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COVID-19 pandemic forced the people to social distancing across the world. This pandemic disrupted various aspects of life including educational activities which resulted in implementation of online teaching and learning strategies for schools, colleges and universities' students. About 1500 million students suffered due to closure of the educational institutions. The overall effects of this closure of educational institutes on students' learning, including nursing students, have been negative. This study was aimed to investigate the impact of barriers to learning, faced by undergraduate nursing students on their attitudes towards e learning during COVID-19 pandemic in Pakistan. A Descriptive, analytical study was conducted on a sample of 250 undergraduate nursing students from four nursing colleges in Pakistan. A standardized questionnaire consisted of a total of 53 questions for the collection of information related to e- learning barriers and their effects on the attitudes of undergraduate nursing students towards e-learning was used for data collection. The results of this research study showed that (82.8%) of the undergraduate nursing students were facing certain barriers with regard to e-learning. The most dominant barriers faced by undergraduate nursing students were the infrastructure and technology dimension (88.8%) technical and management support dimension (83.2%), and curriculum content dimension (82%). The results of the current study demonstrated that a high percentage of the respondents (64.8%) has a negative attitude towards e-learning. the undergraduate nursing students faced various types of barriers towards e-learning during COVID-19 Pandemic. The majority of the learners had negative attitudes toward e-learning. However, there was no significant association present between barriers to e-learning and students' attitude towards e-learning.
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Introduction: Pakistan has a high prevalence of chronic respiratory disorders, including bronchial asthma and chronic obstructive pulmonary disease (COPD). Objective(s): Finding the effect of COVID-19 on chronic respiratory disease in Pakistan is the study's key goal. Material(s) and Method(s): From February 2021 to December 2021, this cross-sectional research was carried department of pulmonology at HMC hospital Peshawar A specified To differentiate between the COVID-19 era and the period preceding it, a set of criteria in the form of a questionnaire was applied. Result(s): A total of 157 participants contributed to the data set. Patients who tested positive for COVID 19 were additionally asked about their experiences with respiratory co morbidities. More than a third of respondents mentioned COPD as a co morbidity;many also mentioned bronchial asthma, ILD, and tuberculosis (TB). Conclusion(s): COVID-19 would certainly increase chronic respiratory disorders in Khyber Pakhtunkhwa. The pandemic might increase respiratory disorders, strain health systems, and cost people impacted. Increase public health awareness and ensure chronic respiratory illness patients get proper treatment and resources to address these issues. To decrease the pandemic's effect on Khyber Pakhtunkhwa's population, early respiratory disease identification and treatment techniques are needed.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Over the past two years, e-banking services became very popular and safe transaction processes in the context of COVID-19 in Bangladesh. The purpose of this study is to analyze how the pandemic has affected Bangladesh's e-banking system. Using stratified random sampling in a randomized block design, a questionnaire was developed that registered participants' responses on a five-point Likert scale to examine the current state of e-banking during the COVID-19 pandemic (January-February 2022). Survey response data from 200 respondents in the commercial port city of Chattogram, Bangladesh, were delivered and returned via e-mail and hand-to-hand delivery, to enable the researcher to learn users' opinions and e-banking satisfaction levels. To test the hypotheses, the study applied the Kolmogorov-Smirnov test, the Shapiro-Wilk test, Spearman's rho correlation coefficient, the Mann-Whitney U test, and the Kruskal-Wallis H test. The study found that e-banking infrastructure facility, customer e-banking awareness, and the e-banking security service facility were important determinants in increasing bank e-service quality. The e-banking infrastructure and security services facility impressed younger users more than older customers (mean performance: 3.21 and 2.85 vs. 2.48 and 2.16, respectively). Educational qualifications did not affect perceptions of bank e-service quality, the e-banking infrastructure facility, customer e-banking professional knowledge, customer e-banking awareness, and the e-banking security service facility. Customers reported more fascination with private banks than with government-owned banks regarding bank e-service quality, e-banking infrastructure facilities, and customer e-banking awareness (mean performance: 3.51, 3.17, and 4.19 vs. 2.97, 2.29, and 3.65, respectively). Moreover, income level affected customers' e-banking professional knowledge. © Md. Shahnur Azad Chowdhury, Engg Md. Shahidul Islam, Manjurul Alam Mazumder, Sayma Hoque, Habib Ullah, 2022.
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The coronavirus disease-19 pandemic with the characteristics of asymptomatic condition, long incubation period and poor treatment has influenced the entire globe. Coronaviruses are important emergent pathogens, specifically, the recently emerged sever acute respiratory syndrome coronavirus 2, the causative virus of the current COVID-19 pandemic. To mitigate the virus and curtail the infection risk, vaccines are the most hopeful solution. The protein structure and genome sequence of SARS-CoV-2 were processed and provided in record time;providing feasibility to the development of COVID-19 vaccines. In an unprecedented scientific and technological effort, vaccines against SARS-CoV-2 have been developed in less than one year. This review addresses the approaches adopted for SARS-CoV-2 vaccine development and the effectiveness of the currently approved vaccines.Copyright © 2023, Finlay Ediciones. All rights reserved.
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Objective: To study the relationship of demographic factors and co-morbidities with post-COVID-19 recovery in tertiary care hospitals of Peshawar. Methodology: This research was conducted in tertiary care hospitals of Khyber Pakhtunkhwa extending over a period of 6 months starting from 1st July 2020 to 31st December 2020. It was an analytical descriptive study (cross-sectional). Patients were selected through a non-probability consecutive sampling technique. Descriptive statistics were performed with SPSS software 22.0 in the form of the mean (sd) and percentages while univariate and multivariate logistic regression scrutiny was performed with STATA version 13.0. Result(s): A mean age (48.94+/-17.57) was observed up to the post-infection recovery or death. The mean age of post-infection recovered patients in the age series of 18-35 years and >55 years was significantly significant (P<0.05) Out of those who recovered, 110 (79.5%) were males and 49(20.5%) were females while those who died of the infection 15(36.6%) were females and 26(83.8%) were males. Univariate analysis showed that age, residence, hypertension, and ischemic heart disease were the covariates significantly associated (p.value <0.05) with post COVID recovery. In multivariate analysis with adjusted OR, "residence" was the only covariate associated with post-infection recovery. Adjusting for the effect of age, gender, hypertension, diabetes, ischemic heart disease, those who were living in urban areas were most likely to recover from COVID-19 infection as compared to the peri-urban residents (OR=0.067, CI: 0.013-0.333). In the full deduced model, adjusting for age, gender, diabetes, hypertension and ischemic heart disease, being an urban resident was 0.08 times more likely to survive or alive after getting COVID-19 infection as compared to dwellers living in city outskirts (OR=0.08, CI: 0.016-0.360). Conclusion Patients suffering from chronic hypertension and ischemic heart diseases were the most affected having higher post-infection mortalities compared to diabetic patients while, from a demographic point of view, being a resident of an urban area was a protective factor for post-infection recovery. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Previously, several food safety incidents have lowered Chinese consumer confidence regarding the purchase of meat and domestically-produced infant formulas ( DIF). Recently, the COVID-19 pandemic was caused by a food safety issue, and it is, therefore, important to investigate sustainable consumer confidence and its influence on consumption behavior by first estimating consumer confidence in meat and DIF products. The purpose of this study is thus to estimate the sustainable market environment and Chinese consumer confidence behavior post- COVID-19 regarding the purchase of meat and DIF products by applying a choice experiment. An online survey was conducted with 704 consumers residing in Nanjing. The survey obtained information on the features of meat and DIF products that affected consumer purchase consideration and determined the perceived estimated value of the product (price 15.24%, quality certification 31.57%, organic 23.69%, traceability 18.51%). These findings provide insight into consumer perceived premium pay behavior concerning the value estimation of product features according to the market environment (price 191.6 CNY, quality certification 285.3 CNY, organic product 189.1 CNY, and traceability 143.7 CNY). Chinese consumers' low confidence in the safety of meat and DIF products appears less sustainable. Quality certification is the product feature that is most valued, followed by organic origin and production-to-consumption traceability. Apart from these, price is seen as an indication of high quality by consumers with low confidence, which results in a positive image of DIF products. In addition, consumer preferences for production-toconsumption traceability are highly affected by consumer confidence.
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Suppliers play a fundamental role in the success of any supply chain. The damaging and disruptive effects of pandemics (i.e., COVID-19) on businesses and their supply chains have made the role of suppliers even more critical and pronounced. In this chapter, based on a critical review of literature about suppliers’ section, we develop a conceptual model that links both traditional and emerging criteria for suppliers’ selection. The developed model is applied to the case of the automotive industry. Our analysis shows that in a Post-COVID-19 era, suppliers need to invest and develop competencies, capabilities, and resources about human capital, communication skills, information technologies, and strategic commitment. We also provide insights and implications for managing the supply chain risks in a Post-COVID era. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Covid 19 pandemics has demonstrated being a Black Swan, which is a non-expected event with a disruptive impact, forcing the world to change most of the former ways of value creation, collaboration, strategizing and decision making. Supply chain management and the logistics organizational function have also been impacted by this fierce disruption. The author shares some observations of what happened with supply chain decision making during the lockdown, and after that, he proposes several shifts in how strategy is designed, in how decisions are made, and in how should collaboration happen in the supply chain ecosystem. In all instances he describes the expected impacts on post-Covid supply chain decision making, expecting that the proposed shifts could be used by researchers, practitioners, and decision makers to propel further research and strategic experimentation. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Understanding the dynamics of supply chains in highly uncertain and dynamic business environments is an essential prerequisite for effective and efficient managerial decision making in most business organizations. This chapter presents the case for this book and provides an overview of its content. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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In this chapter, we develop the mathematical model of four compartments including classes of susceptible, infected, recovered, and death of infected ones for the recent outbreak of a coronavirus infectious disease (COVID-19). The model is investigated for both integer-order and fractional-order derivatives. The integer-order model is analyzed for an approximate solution using the Taylor's series method along with the numerical simulation showing the validity of the obtained scheme. The fractional-order model is evaluated numerically by Euler's iterative techniques and its results are compared to that of the Taylor's series scheme. The numerical simulation is drawn against the available data at different fractional orders. The fractional-order model is also investigated for qualitative analysis using the well-known theorems of fixed-point theory. The said model is also checked for feasibility and stability by using the techniques of basic reproduction number. © 2022 Elsevier Inc. All rights reserved.
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COVID-19 has caused a global health crisis that has infected millions of people across the globe. Currently, the fourth wave of COVID-19 is about to be declared as Omicron. The new variant of COVID-19 has caused an unprecedented increase in cases. According to World Health Organization, safety measures must be adopted in public places to prevent the spread of the virus. One effective safety measure is to wear face masks in crowded places. To create a safe environment, government agencies adopt strict rules to ensure adherence to safety measures. However, it is difficult to manually analyze the crowded scenes and identify people violating the safety measures. This paper proposed an automated approach based on a deep learning framework that automatically analyses the complex scenes and identifies people with face masks or without facemasks. The proposed framework consists of two sequential parts. In the first part, we generate scale aware proposal to cover scale variations, and in the second part, the framework classifies each proposal. We evaluate the performance of the proposed framework on a challenging benchmark data set. We demonstrate that the proposed framework achieves high performance and outperforms other reference methods by a considerable margin from experimental results. © 2022, IFIP International Federation for Information Processing.
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Liver transplantation (LT) has grown monumentally in the last 40 years. Sarcopenia has emerged as an independent factor associated with increased mortality in patients with end stage liver disease. In this review we aim to shed light upon recent developments in assessment, clinical implications, management of sarcopenia in patients requiring a liver transplant. We also bring attention to the impact of COVID-19 pandemic on sarcopenia which ranges from the disease pathology to the unprecedented preventive measures taken during this time. Assessment tools to risk stratify and assess the degree of COVID related deconditioning in patients with end stage liver disease is an exigency. Management of sarcopenia requires a multifarious approach to address nutritional factors, exercise and pharmacotherapy. We may have to shift gears to focus on more rigorous rehabilitation and nutritional techniques during the times of pandemic. Future studies should evaluate whether recovery of sarcopenia with nutritional management in combination with an exercise program is sustainable and whether that improvement in muscle mass leads to an improvement in clinical outcomes. Data regarding long term and short-term effects of COVID 19 pandemic, to form assessment tools that aim to identify patients who can benefit from multimodal prehabilitation and rehabilitation, is required. © 2021 by the author.
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In this paper, we make use of systems thinking insights to study education during and beyond COVID-19. Systems thinking is a rich discipline that studies nonlinear models of social complex adaptive systems that has many insights and tools that are relevant for modelling and understanding how interactions unfold in educational systems. An important insight of systems thinking is that the root cause of chronic complex problems often lay in the underlying systemic structure. Using insights from systems thinking to study learning/education has many benefits, including: (1) support for rigorous big-picture thinking;(2) anticipating and managing unintended consequences;(3) understanding dysfunctional learning systems using systems archetypes - which are systemic structures that, experts have noticed, typically lead to a performance rut;and finally (4) identification of high-leverage interventions that lead to long-lasting benefits without being neutralized by the system. In the paper, we have modelled COVID-19 pandemic effects on students learning in a novel way by using system thinking tools (Causal Loop Diagrams and Stock and Flow Diagrams), which help us to understand the complex interconnections of students performance, learning and management reforms. We demonstrate that successful student learning during and beyond COVID-19 requires not only a focus on lectures and curriculum reforms but also on motivating students, instilling a growth mindset, and developing strategies to track and minimize online distractions. © 2021 IEEE
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INTRODUCTION: As the surge of COVID-19 continues, low resource settings such as Pakistan have encountered an acute shortage of ICU facilities and trained intensivists. The dearth of resources is apparent in the remote region of Northern Pakistan. Therefore, we established a tele-ICU consultation service model to address these concerns and leverage critical care capacity in these remote settings. METHODOLOGY: This study was conducted in Gilgit and Chitral secondary care hospital in Northern Pakistan. Gilgit is a 46-bedded hospital with 6 ventilators, and Chitral is a 25-bedded hospital with 3 ventilators in their ICU. The study duration is 1 year from July 2020 till June 2021. This is a centralised and decentralised hub-and-spoke tele-ICU model. The main hub is located in Aga Khan University Hospital (AKUH) in the metropolitan city Karachi. The distance from the main hub to the remote facilities is approximately 1800km. The tele-ICU followed a 24/7 Scheduled Care Model (periodic consultations on a predetermined time) and Responsive Care Model (unscheduled teleconsultations prompted by an alert) to provide care. The mode of communication is teleconference calls, video calls, and text messaging. This service is provided by 24/7 AKUH trained intensivists. Patient information such as demographics, clinical course, teleconsultation interventions, and management were obtained from these remote ICUs. RESULTS: A total of 157 patients presented to the tele-ICU from Pakistan's remote regions of Gilgit and Chitral. Of these, 60% were male (n=95). 86% (n=135) patients presented with COVID-19. 64% (n=97) patients had comorbidities with hypertension (47%, n=46) being the most common. Invasive mechanical ventilation was provided to 12% (n=18) of the tele-ICU patients, while 62% patients (n=98) received noninvasive mechanical ventilation interventions. Average length of stay of patients in the tele-ICU was 9 days with a range of 1-41 days. 72% (n=113) patients were discharged home from the hospital. Tele-ICU mortality was 29% (n=44). CONCLUSION: We utilized a peer-to-peer tele-consult model to support critical care services in Northern Pakistan. The survival rate achieved by this model is comparable to national and international hospital published data. This was possible through use of multimodal information technology in Pakistan.
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The aim of this paper is to model corona-virus (COVID-19) taking into account random perturbations. The suggested model is composed of four different classes i.e. the susceptible population, the smart lockdown class, the infectious population, and the recovered population. We investigate the proposed problem for the derivation of at least one unique solution in the positive feasible region of nonlocal solution. For one stationary ergodic distribution, the necessary result of existence is developed by applying the Lyapunov function and the condition for the extinction of the disease is also established. The obtained results show that the effect of Brownian motion and noise terms on the transmission of the epidemic is very high. If the noise is large the infection may decrease or vanish. For validation of our obtained scheme, the results for all the classes of the problem have been simulated numerically. © 2022
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Background: Since February 2020, there have been 825,519 confirmed COVID-19 cases and 17,957 fatalities across Pakistan. The number of ICU beds in Pakistan is approximately 2166, a ratio of 0.7 beds per 100,000 population. Critical care resources are concentrated in metropolitan cities with limited availability in rural areas. These gross shortages have escalated during the COVID-19 pandemic, leaving large parts of the country without access to skilled personnel or ICU beds. The Aga Khan University established a free 24/7 teleICU consultation service to rapidly increase access to trained personnel during the COVID-19 pandemic. Methods: The tele-ICU service adheres to a Scheduled and Responsive Care Model delivered through a centralized and decentralized structure. Using two-way audio-visual technology, the tele-ICU leverages critical care expertise and connects to clinical teams in rural and remote hospital settings. Endto- end encrypted Zoom and WhatsApp applications or telephone calls are utilized. Initially, only COVID-19 patients were consulted;however, coverage was broadened to include surgical and medical patients requiring intensive care. Results: Between June 2020 and April 2021, 1709 teleconsultations have been conducted on 404 patients. These include 339 COVID-19 patients, 231 of which were severe and critically ill. An estimated 20,394 minutes of consultative services have been provided covering 26 hospitals across 4 provinces. The mean call duration of each teleconsultation was 13.29 (1-60) minutes. The major mode of communication was Zoom (45.58%) followed by Telephone (43.30%) and WhatsApp (11.12%). The overall hospital discharge outcome for the teleICU is 58.27% with a mortality rate of 29.13%. The remaining patients (12.60%) were transferred or left against medical advice. Conclusion: To combat the insufficient critical care capacity, Aga Khan University implemented a novel tele-ICU service to provide an innovative solution for coordination of care and increase availability of intensivists in remote settings across Pakistan.
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People around the world of developing countries have faced severe issues during this long pandemic outbreak, and harshly affected mentally, economically and socially. Financial pondering and worries have caused serious psychological and mental health problems among the people whatever is their income. Well-being and metal health of business community are the target constructs of this article to be discussed. The present study was aimed to investigate the demographical backgrounds in relationship to well-being, mental effects and financial causes. An online self-administered data was collected from a sample of population (n=100) in Timergara, Dir Lower, Khyber Pakhtunkhwa, Pakistan. We developed a study with psychometric properties of major scales included well-being, impact event on depression anxiety stress scale (DASS). The event impact was significantly, and negatively associated with wellbeing (r = -.43, p<.01), and positively associated with stress (r = .60, p<.01), anxiety (r = .60, p<.01) and depression (r = .58, p<.01). However, a negative event impact on wellbeing (B= -.23, p<.001), stress (B = .17, p<.001), anxiety (B = .16, p<.001), depression (B = .17, p<.001) was observed with a predictor (R-2) accounted on 43%, 36%, 36%, 36% of variance on outcome, respectively. The results were healthy and generalized to the population of Dir community, Pakistan, in relation to their income loss and effects on mental well-being. It could be assumed that not only ecological, climatic or any other features were the only effective responsible factors, in fact, the psychological and economic impacts seemed to be the major factors affected the most.
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Objective: The aim of this study is to determine the frequency of depression and anxiety in the patients due to COVID-19. Study Design: Cross-sectional Place and Duration: Conducted at Medicine department of District Headquarter Hospital Timergara for duration of six months from February 2020 to July 2020. Methods: Total 120 patients of both genders presented with covid-19 disease were enrolled in this study. Patients detailed demographics age, sex and BMI index were recorded after taking written consent. Patients aged between 15-60 years of age. Prevalence of depression and anxiety were measured among hospitalized patients. Structural questionnaires were implemented. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients was 25.69 ±8.21 years with mean BMI 23.41±3.34 kg/m2. Out of 120 patients, 70 (58.33%) were males and 50 (41.67%) were females. Prevalence of depression was 50% among the patients and frequency of anxiety was 40% observed. 80 (66.7%) patients were from urban areas and 40 (33.3%) were from rural areas. 100 (83.3%) were married and 20 (16.7%) were unmarried. Conclusion: We concluded in this study that frequency of anxiety and depression among the patients was frequently high. Medically ill patients should develop techniques for rapid diagnosis and treatment of depression and anxiety.
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Coronavirus disease 2019 (COVID-19) is a pandemic caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spread of the virus was rapid and currently COVID-19 cases are present worldwide in 213 countries, area or territories. Researchers worldwide are working and sharing their contribution regarding epidemiology, prevention, treatment, clinical and diagnostic patterns of the COVID-19. Current review is another contribution to the current knowledge, presenting the data in organized and systematic format about the current pandemic of COVID-19. The epidemiological information presented in the paper is subject to change as new cases are diagnosed and status of active cases is updated on daily basis.
La enfermedad por coronavirus de 2019 (COVID-19) es una pandemia causada por un nuevo coronavirus, el coronavirus causante del síndrome respiratorio agudo severo 2 (SARS-CoV-2). La difusión del virus fue rápida y, actualmente, existen casos de COVID-19 a nivel mundial en 213 países, áreas o territorios. Los investigadores internacionales trabajan y comparten sus contribuciones en cuanto a epidemiología, prevención, tratamiento, patrones clínicos y diagnósticos de COVID-19. La presente revisión es otra contribución al conocimiento actual, que presenta los datos sobre la pandemia de COVID-19 en formato organizado y sistemático. La información epidemiológica presentada en el documento está sujeta a cambios, a medida que se diagnostiquen nuevos datos y se actualice el estatus de los casos activos, de manera diaria.