Frequency of depression and anxiety among heart failure patients in a tertiary care hospital of Faisalabad, Pakistan Depression & anxiety among cardiac patients

Heart failure (HF) is a chronic illness with high prevalence and mortality, leading toeconomic burden ofhealth due to prolonged hospital stay and re-admissions. Failure to comprehend the importance of identifying mental illnesses could lead to explanations that why the morbidity and mortality of heart failure patients endure to be very high. Objective: To determine the frequency of anxiety and depression in heart failure patients. Methods: It is a descriptive cross sectional study including 323 CHF patients admitted to the Faisalabad Institute of Cardiology hospital, 250 were males and 73 were females, mean age was 54.1 ± 9.2 years having 70 years as maximum and 25 years as minimum.  Data was collected with the help of HADS questionnaire. Patients were interviewed for assessment of anxiety and depression. Data was analyzed using SPSS version 24. Mean and standard deviation was calculated for quantitative data and for qualitative data frequency and percentageswas calculated. To measure the association of anxiety and depression with age categories and gender, chi square test was used. P values less than and equal to 0.05 were taken as significant. Results: The results showed that 43% subjects had <11 score indicating no anxiety, 57% had >11score indicating anxiety. 45% subjects had<11 score indicating no depression, 55% had >11score indicating depression. Conclusions: The study concluded that frequency of depression and anxiety is high in congestive heart failure patients. Strategies are required to assess and diagnose these mental illnesses to establish early treatment which may foster multidisciplinary health care team approach and interventions that address the psychological burden.

Questioning Practices in a Lower Secondary Social Studies Classroom

Asking and answering of questions plays a key role in classroom teaching. Questioning, as a teaching strategy, has a potential to influence students' learning outcomes, especially in high-order thinking which is at the heart of Social Studies classroom practice. This study explored the questioning practices in a lower-secondary co-education social studies classroom in a private school in Karachi, Pakistan. This small-scale study was carried out over seven weeks and employed the qualitative method of data collection, including observations, semi-structured interviews, and focus group discussions. The study found that the classroom practice was revolving around the Initiation- Response-Feedback (IRF) pattern. Teacher's questions dominated the classroom interaction. The teacher asked more questions (181) than students (33). Furthermore, most of the teacher's questions (60%; 108) were low-order. She did ask some high-order (25%; 45) questions. However, she tend to respond to those questions herself. As far as students' questions were concerned, they asked more low-order (52%; 17) questions than high-order (12%; 4). Interestingly, girls asked more questions (17:81%) as compared to the boys (4:19%). While the girls related their active participation to their ‘hard work' and ‘eagerness' to learn, where as the boys found it difficult to participate, because they were less in number' as compared to girls. The study also highlighted some of the possibilities and challenges which influence classroom questioning: teacher's content knowledge and pedagogical skills, classroom environment, and some school factors (time constraints, examination system). It is evident from the findings that classroom questioning is a result of a complex interplay among factors related to teachers (e.g. content knowledge, pedagogical skill, classroom environment, etc) and school's factors (e.g. time constrain and learning for exam). This study provides insight into questioning practices of a Social Studies classroom, using qualitative methods and generating some quantitative information', along with in-depth qualitative data. The findings might prove useful to further the understanding of teaching and learning practices in the Social Studies classroom in the context of the professional development of Social Studies teachers. It also provides a foundation for further research.