PurposeThe use of information and communication technologies (ICTs) has become a major driving force in transforming education worldwide. Similarly, in the last ten years, the usage of ICTs and e-learning in Pakistan has increased. Whereas the latest educational policy of the Government of Pakistan has focused on using ICTs and e-learning in schools and universities. The national professional standards for teachers have also suggested teachers to integrate ICTs in their classrooms and develop e-learning platforms for teaching and learning processes. However, in this study the effectiveness of information and communication and e-learning technologies integration in teaching and learning has been assessed. The context selected for this research study is a public university of Sindh, Pakistan. The research gap, which has been founded through the extensive literature review, indicated that most of the students are not able to utilize ICTs effectively. The first objective of this study is to enable students to gain wider range of knowledge and access Internet for developing a global outlook. Moreover, the second objective of this study is to develop students' capabilities of processing information more effectively and efficiently for teaching and learning.Design/methodology/approachBy nature, this study is quantitative survey-based research study. For this purpose, data has been collected from students and teachers of English, Computer Science and Business Administration departments of targeted university, survey questionnaires have been adopted as a data collection tool. Whereas the random sampling technique is used for the collection of data by using Morgan table of sample size. Additionally, data has been collected from 100 participants, 80 of them were students and 20 were teachers, and data has been analyzed by using SPSS 22.0 software.FindingsThe findings of this study have indicated the student's level of interest toward the integration of ICTs and e-learning in science and social science courses. Similarly, the findings specify that through ICT and e-learning materials, students can learn more effectively, which can also facilitate teachers for their teaching process in this modern era of technology. Whereas the issue that has been specified through the findings is that the teachers are not encouraged by the management of the university to implement the ICT in their teaching and learning due to their concerns on the limited resources and lack of competencies.Practical implicationsFor the practical implication, the findings of this study will facilitate the teachers and learners for integrating the ICTs and e-learning in their course curriculums and interactive teaching practices as per modern era of technology. Also, this study will help the provincial leader and policymakers by addressing the teachers’ concern to encourage the integration of ICT tools and develop capabilities for interactive classrooms for effective teaching and learning.Originality/valueThis is the first study of its nature that has been conducted in the Pakistani public university in rural setting, and the finding of this study will facilitate and help the institutional and government stakeholders to where and how they can effectively integrate ICTs and e-learning in classrooms for interactive teaching and learning processes in the rural Sindh.

Nurses working in cancer settings have difficulty identifying distress using their routine clinical judgement and tend to make more false-negative than false-positive errors. Evidence-based strategies that improve detection of mild and moderate distress are required in routine cancer care.

Background Lupus anticoagulant (LA) assays are compromised in anticoagulated patients, and existing strategies to overcome the interferences have limitations. The prothrombin‐activating Taipan snake venom time (TSVT) screening test and ecarin time (ET) confirmatory test are innately insensitive to vitamin K antagonists (VKA) and direct factor Xa inhibitors (DFXaI). Objectives Validate standardized TSVT/ET reagents for LA detection, in a multicenter, multiplatform study. Patients/Methods Six centers from four countries analyzed samples with TSVT/ET from 81 nonanticoagulated patients with LA, patients with established antiphospholipid syndrome (APS), and proven persistent LA who were either not anticoagulated (n = 120) or were anticoagulated with VKAs (n = 180) or DFXaIs (n = 71). Additionally, 339 nonanticoagulated LA‐negative patients, and 575 anticoagulated non‐APS patients (172 VKA, 403 DFXaI) were tested. Anticoagulant spiking experiments were performed and 112 samples containing potential interferences (i.e., direct thrombin inhibitors) were tested. Results were evaluated against locally derived cutoffs. Imprecision was evaluated. Results Cutoffs were remarkably similar despite use of different analyzers and donor populations. Cutoffs for TSVT ratio, ET ratio, percent correction, and normalized TSVT ratio/ET ratio ranged between 1.08 and 1.10, 1.09 and 1.12, 9.3% and 14.8%, and 1.10 and 1.15, respectively. Coefficients of variation for TSVT and ET ratios were ≤5.0%. TSVT/ET exhibited sensitivity, specificity, and negative and positive predictive values of 78.2%/95.0%/86.3%/91.5%, respectively, with established APS as the LA‐positive population, and 86.9%/95.0%/76.8%/97.4%, respectively, with triple‐positive APS. Interference was seen with direct thrombin inhibitors, unfractionated heparin, and low molecular weight heparins, but not VKAs or DFXaIs. Conclusions TSVT/ET are validated for LA detection in nonanticoagulated patients and those on VKAs or DFXaIs.

Underreporting of adverse drug reactions (ADRs) has placed a heavy financial burden on health care resources worldwide. Realizing the importance of proper ADR reporting is paramount for implementing better patient care. This study was designed to assess knowledge, attitude, and practice (KAP) of ADR reporting among United Arab Emirates (UAE) health care professionals to clarify their present strategies and identify steps to avoid underreporting. A self-administered cross-sectional questionnaire was designed and randomly distributed to different health care personnel ( = 150). All participants were briefly informed about the aim of the study and given sufficient time to respond. The responses were collected over 6 months. The data were statistically analyzed for each reporter category (community pharmacist, hospital pharmacist, and doctors) using the chi-square test. We found that 81%, 83%, and 83.3% of doctors, community pharmacists, and hospital pharmacists, respectively, were not aware of the existence of a reporting center and 56%, 60%, and 72% were not aware of a reporting procedure. Poor ADR reporting practices were shown by responders; only 19%, 14%, and 12.1% of doctors, community pharmacists, and hospital pharmacists reported ADRs. This study showed poor KAP results among health care professionals. Proper educational intervention strategies should be established in different health care settings for better patient care. With proper guidance, objectives in all health care settings should be targeted to positively change the concept of health care to consider ADR reporting as a common accepted daily routine practice.

Background. Aducanumab, a new monoclonal antibody that targets β-amyloid aggregates, has been granted conditional approval by the U.S. FDA for treatment of mild Alzheimer’s disease (AD). The approval of this drug without a confirmed significant clinical impact has resulted in several debates. Objective. In this narrative review, aducanumab approval-related controversy, the drug’s pharmacokinetics and pharmacodynamic characteristics, evidence from the efficacy and safety trials of aducanumab, implications of the drug approval, and the future directions in the management of patients with AD are summarized. Methods. Using relevant keywords, Google Scholar, Web of Science, and MEDLINE databases and manufacturer’s website were searched. Results. Infusion of aducanumab at a higher dose resulted in a modest slowing of cognitive decline among patients with mild cognitive impairment or early-onset AD dementia. The drug however can cause amyloid-related imaging abnormalities. Due to modest impact on cognition, the use of this drug by patients with AD will most likely be limited. The manufacturer is required to run an extended phase IIIb trial to verify the benefit of this drug. Access to therapy requires a careful selection of patients and periodic monitoring to ensure the optimal use of the drug. Conclusion. Despite the limitations, aducanumab is the first disease-modifying therapy approved for the treatment of AD. Aducanumab addresses a part of the pathogenesis of AD; therefore, drugs that can act on multiple targets are needed. In addition, the search for preventive strategies, validated plasma-based assays, and newer drugs for AD, which are effective, safe, convenient, and affordable, is vital.

Chronic pain, the most common complication of diabetes, is treated with medication often to no avail. Our study aimed to compare the use of mindfulness meditation and progressive relaxation to reduce chronic pain in older females with diabetes. Methods The 105 study participants were divided randomly into 3 groups: Group MM (mindfulness meditation), Group CM (control meditation), and Group PM (progressive relaxation meditation). Assessment of analgesic effectiveness required changes in average daily pain Brief Pain Inventory (BPI) modified for painful diabetic peripheral neuropathy and Patient Global Impression of Change using descriptive statistics, Student’s t test, and analysis of variance where applicable. Results Both Groups MM and PM experienced significant ( P < .05) reduction in average daily pain in last 24 hours at study end compared to baseline (28.7% and 39.7%, respectively). Group MM had more significant ( P < .01) reduction of pain compared to control, a score of 5.2 ± 1.2 dropped to 3.0 ± 1.1 by week 12 of treatment. Groups MM and PM showed significant improvement in patients’ impression at study end, 75 ± 5.1% (n = 36) and 61 ± 6.5% (n = 32), respectively. In Group MM, patient satisfaction scores increased significantly ( P < .05) to 3.8 ± 1.9 by week 12. Conclusion Integrative therapies such as mindfulness meditation can be part of a comprehensive pain management plan. Benefits include reduction of pain-related medication consumption, better treatment outcomes, improvement in comorbid conditions such as anxiety and depression as well as no risk of addiction or abuse.

Health literacy is how well the patients are able to attain, deal with, and understand basic health information. This is particularly important when it comes to comprehending prescribed medication instructions. To improve the communication strategies for health-care professionals during patient counseling, our study aimed to assess the influence of health literacy and medication adherence in older patients. The objectives of the study were to evaluate associations that occur between the level of health literacy and medication adherence. This study used a convenience sampling method of females (older than 60 years) attending the diabetic clinic in two hospital settings ( N = 524). All study participants filled three validated questionnaires: these were the Literacy Assessment for Diabetes, the Diabetes Numeracy Test, and a modified Brief Adherence Rating Scale. To assess the spectrum of health literacy differences, we used χ2 analysis and linear regression analysis. Individuals with adequate health literacy were more likely to remember to take their medications compared with those with inadequate health literacy, χ2(4) = 11.6, p = .04. Adequate literacy level study participants were more likely to not change the dose of their medications without medical advice (12.3%) compared with those individuals with inadequate health literacy (2.8%), χ2(4) = 11.13, p = .03. The results in our study suggest that health-care professionals should focus on appropriate communication attuned to the assessment of health literacy levels particularly in older female patients when discussing medication instructions.

Insights into the mechanisms involving gene expression in diabetic neuropathy can help pinpoint genes with altered expression. This will help in the development of novel alternative therapeutic strategies to significantly slow the progression of neuropathy in susceptible individuals and perhaps even prevention.