This study investigated the effect of different risk factors in the occurrence of urinary bladder cancer in Pakistan on the basis of a case control study using both descriptive and analytical approaches. A sample of 900 subjects including 300 cases and 600 controls was selected from different areas of Pakistan including headquarter of all four provinces and federal area (Islamabad) through a questionnaire. The requisite information was obtained from all the patients/ controls by the researcher using the direct interview method. From the headquarters of Khyber PukhtoonKhwa, Sindh, Baluchistan and federal area (Islamabad), 150 subjects (including cases and controls) were taken from wards of two selected public hospitals but from the headquarter of the Punjab (Lahore), 300 subjects (including cases and controls) were taken from the wards of four selected public hospitals. Controls are taken by matching the gender, area of residence and age above 40 years. About 22 factors with sub categories were included in the study. For bivariate analysis, the chi-square, phi/v statistics and Kandall’s tau-b are used. For the purpose of multivariate analysis, the binary logistic regression was run by using the SPSS (version-16) to observe the significant risk factors and prediction of the model. In the descriptive analysis, it was observed that risk of bladder cancer increases with an increase in the number of cigarettes smoked per day, years of smoking and risk decreases when the stop smoking period increases. Further more, similar results were observed in the bivariate analysis. In the overall analysis, the six factors including hair dye, chemical exposure, family history, cigarette smoking, fried items and fats items are found to be positively significant with the odds ratios and 95 % confidence intervals of odds ratios (2.96; 1.396-6.279), (2.59; 1.460-4.607), (3.13; 1.325-7.394), (10.6; 7.007-15.941), (2.11; 1.364-3.269) and (2.08; 1.309-3.305), respectively. While the three factors including lifestyle, fluid consumption and use of fruits are found to be negatively significant with odds ratios and 95% confidence intervals for the odds ratios (0.102; 0.056-0.187), (0.268; 0.183-0.392) and (0.292; 0.193-0.440), respectively indicating that these three factors are protective factors against urinary bladder cancer. In area wise study, eight factors age, social status, lifestyle, family history, cigarette smoking, tea, fluid consumptions and fruits in Punjab, three factors cigarette smoking, source of drinking water and fried items in Islamabad, six factors chemical exposure, lifestyle, cigarette smoking, fluid consumption, fried items and fruit in Khyber Pukhtoon Khwa, three factors cigarette smoking, fluid consumption and fruits in Baluchistan and two factors cigarette smoking and fluid consumption in Sindh are found to be significant. In eight factors of Punjab, age, family history, cigarette smoking and tea are found to be positively significant while the other four factors social status, lifestyle, fluid consumptions and fruits are negatively associated with the bladder cancer. In three factors of Islamabad, two factors cigarette smoking and fried items are observed to be positively significant while the source of drinking water (government provided water) is observed to be protective as compared to the tap water. In six factors of Khyber Pukhtoon Khwa, chemical exposure, cigarette smoking and fried items are directly associated with the risk of bladder cancer while the other three factors lifestyle, fluid consumption and fruit are the protective factors for the disease. In three factors of Baluchistan, cigarette smoking is found to be positively significant while the fluid consumption and fruits are inversely associated with risk of bladder cancer. In two factors of Sindh, cigarette smoking is directly associated with disease while the other fluid consumption is found to be negatively significant. Cigarette smoking is the major risk factor and found to be significant in each area of Pakistan. Fluid consumption is also major protective factor and found to be significant in all areas except Islamabad. In studying the occupational risk factors, four categories of the occupations including cooks, drivers, metal workers and textile workers are found to be significant with the odds ratios and the 95% confidence intervals (14.132; 4.068 - 49.088), (7.949; 3.321- 19.025), (7.571; 3.147 - 18.214) and (2.168; 1.136 - 4.138), respectively. While the farmers, painters and leather workers are observed to be insignificant in Pakistan. According to this study, the cooks are at higher risk of bladder cancer as compared to all other occupations. Key Terms: Bladder cancer, Risk Factors, Logistic Regression, Odds ratio, Controls, Significance, Retrospective
To develop in children a broad range of skills, including the problem solving, interpersonal and communication skills that are essential for successful living in a rapidly changing society. The curriculum encourages student initiative by providing children with materials, equipment, and time to pursue activities they choose. At the same time, it provides teachers with a framework for guiding children’s independent activities toward sequenced learning goals. There are seven specific types of learning styles. Visual learners prefer to learn mathematics through pictures, diagrams etc. A well-balanced intelligent child is able to develop all the types of learning styles. The students have to understand and accept their type of learning style earlier so that learning becomes easier and less stressful in the future. But it is important to train and practice the other types of learning styles so that the children can utilize them as effectively as possible. The teacher plays a key role in instructional activities by selecting appropriate, developmentally sequenced material and by encouraging children to adopt an active problem-solving approach to learning. This teacher-student interaction teachers helping students achieve developmentally sequenced goals while also encouraging them to set many of their own goals uniquely distinguishes the High/Scope Curriculum from direct-instruction and child-centered curricula (high/Scope Educational Research Foundation, 1989). Teachers keep notes about significant behaviors, changes, statements, and things that help them better understand a child’s way of thinking and learning. Teachers use two mechanisms to help them collect data: the key experiences note form and a portfolio. The High/Scope Child Observation Record is also used to assess children’s development. According to Ronald Barnett, learning may or may not take place when a subject is taught. While discussing this point he has presented two contrasting images of quality. They are institutional performance and student experience, student learning or student achievement. The teacher in his opinion is central to higher education. Teaching may be able to improve the quality of student’s learning but the teacher should remind himself that it may also impair the quality of student’s learning. This is partly because student’s learning strategies vary under two polarities, one between deep and surface understanding and the other between holistic and atomistic understanding of their learning experiences. He goes on to add that for a student, learning has three distinct aspects: learning style, motivation and curriculum demands. Therefore teachers have to pursue, beyond teaching strategies to enable their students to attain certain specific skills.
One and two dimensional nonlinear dissipative structures are studied with non-Maxwellian electrons in nonuniform magnetized plasmas. In 1D (one dimension), nonlinear drift-wave is derived by employing the drift approximation whereas, in 2D (two dimensions) under the weak nonlinearity limit, coupled drift-ion acoustic wave is derived. In the linear regime, it is observed that the nonthermal electron population modi es the frequency of coupled drift ion acoustic wave. Formation of shock structures is observed with nonthermal Cairns and kappa distributed electrons and it is found that the presence of these distributions signi cantly modi es these nonlinear structures. Velocity of nonlinear structures and diamagnetic drift velocity are found to play a signi cant role in the formation of these structures. Existence regimes for one and two dimensional drift shock waves are found and it is observed that kappa distributed electrons for 1D case can give rise to compressive as well as rarefactive shock structures whereas, Cairns distributed electrons are found to behave in a di erent way for the formation of these drift shock structures. Coupling of drift waves and ion-acoustic waves in linear and nonlinear regime are studied in a nonuniform magnetized plasma comprising of two ion species (i.e. Oxygen and Hydrogen ions) in the presence of nonthermal distribution of electrons. Dispersion characteristics of coupled drift-ion acoustic waves are found to be modi ed for kappa and Cairns distributed nonthermal electrons population as well as for di erent ratios of ion number densities. Drift solitary waves are studied by deriving the one dimensional KdV and two dimensional KP like equations for pure drift and coupled drift-ion acoustic waves respectively. These solitary structures are observed to be modi ed in the presence of di erent ratios of ion number densities as well as nonthermal distribution of electrons. Existence regimes for drift solitary waves are determined with the help of the velocity of the nonlinear structure and diamagnetic drift velocity. Further, using non-Maxwellian Cairns, kappa and q-nonextensive electron distributions along-with sheared ion ow, coupling of drift vortex modes and ion acoustic modes are investigated in a nonuniform magnetized plasma comprising of hot ions. Nonlinear vortex structures are observed in the presence of non-Maxwellian electrons population iii and it is found that there is a shift in the position of these structures because of nonthermal populated electrons. The importance of these particles in the Earth''s auroral zone is pointed out and comparison with their Maxwellian counterpart is also made. Shear ow in dust dynamics driven waves in combination with the dust-neutral drag is studied in a plasma containing ions, electrons and dust. Non-thermal population of ions is considered which has been observed by many satellite missions. It is found that the dissipative instability produced by dust sheared ow and dust-neutral drag gets modi ed because of these nonthermal ions. It is also observed that the dissipative instability enhances for the Cairns distribution whereas, the kappa distribution arrests the growth of this instability. In the nonlinear regime, formation of vortices in the system is studied. It is found that the nonthermal population of ions signi cantly alter these structures by comparison with their Maxwellian counterpart.