A Study on the Correlation of Body Mass Management During Pregnancy with Adverse Pregnancy Outcomes and Labor Progression

Objective:To investigate the effects of body mass management during pregnancy on adverse pregnancy outcomes,duration of labor,and neonatal birth weight.Methods:472 pregnant women who visited Beijing Anzhen Hospital from January to December 2023 were selected,and the pregnant women were divided into 236 each in the observation group and the control group.Body mass of pregnant women was measured and BMI was calculated in early and late pregnancy respectively,and the pregnant women in the control group were guided by routine management,while the observation group was guided by body mass management during pregnancy.The growth of maternal body mass,mode of delivery,postpartum hemorrhage,neonatal score,neonatal blood glucose at birth,and umbilical artery blood,as well as the comparison of the duration of labor,were observed.Results:The observation group was significantly better than the control group in terms of mode of delivery,postpartum hemorrhage,and body mass growth,with statistically significant differences(P<0.05),and there was no statistical significance in terms of neonatal scores,neonatal blood glucose at birth,and umbilical artery blood(P>0.05);the time of the first stage of labor and the time of the second stage of labor of the mothers in the observation group was significantly better than that of the control group,with statistical differences(P<0.05),and the time of the third stage of labor of the mothers in the observation group was statistically better than that of the control group.There was no statistically significant difference between the time of the third stage of labor in the observation group and the control group(P>0.05),and the time of the total stage of labor in the observation group was statistically better than that in the control group(P<0.05).Conclusion:Body mass management during pregnancy can effectively improve maternal control of weight gain,reduce labor time,and decrease the occurrence of adverse pregnancy outcomes.

Self-Management Behaviors of Patients with Hypertension in Daily Life

Background: In a rapidly aging Japanese society, the number of patients with hypertension has seen a steady increase. The basic treatments for hypertension are maintaining blood pressure through medication and preventing complications. It is important for patients with hypertension to perform self-management. This improves their lifestyle while controlling their blood pressure to prevent complications and maintain good health. Purpose: This study aimed to examine the actual self-management behavior ability of patients with hypertension and to clarify the factors involved in their self-management behavior. Methods: A total of 150 patients with hypertension were included in this study. The following data were obtained from the patients as background information: sex, age, years with disease, whether they are receiving antihypertensive agents, type of antihypertensive agent, blood test data, heart thoracic ratio, left ventricular ejection fraction, pulse wave, pulse wave velocity, and height. The levels of self-management skills of the patients were also assessed using the “Instrument to Measure the Self-care of patients with Hypertension” developed by Tsuboi et al. Results: The associations among self-management behaviors in daily life, such as diet, exercise, stress, medication, alcohol intake, and smoking, were analyzed in patients with hypertension. The subjects were classified into the following three groups: aged 65 years or below (Group A), early stage elderly individuals (Group B), and late-stage elderly individuals aged 75 years or over (Group C). The results showed that the subjects in Group C had higher self-management scores for diet, exercise, stress, medication, and drinking than the subjects in the other two groups. The scores of smoking and self-management of the subjects in Group A were high but their other self-management scores were low. All the subjects were taking between 1 to 3 types of oral antihypertensive drugs. The rate of achievement of the target blood pressure was 50% or more in all the three groups. However, the pulse wave velocity was high in all the three groups. Conclusion: The results indicate that the risk of developing disorders of the brain and cardiovascular system is high in all the three groups, owing to the high degree of arteriosclerosis. Therefore, increasing the number of nursing interventions is expected to reduce blood pressure, maintain and promote self-management behavior in daily life, and prevent the onset of complications. The results suggest that nursing interventions involving lifestyle guidance for improving the self-management skills of patients are urgently needed by patients under 65 years of age.

A Strategy of Density-Based Partitioning for Scalability Problem in Network Self-management

A density-based partitioning strategy is proposed for large domain networks in order to deal with the scalability issue found in autonomic networks considering, as a scenario, the autonomic Quality of Service （QoS） management context. The approach adopted focus as on obtaining dense network partitions having more paths for a given vertices set in the domain. It is demonstrated that dense partitions improve autonomic processing scalability, for instance, reducing routing process complexity. The solution looks for a significant trade-off between partition autonomic algorithm execution time and path selection quality in large domains. Simulation scenarios for path selection execution time are presented and discussed. Authors argue that autonomic networks may benefit from the dense partition approach proposed by achieving scalable, efficient and near real-time support for autonomic management systems.

Policy options and system supplies on socialization standard management of city agricultural laborers

It is a social system engineering to solve problems of city agricultural laborers, inevitably concerning series of social phenomenon and the social issues of the city and countryside relations, the government function, the city management, the fair efficiency, the population flows, the labor employment, the social security, and so on. Furthermore, it also involves the profoundly political and economic system reforms, the transformation of government functions, the system perfection, legal administration, the social stability in China. The city government, as the direct superintendent of the agricultural laborers, should adopt the conception of the system engineering to construct a new mechanism of the city agricultural laborers socialization standard management, which has a profound theoretical and practical significance.

Uterotonic drugs use for post partum hemorrhage: An audit of the third stage of labor management

Objectives: Worldwide the use of uterotonic drugs has significantly reduced maternal mortality from postpartum hemorrhage. The objective is to audit the use of uterotonics in the active management of the third and fourth stages of labor. Methods: Personal data, diagnostic clinical information, blood loss and uterotonics administered were extracted from a cohort of 634 consecutive parturient. Trend in Shock Index (Pulse Rate/Systolic Blood Pressure) and 48 hours hematocrit changes were computed and analyzed. Results: There were 422 vagina deliveries and 212 caesarean sections. Primiparous mothers were 141 (34.2%), while grand multiparous mothers were 14 (3.4%). The mean visually estimated postpartum blood loss 165.9 ± 80 ml. There was no significant difference in the mean blood loss between the three parity groups of parturient [P = 0.09]. Fourteen parturient (3.44%) had blood loss ≥500 ml. The value of Shock Index (Pulse Rate/Systolic Blood Pressure) in the study ranged between 0.43 and 1.38. Logistic regression analysis of the variables associated with the switch between the three regimens of uterotonic drugs, showed a significant positive correlation between VEBL and uterotonic drugs administered [Pearson correlation = 0.130, P-value = 0.008]. In addition, there was a significant negative correlation between uterotonic drugs administered and Shock Index at 30 minutes and 2 hours postpartum. The correlation coefficient between VEBL and regimens of uterotonic drugs used was positive and significant (P = 0.019). Conclusion: Visually estimated blood loss, with shock are the main Triggers involved in switching between uterotonic drugs regimens used in active management of PPH. Shock index calculation is vital in management decision. We advocate training of all birth attendants on VEBL.

Midwives’ utilization of nonpharmacological pain relief measures for labor pain management: A descriptive cross-sectional study

Objectives:This study sought to examine midwives’utilization of nonpharmacological pain relief measures in labor pain management and to test the relationship between midwives’knowledge and utilization of nonpharmacological pain relief measures for labor pain management in secondary health facility in Calabar,Cross River State,Nigeria.Materials and Methods:A descriptive cross-sectional design was used for the study.The study was rooted in Katherine Kolcaba’s Comfort theory.Totally,67 participants were recruited for the study using the purposive sampling technique.A self-made structured questionnaire was used to obtain participants’information on knowledge,utilization,and predictors of nonpharmacological pain relief measures.Results:Although 41(61.2%)of the participants had knowledge about nonpharmacological pain relief measures,few did not know some of the cognitive-behavioral and environmental measures in labor pain management.There was 35.8%(24/67)for utilization of cognitive-behavioral measures and 55.2%(37/67)for psychological/emotional measures for labor pain management by respondents,respectively.Fifty(74.6%)of respondents agreed that predictors such as lack of knowledge,lack of updates and training,work experience,best practice guidelines,and equipment were hindrances to utilization.There was statistically significance in relationship between the level of knowledge and utilization of nonpharmacological pain relief measures(r=0.6,P<0.05).Conclusion:The utilization of nonpharmacological measures for labor pain management is low,thus it is recommended that frequent education,training updates on effective labor pain management,provision of clinical guidelines on labor pain management,and enrichment of midwifery training curriculum are imperative to ensure quality labor pain management and positive health outcome.

Modern Enterprise Human Resource Management and Labor Standards System --Theoretical Innovation in Chinese Labor Economics

The goal of this paper is to draw a systematical conclusion from relationship between labor standards system and modem enterprise human resource management. The conclusion will be a theoretical gist and provides methodology foundation for analysis of labor standards system with operable characteristics and rules, which will help to carry out the social economic policy design related to labor standards. The argumentation in this paper belongs to system economics analysis.

Psychological Contract within Labor Relation and Its Management Strategy

The paper argues that labor contracts between employees and organization includes two facets, i.e. economic contracts and psychological contracts, and along with enterprise competition becoming fierce increasingly and labor force becoming diversified all the more, the psychological contracts have crucial effects on employees＇ attitudes, behaviors and performances. We also argue that, under the challenging organization context, if managers want to make strategic partnership with employees, they must link employees with hearts, pay attention to the management of psychological contracts before, during and after signing labor contracts, and keep dynamic equilibrium of psychological contracts.

Distance management of inflammatory bowel disease:Systematic review and meta-analysis

AIM: To review the effectiveness of distance management methods in the management of adult inflammatory bowel disease (IBD) patients.

Obstetrics Risk Management in 5 Iranian Hospitals (Tehran-2012)

Background: Risk management is improving quality of health care services and creating a safer system of care. We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran) to offer some practical strategies to decline obstetric adverse events and provide better pregnancy outcome. Methods: A descriptive, cross-sectional study was carried out in 5 Iranian hospitals (2011-2012).?Twelve Obstetricians/perinatalogists and midwives from 5 hospitalswho were in charge of Maternity Units, were our assistants in these hospitals. We organized a secretariat including Obstetricians/perinatalogists and midwives. The principles of Obstetrics Risk Management were introduced to them in a 2 days’ workshop. Then the delegates from each hospital were asked to report the most common obstetrical complications of their hospitals. The main results were 24 complications. Then for sorting these risks we asked them to do scoring of the 24 complication with 1 - 10 grading in 4 aspects of probability of occurrence, possibility of prevention, priority of interventions and short term response to interventions. Post partum haemorrhage, labor management problems, and neonatal hypothermia got the highest scores in these regards, and then these 24 items were categorized in 2 groups of risk assessment and hospital management. Finally based on Risk Management Rules in Clinical Governance, the complications analysis was done with use of failure mode, effects analysis and practical strategies to decline obstetrical adverse events were suggested. Results: We understood all reported complications had common infrastructural problems: defects in Risk Assessment and Hospital Management Policies. We focused on basic infrastructural management in these 2 main subjects and in these two: our main problems were related to staff management and hospital management issues. Conclusion: Since managerial and staff dependent problems were our main problems, these two should be considered as our main priorities in risk management program.

Partnership Management的探讨

改革开放二十多年来,我国建筑业得到了持续快速的发展,建筑业在国民经济中的支柱产业地位不断加强,对国民经济的拉动作用显著。当前建设工程项目竞争异常激烈,传统工程项目管理组织模式中,参与项目的业主、设计单位和承包商按照订立的契约合同行使权利和义务,以期能实现最大利益化,然而也带来了许多问题。本文介绍一种重要的工程项目经营管理模式——Partnership Management,并就我国借鉴和引用这一模式,提出了一些建议,以便达成多方共赢的目的。

Advances in epidural labor analgesia:Effectiveness and treatment strategies of butorphanol

In this editorial,we provide a critical review of the article by Tang et al published in the World J Clin Cases,focusing on the utilization of butorphanol for epidural analgesia during labor.Our discussion encompasses recent research developments in epidural labor analgesia,specifically highlighting the current status of clinical applications of butorphanol and associated treatment approaches.Epidural analgesia is widely acknowledged as the primary method for pain management during labor,offering effective and prolonged pain relief while allowing mothers to remain alert and actively participate in the delivery process.Among the various drugs utilized for epidural labor analgesia,butorphanol has received increasing attention due to its potential efficacy and distinctive pharmacological properties.As a synthetic opioid analgesic,butorphanol exhibits both agonistic and antagonistic activity on opioid receptors,striking a balance between analgesia and minimizing side effects.Nevertheless,the safety and efficacy of butorphanol in epidural labor analgesia remains controversial.While certain studies have reported positive outcomes with butorphanol,including effective pain relief and a reduced incidence of side effects,others have raised concerns about its safety and efficacy compared to traditional opioids or alternative analgesics.In addition,the optimal dosing strategy and regimen of butorphanol as an adjuvant in epidural labor analgesia still need to be verified.Through comprehensive synthesis and analysis of existing literature,we aim to evaluate the current evidence regarding the use of butorphanol for epidural labor analgesia,delineate areas of consensus and controversy,and propose future avenues for research and clinical practice in this domain.

A Study on Compensation for Management and Protection Expenses of Non-commercial Forests

This paper analyzes the compensation nature of non-commercial forests under different ownership from two aspects, namely, whether the property right is limited and whether the management and protection expense has been incurred: there are no economic loss compensation problems caused by changes and limitation of property rights for the state-owned non-commercial forests with only the compensation on management and protection expense; but for the non-commercial forests owned by collectives or individuals, double compensation for both the economic loss and management expense exists because of limitation on the property right. In addition, an inframarginal economic analysis framework has been built for the management and protection compensation problems faced by non-commercial forests under different ownership in the perspective of the division of labor. Research results show that: the compensation standard for the management and protection expenses of non-commercial forests shall fall in between the "completely self-sufficient forestry economic structure U(Ayz)" and the "completely specialized productive structure of non-commercial forests U(B1)".

6S管理在工程训练中心实验室管理中的应用

6S管理是企业现场管理的有效手段,工程训练中心具备接近制造型企业的生产环境,因此将6S管理引入工程训练中心实验室日常管理中,能有效提高实验室管理标准化、规范化、科学化水平。工程训练中心依据6S管理内涵,结合中心实验室现状,通过建立6S管理推行体制,组织6S管理培训,制定6S管理标准等手段,对实验室进行6S管理改造。通过6S管理的实施,改善了实验室环境,提升实验室人员素养,提高了实验室使用效能。6S管理在劳动育人方面也发挥了积极作用。

Is the feminization of labor harmful to agricultural production? The decision-making and production control perspective

Even today,academics continue to debate the effect of feminization of agricultural labor force on agricultural output.By considering the dimensions of participation in decision-making and production,this study divides the various agricultural production models into three types:(i)the traditional model of decisions made either jointly by men and women or by men alone while both genders participate in production,(ii)complete feminization of agricultural decision-making and the production labor force,and(iii)feminization of the agricultural production labor force only.This study investigates the effects of combining or separating decision-making and production in regard to agricultural development in the context of feminization of the agricultural labor force.Using follow-up data collected from 2004–2008 by the Ministry of Agriculture of China,we built a comprehensive panel data model to test our hypotheses.Our research shows that in comparison to traditional agricultural households and fully feminized agricultural labor forces,partially feminized production resulted in lower grain yield and technological advancement.The feminization of agricultural labor does not necessarily have a negative impact on agricultural output,especially since heavy manual labor is being increasingly replaced by agricultural machinery and outsourcing of tasks.The degree of feminization of the decision-making and production processes should be an important consideration when evaluating the purported negative effects of the feminization of agricultural labor.

Using Alert and Action Expected Times of Delivery in Prevention of Prolonged Labor

Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simplified model proposed by Debdas, the so called paperless partogram, we aimed at evaluating the ability of only using the alert and action lines to prevent prolongation of labor. Methods: This was a cross-sectional study including labor records of women delivered at King Baudouin Hospital of Kinshasa (secondary level) from 01/01 till 31/12/2013. The study was approved by the Faculty Ethical Committee. Inclusion criteria were: 1) live singleton pregnancy, 2) cephalic fetal presentation, 3) lack of uterine scar, 4) monitoring in labor ward by 4 cm of cervical dilation, and 5) delivery at term. For every record, the expected time of delivery (ETD = 6 hours after 4 cm of cervical dilation) was considered “Alert EDT” to which 4 hours were added to obtain the “Action EDT”. Irrespective of other fetal and maternal features contained in the traditional partogram Alert and Action ETD were checked a posteriori on Debdas’s model to derive the appropriate outcome of labor. Results: The study included 357 participants, of which 219 primiparous and 138 multiparous. Vaginal delivery took place in 91% of cases. Full cervical dilation was achieved after 8 - 9 hours (9.5 ± 1.8 hours for primiparous and 8.4 ± 1.7 hours for multiparous women), namely 2 - 3 hours following Alert ETD). This duration is close to the Action ETD. For 32 cesarean sections (9%) final decision took place within the Alert ETD. Conclusion: Using only Alert and Action ETD was found convenient to derive appropriate measures for the outcome of labor. So, the paperless partogram is a simplified method to manage the active stage of labor that could prevent prolongation of labor in our setting.

分娩镇痛:舒适与安全并行,教学与质控并举

分娩镇痛是以遵循产妇自愿和临床安全为原则,通过实施有效的分娩镇痛技术,以最大程度减轻产妇产痛的医疗服务。2018年,北京协和医院成为我国分娩镇痛首批试点单位,近年来在分娩镇痛高质量发展的各项工作中取得了满意成果。本文主要介绍北京协和医院分娩镇痛相关经验,具体包括:(1)合理调配人员安排,多学科联动制定标准化诊疗流程,为安全分娩提供舒适度保障;(2)完善危重孕产妇、新生儿救治方案,为安全分娩保驾护航;(3)传递先进的教学理念,将分娩镇痛培训与救治演练落到实处;(4)开展教育与科普讲座,帮助产妇树立科学分娩镇痛观。希望该经验分享可为我国各级诊疗机构提供参考和借鉴。

Labor Pain Treated with Acupuncture or Acupressure

Opioid-dependent women have an 80% to 90% unintended pregnancy rate, almost double the overall unintended pregnancy rate: 40% globally and 51% in north America. The prescription drug abuse milieu increases the possibility opioid abusing laboring patients. In 2012, neonatal abstinence syndrome occurred in 5.8 per 1000 hospital births. Non-pharmacological labor pain management (NPLPM) is especially recommended for laboring patients with a history of substance abuse. Therefore, literature review was performed to elucidate the efficacy and safety of acupuncture, noninvasive electro-acupuncture (EA), and acupressure in labor pain management. Compared to standard intrapartum controls, bilateral EA at JiaJin or Sanyinjiao significantly reduced visual analog scale (VAS) pain scores 30-minutes post intervention (p < 0.01) and Stage 1 active phase labor length (p < 0.05). EA achieves shorter Stage 2 labor than patient-controlled epidural analgesia (p = 0.05);and 10-point lower VAS pain scores and reduced cesarean delivery rate than no-analgesia controls, p < 0.05. Current evidence indicates that EA should have a role in NPLPM, and that acupressure may have a role in NPLPM. Nevertheless, future RCTs could strengthen the argument for increased EA and acupressure use in NPLPM.

Dazed and Confused:The Impact of Multinational Firms on Local Labor Markets

In this high-speed globalization era,the opportunities for multinational companies(MNCs)have become vast.In such situation,these companies can obtain maximum profit only if they know how to use workforce properly.This paper aims at analyzing how these MNCs can use international workforce without violating ethics,universal labor rights,and human resource rules.For this purpose,two most favored countries i.e.,China and Indonesia have been taken and compared throughout the paper.The first part of this paper deals with the introduction of the profile of above mentioned two countries and opportunities to the MNCs.The second part deals with the roles of institutions in dealing with labor workforce.The third part indicates divergent paths and the convergence of the globalization with its impact over host countries.The final part concludes the entire discussion in a few paragraphs.The entire paper has been developed keeping the scholarly work,journal articles and critical analysis factor under consideration.

“大国小农”背景下中国农业现代化之路——兼论培育农业领域新质生产力的内在逻辑与实现路径

农业领域新质生产力的提出是新质生产力理论在当代农业实践中的遵循与延伸,符合农业生产的客观规律,它将生产力理论的经典构架与现代农业的发展趋势相结合,形成了生产力理论体系的新维度。培育和发展农业领域新质生产力能够有效提升农业劳动力素质、应对农业经营规模受限导致的相关问题并引领农业现代化进程。农业领域新质生产力主要通过科技创新、劳动力素质提升和农业经营体制创新三个维度加快农业现代化进程。当前,农业领域新质生产力的培育和发展主要面临关键技术研发滞后、数字应用场景不足及高素质农业人才缺乏等问题。为此,可通过完善现代化农业大数据体系、培育数字“新农人”专业队伍等措施积极培育农业领域新质生产力,进而推动我国农业的可持续发展并增强国际竞争力。