Exposure to heat stress causes diminished work performance and leads to economic loss.In the last two decades,China has experienced both rapid economic development and environmental warming;however,the spatiotemporal ...Exposure to heat stress causes diminished work performance and leads to economic loss.In the last two decades,China has experienced both rapid economic development and environmental warming;however,the spatiotemporal variations of association between environmental heat and labor loss have been rarely investigated behind this double impact.Here,we evaluated the variation in China's heat-induced labor productivity loss and related economic cost from 2001 to 2019 and investigated the effect of economic development and regional warming.We found that decline in labor productivity because of heat stress increased significantly(p<0.05 for heavy-intensity work),and the corresponding economic loss also exhibited a drastic increase by 6-to 9-fold.The relative economic loss showed a slight but nonsignificant increase with an average value of 0.54%of the annual total earnings.At the sub-regional and sectoral level,adverse effects were more prominent in the southeast region,and the secondary industry sectors,such as construction and manufacturing,contributed to larger proportions of economic losses.The transformation of industrial structure made economic sectors more vulnerable to heat exposure,and increasingly preventive effects of air-conditioning use were noted on economic damage due to heat-induced productivity decline(36.0%relative economic benefits in 2019 compared to 9.7%in 2001).Our findings could provide a deep insight into heat burden on occupational health and heat adaptation strategies regionally under climate change,especially in developing areas with higher temperature and humidity environment.展开更多
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 fou...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.展开更多
基金This study was supported by the National Natural Science Foundation of China(71974092)the Fundamental Research Funds for the Central Universities,China(0207-14380179,0207-14380174,and 0207-14380055)the Frontiers Science Center for Critical Earth Material Cycling,Nanjing University,China。
文摘Exposure to heat stress causes diminished work performance and leads to economic loss.In the last two decades,China has experienced both rapid economic development and environmental warming;however,the spatiotemporal variations of association between environmental heat and labor loss have been rarely investigated behind this double impact.Here,we evaluated the variation in China's heat-induced labor productivity loss and related economic cost from 2001 to 2019 and investigated the effect of economic development and regional warming.We found that decline in labor productivity because of heat stress increased significantly(p<0.05 for heavy-intensity work),and the corresponding economic loss also exhibited a drastic increase by 6-to 9-fold.The relative economic loss showed a slight but nonsignificant increase with an average value of 0.54%of the annual total earnings.At the sub-regional and sectoral level,adverse effects were more prominent in the southeast region,and the secondary industry sectors,such as construction and manufacturing,contributed to larger proportions of economic losses.The transformation of industrial structure made economic sectors more vulnerable to heat exposure,and increasingly preventive effects of air-conditioning use were noted on economic damage due to heat-induced productivity decline(36.0%relative economic benefits in 2019 compared to 9.7%in 2001).Our findings could provide a deep insight into heat burden on occupational health and heat adaptation strategies regionally under climate change,especially in developing areas with higher temperature and humidity environment.
文摘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.
