Midwives’ experiences of providing maternity care to women and families during the COVID-19 pandemic in Northern Italy

ProblemThe COVID-19 pandemic has significantly challenged maternity provision internationally. Rapid and radical changes were implemented, with midwives facing anxiety and moral distress if not able to provide optimal and woman-centred care in line with professional values.BackgroundHealthcare professionals’ stress and burnout are commonly reported during other global emergencies, which may eventually contribute to reduced quality of care. There is lack of evidence of the challenges faced by midwives in Italy during the COVID-19 pandemic.AimTo explore midwives’ experiences of providing care to women and families during the COVID-19 pandemic.MethodsQualitative interpretive phenomenological approach, using semi-structured interviews and thematic analysis. The sample included 15 midwives. Ethical approval was obtained.FindingsFour themes were identified: 1) adjusting to the ever-evolving organisation of care; 2) physical, psychological and relational challenges; 3) support network; 4) deferred sense of awareness.DiscussionMidwives faced professional and personal challenges during the pandemic, displaying feelings of fear, anxiety, uncertainty, discomfort, lack of support and knowledge with potential long-term effects. Adjusting to the continuous, rapid and drastic re-organisation of maternity services was particularly challenging. Factors facilitating a safe, supportive and empowering workplace included support from colleagues and managers, access to appropriate PPE, reliable guidelines, good communication and emotional support. Positive aspects of personal and professional development included communication skills, establishment of trusting relationships, sense of empowerment and teamwork.ConclusionIn the context of a pandemic, optimisation of midwives’ physical, emotional and psychological wellbeing should be considered. Timely and comprehensive guidelines and appropriate resources should be provided to assist midwives in facilitating family-centred respectful maternity care and preserving childbirth as a bio-psychosocial event.     

服务水平约束下的建筑安装行业多仓库联合库存系统模型研究

本文针对建筑安装行业库存管理的特点,对其不同地点的多个仓库的库存方式进行综合分析,建立了服务水平约束下的建筑安装行业多仓库联合库存系统模型,给出了相应的数学模型与算法。通过算例验证表明,服务水平约束下的建筑安装行业多仓库联合库存系统模型可以有效降低建设项目的库存成本,对增加企业利润有着十分重要的现实意义。     

Do Family Meetings Improve Measurable Outcomes for Patients,Carers, or Health Systems? A Systematic Review

Abstract

Family meetings are a common intervention in acute and subacute inpatient care settings. The aim of this systematic review was to investigate the quantitative research exploring the impact of inpatient family meetings on patient, carer, or service outcomes. A search of electronic databases (Medline, Cinahl, Embase, PubMed, and Psychinfo) was conducted from the earliest available time until July 2012. Inclusion and exclusion criteria were applied, and quality assessment of included articles was conducted. Eight studies were included in the final selection. Results indicate that there is some low-to-moderate quality evidence that inpatient family meetings reduce psychological distress of family carers and assist in meeting their information and support needs. There is weak evidence that inpatient family meetings may help to reduce readmission rates and facilitate entry to continuing care programs.     

浅析《中国日报》英语纯新闻报道中导语的词汇特征

消息主要有标题,导语和正文三大部分组成。其中,导语是消息区别于其他文体的重要标志。它以简练而生动的文字表述新闻事件中的最重要的内容。本文借助语料库语言学的相关知识对新闻导语语料库进行了定性和定量分析,试图探究导语的词汇特征。     

The effect of MRP lot sizing on actual cumulative lead times in multi-level systems

This study investigates how different lot sizing techniques influence the cumulative lead time for multi-level production-inventory systems controlled by material requirements planning (MRP). Theoretical approaches, a numerical example, as well as simulation are used to analyse and illustrate the combined effect of lot sizing at different product structure levels. It is shown that lot-sizing requirements for more than a single period, such as fixed period requirements, period under quantity, Silver Meal algorithm, as well as economic order quantity will lead to longer actual cumulative lead times than would be expected, when taking the item lead times along the critical path through the product structure into account. Consequently, MRP will underestimate the cumulative lead time and will require a longer planning horizon. We show that the extension of the cumulative lead techniques covering the time is a lot-sizing related phenomenon and cannot be accounted for by, e.g. using safety lead time. Lot-sizing techniques with multi-period coverage will only occasionally provide the 'expected' cumulative lead time. We also show that average and maximum throughput times, as well as throughput time variability increases with increasing time-period coverage of lots.     

Supply chain management: A just-in-time perspective

Just-in-time (JIT) has been a widely recognized production philosophy alternative since the early 1980s. JIT principles and techniques have been widely adopted in many manufacturing firms. More recently, supply chain management has evolved as a discipline focusing on the design, planning and control of processes linking the initial raw materials to the ultimate consumption of the finished product. Supply chain efficiency is dependent on the efficiencies of the individual manufacturing organizations and the ability to connect along the supply chain. In this paper supply chain management from a JIT perspective is investigated, focusing on the linking mechanisms between successive companies and the collective efficiency of the supply chain.     

流动人口生育保险参与及其性别差异研究

本文利用南开大学“2013年流动人口管理和服务对策研究问卷调查”数据对流动人口生育保险参与性别差异及影响因素进行深入分析,发现流动人口生育保险参与率较低,而且存在显著的性别差异,女性好于男性流动人口。而影响流动人口生育保险参与的因素也存在明显差异,受教育程度、劳动合同、合同协商、工会、企业性质等是影响女性流动人口生育保险参与的显著因素。在此基础上,提出了进一步促进流动人口生育保险参与的对策思考。     

Australian maternity healthcare professionals’ knowledge,attitudes and practices relevant to cord blood banking,donation and clamp timing: A cross-sectional survey

ProblemAustralian health professionals’ knowledge and attitudes towards third stage labour options of cord clamp timing, cord blood banking and donation and their practice of informing parents of these options is unknown.BackgroundParents have several options for the management of their infant’ cord blood during the third stage of labour. Early or deferred cord clamping practices may affect parent choices about physiological transfusion to the neonate and/or cord blood collection for private or public banking or donation.AimTo identify health professionals’ knowledge and attitudes towards third stage labour options of cord clamp timing, cord blood banking and donation and their practice of informing parents of these options.MethodsA total of 129 Australian maternity healthcare professionals responded to the self-administered survey between December 2017 and June 2018.FindingsOccupational differences were revealed in regard to cord clamp timing, cord blood banking and donation knowledge, attitudes and practices. Midwives were more likely to discuss cord clamp timing with parents and to clamp the cord later than obstetricians. Obstetricians were more knowledgeable of cord blood banking and donation options than midwives. Cord blood banking and donation options were discussed by both groups if parents asked.DiscussionIdentification of gaps in knowledge should guide future maternity health professional education that is inclusive of all third stage labour options to ensure that open discussion and informing parents of options is consistent, contemporary and evidence-based.ConclusionTo make informed decisions, parents need evidence-based information on all third stage labour options.     

Probiotics and human lactational mastitis: A scoping review

ProblemLactational mastitis is a common condition amongst breastfeeding women. It is associated with decreased breastfeeding rates and often treated with antibiotics.BackgroundThe anti-inflammatory effects of probiotics have been identified as a potential treatment or prevention strategy for lactational mastitis leading to increased commercial and public interest. Despite the marketing of probiotics to women, evidence is still emerging as to its efficacy.Aim/MethodsThis scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to identify and examine the evidence around probiotic consumption and lactational mastitis. The review addressed the question; what is the evidence regarding probiotic consumption and human lactational mastitis? Studies were critically appraised using the Joanna Briggs Institute checklist for randomised control trials (RCTs).FindingsFive RCTs met the inclusion criteria; three concerned probiotic consumption for the treatment of mastitis, two for the prevention of mastitis. All reported a lower incidence of mastitis in the probiotic groups.DiscussionAlthough potentially promising results were reported across all studies there were significant methodological limitations concerning; appropriately described baseline characteristics, study hypotheses, lack of power calculations, definitional issues, and potential conflicts of interest.ConclusionProbiotics may have utility for the treatment or prevention of lactational mastitis. However only a few studies with significant limitations have been published to date. Well designed and conducted studies are needed before evidence-based recommendations can be made for use of probiotics in the treatment or prevention of lactational mastitis.