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Definition of near miss mortality - a woman who survives a severe life-threatening condition (either after receiving emergency medical or surgical intervention or otherwise) during pregnancy, childbirth or within 42 days of termination of pregnancy.1 Maternal mortality is the death of a woman during pregnancy, childbirth or 42 days after termination of pregnancy. Women with life threatening condition (WLTC) refers to all women whowere either maternal near miss or who died. (WLTC = MNMM + MM) Objectives: To study the incidence of maternal near miss mortality and underlying factors leading to maternal near miss mortality. Methodology: The present a facility based prospective observational study carried from January 2021 till June 2022, i.e., for 18 months involving all the cases that fulfilled criteria for near miss mortality that came to this institute were considered for this study. Results: Majority of patients were booked and registered under government setups - 77 (81.05%). Majority of patients were near miss on admission - 78 (82.10%). According to this study, most common underlying causes of MNMM at this tertiary care centre are Hypertensive disorders - 46 (48.42%), followed by anaemia - 18 (18.94 %) cases. Maternal near miss incidence ratio in our study was 9.6 every 1000 livebirths. Maternalnearmissrate in our study was 8.8 every 1000 obstetricadmissions. Severe maternal outcome ratio was 15.18 every 1000 live births. Conclusion: Maternal near miss incidence ratio in our study was 9.6 every 1000 live births. Maternalnear miss rate in our study was 8.8 every 1000 obstetricadmissions. Severe maternal outcome ratio was 15.18 every 1000 live births. Most common underlying causes of MNMM at this tertiary care centre are Hypertensive disorders - 46 (48.42%), followed by anaemia - 18 (18.94 %) cases. [ABSTRACT FROM AUTHOR]

The influence of the principle of parsimony (Ockham's razor) in diagnostic reasoning started from the foundation of modern medical education by Sir William Osler and, until today, it is the most widely used heuristic method in the clinical practice. In this context, the principle proposes that the minimum number of causes that explains all the symptoms and not multiple individual diagnoses should be sought. However, it has been the object of multiple criticisms for its absolute authority in clinical judgment; the main one is Hickam's dictum that establishes "a patient can have as many diseases as he wants", emphasizing that more than one disease can be responsible for the signs and symptoms. This paper offers a historical and critical perspective of the dilemma in diagnostic thought that allows it to be used as a tool for reflection in medical action. [ABSTRACT FROM AUTHOR]

• Improvement in detection and anticipation of placental complications may be effective in addressing the increasing trend of PPH • Increasing C-sections trends and other interventions may also need to be addressed while quality improvement projects will have a role to play. • Further staff education to upskill to reduce the incidence of unintentional cutting during caesarean section and episiotomies. To analyse temporal trends for primary Postpartum Haemorrhage (PPH), Major Obstetric Haemorrhage (MOH) between 2005 and 2021 and to examine the causes and factors contributing to the risk of PPH during 2017–2021. International ICD-10-AM diagnostic codes from hospital discharge records were used to identify cases of PPH. Temporal trends in PPH and MOH incidence were illustrated graphically. Poisson regression was used to assess the time trends and to examine factors associated with the risk of PPH during 2017–2021. A total of 1,003,799 childbirth hospitalisations were recorded; 5.6% included a diagnosis of primary PPH. Risk increased almost fourfold from 2.5% in 2005 to 9.6% in 2021. The ICD-10 AM code for other immediate primary PPH was recorded for 85% of PPH cases in 2017–2021 whereas a diagnosis of uterine inertia/atony was associated with just 3.6% of the cases. Respectively, trauma-related, tissue-related and thrombin-related causes were associated with one third, 4.2% and 0.5% of cases. A wide range of factors relating to the woman including comorbidities, mode of delivery, labour-related interventions and associated traumas increased risk of PPH but placental complications, especially morbidly adherent placenta, were strong risk factors. Improvement in detection and anticipation of placental complications may be effective in addressing the increasing trend of PPH, however, the trends of increasing C-sections and other interventions may also need to be addressed while staff education and quality improvement projects will have a role to play. [ABSTRACT FROM AUTHOR]

Background: Newborn cholestasis is explained as a persisted rise of the serum conjugated bilirubin outside the first two weeks of life. There are many etiologies of newborn cholestasis that must be differentiated since immediate interference may give a better outcome. Objective: Newborn cholestasis is explained as a persisted rise of the serum conjugated bilirubin outside the first two weeks of life. There are many etiologies of newborn cholestasis that must be differentiated since immediate interference may give a better outcome. Patients and Methods: A cross-sectional research of forty-eight children consulting the Childhood Wellbeing Teaching Hospital in Baghdad/Medical City from 1st of November 2018 to the 30th of November 2021, complete evaluation by full history, physical checkup and laboratory studies. Cholestasis was demarcated as an extended raise of the levels of conjugated bilirubin outside the 1st 2 weeks of age above 1.0mg/dl (17.1µmol/l) if the whole serum bilirubin (TSB) is <5.0 mg/dL or above 20% of the TSB if the TSB is >5.0 mg/dl. Results: Out of 48 children involved in the study, 62.5% resided in Baghdad, and the remainder was belonged to other districts. The mean age of children was 11.1 months. The males constituted 58.3% of them. Eleven cases (22.9%) were caused by congenital infection, nine 18.8% had no cause detected, while 16.7% caused by biliary atresia and 16.7% had unidentified etiology, however 10.4% was related to sepsis. Biliary atresia was more frequent in boys in 62.5% compared to 37.5% in females. Family history was positive only in11.1% of idiopathic neonatal hepatitis. It was found that 81% of cholestatic jaundice were caused by congenital infection. In comparison, 62.5% caused by biliary atresia and 60% caused by sepsis appeared on the second week of the child's age, and this difference was significant statistically P-value 0.01. Conclusion: Innate infections are the most frequent source, where CMV contagion is the most commonly detected. Clinical findings included clay colored stool & elevated alkaline phosphatase concentrations observed primarily on biliary atresia. There are no specific test to identify the etiology of newborn cholestasis. [ABSTRACT FROM AUTHOR]

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study assessed the global trends and burden of severe chest injury, including rib fractures, lung contusions, and heart injuries from 1990 to 2019. Herein, we predicted the burden patterns and temporal trends of severe chest injuries to provide epidemiological evidence globally and in China. Methods: In our analysis, the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability rate (ASYR) of severe chest injury were analyzed by gender, age, sociodemographic index, and geographical region between 1990 and 2019 using data from the Global Burden of Disease study 2019. Trends were depicted by calculating the estimated annual percentage changes (EAPCs). The impact of age, period, and cohort factors was assessed using an Age-Period-Cohort model. Autoregressive integrated moving average (ARIMA) model was employed to predict severe chest injury trends from 2020 to 2050. Results: In 2019, the global number of severe chest injury cases reached 7.95 million, with the highest incidence rate observed in Central Europe (209.61). Afghanistan had the highest ASIRs at 277.52, while North Korea had the lowest ASIRs at 41.02. From 1990 to 2019, the Syrian Arab Republic saw significant increases in ASIR, ASPR, and ASYR, with EAPCs of 10.4%, 9.31%, and 10.3%, respectively. Burundi experienced a decrease in ASIR with an EAPC of − 6.85% (95% confidence interval [CI] − 11.11, − 2.37), while Liberia's ASPR and ASYR declined with EAPCs of − 3.22% (95% CI − 4.73, − 1.69) and − 5.67% (95% CI − 8.00, − 3.28), respectively. Falls and road injuries remained the most common causes. The relative risk of severe chest injury by age, period, and cohort demonstrated a complex effect globally and in China. The ARIMA model forecasted a steady increase in global numbers from 2020 to 2050, while in China, it forecasted an increase in incidence, a decrease in ASIR and ASYR, and an increase in ASPR. Conclusions: This study provides a groundbreaking analysis of global severe chest injury, shedding light on its measures and impact. These findings highlight the need for timely, specialized care and addressing regional disparities to mitigate the severe chest injury burden. [ABSTRACT FROM AUTHOR]

Various different impairments and their interactions can cause reading problems referred to as "dyslexia". Since reading requires the interaction of many abilities, the impairment of each of these abilities can result in dyslexia. Therefore, the diagnosis must differentiate various kinds of dyslexia. The diagnosis of a certain kind of dyslexia cannot be delimited to the investigation and description of symptoms but must also include the investigation of the causes of each kind of dyslexia. For this purpose, a scientifically unequivocal concept of causation and appropriate methods are needed to distinguish them from co-existing impairments that have no causal influence on reading performance. The results of applying these methods cannot be adequately accounted for by a non-scientific, intuitive understanding of necessary and sufficient conditions and causation. The methods suitable for revealing the causes of dyslexia are described in detail, and the results of applying these methods in experiments, in which 356 children with developmental dyslexia participated, are reviewed. Since the concepts of "necessary" and "sufficient" conditions and "causation" proposed in the philosophy of science are not suitable for describing causes of dyslexia and their interaction, they are replaced by a more detailed, experimentally based conceptual framework that provides an accurate description of the conditions required for correct reading and the causes of dyslexia. [ABSTRACT FROM AUTHOR]

This review is intended to explore the SWOC analysis of Migration in India. This concept examines the effects of migration on the social life of individuals and their level of financial security. i.e., we can say strengths, weakness, opportunities, and challenges in the study of Migration. Some other reasons that might contribute to the process of migration were also conferred in this paper. This movement of people used to be relatively straightforward with all intermediaries present, but nowadays it is gender, remittance, and season-specific. The current review paper takes a sociological approach to examining the SWOC analysis of Migration in India. The SWOC is focused on recognizing the causative elements in Migration. The main area of this review is to recognize the reasons for migration and their widespread effects on social, financial, spiritual, and emotional well-being. [ABSTRACT FROM AUTHOR]

A comprehensive analysis was carried out to investigate the driving factors and influencing mechanisms of spatiotemporal variation of sea level at multiple scales in the East China Sea (ECS) via satellite altimetry datasets from 1993 to 2020. Based on the altimetry grid data processed by the local mean decomposition method, the spatiotemporal changes of ECS sea level are analyzed from the multi-scale perspective in terms of multi-year, seasonal, interannual, and multi-modal scales. The results revealed that the ECS regional mean sea level change rate is 3.41 ± 0.58 mm/year over the 28-year period. On the seasonal scale, the regional mean sea level change rates are 3.45 ± 0.66 mm/year, 3.35 ± 0.60 mm/year, 3.39 ± 0.71 mm/year, and 3.57 ± 0.75 mm/year, for the four seasons (i.e., spring, summer, autumn, and winter) respectively. The spatial distribution analysis showed that ECS sea level changes are most pronounced in coastal areas. The northeast sea area of Taiwan and the edge of the East China Sea shelf are important areas of mesoscale eddy activity, which have an important impact on regional sea level change. The ECS seasonal sea level change is mainly affected by monsoons, precipitation, and temperature changes. The spatial distribution analysis indicated that the impact factors, including seawater thermal expansion, monsoons, ENSO, and the Kuroshio Current, dominated the ECS seasonal sea level change. Additionally, the ENSO and Kuroshio Current collectively affect the spatial distribution characteristics. Additionally, the empirical orthogonal function was employed to analyze the three modes of ECS regional sea level change, with the first three modes contributing 26.37%, 12.32%, and 10.47%, respectively. Spatially, the first mode mainly corresponds to ENSO index, whereas the second and third modes are linked to seasonal factors, and exhibit antiphase effects. The analyzed correlations between the ECS sea level change and southern oscillation index (SOI), revealed the consistent spatial characteristics between the regions affected by ENSO and those by the Kuroshio Current. [ABSTRACT FROM AUTHOR]

In most university settings, lecturers have diverse activities which require an enabling environment for optimum and sustainable performance. The absence of this working climate could lead to an emotional outburst known as burnout, a critical health concern that manifests in different ways. Burnout as a psychological impediment is most often overlooked when discussing the range of factors that usually affect the quality of lecturers' professional output. This is because most academics hardly notice they are emotionally unhealthy until this burnout starts manifesting in other aspects of their lives like physical health, social interactions, work and family. It is on this premise that this paper focuses on the indicators, causes of and strategies that can be put in place to curb burnout among university lecturers. The research design used in this study was a cross-sectional survey where an online questionnaire was used to collect both quantitative and qualitative data from 89 lecturers (47.1% Males, 52.9 Females), age range 30-65 years, of the Universities of Bamenda, Buea and Dschang. Quantitative data obtained from the questionnaire was coded and entered into the Statistical Package for Social Sciences (SPSS) version 26.0 while qualitative data was analysed using thematic analysis. The findings revealed that some of the indicators of burnout often exhibited by lecturers are feeling emotionally and physically drained, irritation at minor issues, feeling misunderstood by colleagues and administrators, being frustrated with part of the job and unpleasant level of pressure. The majority of respondents reported that burnout is often caused by constant criticism, overwork, inadequate compensation and poor working social climate. To reduce this emotional/mental challenge, the respondents suggested that there is a need to set up stress management, self -care and work-life balance programmes, and to promote a positive social climate and adequate motivation at the workplace. [ABSTRACT FROM AUTHOR]

The article analyzes the causes and consequences of the post-Soviet breakdown of economic ties between Russia and Africa. The post-Soviet period (since 1991) has led to a breakdown of economic ties between them. It means that trade, investment, and other forms of economic cooperation between the two sides have been significantly reduced or stopped completely. After the collapse of the Soviet Union at the initiative of Mikhail Gorbachev, Africa really became a “non-subject” for diplomats and military personnel stationed in the region, and some economic actors witnessed Moscow’s first initiatives. It was only in early 2018, on the occasion of the arrival of the first shipments of Russian weapons and dozens of “advisers” from Moscow in Bangui, that the French media learned of Russia’s “great comeback” in Africa. This Central African prism powerfully shaped perceptions in Paris: Russian involvement would be a new phenomenon echoing the confrontation between East and West, and Central Africa would be a crucial link in a grand strategy on a continental scale, where Russia would be on its way to establishing itself as a major player. The severing of economic ties between Russia and Africa has negative consequences for both regions, including reduced trade, investment, and political influence, and Russia’s lack of resources and changing political priorities since the collapse of the Soviet Union are the main reasons for it.

Abstract Background This study assessed the global trends and burden of severe chest injury, including rib fractures, lung contusions, and heart injuries from 1990 to 2019. Herein, we predicted the burden patterns and temporal trends of severe chest injuries to provide epidemiological evidence globally and in China. Methods In our analysis, the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability rate (ASYR) of severe chest injury were analyzed by gender, age, sociodemographic index, and geographical region between 1990 and 2019 using data from the Global Burden of Disease study 2019. Trends were depicted by calculating the estimated annual percentage changes (EAPCs). The impact of age, period, and cohort factors was assessed using an Age-Period-Cohort model. Autoregressive integrated moving average (ARIMA) model was employed to predict severe chest injury trends from 2020 to 2050. Results In 2019, the global number of severe chest injury cases reached 7.95 million, with the highest incidence rate observed in Central Europe (209.61). Afghanistan had the highest ASIRs at 277.52, while North Korea had the lowest ASIRs at 41.02. From 1990 to 2019, the Syrian Arab Republic saw significant increases in ASIR, ASPR, and ASYR, with EAPCs of 10.4%, 9.31%, and 10.3%, respectively. Burundi experienced a decrease in ASIR with an EAPC of − 6.85% (95% confidence interval [CI] − 11.11, − 2.37), while Liberia’s ASPR and ASYR declined with EAPCs of − 3.22% (95% CI − 4.73, − 1.69) and − 5.67% (95% CI − 8.00, − 3.28), respectively. Falls and road injuries remained the most common causes. The relative risk of severe chest injury by age, period, and cohort demonstrated a complex effect globally and in China. The ARIMA model forecasted a steady increase in global numbers from 2020 to 2050, while in China, it forecasted an increase in incidence, a decrease in ASIR and ASYR, and an increase in ASPR. Conclusions This study provides a groundbreaking analysis of global severe chest injury, shedding light on its measures and impact. These findings highlight the need for timely, specialized care and addressing regional disparities to mitigate the severe chest injury burden.

Objective: To determine the trend in adolescent maternal deaths and deliveries over a period of 5 years and 9 months (July 2014–March 2020) at the Ekurhuleni Health District in South Africa. Methods: The present study was a retrospective review and secondary data analysis using data from the District Health Information System and clinical oversight data from the District Clinical Specialist Team. The study population was adolescent pregnant women aged 10–19 years who died at health facilities. Descriptive and inferential statistics were used for analysis. Results: There was a total of 12 559 adolescent deliveries. Adolescent birth rate was lower than that of sub‐Saharan Africa. Adolescent deaths (n = 37) contributed to around 8% of the total maternal deaths. Deliveries (97%) and deaths (98%) were most common among women aged 15–19 years. Six (16%) women had a repeat pregnancy. A total of 21 (57%) had booked for antenatal care. There were few antenatal visits (mean 4 ± SD 2.1). The main three causes of death were hypertension (35%) followed by hemorrhage (24%) and suicide (14%). Postpartum deaths (62%) were significantly (chi‐square test, P = 0.02) higher than antepartum deaths (38%). The majority (73%) of newborns were born alive which was significantly (chi‐square test, P = 0.002) higher than those which were stillborn (27%). Conclusion: The main challenges were the high number of adolescent deliveries, repeat pregnancies, and preventable causes of death. Multidisciplinary collaboration involving obstetricians, midwives, pediatricians, school health services, social workers and psychologists is indispensable for comprehensive management, prioritizing pregnancy prevention among this vulnerable group. SYNOPSIS: Adolescent birth rate and mortality was lower than that of sub‐Saharan Africa. Large numbers of adolescent deliveries, suicidal deaths and repeat pregnancy were important challenges. [ABSTRACT FROM AUTHOR]

Migration, a complex international phenomenon of amplitude, a factor in stimulating the globalization of markets, is a social process that has deeply influenced and influences today's society, millions of young people of different nationalities from various countries of emigration choosing the path of migration. The migration of young people from Romania is one of the main migrations to the west of the continent, a very dynamic migration, the approach of which requires a differentiated and complex vision. Through this study, the authors want to familiarize and determine the public interested in this field, to make them aware of the significance of sociological theories on migration, its causality and the socio-economic effects, as a result of it, for any country and especially for Romania. Using statistical-mathematical methods, the study is focused on a succinct analysis of the socio-economic implications of the phenomenon of youth migration from Romania. The age groups considered in the present study are between 18- 35 years. Since 1990, the migration of young people from Romania has increased exponentially as a result of the consequences of economic constraints and the poor opportunities offered by the dynamics of economic and social life. As a result, the consequences of young people's migration from Romania are much more complex than it might seem at first glance. The work ends with the presentation of the results obtained and the conclusions drawn from the research undertaken. For Romania, the migration of young people is a great loss, in the long term their migration affects the socio-economic development capacity of Romania, causes the decrease of the total population and the loss of an important volume of labor. In fact, every action has consequences, and so does migration!

Background: Drug addiction is a social problem that affects people all over the world, Increased manufacturing, distribution, promotion, availability, and social values contribute to this issue. Aims and Objectives: The aim of this study was to explore the causes of substance abuse among users and its impacts. Materials and Methods: The study’s findings were derived through primary research. In-depth interviews with substance users undergoing treatment at a de-addiction center in Srinagar were carried out in June 2022–July 2022. This study included a thematic analysis of the stories of 20 participants. Results: Data gathered through participant narratives revealed personal experiences as well as common themes. A total of 3 themes emerged from the codes, the themes include (1) Initiation of substance abuse (2) Causes associated with substance abuse (3) Consequences of substance abuse. Conclusion: We conclude that the problem of substance abuse in Kashmir has assumed rising dimensions: curiosity, academic pressure, increasing economic stress, and easy accessibility are leading to initiation into substance abuse. It also reveals the harmful effects of substance abuse. Heroin is mostly used substance by abusers for the first time; substance abuse is on the rise, which is highly concerning for every member of society.

Introduction Respiratory diseases constitute a major cause of morbidity and mortality worldwide. The objective of our study was to identify the causes and factors associated with the death of patients in the Pulmonology Department of the Treichville University Hospital. Patients and methods This was a retrospective cross-sectional study analyzing patients who died while hospitalized in the Pneumology Department of Treichville University Hospital between April 2019 and April 2020. Results The study covered 514 files, including 177 deaths, representing an overall mortality of 34.4%. There were 109 men and 68 women with an average age of 45.20 years. The main antecedents were HIV infection (42.18%) and tuberculosis (38.1%). The main causes of death were pulmonary tuberculosis (49.69%), pneumocystosis (20.75%), and bacterial pneumonia (18.87%). Severe anemia (53.68%) and severe renal failure (19.85%) were the biological abnormalities associated with pulmonary pathologies. In univariate analysis, the factors associated with deaths were age less than 25 years, HIV seropositivity, nonmedical access to the service, self-medication, the presence of signs of initial clinical and radiological severity, a diagnosis of tuberculosis and neoplastic pathology, also the existence of difficulties during hospitalization. Multivariate analysis revealed HIV infection [odds ratio (OR)=1.46, confidence interval (CI)=0.27–0.77, P=0.003], diagnosed pulmonary tuberculosis (OR=1.51, CI=0.30–0.87, P=0.01), the presence of signs of clinical severity (OR=1.20, CI=0.09–0.42, P=0.00) and initial radiological severity (OR=1.27, CI=0.11–0.64, P=0.003) and the presence of difficulties during hospitalization (OR=1.16, CI=0.05–0.54, P=0.003). Conclusion Mortality remains high in pulmonology hospitalizations. Currently, tuberculosis and HIV infection are the main causes of death. Efforts to combat these two conditions must be strengthened by taking into account these factors associated with deaths.

Treatment of patients with chronic non-specific back pain (CNBP) is an important issue not only in medicine, but also in modern society as a whole, as it is associated with significant socio-economic burden.The lecture presents the most common anatomical sources of CNBP, the causes of CNBP and issues of differential diagnosis. Much attention is paid to the basic principles of therapy for CNBP: drug therapy, kinesiotherapy and psychological methods. Clinical observations are presented that demonstrate the effectiveness of a multimodal integrated approach to the treatment of CNBP based on the use of cognitive behavioral therapy, educational programs and kinesiotherapy and self-monitoring test tasks.

Background: Injuries are important causes of morbidity and mortality in childhood. There is therefore a need, especially in developing countries, to determine the relative contributions made by injuries singly and in combinations, to childhood morbidity and mortality in hospital practice. Objectives: To determine the causes, patterns, and outcome of various childhood injuries resulting in hospital admissions over a 15-year period. Design: Retrospective analysis of hospital records. Patients and Methods: The case files of all children aged 16 years and below, admitted to the Wesley Guild Hospital, Ilesa, between 1984 and 1998 with burns, poisoning, animal bites and stings, bone, joint, head, soft tissue and other injuries, were analysed and the data on various injury types, compared. Results: Injuries accounted for 5.1 percent of total paediatric admissions and 5.4 percent of deaths during the study period, with males predominating in every injury type. Fractures, burns, poisoning, soft tissue and head injuries constituted 36.5, 23.4, 13.3, 12.2 and 10.6 percent respectively, of the 1,249 total injuries seen. Motor vehicle accidents and falls were responsible for 85.6 percent of all fractures, soft tissue and head injuries. Hot water caused 521 percent of all burns while 36.7 and 24.7 percent respectively, of poisoning were due to kerosene and traditional drug mixtures. Vehicle related injuries constituted a significant percentage of all injuries in the last decade of the review. Duration of hospitalisation was significantly longer for fractures than for any other injury type. Mortality rates were 9.2 and 12.7 percent respectively, for burns and poisoning, both of which accounted for 71.6 percent of deaths due to injuries. Conclusion: Health promoting and injury preventive interventions should be instituted to reduce the rate of injuries and their effects on children.

Summary Background: Millennium Development Goal 4 (MDG4) which seeks to reduce child mortality globally can only be achieved if the causes of the deaths are known. Objectives: To review the pattern of paediatric deaths at the University of Port Harcourt Teaching Hospital and identify possible preventive measures. Materials and Methods: Data of all paediatric deaths documented between January 2003 and December 2005 in the mortality cards of the department of paediatrics, University of Port Harcourt Teaching Hospital, were reviewed retrospectively, and analysed. Results: Out of 3,959 admissions, 304 (7.67 percent) died; 52.3 percent of those that died were males, and 47.4 percent females, while the remaining one was of an ambiguous gender. Neonatal deaths accounted for 53.3 percent of the deaths, while 90.1 percent were aged under five years. The duration of admission ranged from 0.25 to 4704 hours with 40.8 percent and 58.22 percent of the deaths occurring within 24 and 72 hours, respectively. The major disease categories in the deceased were infections/infestations in 37.9 percent, perinatal conditions in 34.7 percent and nutritional deficiencies in 10 percent. Conclusions: The under-fives, especially neonates, remain vulnerable to highly preventable or treatable conditions with infections and neonatal conditions being the major causes, while HIV and AIDS are the emerging challenges. MDG4 can only be attained if all well-known high impact strategies such as improved management of obstetric, neonatal and paediatric emergencies, nutritional interventions and control of HIV/AIDS are widely implemented.

Background: Urinary tract infection (UTI) is common in children with possible severe complications, deserving public health interventions. Aims: To evaluate parental perception of symptoms, causes, complication and treatment of childhood UTI, and proposerelevant interventions. Methods: This is an ethically- approved cross-sectional study using a structured questionnaire comprising a 35-item Likert-like scale on perception of UTI in children with a reliability rating of 0.93. Adequate perception of each variable was defined as mean score ≥ 3.0. Weighted mean scores were tested for significant difference using F-test. Multiple logistic regressions identified possible predictors of adequate perception among the participants. P -value

Background Maternal mortality is the main indicator of maternal health worldwide. The aims of your study were to determine the Maternal Mortality Ratio (MMR) in the governorate of Tunis and to identify the main causes of maternal death. Methods We included all maternal deaths between January 2017 and December 2023, reported to the Tunis Regional Health Directorate. The data collected included the MMR per 100000 live birth, sociodemographic characteristics, causes of death, circumstances of death, autopsy findings, and preventability. Results Sixty one maternal deaths were recorded. The average of MMR was 46, 88 per 100000 live births. Two peaks in the MMR were noted in 2017 and 2020. The average age of the patients was 34, 1 years (±5.1). We noted that 43, 75 % of the patients were not residents of the governorate of Tunis. The postpartum period was the most critical. In fact, 83, 33 % of maternal deaths occurred postpartum. Hemorrhage was the main etiology in 20.8% of cases. The second cause was COVID- 19complicationsin 16, 6% of cases. Conclusion This study of maternal mortality in Tunis opens the debate on the effectiveness of maternal health policies in Tunisia and the areas for improvement.

I argue against elements of Alfred Mele's picture of the nature of intentions and the triggers of intentional actions. Mele (Philosophical Studies 176:2833–2853, 2019) offers rebuttals to my (Herdova, Philosophical Studies, 173(3), 573–587, 2016; Herdova, Philosophical Explorations, 21(3):364–383, 2018) and Ann Bumpus's (2001) arguments which limit the scope of proximal intentions as triggers of intentional actions. Here I offer a response to Mele and provide further arguments in favor of my alternative understanding of intentions and the causes of intentional actions. Contra Mele, I argue for the following interrelated theses. First, intentions, including proximal intentions, have an array of functions or dispositions beyond that of triggering intentional actions. Second, states other than proximal intentions can trigger at least some types of intentional actions. Therefore, it is not the case that all intentional actions need to be triggered by proximal intentions. [ABSTRACT FROM AUTHOR]

In this study, the characteristics and preliminary causes of tropical cyclone remote precipitation (TRP) over China during the period from 1979 to 2020 are investigated. Results indicated that approximately 72.42% of tropical cyclones (TCs) in the Western Pacific produce TRP over China. The peak months for TRP are July and August. The four key regions of TRP are the adjacent areas between the Sichuan and Shaanxi Provinces, the northern coast of the Bohai Sea, the coast of the Yellow Sea, and the southern coast area. The typical distance between the station with TRP and the TC center ranges from 1500 to 2500 km. Most of these stations are situated north to 60° west of north of the TC. The south–west water vapor transportation on the west side of the TC is crucial to TRP. TRP has a decreasing trend because of the decrease in the number of TCs that generate TRP. From the perspective of large-scale environmental conditions, a decrease in the integrated horizontal water vapor transport in Mainland China, the weakening of upward motion at approximately 25°–35°N, which is inconducive to convection, and an increase in low-level vertical wind shear, which is unfavorable for the development of TC in areas with high frequencies of TRP-related TCs, are the factors that result in the decreasing trend of TRP. [ABSTRACT FROM AUTHOR]

Copyright of Die Orthopädie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Road traffic accidents (RTA) are major causes for morbidity, mortality and disability among all age group and people of all socioeconomic status. Considering the increased number of people using motorized vehicle leading to rise in road traffic accidents, our cross-sectional study conducted in a tertiary care hospital in northern Karnataka, India Materials and Methods: A pre-designed semi-structured questionnaire for duration of six months aimed to study the socio demographic profile of road traffic injury victims, to find the antecedent factors influencing the road traffic accidents and also to study the pattern of injury in victims. Results: Total of 516 patients were included in the study. In our study we have found that human error is the most common factor responsible for accident 43.4% followed by drunk and drive 30.6% and most of the accidents occurred in highway 21.1% and drivers are most commonly the victims of accident 69.2%. We have also found that skid is the most common manner of accident. It is very alarming to see that only 33.7% of the participants had valid driving licence. Also, among the people who rode two-wheeler only 7% wore helmet and among persons who drew four-wheeler only 10% wore seat belt. Conclusion: Most participants were male (86%), mostly from rural areas (70.3%), and lived with their families (88%). The findings highlight the need for better road safety measures, stricter traffic regulations, increased public awareness, and improved infrastructure to reduce road traffic accidents [ABSTRACT FROM AUTHOR]

According to the Quran, depression in general is attributed to a lack of religious commitment among Muslims, as well as the accumulation of sadness, anxiety, fear, disorder, psychological pressure, and issues related to family, social, cultural, economic, and political relationships. In the light of the challenges faced by the Yemeni community in Malaysia due to forced displacement from Yemen and the resulting lack of security from this traumatic experience and the inability to return, this study aims to uncover the nature, causes, and effects of psychological depression. Additionally, it seeks to identify proposals for alleviating symptoms based on the perspectives of a sample of 45 individuals from the Yemeni community in Malaysia. The researchers employed descriptive and analytical methods, and the study's theoretical findings were consistent with field observations. The primary cause of depression was found to be fear for the well-being of loved ones, with significant impact stemming from anxiety and stress about the future. One of the key suggestions for alleviation was fostering certainty in future benefits. [ABSTRACT FROM AUTHOR]

Migration, a complex international phenomenon of amplitude, a factor in stimulating the globalization of markets, is a social process that has deeply influenced and influences today's society, millions of young people of different nationalities from various countries of emigration choosing the path of migration. The migration of young people from Romania is one of the main migrations to the west of the continent, a very dynamic migration, the approach of which requires a differentiated and complex vision. Through this study, the authors want to familiarize and determine the public interested in this field, to make them aware of the significance of sociological theories on migration, its causality and the socio-economic effects, as a result of it, for any country and especially for Romania. Using statistical-mathematical methods, the study is focused on a succinct analysis of the socio-economic implications of the phenomenon of youth migration from Romania. The age groups considered in the present study are between 18- 35 years. Since 1990, the migration of young people from Romania has increased exponentially as a result of the consequences of economic constraints and the poor opportunities offered by the dynamics of economic and social life. As a result, the consequences of young people's migration from Romania are much more complex than it might seem at first glance. The work ends with the presentation of the results obtained and the conclusions drawn from the research undertaken. For Romania, the migration of young people is a great loss, in the long term their migration affects the socio-economic development capacity of Romania, causes the decrease of the total population and the loss of an important volume of labor. In fact, every action has consequences, and so does migration!. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Larq Journal for Philosophy, Linguistics & Social Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bullying is a frequently encountered phenomenon, with various behaviors and forms. The present study aims to explore the different perceptions and attitudes of high school students regarding this phenomenon. The analysis took place in a high school in Gorj county and another one in Timiș county, with a total of 84 responses collected from the two schools, the respondents being 12th-grade students. The results of the study show that the most frequent form of bullying reported by respondents is verbal bullying, accounting for 59.5%. Respondents choose to intervene to stop various bullying behaviors in proportion to 56%. Regarding different determinants of bullying behavior towards the respondents, they declare that physical appearance represented a triggering factor for them. The conclusions of the study show that verbal bullying is the predominant form of bullying among the respondents of the study. [ABSTRACT FROM AUTHOR]

In this study, the right to divorce and the reasons for using this right in the Afghan society, the causes of divorce and its negative social and moral effects on the society have been investigated in the light of the Holy Qur'an and the Sunnah of the Prophet. The purpose of the study is to inform people about the negative causes and negative effects for the permanent safety of the family. The research also adopted the analytical approach. The value of the study originates from the basic contribution of the family to the social structure, which is undoubtedly based on the life of the wife and the husband, The results of the research show that divorce in Islamic Sharia is the only way to get rid of the problem that is unbearable for the wife and husband as a joint life. In the Afghan society, divorce has many negative effects, such as hostility, Failure to educate children, shame and insult to the woman and her family, and their future life being unlucky, facing economic challenges or getting addicted to bad moral practices are worth mentioning. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the outcomes and demographics of encephalocele patients who were born and received treatment in our neonatal ICU and conduct a PRISMA literature review. Methods: An Institutional Review Board (IRB)-approved retrospective cohort study was undertaken to investigate the results of treating encephalocele patients at Jackson Memorial Hospital (JMH) from 1998 to 2022. The study focused on assessing outcomes and the impact of maternal socioeconomic factors, such as religion, age, and education, along with the timing of diagnosis, in connection with a systematic review. Results: A total of 20 encephalocele patients were identified (13 females and 7 males), with 15 having available medical records for review. Most of these cases involved occipital encephaloceles (73.3%). Maternal ages at the time of delivery ranged from 15 to 42 years, with a mean age of 27.3 years. The average gestational age at birth was 37 weeks. Ten cases had a prenatal diagnosis documented, occurring between 12 and 24.5 weeks of gestation. Three of the surviving patients had records of prenatal counseling that included discussions about termination. No infections were reported. Among the 15 cases, 11 patients (73.3%) were alive at the last follow-up, with a mean age at follow-up of 4.12 years, ranging from 6 weeks to 15 years post-birth. Hydrocephalus was noted in 26.7%. Only 1 mother had completed high school. Most mothers were either on Medicaid (9 patients) or uninsured (3 patients), with only 3 having commercial insurance. Religious affiliations varied among the mothers, with 14 out of 15 identifying with a particular religion. The systematic review identified 22 articles from various countries, with 11 articles meeting the inclusion criteria for qualitative analysis. These articles revealed potential maternal risk factors for encephaloceles, including low-nutrient diets, inadequate folic acid intake, young maternal age, advanced maternal age, low socioeconomic status, and limited educational attainment. Conclusions: In the twenty-first century, there is a positive trend in the survival rates of children born with encephalocele. However, maternal factors such as low socioeconomic status and limited educational attainment remain prominent, affecting their ability to access timely prenatal care and impacting follow-up medical care for these children. [ABSTRACT FROM AUTHOR]

This paper studies the main factors affecting road traffic accidents (RTAs) using a systematic review. The primary focus is on factors related to road characteristics and driver behaviours. This review also addresses the socioeconomic and demographic factors to provide a clear overview of which groups suffer the most from RTAs. Several factors were found to affect RTAs, notably road characteristics: highways, high-speed roads, unplanned intersections and two-way roads without dividers; driver behaviours: reckless/aggressive driving and riding, excessive speeding, unawareness of traffic laws, and not using safety equipment; and vehicle types: four and two-wheeled. This review found that male and economically productive people with less education were mostly associated with RTAs. In addition, for most of the low and middle-income countries analyzed, there is a lack of quality data relating to RTAs. Nevertheless, this review provides researchers and policy makers with a better understanding of road accidents for improving road safety. [ABSTRACT FROM AUTHOR]

Men of all ages frequently experience erectile dysfunction (ED) or impotence, and it is a difficult health issue that adversely affects the quality of life of those who experience it. There are multiple types of treatment strategies for ED available, depending on the origin and severity of ED, as well as any underlying medical issues. However, these therapeutics are known to have a number of negative health effects. In contrast, plant-based treatments are more effective for managing diseases due to their ability to modulate biological processes like inflammation, oxidative stress, and cell signaling molecules. Many medicinal plants have been reported to be quite helpful in the improvement of ED. In this review, ED and its causes, diagnostic methods, treatment strategies, and some of the most potent plant-based interventions against ED are discussed in greater detail, along with a description of their mechanisms of action and a brief discussion of approaches to increase their efficacy, with a focus on the management of ED using herbal interventions as complementary and alternative medicines. While there is hope that medicinal plants could provide lead substances for erectile dysfunction medications, additional investigation is necessary to ascertain the efficacy and security of these prospective treatments. [ABSTRACT FROM AUTHOR]

Reducing food waste became a priority in the past decades for the majority of nations around the world. But while the interest in this topic is high, not all countries, including Romania - our case study-accurately estimate household food waste quantities. Determining the reality of food waste at household levels is highly valuable because in the end, it can bring insight into what would be the best methods to reduce waste and optimize resource consumption. The current study determined the causes, quantities, and main components of food waste in Romanian households by applying and subsequently analyzing a food waste survey. Our purpose was to determine not only how much food Romanians throw away per week, but also what type of food. In addition, by studying the households' consumption habits we identified the main behavioral triggers of food waste. By applying the survey to a relevant sample of our country's population, we obtained a relatively accurate depiction of food waste attitudes among Romanian consumers and our paper can be a starting point in developing an educational tool aiming to reduce food waste in households. This type of study is important not only for informational reasons but also from a societal standpoint. As a complex community, part of larger international structures and agreements, (such as the European Union, the United Nations, or The Paris Agreement on Climate Change), Romania needs to align itself with the other partners in order to decrease the negative impact on the environment of food waste. [ABSTRACT FROM AUTHOR]

The term site museum refers to a particular kind of museum built on or near a historical or natural site with the goal of preserving and interpreting the site and its excavations. This study is an early exploration of the inherent conflicts of the site museum, which have not been discussed much in existing studies. These conflicts are believed to exist in all site museums. Some are considered unique to the site museum, and others are more severe than those in other museums. The causes of these conflicts could be divided into three main types: the site characteristics, mainly including immovability, location, scale, materials, and conservation; the architectural characteristics of the site museum, such as architectural foundations, enclosure, architectural forms, and permanence; and the institutional characteristics of the site museum, which are collections, exhibitions, and museum powers. The conflicts they have caused are challenging the appropriateness of the way site museums are built. The study argues that these conflicts could not be eliminated but only mitigated partially. Some mediation methods are further discussed in the planning, architectural design, exhibition design, and operation levels. [ABSTRACT FROM AUTHOR]

In recent years, workplace mobbing has become a major global issue, resulting in detrimental organizational behaviors. This phenomenon creates significant obstacles to productivity, competitive edge, and the long-term sustainability of organizations. Addressing mobbing is crucial for maintaining a healthy work environment. Therefore, this paper presents a research study aimed at demonstrating the link between preventing and managing workplace mobbing and its effects on employee motivation and productivity. Workplace bullying, or mobbing, is indeed a prevalent issue in contemporary organizations. To bridge these negative consequences and aid in the management and reduction of mobbing's harmful impacts, this study sought to develop a model that addresses both the causes and effects of mobbing within organizations. The research focuses specifically on the prevention of mobbing in educational institutions. The findings support the general hypothesis that there is a significant relationship between preventing and handling workplace mobbing and the levels of employee motivation and productivity. [ABSTRACT FROM AUTHOR]

Background: Newborn cholestasis is explained as a persisted rise of the serum conjugated bilirubin outside the first two weeks of life. There are many etiologies of newborn cholestasis that must be differentiated since immediate interference may give a better outcome. Objective: Newborn cholestasis is explained as a persisted rise of the serum conjugated bilirubin outside the first two weeks of life. There are many etiologies of newborn cholestasis that must be differentiated since immediate interference may give a better outcome. Patients and Methods: A cross-sectional research of forty-eight children consulting the Childhood Wellbeing Teaching Hospital in Baghdad/Medical City from 1st of November 2018 to the 30th of November 2021, complete evaluation by full history, physical checkup and laboratory studies. Cholestasis was demarcated as an extended raise of the levels of conjugated bilirubin outside the 1st 2 weeks of age above 1.0mg/dl(17.1µmol/l) if the whole serum bilirubin(TSB) is 5.0 mg/dl. Results: Out of 48 children involved in the study ,62.5% resided in Baghdad, and the remainder was belonged to other districts. The mean age of children was 11.1 months. The males constituted 58.3% of them. Eleven cases (22.9%) were caused by congenital infection, nine 18.8% had no cause detected, while 16.7% caused by biliary atresia and 16.7% had unidentified etiology, however 10.4% was related to sepsis. Biliary atresia was more frequent in boys in 62.5% compared to 37.5% in females. Family history was positive only in11.1% of idiopathic neonatal hepatitis. It was found that 81% of cholestatic jaundice were caused by congenital infection. In comparison, 62.5% caused by biliary atresia and 60% caused by sepsis appeared on the second week of the child's age, and this difference was significant statistically P-value 0.01. Conclusion: Innate infections are the most frequent source, where CMV contagion is the most commonly detected. Clinical findings included clay colored stool & elevated alkaline phosphatase concentrations observed primarily on biliary atresia. There are no specific test to identify the etiology of newborn cholestasis.

Abstract Objective Describe characteristics of women whose decedents died during the neonatal period and explore factors associated with postnatal age at time of death. Methods Analysis of data collected at the Child Health and Mortality Prevention Surveillance (CHAMPS) South Africa study site. CHAMPS generates cause of death data in children across nine sites in low‐ and middle‐income countries. Postnatal age at time of neonatal death was evaluated by Kaplan–Meier methods. Factors associated with time to neonatal death were evaluated using Cox proportional hazards regression models. Analyses were conducted in Stata 15.0®. p

Background: Access to high-quality healthcare is a fundamental right, but rural communities in Bangladesh face challenges in accessing such services. Patient satisfaction plays a crucial role in healthcare outcomes. Identifying factors influencing satisfaction is vital for targeted interventions. Methods: A cross-sectional investigation was conducted in rural areas of Sirajganj, Rajshahi, Bangladesh, from April to June 2023. Convenient sampling was employed, and face-to-face interviews were conducted using a semi-structured questionnaire. A total of 411 participants were included in the final analysis. Descriptive statistics, as well as bivariate and multivariable logistic regression analyses, were carried out using SPSS software. Results: Most unmarried participants (mean age: 41.93 ± 14.54 years; age range: 18–88 years) had primary education and a family income below 15,000 BDT. Among them, 80.3 % reported dissatisfaction with treatment. Significant factors linked to dissatisfaction included low education, being a businessman, living in nuclear families, daily physical exercise, difficulty accessing healthcare, average doctor-patient communication, high treatment costs, long waiting times, government hospital services, proximity to healthcare centers, lack of follow-up services, and absence of Telemedicine or M-health services. Conclusion: This study identifies key factors affecting patient satisfaction in rural Bangladesh. Interventions should focus on improving doctor-patient communication, reducing treatment costs and waiting times, enhancing access to healthcare and follow-up services, and incorporating Telemedicine or M-health services. Special attention is needed for businessmen, nuclear family residents, those who exercise daily, and patients using government hospitals or living near healthcare centers, as these groups report higher dissatisfaction.