bluuebunny/crossref_metadata_2025 huggingface dataset:
Goal-oriented care through the eyes of people with chronic conditions
Authors: Boeykens Dagje , Decoster Lara , Lenoir Dorine , De Sutter An , Haverals Reini , Lahousse Lies , Pype Peter , Van de Velde Dominique , Boeckxstaens Pauline , De Vriendt Patricia
Published: January 2024

Background: The healthcare system is faced by an increase in chronic conditions and multimorbidity. People with chronic conditions (i.e., ‘patients’) are often confronted with an overload of tasks (e.g., medication management, control visits) prescribed by multiple providers to manage their conditions. As a result, they are at risk of fragmented care. A strategy to integrate the different processes might be to explicitly focus on the patients’ personal goals. Goal-oriented care (GOC) reorients care from ‘what is the matter with the patient’ to ‘what matters to the patient’ and specifically addresses patients’ personal goals. However, little is known about GOC. Especially about whether and how patients experience GOC during their primary care visits. The aim of this study is to understand the concept of GOC through the patients’ experiences.

Method: Interviews with people with chronic conditions (n=50) were analyzed in two ways. A deductive approach based on the GOC attributes generated in a concept analysis on GOC: goal-elicitation, goal-setting, goal-evaluation, patients’ context, and patients’ needs and preferences. An inductive approach based on a thematic analysis using descriptive phenomenology to identify additional aspects of GOC.

Results: The phase of goal-elicitation was recognized by participants, whereas goal-setting and goal-evaluation were experienced in lesser extent. Regarding the underpinning attributes, mixed feelings were reported concerning the integration of the patients’ context and the presence of their needs and preferences throughout the care process. The inductive analysis revealed specific attention to informing patients about their condition and treatment options and discussing goals in interprofessional collaboration.

Conclusion: Goal-elicitation was already present and seems to be a good foundation for GOC. More attention should be given to goal-setting and goal-evaluation. Developing guidance by means of a workflow, tools, or questions might support people with chronic conditions and providers to underpin the entire care process with the patients’ personal goals.
Becoming Healthier
Authors: Yap Jason
Published: January 2024

To meet the challenges of an ageing population, increasing chronic diseases, and rising healthcare costs, Singapore is embarking on a long-term, multi-year strategic reform to shift care to the community, to improve value for resources expended, and to make the prevention of diseases and complications the focus of the health and social care system. Healthier SG will launch in the middle of 2023 for those aged 60 and above.

The reform will enlist, integrate and enhance the mostly-private primary care sector into primary care networks. Residents will enrol to a selected primary care provider for long-term care relationships based on individualised health plans incorporating primary and secondary preventive activities like lifestyle improvements, health screenings and vaccinations. Social prescribing to community partners will enhance the prevention of disease and complications. Corollary enablers will also be enhanced, from health and social information sharing, to manpower development, to financial incentives and support. Digital Health capabilities like the national patient information repositories and personal trackers will be part of the intended new health ecology.

This presentation will describe the health and social care reform, its origins and drivers and currently intended plan and  desired outcomes, and discuss its theory of change, implementational challenges and potential enablers and barriers for success. In particular, we will discuss the difficulties in the systematic measurement, monitoring and evaluation of a large-scale multi-year reform, and the governance and leadership challenges to maintaining coherence and shaping trajectories in such complex endeavours.
A hospital care coordination team intervention for patients with multimorbidity
Authors: Verhoeff Marlies , De Groot Janke , Van Kan Erik , Peters-Siskens Hanneke , Vermeeren Yolande , Van Munster Barbara
Published: January 2024

Objective: To develop and evaluate a hospital care coordination team intervention for patients with multimorbidity and multiple specialists at the outpatient clinic

Study setting: A middle-large teaching hospital (542 beds) in the Netherlands

Study design: Practice-based, participatory pilot study with mixed-methods, using the Framework for Developing and Evaluating Complex Interventions. The intervention consisted of an intake, a comprehensive review by a dedicated care coordination team, a consultation to discuss results and two follow-up appointments.

Data Collection:  We included adult patients who had visited seven or more outpatient specialist clinics in 2018. We excluded patients with less than two scheduled hospital appointments or if the potential participant was already receiving coordinated care. We collected quantitative and qualitative data on patient characteristics, number and type of recommendations from the comprehensive review, experiences and short-term outcomes.

Principal Findings: 250 patients were assessed for eligibility. We excluded 119 patients, 54 of these patients (21,6%) were deceased at the time of assessment and 28 patients (11,2%) had less than two scheduled appointments. Out of 131 invited patients, 28 participants underwent the intake and comprehensive review. The review produced recommendations for at least two out of three categories (medication, involved medical specialists, other) for 21 participants. Patients’ experienced effects of the intervention ranged from very large to no effect.  Identified key uncertainties of the intervention were finding the best suited patient population and the minimum of required data that can be collected with feasible effort during regular clinical care.

Conclusions: The developed hospital care coordination team intervention resulted in mixed outputs and short-term outcomes. We learned that recruitment and selection should be refined to include patients with multimorbidity who might benefit most. Outcomes of research and clinical care should align as much as possible and focus on evaluating the result of care coordination first.
From Hospital to Home, following a Lower Limb Amputation: A Focus Group Study of Healthcare Professionals views an experience.
Authors: Abrahamsen Charlotte , Dall-Hansen Dorte , Køber Sarah , Schrøder Katja , Evers Chelina D. , Vase Hanne
Published: January 2024

Introduction: Major limb amputations is often associated with loss- a loss of a limb but also independence. Patients undergoing lower limb amputations are often patients with multiple comorbidities, requiring care from numerous healthcare professionals (HCP). It is a patient population with complex needs and limited surplus that might benefit from an integrated care model.

Aim: This study aims to explore Health Care Professionals views and experiences during the transition process from Hospital to Home after a lower limb amputation, using the Safe Journey integrated care program.

Patient population: Patients admitted to hospital for a lower limb amputation, and discharged using the Safe Journey integrated care program.

Method: Two focus group interviews were conducted with 13 HCP’s from a Danish Hospital and three surrounding Municipalities. Included in both groups were nurses, occupational therapists and one physiotherapists. The interview was based on the following 5 questions, and the data was analyzed based on Braun and Clarke´s reflexive thematic analysis.

-Which advantages of the systematic cross-sectoral collaboration did you find?

-Which disadvantages of the systematic cross-sectoral collaboration did you find?

-What do you consider to be most important issues regarding patients transfer?

-What do you consider to be most important issues regarding collaboration?

-How can we ensure safety and continuity when working with patient transfer?

Results: Three themes were identified when analyzing the group interviews.

-Becoming a team across sectors

-Continuity of care as a driver of patients safety

-Challenges in achieving safe transitions

The Safe Journey integrated care program facilitated the construction of an interdisciplinary team and cross-sectoral communication and professional relations, increasing care continuity and patient’s safety. However, HCP’s experienced an increased workload, and The Safe Journey integrated care program was time consuming and required coordination and at-home patient’s visits.

Conclusion: HCP’s found the The Safe Journey integrated care model to be valuable for patients undergoing major lower limb amputation and promotive of cross-sectoral professional relations, communication, continuity and patient safety. However, the model was time- and resource consuming compared to conventional models.

Next step: Our next step will be to create a virtual model of the The Safe Journey integrated care program, to explore is the high quality can be maintained in a less time consuming model.
Healthcare interventions to improve transitions from hospital to home in low-income countries: a scoping review of systematic reviews.
Authors: Mohamedsharif Asma , Gemperli Armin
Published: January 2024

Background: The quality of transition from hospital to home is important for effective healthcare delivery. Hospital discharge is often associated with a lack of continuity that results in fragmented care. Over the past two decades, there have been sustained research activities with intervention addressing transitions. This has generated hundreds of primary studies and lots of systematic reviews. Most of the available guidelines are designed for developed countries. To our knowledge, no study has considered applicability of these interventions in the context of low-income countries.

Objective: We aimed to determine the effectiveness of interventions for transition of care from hospital to home and informed about the relevance of the identified interventions to the context of low-income countries.

Methods: A scoping review of systematic reviews and meta-analyses was performed. The scoping review followed the framework by Arksey and O’Malley. Interventions were classified into effective, ineffective, uncertain or undesirable, based on estimated effects of outcomes (readmission rate, mortality, cost, quality of life and adverse outcomes) and certainty of evidence. Authors from low income country assessed the relevance of the effective interventions for low-income countries using the SUPPORT summary criteria.

Results and discussion: Of 3276 articles that were identified and 72 that were reviewed, a total of 10 were included in the scoping review. A total of 279 individual studies were included across all systematic reviews. Of the 279 trials, 250 (87%) were conducted in high-income countries, none in a low-income country. We created 16 summaries of finding tables. We found seven effective interventions, one ineffective and no intervention with undesirable effect. We were uncertain about the effect of eight interventions. The uncertainty is mainly caused by heterogeneity of included interventions and high risk of bias. The effective interventions were includes home visits, , self-management, virtual ward, case management model and multidisciplinary team models. The relevancy of these interventions to low-income countries is threatened by scarcity of human resources, telecommunication instability and anticipated inequality.

Conclusions: The wide variation in the type of interventions, outcomes, and study designs, suggests that caution be advised in attributing those interventions to all contexts. This study highlights the importance of studies that focus on in-depth understanding of the contextual factors influencing implementations and their dynamics.
Connecting with Rough Sleepers: Community Volunteer Training and Partnership
Authors: Yi Xu , Liu Shuai , Peng Cheng Yu , Lim Su Fee
Published: January 2024

Background: A nationwide study on homelessness in 2019 reported high prevalence of poor health among rough sleepers in Singapore. There are rough sleepers supported by volunteers and community partners within Singapore General Hospital service boundary.  Community nursing team engaged Ministry of Social and Family Development (MSF) Partners Engaging and Empowering Rough Sleepers (PEERS) Network and Homeless Heart, a volunteer group, to reach out to this vulnerable population and to understand challenges faced by volunteers.  The learning needs survey among 39 volunteers was conducted and showed that less than 8% of them were equipped with basic healthcare knowledge and skills. The top three learning needs were i) healthcare resource for homeless (92.1 %), ii) mental Health (68.4%), iii) basic triaging skills (68.4%).

Interventions: A virtual volunteer training programme was developed based on survey findings and inputs from PEERS Network during COVID-19. It was further extended to shelter operators supporting rough sleepers. The training was conducted by community nurses on alternate weekend from February to March 2022. The mode of delivery included didactic teaching and case discussion. A referral process to community nursing for rough sleepers requiring assistance in chronic disease monitoring was established to ensure care continuity. 

Outcomes: A total of 46 participants attended training. All found the program content was useful, relevant to their volunteer activities, and easy to understand. Nearly 80% will recommend this program to their peers. Till date, a total of 5 referrals to Community Nurse Posts were made by volunteers. Nurses conducted health coaching and medication re-consolidation to rough sleepers and also guided volunteers for the subsequent follow up.

Learning Points and Future Plan: It is the first training programme provided by community nurses to volunteers and staff supporting rough sleepers. The programme was tailored to meet participants’ experience and learning needs. Community nursing will further collaborate with PEERS for outreach events and provide onsite training to facilitate effective learning experience. Moving forward, community nurse team will extend the  training program to other community service provides and grassroots volunteer, to support the residents’ physical and psychological well-being  in the community .
Improving outcomes in frail older adults with complex care needs in an ambulatory setting through timely, integrated person-centered care. A case for rapid access frailty clinics in Singapore.
Authors: Lim Jasmine
Published: January 2024

Background: Frailty is a significant risk factor for recurrent hospital admissions and emergency department presentations. Frail older adults are especially vulnerable to hospital related adverse outcomes recognisably functional decline, delirium, institutionalisation and mortality. Fragmentation of care resulting in poorly defined care responsibilities, together with the limitation of community resources to manage acute issues in this group of patients, increase the likelihood of them presenting to an acute care setting.

Methods: A retrospective study evaluated frail older adults seen in an ambulatory Geriatric clinic in a government funded public hospital from 2021 to 2022.  The aim of the study was to determine if timely evaluation of acute issues in an ambulatory setting could avoid a hospital admission or an emergency department presentation. 

Results: Preliminary data in this study showed that (1) timely review of acute issues (<1 week from presentation) led to avoidance of hospital admission, emergency department presentation as well as admission in the next 30 days; (2) the common presentations successfully managed include worsening behavioral and psychological symptoms of dementia (BPSD), delirium, infections and falls; (3) majority of the patients seen were moderately to severely frail based on their clinical frailty score (CFS). Additionally, there was high level of patient and caregiver satisfaction reported.

Conclusion: This study shows that hospital admissions and emergency department presentations can potentially be avoided in frail older adults whose acute medical issues are recognised and managed early. Important contributing factors to the effective management of these patients include: easy accessibility to the primary geriatrician involved, same day investigations, timely follow ups, good social/family support as well as the engagement of community services. Rapid access frailty clinics, a service model built upon the similar recognition that acute issues in frail older adults needed to be addressed promptly, has been described and shown to have benefit elsewhere. In Singapore, innovations in care delivery both within the hospital and in the community has become ever more crucial with an increasingly frail population and in already overwhelmed healthcare institutions. Rapid access frailty clinics can be a useful hospital-based service delivery model to improve care of our frail older adults.
Integrated Broad Intake elevates access to wellbeing in the first line.
Authors: Engelen Marieken
Published: January 2024

Finding the right path to help isn’t easy for a great deal of people. They often don’t know which organization to turn to when looking for this help. In this search, they approach different organizations and caregivers, having to tell their story over and over again. Integrated Broad Intake (IBI) changes that.

IBI makes sure people get referred to the appropriate caregivers or organizations. IBI’s main goal is make sure people get the help they need and are entitled to. IBI aims to find better answers to the needs and questions of people. There are two main objectives:

-Widely accessible organized social care and support

-under protected (vulnerable) people getting what they are entitled to

In IBI three big organizations focused on wellbeing, come together to facilitate the first point of contact in the same way. The first organization is OCMW, the Department of Social Welfare (public), the second is CAW and the third is the social department of the health insurance funds. To realize these 2 objectives they work together offering the same quality of care tot everyone who needs it. They work together with other caregivers in the first line and even with specialized help where needed.

The IBI uses following principles:

-work proactive

-use outreaching

-participative process

-subsidiary use of care

-strength-oriented perspective

-generalist role

When a client comes to one of the three partners, a broad intake is done with clarification of the question (and every question behind this question). With complex cases, when coordination of care is needed, the broad intake is valuable at the start of this coordination.

To best cater to the needs of our clients and further clarify objectives and tools that are needed, some IBI’s have chosen to work with a consultancy agency which uses service design. Service design means you keep putting your client’s needs first. It uses the methodology of co-creation (clients and caregivers) and uses specialized techniques to develop processes and tools ready for implementation. The three partner organisations come together to create new flows, and other stakeholders are added when needed (other caregivers, clients, organisations etc).

IBI usually selects specific target groups to approach and develop processes and tools for. By getting a good understanding of the needs of this target group, the processes and tools you develop better meets the needs of this group. The goal is to learn from what is developed and then use it for other groups. Ultimately, this leads to an extensive collaboration between the three organisations and tools and processes that meets the needs of our clients instead of working supply-driven.
Integrated care pathways between primary, secondary and tertiary health care for Aboriginal and Torres Strait Islander Australians
Authors: Bainbridge Roxanne
Published: January 2024

Empirical evidence and current policy documents strongly indicate a requirement for greater healthcare integration for Aboriginal and Torres Strait Islander people as an extension of the current coordinated care models. System fragmentation and the documented evidence of inadequate care transitions of many Aboriginal and Torres Strait Islander patients test the adequacy and flexibility of health systems to provide access and effective, efficient and appropriate care. Integration across organisations and sectors in the health system is necessary for coordinated patient-centred care that improves patient experiences and health outcomes and adds value to the system by delivering efficiencies. In this project, we aimed to better understand integrated care as a significant quality improvement approach in delivering care between the primary, secondary and tertiary care systems for Aboriginal and Torres Strait Islander people as the first step to real-world design and implementation. Firstly, we used a ‘participatory’ systematic review methodology to identify care processes and effective components needed to support integrated care models between primary, secondary and tertiary care. We focused on the processes involved in its implementation, delivery, and outcomes and impact to develop a conceptual model. Engagement with healthcare providers and community members grounded the theoretical model in real-world contexts. We then tested the model using a jury approach and wargaming, a soft simulation method. The structural reforms needed to ensure effective multistakeholder, multilevel integrated care implementation were identified and priority setting for implementation considered. We will present the developed integrated care model and discuss the inherent opportunities and challenges for implementation.
Big Data and IoT system using a serverless architecture for monitoring and intervention of loneliness in the elderly.
Authors: Jossa Oscar , Osa Ainhoa , Miranda Alberto , Oleagordia Ibon , Gomez Celia , Mendez Amaia , Garcia-Zapirain Soto Begoña
Published: January 2024

An accelerated growth in the life expectancy of the elderly is being caused by medical advancements in recent decades and the decline in birth rates. Therefore, comprehensive care of the elderly represents a major issue. In addition, loneliness and depression have become major emotional disorders of high incidence in this sector of the population, causing difficulty in maintaining an independent life. Thus, this area of attention deserves great attention and intervention. Hence, it is very important the creation of technological tools that provide solutions to the aforementioned problem. This study proposes an IoT system using a serverless architecture, suitable to provide a remote service at home. The system gathers data about the home environment and the residents. The pilot system presents the monitoring stage, which is able to collect data from 6 sensors: presence, temperature, humidity, accelerometer, air quality, and the Fitbit Charge 5. The data is communicated and stored in AWS microservices. In the short term, the objective is to collect data, monitor, and predict patterns using artificial intelligence of variables captured by the system from real users. Additionally, the system will be able to generate alarms when the person is at risk of loneliness or depression to contribute to a rapid intervention. This system intends to provide a personalized solution, with easy implementation and usability, in order to reduce the rates of depression and loneliness in elderly people.
A Comparative Study on Assessment of Depression in Cardiovascular Disease Patients
Authors: Khan Muhammad Arif , Gul Ruqaia , Irshad Erum
Published: January 2024

Aim: To assess depression level in cardiovascular disease patients and compare it with the individual without cardiovascular disease. Methods: A comparative study was conducted to assess the level of depression in cardiovascular disease (CVD) patients. The sample size was 200 (100 CVD patients and 100 non-CVD participants) with a random sampling technique. The Depression, Anxiety, and Stress Scale (DASS-42) was used to assess the level of depression of the study participants. Results: Cardiovascular disease patients recorded significantly higher depression levels than the control group (without CVD). The impact of demographic variables such as gender, age, education and socioeconomic also revealed significant differences in depression level among them. Both, females and elderly CVD patients reported higher depression scores on DASS-42. Depressive level was also higher in CVD patients who had lower levels of education and socioeconomic status. Conclusion: The results of the study revealed that depression is a psychological risk factor and CVD patients. Females, less educated, elderly and with low socioeconomic status CVD patients were more affected. Understanding the complex relationship between mental health issues like depression and cardiovascular disease and impact of gender, education, age and socioeconomic status socioeconomic status has not been researched extensively. Further studies are needed to understand the complexity of these interrelationships Keywords: Depression, Cardiovascular disease, Gender, Age, Education and Socioeconomic status.
Causes, Types and Management of Zygomatic Bone Fracture in Patients Presenting at Tertiary Care Hospital
Authors: Shaukat Ayesha , Nazir Asif , Chauhdry Wajeeha , Hussain Asfar , Khan Tanveer Ahmad , Abbas Nasir
Published: January 2024

Aim: To assess the frequency of different causes, types and management options of zygomatic bone fractures. Method: A cross sectional study was conducted from March 2022 to March 2023 at Oral & Maxillo-Facial Surgery Department, Nishtar Institute of Dentistry, Multan. Seventy two zygomatic bone fracture patients were included meeting inclusion & exclusion criteria after complete clinical & radiological examination.Patient's demographic data, cause, type of fracture and treatment modality executed were collected on a specially designed proforma. Data was analyzed using SPSS version 22. Frequencies, percentages, mean ± standard deviation were taken. Results: Male to female ratio was 3.8:1 with male predominance. Road traffic accident was the leading cause of zygomatic bone fractures (n= 43,60.6%)while Rowe & Kelly’s type IV (inward & posterior) Fracture was most common type of fracture(n=21, 29.2%). ORIF with Two-point fixation was the most common treatment modality executed(n=27,37.5 %). Conclusion: Etiology varies due to geographic area, socio-economic status °ree of RTA. Type fracture depends upon side of impact and Open reduction is modality of choice for the treatment of zygomatic bone fractures. Keywords: Road traffic accidents (RTA);Open reduction & internal fixation (ORIF); zygomatic bone fracture.
Comparison of Musculoskeletal Symptoms of Neck and Shoulder among Different Types of Hand Held Device Users
Authors: Anwar Sabahat , Shaheen Rabia , Hameed Iqra , Farooq Nawal , Sabir Usama Bin , Ghafar Tamjeed , Akdas Efra
Published: January 2024

Background: Prolonged and forceful utilization of hand-held devices has contributed to a global increase in upper extremity and cervical musculoskeletal disorders. These pathologies are directly associated with excessive use of mobile phones and similar devices. Aim: To evaluate the impact of diverse hand-held devices on musculoskeletal (MSK) symptoms in the neck and shoulder and investigate the relation between usage duration and MSK symptoms in the neck and shoulder region. Methods: This study utilized an observational design with a self-structured questionnaire approved by the Department of Physical Therapy at Sargodha Medical College. The sample consisted of 300 young adults aged 21 to 28 years, selected through convenient sampling across different academic years. Data collection involved the distribution of a comprehensive questionnaire, ensuring meticulous responses and privacy. Inclusive criteria included 2nd to final year students, while exclusions maintained homogenity. Results: Among the 300 participants, 76% experienced musculoskeletal discomfort in the neck and shoulder regions, while 24% were asymptomatic. Specifically, 57% reported pain, 16% had numbness, 5% experienced cramping, and 22% felt stiffness. Moreover, 55% of the total population reported some level of pain on Visual Analog Scale, while 45% were pain-free. The study highlights the need for ergonomic design considerations in hand-held devices to minimize the risk of musculoskeletal symptoms in neck and shoulder regions. The findings can guide development of user education programs and workplace interventions to promote proper posture and exercises for individuals using hand-held devices, thereby reducing musculoskeletal discomfort. Conclusion: Excessive utilization of handheld devices is intricately associated with cervico-brachial discomfort, revealing correlations between device typology, duration of usage, postural alignments, and musculoskeletal symptoms. Keywords: Hand-held devices, musculoskeletal symptoms, neck and shoulder discomfort
Work Related Musculoskeletal Complications Experienced by Physical Therapists in Pakistan
Authors: Ali Syed Kashaf , Tauqeer Sana , Ikram Ammarah , Rubab Hafiza Iqra , Wafa Hafiza Sara , Ali Syed Mujtaba
Published: January 2024

Aim: To find out the work related musculoskeletal complications experienced by the physical therapists in Pakistan. Methods: This cross sectional study was conducted on 98 physiotherapists. To gather precise data and address challenges, a self-administered questionnaire was created for demographics. A modified version of the Nordic Questionnaire was used and to locate pain or unpleasant feelings in nine different areas of the body, including the neck, shoulders, elbows, wrists, upper back, lumbar, thighs, knees, and ankles. Utilising a non-probability convenient sampling strategy, the sample size was determined. The Lahore hospitals will be asked for written consent. Data will be gathered from various hospitals in Lahore, including Jinnah Hospital and the UOL teaching hospital. Results: 52% reported that they have feeling trouble in neck during last 7 days. 52% have been feeling any trouble in shoulders. 47.9% have been feeling any trouble in upper back. 41.8% have been feeling any trouble in elbows. 41.8% have been feeling any trouble in wrist/ hands. 60.2% have been feeling any trouble in lower back. 29.5% have been feeling any trouble in hips/thighs. 26.5% have been feeling any trouble in knees. 30.6% have been feeling any trouble in ankles/feet. Conclusion:Physical therapists from Pakistan frequently suffered from work-related musculoskeletal conditions, particularly in the neck, shoulders, wrist, and lower back. Keywords: Physiotherapist, Musculoskeletal, Complications
Frequency of Short Inter-pregnancy Interval in Neonatal Morbidities
Authors: Jameel Madiha , Iftikhar Sabika , . Sadia , Abbas Sumbal , Rasul Fozia Saeed , Karim Sumera Abdul , Anwar Maha
Published: January 2024

Background: The risk of unfavorable perinatal outcomes in the following pregnancy may increase if there has been a short time between the last live birth and the beginning of the current pregnancy. This elevated risk may be brought on by inadequate nutritional replenishment after the delivery of a live newborn, increased cervical insufficiency, or vertical infection transmission after a brief interpregnancy intervals. Aim: To determine frequency of short interpregnancy interval in neonatal morbidities. Study design: The cross-sectional study. Methodology: The Ittefaq hospital's Neonatal ICU served as the study's location. Total 270 neonates, both sexes, 0 to 28 days old, with gestational ages between 37 and 42 weeks (based on a date scan) and birth weights between 2500 and 4000 g were included. Mothers or other witnesses of the included notates were questioned on the time between this pregnancy and the one before it. The term "short interpregnancy interval" (IPI) was used when the time between two successive pregnancies was less than 12 months. Data was analyzed in SPSS 25V. Results: Neonates ranged in age from 13.88 to 7.66 days. Neonatal mortality was 119(44.07%) male and 151(55.93%) female. It took 39.19 weeks on average, plus or minus 1.43 weeks. The average weight at birth was 2720.61 271.56 g. There were 40 neonates (14.81%) with RDS, 58 (14.81%) with NEC, 56 (20.74%) with IVH, 23(8.52%) with ROP, and 93(34.44%) with Sepsis. 200 neonates (74.07%) had a typical inter-pregnancy interval, while 70 (25.93%) had a short inter-pregnancy period. Conclusion: The study's findings indicated that 25.93% of the newborns had short inter-pregnancy intervals, which are frequently associated with neonatal morbidities. IPI is a controllable risk factor for newborn morbidity, hence it is important to urge families to choose the recommended birth spacing. Early identification of this high-risk group can help to prevent negative neonatal outcomes and identify deliveries that may require the attendance of a pediatrician. Keywords: Birth spacing, interpregnancy interval, neonatal morbidity, RDS, NEC, IVH, ROP, Sepsis
Immunization Coverage of Covid-19 among Attendants Accompanying Patients in Gulab Devi Hospital-Pakistan
Authors: Ali Muhammad Mansoor , Zubair Muhammad , Abdullah Muhammad Umer , Javed Muhammad Ahmad , Wazir Muneeza , Javed Fizza , Chaudhari Muntha , Niaz Zahra
Published: January 2024

Background: Covid-19 is one of the major pandemics and health crisis in global history along with SARS-CoV & MERS-CoV. Aim: To find the frequency and distribution of coverage of Covid-19 vaccination among attendants accompanying the patients in Gulab Devi Hospital. Methodology: This cross sectional study used convenience sampling technique. The study population comprised of 386 respondents estimated via S size software. Our data collection team visited various wards & OPDs of hospitals & conducted interviews for the purpose. A structured questionnaire was filled for obtaining the data. Frequency and percentages were calculated for categorical variables while mean and standard deviation was calculated for numeric variable by using SPSS v-23. Results: The vaccination coverage of Covid-19 Immunization was as follows: 69% of our respondents were partially Vaccinated (1 or 2 doses), 14% fully vaccinated (3 or more doses) 17% were non vaccinated. Conclusions: Significant proportion of the participants were partially vaccinated or not vaccinated against COVID-19, indicating the need for further efforts to improve vaccination coverage thus findings emphasized the need for targeted educational campaigns. Keywords: COVID-19, Vaccination Coverage, Attendants, Effectiveness and Response Rate.
Prevalence of Gunshot Injuries Seen in Robbery Cases in Karachi and their Characteristic Features
Authors: Ali Gulzar , Naz Ramlah , Fatima Mehreen , Tirmizi Zubair Ahmed , Ahmed Rafay , Irshad Raheela
Published: January 2024

Aim: To determine the prevalence of gunshot injuries seen in robbery cases at different locations in Karachi and their characteristic features. Methodology: This retrospective observational study was conducted from January to December 2022 at the Office of the Police Surgeons in Karachi and comprised 63 gunshot cases. . Information related to the physical and internal examination of the cases was included. Death features like the presence of rigour mortis, post-mortem lividity, and bleeding status were also included. Results: The mean age was 35.30 ± 14.15, and 95.2% were males. Most of the cases were reported in Ittehad Town (20.6%), with 92.1% of participants having blood stains on their clothes. Around 88.9% had an average physique. Almost 84.1% were developing rigour mortis, 61.9% had post-mortem lividity and 87.3% had identifiable features. Exactly 50.8% of cases were not oozing blood from any wound or site. Internal examination was performed in 46% of the cases. Of which, 19% of participants still had the bullet inside their bodies. It was found that 57.1% of participants instantly died after the gunshot, while 34.9% died within a few minutes, respectively. Most of the participants received gunshots on their chests (n=35), and most of the participants received 2 to 4 bullets at a time (n=67). Conclusion: The high prevalence rate of gunshot injuries during robbery in Karachi. Higher authorities should strictly follow up on the increased number of casualties, and law and enforcement policies should be strictly followed to avoid further such cases. Keywords: Prevalence, Gunshot injuries, Robbery, Characteristic features
Heterogeneity of reservoirs of the Qala suite (on the example of the Neft Dashlary field)
Authors:   «OilGasScientificResearchProject» Institute, SOCAR, Baku, Azerbaijan, Isgandarov M. M. , Abuzarova A. H. ,   «OilGasScientificResearchProject» Institute, SOCAR, Baku, Azerbaijan, Kerimova E. G. ,   «OilGasScientificResearchProject» Institute, SOCAR, Baku, Azerbaijan, Gumbatov A. S. ,   «OilGasScientificResearchProject» Institute, SOCAR, Baku, Azerbaijan
Published: January 2024

In order to study the heterogeneity of reservoir rocks based on core materials and well logging data, an analysis of the lithological-petrographic and reservoir properties of the rocks of the Qala suite of the PS of the Neft Dashlary field was carried out. For a more detailed study, an analysis of laboratory data on subformations (QaS1, QaS2, QaS3 and QaS4) has been carried out, the grainsize composition and reservoir properties (porosity, clay content, permeability and carbonate content) of reservoir rocks were studied. Based on the results of logging data interpretation and analysis of the constructed correlation schemes, heterogeneity, including the study of reservoirs thickness and the variability of their reservoir properties over the area have been studied. Keywords: Kalinskaya suite; Core; Logging; Heterogeneity.
To the question of the study of a vibration device to eliminate seizures during the construction of oil and gas wells
Authors:   Almetyevsk State Oil Institute, Almetyevsk, Russia, Khuzina L. B. , Shaykhutdinov A. F. ,   Almetyevsk State Oil Institute, Almetyevsk, Russia, Kazimov E. A. ,   «OilGasScientificResearchProject» Institute, SOCAR, Baku, Azerbaijan
Published: January 2024

The drilling process is one of the most expensive steps in the construction of an oil well. Therefore, methods that reduce drilling costs without compromising the quality of well construction are always in demand by oil companies. As a rule, specialists in the field of drilling seek to increase the rate of penetration, reduce the number of round trips, eliminate accidents due to tool breaks, ensure uniform weight on bit, reduce time spent on eliminating complications, etc. Among these approaches, a special place is occupied by the technology of using vibration devices to prevent sticking of the drill string. The article presents theoretical studies of the operation of the device for dynamic impact on the bottomhole, allowing to assess the influence of design factors on its operation. The performed studies allow us to recommend the use of the device in a single bottomhole assembly to create pulsating flushing and dynamic loading of the bit. The obtained research results can be used in the design of downhole assemblies of various sizes with hydraulic vibrators for drilling wells. Keywords: Well Drilling; Horizontal Section; Sticking; Weight On Bit; Device; Vibration; Friction.
Proposta didática e Ensino de Geografia
Authors: Barci Andressa , Sacramento Ana
Published: January 2024

Contexto: O ensino dos conteúdos voltados para pensar a cidade a partir do conceito de paisagem colabora na Geografia em trabalhar com as práticas socioespaciais dos estudantes para que eles possam mobilizar seus conhecimentos e contextualizar o que estejam aprendendo na escola a partir da aprendizagem significativa. Desta maneira, o objetivo deste texto é analisar a importância da discussão da paisagem para o ensino de Geografia a partir da proposta didática sobre Silva Jardim-RJ para turmas do 6º ano do ensino fundamental anos finais. Metodologia: A partir da pesquisa-ação que é uma metodologia dinâmica e ativa, pois os sujeitos estão em processo de ação, de construção, de produção. Assim, o desenvolvimento da pesquisa está articulado em quatro partes: a) apresentação e atividade realizada pelos estudantes; b) apresentação da discussão da paisagem; c) análise da paisagem da cidade de Silva Jardim e d) realização da maquete. Considerações: A partir disso podemos concluir que os estudantes aprenderam novos conceitos e conteúdos sobre a cidade e a paisagem, uma vez que eles responderam e participaram das atividades propostas e conseguimos compreender o avanço na interpretação e análise dos conceitos trabalhados.
Entre vivência experiências e reflexões
Authors: Souza Katiurce , Silva Vanessa , Simplicio Geiza , Souza Sirius
Published: January 2024

Contexto: O presente relato descreve as experiências vividas pelos residentes pedagógicos durante o primeiro módulo do Programa Residência Pedagógica (PRP) na área de Geografia. O programa foi desenvolvido no Colégio Estadual Professora Hilda Monteiro de Menezes, na cidade de Campo Formoso/BA, como parte do subprojeto de Geografia da Universidade Federal do Vale do São Francisco (UNIVASF), Campus Senhor do Bonfim/BA. Destaca-se a relevância do PRP para a formação dos futuros docentes de Geografia. Metodologia: O relato aborda os três períodos que compuseram o módulo do PRP. O primeiro período foi de formação, com a participação em eventos, palestras, workshops, cursos e seminários formativos oferecidos pelos residentes para a comunidade acadêmica. O segundo período foi dedicado ao planejamento do programa, enquanto o terceiro período foi o mais significativo, com a regência presencial que durou aproximadamente dez semanas. As experiências e aprendizagens durante esses períodos foram registradas em um diário de bordo, que contribuiu para fortalecer a formação teórico-prática e o processo de ensino-aprendizagem dos futuros docentes.  Considerações: O relato ressalta a importância e relevância do programa para a formação docente, destacando as reflexões, vivências, aprendizagens e conhecimentos adquiridos pelos residentes pedagógicos ao longo do PRP.
The medium-term effects of investment stimulus.
Authors: Domínguez-Díaz Rubén , Hurtado Samuel , Menéndez Carolina
Published: January 2024

This paper presents an endogenous growth general equilibrium model (EGGEM) of firm dynamics and innovative investment for the Spanish economy that allows the medium-term effects of economic policies and shocks to be better understood. The model is calibrated using both aggregate and firm-level data. It is then used to assess the medium-term macroeconomic consequences of the different components of the Next Generation EU (NGEU) programme, including public investment, private capital transfers and innovative investment transfers. According to our baseline simulation, the NGEU funds significantly foster economic activity by raising aggregate productivity, private investment and employment. As a result, annual GDP growth is increased by 0.17 percentage points on average over the period of NGEU disbursement. Among the different policy instruments considered, we find that innovation transfers have the largest impact on aggregate output, only matched by increases in the stock of public capital if it is highly efficient.
Making it easier to register a science blog with Rogue Scholar
Authors: Fenner Martin
Published: January 2024

Yesterday I had to fix a bug in the Rogue Scholar registration form (a software regression that happened over the holidays related to database row level security). This was a reminder that registering a science blog with the Rogue Scholar science blog archive should be quick and painless. Today I made one change that hopefully simplifies registration: Ask for the blog homepage instead of the RSS feed URL.
Doramas e comportamento dos fãs no consumo de bens derivados da cultura asiática: uma análise a partir da mediação da informação
Authors: Moura Maitê Anselmo de , Farias Maria Giovanna Guedes
Published: January 2024

Introdução: Esta pesquisa tem como objetivo analisar se a mediação da informação, realizada pelos perfis de doramas no Instagram, afeta o comportamento dos fãs no consumo de bens derivados da cultura asiática. Método: No processo metodológico, utilizou-se a abordagem quantitativa-qualitativa, sendo um estudo de nível exploratório. Os dados foram coletados por meio de um questionário e analisados com o uso da técnica de análise de conteúdo. Resultados: Os resultados demonstram que, para os fãs, é relevante manter engajamento com o conteúdo dos perfis, além de considerarem relevante a mediação realizada pelos perfis, pois, do contrário, seria difícil manter um contato ativo com a comunidade se essa ação mediadora fosse inexistente. Além disso, verificou-se que a maioria dos fãs, enquanto consumidores do conteúdo mediado, transformam seus hábitos sob diversos aspectos, não se tratando apenas de consumir os doramas, mas pertencer à cultura que é propagada por meio deles. Conclusão: Destarte, conclui-se que a mediação da informação realizada pelos perfis de doramas, na rede social Instagram, impulsionam os fãs a consumirem bens culturais advindos da Ásia.
Analysis of the Advantages of Trademark Registration Offer Compared with Relying on Unfair Competition or Passing-off to Enforce Rights over Trademarks
Authors: Feng Yiteng
Published: January 2024

Compared with relying solely on unfair competition or trademark infringement to maintain brand rights, trademark registration has obvious advantages. It provides statutory protection, ensuring that the rights of trademark owners are guaranteed by law. This registration also grants the exclusive right to use the mark, preventing others from using similar marks that may cause confusion. One of its most important benefits is the presumption of validity in court, thereby putting the onus on the challenger to prove otherwise. Once a trademark is registered, it is protected nationwide, regardless of where it is first used. In the event of infringement, a registered trademark can secure greater damages, potentially deterring illegal use. The enforcement procedure for registered trademarks is more streamlined, which facilitates faster resolution of issues. Registration can be a springboard for international expansion, allowing businesses to register trademarks in other countries more seamlessly. Essentially, for businesses keen to maintain their brand reputation and image, trademark registration is a better choice due to its comprehensive advantages.
E-commerce Industry Supply Chain: Status, Problems and Countermeasures
Authors: Hou Jianan
Published: January 2024

In recent years, the e-commerce industry has been developing rapidly, and at the same time, the quality level of e-commerce industry development is limited by the level of supply chain technology development. As a result, the development of supply chain technology has become the core of the driving force for various enterprises to pursue development. This paper analyses the supply chain status quo of e-commerce industry, finds the problems of excess inventory leading to backlogs, high loss rate of goods leading to waste of resources, and negative impacts caused by failure to deliver on time, and proposes the establishment of perfect supply chain management norms, the establishment of incentives, and the establishment of a research department; the use of cold chain transport, multi-modal transport, the use of automated systems, the establishment of inventory systems, the upgrading of technology, the enhancement of training, regular inspection and maintenance of equipment; the enhancement of management and management of equipment. Regular inspection and maintenance of equipment; strengthening management, improving risk control, establishing a supply network, optimizing routes, and improving service quality are some of the solutions.