The importance of valuing environmental resources,especially in ecotourism sites,has become increasingly important over the last two decades.Ecotourism is now considered as an important source of livelihood of local s...The importance of valuing environmental resources,especially in ecotourism sites,has become increasingly important over the last two decades.Ecotourism is now considered as an important source of livelihood of local stakeholders in backward regions.Therefore,the preservation of ecotourism sites through community participation seems very important to maintain continued flow of tourists.This study aimed at recognizing the importance of community participation for the preservation of ecotourism sites.For this,this study executed a survey based on non-probability sampling in two ecotourism sites(Garpanchkot and Baranti)covering 100 respondents in Purulia District,West Bengal of India.The central issue of this study was to assess the tendency of community participation for the conservation of ecotourism sites and find the optimum condition for offering participatory labour time.This study showed that the participation of young people is high,and the majority of respondents are aware of the importance in protecting ecotourism sites.Because respondents were too poor to offer money,the contingent valuation method(CVM)was used to elicit their willingness to pay(WTP)participatory labour time for the conservation of ecotourism sites.Respondents’age,income,education level,caste,and their perceived environmental quality had significant relationship with their WTP participatory labour time by applying the ordinary least square(OLS)model.It was found that the mean WTP participatory labour time of each respondent in a month is approximately 3.64 h.The significance of this study is that community participation can improve the sense of belonging,trust,and credibility of ecotourism sites,making them more appreciative of the value and protection of these sites.展开更多
Objectives:This study aimed to explore the status of job satisfaction,emotional labour,core competencies and job stress and the associations of emotional labour and core competencies with the job satisfaction of nurse...Objectives:This study aimed to explore the status of job satisfaction,emotional labour,core competencies and job stress and the associations of emotional labour and core competencies with the job satisfaction of nurses in China.Methods:Data were collected by using a self-designed general information questionnaire,a job satisfaction questionnaire(McCloskey/Mueller Satisfaction Scale),a nurse emotional labour questionnaire,the Competency Inventory for Registered Nurses questionnaire,and a nurse job stressor questionnaire.A total of 13,448 nurses from 92 hospitals across mainland of China were surveyed,and 11,337 respondents(84.3%response rate)completed the questionnaires.Results:The survey results indicated that Chinese nurses had average job satisfaction(24.77±5.23),moderate job stress(86.84±21.12),moderate to high emotional labour experiences(55.08±9.63)and high competency(195.77±37.61).Multiple linear regression indicated that surface acting was negatively correlated with job satisfaction(P<0.01),while deep acting(P<0.01)and nurses'core competence(P<0.01)were positively associated with job satisfaction.Besides,The results also indicated job stress,geographical distribution,hospital category,gender,work shift,only children,parenting status,monthly salary,nursing experience,professional title,hospital area were the influencing factors of job satisfaction(P<0.05).Conclusion:The improvement of the emotional labour and competency of nurses may help enhance their job satisfaction.展开更多
This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the lab...This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the labour migration from inland towards coastal area. Then, the demographic characteristics of the migrant labour force are analysed before turning to the analysis on the rare for the migration. Fourthly, the impacts of the migrant workers on the socio-economic development of Nanhai City and the problems are examined. Finally, the prospects and some suggestions for the labour migration are put forward.展开更多
Induction of labour remains one of the most challenging interventions in current obstetrics. Different pharmaceuticals have been used for cervical ripening such as prostaglandins;however they can lead to a number of p...Induction of labour remains one of the most challenging interventions in current obstetrics. Different pharmaceuticals have been used for cervical ripening such as prostaglandins;however they can lead to a number of potential inconvenient risks namely uterine tachysystole and pathological fetal cardiotocography (CTG). In cases of women with previous caesarean births, using prostaglandins would pose even higher risks such as uterine rupture and perinatal mortality. A mechanical method of cervical ripening could represent an alternative for these women. We report the use of the extra-amniotic double balloon cervical device (Cook’s device) for ripening of unfavourable cervix in seventeen women attempting vaginal birth after cesarean section (VBAC). Using Bishop scoring system to assess cervical dilatetion, position, consistency, fetal station and effacement, the unfavourable cervix is the cervix that scores less than 6. We review the relevant literature discussing this method of induction focusing on its effectiveness, simplicity, safety and efficacy, low cost and any associated serious side effects. Conclusion: Success was estimated to be over 50% with no serious life threatening maternal or fetal complications. We considered the process satisfactory and practical. We recommend larger studies to assess safety and efficacy of Cook’s device in vaginal birth after caesarean section before embarking on routine elective caesarean delivery. Objectives: To estimate success rate for vaginal delivery after previous caesarean section using cervical double balloon device (Cook’s device). Design: Three-year observational study. Setting: Maternity unit in district general hospital, UK. Population: Women who had one previous lower segment caesarean section and unfavourable cervix identified as having Bishop Score less than 6. Methods: Data were obtained from the birth registry over 3 years from January 2008 until December 2010. Main outcome: Measure successful vaginal delivery. Results: Out of 25 cases that had induction of labour with history of one previous lower segment caesarean section, 17 patients did fit in the inclusion criteria and were studied. 53% had a successful vaginal delivery while 47% had to have cesarean section either due to failure to progress or pathological cardiotocography. 82% required to have syntocinon infusion for augmentation as per local unit protocol. All newborn babies were in good condition and did not require admission to neonatal intensive care unit.展开更多
Increasingly higher hard coal production capacity in Upper Silesian Coal Basin(Poland) in the last two decades led to significant increase of methane hazard occurrence in the workings of exploitation areas.An increase...Increasingly higher hard coal production capacity in Upper Silesian Coal Basin(Poland) in the last two decades led to significant increase of methane hazard occurrence in the workings of exploitation areas.An increase of methane content in the exploited seams and in the surrounding strata, associated with increasing depth of mining, results in higher methane emission into the longwall areas from exploited seams and degassing seams in the mining-induced de-stressed zone. Operational experience gained by the collieries confirms that reducing methane release during longwall operations often requires decreasing operating speed of a shearer in a shift. The paper presents an analysis of the parameters and factors,which have critical influence on the formation of methane hazard in longwall areas with high production capacity.展开更多
Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be as...Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.展开更多
Objectives: Postpartum hemorrhage is an important cause of maternal morbidity and mortality worldwide. Different preventive strategies were tried to determine the best approach for the management of the 3rd stage of l...Objectives: Postpartum hemorrhage is an important cause of maternal morbidity and mortality worldwide. Different preventive strategies were tried to determine the best approach for the management of the 3rd stage of labour. We aim to determine the effect of umbilical vein oxytocin injection and umbilical cord drainage in the management of third stage of labour in normal vaginal delivery. Patients and Methods: One hundred twenty three (123) females were enrolled into this randomized controlled trial. They were aligned into three groups: 1st group (I) (cord drainage group), 2nd group (II) (oxytocin group) and 3rd group (III) (control cord traction group). The primary outcomes were duration of 3rd stage and blood loss. Results: Both group I and II had statistically significant shorter third stage duration than patients of group III (p < 0.001). Mean ± SD (7.3 ± 3.45, 4.6 ± 1.74, 9.4 ± 3.67) respectively for groups I, II, III. Also, both group I and II had statistically significant less blood loss than patients of group III (p < 0.001). Conclusion: The current study demonstrated that umbilical vein oxytocin injection and umbilical cord drainage significantly reduce the duration and amount of blood loss in the 3rd stage of labour, thus, reducing the risk of post partum hemorrhage.展开更多
On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The...On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The results show that the transfer of rural labour forces into city can increase urban-rural income and bridge the income gap between city and village to a certain extent. However, the capital stock of city in China is greatly more than that of the village, so the rural labour forces transfer cannot eliminate the urban-rural income gap completely. In order to elevate the rural income level in China and narrow urban-rural income gap, the government should paint a picture with two brushes at the same time: on one hand, the government should promote the transfer of rural labour forces into city, and change the status quo of dual urban-rural labour forces market structure; on the other hand, the government should increase the input in rural areas and promote the increase of rural capital stock so as to further increase rural residents' income in the process of labour forces transfer.展开更多
BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction re...BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction remains controversial.According to published literature,stitches are removed through laparoscopic or transvaginal methods.Herein,we report,for the first time,a case of a patient who had undergone laparoscopic cerclage,and then underwent removal of stitches by laparotomy and labour induction in the third trimester of pregnancy.CASE SUMMARY A patient who underwent laparoscopic cervical cerclage due to cervical insufficiency became pregnant naturally following the operation.At 31 wk of pregnancy,severe foetal malformations were found.To successfully induce labour,cerclage stitches were removed via laparotomy,and rivanol was injected directly into the uterus.Following successful induction of labour,the patient delivered a dead foetus.CONCLUSION This report provides a reliable scheme of removing cerclage stitches for patients who have undergone laparoscopic cerclage but experience severe foetal malformations.展开更多
Increasing the labour force participation rates of older workers is a fundamental component of most OECD (Organization for Economic Cooperation and Development) countries' response to the fiscal pressures associate...Increasing the labour force participation rates of older workers is a fundamental component of most OECD (Organization for Economic Cooperation and Development) countries' response to the fiscal pressures associated with ageing populations. Both pension reform and employment policies are key elements to achieving such increases in participation and reversing the early retirement trends of recent decades. Econometric modeling results from a panel of 12 OECD countries indicate that labour market variables have a greater influence than social security pension value or the standard age of retirement on the labour force participation rates of males aged 55-64 years. Further results from modeling the potential asymmetric response of participation rates to unemployment rates indicate that a decrease in unemployment rates has a greater impact upon increasing the labour force participation rates of older workers compared to the effect of an increase on unemployment rates has on discouraging participation. We found mixed results for the asymmetric response of participation to an increase or decrease in pension value. Findings thus emphasize the importance of labour market oriented policies to reduce unemployment rates in the developed economies in coming years to address ageing population concerns.展开更多
A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qua...A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.展开更多
Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqnea...Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqneam Ilit, Israel) devise, was used prior to labour in nulliparous women at 39 - 42 weeks gestation remote from labor. Maternal pelvic parameters, including inter-iliac transverse diameter, obstetric conjugate and interspinous diameter were evaluated. Fetal parameters included head station, biparietal diameter and occipitofrontal diameter. Data on delivery and outcome were collected from the electronic files. Results: The innovative use of sonopelvimetry was applied to 154 consecutive women, none of the participants complained of discomfort or complications observed. The mean time of examination was 15 + 2 minutes. Mean time of examination to delivery interval was 4.8 days (range 0 - 16 days). Small interspinous diameter and high head station were the best predictors for obstructed labour. Analysis indicated 87% sensitivity and 61% specificity for birth weight fetal head station and ISD combined in predicting obstructed labour with an area under the curve of 0.77. Conclusions: Our results indicate that GPS-based?sonopelvimetry combined with fetal estimated weight is a valuable tool in the risk assessment of obstructed labour. Parameters obtained by sonopelvimetry combined with birth weight may be useful.展开更多
<u>Introduction</u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Knowledge of change in the duration of stages of labour would be an e...<u>Introduction</u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Knowledge of change in the duration of stages of labour would be an essential step to reduce the increasing rates of cesarean section reported worldwide.</span><span style="font-family:;" "=""> </span><u><span style="font-family:Verdana;">Objective</span></u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> To study the rate of cervical dilation in the</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> stage of labour in spontaneous and induced labour and in primigravida and multigravida with singleton pregnancy.</span></span><span style="font-family:;" "=""> </span><u><span style="font-family:Verdana;">Methods</span></u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> A prospective observational study conducted at a multispeciality hospital was carried out for a period of 3 years from Jan 2017 to Dec 2019. </span><span style="font-family:Verdana;">A </span><span style="font-family:Verdana;">total </span><span style="font-family:Verdana;">of </span><span style="font-family:Verdana;">640 patients who were admitted with spontaneous and induced labour having singleton pregnancy with cephalic presentation and intact membranes after 34 weeks who delivered vaginally were included for analysis. Progression of labor in </span><span style="font-family:Verdana;">the </span><span style="font-family:;" "=""><span style="font-family:Verdana;">1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> stage of labour was measured by </span></span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">rate of cervical dilation as noted by serial per vaginal examination and findings were plotted in partograph.</span><span style="font-family:;" "=""> </span><u><span style="font-family:Verdana;">Result</span></u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> The difference between mean rate of cervical dilation in </span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">study group is statistically significant between 4</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">6 cm and 6 - 10 cm (P < 0.0001</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;">. When primigravida & multigravida patients were compared for the cervical dilation rate, statistically significant difference was seen between 4 - 6 cm but not in 6 - 10 cm</span><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">Average rate of cervical dilatation was 3.44 (Standard Deviation (SD</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> = 1.84</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> in spontaneous labor while average rate of cervical dilatation was 2.69 (SD = 1.18</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> in induced labor between 6</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">10</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cm of cervical dilatation. </span><u><span style="font-family:Verdana;">Conclusion</span></u></span><span style="font-family:Verdana;">:</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The active </span><span style="font-family:Verdana;">phase of labour starts at 6 cm of cervical dilation in the majority of the patients. </span><span style="font-family:Verdana;">In multigravida, cervix dilates at faster rate before 6 cm. In induced labour cervix dilates at a slower rate than spontaneous labour after 6 cm dilation.</span></span>展开更多
Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to ...Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.展开更多
The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially...The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially the Township and Village Enterprises owned by local residents.This article is conducted on the changing labour relations in Chinese Township and Village Enterprises(TVEs) despite their increasing contributions to China's transition from planned economy to market economy,and studies the labour market and the Labour Law to understand the unique labour mobility and to test the relationship between Human Resource Management(HRM) practice and the performance among TVEs.展开更多
文摘The importance of valuing environmental resources,especially in ecotourism sites,has become increasingly important over the last two decades.Ecotourism is now considered as an important source of livelihood of local stakeholders in backward regions.Therefore,the preservation of ecotourism sites through community participation seems very important to maintain continued flow of tourists.This study aimed at recognizing the importance of community participation for the preservation of ecotourism sites.For this,this study executed a survey based on non-probability sampling in two ecotourism sites(Garpanchkot and Baranti)covering 100 respondents in Purulia District,West Bengal of India.The central issue of this study was to assess the tendency of community participation for the conservation of ecotourism sites and find the optimum condition for offering participatory labour time.This study showed that the participation of young people is high,and the majority of respondents are aware of the importance in protecting ecotourism sites.Because respondents were too poor to offer money,the contingent valuation method(CVM)was used to elicit their willingness to pay(WTP)participatory labour time for the conservation of ecotourism sites.Respondents’age,income,education level,caste,and their perceived environmental quality had significant relationship with their WTP participatory labour time by applying the ordinary least square(OLS)model.It was found that the mean WTP participatory labour time of each respondent in a month is approximately 3.64 h.The significance of this study is that community participation can improve the sense of belonging,trust,and credibility of ecotourism sites,making them more appreciative of the value and protection of these sites.
文摘Objectives:This study aimed to explore the status of job satisfaction,emotional labour,core competencies and job stress and the associations of emotional labour and core competencies with the job satisfaction of nurses in China.Methods:Data were collected by using a self-designed general information questionnaire,a job satisfaction questionnaire(McCloskey/Mueller Satisfaction Scale),a nurse emotional labour questionnaire,the Competency Inventory for Registered Nurses questionnaire,and a nurse job stressor questionnaire.A total of 13,448 nurses from 92 hospitals across mainland of China were surveyed,and 11,337 respondents(84.3%response rate)completed the questionnaires.Results:The survey results indicated that Chinese nurses had average job satisfaction(24.77±5.23),moderate job stress(86.84±21.12),moderate to high emotional labour experiences(55.08±9.63)and high competency(195.77±37.61).Multiple linear regression indicated that surface acting was negatively correlated with job satisfaction(P<0.01),while deep acting(P<0.01)and nurses'core competence(P<0.01)were positively associated with job satisfaction.Besides,The results also indicated job stress,geographical distribution,hospital category,gender,work shift,only children,parenting status,monthly salary,nursing experience,professional title,hospital area were the influencing factors of job satisfaction(P<0.05).Conclusion:The improvement of the emotional labour and competency of nurses may help enhance their job satisfaction.
文摘This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the labour migration from inland towards coastal area. Then, the demographic characteristics of the migrant labour force are analysed before turning to the analysis on the rare for the migration. Fourthly, the impacts of the migrant workers on the socio-economic development of Nanhai City and the problems are examined. Finally, the prospects and some suggestions for the labour migration are put forward.
文摘Induction of labour remains one of the most challenging interventions in current obstetrics. Different pharmaceuticals have been used for cervical ripening such as prostaglandins;however they can lead to a number of potential inconvenient risks namely uterine tachysystole and pathological fetal cardiotocography (CTG). In cases of women with previous caesarean births, using prostaglandins would pose even higher risks such as uterine rupture and perinatal mortality. A mechanical method of cervical ripening could represent an alternative for these women. We report the use of the extra-amniotic double balloon cervical device (Cook’s device) for ripening of unfavourable cervix in seventeen women attempting vaginal birth after cesarean section (VBAC). Using Bishop scoring system to assess cervical dilatetion, position, consistency, fetal station and effacement, the unfavourable cervix is the cervix that scores less than 6. We review the relevant literature discussing this method of induction focusing on its effectiveness, simplicity, safety and efficacy, low cost and any associated serious side effects. Conclusion: Success was estimated to be over 50% with no serious life threatening maternal or fetal complications. We considered the process satisfactory and practical. We recommend larger studies to assess safety and efficacy of Cook’s device in vaginal birth after caesarean section before embarking on routine elective caesarean delivery. Objectives: To estimate success rate for vaginal delivery after previous caesarean section using cervical double balloon device (Cook’s device). Design: Three-year observational study. Setting: Maternity unit in district general hospital, UK. Population: Women who had one previous lower segment caesarean section and unfavourable cervix identified as having Bishop Score less than 6. Methods: Data were obtained from the birth registry over 3 years from January 2008 until December 2010. Main outcome: Measure successful vaginal delivery. Results: Out of 25 cases that had induction of labour with history of one previous lower segment caesarean section, 17 patients did fit in the inclusion criteria and were studied. 53% had a successful vaginal delivery while 47% had to have cesarean section either due to failure to progress or pathological cardiotocography. 82% required to have syntocinon infusion for augmentation as per local unit protocol. All newborn babies were in good condition and did not require admission to neonatal intensive care unit.
文摘Increasingly higher hard coal production capacity in Upper Silesian Coal Basin(Poland) in the last two decades led to significant increase of methane hazard occurrence in the workings of exploitation areas.An increase of methane content in the exploited seams and in the surrounding strata, associated with increasing depth of mining, results in higher methane emission into the longwall areas from exploited seams and degassing seams in the mining-induced de-stressed zone. Operational experience gained by the collieries confirms that reducing methane release during longwall operations often requires decreasing operating speed of a shearer in a shift. The paper presents an analysis of the parameters and factors,which have critical influence on the formation of methane hazard in longwall areas with high production capacity.
文摘Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.
文摘Objectives: Postpartum hemorrhage is an important cause of maternal morbidity and mortality worldwide. Different preventive strategies were tried to determine the best approach for the management of the 3rd stage of labour. We aim to determine the effect of umbilical vein oxytocin injection and umbilical cord drainage in the management of third stage of labour in normal vaginal delivery. Patients and Methods: One hundred twenty three (123) females were enrolled into this randomized controlled trial. They were aligned into three groups: 1st group (I) (cord drainage group), 2nd group (II) (oxytocin group) and 3rd group (III) (control cord traction group). The primary outcomes were duration of 3rd stage and blood loss. Results: Both group I and II had statistically significant shorter third stage duration than patients of group III (p < 0.001). Mean ± SD (7.3 ± 3.45, 4.6 ± 1.74, 9.4 ± 3.67) respectively for groups I, II, III. Also, both group I and II had statistically significant less blood loss than patients of group III (p < 0.001). Conclusion: The current study demonstrated that umbilical vein oxytocin injection and umbilical cord drainage significantly reduce the duration and amount of blood loss in the 3rd stage of labour, thus, reducing the risk of post partum hemorrhage.
基金Supported by the Start-up Projects of Scientific Research of China West Normal University
文摘On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The results show that the transfer of rural labour forces into city can increase urban-rural income and bridge the income gap between city and village to a certain extent. However, the capital stock of city in China is greatly more than that of the village, so the rural labour forces transfer cannot eliminate the urban-rural income gap completely. In order to elevate the rural income level in China and narrow urban-rural income gap, the government should paint a picture with two brushes at the same time: on one hand, the government should promote the transfer of rural labour forces into city, and change the status quo of dual urban-rural labour forces market structure; on the other hand, the government should increase the input in rural areas and promote the increase of rural capital stock so as to further increase rural residents' income in the process of labour forces transfer.
文摘BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction remains controversial.According to published literature,stitches are removed through laparoscopic or transvaginal methods.Herein,we report,for the first time,a case of a patient who had undergone laparoscopic cerclage,and then underwent removal of stitches by laparotomy and labour induction in the third trimester of pregnancy.CASE SUMMARY A patient who underwent laparoscopic cervical cerclage due to cervical insufficiency became pregnant naturally following the operation.At 31 wk of pregnancy,severe foetal malformations were found.To successfully induce labour,cerclage stitches were removed via laparotomy,and rivanol was injected directly into the uterus.Following successful induction of labour,the patient delivered a dead foetus.CONCLUSION This report provides a reliable scheme of removing cerclage stitches for patients who have undergone laparoscopic cerclage but experience severe foetal malformations.
文摘Increasing the labour force participation rates of older workers is a fundamental component of most OECD (Organization for Economic Cooperation and Development) countries' response to the fiscal pressures associated with ageing populations. Both pension reform and employment policies are key elements to achieving such increases in participation and reversing the early retirement trends of recent decades. Econometric modeling results from a panel of 12 OECD countries indicate that labour market variables have a greater influence than social security pension value or the standard age of retirement on the labour force participation rates of males aged 55-64 years. Further results from modeling the potential asymmetric response of participation rates to unemployment rates indicate that a decrease in unemployment rates has a greater impact upon increasing the labour force participation rates of older workers compared to the effect of an increase on unemployment rates has on discouraging participation. We found mixed results for the asymmetric response of participation to an increase or decrease in pension value. Findings thus emphasize the importance of labour market oriented policies to reduce unemployment rates in the developed economies in coming years to address ageing population concerns.
文摘A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.
文摘Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqneam Ilit, Israel) devise, was used prior to labour in nulliparous women at 39 - 42 weeks gestation remote from labor. Maternal pelvic parameters, including inter-iliac transverse diameter, obstetric conjugate and interspinous diameter were evaluated. Fetal parameters included head station, biparietal diameter and occipitofrontal diameter. Data on delivery and outcome were collected from the electronic files. Results: The innovative use of sonopelvimetry was applied to 154 consecutive women, none of the participants complained of discomfort or complications observed. The mean time of examination was 15 + 2 minutes. Mean time of examination to delivery interval was 4.8 days (range 0 - 16 days). Small interspinous diameter and high head station were the best predictors for obstructed labour. Analysis indicated 87% sensitivity and 61% specificity for birth weight fetal head station and ISD combined in predicting obstructed labour with an area under the curve of 0.77. Conclusions: Our results indicate that GPS-based?sonopelvimetry combined with fetal estimated weight is a valuable tool in the risk assessment of obstructed labour. Parameters obtained by sonopelvimetry combined with birth weight may be useful.
文摘<u>Introduction</u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Knowledge of change in the duration of stages of labour would be an essential step to reduce the increasing rates of cesarean section reported worldwide.</span><span style="font-family:;" "=""> </span><u><span style="font-family:Verdana;">Objective</span></u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> To study the rate of cervical dilation in the</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> stage of labour in spontaneous and induced labour and in primigravida and multigravida with singleton pregnancy.</span></span><span style="font-family:;" "=""> </span><u><span style="font-family:Verdana;">Methods</span></u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> A prospective observational study conducted at a multispeciality hospital was carried out for a period of 3 years from Jan 2017 to Dec 2019. </span><span style="font-family:Verdana;">A </span><span style="font-family:Verdana;">total </span><span style="font-family:Verdana;">of </span><span style="font-family:Verdana;">640 patients who were admitted with spontaneous and induced labour having singleton pregnancy with cephalic presentation and intact membranes after 34 weeks who delivered vaginally were included for analysis. Progression of labor in </span><span style="font-family:Verdana;">the </span><span style="font-family:;" "=""><span style="font-family:Verdana;">1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> stage of labour was measured by </span></span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">rate of cervical dilation as noted by serial per vaginal examination and findings were plotted in partograph.</span><span style="font-family:;" "=""> </span><u><span style="font-family:Verdana;">Result</span></u><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> The difference between mean rate of cervical dilation in </span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">study group is statistically significant between 4</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">6 cm and 6 - 10 cm (P < 0.0001</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;">. When primigravida & multigravida patients were compared for the cervical dilation rate, statistically significant difference was seen between 4 - 6 cm but not in 6 - 10 cm</span><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">Average rate of cervical dilatation was 3.44 (Standard Deviation (SD</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> = 1.84</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> in spontaneous labor while average rate of cervical dilatation was 2.69 (SD = 1.18</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> in induced labor between 6</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">10</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cm of cervical dilatation. </span><u><span style="font-family:Verdana;">Conclusion</span></u></span><span style="font-family:Verdana;">:</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The active </span><span style="font-family:Verdana;">phase of labour starts at 6 cm of cervical dilation in the majority of the patients. </span><span style="font-family:Verdana;">In multigravida, cervix dilates at faster rate before 6 cm. In induced labour cervix dilates at a slower rate than spontaneous labour after 6 cm dilation.</span></span>
文摘Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.
文摘The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially the Township and Village Enterprises owned by local residents.This article is conducted on the changing labour relations in Chinese Township and Village Enterprises(TVEs) despite their increasing contributions to China's transition from planned economy to market economy,and studies the labour market and the Labour Law to understand the unique labour mobility and to test the relationship between Human Resource Management(HRM) practice and the performance among TVEs.