Pregnancy care and birth outcomes for women with moderate to super-extreme obesity

PurposeTo describe the health service utilisation and birth outcomes of pregnant women with moderate to super-extreme obesity.BackgroundMaternal obesity is increasingly recognised as a key risk factor for adverse outcomes for both women and their babies. Little is known about the service utilisation and perinatal outcomes of women with obesity beyond a body mass index of 40.MethodWomen with a self-reported pre-pregnancy BMI of 40 or more, who had received care and birthed a baby at the study site between 1 January 2009 and 31 December 2010. Clinical audit was used to identify the health service utilisation and birth outcomes of these women.Results153 women had a BMI of 40 or more. Women saw 6 different health professionals during pregnancy (1–16). Most of their visits were with a medical practitioner, often with limited experience, and almost all women only saw a midwife once at their booking visit (n = 150, 98.0%). While the majority of women experienced a normal pregnancy, free from any complications, almost half the women in this study experienced a caesarean section (n = 74, 48.4%).ConclusionClinical audit has been useful in providing additional information which suggests current maternity care provision is not meeting the needs of this group of women. The model of antenatal care provision may be a mediating factor in the birth outcomes experienced by obese women. The development of effective, targeted antenatal care, designed to meet the needs of these women is recommended.     

Conceptual and ethical problems underpinning calls to abandon vaginal breech birth

The view that vaginal breech birth is unjustifiable due to neonatal safety concerns has resulted in continued calls for breech pregnancies to be managed via a policy of planned caesarean birth. Vaginal breech birth has of course always occurred, but women with term breech pregnancies who seek to have a vaginal birth often face coercive pressures to have a caesarean birth instead. In this paper I argue that even if there is population level evidence that vaginal birth is relatively riskier for the breech presenting fetus, implementing a policy of planned caesarean birth would essentially be an unjustified attempt at forced medical intervention upon women. Advocates of a policy of planned caesarean birth often conflate the acceptability of allocating participants to a treatment group (policy) within the context of a randomized controlled trial with the justifiability of doing that as part of individual health care. Calls for obstetricians to “abandon vaginal breech birth” mistakenly position vaginal breech birth itself as a form of medical intervention that can simply be removed as an option for women by obstetricians. In reality, abandoning vaginal breech birth would entail abandoning women by denying them access to healthcare options that are otherwise available to any woman having a vaginal birth.     

黄金分割法在质量成本管理中的应用

黄金分割优选法是一种求最优化问题的方法。运用黄金分割法的基本原理,可确定质量成本管理中的符合性成本与故障成本的优化投入比例。这为企业选择最优的质量成本模型提供依据,以期以最小的成本获得最大的经济效益。     

0.618的文化内涵探讨

0.618神圣的黄金分割是世界上最美的数字,对0.618的研究可以追溯到古希腊时代。本文阐述了0.618黄金分割的内涵,并介绍了0.618黄金分割在我们生活中的几个应用,使人们对生活、大自然、社会又有了另一层的理解。     

隋唐大运河永济渠新乡段的历史变迁

大运河新乡段是申遗立即列入项目卫河(永济渠)主线的重要组成部分,是中国大运河形成时间较早、延续使用时间较长的河段之一,也是目前河南境内唯一一段可以看到的大运河河道。大运河新乡段历史悠久,始于隋永济渠,明以后改称卫河,历代均为华北平原上沟通南北的重要水道,承担着漕运、灌溉、行洪等功能,对新乡城市发展起到了重要作用。研究挖掘其深厚的历史及文化底蕴,对中国大运河申报世界文化遗产有重要的推进意义。     

A Longitudinal Study of Website Accessibility: Have Social Work Education Websites Become More Accessible?

This study (N = 45 schools) sought to determine the accessibility of baccalaureate social work program websites in 2003 and 2008 using Priority 1 checkpoints from the World Wide Web Consortium 1.0 guidelines. Paired t-test results indicate that the mean accessibility scores of five of the nine items (plus the website accessibility scale as a whole) was statistically higher after five years. However, 75.6% of programs still had one or more Priority 1 accessibility barriers in 2008 and thus did not meet the lowest W3C accessibility guidelines. This highlights the need for more education about barriers to accessibility and methods for making websites more accessible.     

《说文解字》“衣”部字笺证及文化抉微

《说文解字》是中国语言文字学的奠基之作,又是一部文化巨著。汉字是文化的载体。《说文解字》“衣”部字所承载的文化信息是极为丰富的,如祭祀大礼、丧葬礼仪、缝制修理、衣服材质、功用种类、纹饰色泽等。分类辨析,择要笺证,钩沉发隐,因声求义以探寻其文化意蕴。     

“句样”札移

句样原为中国古代诗话里的固有品目。人们在使用某种语言结构类型过程中，已经不满足于前人的、日常语言的习惯结构方式，因而进行加工扭曲、创辟出一种异乎前人的、有别于日常语言习惯结构方式的新的言语形式。这种新鲜的言语形式被创辟出来之后，如果进入了社会语言系统，它就会逐渐定型，形成某种语言结构类型的套语匡格，也就是所谓句样。因此，句样的一个重要特征就在于语言学研究们所曾经表述的：任何一个句样都具有表层结构和深层结构，句样的表层结构是指作创辟出来的新的言语形式，深层结构是指业已为新的言语形式所取代、并未在作的上下出现的那种日常语言的习惯结构形式。     

矩形栅慢波系统的理论与实验研究

为了克服单模近似法在分析矩形栅慢波系统高频特性时的局限性,采用了一种新的方法,即在表示槽区内的场时,保留其高次项,表为一无限本征驻波之和的形式,利用场匹配法得到其色散特性,进而求得耦合阻抗。然后针对矩形栅慢波系统进行了数值计算,并分析了金属栅的几何尺寸对系统高频特性的影响,以作为器件设计的参考。设计出3cm、8mm波段的矩形栅高频结构模型,进行实验测量,得到的实验值与理论值符合良好。