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Growth hormone deficiency (GHD) requires long-term hormone replacement therapy, most commonly through daily injections of recombinant human growth hormone (rhGH). Although effective, this daily regimen may lead to poor adherence, particularly in children. Somapacitan, a long-acting growth hormone analog administered once weekly, has emerged as a potential alternative. This systematic review and meta-analysis compares the efficacy, safety, and biochemical outcomes of once-weekly somapacitan with daily Norditropin in patients with GHD. Following PRISMA guidelines (PROSPERO: CRD420251118208), PubMed and CENTRAL were systematically searched up to August 2025. Randomized controlled trials comparing somapacitan with Norditropin in patients with GHD were included. Data were pooled using a random-effects meta-analysis in Review Manager 5.4, and risk of bias was assessed using the Cochrane RoB 2 tool. Ten randomized controlled trials involving 920 participants were included. Somapacitan and Norditropin demonstrated comparable outcomes in height velocity (MD = 0.12; 95
This study examines contemporary Pashto poetry as a critical cultural site where collective trauma, identity, and resistance are articulated under conditions of prolonged militarization and political marginalization in Pakistan. Drawing on Cultural Trauma Theory, the study conceptualizes poetry not merely as an aesthetic form but as a mode of cultural knowledge through which communities narrate suffering, contest dominant power structures, and preserve collective memory. Focusing on the Pashtun regions of Khyber Pakhtunkhwa and the former Federally Administered Tribal Areas (FATA), the analysis explores how poetic discourse represents state violence, surveillance, displacement, and the transformation of Pashtun identity into a securitized and suspect category. Using qualitative textual and thematic analysis, the study examines a corpus of nineteen contemporary Pashto poems produced in the post-2001 conflict context. The findings demonstrate that Pashtun poetry functions simultaneously as testimony, critique, and resistance by exposing the normalization of violence, the marginalization of Pashtun voices, and the unequal valuation of life and death within dominant national narratives. Through metaphor, imagery, silence, and symbolic inversion, poets reclaim narrative agency and challenge imposed representations of Pashtun identity and history. The study further shows how poetry operates as a cultural counter-archive that preserves alternative memories and perspectives often absent from official narratives of war and security. By foregrounding poetic expression as a site where cultural trauma is articulated and contested, this research contributes to trauma studies, postcolonial literary scholarship, and South Asian cultural studies, demonstrating how marginalized communities employ poetry to resist erasure and articulate alternative moral and political imaginaries beyond securitized frameworks.
Employee retention has emerged as a critical strategic priority for organizations navigating the complexities of the 2026 labor market, characterized by high voluntary turnover averaging 15.9% in high-growth regions and shifting workforce expectations (Zoho Connect, 2026). This systematic and thematic literature review examines the effectiveness of flexible benefits, defined as customizable reward systems that allow employees to select benefits according to their financial, health, and lifestyle needs, as a mechanism for improving employee retention. Using a Systematic Literature Review (SLR) approach, the study synthesized peer-reviewed empirical and conceptual studies published between 2015 and 2026 from Scopus and Web of Science using search terms such as “flexible benefits,” “total rewards,” and “turnover intention,” while applying inclusion criteria focused on relevance, recency, and peer-reviewed academic quality. The review identified five dominant themes: personalization within Total Rewards strategies, reduction of burnout through work-life balance, the role of flexible benefits in signaling Perceived Organizational Support (POS), generational differences in benefit preferences, and implementation barriers. Recent studies also emphasize mental health and family-care benefits as major priorities in post-2024 workplace policies (Paychex, 2025). Despite the growing body of literature, significant research gaps remain, particularly the limited evidence from developing economies such as the Philippines, the lack of longitudinal studies examining long-term retention outcomes, and insufficient analysis of how flexible benefits interact with organizational culture and leadership practices. In the Philippine setting, where average pay increases during 2024–2025 struggled to keep pace with inflation, flexible benefits offer a non-inflationary strategy for workforce stability (TheCompany.ph, 2025). Overall, the review concludes that flexible benefits are most effective when implemented as dynamic, employee-centered retention strategies supported by transparent and inclusive organizational practices.
