Indications for,and timing of,planned caesarean section: A systematic analysis of clinical guidelines

BackgroundThere has been a worldwide rise in planned caesarean sections over recent decades, with significant variations in practice between hospitals and countries. Guidelines are known to influence clinical decision-making and, potentially, unwarranted clinical variation. The aim of this study was to review guidelines for recommendations in relation to the timing and indications for planned caesarean section as well as recommendations around the process of decision-making.MethodA systematic search of national and international English-language guidelines published between 2008 and 2018 was undertaken. Guidelines were reviewed, assessed in terms of quality and extracted independently by two reviewers.FindingsIn total, 49 guidelines of varying quality were included. There was consistency between the guidelines in potential indications for caesarean section, although guidelines vary in terms of the level of detail. There was substantial variation in timing of birth, for example recommended timing of caesarean section for women with uncomplicated placenta praevia is between 36 and 39 weeks depending on the guideline. Only 11 guidelines provided detailed guidance on shared decision-making. In general, national-level guidelines from Australia, and overseas, received higher quality ratings than regional guidelines.ConclusionThe majority of guidelines, regardless of their quality, provide very limited information to guide shared decision-making or the timing of planned caesarean section, two of the most vital aspects of guidance. National guidelines were generally of better quality than regional ones, suggesting these should be used as a template where possible and emphasis placed on improving national guidelines and minimising intra-country, regional, variability of guidelines.     

Women’s attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth

Problem

Rates of medical interventions in childbirth have greatly increased in the Western world.

辽朝黑龙江流域属国、属部朝贡活动研究

辽朝在征服、招抚黑龙江流域乌古、敌烈、鼻骨德、五国部等族群之后,相继建立属国属部制度,并将其纳入王朝"道"一级行政区划之中,各属国属部在中央与地方的双重统辖下进行不同程度的朝贡活动。辽中期建立起管理属国、属部的地方机构,对一些属国属部的统辖机制开始由朝贡制度向行政统辖制度转变,表现出统辖关系紧密的乌古、敌烈部朝贡次数骤然减少,鼻骨德部次之,统辖关系相对疏松的五国部则实行持续而规律的朝贡活动,因此不可简单地认为黑龙江流域属国属部朝贡活动频繁是辽朝对其统辖紧密的体现。     

Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial

Background

Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment.

种次号作为书次号时辅助区分号的设置与应用

本文论述在以种次号作为书次号时如何合理使用辅助区分号，使得馆藏排架更加科学合理，方便读者利用。     

新建本科院校基层教学单位师资队伍建设探析

新建本科院校基层教学单位教研室对于新建本科院校落实教学任务、教学研究与改革、科研等方面起着重要的作用。教研室的师资队伍建设情况直接影响着教研室功能的发挥。对新建本科院校教研室在师资队伍建设方面存在的问题进行了探讨,并提出了自己的建议与意见,希望能对新建本科院校基层教学单位的师资队伍建设有所借鉴。     

ANSYS在TBM步进支撑台座设计中的应用

采用TBM全断面隧道掘进机施工，步进支撑台座的可靠性和经济性是保证工程顺利进行的前提。结合罗宾斯TBM步进方案，选用合理可靠的步进支撑台座，应用ANSYS软件建立有限元模型，以求在保证TBM安全通过的前提下，确定出混凝土标号、浇注量及是否需要配筋等内容来解决施工经济性与便捷性问题。     

试析京杭运河山东段在近代的衰落原因

京杭大运河有“人类历史奇迹”的美誉，是贯通我国南北水运的大动脉。千百年来，在政治、经济、军事、文化等方面发挥了重要作用，成为维系中国大一统局面的政治纽带，大运河也呈现出盛极一时的繁荣局面。但清末至民国时期，由于航道淤塞、黄河改道、漕粮河运改为海运等自然、社会原因，京杭运河一度走向衰落。本文选取京杭运河主要是山东运河在近代以来的衰落情况及其原因作简单分析。     

Statistical techniques in stereology

Stereology typically concerns estimation of properties of a geometric structure from plane section information. This paperprovides a brief review of some statistical aspects of this rapidly developing field, with some reference to applications in the earth sciences. After an introductory discussion of the scope of stereology, section 2 briefly mentions results applicable when no assumptions can be made about the stochastic nature of the sampled matrix, statistical considerations then arising solelyfrom the ‘randomness’ of the plane section. The next two sections postulate embedded particles of specific shapes, the particular case of spheres being discussed in some detail.

References are made to results for ‘thin slices’ and other prob-ing mechanisms. Randomly located convex particles, of otherwise arbitrary shape, are discussed in section 5 and the review concludes with a specific application of stereological ideas to some data on neolithic mining.