.5%), analysis of funding sources across all country income groups revealed that the most prominent source was national (55.4%), followed by international (41.7%) and lastly regional sources (3%). Among the national funding sources, universities accounted for 76.8%, while governments accounted for 14.9%. Further analysis of funding sources by country income group showed that, in low-income and lower-middle-income countries, all or the majority of funding came from international sources, while in high-income and upper-middle-income countries, national funding sources, mainly universities, were the primary sources of funding. The majority of funded articles' first authors were affiliated with academia/university, while a minority were affiliated with government, healthcare organizations or intergovernmental organizations. We identified the following characteristics to be significantly associated with the funding source: country income level, the focus of HPSR articles (within the EMR only, or extending beyond the EMR as part of international research consortia), and the first author's affiliation. Similar funding patterns were observed for COVID-19-related HPSR articles, with national funding sources (78.95%), mainly universities, comprising the main source of funding. In contrast, international funding sources decreased to 15.8%. Conclusion: This is the first study to address the reporting of funding and funding sources in published HPSR articles in the EMR. Approximately 30% of HPSR articles did not report on the funding source. Study findings revealed heavy reliance on universities and international funding sources with minimal role of national governments and regional entities in funding HPSR articles in the EMR. We provide implications for policy and practice to enhance the profile of HPSR in the region. [ABSTRACT FROM AUTHOR]

Pakistan is endemic to several bacterial, parasitic and viral infections including tuberculosis, malaria and dengue that account for a high rate of mortality each year. These different types of infections can occur through various routes of transmission and concurrently in individuals, especially in immunocompromised but rarely among immunocompetent. We report a case of a 25 year old immunocompetent female who was admitted with an initial diagnosis of dengue fever and diagnosed as having co-infection of COVID-19 and Brucella leading to secondary hemophagocytic lymphohistiocytosis (HLH). She was managed for all three infections and complications simultaneously., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Pakistan's health system has a critical role to play in global health security, however, it faces numerous structural and systemic challenges while contributing to international health efforts. Understanding the dynamics of health system is essential for developing effective strategies to prevent, detect, and respond to health emergencies, ensuring regional stability, and the overall global health security This paper documents the strengths and weaknesses of Pakistan's health systems, the impact of the COVID-19 pandemic, challenges such as funding constraints and fragmented healthcare delivery, threats including antimicrobial resistance, and the importance of international collaboration. Anti-microbial particularly multi-drug resistance, food safety in emergencies, surge capacity of the frontline workforce, patient safety at the health care facilities to curtail healthcare associated infections, and strengthening the points of entry are still the areas that need special attention. To optimise the system's performance, governance and accountability mechanisms are necessary to be put in place under the auspices of national public health agency. Pakistan has the potential to transform its health system by addressing these critical areas and improve its preparedness and readiness for any future health emergency of this scale., (© 2024 John Wiley & Sons Ltd.)

Background: The evaluation of undergraduate medical curricula plays a crucial role in ensuring effectiveness and helps in continuous improvement of the learning process. This study aims to compare the effectiveness of online and hybrid teaching models of the first-year MBBS curriculum in the COVID-19 era (2019-20) and the para-COVID-19 pandemic (2020-21)., Study Methodology: Mixed methods study with CIPP model was used. Data was collected by administering a survey and focus group discussions (FGDs) with first-year students from the 2019-2020 and 2020-2021 cohorts, faculty and administrators, which were recorded for analysis. Recorded lectures, guidebooks, planners, and question papers were also scrutinized for quality and adequacy. Furthermore, admission merit, module assessments, and professional examination results were compared and correlated. The learning environment was evaluated through the questionnaire (validated and used by Pakistan Medical and Dental council for inspections of medical schools) and the facilities provided in both years were juxtaposed. The study utilized NVIVO for qualitative and SPSS version 23 for quantitative data analysis., Results: Contextual analysis underscored the critical need for online teaching during the COVID-19 pandemic, with provided resources being deemed sufficient. Notably, the student-faculty ratio stood at 4:1, and essential resources were readily available. The fully online batch outperformed the hybrid teaching class in 2020-21. Process analysis revealed successful session delivery in hybrid and online through webinars and Zoom, accompanied by timely provision of study guides and punctual assessments. Moreover, examination papers demonstrated acceptable reliability (Cronbach's alpha: 0.61) in core subjects. Product analysis indicated that the 2020-21 cohort performed better in modular and professional examinations across all subjects (P < 0.01) despite their lower admission merit compared to the 2019-20 batch., Conclusions: The study revealed challenges faced during total online teaching, highlighting knowledge and skills gaps in students. While students favored hybrid teaching for interaction, faculty preferred online strategies and suggested blended learning. The administration recognized faculty's swift transition but stressed the need for blended learning workshops and strengthening the medical education department. Recommendations include implementing blended learning strategies, conducting faculty workshops, equipping the medical education department for online teaching, and gathering student feedback after each module to enhance the curriculum., (© 2024. The Author(s).)

This paper examines the extent to which refugee girls and young women were able to access learning during COVID-19 education closures in Pakistan, and the role that EdTech played in their learning access. It is based on findings from a survey with 403 Afghan refugee students, along with in-depth interviews with six young female refugees. The research shows that, while the majority of female refugee students were able to continue accessing education in some form during school closures, learning access was nevertheless limited, and a sizable minority were not engaged in any learning during this time. Teacher and institutional support was either absent or inadequate for many students, and infrastructure and devices that serve to support remote learning were not always reliable or accessible. Although male respondents were less likely than females to engage in independent study during the closures, refugee girls and young women were significantly less likely than their male counterparts to own the devices they needed for learning. The findings demonstrate how targeted investment in specific types of EdTech and teacher professional development, as well as supporting educational institutions in the establishment of remote learning opportunities, could help sustain learning during future periods of educational restriction. [ABSTRACT FROM AUTHOR]

Purpose: As Covid-19 became a pandemic, numerous people were forced to stay at home, leading to increased intimate partner violence (IPV) in many countries, particularly in developing and least-developed ones. This paper aims to highlight the IPV based on 15 different cases formed from the practical evidence of five developing countries. Design/methodology/approach: The authors interviewed 15 women from five countries who were the victims of IPV during the early periods of Covid-19 outbreak. Due to geographical remoteness, the authors conducted informal telephone interviews to collect the participants' personal experiences. The conversations were recorded with participants' permission; afterwards, the authors summarized participants' experiences into 15 different cases without revealing their original identities (instead, disguised names were used). Findings: It was revealed that the women were the primary victims of such violence, particularly from their intimate partners (husbands). In most cases, such IPV, as reported by the interviewees, originated or increased after the pandemic when they were forced to stay at home, losing their partners' jobs or income sources. Originality/value: The authors summarized the causes of IPV and put forward a few action recommendations based on the interviewees' practical experience and existing literature. This paper will open a new window for research investigations on IPV during emergencies such as Covid-19 outbreak. [ABSTRACT FROM AUTHOR]

Introduction: Infants are at a higher risk of severe illness with COVID-19 infection compared to older children. While COVID-19 vaccination is not recommended for young infants, they can acquire maternally-derived anti-SARS-CoV-2 antibodies passively through the placenta and breastmilk. We described the persistence of infection-induced maternal antibodies in infant circulation at 9-12 months of age., Methodology: This was a cross-sectional study nested within the INTERCOVID multinational cohort study. For each COVID positive pregnant woman, two unmatched consecutive COVID negative pregnant women were enrolled between April and September 2020. Women with a positive PCR test, radiographic signs consistent with COVID-19, or at least 2 predefined symptoms of COVID-19 were considered as COVID positive. For this nested cross-sectional study, all COVID positive and either one of the COVID negative participants recruited from the Aga Khan University, Pakistan were approached 9-12 months after delivery, and maternal and infant sera were collected for antibody detection., Results: Altogether, 83 mothers provided consent, of whom 32 (38.6 %) were COVID positive and 51 (61.4 %) were COVID negative during pregnancy. Anti-SARS-CoV-2 antibodies were present in 13 (41 %) infants born to COVID positive and 19 (39 %) infants born to COVID negative mothers (p = 0.87). The presence of reactive antibodies in infants at follow-up was associated with maternal antibodies at follow-up (OR:9.50, 95 % CI:2.03-44.42; p = 0.004). COVID infection occurred in 3 (6 %) infants born to COVID negative mothers while no infant born to a COVID positive mother had a history of infection (p = 0.27)., Conclusion: The presence of reactive anti-SARS-CoV-2 antibodies in infants at 9-12 months of age is associated with maternal seropositivity 9-12 months after delivery rather than maternal infection during pregnancy. Further studies are required to validate these findings and assess whether passive immunity in infants is protective against COVID-19 infection., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Taiwan Pediatric Association. Published by Elsevier B.V. All rights reserved.)

Objectives: During the COVID-19 pandemic, the risk of childhood infectious diseases was increased. Post-COVID-19 escalation of chickenpox cases, becoming an emerging public health concern. Thus, the study was designed to compare chickenpox prevalence and Varicella zoster virus (VZV) genotypes circulating before, during, and post-COVID-19 in Pakistan., Methods: A total of 267 lesion specimens collected from tertiary care hospitals, and chickenpox outbreaks from Pakistan were analysed by a two-amplicon approach with phylogenetic analysis., Results: Among suspected cases, overall 178/267 were VZV positive. Majority (84.2 %; 150/178) cases were of post-COVID-19 pandemic time. Small outbreaks occurred soon after COVID-19 in Rawalpindi and Islamabad (Pakistan), 40 positive cases out of 178 cases were outbreak cases. There was first time detection of the M4 genotype, which was significantly associated with disease severity (p = 0.0006) and post-COVID-19 chickenpox outbreaks in 2021 (77.9 %; 46/59; p < 0.00001). However, in pre-COVID-19 only M2 genotype was detected. The M2 prevalence varied from 2019 (100 %; 19/19) to 2022 (3.2 %; 3/91). However, the most prevalent strain of 2022 belonged to the M1 genotype (64.8 %; 59/91)., Conclusion: A significant rise in chickenpox cases detected soon after COVID-19 in Pakistan, and oscillation of different VZV genotypes with first time detection of M4 genotype is an alarming situation. This demands further detailed genotypic studies on transmission dynamics of a rare M4 with other genotypes to protect the local population and restrict spread in other regions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

COVID-19 has had unprecedented effects on construction markets globally due to supply chain disruptions and workforce restrictions, etc. However, construction industries in developing countries are more vulnerable to the obstacles associated with the pandemic. As such, the goal of this paper is to capture the impact of COVID-19 on construction projects' performance in developing countries by taking the Pakistani construction sector into perspective. A multistep project-based research methodology was adopted, including a literature analysis and questionnaire survey with 20 construction professionals to assess factors affected by COVID-19; formulation of open-ended questions against each factor; collecting data using semi structured interviews; and presenting challenges and adopted mitigation strategies to examine the perceived impact. Results showed that the pandemic has caused a total of 13 factors to impact the project performance, which are grouped under four construction groups, including material and equipment, human resource, occupational health and safety, and financial and contracts. The factors impacted the most by the pandemic are cash flow management, supply chain disruptions, increased overheads, construction safety measures, material shortage, contractual issues, and construction workforce. This research contributes to the body of knowledge by providing a foundation for researchers to enhance investigating the impact of the COVID-19 in developing countries. [ABSTRACT FROM AUTHOR]

This paper analyses the war metaphor used in selected Pakistani advertisements about Covid-19 pandemic. The research particularly explores the working of conceptual war metaphor through Conceptual Blending theory (Fauconnier 1997, Fauconnier and Turner 1996, Turner andFauconnier1999, 2000). The paper discusses the cognitive mapping for the Covid metaphors through linguistic analysis which results in a psychological effect of war narrative on the audience. The war narrative thus leads to produce effect of fear and dread; the audience resultantly finds safety in following the Covid SOPs by consuming the advertised product. This study is a qualitative analysis of war metaphor used in selected Pakistani advertisements of soaps, detergents, sanitizers etc. The significance of this research is to correlate the importance of metaphor used in advertisements to magnify the fear of Covid pandemic through language manipulation. As language becomes psychological affair through metaphors; it heightens the effect on the audience which in turn leads to active positive response from them. The response is not only in submission to follow the message of the advertisement but also in readily consumption of the advertised product against the dangers and challenges posed by Covid-19. [ABSTRACT FROM AUTHOR]

Objective: Migrants and refugees are at a disadvantage in accessing basic necessities. The objective of this study is to assess the inequity in access, needs and determinants of COVID-19 vaccination among refugees and migrant populations in Pakistan., Design: We conducted a mixed-method study comprising a cross-sectional survey and a qualitative study. In this paper, we will only report the findings from the cross-sectional survey., Setting: This survey was conducted in different cities of Pakistan including Quetta, Karachi and Hyderabad., Participants: A total of 570 participants were surveyed including refugees and migrants, both in regular and irregular situations., Primary and Secondary Outcome Measures: The primary outcome of the study was to estimate the proportion of refugees and migrants, both in regular and irregular situations vaccinated against COVID-19 and assess the inequity. The χ 2 test and Fisher's exact test were used to determine the significant differences in proportions between refugees and migrants and between regions., Results: The survey showed that only 26.9% of the refugee and migrant population were tested for COVID-19, 4.56% contracted coronavirus, and 3.85% were hospitalised due to COVID-19. About 66% of the refugees and migrants were fully vaccinated including those who received the single-dose vaccine or received all two doses, and 17.6% were partially vaccinated. Despite vaccination campaigns by the government, 14.4% of the refugee and migrant population remained unvaccinated mostly because of vaccines not being offered, distant vaccination sites, limited access, unavailability of COVID-19 vaccine or due to a difficult registration process. Vaccination rates varied across provinces, genders and migrant populations due to misconceptions, and several social, cultural and geographical barriers., Conclusion: This study highlights the COVID-19 vaccine coverage, access and inequity faced by refugees and migrants during the pandemic. It suggests early prioritisation of policies inclusive of all refugees and migrants and the provision of identification documents to ease access to basic necessities., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In this paper, we investigate a fractal-fractional-order mathematical model with the influence of hospitalized patients and the impact of vaccination with fractal-fractional operators. The respective derivatives are considered in the Caputo, Caputo Fabrizio, and Atangana-Baleanu senses of fractional order α and fractal dimension τ . For the proposed problem, some results regarding basic reproduction number and stability are given. Using the next-generation matrix approach, we have investigated the global and local stability of several types of equilibrium points. We provide a detailed analysis of the existence and uniqueness of the solution. Moreover, we fit the model with the real data of Pakistan from June 01, 2020, till March 24, 2021. Then, we use the fractal-fractional derivative to find a numerical solution for the model. MATLAB software is used for numerical illustration. Graphical presentations corresponding to different parameteric values are given as well., (© 2024. The Author(s).)

The uneven recovery in the world economy since the start of Covid-19 wreaking havoc in 2020 has given us a new shape in economic development: the K-shape. As an alternative to the K-shape, we found the possibility of an even worse development: the G-shape. Indonesia, which experienced the deceleration of its economic growth in the prepandemic period, can struggle with a G-shaped recovery. This paper evaluates this possibility by comparing the country to other emerging economies. This study uses 10 economic performance indicators to determine the possibility of a G-shaped recovery in an economy, which represent the demand side, supply side, monetary policy, fiscal policy, health and institutional quality (credit, labor, Total Factor of Productivity, Human Development Index, regulatory quality, CA balance to GDP, current health expenditure, internet bandwidth, debt to GDP, and economic openness). The research sample covers 33 countries. Among them, 7 countries with the highest possibility of G-Shaped economic development were identified: Pakistan, Mexico, Egypt, South Africa, Nigeria, Indonesia, and Brazil. Several counties in samples, including Pakistan, Mexico, Egypt, South Africa, Nigeria, Indonesia, and Brazil, are trapped in long stagnation. The regression result shows a positive relationship between each dependent variable and the GDP, except for economic openness. From the results, the Human Development Index has the highest coefficient among the other independent variables. This paper also employed the Computable General Equilibrium simulation analysis model to project Indonesian economic growth, which shows Indonesia's possibility of being trapped in the G-shaped recovery. [ABSTRACT FROM AUTHOR]

This paper explores the stories of women impacted by COVID-19 and narrated by Pakistani writers. The discussion is primarily based on flash fiction from a recent anthology entitled, The Stained-Glass Window (2020). I critically analyse selected short stories in the context of the cultural taboos (such as, patriarchy, sexism, biological essentialism), historically thrust upon Pakistani women. The analysis is based on the lives of the female protagonists (irrespective of their age, class, race, ethnicity, or religious differences) and their experiences during multiple lockdowns in Pakistan. This textual analysis is presented in the light of Kate Millet's theoretical framework (Millet 1990) to contend that these Pakistani writers resist the deepening sexual politics through fictional characters evidently strengthening the contemporary feminist resistance emerging from Pakistan. The paper is primarily concerned with the issues of sexual politics (Millet 24),'internal colonization' and gender-based power dynamics (25) experienced by women during the pandemic in the light of feminist resistance in 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., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ahmad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This research paper analyzes the spread of COVID-19 in Pakistan using geo-statistical approach to geo-visualize the spatio-temporal pattern hotspots of active cases. The study is based on secondary data, collected from concerned Government Department. Getis-Ord-Gi* statistical model was used to estimate Z score and P score values representing the intensity of active cases in each location. The results indicate that the high intensity of active cases in the selected period is spatially distributed in Punjab and Sindh provinces and extending towards the west. The capital territory also experiences a slight increase in active cases rate. However, the rate of active cases decreases in Khyber Pakhtunkhwa (KP), Balochistan, Gilgit Baltistan (GB) and Azad Jammu and Kashmir with some fluctuations. Overall, this research highlights the usefulness of geo-statistical modeling for identifying hotspots of any epidemic or pandemic. By knowing the hotspots of a disease, policy makers can easily identify the reasons for its spread, trends, and distribution patterns, making it easier to develop management policies to tackle any pandemic situation in the future., Competing Interests: Declaration of Competing Interest I have no pecuniary or other personal interest, direct or indirect, in any matter that raises or may raise a conflict., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Pakistan registered its first COVID-19 related deaths in last week of February 2020. South Asia as a region remained considerably affected by the deadly pandemic with countries like India, Iran and Bangladesh registering a high rate of fatalities and alarming rise in positive cases. Initial impact of the disease on Pakistan was quite severe and with a weak economy and broken public health system, it was anticipated that Pakistan might not be able to withstand the economic, social and psychological impact of the pandemic. However, the Pakistan government adopted the whole-of-the-nation approach by integrating its well-organized military institution along with other state and civilian institutions and tackled the pandemic proactively. The paper, using the Explanatory Case Study technique, analyses Pakistan's dynamic response mechanism from February to October 2020, referred to as "First Wave of COVID-19 Pandemic". The conclusions show that Pakistan orchestrated a coherent response mechanism by creating an effective governance structure, integrating multiple institutions, resorting to smart lockdowns, taking pro-poor economic measures and converting the challenges into opportunities by making indigenous COVID-19 related medical innovations through research universities. Capacity building of testing facilities, protective equipment and specialized patient care coupled with awareness through effective media campaigns paid rich dividends. Implementation of coordinated and effective response measures not only restricted the disease spread but also helped in sustaining the fragile economy of the country. [ABSTRACT FROM AUTHOR]