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.     

萧红与20世纪中国女性文学

萧红是20世纪中国女性文学最杰出的代表性作家之一,与冰心、丁玲、张爱玲等作家相比,其独特性和不可替代性主要表现为三点第一,没有局限于知识女性的狭窄视野,避免陷入女性文学的精英主义误区,自觉为中国最广大下层女性代言,执著关注中国下层妇女的生存状态和人生悲剧;第二,始终如一地坚持以女性视角和女性生命体验来描绘普通女性生存真相并对她们寄寓着深切悲悯,体现出独立、清醒、深刻的现代女性意识;第三,拓展、丰富、深化了20世纪中国女性文学的表现内涵,提高了其审美品格.     

词语累赘与信息羡余

信息羡余是语言运用中加强信息传递的手段。信息羡余有两种加强信息的方式 :音节扩充 ,解释性叠加。语病重复是语句结构上的累赘 ,是应该删除的多余成分。保留信息羡余成分是“求繁” ,是信息传递的足量原则在起作用 ;删除累赘是“求简” ,是语言表达的经济原则在起作用 ,如何把握繁简的度 ,是语言规范工作所面临的一个难题。当前 ,语言规范化领域存在打击面过宽的偏向。区别“信息羡余”和“语病重复” ,可以从两方面考虑 :一是凭借人们的语感 ,一是参照表达实际。有时 ,是重复还是羡余 ,分界不是很清楚     

解读池莉小说创作的主体意识

池莉生活和创作心态朴实平和,这就形成了她独特的平民创作风格。对她创作主体意识的阐释,本文从母性意识、城市情结和真实的自我这三个方面来完成。     

建筑设计意识之我见

建筑是人创造的物质文化产品 ,是科学技术与艺术的统一体 ,蕴含着人们的思想意识、价值观念、审美情趣等。本文介绍了建筑设计活动中的一些见解 ,意在促进建筑水平的提高 ,繁荣建筑创作。     

论词在宋代的接受背景

:词的出现是对传统诗教观念的突破,它的发展经历了一个曲折的过程,不但关乎文学自身的规律,还涉及到复杂的士人心理和社会关系的变革。笔者拟从文学接受的外部环境和内部机制两个角度切入,探讨词在宋代的接受背景。     

Evaluation of HIV/AIDS peer education projects in Zambia

This 1998 evaluation assessed the peer education programmes of HIV/AIDS projects run by four non-governmental organisations. A mini-case study approach was used and analysis was based on cross-case itemistic variables. The projects were assessed only in terms of immediate developmental outcomes to target groups rather than on long-term impact. The study concluded the following: (1) The projects had raised community awareness of HIV/AIDS; (2) Basic knowledge of HIV/AIDS was for the most part accurate; (3) There was anecdotal evidence of behavioural changes in terms of partner-reduction as reported by the projects, though the evidence was sometimes conflicting; and (4) There was evidence that certain traditional practices, which contributed to the spread of the virus (e.g. sexual cleansing and scarification), were becoming modified over time. The programmes were also instrumental in protecting human rights and enabling people living with HIV/AIDS to maintain human dignity.     

论商标翻译的跨文化意识

商标翻译涉及到民族文化、地域文化及他国消费心理等诸多因素。它是一种跨文化翻译。译者应具有很强的跨文化意识。本文从文化的角度，探讨商标翻译。认为商标翻译必须充分考虑文化差异，努力跨越文化鸿沟；必须熟知外国语言习俗，力避他国禁忌。     

现代编辑意识浅议

编辑意识是指在编辑活动中，编辑人员所具有的观念，也就是引导编辑做好选题策划、审稿编稿、出版发行的指导思想，是从事编辑工作的主导意识。不断增强和优化编辑个体素养与群体意识、社会服务与引领学科发展意识、创新与超前意识、商品与经营意识，对促进刊物品质具有重要意义。