Stephen P. Luby
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School Health Education Program in Pakistan (SHEPP)
Almas et al. Pilot and Feasibility Studies (2020) 6:80 https://doi.org/10.1186/s40814-020-00625-x STUDY PROTOCOL Open Access School health education program in Pakistan (SHEPP)—a threefold health education feasibility trial in schoolchildren from a lower-middle-income country Aysha Almas1* , Romaina Iqbal2, Sania Sabir1, Abdul Ghani2 and Khawar Kazmi3 Abstract Background: The school environment plays an essential role in promoting health education and physical activity for children and adolescence, and they are more likely to adapt it into their adulthood. School health education program has been endorsed and emphasized by the World Health Organization has not been implemented in true spirit in Pakistan yet. We aim to test feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors by including BP, BMI, and waist circumference. Methods: It is a parallel-group feasibility intervention trial. It is being conducted in two schools from lower to middle-income areas, at different locations but having the same school curriculum under the Aga Khan Education Service, Pakistan (AKESP). All children aged 9-11 years enrolled from the schools mentioned above were included. Children with any physical disability were excluded. One school received threefold intervention (focused on children, parents, and teachers) of school health education program in Pakistan (SHEPP) while the other school continued routine activity. Intervention of SHEPP is directed towards educating children, parents, and teachers about healthy behaviors. Children will receive interactive educational sessions and specially designed physical activity sessions. A 3-h health education session focusing on same healthy behaviors as for children will be conducted for both parents and teachers. -
Experiences of Young Smokers in Quitting Smoking in Twin Cities of Pakistan: a Phenomenological Study Kanwal Shaheen1, Oyinlola Oyebode2 and Haleema Masud1,2*
Shaheen et al. BMC Public Health (2018) 18:466 https://doi.org/10.1186/s12889-018-5388-7 RESEARCH ARTICLE Open Access Experiences of young smokers in quitting smoking in twin cities of Pakistan: a phenomenological study Kanwal Shaheen1, Oyinlola Oyebode2 and Haleema Masud1,2* Abstract Background: Smoking is highly prevalent in Pakistan claiming the lives of over 100,000 individuals every year. A significant proportion of smokers (24.7%) make an attempt to quit each year but 97.4% fail to quit successfully. Little is known about the reasons for, and experiences of, failed quit attempts. This study was carried out to explore the experiences of young male smokers in quitting smoking in the twin cities of Pakistan Method: A qualitative study was carried out using a phenomenological approach in Rawalpindi and Islamabad. A total of 11 participants were interviewed. All study participants were male and had made at least one quit attempt. Study participants were a mix of smokers who failed to quit smoking, intermittent smokers and successful quitters. Streubert’s (1991) method of phenomenology was followed during data analysis. Results: The experiences of smokers while smoking “the smoking phase” have major effects on their journey towards quitting smoking. The smoking phase consists of three major stages: contact with initial smoking stimuli, the journey from first puff to enjoying smoking and then finally smoking becoming part of life. However, the journey towards quitting smoking is not as simple as the journey towards becoming a smoker. Instead, smokers get trapped in three overlapping cycles of smoking and quit attempts: smoking & forced quitting, smoking & intentional quitting, and smoking & intermittent smoking before successful quitting. -
Tobacco Control Laws in Pakistan and Their Implementation: a Pilot Study in Karachi Javaid Ahmed Khan Aga Khan University, [email protected]
eCommons@AKU Section of Pulmonary & Critical Care Department of Medicine July 2016 Tobacco control laws in Pakistan and their implementation: A pilot study in Karachi Javaid Ahmed Khan Aga Khan University, [email protected] Abdul Malik Amir Humza Sohail Muhammad Arslan Arif Maan Aga Khan University Follow this and additional works at: https://ecommons.aku.edu/ pakistan_fhs_mc_med_pulm_critcare Part of the Critical Care Commons, and the Pulmonology Commons Recommended Citation Khan, J. A., Amir Humza Sohail, A. M., Arif Maan, M. A. (2016). Tobacco control laws in Pakistan and their implementation: A pilot study in Karachi. Journal of Pakistan Medical Association, 66(7), 875-879. Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_pulm_critcare/124 875 PILOT STUDY Tobacco control laws in Pakistan and their implementation: A pilot study in Karachi Javaid Ahmed Khan, 1 Abdul Malik Amir Humza Sohail, 2 Muhammad Arslan Arif Maan 3 Abstract Objectives: In order to limit the high prevalence of tobacco use in Pakistan various tobacco control laws have been implemented. The objective of this study is to serve as a pilot study to assess the implementation of these laws in the largest city of Pakistan, Karachi. Methods: A cross-sectional study was conducted in Karachi. The implementation of tobacco control laws in 'smoke- free' places, the adherence of tobacco companies to these laws, the regulation of cigarette sale, and the awareness and views of the general public regarding tobacco control laws were assessed via direct observation by visits and through self-administered questionnaires. Results: The implementation of tobacco control laws in 'smoke-free' public places was found to be poor. -
Momen N, Begum M (2014)
ISSN 2319-2593 IISUniv.J.S.Sc. Vol.3(1), 52-63 (2014) The Political Challenges for Free and Fair Elections in Bangladesh Nurul Momen and Marzina Begum Abstract There is a perception among the political scientists that a free and fair election is the keystone of good governance. People in Bangladesh expected that the democratic journey in 1991 would bring significant qualitative political changes, but the new democracy has not brought any changes to the lives of the people. Therefore, this article examines the case of Bangladesh and explores about how political issues challenge a free and fair election. Although, elections provide a test of the political system in a country, but political environment in Bangladesh is a threat to the credibility of electoral process. However, every research requires methodology to execute the study. In doing so, both historical and empirical data was used. In the findings, the research found that the current political environment negatively affects to ensure a free and fair election in Bangladesh. This study examines free and fair parliamentary elections by engaging in political analysis of the so-called democracy in Bangladesh. This study mainly focused on political challenges from 1991 to 2012 in the area of parliamentary elections, since the country started their democratic journey from 1991. Keywords: Awami League (AL), Bangladesh, Bangladesh Nationalist Party (BNP), Free and Fair Elections. Introduction Democracy was likely to take root when Bangladesh emerged from a long period of military government in December 1990. Bangladesh is still struggling to foster a democratic political environment due to an intense political conflict over the rules of the political game. -
Changing Modes of Transportation: a Case Study of Rajshahi City Corporation
Changing Modes of Transportation: A Case Study of Rajshahi City Corporation Rabeya Basri Lecturer Department of Economics University of Rajshahi, 6205 Tahmina Khatun Lecturer Department of Humanities (Economics) Rajshahi University of Engineering and Technology Rajshahi Md. Selim Reza Assistant Professor Department of Economics University of Rajshahi, 6205 And Dr. M. Moazzem Hossain Khan Professor Department of Economics University of Rajshahi, 6205 Abstract This study carried out about the comparative study of the changing mode of transportation. Battery operated auto-rickshaws are newly introduced vehicle in city areas and took the place of rickshaw because of cheap cost and comfort. We selected Rajshahi City Corporation (RCC) as a sample area, because there are huge rickshaws and auto-rickshaws used for daily travelling. This study based on primary data and tried to show the socio-economic conditions which ultimately influence the income of auto-rickshaw drivers and rickshaw pullers. Here, linear regression model is used to estimate the income determinants and in case of auto- rickshaw opportunity cost, family member, and other cost have significant impact on income where ownership, age, education of auto-rickshaw drivers have insignificant impact. While in the case of rickshaw other cost and family member have positive and significant effect on income. But education, ownership of vehicle and opportunity cost have found insignificant here. To increase the income of auto drivers as well as rickshaw pullers, number of rickshaw and auto-rickshaw must be limited in city area and ensure that the vehicles have licence issued by proper authority. I. Introduction Economic development and transportation are closely related. -
A Comparative Analysis on Food Security in Bangladesh, India and Myanmar
sustainability Article A Comparative Analysis on Food Security in Bangladesh, India and Myanmar Yuanyuan Chen 1,2 and Changhe Lu 1,2,* 1 Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Research, CAS, Beijing 100101, China; [email protected] 2 College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China * Correspondence: [email protected]; Tel.: +86-10-6488-9110 Received: 9 November 2017; Accepted: 1 February 2018; Published: 4 February 2018 Abstract: In 2013, China proposed the Bangladesh–China–India–Myanmar Economic Corridor initiatives to enhance the economic cooperation between Bangladesh, India, and Myanmar. To serve the priority setting of agricultural cooperation in the initiatives, an analysis is necessary to understand the food security situation and its key influencing factors in the three countries. For this purpose, this study applied a food security index (FSI) to measure the food security level at state scale and analyze its changes in the three countries during 1990–2013. Further, a factor decomposition method was used to quantify the contribution of major factors to the FSI changes. The results showed that the food demand was generally secured in Myanmar and India during 1990–2013 but in shortage by around 10% in most years before 2008 in Bangladesh. The annual FSI values showed a rather obvious periodic variation and a slightly increasing trend during the whole period. Although the grain production in the three countries increased significantly, the FSI was not accordingly improved, as a result of the simultaneous increase of grain consumption. -
Water-Pipe Smoking and Metabolic Syndrome: a Population-Based Study
Water-Pipe Smoking and Metabolic Syndrome: A Population-Based Study Kashif Shafique1*, Saira Saeed Mirza1, Muhammad Kashif Mughal1, Zain Islam Arain2, Naveed Ahmed Khan3, Muhammad Farooq Tareen4, Ishtiaque Ahmad5 1 Institute of Basic Medical Sciences, Dow University of Health Sciences, Karachi, Pakistan, 2 Department of Medicine, Isra Medical University Hospital, Hyderabad, Pakistan, 3 Department of Surgery, Civil Hospital Karachi, Karachi, Pakistan, 4 Department of Health, Government of Pakistan, 5 Afra General Hospital, Faisalabad, Pakistan Abstract Water-pipe (WP) smoking has significantly increased in the last decade worldwide. Compelling evidence suggests that the toxicants in WP smoke are similar to that of cigarette smoke. The WP smoking in a single session could have acute harmful health effects even worse than cigarette smoking. However, there is no evidence as such on long term WP smoking and its impact on chronic health conditions particularly cardiovascular and metabolic conditions. Therefore, we conducted this study to investigate the relationship between WP smoking and metabolic syndrome (MetS). This was a cross-sectional study carried out in Punjab province of Pakistan using the baseline data of a population-based study – Urban Rural Chronic Diseases Study (URCDS). Information was collected by trained nurses regarding the socio-demographic profile, lifestyle factors including WP smoking, current and past illnesses. A blood sample was obtained for measurement of complete blood count, lipid profile and fasting glucose level. MetS was ascertained by using the International Diabetic Federation’s criteria. We carried out multiple logistic regressions to investigate the association between WP smoking and MetS. Final sample included 2,032 individuals – of those 325 (16.0%) were current WP smokers. -
Original Article Prevalence of Cigarette Smoking Among Young Adults In
Original Article Prevalence of cigarette smoking among young adults in Pakistan Rashid Ahmed1,3, Rizwan-ur-Rashid2, Paul W. McDonald1,4,5, S. Wajid Ahmed4 Population Health Research Group (PHR), University of Waterloo1, Department of Computer Science, Mohammad Ali Jinnah University, Karachi2, Department of Statistics and Actuarial Science, University of Waterloo3, Department of Health Studies and Gerontology, University of Waterloo4, NCIC Centre for Behavioural Research and Program Evaluation5 Abstract Objective: To obtain information about the prevalence of cigarette smoking among a selected sample of university students in Karachi and build our understanding of the determinants of smoking with respect to family smoking, smoking in the home, smoke-free public places, and quit smoking cessation programmes. Methods: Data were collected as a part of a pilot project initiated by Jinnah University Karachi. Participants were 629 university students (432 males and 197 females) aged 18-25 years from ten universities in Karachi. Descriptive statistics and Logistic regression analyses were used to determine the results and conclusions. Results: Thirty-nine per cent of students had smoked a whole cigarette in their life time, whereas 25% had smoked 100 or more cigarettes in their lifetime. Overall, 23% of students (31% male and 6% female) were classified as a current smoker and their mean age and standard deviation of smoking initiation was 17±2.7 years (17±2.6) for males and 16±2.9 females. Sixty-three percent of smokers reported that public places should be smoke-free. Logistic regression analyses adjusted by age and gender suggested that parental and sibling influence and number of close friends and individuals who smoke at home were highly predictive of being a smoker. -
Stephen P. Luby
Stephen P. Luby Stanford University Yang and Yamazaki Environment and Energy Building 473 Via Ortega, Stanford, CA 94305 USA phone 1-650-723-4129 fax 1-650-725-3402 email [email protected] Education Creighton University 1981 Bachelor of Arts, summa cum laude (philosophy) University of Texas--Southwestern Medical School at Dallas MD 1986 University of Rochester--Strong Memorial Hospital Internship and residency in Internal Medicine. Centers for Disease Control -- Epidemic Intelligence Service 1990 Completed Preventive Medicine Residency 1993 Professional Experience Stanford University, 9/2012 – currently employed Professor of Medicine (Infectious Diseases & Geographic Medicine), Senior Fellow, Woods Institute for the Environment Senior Fellow, Freeman Spogli Institute for International Studies Associate Dean for Global Health Research Courtesy Appointment, Department of Pediatrics Associate Director for Diversity and Inclusion, Stanford Emmett Interdisciplinary Program in Environment and Resources International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B) Director, Centre for Communicable Diseases, 8/2004 – 8/2012 Country Director, US Centers for Disease Control, US Embassy Dhaka, 8/2004 – 8/2012 1. Secured funding for and oversaw an externally funded research program a. Increased the annual research funding for the research program from $400,000 in 2004 to > $10 million b. Increased the number of scientists working in the unit from 6 in 2004 to 44, and the number of employees from 22 to 500. 2. Coordinated collaboration between ICDDRB and the Centers for Disease Control and Prevention 3. Facilitated multi-disciplinary research across the administrative divisions within ICDDR,B 4. Editor, Health and Science Bulletin, a quarterly surveillance update and original scientific report from ICDDR,B Centers for Disease Control and Prevention Medical Epidemiologist, Foodborne & Diarrheal Diseases Branch, 12/98 – 7/04 Major responsibilities 1 1. -
The Effects of Smoking in Developing Hypertension in Pakistan: a Systematic Review
South East Asia Journal Of Public Health ISSN: 2220-9476 ISSN: 2313-531X (Online) Review The effects of smoking in developing hypertension in Pakistan: a systematic review Qurrat ul Ain1, Krishna Regmi2 1PhD Research Scholar, Centre for Research in Primary and Community Care, University of Hertfordshire, UK. 2Principal Lecturer in Public Health, Faculty of Health and Social Sciences, Institute for Health Research, University of Bedfordshire, UK. Abstract Globally, hypertension is considered one of the most important preventable causes of morbidity and mortality. Several plausible factors have been assessed and identified in relation to high blood pressure but there have been limited studies carried out as to whether smoking can have any effect in developing high blood pressure in Pakistan. This paper aims to examine the effects of smoking in developing hypertension in Pakistan. This study employs a systematic review. A total of 1097 articles were identified (reduced to 61 once duplication was removed). Only six studies met the relevant quality appraisal criteria. Three major databases - Medline, EMBASE and Global Health - were searched using both ‘free terms’ and ‘index-terms’. All selected studies were quality appraised by critical appraisal tools and reviewed by two authors. The studies fell into three distinct themes – awareness, economic status and types of tobacco. Findings of the review indicated that an unhealthy relationship exists between hypertension and smoking, as incidences of hypertension were more prevalent in smokers as compared to non-smokers. In addition, both high systolic and diastolic blood pressure were more frequent in smokers compared to non-smokers. The present study suggests that a positive harmful relationship exists between blood pressure and smoking, and that smokers are more likely to develop high blood pressure compared to non-smokers. -
Tobacco Industry Activities in Pakistan 1992 – 2002 / World Health Organization
WHO-EM/TFI/055/E Tobacco industry activities in Pakistan 1992–2002 Tobacco industry activities in Pakistan, 1992–2002.indd 6 9/7/2010 11:23:24 AM WHO-EM/TFI/055/E Tobacco industry activities in Pakistan 1992–2002 WHO Library Cataloguing in Publication Data World Health Organization. Regional Office for the Eastern Mediterranean Tobacco industry activities in Pakistan 1992 – 2002 / World Health Organization. Regional Office for the Eastern Mediterranean p. WHO-EM/TFI/055/E 1. Tobacco Industry - Pakistan 2. Tobacco – economics 3. Smoking - prevention and control I. Title II. Regional Office for the Eastern Mediterranean (NLM Classification: HD 9130) This publication is the product of contributions by several individuals. The publication was written, and revised, by Joshua Yang, California State University Fullerton. The draft was reviewed by Farrukh Qureshi and Fatima El Awa, WHO Regional Office for the Eastern Mediterranean. Financial support for this publication was provided by Bloomberg Philanthropies. © World Health Organization 2010 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. -
Prevalence and Associated Factors of Cigarette Smoking Among Type 2 Diabetes Patients in Pakistan
73 International Journal of Collaborative Research on Internal Medicine & Public Health Prevalence and Associated Factors of Cigarette Smoking among Type 2 Diabetes Patients in Pakistan Naila Khalid 1 *, Ejaz Ahmad Khan 2, Shifa Saleem 1, Adeel Tahir 3, Hassan Mahmood 4, 5 Sarah Saleem 1 Association for Social Development, Islamabad, Pakistan 2 Health Services Academy, Islamabad, Pakistan 3 National Tuberculosis Control, Islamabad, Pakistan 4 Pakistan Medical Research Council, Islamabad, Pakistan 5 Ministry of Health, Kingdom of Saudi Arabia * Corresponding Author: Naila Khalid No. 79, Street 14, Falcon Complex, Lithrar Road, Rawalpindi, Pakistan Mobile: + 92 322 4889622 | Email: [email protected] Abstract Background: Pakistan ranks six in top ten countries with highest number of diabetics. Contributing factors are age, positive family history and obesity. Factors, such as smoking, increase the risk of cardiovascular events among diabetic patients. The study was planned to document the prevalence and associated factors of cigarette smoking among type-2 diabetes mellitus patients being seen at tertiary care hospitals in Rawalpindi Pakistan. Methodology: A both qualitative and quantitative, cross sectional study was conducted, in order to determine the prevalence and associated factors of cigarette smoking among type 2 diabetics. Our study population was type 2 diabetic patients of 25 or more years of age. For qualitative part, we conducted two Focus Group Discussions (FGDs) with 6-8 participants, followed by semi-structured questionnaire as the qualitative part of the study. Results: Prevalence of cigarette smoking among type 2 diabetes mellitus patients was 27%. There was significant association of male sex (p=0.00), number cigarettes smoked in a day (p=0.000, CI=1.92-2.135), duration of disease (p=0.000, CI=1.500-1.685), duration of cigarette smoking (p=0.000, CI=1.500-1.685), and at least one episode of Cardio Vascular Disease (CVD) (p=0.026).