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Home > An Assessment of Whether Medical Doctors Have the Knowledge That Would Enable Them to Competently Deliver Tobacco Cessation Services

An Assessment of Whether Medical Doctors Have the Knowledge That Would Enable Them to Competently Deliver Tobacco Cessation Services

Thesis Info

Author

Khamonya, Miriam Miima

Department

Family Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728036678

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Background: Tobacco use is the leading cause of preventable morbidity and mortality globally. The international community recognizes this epidemic and compelling evidence exists on the significant contribution of the health care provider in propagating the success of tobacco cessation. The World Health Organization highlights minimal implementation of tobacco control policies by Tanzania despite a rise in tobacco use prevalence. Medical doctors’ competence is a reflection on our commitment to tobacco cessation service delivery. Main Objectives: To assess whether medical doctors have the knowledge that would enable them to competently deliver tobacco cessation services. Specific Objectives 1. To assess medical doctors’ core knowledge on tobacco use and it`s harmful effects. 2. To assess medical doctors’ knowledge on tobacco screening. 3. To determine medical doctors’ awareness on brief tobacco cessation advice. Design: Facility based cross-sectional study. Setting: Public and private health facilities in Dar es Salaam, Tanzania. Participants: Medical doctors in active clinical practice Site: Multicenter study from October 2013 to January 2014. Sample size: 320 medical doctors. Measurement: A 48 item validated questionnaire was used to assess whether medical doctors have the knowledge that would enable them to competently deliver tobacco cessation services; 35 items were scored and each item scored 1 point, two items were nullified because nicotine replacement therapy has not yet been legalized, while 11 items explored participant’s recommendation on tobacco. Competence was defined as an overall score above 25 (71%) of the 35 items. Results: 320 questionnaires were analyzed. Only 21 doctors (7%) attained acceptable level of competence; which was insignificant p=0.4 (significant p< 0.05) and 62 doctors (19%) reflected satisfactorily on tobacco cessation services. Conclusion: The level of acceptable knowledge for competent delivery of tobacco cessation services was low. Doctors affirm that they need further training. Enforcing sustainable ways of integrating comprehensive and evidence based tobacco education and cessation services in our local health care systems are recommended to improve competence in tobacco cessation service delivery.
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المبحث الثالث: خود کلامي

المبحث الثالث: خود کلامي
" خود کلامي" ھذہ المجموعۃ الثالثۃ لبروین شاکر۔

ظھرت ھذہ المجموعۃ الشعریۃ أمام أنظار الشعراء، ومحبي أعمال بروین شاکر لأول مرۃ عام (1985م)، وتعکس ھذہ المجموعۃ الشعریۃ المنازل الراقیۃ عن شخصیۃ الشاعرۃ، وتغیر أسلوب کلامھا ومرارۃ ألفاظھا، وقد أخذت الشاعرۃ تنظر الحیاۃ بنظرۃ أدق قریب من الحقیقۃ والواقع بعید عن الخیال والأمل الزائف۔ تقول الدکتورۃ سلطانۃ بخش یتضح في ’’خود کلامي‘‘ ان السفر الذي بدأت الشاعرۃ في خوشبو فقد تغیر أسلوبہ وحقیقتہ، وقد أصبحت ھذہِ المجموعۃ الشعریۃ صورۃ صادقۃ عن إنسانة بالغۃ تفھم الحیاۃ وتنظر الواقع علی حقیقتہ وتطورت أحاسیسھا، إنما في خوشبو فکان عن الشابۃ المراھقۃ ذات الأحاسیس المليئةبالأحلام والأمل الناعم وکانت تنظر إلی الحیاۃ بالبراء ۃ والبرودۃ الھادئة ۔ یقول أمجد أسلم أمجد ’’أن في شعر بروین شاکر من خوشبو إلى خود كلامي صورۃ واضحۃ عن الإحساسات التي یجد فیہ القاريء دقات عواطفہ الناقصۃ أو الکاملۃ بوضوح، وبراعۃ الشاعرۃ تکتمل في أنھا أعطت صورۃ صادقۃ عن ھذہ المشاعر والإحساسات بشکل لطیف وشعور ھاديء ناعم مليء بألوان البراءۃ۔
ورأي الشاعر حمایت علي في خود کلامي بأن ھذہ المجموعۃ عبارۃ عن تلك الروح التي تعبر عن حیاتھا وشعرھا الذي بہ تجد الأنس في وحدتھا وفراقھا ۔

یتضح من ذلك أن الشاعرۃ تقدمت في العمر والتجربۃ وأخذت تنظر للحیاۃ بصورتھا الحقیقیۃ، وأنھا تعطي تعبیرًا صادقًا عن وحدتھا وآلامھا، وکیف أن قلبھا المکسور یجد اللذۃ في الأنھیار والحزن، وأن جمال الوحدۃ والفراق یجد راحۃ البال والھدوء المسحور عند لقاء الحبیب، وھذہ المجموعۃ الشعریۃ تعطي صورۃ شاملۃ عن الحیاۃ وما فیھا من مشاکل وھموم والفھم العمیق وتنظر إلی الحیاۃ بنظرۃ قاسیۃ لأن الدنیا أقسیٰ من طموحاتھا، وکیف أنھا تحاول السير خلف تحقیق الأحلام والطموح ولکن قساوۃ الحیاۃ لا تساعدھا في تحقیق ھدفھا ولا تعطي لھا ید الأمل ولا تجد القلیل من الضوء في ھذا الطریق المظلم الذي سدّ أبواب أفراحُھا...

Psychological morbidity in medical students after entering into clinical training Psychological morbidity among medical students

Psychological morbidity is emerging as animportant issue for medical students after entering clinical training due to extensiveworking hours. Students find themselves unable to balance competing demands on their time and cannot allocate appropriate time to family, spouses and even to themselves; this leads to complaints about exhaustion and lack of efficiency in their profession. Objective: To assess Psychological morbidity in interns, medical officers and residents Methods: a cross sectional study was conducted. A google form was designed with questions adopting from the three scales of the Maslach Burnout Inventory-General Survey (MBI-GS). Question from all three categories of MBI-GS such as emotional exhaustion, depersonalization and personal accomplishment were considered. The form was distributed via email and Whatsapp to 87 house officers, medical officers and residents of six public healthcare facilities in Lahore. Responses were captured from 73 participants who completed the General Health questionnaire. Seven of these forms were filled by nurses, so in the present study only the response ofthose 66 participants who conformed to the study cross-section were considered. The results were analyzedusing SPSS version 22 for descriptive statistics and chi-square association. Results: A significant association was found between long working hours and emotional exhaustion, depersonalization and personal accomplishment questions in particular. The findings suggests long working hours ruin the mental health of medical professionals, which ultimately produce psychological health impacts. Conclusions: It was concluded that these factors should be considered to reduce psychological morbidity in health professionals.  

Text-Independent Speaker Verification System for Pashto Speakers With Accent and Dialect Recognition

In this thesis, “a text-independent speaker verification system for Pashto speakers using accent and dialect recognition approach” has been designed. The purpose of the designed system is to recognize the region of origin of Pashto native speakers on the basis of their distinct dialects and to verify them using a speaker verification system. Due to the unavailability of the Pashto voice data in the form of different accents and dialects, a Pashto speakers’ database using different dialects of Pashto was developed. In order to develop the data initially, different dialectical variations of Pashto language were studied in detail and then the speech data was collected only from those different regions of Pakistan and Afghanistan where the Pashto is spoken with different dialects. After the database development, it is processed through front end and feature extraction processes where Mel Frequency Cepstral Coefficient (MFCC) features have been extracted from the collected data. After the MFCC feature vectors have been obtained, a Multilayer Perceptron (MLP) based classifier was designed to classify the speakers. Two separate classification experiments were performed (1) Speaker identification followed by dialect identification (2) Text-independent speaker verification followed by dialect identification. Speaker identification followed by dialect identification achieved 96.0 % identification accuracy, whereas, speaker verification followed by dialect identification achieved 100 % verification accuracy. Furthermore, the proposed Gaussian Mixture Model (GMM) based dialect identification system achieved 93.8 % identification accuracy in identifying Pashto native dialects. In order to inspect the noise robustness of the proposed system, the system’s performance was checked with the different degrees of noise level and Signal to Noise Ratio (SNR) was computed for each degree of noise. The performance of the system showed slightly degradation with the increase in the noise level, hence, showed its robustness against noise. A simple Pashto digits recognition (1 to 10 digits of Pashto) was also included in the study using MLP, HMM & SVM classifiers. Comparative analysis showed that the SVM based Pashto digit recognizer with 98.5 % recognition accuracy outperformed both the MLP and HMM based Pashto digit recognizers by showing 1.3 % and 3.3 % improvement in recognition accuracy. In order to benchmark the proposed research, the system’s performance was further tested on classifying some foreign accent of Pashto (Urdu accent of Pashto). In case of classifying the Urdu accent of Pashto, the system achieved 74.4 % recognition accuracy. Finally, the results achieved in the conducted experiments were compared with the recently proposed state of the art dialect identification, speaker verification and Pashto digit recognition systems. Comparative study showed that the proposed system outperformed some recently proposed dialect identification as well as speaker verification systems and showed relative improvement in recognition accuracies.