Socio-economic determinants of out-of-pocket Payments on healthcare in Pakistan

BACKGROUND: Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity in healthcare financing. It helps to formulate an effective health policy. Evidence on OOP in Pakistan is sparse. This paper attempts to fill this research gap. METHODS: We estimated determinants of OOP payments on healthcare in Pakistan. We used data sets of Pakistan Household Integrated Economic Survey (HIES) and Pakistan Standard of Living Measurement (PSLM) Survey for the year 2004-05. We developed a multiple regression model for the determinants of OOP payments using methods of Ordinary Least Square (OLS). We mainly used social, economic, demographic and health variables in our analysis. RESULTS: Median household OOP healthcare in the year 2004-05 was Pakistani Rupees (PKR) 2500 (US$ 41.99) in 2004-05. Household non-food expenditure was the single highest significant predictor of household OOP health expenditure. Household features like literate head and spouse, at least one obstetric delivery in last three years, unsafe water, unhygienic toilet and household belonging to Khyber Pukhtonkhwa (KPK) province were significant positive predictors of OOP payments. Households with male head, bricks used in housing construction, household with at least one child and no elderly, and head of household in a white collar profession were negative predictors of OOP payments. CONCLUSION: Our analysis confirms earlier findings that economic status and number of old aged members are significant positive predictors of OOP payments. This association can direct government to enhance allocations to healthcare and to include program focusing on non-communicable diseases. Our findings suggest further research to explore beneficiaries of government healthcare programs and determinants of high OOP payments by household residing in KPK province than other province. The interaction between white collar profession and their economic status in predicting OOP payments is also an area for further research

Application of desktop manufacturing system (SLA) for the manufacturing of a centrifugal pump impeller using CAD (I-DEAS)

Desktop Manufacturing (DTM) systems which combine personal computer, laser and other technologies are being used to sculpt objects from computer generated models created on computer aided design (CAD) workstations. As a member of DTM systems, StereoLithography Apparatus (SLA) transforms 3-dimensional designs into a 3-D output. This can substantially reduce the time required to produce a prototype through the process of photopolymerization. The process involves the transfer of a liquid plastic monomer into a solid polymer by exposing it to ultraviolet light. Although the process looks productive, inefficiencies can occur, if incorrect parameters are selected before its application for a particular prototype fabrication. In understanding the correct requirements of the prototype being built, efficiency can be maximized by the use of desktop manufacturing systems

Do Workers’ Remittances Boost Human Capital Development?

This study examines the influence of workers’ remittances along with the economic governance system on human capital development in 17 countries having low income, lower middle, upper middle and high income levels by using the annual panel between 1996 and 2013. Overall, results of fixed-effects model reveal that workers’ remittances have significantly positive impact on the human capital development. Results also reveal the positive and significant impact of all selected variables of economic governance system on human capital. It is concluded that the strong economic governance system strengthens the association between workers’ remittances and human capital during the aforementioned time period. JEL Classification: F24, J23 Keywords: Remittances, Economic Governance System, Human Capital Developmen

Biographical Writing (Seerat Nigari) in the Period 1526–1857: A Research Study on Non-Muslim Writers of the Prophet's Life

The Mughal era, spanning from 1526 to 1857, was a golden age of intellectual and literary achievement in the Indian subcontinent. This period witnessed a remarkable confluence of cultures, where not only Muslim scholars but also non-Muslim writers contributed significantly to the intellectual landscape. Among these contributions, the biographical writings on the life of the Prophet Muhammad (ﷺ) by non-Muslim authors stand out. These authors, including Hindus, Sikhs, and others, transcended religious biases to study and document the life of the Prophet Muhammad (ﷺ) and the teachings of Islam. Their works, such as those by Lal Chand Amar Din Jagtiani, Amar Lal Wassan Mal Hangorani, Jethmal Parsram Guljarani, Shrad Seh Prakash, J.S. Dara, Lakshan Prashad, Sundar Lal, Gobind Ram Sethi Shad, and Lajpat Rai, highlight the rich cultural and religious diversity of the Mughal era. These writings not only reflect the ethos of mutual respect and intellectual dialogue but also serve as important historical records. By celebrating the Prophet’s virtues and Islamic teachings, these authors demonstrated fairness and openness, leaving a legacy of interfaith understanding that is relevant even today

Escalation of tuberculosis notification: an analysis of associated social factors

Studies have revealed that socioeconomic factors such as those pertaining to unmarried respondents, dependency, housing congestion and room sharing are associated with tuberculosis rates not only in developing countries but also in developed countries. Karachi has been identified as one of the most vulnerable cities where the spread of TB is increasing with the passage of time. The purpose of the present study is to assess TB notification with reference to some social factors in order that the findings of this study may provide helpful information for guidance related to social and economic policy formulation, at least at the local level to combat and eliminate tuberculosis. The methodology was based on NTP registered patients' data and social factor analysis data which were acquired through questionnaire survey from notified patients. The result pertaining to TB notification reveals an increasing trend during the last seven years from 2007 until 2013. The notification of female patients compared to that of males is high, which is evidence of the fact that women in Pakistan are more affected but a comparison of patients to the total population in the respective years i.e. the patient population ratio, reveals a decreasing trend. The findings of the study emphasize that the problem of TB control can be resolved expeditiously with the cooperation of the public sector, which should be motivated to meet the core requirements of the programme at various administrative levels and strongly enforced standards of quality of li

Smart Water Management with Digital Twins and Multimodal Transformers:A Predictive Approach to Usage and Leakage Detection

Effective water management is crucial in urban and rural settings, requiring efficient usage and timely detection of issues like leakages for sustainability. This paper introduces an integrated framework that combines Digital Twin technology with a multimodal transformer-based model for accurate water usage prediction and leakage detection. The system synchronizes real-time data from various sensors including flow meters, pressure sensors, and thermal imaging devices with a Digital Twin of the water network. Advanced transformer models, specifically the Informer model for long-term time-series prediction and a Water Multimodal Transformer for anomaly detection, process these data to capture complex patterns and dependencies. Experimental results demonstrate the framework’s effectiveness: the Informer model achieved an R2 score of 0.9995 and a Mean Squared Error (MSE) of 2.2, outperforming traditional models. For leakage detection, the model attained 98.4% accuracy and precision, an F1 score of 97.6%, a low False Positive Rate of 0.0019, and an Area Under the Curve (AUC) of 0.984. By fusing diverse sensor data and utilizing advanced transformer architectures, the framework provides a comprehensive view of the water network, enabling real-time decision-making, enhancing forecasting accuracy, and reducing water waste. This scalable solution supports sustainable water management practices in both urban and industrial contexts

Penilaian M-Pembelajaran dalam Sistem Pembelajaran di Institut Pendidikan Guru (Ipg) Melalui Technology, Usability and Pedagogy Model (Tup)

M-Pembelajaran merupakan satu langkah ke hadapan dalam perkembangan pembelajaran elektronik e-Learning. Perkembangan dalam teknologi mobile telah mengubah cara manusia belajar. Pembelajaran tidak terhad dalam bilik kuliah semata-mata tetapi boleh berlaku melangkaui sempadan bilik kuliah serta proses pembelajaran boleh berlaku bila-bila masa dan di mana-mana sahaja. Inovasi dalam m-Pembelajaran membawa kepada perubahan paradigma dalam pendidikan teknologi mobile yang dipercayai mempunyai potensi untuk digunakan dalam pengajaran dan pembelajaran di Institut Pendidikan Guru (IPG). Tujuan kajian ini adalah untuk membuat penilaian berkenaan penggunaan Technology, Usability and Pedagogy Model (TUP) untuk meningkatkan kefahaman terhadap penilaian m-Pembelajaran khususnya dalam penggunaan aplikasi pendidikan dalam kalangan pelajar. Kajian ini menggunakan pendekatan kualitatif iaitu melibatkan instrumen temu bual struktur berdasarkan model TUP. Instrumen dalam fasa ini disemak  oleh tiga orang panel pakar bahagian pembinaan instrumen. Manakala keesahan temu bual juga melibatkan kesahan dalaman atau internal validity yang melibatkan kesahan kriteria (criteria validity) dan semakan rentas (cross checking). Seramai 12 responden yang terlibat dalam kajian ini yang terdiri daripada pelajar (IPG). Tatatcara menganalisis data dibahagikan kepada tiga bahagian iaitu teknologi, kepenggunaan dan pedagogi  semasa proses temu bual dijalankan. Hasil dapatan temu bual dengan pelajar dari aspek teknologi menunjukkan bahawa pelajar menyatakan kemudahan yang disediakan untuk pelaksanaan PdPc dalam model adalah mencukupi. Aspek kepenggunaan model menunjukkan bahawa responden merasakan pedagogi secara mobile sangat menarik. Manakala aktiviti pembelajaran secara keseluruhan dalam model ini adalah menarik dari aspek pedagogi dalam model. Berdasarkan dapatan, kajian ini dapat memberi manfaat bukan sahaja kepada para pensyarah dan pelajar, malah sebagai rujukan kepada sistem pendidikan di Institut Pendidikan Guru dalam mentransformasikan pendidikan melalui kolaborasi dengan teknologi mobile dalam pembelajaran terkini

Marginal bone loss around cement and screw-retained fixed implant prosthesis

Implant-supported fixed restorations are considered as the standard treatment for replacement of missing teeth. These can be either screw or cement retained. The success or failure of implant restorations depend upon amount of marginal bone loss (MBL). The present study is to determine the MBL around cement and screw-retained implant prosthesis and to determine various predictors of the MBL. A retrospective charts review was conducted at the dental clinics, Aga Khan University Hospital, Karachi from February 2017 to June 2017 in which 104 implants restorations were assessed using periapical radiographs. MBL was calculated at baseline and at 12 months and the difference was recorded on a proforma. SPSS version 21.0 was used for statistical analysis. Descriptive statistics was computed. Generalized estimation equation analysis (GEE) was applied to determine the predictors of MBL. Level of significance was kept at ? 0.05. There were 104 implant restorations belonging to 41 patients. Screw retained prosthesis showed significantly greater MBL than cement retained prosthesis (p-value =0 .018) (irrespective of crowns or fixed partial dentures). Other factors that turned out to be significant predictors of MBL were male gender (p-value= 65 yrs. (p-value=0.028) and sites where bone grafting was performed (p-value=0.003). Male patients of age >65 yrs. with sites needing bone grafts who were provided with screw retained prosthesis (irrespective of crown or fixed partial dentures) had significantly greater marginal bone loss around implants