Risk factors associated with gallstone disease in women
- Paracha, Parvez, Asif, Yasmin, Vriesekoop, Frank, Ullah, Shahid, Abbas, Muhammad, Paracha, Saima, Khan, Tariq
- Authors: Paracha, Parvez , Asif, Yasmin , Vriesekoop, Frank , Ullah, Shahid , Abbas, Muhammad , Paracha, Saima , Khan, Tariq
- Date: 2012
- Type: Text , Journal article
- Relation: e-SPEN Journal Vol. 7, no. 3 (2012), p. e129-e134
- Full Text: false
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- Description: Background & aims: Gallstone disease in middle-aged women has been increasing due to changing dietary and environmental factors varying from country to country. The aim of the study was to determine the risk factors associated with gallstone disease in women aged ≥35 years of the district of Peshawar, Pakistan. Study design: A hospital-based case-control study. Methods: One hundred and ten women (55 cases and 55 controls) attending the Surgical Departments of two Government hospitals were enrolled for the study. All subjects were screened for ultra-sonography; biochemical and anthropometric measurements. They were interviewed for their past medical history; physical activity; 24-hr dietary recall and for demographic and socio-economic characteristics. Data were analyzed using Student's t-test, chi-square and multivariate conditional logistic regression to determine mean differences between the continuous variables; establish association between the categorical variables and to determine risk factors associated with gallstone disease, respectively. Results: Of 55 cases, 15 (27%) had a family history of gallstone disease. Thirty five percent of the cases had a single calculus while 65% had multiple calculi with mean size of 14.85 ± 14.46 mm. Conditional logistic regression analysis demonstrated that the body mass index was the most significant risk factor for women's gallstone disease. The adjusted odds ratio for women's BMI ≥ 25 kg/m 2 was 2.93 (95% CI: 1.43-6.01), indicating almost a three times higher risk of gallstone disease than women with BMI < 25 kg/m 2. The risk of gallstone disease was higher for women with low vitamin C intake (OR = 0.27; 95% CI: 0.08-0.91) and low physical activity (OR = 0.48; 95% CI: 0.24-0.96) than women with more physically active (score > 1.3) and having dietary vitamin C intake ≥ 75 mg per day. Conclusion: High body mass index, physical inactivity and low vitamin C intake are associated with gallstone disease in Pakistani women. Longitudinal studies are needed to confirm these findings. © 2012 European Society for Clinical Nutrition and Metabolism.
To remain, migrate abroad or resettle : a complex dynamic process affecting Pakistani physicians' career decisions
- Arif, Muhammad, Cruickshank, Mary, Fraser, John
- Authors: Arif, Muhammad , Cruickshank, Mary , Fraser, John
- Date: 2019
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 14, no. 3 (2019), p.
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- Description: OBJECTIVE This study investigated Pakistani physicians' decision-making concerning their decisions to stay in Pakistan, migrate abroad, or resettle back into their country after working abroad. METHODS This qualitative study employed a phenomenological research design. Thirteen Pakistani physicians characterised as 'stayers', 'leavers' and 'resettlers' were interviewed via telephone to explore their lived experience in 2008-2009. RESULTS Results show a dynamic nature of the physicians' career decision-making depending on their constant weighing of complex personal, family, professional and societal factors. Stayers, leavers and resettlers are not mutually exclusive groups but rather individual physicians' can move between these groups at different stages of career and life. Physicians vary in their decision making. Stayers and resettlers place more emphasis on personal and family reasons and societal factors providing there is a permanent job for them. Leavers focus on health system problems and recent societal problems of personal and societal insecurity. CONCLUSIONS The findings of this study indicates that physician migration, retention and resettlement is a complex issue and there are multiple personal, social, political and economic factors that affect their decisions to stay, move abroad or resettle back into their countries. Therefore, it is recommended that future research focusing on health workers retention, migration and resettlement issues look at it from a holistic perspective rather than focusing only on the economic and professional imperatives. The findings of this study have international implications for health care managers dealing with a highly mobile international medical workforce. Strategies considering different stages of the physician career/ life cycle need to highlight the importance of identity, belonging and place as doctors weigh this with career goals. © 2019 Asia Pacific Journal of Health Management. All Rights Reserved.
- Authors: Arif, Muhammad , Cruickshank, Mary , Fraser, John
- Date: 2019
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 14, no. 3 (2019), p.
- Full Text:
- Reviewed:
- Description: OBJECTIVE This study investigated Pakistani physicians' decision-making concerning their decisions to stay in Pakistan, migrate abroad, or resettle back into their country after working abroad. METHODS This qualitative study employed a phenomenological research design. Thirteen Pakistani physicians characterised as 'stayers', 'leavers' and 'resettlers' were interviewed via telephone to explore their lived experience in 2008-2009. RESULTS Results show a dynamic nature of the physicians' career decision-making depending on their constant weighing of complex personal, family, professional and societal factors. Stayers, leavers and resettlers are not mutually exclusive groups but rather individual physicians' can move between these groups at different stages of career and life. Physicians vary in their decision making. Stayers and resettlers place more emphasis on personal and family reasons and societal factors providing there is a permanent job for them. Leavers focus on health system problems and recent societal problems of personal and societal insecurity. CONCLUSIONS The findings of this study indicates that physician migration, retention and resettlement is a complex issue and there are multiple personal, social, political and economic factors that affect their decisions to stay, move abroad or resettle back into their countries. Therefore, it is recommended that future research focusing on health workers retention, migration and resettlement issues look at it from a holistic perspective rather than focusing only on the economic and professional imperatives. The findings of this study have international implications for health care managers dealing with a highly mobile international medical workforce. Strategies considering different stages of the physician career/ life cycle need to highlight the importance of identity, belonging and place as doctors weigh this with career goals. © 2019 Asia Pacific Journal of Health Management. All Rights Reserved.
An exploratory study of factors influencing pakistani physicians' retention and resettlement career decisions
- Arif, Muhammad, Fraser, John, Cruickshank, Mary
- Authors: Arif, Muhammad , Fraser, John , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Ayub Medical College, Abbottabad : JAMC Vol. 34 , no. 3 (2022), p. S649-S659
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- Description: Background: The recruitment, retention and migration of health workers is a global phenomenon. The literature shows push factors associated with leaving rural areas and developing countries in general are explored in depth. However importantly, some health workers behave differently and decide to stay in or return to a developing country. Less is known about the reasons/ pull factors of this groups' decision making. Methods: This paper aims to explore the perceptions of Pakistani physicians regarding their career decisions to remain in their country, or resettle back after working abroad for some time. Thirteen Pakistani physicians were interviewed via telephones who were working in Pakistan and Australia. Results: The motivation for Pakistani physicians to remain or resettle back into their country stems from the perceived better quality of life in Pakistan compared to the better standard of life overseas. Other reasons include a perceived differentiation between locals and non-locals abroad and the availability of a permanent job in Pakistan. Conclusion: The main factors that contributed to Pakistani physicians' retention and resettlement decisions were mostly personal and family or societal factors and there was a minimal role for professional or health system related factors in their career decisions, except for the availability of permanent jobs in Pakistan.
- Authors: Arif, Muhammad , Fraser, John , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Ayub Medical College, Abbottabad : JAMC Vol. 34 , no. 3 (2022), p. S649-S659
- Full Text:
- Reviewed:
- Description: Background: The recruitment, retention and migration of health workers is a global phenomenon. The literature shows push factors associated with leaving rural areas and developing countries in general are explored in depth. However importantly, some health workers behave differently and decide to stay in or return to a developing country. Less is known about the reasons/ pull factors of this groups' decision making. Methods: This paper aims to explore the perceptions of Pakistani physicians regarding their career decisions to remain in their country, or resettle back after working abroad for some time. Thirteen Pakistani physicians were interviewed via telephones who were working in Pakistan and Australia. Results: The motivation for Pakistani physicians to remain or resettle back into their country stems from the perceived better quality of life in Pakistan compared to the better standard of life overseas. Other reasons include a perceived differentiation between locals and non-locals abroad and the availability of a permanent job in Pakistan. Conclusion: The main factors that contributed to Pakistani physicians' retention and resettlement decisions were mostly personal and family or societal factors and there was a minimal role for professional or health system related factors in their career decisions, except for the availability of permanent jobs in Pakistan.
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