To assess the relationship between the duration of the second stage of labour and postpartum anaemia during vaginal birth.
Methods
An observational, analytical retrospective cohort study was performed at the “Mancha-Centro Hospital” (Spain) during the 2013–2016 period. Data were collected from 3437 women who had a vaginal birth. Postpartum anaemia was defined as a haemoglobin level below 11 g/dL at 24 h postpartum. A univariate analysis was used for potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors.
Findings
The incidence of postpartum anaemia was 42.0%. The risk of postpartum anaemia did not increase in nulliparous women whose duration of the second stage of labour exceeded 4 h. Compared with multiparous women who delivered between 0 and 3 h, multiparous women with a duration of the second stage of labour beyond 3 h were at higher risk of postpartum anaemia (OR = 2.43 [1.30–4.52]).
Conclusion
The duration of the second stage of labour beyond 4 h is safe for postpartum anaemia in nulliparous women. However in multiparous women, monitoring should increase if the second stage of labour exceeds 3 h given the increased risk of postpartum anaemia. 相似文献
In this paper we study the m-clique free interval subgraphs. We investigate the facial structure of the polytope defined as the convex hull of the incidence vectors associated with these subgraphs. We also present some facet-defining inequalities to strengthen the associated linear relaxation. As an application, the generalized open-shop problem with disjunctive constraints (GOSDC) is considered. Indeed, by a projection on a set of variables, the m-clique free interval subgraphs represent the solution of an integer linear program solving the GOSDC presented in this paper. Moreover, we propose exact and heuristic separation algorithms, which are exploited into a Branch-and-cut algorithm for solving the GOSDC. Finally, we present and discuss some computational results. 相似文献
Managing risk in infrastructure systems implies dealing with interdependent physical networks and their relationships with the natural and societal contexts. Computational tools are often used to support operational decisions aimed at improving resilience, whereas economics‐related tools tend to be used to address broader societal and policy issues in infrastructure management. We propose an optimization‐based framework for infrastructure resilience analysis that incorporates organizational and socioeconomic aspects into operational problems, allowing to understand relationships between decisions at the policy level (e.g., regulation) and the technical level (e.g., optimal infrastructure restoration). We focus on three issues that arise when integrating such levels. First, optimal restoration strategies driven by financial and operational factors evolve differently compared to those driven by socioeconomic and humanitarian factors. Second, regulatory aspects have a significant impact on recovery dynamics (e.g., effective recovery is most challenging in societies with weak institutions and regulation, where individual interests may compromise societal well‐being). And third, the decision space (i.e., available actions) in postdisaster phases is strongly determined by predisaster decisions (e.g., resource allocation). The proposed optimization framework addresses these issues by using: (1) parametric analyses to test the influence of operational and socioeconomic factors on optimization outcomes, (2) regulatory constraints to model and assess the cost and benefit (for a variety of actors) of enforcing specific policy‐related conditions for the recovery process, and (3) sensitivity analyses to capture the effect of predisaster decisions on recovery. We illustrate our methodology with an example regarding the recovery of interdependent water, power, and gas networks in Shelby County, TN (USA), with exposure to natural hazards. 相似文献
An accurate procedure is proposed to calculate approximate moments of progressive order statistics in the context of statistical inference for lifetime models. The study analyses the performance of power series expansion to approximate the moments for location and scale distributions with high precision and smaller deviations with respect to the exact values. A comparative analysis between exact and approximate methods is shown using some tables and figures. The different approximations are applied in two situations. First, we consider the problem of computing the large sample variance–covariance matrix of maximum likelihood estimators. We also use the approximations to obtain progressively censored sampling plans for log-normal distributed data. These problems illustrate that the presented procedure is highly useful to compute the moments with precision for numerous censoring patterns and, in many cases, is the only valid method because the exact calculation may not be applicable. 相似文献
ABSTRACTIn this article responsibilisation in social work is studied by analysing two Finnish state-level policy documents (called final report and research report) which concern a current activation initiative called inclusive social security (ISS). It is asked how social workers and clients are constructed as responsible subjects in these documents. Responsibilisation refers to the advanced liberal mode of governmentality, which aims to strengthen citizens’ abilities to self-governance through various techniques that include the intertwined elements of surveillance and empowerment. It is demonstrated that the policy documents construct the social workers’ and the clients’ responsibilities partly in different ways. The final report leads activation to be based on shared responsibility and social work to be more community-based, whereas the research report strengthens more individual-based responsibility of clients and social workers. For the clients, the interpretation of ISS based on shared responsibility would probably be less stigmatising and paternalistic than the one based on individual responsibilities, i.e. approaching long-term unemployed citizens as being personally ‘at risk’ and thus a justified target group of individualised techniques for activation. For social workers and clients, future activation appears to be a wide mix of different techniques, moral expectations and possible ways of being a responsible subject. 相似文献
We analyze cooperation of individuals in a family context, using a Public Good game. In a lab experiment, 165 individuals from 55 three-generation families (youth, parent, and grandparent) play a repeated Public Good game in three different treatments: one in which three members of the same family play each other (family), a second with the youth and two non-family members, while preserving the previous generational structure (inter-generational), and a third in which three randomly-selected players play each other (random). We find that all the age groups cooperate more when playing with relatives, indicating that family ties may have a positive relationship to contributions to the Public Good. We also find that this trend is more evident for the youths and the parents than for the grandparents. Furthermore, young individuals tend to cooperate less than older generations, especially in non-family treatments. Our results serve as evidence of the relationship between family ties and inter-generational cooperative behaviors.
Open innovation and absorptive capacity are two concepts based on the idea that companies can leverage the knowledge generated externally to improve their innovation performance. The aim of this paper is to analyse the joint effect of open innovation and absorptive capacity on a firm's radical innovation. Open innovation is expressed in terms of external search breadth and depth strategies and absorptive capacity is described by distinguishing between potential and realized absorptive capacity. In order to test our hypotheses, we carried out empirical research in firms operating in high-technology industries. The results indicate that internal routines and processes for absorbing external knowledge help explain radical innovation as they show a significant effect of potential and realized absorptive capacity. Also, there is a moderating effect of absorptive capacity on open innovation. Specifically, potential absorptive capacity exerts a positive effect on the relationship between external search breadth and depth and radical innovation. Realized absorptive capacity moderates the influence of external search breadth. These findings confirm the complementary nature of absorptive capacity and open innovation search strategies on radical innovation. 相似文献
Catastrophic events, such as floods, earthquakes, hurricanes, and tsunamis, are rare, yet the cumulative risk of each event occurring at least once over an extended time period can be substantial. In this work, we assess the perception of cumulative flood risks, how those perceptions affect the choice of insurance, and whether perceptions and choices are influenced by cumulative risk information. We find that participants' cumulative risk judgments are well represented by a bimodal distribution, with a group that severely underestimates the risk and a group that moderately overestimates it. Individuals who underestimate cumulative risks make more risk‐seeking choices compared to those who overestimate cumulative risks. Providing explicit cumulative risk information for relevant time periods, as opposed to annual probabilities, is an inexpensive and effective way to improve both the perception of cumulative risk and the choices people make to protect against that risk. 相似文献
Not only ETO (Engineering to Order), but even serial production industry should know how to deal with projects and their schedule: plant commissioning, shutdown, introducing new products and similar circumstances should be managed with adequate planning and resource allocation techniques to create a schedule useful in decision making during the execution. The current complex reality, with evolving technologies and fierce pressure to reach the market as soon as possible, pushes the project managers to use more advanced techniques than waterfall planning, such as agile or lean. It also requires them to take a holistic view and manage concurrent tasks in complex projects. The contributions of this paper are two: the proposal to control specific parallel groups of waterfall activities under uncertain environments, which can lead to iterations and reworks, as a single concurrent Activity Managed by Kanban Methods (AMKM). This activity can be subsequently embedded into traditional scheduling approaches as CPM-PERT. The second contribution is the feasibility of its application in industrial environments due to the affordability of simulation software. Two use cases are shown as evidence. It is not a disruptive proposal, but a kaizen action based on very mature technologies. Finally, it is suggested some improvements to be implemented in Project Management Software due to this ‘kaizen’ proposal. 相似文献