Women's rights in Pakistan: a forensic perspective

Pakistan is a large and an important West Asian country which came into being in the name of Islam and therefore Islamic tenets remain the core of its constitution. The laws of the state have to conform to Islamic law so that they can have a positive impact on the society. Unfortunately, in Pakistan today not all men enjoy the rights and facilities to which they are entitled and women are doubly disadvantaged by poverty and gender. With their own political agendas, various governments have promulgated laws which affect the society in various ways. The laws which directly influence women's rights merit mention, as women comprise more than 50% of the population of Pakistan and are still kept on the sidelines by the male dominant society. The Muslim Family Law Ordinance, 1961, and the Hudood Ordinance, 1979 were both promulgated by military dictators with different visions. The former codified the rights of women bestowed by Islamic law; the latter repealed laws for sexual offences according to the injunctions of Islam and had a negative impact. Both laws need the assistance of forensic medicine as age estimation and medical examinations are necessary if they are to be followed in the right perspective. However, a legal need for an examination by an expert in forensic medicine is sadly lacking in both laws. This has happened due to lack of training of forensic physicians and therefore a lack of research in important areas of forensic medicine in the country. This paper examines these laws and the interaction they have with forensic medicine and proposes that the laws need revision in accordance with modern science, incorporating forensic sciences as well as the injunctions of Islam.     

Protocol-Driven Decision Support within e-Referral Systems to Streamline Patient Consultation,Triaging and Referrals from Primary Care to Specialist Clinics

Patient referral is a protocol where the referring primary care physician refers the patient to a specialist for further treatment. The paper-based current referral process at times lead to communication and operational issues, resulting in either an unfulfilled referral request or an unnecessary referral request. Despite the availability of standardized referral protocols they are not readily applied because they are tedious and time-consuming, thus resulting in suboptimal referral requests. We present a semantic-web based Referral Knowledge Modeling and Execution Framework to computerize referral protocols, clinical guidelines and assessment tools in order to develop a computerized e-Referral system that offers protocol-based decision support to streamline and standardize the referral process. We have developed a Spinal Problem E-Referral (SPER) system that computerizes the Spinal Condition Consultation Protocol (SCCP) mandated by the Halifax Infirmary Division of Neurosurgery (Halifax, Canada) for referrals for spine related conditions (such as back pain). The SPER system executes the ontologically modeled SCCP to determine (i) patient’s triaging option as per severity assessments stipulated by SCCP; and (b) clinical recommendations as per the clinical guidelines incorporated within SCCP. In operation, the SPER system identifies the critical cases and triages them for specialist referral, whereas for non-critical cases SPER system provides clinical guideline based recommendations to help the primary care physician effectively manage the patient. The SPER system has undergone a pilot usability study and was deemed to be easy to use by physicians with potential to improve the referral process within the Division of Neurosurgery at QEII Health Science Center, Halifax, Canada.     

PopAffiliator: online calculator for individual affiliation to a major population group based on 17 autosomal short tandem repeat genotype profile

Because of their sensitivity and high level of discrimination, short tandem repeat (STR) maker systems are currently the method of choice in routine forensic casework and data banking, usually in multiplexes up to 15?C17 loci. Constraints related to sample amount and quality, frequently encountered in forensic casework, will not allow to change this picture in the near future, notwithstanding the technological developments. In this study, we present a free online calculator named PopAffiliator (http://cracs.fc.up.pt/popaffiliator) for individual population affiliation in the three main population groups, Eurasian, East Asian and sub-Saharan African, based on genotype profiles for the common set of STRs used in forensics. This calculator performs affiliation based on a model constructed using machine learning techniques. The model was constructed using a data set of approximately fifteen thousand individuals collected for this work. The accuracy of individual population affiliation is approximately 86%, showing that the common set of STRs routinely used in forensics provide a considerable amount of information for population assignment, in addition to being excellent for individual identification.     

Applying Social Network Analysis to Understand the Knowledge Sharing Behaviour of Practitioners in a Clinical Online Discussion Forum

Background

Knowledge Translation (KT) plays a vital role in the modern health care community, facilitating the incorporation of new evidence into practice. Web 2.0 tools provide a useful mechanism for establishing an online KT environment in which health practitioners share their practice-related knowledge and experiences with an online community of practice. We have implemented a Web 2.0 based KT environment—an online discussion forum—for pediatric pain practitioners across seven different hospitals in Thailand. The online discussion forum enabled the pediatric pain practitioners to share and translate their experiential knowledge to help improve the management of pediatric pain in hospitals.

Objective

The goal of this research is to investigate the knowledge sharing dynamics of a community of practice through an online discussion forum. We evaluated the communication patterns of the community members using statistical and social network analysis methods in order to better understand how the online community engages to share experiential knowledge.

Methods

Statistical analyses and visualizations provide a broad overview of the communication patterns within the discussion forum. Social network analysis provides the tools to delve deeper into the social network, identifying the most active members of the community, reporting the overall health of the social network, isolating the potential core members of the social network, and exploring the inter-group relationships that exist across institutions and professions.

Results

The statistical analyses revealed a network dominated by a single institution and a single profession, and found a varied relationship between reading and posting content to the discussion forum. The social network analysis discovered a healthy network with strong communication patterns, while identifying which users are at the center of the community in terms of facilitating communication. The group-level analysis suggests that there is strong interprofessional and interregional communication, but a dearth of non-nurse participants has been identified as a shortcoming.

Conclusions

The results of the analysis suggest that the discussion forum is active and healthy, and that, though few, the interprofessional and interinstitutional ties are strong.     

Increasing the reference populations for the 55 AISNP panel: the need and benefits

Ancestry inference for an individual can only be as good as the reference populations with allele frequency data on the SNPs being used. If the most relevant ancestral population(s) does not have data available for the SNPs studied, then analyses based on DNA evidence may indicate a quite distantly related population, albeit one among the more closely related of the existing reference populations. We have added reference population allele frequencies for 14 additional population samples (with >1100 individuals studied) to the 125 population samples previously published for the Kidd Lab 55 AISNP panel. Allele frequencies are now publicly available for all 55 SNPs in ALFRED and FROG-kb for a total of 139 population samples. This Kidd Lab panel of 55 ancestry informative SNPs has been incorporated in commercial kits by both ThermoFisher Scientific and Illumina for massively parallel sequencing. Researchers employing those kits will find the enhanced set of reference populations useful.

     

An Intelligent Tele-Healthcare Environment Offering Person-Centric and Wellness-Maintenance Services

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift—patient centerd services as opposed to provider centerd services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE—Tele–Healthcare Information and Diagnostic Environment. TIDE manifests an intelligent healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services—i.e., both wellness maintenance and illness management services—ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role—spanning from wellness to illness issues—the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro–active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies—Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics—to implement a sophisticated healthcare delivery infostructure.     

STR data for the AmpFlSTR Identifiler loci in Kuwaiti population

Allele frequencies for 15 STR loci included in AmpFlSTR((R)) Identifiler((R)) kit were ascertained in a sample population of 502 unrelated Kuwaiti individuals. Allele frequencies were compared with 6 Caucasian populations using an exact test. This showed that the Kuwaiti population was very similar to the neighboring Iraqi and Saudi populations. As the geographical distance between the populations increased, as expected, more differences were observed. Relevant forensic parameters were also determined.     

Evaluation of an online discussion forum for emergency practitioners

Knowledge is a critical element in the delivery of quality healthcare. In a busy emergency department (ED) clinicians attempting clinically relevant discussion with their peers face multiple interruptions and a lack of sustained meaningful interactions. Information and communication technologies such as online discussion forums enable practitioners to share practice knowledge at times that fit into their daily workflow. We conducted an experiment in which we provided emergency clinicians with access to an asynchronous discussion forum as a medium to support development of an online social network for information exchange. The outcomes were evaluated using a social network perspective to better understand the knowledge seeking and sharing behaviors among rural and urban emergency practitioners participating in the online discussion forum. The online discussion forum created an opportunity for emergency practitioners from multiple ED sites to engage in dialogue around topics that were relevant to their practice learning needs.     

STR data for the AmpFlSTR SGM Plus loci from two South Asian populations

Using the Applied Biosystems' AmpFlSTR SGM Plus PCR amplification kit, we studied the allele frequency distribution of 10 STR loci in two south Asian populations: one from the Gujarat region of India represented by 172 unrelated Gujaratis, now resident in England; and a Pakistani population, represented by 155 unrelated individuals. Gujarat borders southeast Pakistan. There were no significant deviations from Hardy-Weinberg equilibrium in either population after Bonferroni correction. The combined power of discrimination and exclusion for the Indian population were 0.999999999999544 and 0.9999785, respectively; for the Pakistani population, they were 0.999999999999865 and 0.9998975, respectively. F(ST) (or theta) between these two populations was estimated as 0.00146.