Mistreatment during Childbirth: Impact on Maternal Outcomes and Importance of Provider Perspectives

Background: Dying in childbirth is one of the most common causes of death for women. While maternal mortality rates, defined as deaths per 100,000 live births, have been steadily dropping in most countries worldwide, maternal mortality rates have doubled in the United States in the last twenty years. This commentary examines the various contributing factors to this trend. Methods: A literature review was performed using the keywords: maternal mortality, United States, disrespectful maternity care, obstetric violence, provider perspectives, and disparities. Maternal mortality statistics were obtained from the World Health Organization website. Results: Medical factors associated with maternal mortality include increased maternal age and cardiovascular conditions. Social factors include barriers to healthcare access, delays in receiving medical care, reduction in reproductive health services in some states, and non-obstetrical deaths such as accidents, domestic violence, and suicide. Racial inequities and disparities of care are reflected in higher maternal mortality rates for minorities and people of color. Disrespectful maternity care or obstetric violence has been reported worldwide as a factor in delay of lifesaving obstetrical care and reluctance by a pregnant person to access the healthcare system. About one in five US women has reported experiencing mistreatment, varying from verbal abuse to lack of privacy, from coerced procedures to neglect during childbirth. Conclusion: This commentary highlights the importance of inclusion of providers in research on respectful maternity care. Provider burnout, moral distress, limited time, and burden of clinical responsibilities are known challenges to respectful and comprehensive medical care. The association of disrespectful care with poor maternal outcomes needs to be studied. Exploring root causes of disrespectful childbirth care can empower nurses, midwives, and physicians to improve their environment and find solutions to reduce a potential cause of maternal mortality.

Effective Utilization of Government-Provided CTI by Small Businesses within the Defense Industrial Base

There are two broad objectives of the research reported in this paper. First, we assess whether government-provided cyber threat intelligence (CTI) is helpful in preventing, or responding to, cyber-attacks among small businesses within the U.S. Defense Industrial Base (DIB). Second, we identify ways of improving the effectiveness of government-provided CTI to small businesses within the DIB. Based on a questionnaire-based survey, our findings suggest that government-provided CTI helps businesses within the DIB in preventing, or responding to, cyber-attacks providing a firm is familiar with the CTI. Unfortunately, a large percentage of small firms are not familiar with the government-provided CTI feeds and consequently are not utilizing the CTI. This latter situation is largely due to financial constraints confronting small businesses that prevent firms from having the wherewithal necessary to effectively utilize the government-provided CTI. However, we found a significant positive association between a firm’s familiarity with the government-provided CTI and whether a firm is being periodically reviewed by the Defense Counterintelligence and Security Agency (DCSA) or is compliant with the Cybersecurity Maturity Model Certification (CMMC) program. The findings from our study also show that the participating firms believe that external cyber threats are more likely to be the cause of a future cybersecurity breach than internal cybersecurity threats. Finally, our study found that the portion of the IT budget that small businesses within the DIB spend on cybersecurity-related activities is dependent on the perception that a firm would be the target of an external cyber-attack.

Childhood Development Cross Culturally:Implications for Designing Childhood Obesity Interventions and Providing Culturally Competent Care

United States is experiencing significant growth in its foreign-born population,especially Chinese American population comprising of 1.2%of the U.S.population.Many healthcare providers are challenged in their efforts to provide culturally competent healthcare to this population.To provide culturally competent healthcare,healthcare providers should understand variations in cultural attributes that impact health.One group in which cultural variation holds great influence is that of children.Culture influences a child's behavior,development and health.This article provides a cross-cultural,comparative examination of important cultural influences on child behaviors development and health in China and the U.S.Using the findings about these two populations,interventions for childhood obesity cross culturally are addressed through the analysis of a U.S.based Children's Obesity Program.The author suggests that uniquely different approaches to childhood obesity intervention research are needed based upon the cultural differences identified within this paper.

Providing for the Future

Taikang Life makes deep inroads into China’s lucrative life insurance industry PURCHASING insurance policies in China has become a popular business trend in recent years.The size of the middle class continues to grow by leaps and bounds,as more Chinese residents can afford life insurance for their families.Taikang Life Co.Ltd.,one of China’s top five life

Rationale of a Cross Sectional Descriptive Study on Knowledge and Practices of Healthcare Providers on Postpartum Hemorrhage Management in Kinshasa, the Democratic Republic of the Congo

Background: Healthcare Providers’ knowledge and practice of postpartum hemorrhage (PPH) management are essential to reduce maternal morbidity and mortality. PPH is a public health problem due to the high maternal mortality (MM) associated with it worldwide (25%). Improving the quality of PPH management is a major challenge in low-income countries where, despite the progress made in its management, PPH remains a major contributor to maternal morbidity and mortality. Objective: We will evaluate the level of knowledge and practices of providers in the PPH management in Kinshasa in the Democratic Republic of the Congo (DRC). Methods: This study will be descriptive and cross-sectional. The minimum sample size will be 86. Our study population will consist of delivery room care providers. Results will be reported as percentage proportion and mean plus or minus standard deviation. Comparisons of means between groups will be made using Student’s t-test and Pearson’s chi-square test. The test will be statistically significant for a p value 0.05. Data will be collected and processed anonymously and confidentially. Conclusion: Improving quality of care must be a priority in obstetrics. This evaluation requires us to determine the level of knowledge and practices of providers in the PPH management in Kinshasa.

Light-Weighted Decision Support Framework for Selecting Cloud Service Providers

Multi-criteria decision making(MCDM)is a technique used to achieve better outcomes for some complex business-related problems,whereby the selection of the best alternative can be made in as many cases as possible.This paper proposes a model,the multi-criteria decision support method,that allows both service providers and consumers to maximize their profits while preserving the best matching process for resource allocation and task scheduling.The increasing number of service providers with different service provision capabilities creates an issue for consumers seeking to select the best service provider.Each consumer seeks a service provider based on various preferences,such as price,service quality,and time to complete the tasks.In the literature,the problem is viewed from different perspectives,such as investigating how to enhance task scheduling and the resource allocation process,improve consumers’trust,and deal with network problems.This paper offers a novel model that considers the preferences of both service providers and consumers to find the best available service provider for each consumer.First,the model adopts the best-worst method(BWM)to gather and prioritize tasks based on consumers’and service providers’preferences.Then,the model calculates and matches similarities between the sets of tasks from the consumer’s side with the sets of tasks from the provider’s side to select the best service provider for each consumer using the two proposed algorithms.The complexity of the two algorithms is found to be O(n3).

Examining Knowledge Decay in the Anesthesia Provider—An Integrative Review

Background: Knowledge decay can be present in a lot of different careers but it is especially important when affecting the anesthesia provider. Knowledge decay can lead to skill decay. Therefore, it leads to worse patient outcomes. It is important to know how knowledge decay occurs and to know how to prevent it. Purpose: The purpose of this review was to explore the contributing factors of knowledge decay while also examining how different learning activities can be used to prevent it from occurring. Methods: A systematic literature search was performed in PubMed, Cochrane databases, and Embase. The American Association of Nurse Anesthesiology website was also examined. Findings: Knowledge decay usually occurs when either the anesthesia provider is in a new area of practice or when the provider has had a significant amount of time pass since the latest implementation of an anesthesia skill. The type of activity shown to best combat knowledge decay is the use of a simulation-based learning activity. Classroom learning can also help combat knowledge decay, but not to the same extent. Conclusions: The most significant way to prevent knowledge decay in the anesthesia provider is to implement simulation-based learning activities, as well as keep anesthesia providers comfortable with the skills that they practice.

The Extent of Partograph Use and Associated Factors among Obstetric Care Providers in Government Hospitals in Southern Ethiopia: A Cross-Sectional Study

Background: Prolonged labor is a significant contributor to maternal morbidity and mortality. The World Health Organization encourages using the partograph to keep track and solve this issue. The extent of partograph use in Ethiopia, however, is hardly understood. This study aimed to ascertain the level of partograph use and related variables among obstetric care providers in government hospitals in southern Ethiopia. Methods: A cross-sectional institutional study was conducted among obstetric care providers in government hospitals in southern Ethiopia, from March to December 2015. The data were collected using a pre-tested questionnaire and format. To establish a statistical relationship, an odds ratio with a 95% confidence interval was utilized. Results: A total of 212 (55.1%) obstetric providers reported routine use of partograph to monitor labor. Midwives [AOR: 3.4, 95% CI: (1.2, 9.4)], clinical nurses [AOR: 3.0, 95% CI: (1.1, 7.6)], knowledge of partographs [AOR: 2.0, 95% CI: (1.2, 3.5)], positive attitudes toward partograph use [AOR: 3.7, 95% CI: (1.7, 7.7)], service of 2 - 5 years [AOR: 3.4, 95% CI: (2.8, 4.4)] and service of more than five years [AOR: 2.3, 95% CI: (2.0, 3.3)] were associated with partograph use. Conclusion: This study has shown that the use of partographs to monitor labor among obstetricians is consistent with other studies from developing countries. However, this does not mean that obstetric care does not need to be strengthened, as a significant proportion of obstetricians still do not use the partograph for labor monitoring. Therefore, it is recommended that midwives and nurses be given preference in the delivery of obstetric services, the knowledge and attitudes of providers be improved, and mechanisms be developed that can help keep senior care providers.

Respecting Each Other and Being Loyal to ZTE Career Providing Refined Service and Focusing on Customers' Requirements Working Hard to Create Famous ZTE Brand Improving ZTE Efficiency with Scientific Management

ZTE Corporation is China’s largest listedtelecommunications equipment provider spe-cialized in offering a full range of tailor-madesolutions for customers in high-,middle-andlow-end markets.

CHINA-AFRICA DEVELOPMENT FUND:Providing a bridge for investment

THE Durban COP 17 gathering was always seen as a station on the long journey of global climate change consensus and not the destination.

CHINA-AFRICA DEVELOPMENT FUND:Providing a bridge for investment

Establishing a China-Africa Development Fund(CADFund) to encourage and support Chinese enterprises to invest in Africa was one of the eight measures implemented to strengthen China-Africa cooperation pledged by China at the Beijing Summit of the Forum on China-Africa Cooperation(FOCAC) in 2006. The Fund became operational in June 2007 with a first-phase funding of $1 billion provided by China Development Bank(CDB).The funding is expected

Making Sense of Anything thru Analytics: Employees Provident Fund (EPF)

Employees Provident Fund (EPF) has always been a hot topic, from the previous Government permitted “withdrawals” during the pandemic to the present Government disallowing further withdrawals (afraid it would lead to a financial crisis) and allowing emergency loans through an EPF collateral agreement. The latter used median studies to “contribute” MYR 500 to EPF members with less than RM 10,000 in their accounts. Baffled/bewildered by the current Government’s generosity and highlighted in this paper, I used Monte Carlo simulation, a method used by analysts when determining the size of a client’s portfolio to support their desired retirement lifestyle, to establish a reference-type table displaying ideal savings when reaching 50. The Government could use the table mentioned above to give more meaningful contributions to EPF members, apart from EPF active and inactive members, knowing where they stand concerning their current EPF savings.

改进注意力模型的食品图像识别方法

随着人们对健康饮食需求的日益增加,各种饮食评估辅助软件应运而生,食品图像识别问题受到越来越多的关注。食品图像识别属于细粒度图像识别问题,较其他图像识别难度更大。目前主流的食品图像数据集,如ISIA Food-500、ETH Food-101、Vireo Food-172等所包含的图像数量偏少,难以很好地训练图像识别系统,进一步增大了图像识别难度。提出一种基于注意力机制的图像识别方法,该方法在自注意力的基础上引入局部注意力的概念,用于描绘图像细粒度特征,提高图像识别的准确率。此外,还提出一种图像自监督预训练算法,缓解食品图像训练样本不足的问题。实验结果表明,所提方法在ISIA Food-500数据集的Top-1和Top-5准确率分别达到65.58%和90.03%,性能优于现有的其他算法。

考虑碳排放分摊的综合能源服务商交易策略

为寻求在满足用户用能需求的同时降低系统碳排放的有效途径,提出了一种考虑碳排放分摊的多综合能源服务商能源交易策略。基于网络流模型实现碳流追踪并联合Shapley理论建立了综合能源服务商碳排放成本计算模型。应用Nash议价理论构建了多综合能源服务商合作博弈运行模型,将综合能源服务商碳排放成本引入优化目标函数,并利用分布式算法求解最优能源交易量和交易费用。基于由修改的IEEE 39节点电网和12节点气网构成的多综合能源服务商系统进行仿真分析,验证了所提模型和方法的有效性。

DRG付费下医疗服务供方道德风险表现与防范对策

目的:梳理医保支付方式改革下医疗服务供方道德风险的行为表现,提出防范的对策建议。方法:收集35家样本医院DRG结算数据,对编码人员进行问卷调查,对相关部门工作人员进行访谈,探究医疗服务供方道德风险的疑点与特征。结果:DRG付费引发医疗服务供方新的道德风险行为,在医疗服务前期、中期、后期有不同的表现形式,给患者、医保基金和医疗机构造成了不利影响。结论:DRG付费下要加强对医疗服务供方监管,创新监管模式,完善医保沟通渠道,建立协商谈判机制,加强诊疗规范,提高编码能力,防范新型道德风险行为。

一种多用户频谱分配优化模型建立与求解

为解决多区域多用户在通信过程中的频谱最优分配与激励问题,本文首先在考虑多个通信运营商及多个小区用户的情况下,通过区块链理论对不同小区不同用户的频谱分配问题进行分析建模,并建立频谱最优分配优化模型;其次,针对优化模型的约束条件,通过引入拉格朗日及二分法理论对其进行求解,进而得出不同小区用户人数与频谱分配之间的数学关系;最后,通过仿真证明了容纳小区人数与频谱持有量近似地呈线性关系,且基站功率越大,近似直线的斜率越大。当基站的持有频谱量较少时,提高功率对可容纳人数的增加影响较小,随着频谱量的增加,提高基站功率,可容纳人数随之近似线性增加。

论网络服务提供者对侵权通知的审查义务

“通知-删除”规则在我国网络侵权治理中发挥着重要作用,随着网络侵权形势日趋复杂,亟须确立网络服务提供者对侵权通知的审查义务以应对频发的错误通知。对比分析不同法域“通知-删除”规则的差异,尊重网络服务提供者对侵权通知进行审查的事实,从法解释论视角,明确网络服务提供者对侵权通知的审查义务。我国法语境下的“通知-删除”规则应为归责规范,适用过错责任原则,网络服务提供者的审查义务是其注意义务的组成部分。确定网络服务提供者对侵权通知审查义务的内容应当同步考量权利人的维权成本和网络服务提供者的审查负担,以“盖然性优势”为标准对通知的不同要素进行审查,是网络服务提供者对侵权通知的审查义务的一般性内容。针对不同类型权利的权属证据和侵权证据,网络服务提供者的审查逻辑和判断标准可进行适当调整。

考虑不确定性的综合能源供应商日前优化运行策略

综合能源供应商作为多能源供应主体,可以参与市场化交易。为探索综合能源供应商在电力市场环境下新的盈利点,构建了考虑需求响应的多主体互动机制,并充分考虑光伏出力、多元用能需求、市场电价以及需求响应资源潜力的不确定性,采用区间优化方法构建了表征综合能源供应商日前运行优化问题的混合整数线性规划模型,得到综合能源供应商的购能、设备运行以及需求响应资源调用等策略。算例验证结果表明,需求响应机制可以有效降低购电成本,增加综合能源供应商的运行收益。

论短视频版权侵权行为中平台责任的认定

长视频版权方与短视频平台之间的矛盾是愈演愈烈的长短视频之争中需要首先解决的问题,短视频版权侵权行为中平台责任的认定亟须得到明确。合理使用情形的排除是平台担责的前提,重点是对“适当引用”条款的理解,应通过非实质性引用和比例原则检验引用是否适当。避风港规则是判断平台是否被归责的标准,红旗原则是排除避风港规则适用的例外。平台对用户上传内容的实质审查义务取决于平台对内容的版权性接触事实或接触可能,但平台对内容的合规审查义务并不必然触发其对内容版权合法性的审查义务。提供网络服务的类型是平台担责的基础,平台身份越靠近网络中介服务提供者,越有可能通过避风港规则免责;反之,平台身份越靠近网络内容提供者,越难以通过避风港规则免责。