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.     

精神回溯与意象精研的本质书写--林雪诗歌评论

林雪是当代汉语诗歌的重要诗人，她“在心为志，发言为诗”，诗风大气沉郁。她近期的诗歌，情怀与思辨相互倚重、酵化，介入生活与提炼心性同步发力，题材多样，手法多变，情感收放自如，气韵放达从容。她对现实的观照，对时空的架构，对存在的开掘，都呈现出一种新的气象。她自觉地从先期女性主义诗写中觉醒，到如今的清澈中隐显尘世的味蕾，对生活细节和感念触觉的精妙镂刻，以及对世道人心的专注和细致打量。     

Decision‐making under uncertainty in child protection: Creating a just and learning culture

The argument is made for having a positive error culture in child protection to improve decision‐making and risk management. This requires organizations to accept that mistakes are likely and to treat them as opportunities for learning and improving. In contrast, in many organizations, a punitive reaction to errors leads to workers hiding them and developing a defensive approach to their practice with children and families. The safety management literature has shown how human error is generally not simply due to a “bad apple” but made more or less likely by the work context that helps or hinders good performance. Improving safety requires learning about the weaknesses in the organization that contribute to poor performance. To create a learning culture, people need to feel that when they talk about mistakes or weak practice, there will be a constructive response from their organization. One aspect of reducing the blame culture is to develop a shared understanding of how practice will be judged and how those appraising practice will avoid the hindsight bias. To facilitate a positive error culture, a set of risk principles are presented that offer a set of criteria by which practice should be appraised.     

The disembedded digital economy: Social protection for new economy employment in China

This research focuses upon employment in the new economy, exploring labour protection and social protection in the digital age in China. Through an empirical survey conducted in three Chinese cities, social insurance and the labour rights of employees in the digital economic sector, such as gig employment, e-commerce, and various other forms of online employment, have been examined in-depth. This study reveals new regulatory loopholes in the digital labour market, which have substantially eroded the basis of social policy arrangements in China, “softening” participation in social insurance branches and compliance with labour regulations remarkably. Drawing upon the theoretical concepts of Polanyi on embeddedness and disembeddedness, we argue that the digital employment sector in China has been increasingly disembedded from social institutions and social control. The new configuration in the digital field of social policy requires novel conceptual models and institutional settings to cope with increasing social risks in virtual spaces.     

关于高校中层副职干部几个基本问题的思考

高校中层副职干部具有高校干部、中层干部和副职干部的群体特征，应当具备相应的政治、思想、道德、业务、能力和身体等方面的基本素质。高校应当按照现行干部配置规制，结合内部管理体制和工作机制任用干部。高校中层副职干部的日常活动涉及到社会、学校、家庭等多个层面，必须妥善处理好各种人事关系。     

对区域高等教育战略规划的若干思考--基于《加利福尼亚州高等教育总体规划（1960-1975）》的分析

《加利福尼亚州高等教育总体规划（1960—1975）》是区域高等教育战略规划领域的成功范例，规划内容通过州宪法性效力、州法律法规性效力以及行业约定性效力三种形式发挥作用。准确把握关键问题、秉持院校自治理念、深入开展调研等做法值得借鉴。我国区域高等教育机遇与挑战并存，教育规划应当坚持治理理念、以人为本理念和系统论理念，对区域高校定位作出合理预期与安排，引导区域高等教育健康和谐发展。     

零售4.0时代先行发货问题的大数据分析

在零售4.0时代，渠道的多样化不仅丰富了数据源，还能迅速生成大量数据，需要通过分析大数据，为决策提取有意义的信息，通过分析先行发货的重要性，提出了一种基于遗传算法（GA）的优化模型，预测顾客何时购买，然后在顾客线下单前将产品运送到距顾客最近的配送中心，解决先行发货中存在的问题。研究认为，需要先部署云计算来存储所有渠道生成的大数据，再应用基于集群的关联规则挖掘研究顾客的购买行为，根据“如果-那么”预测规则预测未来的采购情况，最后利用修正的遗传算法生成最优的先行发货计划；这种遗传算法考虑了其在运输成本和运输距离之外，还有预测规则的置信度，利用大量的数值实验权衡了先行发货中的不同因素，验证了模型的最优可靠性     

金诗学唐的历程

金代诗歌在受苏轼等宋代诗人的影响之外 ,也受到唐诗的浸润。本文依据金诗发展变化的自身情况 ,考察了金诗学唐的历程。文中将金诗学唐分为金初“借才异代”时期、“国朝文派”时期、金代后期等三个阶段 ,做了比较详细的论述 ,从一个方面展示了金诗发展的轨迹 ,揭示了金诗的某些重要特点 ,对于我们深入地认识金诗是有裨益的     

森林可持续经营的政策支持体系——亚太区域示范林项目中国临安示范林实践

运用参与性诊断(即PRRA)方法对临安示范林地区的森林经营主要政策进行了诊断分析,找出了现行政策存在的问题,如:政策环境欠佳,产权政策不到位,税费政策不合理,林业产品生产、加工和销售脱节,森林生态效益补偿政策欠规范、不合理等.同时,运用参与性设计的方法对若干主要政策进行专项设计,并在此基础上,从优化森林可持续经营的政策环境和规范政策系统运行两方面入手,提出一套科学、合理和有效的适合当地水平的森林可持续经营综合设计方案,以促进示范林网络的发展.     

关于高校办公室网络化管理的思考

随着科学技术和高等教育的发展,网络也广泛运用于高校办公室的管理工作,并在其中起着重要的作用。