18 research outputs found
Prevalence and determinants of mental health issues among the university students and its impact on their academic performance and well-being in Punjab, Pakistan
Get PDFChaudary NA. Prevalence and determinants of mental health issues among the university students and its impact on their academic performance and well-being in Punjab, Pakistan. Bielefeld: Universität Bielefeld; 2017.### Background
Mental illnesses constitute a significant portion of the global burden of disease (World Health Organization, 2016). However, the scale of their impact on populations is frequently not reflected in governmental spending and policy concerns. Mental health issues have been, and remain, less of a priority in a number of countries across the world (Patel et al., 2016; Whiteford et al., 2013). The limited focus on mental health issues appears to be more profound when viewed from the perspective of inequality of wealth among countries. Developing countries tend to spend lesser on mental health issues than developed countries, even when accounted for their comparative spending on physical health issues (Gadit, 2007; Saraceno et al., 2007). This owes much to the perception that mental illnesses are not life threatening and therefore do not generally gain the political momentum required to direct resources towards their management.
It is only recent that the burden of mental health issues has been measured in terms which reveal the scale of their social as well as economic burden not only in health sector but in other spheres of social activity (Bloom et al., 2011; Centre for Mental Health, 2010; Patel et al., 2016). The introduction of concepts such as Years Lived with Disability (YLDs) and Disability Adjusted Life Years (DALYs) have highlighted the gravity of mental health issues and their relative importance in relation to other more established concerns such as cancer and HIV/AIDS (Murray et al., 2012; Whiteford et al., 2013). Still, the share of mental health issues in the global burden of disease cannot be adequately gauged due to indirect impacts it causes on the progression of physical health conditions.
Mental health issues are not evenly spread across population segments and research suggests that youth are more vulnerable to mental health issues than other age groups (Erskine et al., 2015; Patel, Flisher, Hetrick, & McGorry, 2007).Within the youth segment, students have been shown to be particularly vulnerable to mental illnesses. The reason for this could be that mental health issues are largely dependent on social conditions and students are exposed to stressful conditions not only in wider society but also to those associated with the academic environment.
In view of the above, the present study is conducted in Pakistan which has a 57 million population aged 15 to 29 years. Among these, 1.8 million young people are studying in universities (Government of Pakistan, 2015). Despite challenges at several fronts, Pakistan boasts of its young population and envisions its youth as a driver of socioeconomic development in foreseeable future. However, investment in the development of young population has been minimal which is evident from Pakistan’s dismal literacy rate and rates of transition from schools to universities (Nasir & Nazli, 2010). If any, there is very limited coordination between education and health sector nor are there any robust structures which could cater to the health needs of students (Khan, 2013). The lack of institutional structures for health within universities most adversely affects subtle mental health issues which are less likely to be self-diagnosed.
### Objectives of the Study
This study is intended to measure the determinants, prevalence and outcomes of mental health issues among the university students of Pakistan. It considers the influence of health-related behaviors, academic and non-academic stressors on mental health issues. The academic and demographic characteristics of students are taken as confounding variables and their impacts on stressors and mental health issues have been examined. Thereafter, the impacts of mental health issues on academic performance and subjective well-being of students have been measured. Finally, this study describes the coping strategies used by students to mitigate mental health issues and discusses how these are related with their demographic characteristics.
### Theoretical Framework
This study is theoretically embedded in stress theory introduced by Selye (Selye, 1950; 1956). The stress theory presents an elaborate process wherein it is argued that the accumulation of stressors might result in stress depending on the context of the occurrence of stress. The stress experienced by an individual may or may not lead to distress depending on the nature and scope of coping resources embodied by that individual. In the context of present study, the university students are assumed to be confronted with several academic and non-academic stressors which may lead to stress. The effect of these stressors may be increased or decreased due to personal circumstances of individual students. However, mental health is also affected by issues which are intrinsic to an individual. These issues include health behaviors, self-rated physical health, psychosomatic complaints and chronic illnesses. In this study, these internal factors are dealt parallel to the stressors explained above. This distinction is based on the effort in this study to independently assess the impact of university related factors and personal factors on mental health issues. The stress theory further states that coping resources of an individual are a mitigating factor in the transition from stress to distress. While, this study has attempted to investigate how the students cope with stress, it has also tried to figure out the coping strategies used by students suffering from distress. Finally, as hypothesized by stress theory, this study examined the outcomes of distress for the students. Given the wide range of outcomes which may arise from distress, these outcomes were limited to students’ academic performance and subjective well-being.
### Methods and Materials
This quantitative study adopted a cross sectional design to guide data collection. Using multi-stage cluster sampling technique, the data were collected from 1308 randomly selected students of age (15-29) from three selected public universities in the province of Punjab, Pakistan. The data were collected through a pre-coded self-administered questionnaire. The questionnaire consisted of six distinct sections. The first section of the questionnaire dealt with the demographic details and academic background of the respondents. The second section included questions about self-rated health status, health related behaviors and Psychosomatic Health Complaints (PHCs) of the students. The third section measured academic and non-academic stressors faced by the students. The fourth section comprised of standardized tools to measure perceived stress, depressive symptoms and psychological well-being of students. The fifth segment measured the academic performance and level of satisfaction with the different areas of life whereas the sixth section dealt with coping strategies used by students to mitigate stress. Findings based on the collected data are presented in two sections. Descriptive statistics section includes results presented in the form of frequencies and percentages whereas in the inferential statistics section, simple, binary and multinomial logistic regression analyses are used for hypothesis testing.
### Key Findings
The response rate was 91.4%, excluding partially filled questionnaires. The findings revealed that an overwhelming majority of students at the universities were 20-24 years of age with the mean age of 21.5 years. The proportion of male and female students was almost equal and most the respondents (61.5%) in the sample belonged to urban areas. The study sample represented students from diverse family backgrounds in terms of parents’ education, family income etc.
A major finding was that gender and income insufficiency were associated with all three types of mental health issues considered in this study. Students living home and those enrolled in Bachelors programs were more affected with mental health issues than their counterparts. General health and health related behaviors had a significant impact on mental health of students across all the selected universities. Academic stressors such as examinations were considered by students as severe stressors. However, in terms of impact, non-academic stressors such as family expectations and problems in interaction with fellow students had a more profound impact on mental health. The prevalence of perceived stress and depressive symptoms were high at 54.1% and 44.2% respectively across the study sample. Students suffering from high levels of distress and depression had poor objective and subjective academic performance. Even students with higher grades were likely to report their subjective academic performance as poor if they were suffering from mental health issues. Depressive symptoms had more impact on subjective well-being of students than perceived stress. Few students used problem focused strategies to cope with mental health issues. The use of religious coping strategies was high in the study sample.
### Discussion
The prevalence of distress and depression in this study was like most research conducted elsewhere. However, this study also highlighted those determinants of mental health issues which were rooted in peculiar conditions of the study area. These determinants such as English language as the medium of instruction or interaction with opposite gender were not reported in the studies consulted by the author. Financial dependency of students on their families was significantly higher than what is reported in studies from Western countries. Furthermore, the amount of physical activity undertaken by the students was substantially lower than what most previous studies elsewhere have reported. Consistent with most previous studies, academic performance and subjective well-being were adversely affected by distress and depression. Similarly, some of the coping strategies reported in this study, especially those grounded in religious beliefs, were a novelty in view of previous research.
### Conclusion
This study was the first attempt of its kind to measure the prevalence of mental health issues in public sector universities of Pakistan. The high prevalence of mental health issues reported in this study was not matched by the scant health services available at the universities. Students were dissatisfied with the facilities at their universities, and there seemed to be a disconnect between students’ needs and policies devised by universities’ administrations. It is suggested that similar studies may be conducted to inform mental health policies at the university level, which would focus on mental health promotion and disease prevention
Regulation of the PI3-Kinase/PTEN Signaling Pathway by TGF-? in Prostate Cancer Cells, 2018
Get PDFTransforming growth factor -? (TGF-?) plays an important role in the progression of prostate cancer. It acts as a tumor suppressor in normal epithelial cells but as a tumor promoter in advanced prostate cancer cells. The PI3-kinase pathway has been shown to play integral roles in many cellular processes including cell proliferation, survival, and cell migration in many cell types. PI3-kinase pathway mediates TGF-? effects on prostate cancer cell migration and invasion. Phosphatase and tensin homolog (PTEN), a tumor suppressor gene, inhibits PI3-kinase pathway and is frequently mutated in prostate cancers. In this present study, we investigated possible roles of PTEN in TGF-? effects on proliferation, migration, and the activation of PI3-kinase/AKT pathway in prostate cancer cells. PTEN was expressed in DU145 cells; however PC3 cells lack PTEN expression. TGF-?1 and TGF-?3 had no effect on PTEN mRNA levels but both isoforms increased PTEN protein levels in DU145 and RWPE1 cells, suggesting that TGF-? may mediate regulation of PTEN protein stability. TGF-?1 and TGF-?3 increased PTEN protein levels even in the presence of cycloheximide, a protein synthesis inhibitor, in DU145 cells. In addition, TGF-? upregulated phosphorylation of PTEN, stabilizing PTEN protein. Increase of PTEN protein levels in these cells may also indicate that PTEN may mediate TGF-? effects on cell proliferation. Knockdown of PTEN in DU145 cells resulted in significant increase in cell proliferation which was no longer affected by TGF-? isoforms. PTEN overexpression in PC3 cells inhibited cell proliferation. Knockdown of endogenous PTEN enhanced cell migration in DU145 cells, whereas PTEN overexpression reduced migration in PC3 cells and reduced phosphorylation of AKT in response to TGF-?. Based on these results, we conclude that PTEN plays a role in inhibitory effects of TGF-? on cell proliferation whereas its absence may enhance TGF-? effects on activation of PI3-kinase pathway and cell migration. KEYWORDS: Biochemistry, Biology, Cancer Biology, Cell Biology, Male Urogenital Diseases, Molecular Biolog
Costs of testing for ocular Chlamydia trachomatis infection compared to mass drug administration for trachoma in the Gambia: application of results from the PRET study.
Get PDFBACKGROUND: Mass drug administration (MDA) treatment of active trachoma with antibiotic is recommended to be initiated in any district where the prevalence of trachoma inflammation, follicular (TF) is ≥ 10% in children aged 1-9 years, and then to continue for at least three annual rounds before resurvey. In The Gambia the PRET study found that discontinuing MDA based on testing a sample of children for ocular Chlamydia trachomatis(Ct) infection after one MDA round had similar effects to continuing MDA for three rounds. Moreover, one round of MDA reduced disease below the 5% TF threshold. We compared the costs of examining a sample of children for TF, and of testing them for Ct, with those of MDA rounds. METHODS: The implementation unit in PRET The Gambia was a census enumeration area (EA) of 600-800 people. Personnel, fuel, equipment, consumables, data entry and supervision costs were collected for census and treatment of a sample of EAs and for the examination, sampling and testing for Ct infection of 100 individuals within them. Programme costs and resource savings from testing and treatment strategies were inferred for the 102 EAs in the study area, and compared. RESULTS: Census costs were 108.79. MDA with donated azithromycin cost 796.90 per EA, with Ct testing kits costing 1.38 per result. However stopping or deciding not to initiate treatment in the study area based on testing a sample of EAs for Ct infection (or examining children in a sample of EAs) creates savings relative to further unnecessary treatments. CONCLUSION: Resources may be saved by using tests for chlamydial infection or clinical examination to determine that initial or subsequent rounds of MDA for trachoma are unnecessary
Effect of magnetic field on carbon nanotubes and graphene structure synthesized at low pressure via arc discharge process
No full textWhen can antibiotic treatments for trachoma be discontinued? Graduating communities in three African countries.
Get PDFBACKGROUND: Repeated mass azithromycin distributions are effective in controlling the ocular strains of chlamydia that cause trachoma. However, it is unclear when treatments can be discontinued. Investigators have proposed graduating communities when the prevalence of infection identified in children decreases below a threshold. While this can be tested empirically, results will not be available for years. Here we use a mathematical model to predict results with different graduation strategies in three African countries. METHODS: A stochastic model of trachoma transmission was constructed, using the parameters with the maximum likelihood of obtaining results observed from studies in Tanzania (with 16% infection in children pre-treatment), The Gambia (9%), and Ethiopia (64%). The expected prevalence of infection at 3 years was obtained, given different thresholds for graduation and varying the characteristics of the diagnostic test. RESULTS: The model projects that three annual treatments at 80% coverage would reduce the mean prevalence of infection to 0.03% in Tanzanian, 2.4% in Gambian, and 12.9% in the Ethiopian communities. If communities graduate when the prevalence of infection falls below 5%, then the mean prevalence at 3 years with the new strategy would be 0.3%, 3.9%, and 14.4%, respectively. Graduations reduced antibiotic usage by 63% in Tanzania, 56% in The Gambia, and 11% in Ethiopia. CONCLUSION: Models suggest that graduating communities from a program when the infection is reduced to 5% is a reasonable strategy and could reduce the amount of antibiotic distributed in some areas by more than 2-fold
A single round of mass azithromycin treatment is sufficiant for trachoma elimination in The Gambia
Get PDFPrevalence of, and risk factors for, trachoma and ocular Chlamydia trachomatis infection in The Gambia and Tanzania
Get PDFComparison of Surgical Outcome of Anterior Circulation Aneurysms With and Without Proximal Temporary Artery Occlusion
Get PDFObjective: To compare the outcome of the TAO vs. no TAO during aneurysm surgery in terms of clinically significant postoperative ischemic changes due to vasospasm.
Material and Methods: A quasi-experimental study was conducted at Lahore General Hospital wherein 82 patients were enrolled. This study was conducted when the first author was working as PGR at LGH Lahore during 2015 to 2017. Patients were followed from admission to three-month post-op. During the follow-up, patients with clinical substantial post-op ischemic changes were calculated on CT Angiography for the presence of vasospasm.
Results: Mean age of the patients was 45.23 years. Proximal TAO was done in 30% (n=25) patients. Clinically significant post-op ischemic changes were seen in 29.3% (n = 24) patients. Of the patients who underwent proximal TAO, longer occlusion time (> 10 mins) was significantly associated with ischemic changes (p-value 0.015). Age > 50 years also showed a statistically significant association with clinical vasospasm (p-value < 0.001).
Conclusion: Temporary proximal artery clipping when employed within a limited duration appears to be safe and has no significant impact on clinical vasospasm. Since vasospasm is multifactorial, avoiding a longer duration of proximal TAO in patients with advancing age could decrease the frequency of post-operative ischemic changes due to vasospasm in such patients
Studying the Navigation Assistance System for the Visually Impaired and Blind Persons and ICT use by their Caretakers
No full textAbstractTelecare solutions have been seen as a potential means of addressing the future care needs of ageing societies. With the growing proportion of dependent people (ageing, disabled users), tele-assistance and tele-monitoring platforms will play a significant role to provide an efficient and less-costly remote care and support. It will allow aged and disabled persons to maintain their independence and lessen the burden and cost of caregiving. In the case of visually impaired (VIP) and blind persons, guide dog and white cane provide them a fair degree of independence. However, those are very limited in guiding the user towards a specific desired location, especially in an unknown environment. The assistance of other people presents a feasible solution, though it does not improve the idea of autonomous guidance and privacy. This paper presents a tele-guidance based navigation assistance system that is based on the idea that a blind or VIP pedestrian can be assisted by haptics based cues and spoken instructions from a remote caretaker who receives a live video stream from a camera carried by the blind or VIP. Also, we present results of the study conducted in Pakistan with 14 blind and VIP participants for testing haptics user interface concept of proposed teleguidance system. In this study also two caretakers are interviewed. In addition, we present results of the attitude towards assistive technology study conducted with 19 blind and VIP in Finland. Moreover, we introduce the environmental model to aid development of assistive tools for blind and VIP.Abstract
Telecare solutions have been seen as a potential means of addressing the future care needs of ageing societies. With the growing proportion of dependent people (ageing, disabled users), tele-assistance and tele-monitoring platforms will play a significant role to provide an efficient and less-costly remote care and support. It will allow aged and disabled persons to maintain their independence and lessen the burden and cost of caregiving. In the case of visually impaired (VIP) and blind persons, guide dog and white cane provide them a fair degree of independence. However, those are very limited in guiding the user towards a specific desired location, especially in an unknown environment. The assistance of other people presents a feasible solution, though it does not improve the idea of autonomous guidance and privacy. This paper presents a tele-guidance based navigation assistance system that is based on the idea that a blind or VIP pedestrian can be assisted by haptics based cues and spoken instructions from a remote caretaker who receives a live video stream from a camera carried by the blind or VIP. Also, we present results of the study conducted in Pakistan with 14 blind and VIP participants for testing haptics user interface concept of proposed teleguidance system. In this study also two caretakers are interviewed. In addition, we present results of the attitude towards assistive technology study conducted with 19 blind and VIP in Finland. Moreover, we introduce the environmental model to aid development of assistive tools for blind and VIP
Aminullah Chaudary. Political Administrators: The Story of Civil Service of Pakistan. Oxford University Press, 2011. 371 pages, Rs 895.00.
Get PDFA bureaucracy is a group of individuals who are non-elected
and serve as government employees to help implement rules and laws of a
country. The term bureaucracy was created by combining the words
‘bureau’ which means desk or office and ‘kratos’, meaning rule or
political power to govern. Different countries have adopted various ways
to induct people to run the government and make new laws. Max Weber, a
renowned and notable German administrative scholar is credited to be the
pioneer of the use of bureaucracy in public administration. In this book
on the Civil Service of Pakistan, the author has described the way
bureaucratic culture gained strength and restricted the grooming of
political culture in the country. He shows how ‘seniority’ overwhelmed
‘merit’ in the promotion process of the officers in the Civil Service of
Pakistan (CSP), an offspring of the Indian Civil Service (ICS). The CSP
officers always considered themselves as an élite class and looked down
upon the politicians. The author narrates the superior attitude of
Iskander Mirza (a notable member of the ICS, then CSP) in these words:
“Mirza was proud of his IPS and CSP lineage and never missed an
opportunity of proclaiming this fact. His admiration for the colonial
system of administration was matched by a corresponding contempt for
politicians.” The relationship between the bureaucracy and the military
was to ensure that politicians did not make a mess of things. The
bureaucracy was able to call on the military in times of crisis and
never worried about its overstaying the visit. The basic theme of the
Indian Civil Service was that the local Indians were recruited as
officers by the British to suppress and control an enslaved people.
Unfortunately, even after gaining independence the mindset of the
bureaucratic staff didn’t change and they conveniently forgot that an
independent nation required a different approach
