Severe Acute Malnutrition (SAM) is a serious public health problem in many low- and middle-income countries (LMICs). Therapeutic programs are often considered the most effective solution to this problem. However, multiple social and structural factors challenge the social inclusion, sustainability, and effectiveness of such programs. In this article, we aim to explore how poor and remote households face structural inequities and social exclusion in accessing nutrition-specific programs in Pakistan. The study specifically highlights significant reasons for the low coverage of the Community Management of Acute Malnutrition (CMAM) program in one of the most marginalized districts of south Punjab. Qualitative data are collected using in-depth interviews and FGDs with mothers and health and nutrition officials. The study reveals that mothers’ access to the program is restricted by multiple structural, logistical, social, and behavioral causes. At the district level, certain populations are served, while illiterate, and poor mothers with lower cultural capital from rural and remote areas are neglected. The lack of funding for nutrition causes the deprioritization of nutrition by the health bureaucracy. The subsequent work burden on Lady Health Workers (LHWs) and the lack of proper training of field staff impact the screening of SAM cases. Moreover, medical corruption in the distribution of therapeutic food, long distances, traveling or staying difficulties, the lack of social capital, and the stigmatization of mothers are other prominent difficulties. The study concludes that nutrition governance in Pakistan must address these critical challenges so that optimal therapeutic coverage can be achieved.

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.

AimPrevious theory and research postulate that workaholism is one of the important factors that contribute to burnout. The present study aimed to analyze the role of psychological capital as a mediator between the two. Moreover, the study examined the moderating role in the stated mediated relationship.MethodsThe researchers approached a sample of university teachers (N = 1,008) including both male (n = 531) and female (n = 477) university teachers by using a multi-stage random sampling technique. For this purpose, DUWAS-10 Oldenburg Burnout Inventory, Challenging Job Demands Scale, and Anila PsyCap Scale were applied to measure workaholism, burnout, challenging job demands, and PsyCap, respectively. The data obtained from the sample was subjected to analysis by using Model 14 of Process Macro by Hayes.ResultsThe results confirmed the mediating role of PsyCap and moderating role of time pressure and cognitive demands in the relationship of the two variables. The results concluded that workaholism is not directly related to burnout rather the negative relationship existed through psychological capital, and the mediated relationship was stronger for the university employees who were to face a higher level of challenging job demands including cognitive demands and time pressure.ConclusionBurnout is an occupational health problem that causes devastating effects on both the employees as well as to the organizational economy. Improving personal resources might help the negative relationship between workaholism and burnout in higher education institutions in the country.

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Loneliness and cognitive impairment is a serious concern among the older adults and is a significant factor influencing elderly quality of life. The current study aimed to examine the associations among loneliness, cognitive functioning and quality of life in Pakistani older adults. The study is cross sectional study with a non-probability purposive sample comprising of 149 Pakistani older adults of ages 60 years and above. Internationally standardized scales have been used to collect online data. Multiple linear regression results indicate that loneliness (β= -0.23, p<.001) and cognitive functioning (β= 0.32, p<.001) are significant predictors of the quality of life in older adults. Furthermore, older men scored higher on loneliness and cognitive impairment than older women and the overall quality of life was better in women participants as compared to men. There is need for social and health interventions to promote the quality of life of elderly population, especially in times of pandemic, with specific focus on reducing loneliness and cognitive impairment, Keywords: Loneliness, cognitive functioning, quality of life, older adults, gender difference

Background Operating Department Practitioners (ODPs) are neglected human resources for health with regard to both professional development and research for patient safety. The surgical theatre is associated with the highest mortality rates and with the onslaught of the COVID-19 pandemic. ODPs are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. Methods A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Results Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. Conclusions The public health sector, in Pakistan and other developing regions, need to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.

Background: Operating Department Practitioners (ODPs) are neglected human resources for health with regard to both professional development and research for patient safety. The surgical theatre is associated with the highest mortality rates and with the onslaught of the COVID-19 pandemic. ODPs are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics.Methods: A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes.Results: Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. Conclusions: The public health sector, in Pakistan and other developing regions, need to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.

was 69.2 years (range 33-92 years). 119 (65%) had mild, 58 (32%) moderate and 5 (3%) severe hyponatraemia. 74 (40%) were adenocarcinomas, 58 (32%) squamous carcinomas, 43 (24%) SCLC and 7 (4%) had unspecified non-small cell lung cancer. 89(49%) had metastatic disease at diagnosis. 18/43 (42%) small cell, 14/58 (33%) squamous, 23/74 (31%) adenocarcinoma patients had moderate to severe hyponatraemia. 132 (74%) of this cohort had active oncological treatment: 93 (51%) chemotherapy, 25 (14%) radiotherapy, 17 (9%) surgery whilst 47 (26%) had best supportive care. 28 (15%) had a biochemical response to treatment, 11 (39%) of these patients were adenocarcinomas, 10 (36%) squamous carcinomas and 7 (25%) SCLC. Conclusion: Hyponatraemia in lung cancer patients is widely distributed in various age groups and histological subtypes. Among those admitted with hyponatraemia, severe cases (<124mEq/L) were rare. Higher rates of SIADH are seen in SCLC than in any other malignancy and our data confirmed that, proportionately, more SCLC patients had moderate e severe hyponatremia than non-small cell lung cancer patients. Hyponatraemia does respond to active oncological treatment including chemotherapy, radiotherapy and surgery. Although historically, hyponatraemia is considered as a poor prognostic marker, this should not preclude active oncological management. Asymptomatic patients with SIADH have been managed initially by fluid restriction but patient compliance is usually poor. Older medications such as demeclocycline, urea and lithium are limited by variable efficacy, poor palatability and/or toxicity, thus underscoring the need for new approaches. Tolvaptan, a new vasopressin receptor antagonist, can improve hyponatraemia due to SIADH. Further studies are needed to evaluate the prognostic value of hyponatraemia and its treatment in cancer patients.