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1.
Nuria Infante-Torres Milagros Molina-Alarcón Ana Rubio-Álvarez Julián Rodríguez-Almagro Antonio Hernández-Martínez 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e318-e324
Aim
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2.
Robin S. Cronin Minglan Li Kate Culliney Robyn Maude Katherine Nelson 《Women and birth : journal of the Australian College of Midwives》2018,31(5):422-429
Background
Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.Aim
The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.Methods
An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.Findings
Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.Conclusions
Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education. 相似文献3.
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
4.
Luis Villar-Fidalgo María del Mar Espinosa Escudero Manuel Domínguez Somonte 《生产规划与管理》2019,30(8):624-638
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
5.
Social Indicators Research - Monitoring progress towards the Sustainable Development Goals by 2030 requires the global community to disaggregate targets along socio-economic lines, but little has... 相似文献
6.
7.
This paper proposes ‘comprehensive neighbourhood mapping’ as a schema for gathering and interpreting information within a given geographical area which is informed by imaginative thinking about the safety of children and young people from sexual crime. It would build upon current forms of profiling by local authorities, health authorities and central Government. CNM would actively involve local people, in partnership with agencies, in ‘mapping’ danger points and support points. Eight components are discussed, including environmental issues, locations of sex offenders, sites where teenagers meet and share information, supportive individuals and organizations. Some issues for pilot projects are discussed, including the need to set up planning and implementation groups and to integrate CNM into wider child protection and community safety strategies. CNM is grounded in an ecological perspective which sees partnership approaches as essential and believes an overarching view of neighbourhood needs, based on detailed local information and understanding of how different forms of harm interconnect, is crucial in developing child protection strategies. At times of acute official anxiety about community ‘lynch‐mob’ reactions to known paedophiles, CNM aims to build communities which instead are informed and thoughtful about child protection. Copyright © 2002 John Wiley & Sons, Ltd. 相似文献
8.
9.
María del Carmen Méndez García 《Intercultural Education》2005,16(1):57-68
The sociocultural content of foreign language textbooks has become a concern of scholars and practitioners owing to the fact that the traditional emphasis on purely linguistic issues has been expanded to embrace a language in context approach. This paper studies the English‐speaking communities that are described in English language teaching textbooks marketed in Spain. It examines to what extent an international and/or intercultural approach is a constituent element in their design. 相似文献
10.
Demographic Shifts in the Czech Republic after 1989: A Second Demographic Transition View 总被引:1,自引:1,他引:0
A dramatic change in fertility,family formation and living arrangements tookplace in the Czech Republic over the 1990s. Theestablishment of democracy, profound socialtransformation and transition to the marketeconomy affected the values and demographicbehaviour of the young Czech generation. Thispaper examines whether these demographic shiftscan be interpreted within the framework of thesecond demographic transition. The theoreticalpart discusses the idea of the transition,outlining three distinctive conceptualisations.Two of them – the view of the transition as aprogression of characteristic interrelateddemographic changes and a broader viewstressing the importance of underlyingideational factors – fit the Czech situationvery well. A comparison with the Netherlandsreveals that the onset of the transition in theCzech Republic may be clearly located in thefirst half of the 1990s, lagging two decadesbehind the Netherlands. 相似文献