Plaaslike regerings speel 'n belangrike rol in die ontwikkeling van die lewensbestaan van plaaslike gemeenskappe in Suid-Afrika. Plaaslike regerings is verantwoordelik vir die verskaffing en lewering van basiese dienste soos lopende water, behoorlike sanitasie, skoon energie, afvalverwydering en ordentlike behuising. Openbare deelname (PP) is waarskynlik 'n noodsaaklike element van plaaslike demokrasie waardeur plaaslike gemeenskappe kan bydra tot verbeterde dienslewering. Die huidige studie het gefokus op die assessering van die rol van PP in dienslewering in die Ekurhuleni Metropolitaanse Munisipaliteit. Dit is gedoen deur 'n beskrywende navorsingsontwerp aan te neem. Data oor die faktore wat PP beïnvloed, is ingesamel van vier verskillende gemeenskapsgroepe (d.w.s. burgers, besighede, munisipale bestuurders en wykskomiteelede), met behulp van vraelyste en onderhoude. Die resultate het getoon dat inligting oor PP verkry word via radio, televisie, koerante en selfone. Oor die algemeen is die inisiatiewe wat aan die 'Batho Pele'-beginsels voldoen, aanvaarbaar in die Ekurhuleni-gemeenskap. Verder, met betrekking tot die kwaliteit van die dienste wat deur die munisipaliteit gelewer word, het die bevindinge vasgestel dat burgers saamstem dat die munisipaliteit bewus is van die diensgehalte wat in die EMM aangebied word. Alhoewel sommige landsburgers saamstem met die gehalte van die dienslewering, meen sommige van hulle dat die proses steeds nie konsekwent is nie.

Local governments play an important role in the development of the livelihoods of local communities in South Africa. Local governments are responsible for the provision and delivery of basic services such as running water, proper sanitation, clean energy, waste removal, and decent housing. Public participation (PP) is arguably an essential element of local democracy through which local communities can contribute to improved service delivery. The current study focused on assessing the role of PP in service delivery in the Ekurhuleni Metropolitan Municipality. This was done by adopting a descriptive research design. Data on the factors affecting PP were collected from four different community groups (i.e., citizens, businesses, municipal managers, and ward committee members), using questionnaires and interviews. The results showed that information about PP is obtained via radio, television, newspapers, and mobile phones. Generally the initiatives relating to the 'Batho Pele' principles are acceptable in the Ekurhuleni community. Furthermore, concerning the quality of the services delivered by the municipality, the findings established that citizens agree that the municipality is aware of the service quality offered in the EMM. Although some citizens agree with the quality of the service delivery, some of them believe that the process still lacks consistency.

Die probleem wat hierdie studie genoodsaak het, was dat sommige oonde wat verantwoordelik was vir die verdere verwerking van staalpype by Maatskappy X nie aan 'n programmeerbare logiese beheer (PLC)-Internet of Things (IoT) stelsel gekoppel was nie. Dit het die produkvloei vertraag. Om hierdie probleem aan te spreek, is PLC-IoT-stelsels geïntegreer sodat die produksiestelsel meer effektief kon wees. Hierdie studie modelleer en simuleer dus die geïntegreerde PLC-IoT-beheerstelsel, deur die stelseldinamika-modelleringsbenadering te gebruik om die werkverrigting van die outomatiese gasoonde te ondersoek. Die PLC-IoT bestaan uit 'n interne module wat gebruik word om die datastroom te verwerk. Na die implementering van die voorgestelde beheerstelsel is primêre data verkry deur die werkverrigting van die stelsel voortdurend te evalueer. Die navorsingsmetodologie wat gebruik is, het kwantitatiewe analise en 'n simulasiemodel met behulp van die Anylogic-sagteware behels. Die resultaat van die aflewering en voorraad van blokke vanaf 'n outomatiese stelsel het 'n opwaartse neiging getoon met aflewering en 'n voorraad van 'n blokke op ongeveer 90 minute; terwyl 'n stelsel wat nie met PLC-IoT geoutomatiseer is nie, 'n afwaartse neiging van ingots getoon het. Dit wys dat die bekendstelling van die PLC-IoT vir beheer die stelsel meer effektief maak. Die bevindinge van hierdie studie kan die vervaardigers help om vervaardigings- of produksiedoeltreffendheid, aansienlike tydbesparings en beter monitering van die vervaardigingsproses te bereik.

The problem that necessitated this study was that some furnaces that were responsible for the further processing of steel pipes at Company X were not connected to a programmable logic control (PLC)-Internet of Things (loT) system. This slowed down the product flow. To address this problem, PLC-IoT systems were integrated so that the production system could be more effective. This study therefore models and simulates the integrated PLC-IoT control system, using the system dynamics modelling approach to investigate the performance of the automated gas furnaces. The PLC-IoT consists of an internal module that is used to process the data stream. After the implementation of the proposed control system, primary data was acquired by continuously evaluating the performance of the system. The research methodology used involved quantitative analysis and a simulation model using the Anylogic software. The result of the delivery and inventory of ingots from an automated system showed an upward trend with delivery and an inventory of an ingot at about 90 minutes; while a system that was not automated with PLC-IoT showed a downward trend of ingots. This shows that the introduction of the PLC-IoT for control makes the system more effective. The findings of this work could assist the manufacturers in achieving manufacturing or production efficiency, significant time savings, and better monitoring of the manufacturing process.

Abstract: This research proposes two models for the problem of short-term economic dispatch of electrical power systems through nonlinear programming (NLP). The problems raised will be resolved through the cost function of the classic economic dispatch where thermal and hydraulic generation plants will be considered to obtain the electrical power generated in each of the nodes. The proposed methodology will be used for a short-term period of 24 hours with different hourly demand, as it is a short-term dispatch, it focuses on the delivery of power that covers the designated demand in each schedule, so it will not consider a deficit cost or uncertainty in the variables in any of the cases. In the first instance, the model will be developed for a single node with cascade reservoirs, while the second case will be developed in the IEEE 14-bus system. The non-linear programming shows satisfactory results, complying with the operational restrictions implemented in the mathematical model, in addition, the participation of thermal generation is considerably reduced, which represents a lower cost. The first model of a node is validated through bibliography, obtaining an operating cost of $904,990. In the same way, complying with all the designated parameters, the second model obtains a total cost of $129,800, satisfying the total demand in both cases, subject to each of its restrictions.

Resumen: La presente investigación propone dos modelos al problema de despacho económico a corto plazo de los sistemas eléctricos de potencia por medio de la programación no lineal (PNL). Los problemas planteados serán resueltos mediante la función de costo del despacho económico clásico en donde se considerarán centrales de generación térmica e hidráulicas para obtención de la potencia eléctrica generada en cada uno de los nodos, la metodología propuesta será utilizada para un periodo a corto plazo de 24 horas con diferente demanda horaria, al ser un despacho a corto plazo este se enfoca en la entrega de potencia que cubra la demanda designada en cada horario, por lo que no considerará para ninguno de los casos un costo de déficit o incertidumbre en las variables. En primera instancia se desarrollará el modelo para un solo nodo con embalses en cascada, mientras que el segundo caso será desarrollado en el sistema de 14 buses de la IEEE. La programación no lineal muestra resultados satisfactorios cumpliendo con las restricciones operativas implementadas en el modelo matemático, además se reduce considerablemente la participación de generación térmica lo que representa menor costo, el primer modelo de un nodo es validado mediante bibliografía obteniendo un costo de operación de $904.990. De la misma forma, cumpliendo con todos los parámetros designados, el segundo modelo llega a obtener un costo total de $129.802,16 satisfaciendo el total de la demanda en ambos casos, sujeto a cada una de sus restricciones.

Abstract This article explores the design and application of machine learning techniques to enhance traditional approaches for solving NP-hard optimization problems. Specifically, it focuses on the Last-Mile Routing Research Challenge (LMRRC), supported by Amazon and MIT, which sought innovative solutions for cargo routing optimization. While the challenge provided travel times and zone identifiers, the dependency on these factors raises concerns about the algorithms’ generalizability to different contexts and regions with standard delivery services registries. To address these concerns, this study proposes personalized cost matrices that incorporate both distance and time models, along with the relationships between delivery stops. Additionally, it presents an improved approach to sequencing stops by combining exact and approximate algorithms, utilizing a customized regression technique alongside fine-tuned metaheuristics and heuristics refinements. The resulting methodology achieves competitive scores on the LMRRC validation dataset, which comprises routes from the USA. By carefully delineating route characteristics, the study enables the selection of specific technique combinations for each route, considering its geometrical and geographical attributes. Furthermore, the proposed methodologies are successfully applied to real-case scenarios of last-mile deliveries in Montevideo (Uruguay), demonstrating similar average scores and accuracy on new testing routes. This research contributes to the advancement of last-mile delivery optimization by leveraging personalized cost matrices and algorithmic refinements. The findings highlight the potential for improving existing approaches and their adaptability to diverse geographic contexts, paving the way for more efficient and effective delivery services in the future.

Resumen Este artículo explora el diseño y aplicación de técnicas de aprendizaje automático para mejorar los enfoques tradicionales y así resolver problemas de optimización NP-hard. En particular, se enfoca en el Last-Mile Routing Research Challenge (LMRRC), apoyado por Amazon y MIT, que buscaba soluciones innovadoras para la optimización de rutas de carga. Si bien el desafío proporcionó tiempos de viaje e identificadores de zona, la dependencia de estos factores plantea preocupaciones sobre la generalización de los algoritmos a diferentes contextos y regiones con registros de servicios de entrega estándar. Para abordar estas interrogantes, este estudio propone matrices de costos personalizadas que incorporan modelos de distancia y tiempo, junto con las relaciones entre las paradas de entrega. Además, presenta enfoques mejorados para la secuenciación de paradas mediante la combinación de algoritmos exactos y aproximados, utilizando técnicas de regresión personalizada junto con metaheurísticas y refinamientos heurísticos ajustados. La metodología resultante logra puntajes competitivos en el conjunto de datos de validación LMRRC, que usa rutas de EE. UU. Al delinear cuidadosamente las características de la ruta, el estudio permite la selección de combinaciones de técnicas específicas para cada ruta, considerando sus atributos geométricos y geográficos. Además, las metodologías propuestas se aplican con éxito a escenarios de casos reales de entregas en Montevideo (Uruguay), demostrando puntajes promedio y precisión similares en nuevas rutas de prueba. Esta investigación contribuye al avance de la optimización de la entrega de última milla al aprovechar matrices de costos personalizadas y refinamientos algorítmicos. Los hallazgos resaltan el potencial para mejorar los enfoques existentes y su adaptabilidad a diversos contextos geográficos, allanando el camino para servicios de entrega más eficientes y efectivos en el futuro.

INTRODUCTION: Holistic healthcare service delivery requires rehabilitation personnel to consider all the components of health that influence the client's quality of life. However, there is limited literature on approaches to implementing rehabilitation services within South African public healthcare. This study explored rehabilitation personnel's (such as occupational therapists, speech therapists, physiotherapists) use of occupation-based practice impairment-based practice and the barriers and facilitators associated with their practice choice. METHODS: A qualitative research design was conducted through semi-structured interviews (13 participants), a focus group (4 participants) and community mapping. Purposive sampling was utilised to select participants in the iLembe district, KwaZulu-Natal, South Africa. Data were analysed using deductive thematic analysis. FINDINGS: Three themes emerged from the study; Attitudes towards impairment-based practice, Reflections on OBP, and The way forward. The need to focus on all the components of health rather than just the disease and the benefits of using the occupation-based practice approach were highlighted. Additionally, different factors required to implement holistic rehabilitation services and the barriers to OBP were identified. CONCLUSION: Although the study identified OBP benefits, various barriers associated with its implementation were identified. Rehabilitation personnel, community stakeholders, and clients must work together to improve OBP implementation in public healthcare by combating the barriers identified in the study. IMPLICATIONS FOR PRACTICE: This study has implications for rehabilitation service implementation in the iLembe district public healthcare sector. OBP was perceived to have more quality of life and health outcomes, which leads to implications for practice. There is a need to transition from the medical model with approaches only focusing on body structures and functions into approaches that consider all the components of health, such as the OBP. Even though there are barriers towards OBP implementation, rehabilitation personnel can still promote its implementation through inter-professional practice, continuous professional development and health promotion. Furthermore, there are implications for undergraduate programmes to equip undergraduates with the skills to implement OBP within under-resourced facilities.

ABSTRACT Introduction: neonatal herpes is a rare entity associated with high morbidity and mortality. The probability of transmission to the newborn ranges from 5% to 85%. The diagnosis is difficult due to the lack of clinical signs, unreliable serology and the non-availability of PCR in public services in developing countries. IgM in pregnant women could be used as a suspected marker to evaluate the neonate. Objective: To characterize newborn children of pregnant women with positive IgM for HSV 1-2 and the prevalence of encephalitis in infants. Materials and methods: Observational, descriptive, prospective study, carried out from May 2020 to October 2021. Newborns (NB) of mothers with positive IgM for Herpes Virus Simplex (HSV) from the second half of pregnancy were included. In newborns, IgG and IgM were performed, and in addition, PCR-RT for HSV 1-2 in blood and/or CSF, excluding those born in other hospitales and/or without maternal serology data. Results: We included 36 patients. Maternal age was 28 years (DS + 4), 5% with a history of HSV. 61% were delivered via cesarean section, 36% were premature, 13% had IUGR. 22% of the newborns had acute symptoms. 19% had thrombocytopenia, 44% had GOT alteration. 63% were PCR positive for HSV in serum and 44% were CSF-positive. Hemorrhage, hydrocephalus and leukomalacia were found in 27%. No differences were found in clinical expression by type of delivery. Conclusions: Newborns born to pregnant women with positive IgM for HSV from the second half of pregnancy or peripartum, presented HSV infection as determined by PCR in blood or CSF, regardless of the route of delivery. Serological diagnosis in pregnant women allows early screening, diagnosis and treatment of the NB.

RESUMEN Introducción: El herpes connatal es una entidad infrecuente asociada a elevada morbimortalidad. La probabilidad de transmisión al recién nacido va de 5% al 85%. El diagnóstico se dificulta por falta de clínica, serología no confiable y por la no disponibilidad de PCR en los servicios públicos de países en vías de desarrollo. La IgM en gestantes podría ser utilizada como un marcador de sospecha para evaluar al neonato. Objetivo: Caracterizar a los recién nacidos, hijos de gestantes con IgM positiva para HVS 1-2 y la frecuencia de encefalitis en los infantes. Materiales y métodos : Estudio observacional, descriptivo, prospectivo, realizado de mayo de 2020 a octubre de 2021. Se incluyeron recién nacidos (RN) de madres con IgM positiva para Herpes Virus Simplex (HVS) a partir de la segunda mitad del embarazo. En el RN se realizó serología IgG e IgM, y además, PCR- RT para HVS 1-2 en sangre y/o LCR, excluyéndose los nacidos en otras maternidades y/o sin datos de serología materna. Resultados: 36 pacientes. Edad materna 28 años (DS + 4), 5% con antecedentes de HVS, 61% cesárea. 36% prematuros, 13% RCIU. Síntomas agudos en el RN 22%. De ellos, 19% plaquetopenia, 44% alteración de GOT. 63% PCR HVS en sangre y 44% en LCR. Se encontró hemorragia, hidrocefalia, leucomalacia en 27%. No se encontró diferencias en la expresión clínica por tipo de parto. Conclusiones: Los RN hijos de gestantes con IgM positiva para VHS desde la segunda mitad del embarazo o periparto, presentaron infección por VHS determinada por PCR en sangre o LCR, independiente de la vía del parto. El diagnóstico serológico en embarazadas permite la pesquisa, diagnóstico y tratamiento temprano del RN.

Resumo A sequência TRAP (twin reversed arterial perfusion) é uma complicação rara das gestações múltiplas monocoriónicas. Esta condição tem consequências para ambos os fetos - o feto acárdico e o feto “bomba”. O presente caso refere-se a uma gestação gemelar monocoriónica complicada por TRAP diagnosticada no primeiro trimestre. Após discussão multidisciplinar eesclarecimento do casal, foi decidida a abordagem conservadora por não se verificarem anomalias genéticas ou outras complicações no desenvolvimento do feto normal e o desenvolvimento do feto ter sido interrompido às 16 semanas de gestação. A gravidez resultou num parto eutócico a termo. Apesar de não existir ainda consenso quanto à abordagem ideal, vários estudos tê, demonstrado a validade das abordagens conservadoras em detrimento da intervenção in utero.

Abstract Twin reversed arterial perfusion (TRAP) is a rare sequence that complicates monochorionic multiple pregnancies. This condition affects both fetuses - the acardiac twin and the pump twin. This report presents the case of a monochorionic multiple pregnancy complicated by TRAP diagnosed in the first trimester. After clarifying the couple and multidisciplinary discussion, conservative management was chosen because no genetic abnormalities or complications were identified in the normal twin development throughout pregnancy, and the acardiac twin stopped growing at 16 weeks, resulting in a vaginal term delivery of a healthy baby. In utero intervention is currently the first-line treatment option in these cases, but several studies have reported the benefits of an expectant approach. The optimal approach has not yet been established.

Resumo A Hérnia Diafragmática Congénita (HDC) é um dos defeitos congénitos de maior gravidade, estando associado a elevada morbilidade e mortalidade neonatal. Esta anomalia congénita é habitualmente diagnosticada às 22-24 semanas, contudo, no presente caso os sinais ecográficos sugestivos desta patologia não se encontravam presentes nessa idade gestacional. Deste modo, é importante avaliar a morfologia fetal no 3.º trimestre, de forma a detectar anomalias de possível manifestação tardia. A ecografia é crucial para o diagnóstico pré-natal da HDC, permitindo uma vigilância adequada e a referenciação in utero para um centro terciário.

Abstract Congenital diaphragmatic hernia (CDH) is one of the most severe birth defects, with extremely high neonatal mortality and morbidity. The average gestational age for its diagnosis is 22-24 weeks, but in our clinical case, the echographic signs suggestive of CDH were not present at that gestational age. It is therefore important to value the fetal morphological study in the 3rd trimester ultrasound to detect malformations of late manifestation, such as this one. Ultrasound is crucial for prenatal diagnosis, in order to allow adequate surveillance and planning of delivery in a terciary hospital.

ABSTRACT This paper addresses the study of the bubble filter and web information. The main purpose was to analyze how the bubble filter, in its purpose of algorithmically managing content, can ensure the diversity of information sources for Internet users. For this purpose, a descriptive investigation was carried out with the scope of explanation and interpretation based on the systematic review of specialized literature in the Scopus, Web of Science, and SciE-LO databases, mainly. For the collection of information, the documentary review technique was chosen using the instrument of documentary analysis cards. It is concluded that the bubble filter impacts the right to information, as it affects the complete perception of reality and the understanding of the world. This is due to the delivery of information and the hiding of information that is managed by this algorithm, as it turns out to be a spiral of ideologies, tastes, preferences recorded and stored in the user's browsing, avoiding the knowledge of contrary or alternate positions. content users Scopus Science SciELO SciE LO databases mainly cards world algorithm ideologies tastes user s browsing positions

RESUMEN El presente trabajo aborda el estudio del filtro burbuja y la información web. El objetivo principal fue analizar cómo el filtro burbuja, en su propósito de gestionar algo-rítmicamente los contenidos, permite garantizar la diversidad de fuentes de información en los usuarios de Internet. Para dicho fin, se realizó una investigación descriptiva con alcance de explicación e interpretación basada en la revisión sistemática de la literatura especializada en las bases de datos Scopus, Web of Science y SciELO, principalmente. Para la recolección de información, se optó por la técnica de revisión documental utilizando el instrumento de fichas de análisis documental. Se concluye que el filtro burbuja impacta en el derecho a la información, pues afecta la percepción completa de la realidad y la comprensión del mundo. Ello obedece a que la entrega de la información y el ocultamiento de la información que es administrada por este algoritmo resultan ser una espiral de ideologías, gustos, preferencias registradas y almacenadas en las navegaciones del usuario, que evitan el conocimiento de posiciones contrarias o alternas. web algorítmicamente algo rítmicamente contenidos Internet fin Scopus SciELO principalmente mundo ideologías gustos usuario alternas

BACKGROUND. The presence of fathers during the birth of their babies has been recognised as beneficial for both the mother and the baby. OBJECTIVE. To investigate the reasons and demographic factors associated with father absence at delivery. METHODS. We conducted a quantitative, cross-sectional study. Anonymous questionnaires were completed by mothers admitted to the postnatal ward at Pelonomi Tertiary Hospital in Bloemfontein, South Africa, after a live birth. Mothers answered questions regarding mother and father characteristics (age, employment, residence), whether the father was present or absent at delivery and the reasons for his absence. RESULTS. The highest percentage (30.7%) of the 137 participating mothers was in the age range 20 - 25 years. More than half (56.2%) resided in Bloemfontein/Mangaung, and 70.6% were unemployed. Most mothers (68.4%) were multiparous. In total, 81.0% of fathers were absent at delivery, although 50.0% had planned to be at the delivery. The main reason for their absence was employment (52.7%), which can be substantiated by the fact that most fathers (80.3%) were employed. For more than half (58.1%) of the deliveries, neither the father nor any other person (family member or friend) was present at the delivery. There was no association between maternal or paternal demographics and father absence at delivery. CONCLUSION. Father absence was common. Community-based programmes must encourage father involvement in all spheres of their children's lives and create awareness of the impact that their presence during birth can have.

Resumo Introdução: O síndroma de Bardet-Biedl (SBB) é uma doença multissistémica rara, de transmissão predominantemente autossómica recessiva, genética e clinicamente heterogénea. A sua prevalência na Europa varia entre 1:125.000 e 1:175.000, afetando de igual modo ambos os sexos. Este síndroma define-se por obesidade, polidactilia, anomalias genitourinárias, distrofia retiniana e dificuldades cognitivas, que se associam de forma variável e pode incluir um amplo espectro de outras manifestações menos prevalentes. O diagnóstico da SBB é clínico, sendo confirmado por análise molecular, o que permite o aconselhamento genético dos restantes membros da família e a realização do diagnóstico pré-natal. Atualmente não existe tratamento curativo, mas o diagnóstico precoce é importante para orientar o acompanhamento multidisciplinar. O médico de família, pela sua proximidade com o doente e seguimento longitudinal, poderá identificar sinais de alarme relativos ao diagnóstico e à identificação de complicações da doença, além de poder ajudar a mitigar impactos psicossociais deletérios. Descrição do caso: Utente do sexo masculino, quatro anos de idade, raça caucasiana, natural de Lisboa, primeiro filho de uma fratria de três. A gravidez foi vigiada pelo seu médico de família, tendo, por alterações na ecografia morfológica - rins poliquísticos e polidactilia - iniciado seguimento na consulta de genética médica, onde se estabeleceu o diagnóstico de SBB tipo 4. Nasceu por parto eutócico de uma gestação de termo sem outras intercorrências. Foi referenciado às consultas de pediatria, genética, nefrologia, oftalmologia, otorrinolaringologia, cirurgia pediátrica plástica e cardiologia pediátrica. Com cerca de um ano de idade foi-lhe diagnosticada miopia. Aos três anos foi submetido a desarticulação de dedos supranumerários. Presentemente mantém vigilância na consulta de saúde infantil da USF e acompanhamento nutricional, apresentando progressão estaturo-ponderal adequada. Comentário: O objetivo deste trabalho é relatar um caso de SBB e identificar o papel do médico de família na sinalização e acompanhamento da criança com doença genética rara.

Abstract Introduction: Bardet-Biedl syndrome (BBS) is a rare multisystem disorder, predominantly of autosomal recessive transmission, with genetic and clinical heterogeneity. Prevalence in Europe varies from 1:125,000 to 1:175,000, equally affecting both sexes. BBS is defined by a variable combination of obesity, polydactyly, genitourinary anomalies, retinal dystrophy, cognitive impairment, and other less prevalent manifestations. The diagnosis of BBS is clinical, confirmed by molecular analysis. This allows for genetic counseling of families and the possibility of prenatal diagnosis. Currently, there is no curative treatment for BBS, being early diagnosis is important to plan a multidisciplinary follow-up. Family physicians, owing to their closeness with the patient and longitudinal follow-up, may identify red flags leading both to early diagnosis and early detection of complications, and to detect and mitigate any psychosocial mishaps. Case description: Male, Caucasian, four years old, born in Lisbon, first of three children. The pregnancy was initially followed by the general practitioner. Due to changes in the routine morphological ultrasound - polycystic kidneys and polydactyly - a referral was made to a consultation of medical genetics, where the genetic study was carried out to establish the diagnosis of BBS type 4. He was born by eutocic delivery, at the end of a full-term gestation, without complications. He was referred to consultations in pediatrics, genetics, nephrology, ophthalmology, otorhinolaryngology, pediatric plastic surgery, and pediatric cardiology. At about one year of age, he was diagnosed with myopia. At the age of three, he underwent the first disarticulation of the supernumerary fingers and toes. The child keeps follow-up at the USF consultation and nutritional monitoring, so far showing adequate height-weight progression. Comment: The objective of this case report is to describe a case of BBS and to identify the role of the family physician in the referral and follow-up of a child with a rare genetic disorder.

INTRODUCTION: Caries and gingival disease are prevalent oral health issues affecting more than 80% of school-going children including those with special needs attending special schools. Schools play a crucial role in promoting oral health, providing education and identifying issues early. These school-based health programmes are essential for addressing these issues and can reach more than 1 billion children worldwide, as well as school staff, families and the community. AIMS AND OBJECTIVES: To determine the current delivery of oral health care programmes in the identified special schools by means of a semi-structured interview with school managers. DESIGN: A descriptive qualitative study design. METHODS: All school managers (principals) who were responsible for the facilitation of the implementation and delivery of oral health services in each of the 22 special schools were invited to participation in the study. Purposive sampling was used to select the managers at the various special schools. Data collection comprised face-to-face, semi-structured interviews to explore the specific provision of oral health-related interventions and programmes (1 interview was conducted per school, n=22). RESULTS: Six emergent themes were present in the study: oral health activities, implementation and evaluation process, implementation challenges, policy content perceptions, dental examinations and oral health prevalence in special schools. Oral hygiene was identified as a priority, with educators and school nurses responsible for school oral health education, supervised teeth brushing programme, pain management, oral examinations in some cases and referral for dental treatments through engaging parents, learners and health workers in oral health promotion, which was supported by the school's health policy with the departmental heads responsible for programme evaluation. However, the implementation of the programmes was impacted by five factors: lack of parental support, lack of professional guidance, lack of resources, lack of support from the oral health department and the Covid-19 pandemic further exacerbated these challenges. CONCLUSION: The study reveals that special schools have preventative and promotive oral health programmes, but they need therapeutic or curative services to address unmet treatment needs. Factors affecting these programmes have led to gaps in implementation processes. Together, these findings point to an urgent need for a review of oral health care programmes in KwaZulu-Natal special schools to ensure proper support and collaboration between key stakeholders to reduce negative effects and improve overall oral health programmes.

Abstract Introduction: Vacuum extraction is the instrument of choice for assisting instrumental delivery in developed countries. Objective: The aim of the study is to present the maternal and fetal outcomes of vacuum use in the Chilean population and promote its availability and usage in our country and Latin America. Method: The study was performed between October 2017 and December 2021, including patients who underwent instrumental delivery with a vacuum extraction at the Hospital San Juan de Dios in Chile. Successful vacuum deliveries were compared with deliveries where another instrument was required, or a cesarean section was performed after instrument use. Results: A total of 153 vacuum deliveries were carried out, accounting for 28.59% of all instrumental deliveries. 79.74% were successful. 5.88% did not receive anesthesia or received local anesthesia. Only 3.27% experienced perineal tear with involvement of the anal sphincter. 91.5% of newborns had no fetal complications. 20.3% required neonatal resuscitation. Conclusions: The study demonstrates that the vacuum is a safe and effective option for instrumental delivery in our population. Proper training and appropriate protocols are necessary to ensure successful outcomes.

Resumen Introducción: El vacuum es el instrumento de elección para asistir el parto instrumental en países desarrollados. Objetivo: El objetivo del estudio es exponer los resultados maternos y fetales del uso del vacuum en población chilena y promover su disponibilidad y uso en nuestro país y Latinoamérica. Método: El estudio se realizó entre octubre de 2017 y diciembre de 2021, incluyendo a pacientes que tuvieron parto instrumental con vacuum en el Hospital San Juan de Dios de Chile. Se compararon los partos exitosos con vacuum y los partos en los que se requirió el uso de otro instrumento o una cesárea posterior al uso del instrumento. Resultados: Se realizaron 153 vacuum, correspondientes al 28,59% del total de partos instrumentales. El 79,74% tuvo éxito. El 5,88% no recibió anestesia o se aplicó anestesia local. Solo el 3,27% presentó desgarro perineal con compromiso del esfínter anal. El 91,5% de los recién nacidos no tuvieron complicaciones fetales. Un 20,3% requirió reanimación neonatal. Conclusiones: El estudio muestra que el vacuum es una opción segura y efectiva de parto instrumental en nuestra población. La correcta capacitación y protocolos adecuados son necesarios para garantizar resultados exitosos.

Abstract In the context of the recent transformations undergone by work in Brazilian metropolises, there has been a multiplication of precarious jobs related to circulation of goods. The crisis of capital and of the value-form seem to be giving rise to the need of efficient circulation as a condition for accumulation, which is reflected in the so- -called logistical urbanization. The article presents an interpretation of these processes based on Lefebvre’s levels of analysis of the urban (G-M-P). By exploring the relationship between crisis of capital, logistical urbanization, and the everyday dimension of app-based delivery workers, we conclude that the precarization of work and the production of logistical infrastructures emerge as material expressions of the increasing crisis of the valorization of value; at the same time, they alter the forms of struggle of the working class.

Resumo Considerando as recentes transformações do trabalho nas metrópoles brasileiras, observa-se uma multiplicação do trabalho precário baseado na circulação de mercadorias. A crise do capital e da forma-valor parece dar origem a um imperativo de circulação eficiente como condição de possibilidade para a acumulação, que se reflete na chamada urbanização logística. Este artigo apresenta uma interpretação desses processos a partir da perspectiva lefebvriana dos níveis de análise do urbano (G-M-P). Ao explorar a relação entre crise do capital, urbanização logística e a dimensão cotidiana dos entregadores de aplicativo, concluímos que a precarização do trabalho e a produção de infraestruturas logísticas aparecem como expressão material do aprofundamento da crise da valorização do valor, alterando simultaneamente as formas de luta da classe trabalhadora.

Resumo Diante das mudanças econômicas, políticas e tecnológicas do mundo do trabalho no território urbano, enfrentamos hoje novas informalidades que precarizam as relações e condições de trabalho de forma global. O objetivo deste ensaio é tecer reflexões críticas sobre os processos de novas subjetivações e riscos psicossociais da uberização do trabalho e seus impactos nas dinâmicas territoriais, destacando as empresas-plataforma que oferecem serviços de táxi e entrega, fazendo um panorama que desloca do cenário internacional para o nacional. Os trabalhadores uberizados enfrentam situações singulares de violências das empresas-plataforma e urbana, agravando os riscos psicossociais, a dignidade, a saúde e a qualidade de vida dos trabalhadores. As práticas, gestão e contradições dessas empresas denotam a privação do direito à cidade e a captura da subjetividade dos trabalhadores. econômicas urbano global territoriais empresasplataforma plataforma entrega nacional urbana dignidade práticas

Abstract In view of the economic, political, and technological changes in the world of work within the urban territory, nowadays we are facing new informalities that increase the precariousness of work relationships and conditions in a global level. This essay aims to reflect critically on new subjectivations and on psychosocial risks related to the uberization of work, analyzing their impacts on territorial dynamics. We highlight platform companies that offer taxi and delivery services, and we provide a panorama that shifts from the international to the national scenario. Uberized workers face unique episodes of violence committed by platform companies and urban violence, which intensify psychosocial risks and harm workers' dignity, health, and quality of life. The practices of platform companies, as well as their management and contradictions, reveal a deprivation of the right to the city and the capture of workers' subjectivity. economic political territory level dynamics services scenario dignity health life contradictions subjectivity