Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study

ObjectiveTo compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia.DesignProspective cohort study.SettingTwo maternity hospitals in Ireland.PopulationA total of 1221 nulliparous women who gave birth vaginally or by emergency caesarean section.MethodsMultinomial logistic regression was used to analyse categorical outcomes, with results presented as ratios of relative risks (RRR). For dichotomous outcomes we used logistic regression, with results presented as odds ratios (OR).Main outcome measuresMode of birth, IV syntocinon use, pyrexia (≥38 °C), antibiotic treatment, first stage labour ≥10 h, second stage labour ≥2 h, blood loss (≥500 mls, ≥1000 mls), perineal trauma. Neonatal outcomes included Apgar score ≥7 at 1 min and 5 min, admission to neonatal intensive care unit, and infant feeding method.ResultsWomen using EA were more likely to require a vacuum-assisted birth (RRR 3.35, p < 0.01) or forceps-assisted birth (RRR 11.69, p < 0.01). Exposure to EA was associated with significantly greater risk of ≥10 h first (OR 6.72, p = 0.01) and ≥2 h second (OR 2.25, p < 0.01) stage labour, increased likelihood of receiving IV syntocinon (OR 9.38, p < 0.01), antibiotics (OR 2.97, p < 0.01) and a greater probability of pyrexia (OR 10.26, p < 0.01). Women who used EA were half as likely to be breastfeeding at three months postpartum (OR 0.53, p < 0.01). No differences were observed between groups in neonatal outcomes.ConclusionsOur data shows significant associations between EA use and several intrapartum outcomes.     

Evaluation of an intervention supporting breastfeeding among late-preterm infants during in-hospital stay

BackgroundLate-preterm infants show lower breastfeeding rates when compared with term infants. Current practice is to keep them in low-risk wards where clinical guidelines to support breastfeeding are well established for term infants but can be insufficient for late-preterm.ObjectiveThe aim of this study was to evaluate an intervention supporting breastfeeding among late-preterm infants in a maternity service in the Basque Country, Spain.MethodsThe intervention was designed to promote parents’ education and involvement, provide a multidisciplinary approach and decision-making, and avoid separation of the mother-infant dyad. A quasi-experimental study was conducted with a control (n = 212) and an intervention group (n = 161). Data was collected from clinical records from November 2012 to January 2015. Feeding rate at discharge, breast-pump use, incidence of morbidities, infant weight loss and hospital stay length were compared between the two groups.ResultsInfants in the control group were 50.7% exclusive breastfeeding, 37.8% breastfeeding, and, 11.5% formula feeding at discharge, whereas in the intervention group, frequencies were 68.4%, 25.9%, and 5.7%, respectively (p = 0.002). Mothers in the intervention group were 2.66 times more likely to use the breast-pump after almost all or all feeds and 2.09 times more likely to exclusively breastfeed at discharge. There were no significant differences in morbidities and infant weight loss between groups. Hospital stay was longer for infants who required phototherapy in the intervention group (p = 0.009).ConclusionThe intervention resulted in a higher breastfeeding rate at discharge. Interventions aimed to provide specific support among late-pretem infants in maternity services are effective.     

谈大型超市的防火管理

随着经济的发展和人民物质文化生活的提高,各种类型的超市如雨后春笋般出现在闹市和大街小巷,特别是大型和特大型超市在极大地满足了群众购物需要的同时,也蕴涵着重大的火灾隐患。本文针对大型超市的防火提出了应对措施。     

獭兔养殖综合技术研究

对獭兔的适应性、饲养管理、疾病防治、产品加工等养殖综合技术进行了研究,提出了獭兔的“三改、两杯、两早一分和两选两适”规范化饲养管理制度和疾病综合防治技术措施,探索出了优质獭兔毛皮和“富钙兔肉脯”的加工工艺以及獭兔良种推广的有效途径。     

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.     

Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: A randomised control trial

ObjectiveTo evaluate the effect of mother–infant immediate skin-to-skin contact on primiparous mother's breastfeeding self-efficacy.Study designA randomised control trial.SettingsThe study was conducted in Omolbanin obstetrics hospital (large tertiary hospital), Mashhad, Iran.Participants114 18–35 year-old primiparous, Iranian, healthy and full term mothers who anticipated normal vaginal delivery and intended to breastfeed their babies.InterventionSkin-to-skin contact immediately after birth and then controlling breastfeeding self-efficacy at 28 days postpartum.Main outcome measureMaternal breastfeeding self-efficacy at 28 days postpartum and success in first breastfeeding and mean time of first breastfeeding initiation.ResultsA total of 92 mother–infant dyads (47 dyads in skin-to-skin care skin-to-skin contact group and 45 dyads in routine care group) were monitored and analysed. In skin-to-skin contact group, breastfeeding self-efficacy was 53.42 ± 8.57 SD as compared to 49.85 ± 5.50 SD in routine care group which is significantly higher in skin-to-skin contact group (p = 0.0003).Successful breastfeeding initiation rate was 56.6% in skin-to-skin contact group as compared to 35.6% in routine care group (p = 0.02).Time to initiate first feed was 21.98 ± 9.10 SD min in SSC group vs. 66.55 ± 20.76 min in routine care group (p < 0.001).ConclusionMother–infant immediate skin-to-skin contact is an easy and available method of enhancing maternal breastfeeding self-efficacy. High breastfeeding self-efficacy increases exclusive breastfeeding duration.     

试论西部大开发中少数民族传统文化重构的特点

本文通过对西部大开发过程中少数民族文化重构的必然性、多元性、个体自愿性、长期性等特点的分析,论证并指出:西部开发过程中少数民族传统文化的变迁、重构是必然趋势,并且这个重构是长期的发展过程。在此过程中,应以个体自愿的原则为基础,让各种文化的主人从多元的社会文化取向中自主选择取舍,以达到“中和位育”的最终结果,在西部民族地区形成“各美其美”、“美美与共”、“和而不同”的多元文化混一的文化环境。与此同时,笔者对学术界中值得商榷的提法也进行了必要的修正。     

曲线分类建模方法及其在GDP预测中的应用

传统方法解决大规模时序曲线的预测建模问题,需要对每条曲线逐一建模,使得建模工作量相当庞大,在实际应用中缺乏可操作性。文章提出一种解决此问题的新方法——曲线分类建模方法。该方法先减少曲线的模型种类,再进行曲线分类和分类建模,在尽可能保留原始信息的前提下较大程度地降低了建模的工作量。文章阐述了该方法的原理和计算过程,并以应用于多地区GDP曲线的预测案例说明该方法的实用性和有效性。     

A Commentary on the Triadic Theory of Influence as a Guide for Adapting HIV Prevention Programs for New Contexts and Populations

Summary

The purpose of this paper is to illustrate how the Collaborative HIV Prevention and Adolescent Mental Health Project-South Africa (CHAMPSA) began and to present some of the results from this South African version of CHAMP. This paper informs readers of a number of lessons about international program translation. The first important lesson is that there are universal principles of health behavior change that seem to be useful across cultures. The implementation of these principles, however, needs to be informed by an in-depth understanding of local cultural contexts. The second important lesson is that it is possible to undertake large-scale, scientifically sophisticated community-based prevention research in developing countries through international collaborative research projects. It is the authors' hope that this mixture of science, service, and business will inspire other public health, community mental health, research, and business professionals to develop international prevention interventions that can be shown to be effective, and disseminated on a wide scale.     

具有不确定的时滞微分系统的稳定性

研究具有不确定的时滞微分大系统的鲁棒稳定性问题，利用李雅普诺夫函数和不等式分析方法，给出了不确定性时滞微分大系统在不依赖时滞的反馈分散控制下是稳定化的、渐近稳定化和指数稳定化的充分条件。