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Is organizational performance likely to improve when an organization employs acolytes (i.e., individuals with considerable experience of working with high-reputation industry leaders)? Firms with able, motivated, and opportunity-seeking acolytes are likely to benefit more in terms of unobtrusive access to quality knowledge and improved performance. Through a detailed qualitative treatment, this work identifies high-reputation leaders, acolytes and 312 beauty salons that employed acolytes. An analysis of lagged survey responses of 286 senior managers at these beauty salons showed that the performance of salons improves, when acolytes high in knowledge-sharing competencies--i.e., ability, motivation, and opportunity-seeking--are employed. In line with social learning theory, acolytes acquire and display knowledge-sharing competencies due to their association and work experience with industry greats. This study found that these knowledge-sharing competencies help acolytes overcome the barriers to knowledge-sharing and make knowledge more deployable and redeemable for better performance. We also found that with high homophily between acolytes and fellow employees, knowledge-sharing competencies of acolytes work better and more knowledge is received by the firms.

This study explored the students' perspectives regarding online classes and the problems they have faced while attending online classes during crisis situation of COVID-19. Convergent parallel mix method design was adopted for this study and used online survey and structured interviews for data collection. The participants of the study were first semester social sciences students from two public universities of Rawalpindi city. Sample size for the survey was n=100 which was selected purposively and conveniently whereas, sample size for structured interviews was n=12. Results of the study indicated that higher educational institutes were not ready for this new approach of teaching as there was no proper access to learning management system (LMS).Most of the students were only receiving lectures in the form of power point slides or PDF whereas few teachers were using video lectures. Majority of the participants were not satisfied with this approach of teaching due to many problems including household chores, non-flexibility of online classes, electricity crisis, internet access and speed issues, lack of face to face interaction, explanation, understanding, and students' involvement. It is suggested that during this time, the institutes can improve their online LMS and make their staff ready for online classes.

The study was conducted in three phases that is testing, using multimedia and observation of the controlled group. Major objective of the research were to assess the implications of software development design on learners and to identify effects of interactive multimedia environment on learning patterns of learners' at graduate level. The researchers followed experimental design of research and selected a group of six learners from social science departments through purposive sampling technique. Researchers observed and interviewed the sampled learners who used LMS software. The analysis was made to find out results of patterns of multimedia interactions. It was found that in controlled environmental situations, the learners effectively learned by using interactive multimedia. Learners' capacity of learning was developed when they were given freedom to use variety of learning strategies. These learning strategies were based on the ability and cognition of individual learner. It was also found that the interface design also facilitated exploration as well as, provided guidance to make choices. Learners used concept maps as an important tool which helped them in their structured learning. The research concluded that capabilities of the learners may be evoked through nodes, internal motivation and use of innovative learning techniques.

The heterogeneous data acquired by educational institutes about students' careers (e.g., performance scores, course preferences, attendance record, demographics, etc.) has been a source of investigation for Educational Data Mining (EDM) researchers for over two decades. EDM researchers have primarily focused on course-specific data analyses of students' performances, and rare attempts are made at the domain level that may benefit the educational institutes at large to gauge and improve their institutional effectiveness. Our work aims to fill this gap by examining students' transcripts data for identifying similar groups of students and patterns that might associate with these different cohorts of students based on: (a) difficulty level of a course category, (b) formation of course trajectories, and, (c) transitioning of students between different performance groups. We have exploited descriptive data mining and visualization methods to analyze transcript data of 1398 undergraduate Computer Science students of a private university in Pakistan. The dataset includes students' transcript data of 124 courses from nine distinct course categories. In the end, we have discussed our findings in detail, challenges, and, future work directions.

COVID-19 proved a pandemic that has affected the whole world on a large scale. Every walk of life got disturbed by this pandemic. Educational institutions not only in Pakistan but all over the globe remain closed, which causes a loss of study for the students of all Grades, notably Higher education (Postgraduate Level), which directly affected education, learners, and teachers in terms of learning, time, and economically. Virtual Teaching (VT) is proving an emerging method of teaching in the field of education all over the world. Developed countries have opted for this method of teaching much before. In Pakistan, universities under the directions of HEC started Virtual Teaching VT (Online Teaching) for the students, which was an attempt to cover the loss on an experimental basis. This study is conducted to know the impact of VT on ESL students' behavior. For this purpose among 100 students of KFUEIT, RYK University distributed a questionnaire to measure their behavior level. Students' participation was inspiriting, and their response found positive in this new field of Teaching.

This qualitative study explored the practices and issues related to blended learning in university. It adopted purposive-cum convenient sampling technique. The researchers collected qualitative data from 30 university teachers and 60 undergraduate students through focused group interviews. The researchers did thematic analysis of the data keeping in view objectives of the study. It demonstrated that university academia and undergraduate students use online resources in support of face-to-face instruction. They get videos, PowerPoint presentations, and handouts of textual materials from such sources including YouTube, repositories, search engines and databases. Generally, they use blended instruction for every lesson and in teaching learning process. They use social media for communication and interaction purpose. The study affirmed that the blended learning involves undergraduate students actively in teaching learning process. Blended learning activities create an 'edutainment' environment and involve more senses of the students to promote and sustain their motivation to learn. It also promotes opportunities of collaborative learning i.e. pairing & sharing, and learning in their circles. Lack of university support in adopting online and blended learning formally, lack of sophisticated technology and policy guidelines of the university, authenticity of learning resources and information, and time management appeared to be the main issues of blended learning. However, in spite of these issues, the university academia and students appeared to be eager to embrace blended learning even under tight academic calendar and credit [hours] scheme having too space in the timetable and academic calendar to adopt it formally.

Checking essays written by students is a very time consuming task. Besides spellings and grammar, they also need to be evaluated on their semantic content such as cohesion, coherence, etc. In this study we focus on one such aspect of semantic content which is the topic of the essay. Putting it formally, given a prompt or essay-statement and an essay, this study aims to address the problem of predicting whether the essay is off-topic or not using machine learning techniques. With an increase in online learning and evaluation platforms especially during the COVID-19 pandemic, the off-topic detection system can be very useful to check essays that are mainly submitted online. In this paper, we answer the question: given a prompt and an essay written in Pakistani English, can the process of detecting whether the essay is off-topic or not be reliably and completely autonomized with zero human intervention using currently available tools and techniques? For this purpose, we explore and implement various embedding techniques proposed in recent years to extract similarity or dissimilarity features between question and response, and compare the performance of these techniques using 10 benchmark data sets and 6 classifiers. With different classifiers and different datasets along with different embeddings, we conclude that combining word mover distance, average word embeddings and idf weighted word embeddings together and then using random forest as the classifier is the best combination for off-topic essay detection. The accuracy obtained is 93.5%.

In recent research on information systems (IS), the advantages of social networking sites (SNS) in the education field have received widespread attention. However, excessive use of SNSs will negatively impact students academic performance, leading to the discontinuation intentions of social media. Therefore, this study aims to investigate an extended research model drawing on the stress-strain-outcome (SSO) theory and transactional model of stress to examine the adverse effect of SNS stressors on academic performance. The required data from the target population was collected through a structured questionnaire. The valid sample size of this study was n = 505 respondents. The data were analyzed using structural equation modeling (SEM) in AMOS (version 23.0) to examine the study hypotheses. The results confirmed that the SNS stressors, namely, social overload, information overload, and system feature overload, induce strain in terms of poor academic performance by generating feelings of guilt. It also unravels the effect of guilt feelings on discontinuance intention indirectly. This study offers imperative theoretical and practical implications.

The study of self-efficacy and its impact on human performance has intrigued many scholars during the last two decades, for example, Clayson and Sheffet, 2006; Nauta, 2004; Muijsand Rejnolds 2001; Bandura, 1997 and Soodak and Podell, 1993. This study was conducted with the objective to find out the impact ofteacher self-efficacy on the secondary school students' academic achievement. For this purpose, sixty (60) secondary school teachers and a hundred (100) secondary school students in Chiltan Town of Quetta city were randomly selected. To collect the data, teacher self-efficacy questionnaire for teachers was used and to measure students' academic achievement a test was developed. Data were analyzed through Pearson Correlation and Multiple Regressions. The findings of the study revealed that teacher self-efficacy has a positive impact on the students' academic achievement. The results of the study and their pedagogical implications have been discussed, and recommendations have been provided for further researches.

This study aims to study households' expectations for their children's academic performance in Khyber Pakhtunkhwa, Pakistan. Education has a significant role in increasing the productivity and income level of an individual in a society. Household education, income, distance from school, gender discrimination within household and cost of education can affect parents' expectations of their children. The present study aims to understand why households in Khyber Pakhtunkhwa, Pakistan do not send their children to school, when free and compulsory public schools are available. A two stage Propensity Score Matching approach was applied in the study. Data were estimated through two stages Propensity Score Method. The first stage consists of probability model, used to estimate the propensity score of the characteristics of household. In the second stage, each household group was matched to predict households with similar propensity score values. Literacy rate had a negative effect on the completion of school for household members under 20 years. This means that most school graduates are unable to even read and understand. This is due to dynamic causes, like untrained teachers, lack of facilities, old syllabus, and poor quality education and socio-economic background of the household. But the main delinquency is the failure of educational policies attributed to inadequate economic structure and political instability since the existence of Pakistan. Pakistan government and policy makers need to take initiatives to improve the socio-economic condition of the individuals in the province, and also to give awareness about the importance of education in the region. Further investigation is needed to know the effect of other heterogeneous treatment.

Effective teaching is a key factor in educational effectiveness and improvement. To facilitate the knowledge exchange regarding effective teaching in secondary education internationally, there has been a growing interest in using classroom observation measures. However, little is known regarding the comparability of observation measures across various national contexts (measurement invariance). Consequently, comparing effective teaching behaviour across contexts is compromised by issues of construct and measurement equivalence. In the present study, we investigated measurement invariance of the International Comparative Analysis of Learning and Teaching (ICALT) for measuring teaching behaviour across various national contexts including the Netherlands, South Korea, South Africa, Indonesia, Hong Kong-China, and Pakistan. Results showed that ICALT indicates full strict invariance in four out of the six countries, which provides a possibility to compare teaching behaviour in the Netherlands, South Korea, South Africa, and Indonesia. South Korea indicated the highest quality of teaching behaviour, while Indonesia indicated the lowest.

Purpose: Short-term motivation encompasses specific, challenging and attainable goals that develop in the limited timespan. On the other hand, long-term motivation indicates a sort of continuing commitment that is required to complete assigned task. As short-term motivational problems span for a limited period of time, such as a session, therefore, they need to be addressed in real time to keep the learner engaged in the learning process. Similarly, long-term learners' motivation plays an equally important role to retain the learner in the long run and minimize the risk of dropout. Therefore, the purpose of this study is to incorporate a comprehensive learner motivation model that is based on short-term and long-term aspects of the learners' motivation. This approach enables Web-based educational systems to identify the real-time motivational state of the learner and provide personalized interventions to keep the learners engaged in learning process. Design/methodology/approach: Recent research regarding personalized Web-based educational systems demonstrates learner's motivation to be an essential component of the learning model. This is because of the fact that low motivation results in either students' less engagement or complete drop out from the learning activities. A learner motivation model is considered to be a set of perceptions and beliefs that the system has developed about a learner. This includes both short-term and long-term motivations of leaners. Findings: This study proposed a framework of a domain independent learners' motivation model based on firm educational theories. The proposed framework consists of two modules. The primary module deals with real-time identification of motivation and logging off activities such as login, forum participation and adherence to assessment deadline. Secondary module maintains the profile of leaners associated with both short-term and long-term motivation. A study was conducted to verify the impact of learners' motivation model and personalized interventional strategies based on proposed model, using Systematical Information Education Method assessment standards. The results show an increase in motivational index and the characteristics associated with motivation during the conducted study. Originality/value: Motivational diagnosis is important for both traditional classrooms and Web-based education systems. It is one of the major elements that contribute in the success of the learning process. However, dropout rate among online students is very high, which leads to incorporate motivational elements in more personalized way because motivated students will retain the course until they successfully complete it. Hence, identifying learner's motivation, updating learners' motivation model based on this identification and providing personalized interventions are the key for the success of Web-based educational systems.

Children have higher threats due to their exposure and higher susceptibility to the environmental pollutants. The current study put an effort on detecting different heavy metals in children play products and its related effects on children's health. Heavy metals were detected in the selected samples from the local markets of city Lahore by using flame atomic absorption spectrometer (iCE 3000 series). Results showed that the concentrations of heavy metals (Cr, Ni and Zn) except Pb and Cd are below the EU migration limits. The concentration of Pb in all samples and the concentration of Cd in nineteen samples exceeds from the limits. Highest values of Pb and Cd detected in poster paints were (8.33 ± 1 mg/kg) and (0.94 ± 0.1 mg/kg), respectively. In crayons and playing dough highest values of Pb and Cd detected were (10.94 ± 1 mg/kg), (2.75 ± 0.1 mg/kg) and (9.313 ± 01 mg/kg), (1.9 ± 0.1 mg/kg), respectively. Obtained results are further used to calculate both the oral and dermal health risks of these playing products. The value of the total health risk assessment was less than 1 in all the selected playing products. The maximum value of the total health risk assessment is detected in crayon (3.97E-02), which can cause serious health problems. Therefore, it is needed to make laws which limit the use of heavy metals in these playing products in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Research related to HIV stigma is in its initial stages in Pakistan. With the recent increase in HIV cases among injection drug users, there is a growing need to study the psychosocial aspects of the disease to address and mitigate the factors associated with stigma. HIV stigma has been identified as a contributor to depression and a barrier to effective treatment. Aim: This study examines the moderating role of perceived social support from three sources, i.e., family, friends, and significant others, in reducing the impact of HIV stigma on depression among individuals living with HIV in Pakistan. Methodology: 150 male HIV patients were approached whose likely mode of infection was through injection drug usage. The study explored the moderating role of three sources of perceived social support. Semi-structured interviews and standardized measurements were employed to assess levels of stigma, depression, and perceived social support. Results: The findings indicated that family support emerged as the most effective moderating factor in the relationship between HIV/AIDS stigma and depression. Support from significant others was observed as the second one. However, the study did not find substantial moderating effects from friends' support on the relationship between stigma and depression. Conclusion: In Pakistan, where a collectivist societal structure prevails, interventions to reduce HIV/AIDS stigma should focus on strengthening the family support system for patients. The study's outcomes underscore the importance of tailored interventions that consider the cultural context to mitigate the adverse impact of HIV stigma on mental health of people living with HIV. [ABSTRACT FROM AUTHOR]

Introduction Neurosurgery receives several applicants every year, but the decreasing size of the neurosurgery workforce in Pakistan despite evidence of initial student interest is perplexing. Therefore, it is vital to evaluate the perspective of medical students and recent graduates to get a holistic view of perceptions toward neurosurgery. Materials and Methods A nationwide cross-sectional study was conducted on a sample of medical students and recent graduates from different medical colleges. Their perceptions were gauged by multiple choice questions and barriers identified using Likert scale questions. Statistical analyses were carried out using the IBM Statistical Package for Social Sciences (SPSS) version 26. Results A total of 2,481 responses were recorded from study participants. Neurosciences and neurosurgery were a part of a medical school curriculum for the majority (64.9%) of the participants. However, a significant number (65.4%) of the participants do not have the opportunity to rotate in the field of neurosurgery. The respondents' perception of neurosurgery is shaped by various factors, such as university lectures (21.9%), digital media (16.7%), and social media (15.2%). Known patients (5.7%) and known neurosurgeons (4.8%) were considered the least influential sources. The top three characteristics associated with neurosurgery were consistent for both male and female students: difficult, interesting, and brain. Male respondents (25.22%) predominantly described neurosurgery as difficult, while female respondents (21.98%) found it interesting. Many females perceived neurosurgery as a male-dominated specialty, with 64% female participants agreeing with gender bias compared to 36% of males. Conclusion This study uncovers that medical students' views on neurosurgery are shaped by lectures, digital media, and social media, leading to preconceived ideas. These notions, including extended working hours, limited work–life balance, competition, gender bias, and stereotypes, impede their interest and comprehension of neurosurgery as a profession. To address this, students should have more opportunities to familiarize themselves with the field, allowing them to challenge these misconceptions and discover the captivating world of neurosurgery. [ABSTRACT FROM AUTHOR]

Background: Raising a child with hydrocephalus can be very challenging, especially in low- and middle-income countries. In Pakistan, mothers being the primary caregivers for their hydrocephalic children are under tremendous stress. Methods: This study explores the challenges faced by Pakistani mothers raising children with hydrocephalus, employing a qualitative methodology through focus group discussions comprising ten mothers of hydrocephalic babies at Tertiary Care Hospital in Pakistan. Results: The findings highlight three main themes: emotional toll, social isolation, and financial strain. Mothers experience significant emotional stress due to societal stigma and a lack of support, particularly from their husbands and family. Social isolation is prevalent, as mothers fear sharing their burdens and face physical confinement due to their children's needs. Financial strain is another major issue, with high medical costs adding to their economic difficulties. Conclusion: The study emphasizes improved access to specialized care, awareness campaigns to reduce stigma, financial assistance, and stronger community support networks to support these mothers better. Addressing these unmet needs is crucial for empowering Pakistani mothers in their caregiving roles and improving the quality of life for their children with hydrocephalus. [ABSTRACT FROM AUTHOR]

A massive landslide occurred in Domeshi area, District Muzaffarabad, Pakistan, in two distinct phases: an initial movement on August 1, followed by complete failure on August 4, 2023. The landslide movement persisted for 96 h, with a runout distance of 500 m. The event destroyed numerous residential structures, impacting multiple families, and causing extensive damage to cultivated land and road infrastructure. To comprehensively understand the failure mechanisms, a detailed study was undertaken, encompassing site investigations, unmanned aerial vehicle (UAV) photography, geotechnical and geophysical investigations, petrographic analysis, kinematics, and numerical simulations. The field evidence indicates that the active deformation along the Jhelum Fault (JF) within the landslide's main body weakened the surrounding rock formations. Intense rainfall saturated pre-existing fractures, creating critical zones of weakness. Highly plastic clays along fault plane contributed significantly to volume changes, especially during and after rainfall events. Kinematic analysis identified bedding joints as prevalent failure planes for planar sliding. Geophysical survey revealed a layer of unconsolidated material extending 25–30 m below the landslide's scarp, accompanied by various fractures, including a deep fracture (i.e., JF) up to 300 m depth. Petrographic investigations showed microfractures, micro faults, and intragranular mineral breakage, indicative of intense tectonic stresses. Slope stability analysis indicated factors of safety (FoS) and strength reduction factor (SRF) less than 1, suggesting the potential for further failure in the lower sections of the landslide. Multiple factors, including slope geometry, active tectonics, material composition, and anthropogenic factors (i.e., slope loading and cutting for road and building construction, improper drainage distribution), contributed to the landslide's occurrence, however, the rainfall emerged as the primary triggering event. [ABSTRACT FROM AUTHOR]

Organizations have prioritized green innovation (GI) following the increasing stakeholder pressure (SP) on sustainable growth through megaproject social responsibility (MSR). A sustainable megaproject delivery involves three essential determinants. However, few studies have focused on the complicated relationships between these determinants and megaproject success (MPS). Hence, this study examines the relationships between SP, GI, and MPS by considering the key mediating role of MSR. Data were collected from 245 respondents in Pakistan's construction industries. The study tests the hypotheses using partial least squares structural equation modeling that SP positively influences both MPS and GI, and that MSR partially mediates this relationship. The findings suggest that stakeholder pressure plays a crucial role in promoting MPS and GI through the adoption of socially responsible practices. These findings add to the body of knowledge on the direct and indirect effects of SP and MPS and SP and GI, which have been inconsistent in previous research. In practice, engineering managers can increase GI and MPS by focusing more on SP and MSR. [ABSTRACT FROM AUTHOR]

The Virtual University was established in 2002 and it is the first Pakistani University based completely on modern information and communication technologies. The sub campuses are situated in one hundred cities of Pakistan and these campuses are facilitating students to provide infrastructure. The dropout rate is continuously increasing during the last three years. The main objective of the study was to find out the causes of female dropout at undergraduate level. The study was qualitative in nature. A semi structured interview was developed to collect the information. The data was collected from the drop out female students of April, 01, 2015 to March, 30 2016. There were 90 students in all. All the students were enrolled in undergraduate classes and unable to complete their degree. A telephonic interview was conducted and asked them to explain reasons regarding dropout. All the reasons were grouped and five major reasons were identified. The major reasons were: Financial problem, married and unable to continue, time management, unable to understand VU mode of instructions and admitted to another institute. The recommendations were made in the light of findings to minimize the dropout rate of the students.

The private higher education sector in developing countries is challenged with high turnover, which has resulted in lowered sustainable competitive advantage. The resource-based theory considers strategic resources as a vital source to achieve a competitive advantage among its competitors. We argue that staff retention is a key factor to address these issues; therefore, the impact of internal marketing strategies on staff retention is examined through a sample of 352, collected from private higher education institutes in Pakistan, using close-ended questionnaire on 5-point Likert scale. The results highlight that economic, social and repute factors of internal marketing promote favorable employee attitude. Despite psychological contract violation, economic factor emerges as a key factor for staff retention. The results provide deep insight into higher education sector regulator as well as HR managers in private higher education universities to improve longer staff retention for sustainable competitive advantage while ensuring education quality.

This research explores teachers' opinions on the use of visual aids (e.g., pictures, animation videos, projectors and films) as a motivational tool in enhancing students' attention in reading literary texts. To accomplish the aim of the research, a closed ended questionnaire was used to collect the required data. The targeted population for this research was the staff and students of the public and private educational institutions of District Dera Ghazi Khan. In this research the primary data was used for gathering information. The collected data is analyzed through the SPSS software and also data was represented in the percentage distribution of pie, line, and bar graphs. The analysis of the data indicated that the majority of the teachers and students had positive perceptions of the use of visual aids.

Health Education, particularly in elementary schools, appears to be a neglected area in Pakistan. This study investigated the health education needs of elementary school students. The purpose of the present study is to assess health education needs of elementary school students. The study adopted mix approach of (qualitative and quantitative) research for data collection. The quantitative data were collected by administering piloted questionnaire on elementary school students (n = 400) and the response rate was 82% (as 328 responses were complete). The same participants were also interviewed in groups of 4-6 students. The data collected through questionnaire were analyzed quantitatively; whereas, interviews were analyzed thematically. Overall 68% of the elementary school students required information about the main constructs of health education; 69% appeared to be keen on knowing about physical environment in and around their schools and homes; 77% were interested to get awareness about commonly spreading out diseases and puberty issues. The results of this study appeared to be aligned to the social context of Bahawalpur, Pakistan. The elementary school students were merely aware of the main constructs of health education and needed awareness, specifically in food and nutrition, hygiene, seasonal and tropical diseases, infectious diseases, and psychological problems. Proper school health education programme may be initiated for elementary school students.

Intellectual capital is a concept that is achieving researcher's attention day by day. The main purpose of this research study is to explore the role and relationship of intellectual capital and its three components on the performance and efficient working of universities in Pakistan. Education sector especially universities were selected because it plays a critical role for the development and growth of knowledge intensive sector. So in this research study 3 components of intellectual capital such as human capital, structural capital and relational capital were taken as independent variables and institution's performance is taken as dependent variable. In this research study a structured questionnaire is adopted from the past research studies and 800 responses have been collected from various public and private university students in Pakistan. Reliability analysis is conducted to check the reliability of constructs and Pearson's correlation is applied to explore the relationship of three components of IC on institution performance. Results indicate that all the three components show a significant relationship with performance but among the three components, the relation of human capital is more prominent.

Climate change affects the spread of waterborne infectious diseases, yet research on vulnerability to outbreaks remains limited. This integrative review examines how climate variables (temperature and precipitation) relate to human vulnerability factors in Pakistan. By 2060, mean temperatures are projected to rise from 21.68°C (2021) to 30°C, with relatively stable precipitation. The epidemiological investigation in Pakistan identified Diarrhea (119,000 cases/year), Malaria (2.6 million cases/year), and Hepatitis (A and E) as the most prevalent infections. This research highlighted vulnerability factors, including poverty (52% of the population), illiteracy (59% of the population), limited healthcare accessibility (55% of the population), malnutrition (38% of the population), dietary challenges (48% of the population), as well as exposure to water pollution (80% of the population) and air pollution (55% of the population). The findings suggest that the coordinated strategies are vital across health, environmental, meteorological, and social sectors, considering climatic variability patterns and population vulnerability determinants. [ABSTRACT FROM AUTHOR]

Background: Bt technology has played significant role in controlling bollworms and increasing cotton yield in earlier days of its introduction, a subsequent decline in yield became apparent over time. This decline may be attributed to various environmental factors, pest dynamics, or combination of both. Therefore, the present biophysical survey and questionnaire were designed to evaluate the impact of Bt cotton on bollworms management and its effect on reducing spray costs, targeting farmers with varied landholdings and educational backgrounds. Additionally, data on farmers' cultivated varieties and the prevalence of bollworms and sucking insects in their fields were recorded. Subsequently, about eleven thousand cotton samples from farmer fields were tested for Cry1Ac, Cry2Ab and Vip3A genes by strip test. Results: In this analysis, 83% of the farmers planting approved varieties believe that Bt technology control bollworms, while 17% hold contradictory views. Similarly, among farmers cultivating unapproved varieties, 77% agree on effectiveness of Bt technology against bollworms, while 23% disagree. On the other hand, 67% of farmers planting approved varieties believe that Bt technology does not reduce spray costs, while 33% agree with the effectiveness. Similarly, 78% of farmers cultivating unapproved varieties express doubt regarding its role to reduce spray costs, while 22% are in favour of this notion. Differences in opinions on the effectiveness of Bt cotton in controlling bollworms and reducing spray cost between farmers planting unapproved and approved varieties may stem from several factors. One major cause is the heavy infestation of sucking insects, which is probably due to the narrow genetic variation of the cultivated varieties. Additionally, the widespread cultivation of unapproved varieties (21.67%) is also an important factor to cause different opinions on the effectiveness of Bt cotton. Conclusion: Based on our findings, we propose that the ineffective control of pests on cotton crop may be attributed to large scale cultivation of unapproved varieties and non-inclusion of double and triple transgene technologies in country's sowing plan. On the basis of our findings, we suggest cotton breeders, regulatory bodies and legislative bodies to discourage the cultivation of unapproved varieties and impure seed. Moreover, the adoption of double and triple Bt genes in cottons with a broad genetic variation could facilitate the revival of the cotton industry, and presenting a promising way forward. [ABSTRACT FROM AUTHOR]

Deviant workplace behaviors (DWB) cause enormous costs to organizations, sparking considerable interest among researchers and practitioners to identify factors that may prevent such behavior. Drawing on the theory of moral development, we examine the role of ethics-oriented human resource management (HRM) systems in mitigating DWB, as well as mechanisms that may mediate and moderate this relationship. Based on 232 employee-supervisor matched responses generated through a multi-source and multi-wave survey of 84 small and medium enterprises (SMEs) in Pakistan, our multilevel analysis found that ethics-oriented HRM systems relate negatively to employee DWB via the mediation of perceptual and reflective moral attentiveness. This indirect relationship is further moderated by two societal-inequality induced factors – employee gender and income level – such that the indirect effects of ethics-oriented HRM systems on DWB through perceptual and reflective moral attentiveness are stronger among women and lower-income employees. [ABSTRACT FROM AUTHOR]

This work examines students' perceptions and engagement with face-to-face teaching and content-delivery methods and especially with technology-mediated, fully online courses in connection with the Pakistani higher education system. Nowadays, learning technologies are being integrated at unprecedented levels and it important to know their attitude to particular learning environment. To do this, the research seeks to establish the following hypothesis as true: There exists positive relationship between the educational environment and perceptions/interactions among the students. Scalable, the research utilizes 225 participants in regression analysis, correlation analysis and ANOVA to analyses the effect of educational settings on student engagement. Findings show that there is a highly significant positive relationship (r = O. 648, P=<0. 001) and reasonable amount of variance explained by the educational environment on students' perception (R² = O.420). Cronbach's Alpha High Coefficients of 0. 9941 for Educational Environment and 0. 9983 for Student Perceptions revealed that both the measurement tools used in obtaining results are reliable that enhances the validity of the findings. This study offers helpful recommendations for educational organizations in Pakistan to implement useful technological learning experiences alongside the conventional conventional form of face-to-face interactions to improve the students' engagement levels as well as their satisfaction indices. [ABSTRACT FROM AUTHOR]

This study aims to assess the impact of digital technology use on the digital well-being of adolescents in Pakistan and Canada. Unlike previous research relying on secondary data, this study gathers primary data directly from adolescents on a five-dimensional Likert scale from the Center for Trusted Internet and Community at the National University of Singapore. The study examines the impact of digital technology use on digital consumption, health, civic participation, employment, and social relations, as well as their subsequent effects on digital well-being. A quantitative approach was employed, with data sample of 300 survey questionnaires from Pakistan and Canada. The findings show a positive correlation between digital technology use and digital consumption, civic participation, employment, and social relations. Negative impacts are observed on digital health due to low use of health apps, resulting in headaches, eye strain, and sleep issues. Differences in digital civic participation and online shopping habits are influenced by economic and accessibility factors. Encourage balanced digital consumption, promote health app usage, and enhance digital literacy programs to support informed civic participation. [ABSTRACT FROM AUTHOR]

In this paper, the primary objective of the research team was to find out the relationship between student satisfaction and the following variables of the distance learning environment: instructors' performance, course evaluation and student-instructor interaction. The sample consisted of 245 students of Allama Iqbal Open University of Pakistan. The purpose of this study was to address the most recent problem of AIOU students relevant to their distance learning. The problem was that most of the people in Pakistan perceived distance learning as poorer quality. Therefore, the researchers conducted this study to find out whether it's only people perception or there is any thing in reality about the poorer outcome of the distance learning students as compare to traditional students. By using correlation, regression and descriptive analysis, it was found that just like the traditional education, in distance learning education at AIOU, enough interaction take place between students and their instructors, courses are up to date and well designed, instructors are devoted, motivated and equipped with the required skill and knowledge. Moreover, the faculty at AIOU is delivering distance learning courses that meet the students' needs in regard to students-instructor interaction, instructor performance and course evaluation. (Contains 5 tables.)

The major purpose of the study was to compare the frequency and effectiveness of positive and negative reinforcement practices deployed by teachers in boys' and girls' secondary schools in urban and rural areas. It was hypothesized that there would be no difference in use of reward and punishment by teachers in secondary schools in urban and rural areas with respect to their frequency and effectiveness. The results of this study brought out a clear picture of the reward and punishment practices being followed in schools, which may serve as a useful tool for improving these practices that influence development of students? desired behaviour. The population of the study comprised of the teachers serving in government secondary schools of Punjab. A sample of 1,000 teachers (200 from district Rawalpindi, 150 from district Attock, 200 from district Lahore, 150 from district Gujranwala, 150 from district Multan, and 150 from district Khanewal) was randomly selected in such a way that the proportion of rural and urban boys? and girls? secondary school teachers was evenly balanced. In order to collect data from sample teachers, a comprehensive questionnaire was developed and personally administered. The data obtained was tabulated, analyzed and interpreted by using appropriate descriptive and inferential tests of significance, such as one-way chi-square and two-way chi-square. The level of significance was 0.05. On the basis of results and discussion, it was concluded that the teachers of urban schools had better knowledge of using reward and punishment with respect to their frequency and effectiveness as well. There should be a countrywide program to train teachers according to the demands of the new era.

The major purpose of this paper was to examine the quality of various aspects of higher education in the private sector of Pakistan by adopting a descriptive method of research. The population of the study constituted 270 administrators, 6,180 teachers and 61,108 students in existing 54 private universities and degree-awarding institutions of Pakistan. The method of cluster sampling was used to select the study sample of 840 people, which was carried out in two stages. In the first stage, 12 clusters of universities were randomly chosen out of the total population of private universities. In the second stage, 60 administrators, 180 teachers and 600 students were selected through a random sampling procedure with five administrators, 15 teachers and 50 students from each selected cluster. Three questionnaires, developed and refined through pre-testing, were used as measuring instruments to collect data. The researcher personally visited each university and collected data from the sample. The collected data was tabulated, analyzed and interpreted by using ANOVA and t test techniques.

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Background: This study aimed to evaluate health literacy and general health status among school principals and vice principals in Pakistan, (1) to identify work-related factors associated with them, and (2) to determine their association with physical and mental health, particularly in the context of the COVID-19 pandemic. Methods: An online-based cross-sectional survey was conducted among 350 school principals and vice principals in Punjab province, Pakistan. The study was conducted under the COVID Global Health Literacy Network. Data related to socio-demographic characteristics, health literacy, general health status, chronic illnesses and impairment, well-being, psychosomatic complaints, and emotional exhaustion were collected. We applied bivariate analyses as well as binary and multivariable logistic regression analyses. Results: Over half of the respondents (66.6%) had sufficient levels of health literacy. A good general health status was reported by 80.3%. One of the strongest predictors of health literacy and general health status was school position (principals vs. vice principals). Additionally, those with sufficient health literacy were less likely to have frequent emotional exhaustion; while those having good general health status were less likely to report low well-being, frequent emotional exhaustion, and psychosomatic complaints. The study also found that females were less likely to have a good general health status (OR 0.45) and were more likely to have frequent emotional exhaustion (OR 1.75) as well as psychosomatic complaints (OR 1.94) than males. Conclusions: Limited health literacy in school leaders requires interventions for better decision-making on health matters, emphasizing the need for targeted training programs. [ABSTRACT FROM AUTHOR]

Seven Phytophthora isolates were recovered from roots and rhizosphere soil of different plants of the Bajaur, a newly merged district in Khyber Pakhtunkhwa province of Pakistan. These isolates were characterized morphologically as well as molecularly using internal transcribed spacer (ITS) sequences and of them identified are Phytophthora lacustris, Phytophthora capsici, Phytophthora citrophthora and Phytophthora nicotianae. P. lacustris appeared to be a new record from Pakistan not hitherto reported. P. nicotianae and P. citrophthora are reported for the first time from the rhizosphere of Isodon rugosus and Cajanus cajan in Pakistan. [ABSTRACT FROM AUTHOR]

In the history of humankind, lunar eclipse has always captured attention and imagination of human beings. This study is an anthropological attempt to describe prevailing perceptions and myths about lunar eclipse and resultant religious and cultural practices in some of the rural areas of Central Punjab, Pakistan. For this purpose, qualitative research techniques of in-depth interviews and focus group discussions have been used to understand and untangle the strings of indigenous perpetuations about a celestial phenomenon. The research findings showed multiple sets of socio-cultural and religious beliefs and practices which have been followed through generations that demonstrate the richness of culture and mythological value of local verbal tales. Perceptions include fear of God, remembering the day of judgment, good or bad luck, and occurrence of disease. Practices include praying, charity, taking certain precautions to avoid the disease, and doing some religious and cultural rituals. Some unique folktales are also narrated by the respondents of the locale which have specific socio-cultural meanings for them. The paper describes all these perceptions and practices in two main parts: socio-cultural perceptions and practices and religious perceptions and practices. [ABSTRACT FROM AUTHOR]

Objective: To compare the use of Titanium clips and Monopolar diathermy for laparoscopic appendectomy mesoappendix closure in terms of operative time and cost. Study Design: Quasi-experiment study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Nowshera Pakistan, from Jul 2021 to Jun 2022. Methodology: A total of 70 patients who were diagnosed with acute appendicitis and were admited for laparoscopic appendectomy were randomly divided into two groups via the lotery method. In Group-A, the closure of the mesoappendix was done using Titanium clips, and in Group-B, the ligation of the mesoappendix was done using Monopolar diathermy. Patient outcomes in terms of operative time and procedure cost were assessed. Results: Out of 70 patients, 49(70.0%) were males and 21(30.0%) were females, aged 18 to 60 years, with a mean age of 37.57±7.71 years. The overal mean weight of the patients was 65.29±12.14 kg; height was 1.71±0.12 metres; and BMI was 24.96±5.23 kg/m2, respectively. Prolonged operative time was observed in 16(45.71%) patients in Group-A, compared to 7(20.0%) in Group-B (p-value 0.022). In Group-A, the total cost of the operation was Rs. 32,000, whereas in Group-B, it was Rs. 30,000 (p-value=0.001). Conclusion: This study concluded that Monopolar diathermy for the closure of the mesoappendix is beter in terms of operating time and cost as compared to the use of Titanium clips. [ABSTRACT FROM AUTHOR]

This study inspects the insights and practices of gratitude among Pakistani university students using qualitative research method. Convenience sampling was used. The study gathered data through semi-structured interviews with 15 students, aged 18 to 25, and open-ended questionnaires filled by 25 students. The data were evaluated using thematic analysis, uncovering key themes: Understanding gratitude, expressing gratitude, Social Media’s effect on Gratitude, Gratitude and Academic Performance, Benefits of Gratitude, and Gratitude in Family Relationships. The findings feature the social, religious, and cultural variables forming students’ perspectives on gratitude. Prominently, gratitude was found to improve academic execution and stress management. Although, social issues like debasement and divergence were recognized as boundaries to offering gratitude. The study presumes that encouraging gratitude in universities can reinforce the learning environment, however systems should think about the broader social setting. Further exploration is expected to investigate gratitude in different instructive settings and over time to comprehend its advancing role. This exploratory study gives fundamental bits of knowledge into gratitude in Pakistani society and lays the preparation for future examination on its more extensive ramifications. [ABSTRACT FROM AUTHOR]

Soil salinity is a significant challenge in agriculture, particularly in arid and semi-arid regions such as Pakistan, leading to soil degradation and reduced crop yields. The present study assessed the impact of different salinity levels (0, 25, and 50 mmol NaCl) and biochar treatments (control, wheat-straw biochar, rice-husk biochar, and sawdust biochar applied @ 1% w/w) on the germination and growth performance of wheat. Two experiments: a germination study and a pot experiment (grown up to maturity), were performed. The results showed that NaCl-stress negatively impacted the germination parameters, grain, and straw yield, and agronomic and soil parameters. Biochar treatments restored these parameters compared to control (no biochar), but the effects were inconsistent across NaCl levels. Among the different biochars, wheat-straw biochar performed better than rice-husk and sawdust-derived biochar regarding germination and agronomic parameters. Biochar application notably increased soil pHs and electrical conductivity (ECe). Imposing NaCl stress reduced K concentrations in the wheat shoot and grains with concomitant higher Na concentrations in both parts. Parameters like foliar chlorophyll content (a, b, and total), stomatal and sub-stomatal conductance, and transpiration rate were also positively influenced by biochar addition. The study confirmed that biochar, particularly wheat-straw biochar, effectively mitigated the adverse effects of soil salinity, enhancing both soil quality and wheat growth. The study highlighted that biochar application can minimize the negative effects of salinity stress on wheat. Specifically, the types and dosages of biochar have to be optimized for different salinity levels under field conditions. [ABSTRACT FROM AUTHOR]

In recent years, financial literacy has attracted much attention in the field of household finance as individuals have become more concerned about their financial well-being. Besides, financial products have become more complex over the years. Therefore, financial literacy has become crucial for financial decision making and has received the attention of policymakers, researchers and regulatory bodies. This study investigates the cross-sectional heterogeneity on the relationship between financial literacy and stock market participation in an emerging economy, particularly Pakistan. This study uses the survey data of the 300 individuals residing in Islamabad. Exploratory factor analysis is used to assess convergent and discriminant validity of the survey data. Results are estimated using logistic regression. Results of this study show that individuals with higher levels of financial literacy tend to participate more in the stock market. This study also finds the support for gender gap on the financial literacy and participation in the stock market. Further, it is observed that age, qualification and income are positively associated with stock market participation. In the end, the conclusion of the study is given along with significant policy implications. [ABSTRACT FROM AUTHOR]

The district Toba Tek Singh is located in the center of Punjab province. It occupies 2nd important position in national citrus production after Sargodha, with citrus orchard area of 11412 hectares and annual production of 160758 tons. Citrus productivity in Pakistan, in general, and Toba Tek Singh, in particular, is far below its its potential which could be attributed to several factors but poor soil health and inadequate soil fertility may be considered an important reason. A comprehensive nutrient indexing survey of thirty citrus orchards grown in different parts of district Toba Tek Singh was conducted to evaluate the soil characteristics and plant nutrient status. GPS coordinates of selected sites were recorded prior to sampling. Soil samples were coll ected at 0-20 cm, 21-40 cm and 41-60 cm depth using standard procedure. Five soil samples were collected from each site to get a composite sample for each depth. The leaf samples were collected from the 7-month-old non-fruiting branches of plants around the tree canopy during the month of September, 2022. Five healthy and uniform citrus trees were sampled from each site to get a composite leaf sample. The soil samples were analyzed for pH, electrical conductivity (EC), soil organic matter (SOM) and calcium carbonate (CaCO3). The soil and leaf samples were analyzed for macro and micronutrients. It was found that most of orchard soils of district Toba Tek Singh were moderately alkaline (pH 7.52-8.90), slight to strong calcareous (2-15% CaCO3), non-saline (0.77-3.0 dS m-1 EC) and low in SOM (0.23-1.49%) with low to medium nitrogen (0.01-0.06%) and phosphorus (0.58-10.52 mg kg-1) while medium to high potassium (56.47-315.34 mg kg-1). The sampled soils were low to marginal in boron (0.09-0.72 mg kg-1), copper (0.05-0.59 mg kg-1), iron (0.23-10.75 mg kg-1) and zinc (0.03-1.83 mg kg-1) while adequate in manganese (1.35-26.20 mg kg-1). Leaf analysis revealed that almost 50% orchards were deficient in phosphorus (0.05-0.23%) and potassium (0.40-1.76%), while having low to marginal values of copper (1.96-20.99 mg kg-1), zinc (4.13-31.96 mg kg-1), boron (3.12-95.40 mg kg-1), manganese (42.62- 96.46 mg kg-1) but adequate iron (171-552 mg kg-1). The surveyed orchard soils were mostly alkaline calcareous, deficient in organic matter and having low to moderate macro and micronutrients. [ABSTRACT FROM AUTHOR]

To determine the incidence of antimicrobial-resistant emerging pathogens, Clostridium difficile, and its associated risk factors in tertiary care setups of Pakistan. This cross-sectional prospective study was conducted from January 2019 to December 2020, to determine the prevalence and antimicrobial resistance patterns of C. difficile strains isolated from 450 stool specimens of patients suffering from diarrhea hospitalized in tertiary care hospitals in Peshawar, Pakistan. The stool samples of the patients were processed for culture and detection of toxin A and toxin B by enzyme-linked immunosorbent assay (ELISA) and tpi PCR. The drug sensitivity test was performed for antibiotics including ampicillin, cefixime, cefepime, amoxicillin, nalidixic acid, sulpha/TMP (SXT), chloramphenicol, metronidazole, vancomycin, ciprofloxacin, levofloxacin, and imipenem. Of 450 stool specimens, 108 (24%) were positive for C. difficile by stool culture, whereas 115 (25.5%) were only positive for C. difficile toxins based on ELISA and PCR (128 (28.6%). Of 108, 90.7% (n = 98) isolates were resistant to one antibiotic, and 90 (83.4%) were resistant to three or more antimicrobials. The highest resistance rates were found against penicillin (83.3%) followed by amoxicillin (70%), nalidixic acid (61%), and metronidazole (38%), and the lowest resistance was found against vancomycin (6.4%) and imipenem (3.7%). CDI was statistically significantly correlated with increased age, use of antibiotics, abdominal surgeries, use of proton pump inhibitors and H2a, and presence of comorbidities. The high frequency of C. difficile in Peshawar, Pakistan, indicates that CDI is an important nosocomial infection in different hospitals. The results will be helpful for clinicians to redesign control and therapeutic strategies in hospitals. [ABSTRACT FROM AUTHOR]

[Purpose] This study assesses the duties of the mass media operating in Pakistan, the state of its affairs, and the domestic roles it can play in benefiting communities in distress, especially during the pandemic caused by the coronavirus. Media workers use "emergency" as a generic term to describe all sorts of crises, including an outbreak. Although it fulfills the essential criteria on which disseminators can devise a crisis management plan, it does not address the core issue: how a health emergency differs from other disasters. In the sociocultural context, the role of media personnel in Pakistan becomes more problematic due to several shortcomings. As public and community health is not up in mainstream media's agenda and they focus more on politico -social issues, the media workers' job of collecting data, writing facts, and sharing information becomes more challenging. [Methodology/Approach/Design] This study entails a mixed method with a descriptive approach based on empirical data to analyze the media's role in Pakistan and forecast its duties during the COVID-19 epidemic. For COVID-19 integrated statistics, it drew upon the numeric data provided by domestic and international health organizations. [Findings] For a qualitative assessment, the authors organized a survey reflecting the responsibilities of media and problematics of Pakistani media amid emergencies using a 5-point Likert Scale. The survey was conducted through random phone calls, following the government's directions regarding standard operating procedures (SoPs) amid the pandemic. [ABSTRACT FROM AUTHOR]

Objective: We assessed the effectiveness of oral Hydroxychloroquine (HC), Azithromycin (AZ) and Oseltamivir (OS), alone or combined, among patients hospitalized with mildly symptomatic coronavirus infectious disease (COVID-19). Methods: Following the approval of the National Bioethics Committee and prospective registration (clinicaltrials.gov NCT04338698), a multicenter randomized clinical trial of adaptive design was conducted at 10 multispecialty hospitals in Pakistan. Patients were randomized into seven treatment groups. Starting April 15, 2020, consenting, eligible, otherwise healthy adult patients or those with co-morbidities under control, were recruited if they presented with mildly symptomatic COVID-19 (scored 3 on a 7-point ordinal scale anchored between 1 = not hospitalized, able to undertake normal activities, to 7 = death) confirmed by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). Two primary outcomes were assessed by day seven: Turning qRT-PCR negative; and clinical improvement of two points from the baseline. Outcome rates were compared using a chi-square test. Multiple imputations were applied to handle missing data. An interim data analysis was carried out on July 19, 2020, following which the study continued without treatment group changes. Data Safety and Monitoring Board advised to stop recruitment due to its futility on January 18, 2021. Results: Of 471 patients randomized, a total of 426 (90.4%) completed the follow-up for primary outcomes. Based on imputed data analyses at day seven: Total qRT-PCR negative cases were 137/471 (29%, 95% CI 25.0 - 33.4). By day seven, a total of 111/471 (23.5%, 95% CI 19.8 - 27.6) showed clinical improvement. No serious or non-serious adverse event was reported. Conclusions: Among patients with mild COVID-19, there was no statistically significant difference in the effectiveness of oral antimalarial, antiviral, or antibiotic treatments. [ABSTRACT FROM AUTHOR]

The Eocene Kuldana Formation (KF) in the Yadgar area of Pakistan, comprises a diverse range of sedimentary facies, including variegated red beds of shales, mudstones, and sandstones, as well as interbedded limestone and marl. In this study, we conducted an integrated micropaleontological, sedimentological, mineralogical, and geochemical investigation to determine the depositional setting, biochronology, provenance, and paleoclimate of the KF. The study identified six lithofacies and six microfacies, which indicate a variety of environments ranging from floodplains and channels to the margins and shallow marine settings. The nannofossil biostratigraphy places the KF in the Early Eocene, more precisely the NP10 zone (Ypresian), and the fossil zone of benthic foraminifera classifies the study section as the Shallow Benthic Zone SBZ-8 (Middle Ilerdian 2). In terms of petrography, the KF sandstone was classified as litharenite and feldspathic litharenite, while the QtFL diagram suggests a recycled orogen. Geochemical proxies indicate an oxidizing environment, a high-to-low regular sedimentation rate, moderate-to-intense chemical weathering in the source region, and a warm-humid to dry climate during the deposition of KF. Overall, the findings suggest that the deposition of KF marks the end of Neo-Tethys due to the Early Eocene Indian–Kohistan collision and that the uplifting of the Himalayas provided the source for the deposition of KF in the foreland basin. The study provides new insights into the depositional environment, biochronology, provenance, and paleoclimate of KF, and highlights the potential for red beds as reliable indicators of oxygenation levels in proximity to mineral deposits. [ABSTRACT FROM AUTHOR]

Although research establishes a link between knowledge‐intensive human resource (HR) practices (KIHRP) and knowledge‐intensive team (KIT) performance, knowledge is limited about the underlying mechanisms and boundary conditions that determine this relationship. This study integrates the ability–motivation–opportunity (AMO) framework and theory of team adaptation into an information processing perspective to present a cohesive model that explains the mediating role of team knowledge sharing and reflexivity processes, and moderation of organization's technological knowledge management (KM) capability to explain the effect of KIHRP on KIT performance. Data were collected in three waves and from three sources consisting of 380 knowledge workers from 123 teams in 74 organizations in Pakistan. The findings indicate that KIHRP relates positively to KIT performance directly as well as via team knowledge sharing and reflexivity processes where the organization's technological KM capability further strengthens this relationship. [ABSTRACT FROM AUTHOR]

Introduction. According to the Global Climate Risk Index, Pakistan is ranked as the fifth-most vulnerable country to climate change. Most recently, during June-August 2022, heavy torrential rains coupled with riverine, urban, and flash flooding led to an unprecedented disaster in Pakistan. Around thirty-three million people were affected by the floods. More than 2 million houses were damaged, leaving approximately 8 million displaced and approximately 600,000 people in relief camps. Among those, 8.2 million women and 16 million children are the worst affected, with many requiring urgent medical and reproductive healthcare. To plan an efficient healthcare program and a climate-resilient health system, it is crucial to understand the issues that the affected people face during floods. Methodology. This rapid assessment included the population in the most severely affected districts across the four provinces of Pakistan. A mixed methods approach using qualitative and quantitative techniques was utilized. A total of 52 qualitative, in-depth interviews were conducted with community-level healthcare providers, national and provincial government departments, and development partners involved in relief activities. Using a structured questionnaire, the quantitative cross-sectional survey was conducted with a final sample of 422 women, married and unmarried (15-49 years old), residing in the relief camps in the flood-affected areas. The outcome variable of the survey was the access to sexual and reproductive health services faced by the women in the flood-affected districts. Data collection took place four months postfloods during Nov-Dec 2022, while the data analysis was conducted between Dec 2022 and Jan 2023. The quantitative data was analyzed using SPSS (Statistical Package for the Social Sciences) version 20, and qualitative data was analyzed using NVivo 12. Ethical consent was sought from all the participants. Ethical approval was also sought from the ethics committee of the Health Services Academy, Government of Pakistan. Results. The findings indicated that, overall, all the provinces were unprepared for a calamity of such a large magnitude. Access to services and health data reporting from the flood-affected areas was challenging mainly due to a shortage of trained health workforce because of the displacement of a large volume of the health workforce. Overall, equipment, medicines, supplies, and food were scarce. Women residing in the camps were markedly affected, and 84% (375) were not satisfied with the flood relief services provided to them. The floods impacted their monthly income as 30% (132) of respondents started depending on charity postfloods. Almost 77% (344) reported limited access to sexual and reproductive health services and had yet to receive sanitary, hygiene, and delivery kits, while 69% (107 out of 154) of girls stopped schooling postfloods. Almost 77% (112) of the married women reported having a child less than one year of age. Yet, only 30% (44 out of 144 currently married women) were using any form of family planning method—damage to the health facilities affected access to overall maternal care services. Conclusion. The findings concluded that there was no planning for sexual and reproductive health services in the flood-affected areas. Several barriers were identified. The government and development partners needed to prepare to cater to women's needs during the floods. The findings highlight the need for collaborative efforts between the government, civil society, and development partners to address the challenges faced in disaster management and strengthen disaster management capacity. [ABSTRACT FROM AUTHOR]

Infant mortality in Pakistan was alarmingly high until the early 1990s, at 86 deaths per 1,000 live births. Despite a 24-point decline over the past three decades, reducing the rate to 62 per 1,000, Pakistan remains among countries with the highest infant mortality rates. This study evaluated the extent, causes, and associated risk factors of infant mortality in Pakistan. Using Univariate and cross-tabulation analyses, data were weighted by survey year. A twostage multi-variable logistic regression model analyzed the risk factor of childbirth in health facilities. Results included odds ratios (OR) and Chi-square tests for categorical differences. Interviews with 167,151 women revealed 84,352 (50.46%) gave birth in health facilities: 22,089 in 1991, 8,166 in 2007, 11,751 in 2013, and 41,372 in 2017. Health facility births rose from 13.6% in 1991 to 64% in 2017. Urban residence, age 30+, secondary education, and government employment were significant factors in health facility usage. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of global morbidity and mortality, with acute exacerbations significantly worsening patient outcomes. These exacerbations often lead to hospitalizations and increased healthcare costs. Proper management, guided by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, is essential to improving care. However, real-world adherence to these recommendations can vary. Objective: To assess how acute COPD exacerbations were handled at a tertiary care hospital of Peshawar. Methodology: In the emergency department of Hayatabad Medical Complex Peshawar, between November 2021 and December 2023, we retrospectively examined clinical data of patients presenting with acute exacerbations of COPD. The management was assessed in light of the GOLD 2019 report's and earlier audits' recommendations. Results: Total 170 patients (mean age 73 years, range 41-95 years, 54% male) were included. GOLD risk group (A-D) was only documented in 39% of the cases. At the time of presentation, 74% of the patients had their respiratory rate evaluated, and 69% had their blood gas analysis done. In all, 95% of the patients had chest imaging performed. Short-acting bronchodilators were used as initial symptomatic management in 56% of cases. Among them, 92% had systemic steroid therapy implemented. Conclusion: The GOLD guidelines were not fully followed, particularly in relation to non-invasive breathing, early symptomatic treatment, and severity assessment. These findings highlight the significance of periodic practice revisions on a regular basis, which may raise practitioners' knowledge and enhance the standard of COPD care in the long run. [ABSTRACT FROM AUTHOR]

Background: Pancreatic neuroendocrine tumors (P-NETs) constitute a subset of pancreatic mass lesions characterized by diverse clinical presentations. Despite their inherent malignant potential, the timely identification and treatment of these tumors are critical for achieving favorable clinical outcomes. This study aims to shed light on the heterogeneous tumor biology of P-NETs and the management strategies employed at a tertiary care center in Pakistan. Method: A retrospective study encompassing all patients with a biopsy-confirmed diagnosis of P-NETs at Shifa International Hospital between January 1st, 2016, and June 30th, 2021, was conducted. Meticulous data extraction from pathology records and thorough searches of medical records were performed to gather relevant demographic and clinical information. Results: A total of 24 patients were retrieved from our database, with 13 (54%) female patients. The mean age was 49.5 ± 16.3 years. Eight out of the 24 patients presented with abdominal pain. Most patients (14 out of 24) had lesions in the pancreatic head region. In three cases, lesions exhibited multicentricity. The mean lesion size measured 4.4 ± 2.3 cm. Three of the 24 patients displayed distant liver metastasis at the presentation time. 19 out of the 24 patients underwent surgical resections, while endoscopic ultrasound (EUS)-guided biopsy was performed in 4 out of 24 cases. EUS-guided tissue biopsy yielded accurate diagnoses in all four cases. Conclusion: Most P-NETs are non-functional, and there is an almost equal distribution between male and female patients. Solitary lesions predominate, and metastasis is uncommon at initial presentation. EUS-guided fine needle biopsy stands out as a dependable diagnostic modality for P-NETs. [ABSTRACT FROM AUTHOR]