Is there a 'pig cycle' in the labour supply of doctors? How training and immigration policies respond to physician shortages.

PubMed

Chojnicki, Xavier; Moullan, Yasser

2018-03-01

Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004. By calculating panel fixed-effect estimates, we find that after a period of medical shortages, OECD governments produce more medical graduates in the long run but in the short term, they primarily recruit from abroad; however, at the same time, certain practising physicians choose to emigrate. Simulation results show the limits of recruiting only abroad in the long term but also highlight its appropriateness for the short term when there is a recurrent cycle of shortages/surpluses in the labour supply of physicians (pig cycle theory). Copyright © 2018 Elsevier Ltd. All rights reserved.

Dentist education and labour market in Mexico: elements for policy definition

PubMed Central

2012-01-01

Background Here, the educational and labour market characteristics of Mexican dentists are revised. Dentistry is a health profession that has been scarcely studied in developing countries. This analysis attempts to understand the relationships and gaps between the supply and demand of dentists in the country. Around 5000 new dentists graduate every year looking for a place in the labour market. Methods A cross-sectional study with exploratory, descriptive and correlational scope was carried out between 2006 and 2008. Analyses of quantitative data on dentists from national surveys and occupational statistics were complemented with qualitative information provided by 43 key informants in five Mexican states. Results The 2008 dentist labour market can be characterized as follows: 75% worked in the private sector, most of them independently; more than two-thirds were women; the proportion of specialists was low (slightly more than 10%); unemployment was more than 20% and labour wastage was nearly 40%, with most wastage corresponding with female dentists. The increase in the number of dentists entering the labour market during the last two decades is more related to the educational market than to the population’s health needs and the number of dentists actually required to meet them. Conclusions The problems identified in the Mexican dentist labour market necessitate urgent intervention on behalf of regulatory bodies in order to balance the tendencies of supply and demand in the number of trained professionals as well as in their incorporation into different market areas. Adequate policies are required to increase the likelihood of achieving this objective. PMID:22974344

Dentist education and labour market in Mexico: elements for policy definition.

PubMed

González-Robledo, Luz María; González-Robledo, María Cecilia; Nigenda, Gustavo

2012-09-13

Here, the educational and labour market characteristics of Mexican dentists are revised. Dentistry is a health profession that has been scarcely studied in developing countries. This analysis attempts to understand the relationships and gaps between the supply and demand of dentists in the country. Around 5000 new dentists graduate every year looking for a place in the labour market. A cross-sectional study with exploratory, descriptive and correlational scope was carried out between 2006 and 2008. Analyses of quantitative data on dentists from national surveys and occupational statistics were complemented with qualitative information provided by 43 key informants in five Mexican states. The 2008 dentist labour market can be characterized as follows: 75% worked in the private sector, most of them independently; more than two-thirds were women; the proportion of specialists was low (slightly more than 10%); unemployment was more than 20% and labour wastage was nearly 40%, with most wastage corresponding with female dentists. The increase in the number of dentists entering the labour market during the last two decades is more related to the educational market than to the population's health needs and the number of dentists actually required to meet them. The problems identified in the Mexican dentist labour market necessitate urgent intervention on behalf of regulatory bodies in order to balance the tendencies of supply and demand in the number of trained professionals as well as in their incorporation into different market areas. Adequate policies are required to increase the likelihood of achieving this objective.

The Interaction between Higher Education and Labour Market in Changing Economic Environment

ERIC Educational Resources Information Center

Gravite, Aija

2015-01-01

This paper explores challenges higher education institutions face while ensuring one of the quality assurance criteria--meeting the demands of labour market. The relationship between labour market and higher education institutions becomes even more complicated during the periods of rapid changes in labour market caused by economic collisions. In…

Hard Lessons for Lifelong Learners? Age and Experience in the Graduate Labour Market

ERIC Educational Resources Information Center

Purcell, Kate; Wilton, Nick; Elias, Peter

2007-01-01

The expansion of the higher education system and widening access to undergraduate study has led to growing diversity within the graduate labour supply, including increasing numbers who studied for their degrees as mature students. Analysis of graduates entering the labour market prior to the major expansion in the early 1990s indicated that those…

Halal Supply Chain Management Streamlined Practices: Issues and Challenges

NASA Astrophysics Data System (ADS)

Hijrah Abd Kadir, Muhammad; Zuraidah Raja Mohd Rasi, Raja; Omar, Siti Sarah; Manap, Zariq Imran Abdul

2016-11-01

The quickly developing worldwide halal in business sector has given a remarkable window of chance, which empowers Malaysia to the renowned halal centre in worldwide (known as Halal-hubs). Malaysia also has proactively taken a lead in halal activities, which is presently considered as the benchmark for a halal framework worldwide. Malaysia also set up the Halal Industry Development Corporation (HDC) which driving a wide range of halal activities since the demand of halal food has increased significantly which is very crucial for a Muslim in ensuring its authenticity and integrity. Even in parallel to this developments, many studies has been conducted because there are many issues still occurs in the food industry. The issue of consumer awareness and understanding the halal principles, mixing of halal and non- halal products, halal certification and logo compliance with Shariah law and lack of regulation and enforcement need the serious attention by all parties along the supply chain. The challenges occur mainly in the halal food segregation and halal traceability of the products. The unit of analysis in this study different halal stakeholders group which are JAKIM, Halal Development Centre (HDC), Raw Material Manufacturers, Retailers and Government Agencies. This paper attempt discusses the issues and challenges occurs in the halal supply chain and faced by the practitioners as well as the relevant parties involved in the industry especially for food products manufacturers. The study would like to give a basic information about the issues and challenges in the contribution of Halal Supply Chain Management (HSCM) as well as for the future studies.

The State of the Labour Market in South Africa after the First Decade of Democracy

ERIC Educational Resources Information Center

Burger, Rulof; Woolard, Ingrid

2005-01-01

While the political transition to democratic rule in South Africa was smooth and rapid, the economic transition has been slow and difficult. Nowhere is this more apparent than in the labour market. Job creation has not matched growing labour supply and the unemployment rate continues to rise. This article attempts to document and identify the key…

Obstructed labour.

PubMed

Neilson, J P; Lavender, T; Quenby, S; Wray, S

2003-01-01

Obstructed labour is an important cause of maternal deaths in communities in which undernutrition in childhood is common resulting in small pelves in women, and in which there is no easy access to functioning health facilities with the capability of carrying out operative deliveries. Obstructed labour also causes significant maternal morbidity in the short term (notably infection) and long term (notably obstetric fistulas). Fetal death from asphyxia is also common. There are differences in the behaviour of the uterus during obstructed labour, depending on whether the woman has delivered previously. The pattern in primigravid women (typically diminishing contractility with risk of infection and fistula) may result from tissue acidosis, whereas in parous women, contractility may be maintained with the risk of uterine rupture. Ultimately, tackling the problem of obstructed labour will require universal adequate nutritional intake from childhood and the ability to access adequately equipped and staffed clinical facilities when problems arise in labour. These seem still rather distant aspirations. In the meantime, strategies should be implemented to encourage early recognition of prolonged labour and appropriate clinical responses. The sequelae of obstructed labour can be an enormous source of human misery and the prevention of obstetric fistulas, and skilled treatment if they do occur, are important priorities in regions where obstructed labour is still common.

The Far Right Challenge

PubMed Central

Halikiopoulou, Daphne

2018-01-01

Speed and Mannion make a good case that the rise of populism poses significant challenges for health policy. This commentary suggests that the link between populism and health policy should be further nuanced in four ways. First, a deconstruction of the term populism itself and a focus on the far right dimension of populist politics; second, a focus on the supply side and more specifically the question of nationalism and the ‘national preference’; third, the dynamics of party competition during economic crisis; and fourth the question of policy, and more specifically the extent to which certain labour market policies are able to mediate demand for the far right. PMID:29524946

The Teacher Labour Market in the US: Challenges and Reforms

ERIC Educational Resources Information Center

Belfield, Clive R.

2005-01-01

This article describes the teaching profession and teacher labour market in the US. Over the period since 1966, the profession has become 80% female, highly credentialled, considerably more senior, and increasingly unionized. In contrast, formal working conditions have changed relatively little, although class sizes are now approximately 30%…

Opportunities and Challenges in the Design and Analysis of Biomass Supply Chains

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lautala, Pasi T.; Hilliard, Michael R.; Webb, Erin

The biomass supply chain is one of the most critical elements of large-scale bioenergy production and in many cases a key barrier for procuring initial funding for new developments on specific energy crops. Most productions rely on complex transforming chains linked to feed and food markets. The term 'supply chain' covers various aspects from cultivation and harvesting of the biomass, to treatment, transportation, and storage. After energy conversion, the product must be delivered to final consumption, whether it is in the form of electricity, heat, or more tangible products, such as pellets and biofuels. Effective supply chains are of utmostmore » importance for bioenergy production, as biomass tends to possess challenging seasonal production cycles and low mass, energy and bulk densities. Additionally, the demand for final products is often also dispersed, further complicating the supply chain. The goal of this paper is to introduce key components of biomass supply chains, examples of related modeling applications, and if/how they address aspects related to environmental metrics and management. The paper will introduce a concept of integrated supply systems for sustainable biomass trade and the factors influencing the bioenergy supply chain landscape, including models that can be used to investigate the factors. Our paper will also cover various aspects of transportation logistics, ranging from alternative modal and multi-modal alternatives to introduction of support tools for transportation analysis. Lastly, gaps and challenges in supply chain research are identified and used to outline research recommendations for the future direction in this area of study.« less

Opportunities and Challenges in the Design and Analysis of Biomass Supply Chains

DOE PAGES

Lautala, Pasi T.; Hilliard, Michael R.; Webb, Erin; ...

2015-06-30

The biomass supply chain is one of the most critical elements of large-scale bioenergy production and in many cases a key barrier for procuring initial funding for new developments on specific energy crops. Most productions rely on complex transforming chains linked to feed and food markets. The term 'supply chain' covers various aspects from cultivation and harvesting of the biomass, to treatment, transportation, and storage. After energy conversion, the product must be delivered to final consumption, whether it is in the form of electricity, heat, or more tangible products, such as pellets and biofuels. Effective supply chains are of utmostmore » importance for bioenergy production, as biomass tends to possess challenging seasonal production cycles and low mass, energy and bulk densities. Additionally, the demand for final products is often also dispersed, further complicating the supply chain. The goal of this paper is to introduce key components of biomass supply chains, examples of related modeling applications, and if/how they address aspects related to environmental metrics and management. The paper will introduce a concept of integrated supply systems for sustainable biomass trade and the factors influencing the bioenergy supply chain landscape, including models that can be used to investigate the factors. Our paper will also cover various aspects of transportation logistics, ranging from alternative modal and multi-modal alternatives to introduction of support tools for transportation analysis. Lastly, gaps and challenges in supply chain research are identified and used to outline research recommendations for the future direction in this area of study.« less

Opportunities and Challenges in the Design and Analysis of Biomass Supply Chains.

PubMed

Lautala, Pasi T; Hilliard, Michael R; Webb, Erin; Busch, Ingrid; Richard Hess, J; Roni, Mohammad S; Hilbert, Jorge; Handler, Robert M; Bittencourt, Roger; Valente, Amir; Laitinen, Tuuli

2015-12-01

The biomass supply chain is one of the most critical elements of large-scale bioenergy production and in many cases a key barrier for procuring initial funding for new developments on specific energy crops. Most productions rely on complex transforming chains linked to feed and food markets. The term 'supply chain' covers various aspects from cultivation and harvesting of the biomass, to treatment, transportation, and storage. After energy conversion, the product must be delivered to final consumption, whether it is in the form of electricity, heat, or more tangible products, such as pellets and biofuels. Effective supply chains are of utmost importance for bioenergy production, as biomass tends to possess challenging seasonal production cycles and low mass, energy and bulk densities. Additionally, the demand for final products is often also dispersed, further complicating the supply chain. The goal of this paper is to introduce key components of biomass supply chains, examples of related modeling applications, and if/how they address aspects related to environmental metrics and management. The paper will introduce a concept of integrated supply systems for sustainable biomass trade and the factors influencing the bioenergy supply chain landscape, including models that can be used to investigate the factors. The paper will also cover various aspects of transportation logistics, ranging from alternative modal and multi-modal alternatives to introduction of support tools for transportation analysis. Finally gaps and challenges in supply chain research are identified and used to outline research recommendations for the future direction in this area of study.

Opportunities and Challenges in the Design and Analysis of Biomass Supply Chains

NASA Astrophysics Data System (ADS)

Lautala, Pasi T.; Hilliard, Michael R.; Webb, Erin; Busch, Ingrid; Richard Hess, J.; Roni, Mohammad S.; Hilbert, Jorge; Handler, Robert M.; Bittencourt, Roger; Valente, Amir; Laitinen, Tuuli

2015-12-01

The biomass supply chain is one of the most critical elements of large-scale bioenergy production and in many cases a key barrier for procuring initial funding for new developments on specific energy crops. Most productions rely on complex transforming chains linked to feed and food markets. The term `supply chain' covers various aspects from cultivation and harvesting of the biomass, to treatment, transportation, and storage. After energy conversion, the product must be delivered to final consumption, whether it is in the form of electricity, heat, or more tangible products, such as pellets and biofuels. Effective supply chains are of utmost importance for bioenergy production, as biomass tends to possess challenging seasonal production cycles and low mass, energy and bulk densities. Additionally, the demand for final products is often also dispersed, further complicating the supply chain. The goal of this paper is to introduce key components of biomass supply chains, examples of related modeling applications, and if/how they address aspects related to environmental metrics and management. The paper will introduce a concept of integrated supply systems for sustainable biomass trade and the factors influencing the bioenergy supply chain landscape, including models that can be used to investigate the factors. The paper will also cover various aspects of transportation logistics, ranging from alternative modal and multi-modal alternatives to introduction of support tools for transportation analysis. Finally gaps and challenges in supply chain research are identified and used to outline research recommendations for the future direction in this area of study.

Transcription Analysis of the Myometrium of Labouring and Non-Labouring Women

PubMed Central

Hutchinson, James L.; Hibbert, Nanette; Freeman, Tom C.; Saunders, Philippa T. K.; Norman, Jane E.

2016-01-01

An incomplete understanding of the molecular mechanisms that initiate normal human labour at term seriously hampers the development of effective ways to predict, prevent and treat disorders such as preterm labour. Appropriate analysis of large microarray experiments that compare gene expression in non-labouring and labouring gestational tissues is necessary to help bridge these gaps in our knowledge. In this work, gene expression in 48 (22 labouring, 26 non-labouring) lower-segment myometrial samples collected at Caesarean section were analysed using Illumina HT-12 v4.0 BeadChips. Normalised data were compared between labouring and non-labouring groups using traditional statistical methods and a novel network graph approach. We sought technical validation with quantitative real-time PCR, and biological replication through inverse variance-weighted meta-analysis with published microarray data. We have extended the list of genes suggested to be associated with labour: Compared to non-labouring samples, labouring samples showed apparent higher expression at 960 probes (949 genes) and apparent lower expression at 801 probes (789 genes) (absolute fold change ≥1.2, rank product percentage of false positive value (RP-PFP) <0.05). Although half of the women in the labouring group had received pharmaceutical treatment to induce or augment labour, sensitivity analysis suggested that this did not confound our results. In agreement with previous studies, functional analysis suggested that labour was characterised by an increase in the expression of inflammatory genes and network analysis suggested a strong neutrophil signature. Our analysis also suggested that labour is characterised by a decrease in the expression of muscle-specific processes, which has not been explicitly discussed previously. We validated these findings through the first formal meta-analysis of raw data from previous experiments and we hypothesise that this represents a change in the composition of

Combating the Reliability Challenge of GPU Register File at Low Supply Voltage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tan, Jingweijia; Song, Shuaiwen; Yan, Kaige

Supply voltage reduction is an effective approach to significantly reduce GPU energy consumption. As the largest on-chip storage structure, the GPU register file becomes the reliability hotspot that prevents further supply voltage reduction below the safe limit (Vmin) due to process variation effects. This work addresses the reliability challenge of the GPU register file at low supply voltages, which is an essential first step for aggressive supply voltage reduction of the entire GPU chip. We propose GR-Guard, an architectural solution that leverages long register dead time to enable reliable operations from unreliable register file at low voltages.

Challenges in the management of the blood supply.

PubMed

Williamson, Lorna M; Devine, Dana V

2013-05-25

Although blood suppliers are seeing short-term reductions in blood demand as a result of initiatives in patient blood management, modelling suggests that during the next 5-10 years, blood availability in developed countries will need to increase again to meet the demands of ageing populations. Increasing of the blood supply raises many challenges; new approaches to recruitment and retainment of future generations of blood donors will be needed, and care will be necessary to avoid taking too much blood from these donors. Integrated approaches in blood stock management between transfusion services and hospitals will be important to minimise wastage--eg, by use of supply chain solutions from industry. Cross-disciplinary systems for patient blood management need to be developed to lessen the need for transfusion--eg, by early identification and reversal of anaemia with haematinics or by reversal of the underlying cause. Personalised medicine could be applied to match donors to patients, not only with extended blood typing, but also by using genetically determined storage characteristics of blood components. Growing of red cells or platelets in large quantities from stem cells is a possibility in the future, but challenges of cost, scaling up, and reproducibility remain to be solved. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cash transfer programme, productive activities and labour supply: Evidence from randomized experiment in Kenya

PubMed Central

Asfaw, Solomon; Davis, Benjamin; Dewbre, Josh; Handa, Sudhanshu; Winters, Paul

2015-01-01

This paper reports analysis of the impact of Kenya’s Cash Transfer for Orphans and Vulnerable Children Programme on the household decisions on productive activities using data from a randomized experimental design. Results show that the programme had a positive and significant impact on food consumption coming from home production, accumulation of productive assets, especially on the ownership of small livestock and on formation of nonfarm enterprise, especially for females. The programme has provided more flexibility to families in terms of labour allocation decisions, particularly for those who are geographically isolated. The programme was also found to have reduced child labour, an important objective of the programme. However we find very little impact of the programme on direct indicators of crop production. PMID:25663712

Career Education and Labour Market Conditions: The Skills Gap Myth.

ERIC Educational Resources Information Center

Hyslop-Margison, Emery J.; Welsh, Benjamin H.

2003-01-01

Asserts that it is a questionable claim that a widespread knowledge and skill shortage is causing current labour market supply problems, unemployment, or increased social stratification. Adds that the percentage of new jobs requiring high levels of knowledge and skill is limited when compared to low-skilled service industry occupations. Questions…

A narrative review on the effect of economic downturns on the nursing labour market: implications for policy and planning

PubMed Central

2012-01-01

Economic downturns and recession lead to budget cuts and service reductions in the healthcare sector which often precipitate layoffs and hiring freezes. Nurses, being the largest professional group in healthcare, are strongly affected by cost reductions. Economic downturns destabilize the nursing labour market with potential negative outcomes, including serious shortages, extending beyond the recessionary period. The objectives of this manuscript are to provide an overview of the potential short- and long-run impact of economic downturns on the supply and demand of nurses, and present healthcare decision makers with a framework to enhance their ability to strategically manage their human resources through economic cycles. A narrative review of the literature on the effects of economic downturns on the nursing labour market in developed countries was carried out with a special focus on studies offering a longitudinal examination of labour force trends. Analysis indicates that economic downturns limit the ability of public payers and institutions to finance their existing health workforce. As salaried healthcare workers, nurses are especially susceptible to institutional budget cuts. In the short run, economic downturns may temporarily reduce the demand for and increase the supply of nurses, thereby influencing nursing wages and turnover rates. These effects may destabilise the nursing labour market in the long run. After economic downturns, the market would quickly display the pre-recessionary trends and there may be serious demand–supply imbalances resulting in severe shortages. Potential long-term effects of recession on the nursing labour market may include a downsized active workforce, difficulty in retaining younger nurses, a decreased supply of nurses and workforce casualisation. Lack of understanding of labour market dynamics and trends might mislead policy makers into making misinformed workforce downsizing decisions that are often difficult and expensive

A narrative review on the effect of economic downturns on the nursing labour market: implications for policy and planning.

PubMed

Alameddine, Mohamad; Baumann, Andrea; Laporte, Audrey; Deber, Raisa

2012-08-20

Economic downturns and recession lead to budget cuts and service reductions in the healthcare sector which often precipitate layoffs and hiring freezes. Nurses, being the largest professional group in healthcare, are strongly affected by cost reductions. Economic downturns destabilize the nursing labour market with potential negative outcomes, including serious shortages, extending beyond the recessionary period. The objectives of this manuscript are to provide an overview of the potential short- and long-run impact of economic downturns on the supply and demand of nurses, and present healthcare decision makers with a framework to enhance their ability to strategically manage their human resources through economic cycles.A narrative review of the literature on the effects of economic downturns on the nursing labour market in developed countries was carried out with a special focus on studies offering a longitudinal examination of labour force trends. Analysis indicates that economic downturns limit the ability of public payers and institutions to finance their existing health workforce. As salaried healthcare workers, nurses are especially susceptible to institutional budget cuts. In the short run, economic downturns may temporarily reduce the demand for and increase the supply of nurses, thereby influencing nursing wages and turnover rates. These effects may destabilise the nursing labour market in the long run. After economic downturns, the market would quickly display the pre-recessionary trends and there may be serious demand-supply imbalances resulting in severe shortages. Potential long-term effects of recession on the nursing labour market may include a downsized active workforce, difficulty in retaining younger nurses, a decreased supply of nurses and workforce casualisation.Lack of understanding of labour market dynamics and trends might mislead policy makers into making misinformed workforce downsizing decisions that are often difficult and expensive to

Challenges and opportunities of health care supply chain management in the United States.

PubMed

Elmuti, Dean; Khoury, Grace; Omran, Omar; Abou-Zaid, Ahmed S

2013-01-01

This article explores current supply chain management challenges and initiatives and identifies problems that affect supply chain management success in the U.S. health-care industry. In addition, it investigates the impact of health care supply chain management (SCM) initiatives on the overall organizational effectiveness. The attitudinal results, as well as the performance results presented in this study support the claim of health care proponents that the SCM allows organizations to reduce cost, improve quality, and reduce cycle time, and leads to high performance.

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

NASA Astrophysics Data System (ADS)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

The development of a Simplified, Effective, Labour Monitoring-to-Action (SELMA) tool for Better Outcomes in Labour Difficulty (BOLD): study protocol.

PubMed

Souza, João Paulo; Oladapo, Olufemi T; Bohren, Meghan A; Mugerwa, Kidza; Fawole, Bukola; Moscovici, Leonardo; Alves, Domingos; Perdona, Gleici; Oliveira-Ciabati, Livia; Vogel, Joshua P; Tunçalp, Özge; Zhang, Jim; Hofmeyr, Justus; Bahl, Rajiv; Gülmezoglu, A Metin

2015-05-26

techniques. This research offers an opportunity to revisit the theoretical basis of the partograph. It is envisioned that the final product would help providers overcome the challenging tasks of promptly interpreting complex labour information and deriving appropriate clinical actions, and thus increase efficiency of the care process, enhance providers' competence and ultimately improve labour outcomes. Please see related articles ' http://dx.doi.org/10.1186/s12978-015-0027-6 ' and ' http://dx.doi.org/10.1186/s12978-015-0028-5 '.

Sustainability and Productivity Indicators with Sensitivity Truth Table for Unskilled Thai Labour Reverse Migration

ERIC Educational Resources Information Center

Panaingvait, Poj; Chakpitak, Nopasit; Yodmongkol, Pitipong; Sureephong, Paradorn; Nimmonrat, Acrapol

2014-01-01

Thailand, a developing country, had labours migrating from the agriculture into the industrial due to higher pay in the past. However the economic force has made the government policy to focus on creativity and developing technology towards automatic production. Unskilled Thai labours are facing a big challenge after retirement, which is called…

The nature of labour pain: An updated review of the literature.

PubMed

Whitburn, Laura Y; Jones, Lester E; Davey, Mary-Ann; McDonald, Susan

2018-04-20

The pain experience associated with labour is complex. Literature indicates psychosocial and environmental determinants of labour pain, and yet methods to support women usually target physiological attributes via pharmacological interventions. To provide an update of our understanding of labour pain based on modern pain science. The review aims to help explain why women can experience labour pain so differently - why some cope well, whilst others experience great suffering. This understanding is pertinent to providing optimal support to women in labour. A literature search was conducted in databases Medline, Cumulative Index to Nursing and Allied Health Literature and PsycINFO, using search terms labor/labour, childbirth, pain, experience and perception. Thirty-one papers were selected for inclusion. Labour pain is a highly individual experience. It is a challenging, emotional and meaningful pain and is very different from other types of pain. Key determinants and influences of labour pain were identified and grouped into cognitive, social and environmental factors. If a woman can sustain the belief that her pain is purposeful (i.e. her body working to birth her baby), if she interprets her pain as productive (i.e. taking her through a process to a desired goal) and the birthing environment is safe and supportive, it would be expected she would experience the pain as a non-threatening, transformative life event. Changing the conceptualisation of labour pain to a purposeful and productive pain may be one step to improving women's experiences of it, and reducing their need for pain interventions. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Opportunities and Challenges in Supply-Side Simulation: Physician-Based Models

PubMed Central

Gresenz, Carole Roan; Auerbach, David I; Duarte, Fabian

2013-01-01

Objective To provide a conceptual framework and to assess the availability of empirical data for supply-side microsimulation modeling in the context of health care. Data Sources Multiple secondary data sources, including the American Community Survey, Health Tracking Physician Survey, and SK&A physician database. Study Design We apply our conceptual framework to one entity in the health care market—physicians—and identify, assess, and compare data available for physician-based simulation models. Principal Findings Our conceptual framework describes three broad types of data required for supply-side microsimulation modeling. Our assessment of available data for modeling physician behavior suggests broad comparability across various sources on several dimensions and highlights the need for significant integration of data across multiple sources to provide a platform adequate for modeling. A growing literature provides potential estimates for use as behavioral parameters that could serve as the models' engines. Sources of data for simulation modeling that account for the complex organizational and financial relationships among physicians and other supply-side entities are limited. Conclusions A key challenge for supply-side microsimulation modeling is optimally combining available data to harness their collective power. Several possibilities also exist for novel data collection. These have the potential to serve as catalysts for the next generation of supply-side-focused simulation models to inform health policy. PMID:23347041

Antispasmodics for labour.

PubMed

Rohwer, Anke C; Khondowe, Oswell; Young, Taryn

2013-06-05

Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour are much greater in poor resource settings. Active management of labour versus physiological, expectant management, has shown to decrease the occurrence of prolonged labour. Administering antispasmodics during labour could also lead to faster and more effective dilatation of the cervix. Interventions to shorten labour, such as antispasmodics, can be used as a preventative or a treatment strategy in order to decrease the incidence of prolonged labour. As the evidence to support this is still largely anecdotal around the world, there is a need to systematically review the available evidence to obtain a valid answer. To assess the effects of antispasmodics on labour in term pregnancies. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2013), the ProQuest dissertation and thesis database, the dissertation database of the University of Stellenbosch and Google Scholar (28 February 2013) and reference lists of articles. We also contacted pharmaceutical companies and experts in the field. We did not apply language restrictions. Randomised controlled trials comparing antispasmodics with placebo or no medication in women with term pregnancies. Two review authors independently screened abstracts and selected studies for inclusion, assessed risk of bias and extracted data. Data were checked for accuracy. We contacted trial authors when data were missing. Twenty-one trials (n = 3286) were included in the review. Seventeen trials (n = 2617) were included in the meta-analysis. Antispasmodics used included valethamate bromide, hyoscine butyl-bromide, drotaverine hydrochloride, rociverine and camylofin dihydrochloride. Most studies included

Antispasmodics for labour.

PubMed

Rohwer, Anke C; Khondowe, Oswell; Young, Taryn

2012-08-15

Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour are much greater in poor resource settings. Active management of labour versus physiological, expectant management, has shown to decrease the occurrence of prolonged labour. Administering antispasmodics during labour could also lead to faster and more effective dilatation of the cervix. Interventions to shorten labour, such as antispasmodics, can be used as a preventative or a treatment strategy in order to decrease the incidence of prolonged labour. As the evidence to support this is still largely anecdotal around the world, there is a need to systematically review the available evidence to obtain a valid answer. To assess the effects of antispasmodics on labour in term pregnancies. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 September 2011), the ProQuest dissertation and thesis database, the dissertation database of the University of Stellenbosch (2 September 2011), Google Scholar (2 September 2011) and reference lists of articles. We also contacted pharmaceutical companies and experts in the field. We did not apply language restrictions. Randomised controlled trials comparing antispasmodics with placebo or no medication in women with term pregnancies. Two review authors independently screened abstracts and selected studies for inclusion, assessed risk of bias and extracted data. Data were checked for accuracy. We contacted trial authors when data were missing. Nineteen trials (n = 2798) were included in the review. Fifteen trials (n = 2129) were included in the meta-analysis. Antispasmodics used included valethamate bromide, hyoscine butyl-bromide, drotaverine hydrochloride, rociverine and camylofin dihydrochloride. Most studies

(Un)healthy relationships: African labourers, profits and health services in Angola's colonial-era diamond mines, 1917-75.

PubMed

Varanda, Jorge; Cleveland, Todd

2014-01-01

The Companhia de Diamantes de Angola, or Diamang, mined for diamonds in colonial Angola from 1917 until independence in 1975. The enterprise's Health Services Division (SSD) was responsible for supplying mine managers with an African labour force comprised of healthy, and therefore productive, employees. In practice, though, this otherwise 'healthy' system did not always work. While SSD personnel attempted to fulfil their charge by implementing a series of screening measures, production targets and a scarcely-populated regional labour pool regularly prompted senior officials to compel the SSD to clear recruits who were otherwise unfit for mine service. Drawing upon interviews with former SSD staff and African labourers, as well as company and colonial archival sources, this article focuses on the interplay over time between the SSD, the company's production demands and these labourers.

The Role of Education and Training in Enhancing Labour Productivity in Arab Countries in Africa

ERIC Educational Resources Information Center

ElObeidy, Ahmed A.

2016-01-01

Labour productivity in Arab countries is low by international standards and this problem occurs in Arab countries both inside and outside Africa. There are 10 Arab countries in Africa: Egypt, Libya, Tunisia, Algeria, Morocco, Mauritania, Sudan, Somalia, Djibouti and Comoros. Enhancing labour productivity is a major challenge for Arab countries.…

Exploring Work and Development Options to Reduce Early Labour Force Exit of Mature Aged Australians

ERIC Educational Resources Information Center

Pillay, Hitendra; Kelly, Kathy; Tones, Megan

2008-01-01

Early labour force exit is a significant challenge associated with the ageing workforce in Australia and many other developed countries. A reduction and increased flexibility of work hours has been suggested to improve labour force participation of the mature aged cohort. However, little is known about mature aged workers' aspirations for…

Where Tradies Work: A Regional Analysis of the Labour Market for Tradespeople

ERIC Educational Resources Information Center

Lewis, Phil; Corliss, Michael

2010-01-01

As Australia's economy recovers from the economic downturn, attention is turning once again to skills shortages. To gain insights into the labour market for tradespeople, this report investigates changes in supply, demand and how adjustment occurred through the varied economic conditions of the past 20 years. It concludes that there was no overall…

Antiretroviral drug supply challenges in the era of scaling up ART in Malawi.

PubMed

Schouten, Erik J; Jahn, Andreas; Ben-Smith, Anne; Makombe, Simon D; Harries, Anthony D; Aboagye-Nyame, Francis; Chimbwandira, Frank

2011-07-06

The number of people receiving antiretroviral treatment (ART) has increased considerably in recent years and is expected to continue to grow in the coming years. A major challenge is to maintain uninterrupted supplies of antiretroviral (ARV) drugs and prevent stock outs. This article discusses issues around the management of ARVs and prevention of stock outs in Malawi, a low-income country with a high HIV/AIDS burden, and a weak procurement and supply chain management system. This system for ARVs, paid for by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and bypassing the government Central Medical Stores, is in place, using the United Nations Children's Fund's (UNICEF's) procurement services. The system, managed by a handful of people who spend limited time on supply management, is characterized by a centrally coordinated quantification based on verified data from all national ART clinics, parallel procurement through UNICEF, and direct distribution to ART clinics. The model worked well in the first years of the ART programme with a single first-line ARV regimen, but with more regimens becoming available (e.g., alternative first-line, second-line and paediatric regimens), it has become more difficult to administer. Managing supplies through a parallel system has the advantage that weaknesses in the national system have limited influence on the ARV procurement and supply chain management system. However, as the current system operates without a central warehouse and national buffer stock capacity, it diminishes the ability to prevent ARV stock outs. The process of ordering ARVs, from the time that estimates are made to the arrival of supplies in health facilities, takes approximately one year. Addressing the challenges involved in maintaining ARVs through an efficient procurement and supply chain management system that prevents ARV stock outs through the establishment of a dedicated procurement team, a central warehouse and/or national buffer stock is a

Development and the Underutilisation of Labour: Lessons of the Dominican Republic Employment Mission

ERIC Educational Resources Information Center

Pazos, Felipe

1975-01-01

In recent years the economy of the Dominican Republic has experienced rapid growth without reducing urban unemployment. The research project measured the relationship between growth and employment, examining the behavior of factors affecting labor demand and supply. Available from: ILO Publications, International Labour Office, CH-1211, Geneva,…

Labour circulation and the urban labour process.

PubMed

Standing, G

1986-01-01

The author investigates aspects of labor circulation, which he defines as "temporary movement between geographical areas for work or in search of work....[He attempts to determine] what roles have been played by labour circulation in the development of urban-industrial labour forces in the transition to industrial capitalism." Factors considered include the exploitation and oppression of labor migrants; the industrial-urban labor reserve; urban socioeconomic stratification and discrimination by age, sex, or race; the division of labor; and policy options. excerpt

Labour dystocia--risk of recurrence and instrumental delivery in following labour--a population-based cohort study.

PubMed

Sandström, A; Cnattingius, S; Wikström, A K; Stephansson, O

2012-12-01

To investigate risk of recurrence of labour dystocia and mode of delivery in second labour after taking first labour and fetal and maternal characteristics into account. A population-based cohort study. The Swedish Medical Birth Register from 1992 to 2006. A total of 239 953 women who gave birth to their first and second singleton infants in cephalic presentation at ≥ 37 weeks of gestation with spontaneous onset of labour. We used logistic regression analysis to estimate crude and adjusted odds ratios. Labour dystocia and mode of delivery in second labour. Overall labour dystocia affected only 12% of women with previous dystocia. Regardless of mode of first delivery, rates of dystocia in the second labour were higher in women with than without previous dystocia, but were more pronounced in women with previous caesarean section (34%). Analyses with risk score groups for dystocia (risk factors were long interpregnancy interval, maternal age ≥ 35 years, obesity, short maternal stature, not cohabiting and post-term pregnancy) showed that risk of instrumental delivery in second labour increased with previous dystocia and increasing risk score. Among women with trial of labour after caesarean section with previous dystocia and a risk score of 3 or more, 66% had a vaginal instrumental or caesarean delivery (17 and 49%, respectively). In women with trial of labour after caesarean section without previous dystocia and a risk score of 0, corresponding risk was 32% (14 and 18%, respectively). Previous labour dystocia increases the risk of dystocia in subsequent delivery. Taking first labour and fetal and maternal characteristics into account is important in the risk assessments for dystocia and instrumental delivery in second labour. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Challenges in physician supply planning: the case of Belgium.

PubMed

Stordeur, Sabine; Léonard, Christian

2010-12-08

Planning human resources for health (HRH) is a complex process for policy-makers and, as a result, many countries worldwide swing from surplus to shortage. In-depth case studies can help appraising the challenges encountered and the solutions implemented. This paper has two objectives: to identify the key challenges in HRH planning in Belgium and to formulate recommendations for an effective HRH planning, on the basis of the Belgian case study and lessons drawn from an international benchmarking. In Belgium, a numerus clausus set up in 1997 and effective in 2004, aims to limit the total number of physicians working in the curative sector. The assumption of a positive relationship between physician densities and health care utilization was a major argument in favor of medical supply restrictions. This new regulation did not improve recurrent challenges such as specialty imbalances, with uncovered needs particularly among general practitioners, and geographical maldistribution. New difficulties also emerged. In particular, limiting national training of HRH turned out to be ineffective within the open European workforce market. The lack of integration of policies affecting HRH was noteworthy. We described in the paper what strategies were developed to address those challenges in Belgium and in neighboring countries. Planning the medical workforce involves determining the numbers, mix, and distribution of health providers that will be required at some identified future point in time. To succeed in their task, health policy planners have to take a broader perspective on the healthcare system. Focusing on numbers is too restrictive and adopting innovative policies learned from benchmarking without integration and coordination is unfruitful. Evolving towards a strategic planning is essential to control the effects of the complex factors impacting on human resources. This evolution requires an effective monitoring of all key factors affecting supply and demand, a dynamic

Challenges in physician supply planning: the case of Belgium

PubMed Central

2010-01-01

Introduction Planning human resources for health (HRH) is a complex process for policy-makers and, as a result, many countries worldwide swing from surplus to shortage. In-depth case studies can help appraising the challenges encountered and the solutions implemented. This paper has two objectives: to identify the key challenges in HRH planning in Belgium and to formulate recommendations for an effective HRH planning, on the basis of the Belgian case study and lessons drawn from an international benchmarking. Case description In Belgium, a numerus clausus set up in 1997 and effective in 2004, aims to limit the total number of physicians working in the curative sector. The assumption of a positive relationship between physician densities and health care utilization was a major argument in favor of medical supply restrictions. This new regulation did not improve recurrent challenges such as specialty imbalances, with uncovered needs particularly among general practitioners, and geographical maldistribution. New difficulties also emerged. In particular, limiting national training of HRH turned out to be ineffective within the open European workforce market. The lack of integration of policies affecting HRH was noteworthy. We described in the paper what strategies were developed to address those challenges in Belgium and in neighboring countries. Discussion and evaluation Planning the medical workforce involves determining the numbers, mix, and distribution of health providers that will be required at some identified future point in time. To succeed in their task, health policy planners have to take a broader perspective on the healthcare system. Focusing on numbers is too restrictive and adopting innovative policies learned from benchmarking without integration and coordination is unfruitful. Evolving towards a strategic planning is essential to control the effects of the complex factors impacting on human resources. This evolution requires an effective monitoring of

Future supply chains enabled by continuous processing--opportunities and challenges. May 20-21, 2014 Continuous Manufacturing Symposium.

PubMed

Srai, Jagjit Singh; Badman, Clive; Krumme, Markus; Futran, Mauricio; Johnston, Craig

2015-03-01

This paper examines the opportunities and challenges facing the pharmaceutical industry in moving to a primarily "continuous processing"-based supply chain. The current predominantly "large batch" and centralized manufacturing system designed for the "blockbuster" drug has driven a slow-paced, inventory heavy operating model that is increasingly regarded as inflexible and unsustainable. Indeed, new markets and the rapidly evolving technology landscape will drive more product variety, shorter product life-cycles, and smaller drug volumes, which will exacerbate an already unsustainable economic model. Future supply chains will be required to enhance affordability and availability for patients and healthcare providers alike despite the increased product complexity. In this more challenging supply scenario, we examine the potential for a more pull driven, near real-time demand-based supply chain, utilizing continuous processing where appropriate as a key element of a more "flow-through" operating model. In this discussion paper on future supply chain models underpinned by developments in the continuous manufacture of pharmaceuticals, we have set out; The significant opportunities to moving to a supply chain flow-through operating model, with substantial opportunities in inventory reduction, lead-time to patient, and radically different product assurance/stability regimes. Scenarios for decentralized production models producing a greater variety of products with enhanced volume flexibility. Production, supply, and value chain footprints that are radically different from today's monolithic and centralized batch manufacturing operations. Clinical trial and drug product development cost savings that support more rapid scale-up and market entry models with early involvement of SC designers within New Product Development. The major supply chain and industrial transformational challenges that need to be addressed. The paper recognizes that although current batch operational

Forecasting supply and demand in nursing professions: impacts of occupational flexibility and employment structure in Germany.

PubMed

Maier, Tobias; Afentakis, Anja

2013-06-05

In light of Germany's ageing society, demand for nursing professionals is expected to increase in the coming years. This will pose a challenge for policy makers to increase the supply of nursing professionals. To portray the different possible developments in the supply of nursing professionals, we projected the supply of formally trained nurses and the potential supply of persons who are able to work in a nursing profession. This potential supply of nursing professionals was calculated on the basis of empirical information on occupational mobility provided by the German Microcensus 2005 (Labour Force Survey). We also calculated how the supply of full-time equivalents (FTEs) will develop if current employment structures develop in the direction of employment behaviour in nursing professions in eastern and western Germany. We then compared these different supply scenarios with two demand projections ('status quo' and 'compression of morbidity' scenarios) from Germany's Federal Statistical Office. Our results show that, even as early as 2005, meeting demand for FTEs in nursing professions was not arithmetically possible when only persons with formal qualification in a nursing profession were taken into account on the supply side. When additional semi-skilled nursing professionals are included in the calculation, a shortage of labour in nursing professions can be expected in 2018 when the employment structure for all nursing professionals remains the same as the employment structure seen in Germany in 2005 (demand: 'status quo scenario'). Furthermore, given an employment structure as in eastern Germany, where more nursing professionals work on a full-time basis with longer working hours, a theoretical shortage of nursing professionals could be delayed until 2024. Our analysis of occupational flexibility in the nursing field indicates that additional potential supply could be generated by especially training more young people for a nursing profession as they tend to

Forecasting supply and demand in nursing professions: impacts of occupational flexibility and employment structure in Germany

PubMed Central

2013-01-01

Background In light of Germany's ageing society, demand for nursing professionals is expected to increase in the coming years. This will pose a challenge for policy makers to increase the supply of nursing professionals. Methodology To portray the different possible developments in the supply of nursing professionals, we projected the supply of formally trained nurses and the potential supply of persons who are able to work in a nursing profession. This potential supply of nursing professionals was calculated on the basis of empirical information on occupational mobility provided by the German Microcensus 2005 (Labour Force Survey). We also calculated how the supply of full-time equivalents (FTEs) will develop if current employment structures develop in the direction of employment behaviour in nursing professions in eastern and western Germany. We then compared these different supply scenarios with two demand projections ('status quo' and 'compression of morbidity' scenarios) from Germany's Federal Statistical Office. Results Our results show that, even as early as 2005, meeting demand for FTEs in nursing professions was not arithmetically possible when only persons with formal qualification in a nursing profession were taken into account on the supply side. When additional semi-skilled nursing professionals are included in the calculation, a shortage of labour in nursing professions can be expected in 2018 when the employment structure for all nursing professionals remains the same as the employment structure seen in Germany in 2005 (demand: 'status quo scenario'). Furthermore, given an employment structure as in eastern Germany, where more nursing professionals work on a full-time basis with longer working hours, a theoretical shortage of nursing professionals could be delayed until 2024. Conclusions Our analysis of occupational flexibility in the nursing field indicates that additional potential supply could be generated by especially training more young people

Supply chain challenges. building relationships.

PubMed

Beth, Scott; Burt, David N; Copacino, William; Gopal, Chris; Lee, Hau L; Lynch, Robert Porter; Morris, Sandra

2003-07-01

Supply chain management is all about software and systems, right? Put in the best technology, sit back, and watch as your processes run smoothly and the savings roll in? Apparently not. When HBR convened a panel of leading thinkers in the field of supply chain management, technology was not top of mind. People and relationships were the dominant issues of the day. The opportunities and problems created by globalization, for example, are requiring companies to establish relationships with new types of suppliers. The ever-present pressure for speed and cost containment is making it even more important to break down stubbornly high internal barriers and establish more effective cross-functional relationships. The costs of failure have never been higher. The leading supply chain performers are applying new technology, new innovations, and process thinking to far greater advantage than the laggards, reaping tremendous gains in all the variables that affect shareholder value: cost, customer service, asset productivity, and revenue generation. And the gap between the leaders and the losers is growing in almost every industry. This roundtable gathered many of the leading thinkers and doers in the field of supply chain management, including practitioners Scott Beth of Intuit, Sandra Morris of Intel, and Chris Gopal of Unisys. David Burt of the University of San Diego and Stanford's Hau Lee bring the latest research from academia. Accenture's William Copacino and the Warren Company's Robert Porter Lynch offer the consultant's perspectives. Together, they take a wide-ranging view of such topics as developing talent, the role of the chief executive, and the latest technologies, exploring both the tactical and the strategic in the current state of supply chain management.

Social responsibility in tobacco production? Tobacco companies' use of green supply chains to obscure the real costs of tobacco farming.

PubMed

Otañez, Marty; Glantz, Stanton A

2011-11-01

Tobacco companies have come under increased criticism because of environmental and labour practices related to growing tobacco in developing countries. Analysis of tobacco industry documents, industry websites and interviews with tobacco farmers in Tanzania and tobacco farm workers, farm authorities, trade unionists, government officials and corporate executives from global tobacco leaf companies in Malawi. British American Tobacco and Philip Morris created supply chains in the 1990 s to improve production efficiency, control, access to markets and profits. In the 2000s, the companies used their supply chains in an attempt to legitimise their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labour and reduce deforestation in developing countries. The tobacco companies used nominal self-evaluation (not truly independent evaluators) and public relations to create the impression of social responsibility. The companies benefit from $1.2 billion in unpaid labour costs because of child labour and more than $64 million annually in costs that would have been made to avoid tobacco-related deforestation in the top 12 tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices. The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labour and high rates of deforestation. Strategies to counter green supply chain schemes include securing implementing protocols for the WHO Framework Convention on Tobacco Control to regulate the companies' practices at the farm level.

Embodied labour in music work.

PubMed

Pettinger, Lynne

2015-06-01

This paper frames the work of performance as embodied labour in order to understand the contingent production of particular music performances. It is an interdisciplinary account that sits at the intersection of the sociology of work, culture and the body. The concept of embodied labour is developed with reference to the complex account of materiality - of bodies and things - present in Tim Ingold's account of skill. This material account of skill is used to inform use to develop already of well established conceptualizations of body labour: craft, emotional and aesthetic labour through a reading of how these dimensions of embodied labour make possible the work of performance. © London School of Economics and Political Science 2015.

Bolsa Escola: Breaking the Cycle of Poverty, Child Labour and School Disaffection in Brazil

ERIC Educational Resources Information Center

Denes, Christian Andrew

2004-01-01

The Bolsa Escola program in Brazil presents a clear break from the economic growth models and supply-side based strategies of the past. Founded on the assumption that the supplemental income generated by child labour outweighs the potential benefits of primary education, Bolsa Escola attempts to address the demand-side component of high dropout…

Future Supply Chains Enabled by Continuous Processing-Opportunities Challenges May 20-21 2014 Continuous Manufacturing Symposium.

PubMed

Srai, Jagjit Singh; Badman, Clive; Krumme, Markus; Futran, Mauricio; Johnston, Craig

2015-03-01

This paper examines the opportunities and challenges facing the pharmaceutical industry in moving to a primarily "continuous processing"-based supply chain. The current predominantly "large batch" and centralized manufacturing system designed for the "blockbuster" drug has driven a slow-paced, inventory heavy operating model that is increasingly regarded as inflexible and unsustainable. Indeed, new markets and the rapidly evolving technology landscape will drive more product variety, shorter product life-cycles, and smaller drug volumes, which will exacerbate an already unsustainable economic model. Future supply chains will be required to enhance affordability and availability for patients and healthcare providers alike despite the increased product complexity. In this more challenging supply scenario, we examine the potential for a more pull driven, near real-time demand-based supply chain, utilizing continuous processing where appropriate as a key element of a more "flow-through" operating model. In this discussion paper on future supply chain models underpinned by developments in the continuous manufacture of pharmaceuticals, we have set out; The paper recognizes that although current batch operational performance in pharma is far from optimal and not necessarily an appropriate end-state benchmark for batch technology, the adoption of continuous supply chain operating models underpinned by continuous production processing, as full or hybrid solutions in selected product supply chains, can support industry transformations to deliver right-first-time quality at substantially lower inventory profiles. © 2015 The Authors. Journal of Pharmaceutical Sciences published by Wiley Periodicals, Inc. and the American Pharmacists Association. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Misalignment between Post-Secondary Education Demand and Labour Market Supply: Preliminary Insight from Young Adults on the Evolving School to Work Transition

ERIC Educational Resources Information Center

Graham, John R.; Shier, Micheal L.; Eisenstat, Marilyn

2014-01-01

Most research on labour market outcomes and higher education finds a positive relationship. This qualitative research sought to better understand how higher educational attainment contributes to employment outcomes from a subsample (n = 15) of a larger study (N = 36) on youth labour market attachment among minority, low socioeconomic status young…

Midwives' experience of their education, knowledge and practice around immersion in water for labour or birth.

PubMed

Lewis, Lucy; Hauck, Yvonne L; Butt, Janice; Western, Chloe; Overing, Helen; Poletti, Corrinne; Priest, Jessica; Hudd, Dawn; Thomson, Brooke

2018-06-19

There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic. This mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia. Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire. Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth. Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts. The majority (85%; 29 of 34) of midwives surveyed returned a questionnaire. Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven. Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth. Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance. Phase two included two focus groups of seven and five midwives. Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth. This research contributes to the growing knowledge base examining midwives' education, knowledge and practice around

Hypnosis for induction of labour.

PubMed

Nishi, Daisuke; Shirakawa, Miyako N; Ota, Erika; Hanada, Nobutsugu; Mori, Rintaro

2014-08-14

Induction of labour using pharmacological and mechanical methods can increase complications. Complementary and alternative medicine methods including hypnosis may have the potential to provide a safe alternative option for the induction of labour. However, the effectiveness of hypnosis for inducing labour has not yet been fully evaluated. To assess the effect of hypnosis for induction of labour compared with no intervention or any other interventions. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2014), handsearched relevant conference proceedings, contacted key personnel and organisations in the field for published and unpublished references. All published and unpublished randomised controlled trials (RCTs) and cluster-RCTs of acceptable quality comparing hypnosis with no intervention or any other interventions, in which the primary outcome is to assess whether labour was induced. Two review authors assessed the one trial report that was identified (but was subsequently excluded). No RCTs or cluster-RCTs were identified from the search strategy. There was no evidence available from RCTs to assess the effect of hypnosis for induction of labour. Evidence from RCTs is required to evaluate the effectiveness and safety of this intervention for labour induction. As hypnosis may delay standard care (in case standard care is withheld during hypnosis), its use in induction of labour should be considered on a case-by-case basis.Future RCTs are required to examine the effectiveness and safety of hypnotic relaxation for induction of labour among pregnant women who have anxiety above a certain level. The length and timing of the intervention, as well as the staff training required, should be taken into consideration. Moreover, the views and experiences of women and staff should also be included in future RCTs.

Labour Disputes of Gifted Employees

ERIC Educational Resources Information Center

van der Waal, Ido; Nauta, Noks; Lindhout, Rebecca

2013-01-01

This article describes a study on labour disputes of gifted people. Fifty-five gifted people, who have had one or more labour disputes, which resulted in their staying at home and filling out an online survey. Face-to-face interviews were held with seven respondents with more than two labour disputes. In this article, we describe the results of…

Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation

PubMed Central

Otañez, M G; Muggli, M E; Hurt, R D; Glantz, S A

2006-01-01

Objectives To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation. Design Analyses of internal tobacco industry documents and ethnographic data. Results British American Tobacco co‐founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT's initial projects were budgeted at US$2.3 million over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US$40 million over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT's efforts to combat child labour in Malawi through ECLT was developed to support the company's “corporate social responsibility agenda” rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector. Conclusion In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco. PMID:16728754

Trade, Labour Markets and Health.

PubMed

McNamara, Courtney; Labonté, Ronald

2017-04-01

Previous analyses indicate that there are a number of potentially serious health risks associated with the Trans-Pacific Partnership (TPP). The objective of this work is to provide further insight into the potential health impacts of the TPP by investigating labour market pathways. The impact of the TPP on employment and working conditions is a major point of contention in broader public debates. In public health literature, these factors are considered fundamental determinants of health, yet they are rarely addressed in analyses of trade and investment agreements. We therefore undertake a prospective policy analysis of the TPP through a content analysis of the agreement's Labour Chapter. Provisions of the Chapter are analyzed with reference to the health policy triangle and four main areas through which labour markets influence health: power relations, social policies, employment conditions and working conditions. Findings indicate that implementation of the TPP can have important impacts on health through labour market pathways. While the Labour Chapter is being presented by proponents of the agreement as a vehicle for improvement in labour standards, we find little evidence to support this view. Instead, we find several ways the TPP may weaken employment relations to the detriment of health.

Non-pharmacologic labour pain relief.

PubMed

Prasertcharoensuk, Witoon; Thinkhamrop, Jadsada

2004-10-01

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. To examine the effectiveness of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. The trials included three trials of hypnosis (n = 189), one involving audio-analgesia (n = 25), one involving (n = 22), and one trial of music (n = 30). Women receiving hypnosis were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.55 to 4.71). No differences were seen for women recieving, music or audio analgesia. Hypnosis may be beneficial for the management of pain during labour. However, few complementary therapies have been subjected to proper scientific study.

Future Supply Chains Enabled by Continuous Processing—Opportunities and Challenges. May 20–21, 2014 Continuous Manufacturing Symposium

PubMed Central

Srai, Jagjit Singh; Badman, Clive; Krumme, Markus; Futran, Mauricio; Johnston, Craig

2015-01-01

This paper examines the opportunities and challenges facing the pharmaceutical industry in moving to a primarily “continuous processing”-based supply chain. The current predominantly “large batch” and centralized manufacturing system designed for the “blockbuster” drug has driven a slow-paced, inventory heavy operating model that is increasingly regarded as inflexible and unsustainable. Indeed, new markets and the rapidly evolving technology landscape will drive more product variety, shorter product life-cycles, and smaller drug volumes, which will exacerbate an already unsustainable economic model. Future supply chains will be required to enhance affordability and availability for patients and healthcare providers alike despite the increased product complexity. In this more challenging supply scenario, we examine the potential for a more pull driven, near real-time demand-based supply chain, utilizing continuous processing where appropriate as a key element of a more “flow-through” operating model. In this discussion paper on future supply chain models underpinned by developments in the continuous manufacture of pharmaceuticals, we have set out; The significant opportunities to moving to a supply chain flow-through operating model, with substantial opportunities in inventory reduction, lead-time to patient, and radically different product assurance/stability regimes. Scenarios for decentralized production models producing a greater variety of products with enhanced volume flexibility. Production, supply, and value chain footprints that are radically different from today's monolithic and centralized batch manufacturing operations. Clinical trial and drug product development cost savings that support more rapid scale-up and market entry models with early involvement of SC designers within New Product Development. The major supply chain and industrial transformational challenges that need to be addressed. The paper recognizes that although current

Contraception supply chain challenges: a review of evidence from low- and middle-income countries.

PubMed

Mukasa, Bakali; Ali, Moazzam; Farron, Madeline; Van de Weerdt, Renee

2017-10-01

To identify and assess factors determining the functioning of supply chain systems for modern contraception in low- and middle-income countries (LMICs), and to identify challenges contributing to contraception stockouts that may lead to unmet need. Scientific databases and grey literature were searched including Database of Abstracts of Reviews of Effectiveness (DARE), PubMed, MEDLINE, POPLINE, CINAHL, Academic Search Complete, Science Direct, Web of Science, Cochrane Central, Google Scholar, WHO databases and websites of key international organisations. Studies indicated that supply chain system inefficiencies significantly affect availability of modern FP and contraception commodities in LMICs, especially in rural public facilities where distribution barriers may be acute. Supply chain failures or bottlenecks may be attributed to: weak and poorly institutionalized logistic management information systems (LMIS), poor physical infrastructures in LMICs, lack of trained and dedicated staff for supply chain management, inadequate funding, and rigid government policies on task sharing. However, there is evidence that implementing effective LMISs and involving public and private providers will distribution channels resulted in reduction in medical commodities' stockout rates. Supply chain bottlenecks contribute significantly to persistent high stockout rates for modern contraceptives in LMICs. Interventions aimed at enhancing uptake of contraceptives to reduce the problem of unmet need in LMICs should make strong commitments towards strengthening these countries' health commodities supply chain management systems. Current evidence is limited and additional, and well-designed implementation research on contraception supply chain systems is warranted to gain further understanding and insights on the determinants of supply chain bottlenecks and their impact on stockouts of contraception commodities.

Experiences of early labour management from perspectives of women, labour companions and health professionals: A systematic review of qualitative evidence.

PubMed

Beake Rm Ma Research Associate, Sarah; Chang Ba MPhil PhD Lecturer, Yan-Shing; Cheyne Rm Rgn MSc PhD Professor Of Midwifery, Helen; Spiby MPhil Rn Rm Professor Of Midwifery, Helen; Sandall Rm MSc PhD Professor Of Social Science And Women's Health, Jane; Bick, Debra

2018-02-01

to examine evidence of women's, labour companions' and health professionals' experiences of management of early labour to consider how this could be enhanced to better reflect women's needs. a systematic review of qualitative evidence. women in early labour with term, low risk singleton pregnancies, not booked for a planned caesarean birth or post-dates induction of labour, their labour companions, and health professionals responsible for early labour care (e.g. midwives, nurse-midwives, obstetricians, family doctors). Studies from high and middle income country settings were considered. 21 publications were included from the UK, Ireland, Scandinavia, USA, Italy and New Zealand. Key findings included the impact of communication with health professionals (most usually midwives) on women's decision making; women wanting to be listened to by sympathetic midwives who could reassure that symptoms and signs of early labour were 'normal' and offer clear advice on what to do. Antenatal preparation which included realistic information on what to expect when labour commenced was important and appreciated by women and labour companions. Views of the optimal place for women to remain and allow early labour to progress differed and the perceived benefit of support and help offered by labour companions varied. Some were supportive and helped women to relax, while others were anxious and encouraged women to seek early admission to the planned place of birth. Web-based sources of information are increasingly used by women, with mixed views of the value of information accessed. women, labour companions and health professionals find early labour difficult to manage well, with women unsure of how decisions about admission to their planned place of birth are taken. It is unclear why women are effectively left to manage this aspect of their labour with minimal guidance or support. Tailoring management to meet individual needs, with provision of effective communication could reassure

Increased oxidative stress in human fetal membranes overlying the cervix from term non-labouring and post labour deliveries.

PubMed

Chai, M; Barker, G; Menon, R; Lappas, M

2012-08-01

Enzymatic breakdown of the collagen-rich extracellular matrix (ECM) that connects the amnion and chorion layers of the fetal membranes is one of the key events leading to rupture of membranes. Oxidant stress caused by increased formation of reactive oxygen species and/or reduced antioxidant capacity may predispose to membrane rupture, a major cause of preterm birth. The aim of this study was to determine the effect of human labour and supracervical (SC) apposition on antioxidant enzymes and 8-isoprostane (a marker of lipid peroxidation). To determine the effect of human labour on oxidative stress status, fetal membranes from the SC site (SCS) were collected from women at term Caesarean section (no labour), and from the site of membrane rupture (SOR) after spontaneous labour onset and delivery (post labour). To determine the effect of SC apposition on oxidative stress status, amnion was collected from the SCS and a distal site (DS) in women at term Caesarean section in the absence of labour. The release of 8-isoprostane was significantly higher in amnion from the SCS compared to DS, and in fetal membranes from the SOR compared to the SCS. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity were lower in amnion from the SC compared to DS. SOD gene expression and enzyme activity were lower in fetal membranes after labour. There was no difference in expression or activity in catalase, GPx and glutathione reductase (GSR) between no labour and post labour fetal membranes. In primary amnion cells, SOD supplementation significantly augmented IL-1β induced MMP-9 expression and activity. In summary, non-labouring SC fetal membranes are characterised by reduced antioxidant enzyme activity when compared to distal membranes, and, as such, may be more susceptible to oxidative damage and thus membrane rupture. Copyright © 2012 Elsevier Ltd. All rights reserved.

Challenges to overcome: energy supply for remote consumers in the Russian Arctic

NASA Astrophysics Data System (ADS)

Morgunova, M. O.; Solovyev, D. A.

2017-11-01

The paper explores challenges of power supply for remote users through the case of the Northern Sea Route (NSR) supportive infrastructure development and specially nature protected areas (NPA) of the Russian Arctic. The study is based on a comprehensive analysis of relevant data of the state of renewable energy in the Russian Arctic. The paper gives policy recommendations on how to extend the use of renewable energy power plants in the region, optimize their input and increase cost-effectiveness and safety.

Midwives׳ decision making about transfers for 'slow' labour in rural New Zealand.

PubMed

Patterson, Jean; Skinner, Joan; Foureur, Maralyn

2015-06-01

Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour. Ethics approval was obtained from the NZ National Ethics Committee. to explore midwives׳ decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. New Zealand. 15 midwives who provided LMC services to women in their rural areas. 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman׳s preferences and the distance and time involved in the transfer. the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context. Copyright © 2015 Elsevier Ltd. All rights reserved.

Arrival in the labour ward in second stage of labour--any prognostic significance?

PubMed

Nkyekyer, K

1998-05-01

A comparative descriptive study was carried out to determine whether, in uncomplicated term pregnancies with the foetus in vertex presentation, there were any differences in maternal or foetal outcome between women who arrived in the labour ward in second stage of labour and those who arrived in early active phase. There were two hundred and seventeen women each in the study and comparison groups. There were no significant differences between the two groups as regards age, parity, marital status and level of education. Women in the comparison group were better antenatal clinic attendants. Those in the study group were more likely to have indicated that they had problems with transportation. They also had considerably shorter labours and all achieved spontaneous vaginal deliveries; a significant proportion (10.6%) of the comparison group had interventional deliveries. The incidence of episiotomies, lower genital tract injuries, manual removal of placenta and postpartum haemorrhage after vaginal delivery were not different between the two groups. Babies born to mothers in the study group were significantly lighter, by about 170 gms, and had a lower incidence of low one-minute Apgar scores. There were no significant differences in the rates of admission to the neonatal intensive care unit or in early neonatal deaths. Arrival in the labour ward in second stage of labour prognosticates non-interventional delivery without any increased risk of adverse outcome to the mother or her baby.

Technical and Vocational Education and Training and the Labour Market in Israel

ERIC Educational Resources Information Center

Eisenberg, Eli

2006-01-01

The aim of this report is to contribute to a better understanding of the current status of technical and vocational education and training (TVET) for human resources development (HRD) and the labour market in Israel. It describes the role and involvement of the various sectors in HRD and identifies the barriers, challenges, priorities, initiatives…

Journey to confidence: women's experiences of pain in labour and relational continuity of care.

PubMed

Leap, Nicky; Sandall, Jane; Buckland, Sara; Huber, Ulli

2010-01-01

An evaluation carried out at King's College Hospital Foundation National Health Service Trust in London identified that women who received continuity of carer from the Albany Midwifery Practice were significantly less likely to use pharmacological pain relief when comparisons were made with eight other midwifery group practices and the local maternity service as a whole. This study was designed to explore women's views of this phenomenon. We conducted a thematic analysis of semistructured, audiotaped, in-depth interviews with 10 women who reflected on their experiences of preparation and support for pain in labour and midwifery continuity of carer with Albany midwives, using a qualitative descriptive methodological approach. Women reflected positively on how, throughout pregnancy and labour, their midwives promoted a sense of their ability to cope with the challenge of labour pain. This building of confidence was enabled through a relationship of trust that developed with their midwives and the value of hearing other women's stories during antenatal groups. These experiences enhanced women's ability to overcome fears and self-doubt about coping with pain and led to feelings of pride, elation, and empowerment after birth. Women valued being encouraged and supported to labour without using pharmacological pain relief by midwives with whom they developed a trusting relationship throughout pregnancy. Features of midwifery approaches to pain in labour and relational continuity of care have important implications for promoting normal birth and a positive experience of pregnancy, labour, and birth for women. Copyright (c) 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.

Demand and utilisation of labour analgesia service by Nigerian women.

PubMed

Imarengiaye, C O; Ande, A B A

2006-02-01

This study sought to determine the clinical correlates of the demand and utilisation of labour analgesia resources by Nigerian women in labour. All consenting women were interviewed on arrival at the Unit and while in labour. Biodata, options for relief of labour pain, request for analgesia, method of analgesia, VAS score and cervical score at time of request for analgesia were obtained. A total of 288 women in labour were studied. Of these, 108 (37.5%) patients were aware that the pain of labour can be relieved but only 26.0% had prenatal information on labour analgesia. However, 85.1% of the patients would want their pain of labour relieved. A total of 112 (38.9%) did receive analgesia during labour. Cervical dilatation of <4 cm at presentation to the Unit and nulliparity were likely factors for pain treatment during labour (p = 0.001, chi2 test). There is poor utilisation of labour analgesia services. Improved antenatal information on labour analgesia may boost the utilisation of these resources by Nigerian women in labour.

Highly Skilled Labour and International Mobility in South America. OECD Science, Technology and Industry Working Papers, 2004/10

ERIC Educational Resources Information Center

Barrere, Rodolfo; Luchilo, Lucas; Raffo, Julio

2004-01-01

This paper presents the main trends in respect of the supply of human resources in science and technology (HRST) in Latin America and the international mobility of its highly skilled labour. This will be done through the identification of potential data sources, followed by a presentation of indicators drawn from these sources. In addition, a…

Pathways linking drug use and labour market trajectories: the role of catastrophic events

PubMed Central

Richardson, Lindsey; Small, Will; Kerr, Thomas

2015-01-01

People affected by substance use disorders often experience sub-optimal employment outcomes. The role of drug use in processes that produce and entrench labour market precarity among people who inject drugs (PWID) have not, however, been fully described. We recruited 22 PWID from ongoing prospective cohort studies in Vancouver, Canada and conducted semi-structured retrospective interviews and employed a thematic analysis that draws on concepts from life course theory to explore mechanisms and pathways linking drug use and labour market trajectories. Narratives identified processes corresponding to: causation, whereby suboptimal employment outcomes led to harmful drug use; direct selection, where impairment, health complications or drug seeking activities selected individuals out of employment; and indirect selection, where external factors, such as catastrophic events, marked the initiation or intensification of substance use concurrent with sudden changes in capacities for employment. Catastrophic events linking negative transitions in both drug use and labour market trajectories were of primary importance, demarcating critical initiation and transitional events in individual risk trajectories. These results challenge conventional assumptions about the primacy of drug use in determining employment outcomes among PWID, and suggest the importance of multi-dimensional supports to mitigate the initiation, accumulation and entrenchment of labour market and drug-related disadvantage. PMID:26358407

Biofeedback for pain management during labour.

PubMed

Barragán Loayza, Irma Marcela; Solà, Ivan; Juandó Prats, Clara

2011-06-15

Labour is often associated with pain and discomfort caused by a complex and subjective interaction of multiple factors, and should be understood within a multi-dimensional and multi-disciplinary framework. Within the non-pharmacological approach, biofeedback has focused on the acquisition of control over some physiological responses with the aid of electronic devices, allowing individuals to regulate some physical processes (such as pain) which are not usually under conscious control. The role of this behavioural approach for the management of pain during labour, as an addition to the standard prenatal care, has been never assessed systematically. This review is one in a series of Cochrane reviews examining pain relief in labour, which will contribute to an overview of systematic reviews of pain relief for women in labour (in preparation). To examine the effectiveness of the use of biofeedback in prenatal lessons for managing pain during labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2011), CENTRAL (The Cochrane Library 2011, Issue 1), PubMed (1950 to 20 March 2011), EMBASE (via OVID) (1980 to 24 March 2011), CINAHL (EBSCOhost) (1982 to 24 March 2011), and PsycINFO (via Ovid) (1806 to 24 March 2011). We searched for further studies in the reference lists of identified articles. Randomised controlled trials of any form of prenatal classes which included biofeedback, in any modality, in women with low-risk pregnancies. Two authors independently assessed trial quality and extracted data. The review included four trials (186 women) that hugely differed in terms of the diversity of the intervention modalities and outcomes measured. Most trials assessed the effects of electromyographic biofeedback in women who were pregnant for the first time. The trials were judged to be at a high risk of bias due to the lack of data describing the sources of bias assessed. There was no significant evidence of a difference between biofeedback

Does oral carbohydrate supplementation improve labour outcome? A systematic review and individual patient data meta-analysis.

PubMed

Malin, G L; Bugg, G J; Thornton, J; Taylor, M A; Grauwen, N; Devlieger, R; Kardel, K R; Kubli, M; Tranmer, J E; Jones, N W

2016-03-01

Labour is a period of significant physical activity. The importance of carbohydrate intake to improve outcome has been recognised in sports medicine and general surgery. To assess the effect of oral carbohydrate supplementation on labour outcomes. MEDLINE (1966-2014), Embase, the Cochrane Library and clinical trial registries. Randomised controlled trials (RCT) of women randomised to receive oral carbohydrate in labour (<6 cm dilated), versus placebo or standard care. Authors were contacted to provide data. Individual patient data meta-analyses were performed to calculate pooled risk ratios (RR) and 95% confidence intervals (CI). Eight RCTs met the inclusion criteria. Six authors responded, four supplied data (n = 691). Three studies used isotonic drinks (one placebo-controlled, two compared with standard care), and one an advice booklet regarding carbohydrate intake. The mean difference in energy intake between the intervention and control groups was small [three studies, 195 kilocalories (kcal), 95% CI 118-273]. There was no difference in the risk of caesarean section (RR 1.15, 95% CI 0.83- 1.61), instrumental birth (RR 1.26, 95% CI 0.96-1.66) or syntocinon augmentation (RR 0.99, 95% CI 0.86-1.13). Length of labour was similar (mean difference -3.15 minutes, 95% CI -35.14 to 41.95). Restricting the analysis to primigravid women did not affect the result. Oral carbohydrates did not increase the risk of vomiting (RR 1.09, 95% CI 0.78-1.52) or 1-minute Apgar score <7 (RR 1.23, 95% CI 0.82-1.83). Oral carbohydrate supplements in small quantities did not alter labour outcome. Oral carbohydrate does not affect labour. But the difference between intervention and control equals 10 teaspoons sugar. © 2016 Royal College of Obstetricians and Gynaecologists.

The Supply of Young Craftsmen to an Industry.

DTIC Science & Technology

1980-06-12

Economic Rationale of Occupation Choice: Comment."’ Industrial and Labour Relations Review 26 (April 1973): 996-1000. LEVINE, ADELINE. "Educational and...satisfaction of the requirements for the degree of Doctor of Philosophy 4 May, 1980 Dissertation directed by Sheldon Edward Haber Professor of Economics ...ABSTRACT In this study, three models are developed for assessing the effects of economic and demographic factors on the supply of young craftsm,-n to

Emotional labour underlying caring: an evolutionary concept analysis.

PubMed

Huynh, Truc; Alderson, Marie; Thompson, Mary

2008-10-01

This paper is a report of a concept analysis of emotional labour. Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, PsycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurses adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements: organization (i.e. social norms, social support), nurse (i.e. role identification, professional commitment, work experience and interpersonal skills) and job (i.e. autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions: nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e. productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive). The concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.

Child Labour and Educational Success in Portugal

ERIC Educational Resources Information Center

Goulart, Pedro; Bedi, Arjun S.

2008-01-01

The current debate on child labour focuses on developing countries. However, Portugal is an example of a relatively developed country where child labour is still a matter of concern as between 8% and 12% of Portuguese children may be classified as workers. This paper studies the patterns of child labour in Portugal and assesses the consequences of…

A translational approach to studying preterm labour

PubMed Central

Tribe, Rachel Marie

2007-01-01

Preterm labour continues to be a major contributor to neonatal and infant morbidity. Recent data from the USA indicate that the number of preterm deliveries (including those associated with preterm labour) has risen in the last 20 years by 30%. This increase is despite considerable efforts to introduce new therapies for the prevention and treatment of preterm labour and highlights the need to assess research in this area from a fresh perspective. In this paper we discuss i) the limitations of our knowledge concerning prediction, prevention and treatment of preterm labour and ii) future multidisciplinary strategies for improving our approach. PMID:17570168

A balancing act in an unknown territory: a metasynthesis of first-time mothers' experiences in early labour.

PubMed

Eri, Tine S; Bondas, Terese; Gross, Mechthild M; Janssen, Patricia; Green, Josephine M

2015-03-01

to integrate findings of individual studies in order to broaden the understanding of first-time mothers' experiences of early labour. the methodology was metasynthesis which is based on the interpretive meta-ethnography described by Noblit and Hare (1988). Metasynthesis is research on research which synthesises the findings of previous qualitative studies, and the focus is on interpretation and the creation of new knowledge. all included studies originated from high resource countries (USA 2, UK 4, and Scandinavia 5) and all were carried out in a context of hospital based maternity care. a total of 231 women participated in the studies. 11 articles were included. The main results are presented with the metaphor a balancing act in an unknown territory. The 'unknown territory' has a double meaning: as the personal experience of going into labour for the first time and as encountering the maternity care system. On both levels women have to make significant decisions: whether labour really has started and subsequently when to go to the hospital. A key challenge is to balance the arrival on the labour ward at the 'right' time, not too early and not too late. Arriving at the 'right' time leads to a positive path, while arriving 'too soon' might lead to a cascade of negative experiences. The results are further presented with five central themes: 'Finding out if labour has started is absorbing'; 'Dealing with labour at home'; 'Trying to arrive at the labour ward at the right time'; 'There is always a risk of being sent home'; 'Encountering health professionals arouses strong emotions'. the metasynthesis broadens the understanding of first-time mothers' experiences of early labour, and suggests that women's needs when planning a hospital birth are not being adequately met at this stage in the labour process. Three areas of future research are suggested: how to support and strengthen women during pregnancy in order to cope with early labour; women's experiences of early

Whole-School Management Issues Concerning the PE Department: "A Natural Division of Labour?"

ERIC Educational Resources Information Center

Williams, Gareth Mark; Williams, Dean

2013-01-01

Utilising the labour ideas of Adam Smith and Emile Durkheim as a theoretical basis, the main objective of this study was to investigate the perception that Heads of Physical Education (HoPE) face unique management and leadership challenges. Results showed that HoPE believe that they are overburdened with tasks primarily involving the delegation of…

Off-Farm Labour Decision of Canadian Farm Operators: Urbanization Effects and Rural Labour Market Linkages

ERIC Educational Resources Information Center

Alasia, Alessandro; Weersink, Alfons; Bollman, Ray D.; Cranfield, John

2009-01-01

Understanding the factors affecting off-farm labour decisions of census-farm operators has significant implications for rural development and farm income support policy. We examine the off-farm labour decisions of Canadian farm operators using micro-level data from the 2001 Census of Agriculture combined with community level data from the 2001…

Pathways linking drug use and labour market trajectories: the role of catastrophic events.

PubMed

Richardson, Lindsey; Small, Will; Kerr, Thomas

2016-01-01

People affected by substance use disorders often experience sub-optimal employment outcomes. The role of drug use in processes that produce and entrench labour market precarity among people who inject drugs (PWID) have not, however, been fully described. We recruited 22 PWID from ongoing prospective cohort studies in Vancouver, Canada, with whom we conducted semi-structured retrospective interviews and then employed a thematic analysis that drew on concepts from life course theory to explore the mechanisms and pathways linking drug use and labour market trajectories. The participants' narratives identified processes corresponding to causation, whereby suboptimal employment outcomes led to harmful drug use; direct selection, where impairment, health complications or drug-seeking activities selected individuals out of employment; and indirect selection, where external factors, such as catastrophic events, marked the initiation or intensification of substance use concurrent with sudden changes in capacities for employment. Catastrophic events linking negative transitions in both drug use and labour market trajectories were of primary importance, demarcating critical initiation and transitional events in individual risk trajectories. These results challenge conventional assumptions about the primacy of drug use in determining employment outcomes among PWID and suggest the importance of multidimensional support to mitigate the initiation, accumulation and entrenchment of labour market and drug-related disadvantage. © 2015 Foundation for the Sociology of Health & Illness.

Migration in a segmented labour market.

PubMed

Gordon, I

1995-01-01

"Current research in migration is moving on from neo-classical and behavioural perspectives to a more structural approach relating to wider processes, issues of power and the particular role of employers. Within this programme a key issue for investigation is the interaction between spatial mobility and the structuring of labour markets. This paper focuses on the significance of labour market segmentation--in terms both of job stability and gender--for migration, both theoretically and through an empirical analysis of data from the UK Labour Force Survey on sponsored and unsponsored moves." excerpt

A meta-synthesis of fathers' experiences of their partner's labour and the birth of their baby.

PubMed

Johansson, M; Fenwick, J; Premberg, A

2015-01-01

to develop greater understanding of how expectant fathers experience their partner's labour and the subsequent birth of their baby. a qualitative meta-synthesis. Data were search for in CINAHL, PubMed, Psych Info and SCOPUS. eight studies conducted in England, Malawi, Nepal and Sweden were included. 120 fathers with experiences of their partner having a spontaneous vaginal, assisted or surgical birth. 1st order themes were identified and subsequently grouped into seven 2nd order themes. Finally through a process of exploring patterns and connections seven 3rd order themes were developed which produced new insights into the men's experiences of labour and birth. This meta-synthesis revealed that most men wanted to be actively involved in their partner's labour, present at the birth and respected for what they could contribute. Men recognised that birth was a unique event that may be potentially challenging requiring a level of preparation. There were also men who felt pressured to attend. During the actual experience of labour men commonly expressed overwhelming feelings and inadequacy in their ability to support their partner. They particularly struggled with the 'pain' of labour. Midwives were subsequently identified as best placed to make a significant difference to how men perceived their experiences of labour and what they described as the life changing event of birth. the expectant fathers' birth experiences were multidimensional. Many were committed to being involved during labour and birth but often felt vulnerable. Being prepared and receiving support were essential elements of positive experience as well as contributing to their ability to adequately support the labouring woman. men's ability to actively prepare for, and be supported through, the labour and birth process influences their perceptions of the childbirth event as well as their sense of connection to their partner. Couples should be given opportunities to explore expectations and how these may

The second stage of labour.

PubMed

Baston, Helen

2004-03-01

This is the third 'midwifery basics' series aimed at student midwives, and focuses on midwifery care during labour. This month, we look at care during the second stage of labour. Students are encouraged to seek further information through a series of activities, and to link theory with practice by considering the issues relating to the care of the woman described in the vignette.

TENS (transcutaneous electrical nerve stimulation) for labour pain.

PubMed

Francis, Richard

2012-05-01

Because TENS is applied inconsistently and not always in line with optimal TENS application theory, this may explain why TENS for labour pain appears to be effective in some individuals and not in others. This article reviews TENS theory, advises upon optimal TENS application for labour pain and discusses some of the limitations of TENS research on labour pain. TENS application for labour pain may include TENS applied to either side of the lower spine, set to 200 mus pulse duration and 100 pulses per second. As pain increases, TENS intensity should be increased and as pain decreases, TENS intensity should be reduced to maintain a strong but pain free intensity of stimulation. This application may particularly reduce back pain during labour.

Applied magnetism: A supply-driven materials challenge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rios, Orlando; McCall, Scott K.

Permanent magnets are important in many green energy technologies including wind turbine generators and hybrid-electric vehicle motors. For these applications, volume and weight are important factors driving the overall design, and therefore a high energy density, or energy product, is an important figure of merit. This quantity defines the magnetic energy contained in a given volume of material, and so higher energy density magnets enable smaller, lighter applications. Currently, the most powerful magnets suitable for commercial purposes contain rare earth elements (REE), usually neodymium and dysprosium in the neodymium-iron-boride class of magnets. However, for select applications, often requiring high temperatures,more » samarium cobalt is the alloy of choice. These magnets have energy densities several times greater than their nearest non-REE-based competitor, which for some applications is the defining factor in creating a viable device. The global supply of these REE is overwhelmingly produced in China, which in 2015 mined more than ten times as much as the next largest producer (Australia). Such market domination effectively creates a single source of supply, leaving industries which rely on REE consumption susceptible to price shocks and supply disruptions of these critical materials. Furthermore, this supply sensitivity may act as a drag on the adaptation rate of green energy technologies, particularly for large-scale users.« less

Applied magnetism: A supply-driven materials challenge

DOE PAGES

Rios, Orlando; McCall, Scott K.

2016-05-27

Permanent magnets are important in many green energy technologies including wind turbine generators and hybrid-electric vehicle motors. For these applications, volume and weight are important factors driving the overall design, and therefore a high energy density, or energy product, is an important figure of merit. This quantity defines the magnetic energy contained in a given volume of material, and so higher energy density magnets enable smaller, lighter applications. Currently, the most powerful magnets suitable for commercial purposes contain rare earth elements (REE), usually neodymium and dysprosium in the neodymium-iron-boride class of magnets. However, for select applications, often requiring high temperatures,more » samarium cobalt is the alloy of choice. These magnets have energy densities several times greater than their nearest non-REE-based competitor, which for some applications is the defining factor in creating a viable device. The global supply of these REE is overwhelmingly produced in China, which in 2015 mined more than ten times as much as the next largest producer (Australia). Such market domination effectively creates a single source of supply, leaving industries which rely on REE consumption susceptible to price shocks and supply disruptions of these critical materials. Furthermore, this supply sensitivity may act as a drag on the adaptation rate of green energy technologies, particularly for large-scale users.« less

Emotional Labour and Governmentality: Productive Power in Childcare

ERIC Educational Resources Information Center

Monrad, Merete

2017-01-01

This article examines the interplay between governance and cost-containment efforts in the public sector and the emotional labour and well-being of childcare workers. Care-work researchers have highlighted the complexities of power in emotional labour, such as the fact that emotional labour may simultaneously benefit the individual worker and…

Health status and labour force participation: evidence from Australia.

PubMed

Cai, Lixin; Kalb, Guyonne

2006-03-01

This paper examines the effect of health on labour force participation using the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The potential endogeneity of health, especially self-assessed health, in the labour force participation equation is addressed by estimating the health equation and the labour force participation equation simultaneously. Taking into account the correlation between the error terms in the two equations, the estimation is conducted separately for males aged 15-49, males aged 50-64, females aged 15-49 and females aged 50-60. The results indicate that better health increases the probability of labour force participation for all four groups. However, the effect is larger for the older groups and for women. As for the feedback effect, it is found that labour force participation has a significant positive impact on older females' health, and a significant negative effect on younger males' health. For younger females and older males, the impact of labour force participation on health is not significant. The null-hypothesis of exogeneity of health to labour force participation is rejected for all groups. Copyright 2005 John Wiley & Sons, Ltd.

Delivery outcomes after day and night onset of labour.

PubMed

Kanwar, Sandeep; Rabindran, Ranjit; Lindow, Stephen W

2015-11-01

To describe the outcome of night onset of labour as compared with the day onset of labour to investigate if labour that begins at night is more efficient. Retrospective review of labour and delivery data. A large United Kingdom maternity service. Over the period of 10 years, there were 30,022 deliveries, of which 19,842 were studied. A United Kingdom maternity department database was used to identify deliveries over a 10-year period, and the delivery outcomes were retrieved from these records. The 19,842 labours were divided into two categories: night onset (22.00-06.00 h) and day onset (10.00-18.00 h). Rates of operative intervention, augmentation, epidural usage and labour duration. A significant difference in delivery outcome was noted (P=0.004) with the night-onset labours having more normal deliveries (83.6% vs. 82.5%), fewer caesarean sections (8.7% vs. 10.1%), fewer labour augmentations with syntocinon (14.9% vs. 19.5%, P<0.001), fewer artificial rupture of membranes (14.1% vs. 15.6% P<0.001) and a significantly shorter mean first stage duration (4 h 58 min vs. 5 h 7 min, P<0.05). The proportion of women from each group who delivered between 09.00 and 17.00 h was 3660 (31.1%) in the night-onset group and 2414 (30%) in the day-onset group (χ2=1.3, P=NS) Conclusions: Labours that start at night appear to be more efficient than labours that start during the day.

Labour Market Outcomes of Higher Education Undertaken Abroad

ERIC Educational Resources Information Center

Wiers-Jenssen, Jannecke; Try, Sverre

2005-01-01

The aim of this article is to analyse the transferability of higher education undertaken abroad to a domestic labour market. More specifically, how do Norwegians who have undertaken their education abroad cope on the labour market compared to those who have a corresponding education from Norway? To examine this, we analyse short-term labour market…

The Challenge of Providing Safe Water with an Intermittently Supplied Piped Water Distribution System

NASA Astrophysics Data System (ADS)

Kumpel, E.; Nelson, K. L.

2012-12-01

An increasing number of urban residents in low- and middle-income countries have access to piped water; however, this water is often not available continuously. 84% of reporting utilities in low-income countries provide piped water for fewer than 24 hours per day (van den Berg and Danilenko, 2010), while no major city in India has continuous piped water supply. Intermittent water supply leaves pipes vulnerable to contamination and forces households to store water or rely on alternative unsafe sources, posing a health threat to consumers. In these systems, pipes are empty for long periods of time and experience low or negative pressure even when water is being supplied, leaving them susceptible to intrusion from sewage, soil, or groundwater. Households with a non-continuous supply must collect and store water, presenting more opportunities for recontamination. Upgrading to a continuous water supply, while an obvious solution to these challenges, is currently out of reach for many resource-constrained utilities. Despite its widespread prevalence, there are few data on the mechanisms causing contamination in an intermittent supply and the frequency with which it occurs. Understanding the impact of intermittent operation on water quality can lead to strategies to improve access to safe piped water for the millions of people currently served by these systems. We collected over 100 hours of continuous measurements of pressure and physico-chemical water quality indicators and tested over 1,000 grab samples for indicator bacteria over 14 months throughout the distribution system in Hubli-Dharwad, India. This data set is used to explore and explain the mechanisms influencing water quality when piped water is provided for a few hours every 3-5 days. These data indicate that contamination occurs along the distribution system as water travels from the treatment plant to reservoirs and through intermittently supplied pipes to household storage containers, while real

Immersion in water in labour and birth

PubMed Central

Cluett, Elizabeth R; Burns, Ethel

2014-01-01

Background Enthusiasts suggest that labouring in water and waterbirth increase maternal relaxation, reduce analgesia requirements and promote a midwifery model of care. Critics cite the risk of neonatal water inhalation and maternal/neonatal infection. Objectives To assess the evidence from randomised controlled trials about immersion in water during labour and waterbirth on maternal, fetal, neonatal and caregiver outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 June 2011) and reference lists of retrieved studies. Selection criteria Randomised controlled trials comparing immersion in any bath tub/pool with no immersion, or other non-pharmacological forms of pain management during labour and/or birth, in women during labour who were considered to be at low risk of complications, as defined by the researchers. Data collection and analysis We assessed trial eligibility and quality and extracted data independently. One review author entered data and the other checked for accuracy. Main results This review includes 12 trials (3243 women): eight related to just the first stage of labour: one to early versus late immersion in the first stage of labour; two to the first and second stages; and another to the second stage only. We identified no trials evaluating different baths/pools, or the management of third stage of labour. Results for the first stage of labour showed there was a significant reduction in the epidural/spinal/paracervical analgesia/anaesthesia rate amongst women allocated to water immersion compared to controls (478/1254 versus 529/1245; risk ratio (RR) 0.90; 95% confidence interval (CI) 0.82 to 0.99, six trials). There was also a reduction in duration of the first stage of labour (mean difference −32.4 minutes; 95% CI −58.7 to −6.13). There was no difference in assisted vaginal deliveries (RR 0.86; 95% CI 0.71 to 1.05, seven trials), caesarean sections (RR 1.21; 95% CI 0.87 to 1.68, eight

What influences midwives in estimating labour pain?

PubMed

Williams, A C de C; Morris, J; Stevens, K; Gessler, S; Cella, M; Baxter, J

2013-01-01

Clinicians' estimates of patients' pain are frequently used as a basis for delivering care, and the characteristics of the clinician and of the patient influence this estimate. We studied pain estimation by midwives attending women in uncomplicated labour. Sixty-six practising midwives of varied age, ethnicity and professional experience were asked to complete a trait empathy measure and then to estimate the maximum pain and anxiety experienced by six women whose filmed labour contractions they viewed. Additionally, they rated similarity to the labouring women in ethnicity, and described their beliefs about pain expression according to ethnicity. Midwife estimates of pain and anxiety were highly correlated. Longer professional experience was associated with lower pain estimates, while more births to the midwife herself was associated with higher pain estimates. A multiple regression model identified number of births to the midwife herself, and two components of empathy (perspective taking and identification), to be important in predicting midwife pain estimates for women in labour. Midwives expressed clear beliefs about women's expression of pain during labour according to ethnicity, but these beliefs were not consistent across midwives, even between midwives of similar ethnicity. Midwives' personal characteristics can bias the estimation of pain in woman in labour and therefore influence treatment. © 2012 European Federation of International Association for the Study of Pain Chapters.

[Emotional labour of nursing care: an evolutionary concept analysis].

PubMed

Truc, Huynh; Alderson, Marie; Thompson, Mary

2009-06-01

Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, psycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurse adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements : organization (i.e.social norms, social support), nurse (i.e.role identification, professional commitment, work experience and interpersonal skills) and job (i.e.autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions : nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e.productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive) the concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.

Narratives of neoliberalism: 'clinical labour' in context.

PubMed

Parry, Bronwyn

2015-06-01

Cross-border reproductive care has been thrust under the international spotlight by a series of recent scandals. These have prompted calls to develop more robust means of assessing the exploitative potential of such practices and the need for overarching and normative forms of national and international regulation. Allied theorisations of the emergence of forms of clinical labour have cast the outsourcing of reproductive services such as gamete donation and gestational surrogacy as artefacts of a wider neoliberalisation of service provision. These accounts share with many other narratives of neoliberalism a number of key assertions that relate to the presumed organisation of labour relations within this paradigm. This article critically engages with four assumptions implicit in these accounts: that clinical labourers constitute a largely homogeneous underclass of workers; that reproductive labour has been contractualised in ways that disembed it from wider social and communal relations; that contractualisation can provide protection for clinical labour lessening the need for formal regulatory oversight; and that the transnationalisation of reproductive service labour is largely unidirectional and characterised by a dynamic of provision in which 'the rest' services 'the West'. Drawing on the first findings of a large-scale ethnographic research project into assisted reproduction in India I provide evidence to refute these assertions. In so doing the article demonstrates that while the outsourcing and contractualisation of reproductive labour may be embedded in a wider neoliberal paradigm these practices cannot be understood nor their impacts be fully assessed in isolation from their social and cultural contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Far Right Challenge Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

PubMed

Halikiopoulou, Daphne

2017-07-11

Speed and Mannion make a good case that the rise of populism poses significant challenges for health policy. This commentary suggests that the link between populism and health policy should be further nuanced in four ways. First, a deconstruction of the term populism itself and a focus on the far right dimension of populist politics; second, a focus on the supply side and more specifically the question of nationalism and the 'national preference'; third, the dynamics of party competition during economic crisis; and fourth the question of policy, and more specifically the extent to which certain labour market policies are able to mediate demand for the far right. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Midwives' experiences of transfer in labour from a Western Australian birth centre to a tertiary maternity hospital.

PubMed

Kuliukas, Lesley J; Lewis, Lucy; Hauck, Yvonne L; Duggan, Ravani

2016-02-01

When transfer in labour takes place from a woman-centred, midwifery led centre to a tertiary maternity hospital it is accepted that women are negatively affected, however the midwife's role is unevaluated, there is no published literature exploring their experience. This study aimed to describe these experiences. Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of the midwives. Seventeen interviews of transferring midwives took place and data saturation was achieved. The overall findings suggest that midwives find transfer in labour challenging, both emotionally and practically. Five main themes emerged: (1) 'The midwife's internal conversation' with subtheme: 'Feeling under pressure', (2) 'Challenged to find a role in changing circumstances' with subtheme: 'Varying degrees of support', (3) 'Feeling out of place' with subtheme: 'Caught in the middle of different models of care, (4) 'A constant support for the parents across the labour and birth process' with subthemes: 'Acknowledging the parents' loss of their desired birth' and (5) 'The midwives' need for debrief'. Midwives acknowledged the challenge of finding the balance between fulfilling parents' birth plan wishes with hospital protocol and maintaining safety. Transfer for fetal or maternal compromise caused anxiety and concern. The benefits of providing continuity of care were acknowledged by the midwife's knowledge of the woman and her history but these were not always recognised by the receiving team. Discussing the transfer story afterwards helped midwives review their practice. Effective communication between all stakeholders is essential throughout the transfer process. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Balancing the health workforce: breaking down overall technical change into factor technical change for labour-an empirical application to the Dutch hospital industry.

PubMed

Blank, Jos L T; van Hulst, Bart L

2017-02-17

Well-trained, well-distributed and productive health workers are crucial for access to high-quality, cost-effective healthcare. Because neither a shortage nor a surplus of health workers is wanted, policymakers use workforce planning models to get information on future labour markets and adjust policies accordingly. A neglected topic of workforce planning models is productivity growth, which has an effect on future demand for labour. However, calculating productivity growth for specific types of input is not as straightforward as it seems. This study shows how to calculate factor technical change (FTC) for specific types of input. The paper first theoretically derives FTCs from technical change in a consistent manner. FTC differs from a ratio of output and input, in that it deals with the multi-input, multi-output character of the production process in the health sector. Furthermore, it takes into account substitution effects between different inputs. An application of the calculation of FTCs is given for the Dutch hospital industry for the period 2003-2011. A translog cost function is estimated and used to calculate technical change and FTC for individual inputs, especially specific labour inputs. The results show that technical change increased by 2.8% per year in Dutch hospitals during 2003-2011. FTC differs amongst the various inputs. The FTC of nursing personnel increased by 3.2% per year, implying that fewer nurses were needed to let demand meet supply on the labour market. Sensitivity analyses show consistent results for the FTC of nurses. Productivity growth, especially of individual outputs, is a neglected topic in workforce planning models. FTC is a productivity measure that is consistent with technical change and accounts for substitution effects. An application to the Dutch hospital industry shows that the FTC of nursing personnel outpaced technical change during 2003-2011. The optimal input mix changed, resulting in fewer nurses being needed to let

Head-to-cervix force: an important physiological variable in labour. 1. The temporal relation between head-to-cervix force and intrauterine pressure during labour.

PubMed

Allman, A C; Genevier, E S; Johnson, M R; Steer, P J

1996-08-01

To investigate the relation between the rise in intrauterine pressure and rise in fetal head to cervix force in normal, slow and induced labour. Prospective observational study. The labour ward of a London teaching hospital. Forty patients were recruited from the antenatal clinic and labour ward of a West London Hospital. Five had normal onset and progression of labour, 14 had slow progression of labour and 21 had induced onset of labour. Intrauterine pressure and head-to-cervix force was measured simultaneously using an intrauterine pressure catheter and a specially designed four sensor head-to-cervix force probe. For each contraction of each labour, scattergrams of force by pressure were plotted. Three patterns were observed. When the rise in pressure preceded the rise in force, a positive 'loop' was generated. When the rise in pressure and force occurred simultaneously a linear pattern was generated (a neutral 'loop'). When the rise in pressure lags the rise in force, a negative 'loop' was generated. In normally progressive labour the distribution of loops was 29.1%, 22.6% and 48.3%, respectively, in slow labour the distribution was 26.1%, 14.1% and 59.8% and in induced labour the distribution was 33.8%, 14.4% and 51.8%. These distributions were not statistically different. However, a higher proportion of negative loops was observed in labours augmented with oxytocin compared to those receiving no oxytocin (MW-U = 87, P = 0.036). No differences were observed comparing parity, use of PGE2, epidural analgesia, or mode of delivery. Contraction frequency (number/10 minutes) was inversely correlated to the percentage of negative loops (rs = -0.34, P = 0.033) and positively correlated with percentage of positive loops (rs = 0.36, P = 0.027). This is the first report of the temporal relation between intrauterine pressure and head-to-cervix force in labour. The most common pattern is that the rise in pressure lags the rise in force, suggesting that a seal has to be

Epidural labour analgesia using Bupivacaine and Clonidine

PubMed Central

Syal, K; Dogra, RK; Ohri, A; Chauhan, G; Goel, A

2011-01-01

Background: To compare the effects of addition of Clonidine (60 μg) to Epidural Bupivacaine (0.125%) for labour analgesia, with regard to duration of analgesia, duration of labour, ambulation, incidence of instrumentation and caesarean section, foetal outcome, patient satisfaction and side effects. Patients & Methods: On demand, epidural labour analgesia was given to 50 nulliparous healthy term parturients (cephalic presentation), divided in two groups randomly. Group I received bupivacaine (0.125%) alone, whereas Group II received bupivacaine (0.125%) along with Clonidine (60 μg). 10 ml of 0.125% bupivacaine was injected as first dose and further doses titrated with patient relief (Numerical Rating Scale <3). Top ups were given whenever Numerical Rating Scale went above 5. Results: There was statistically significant prolongation of duration of analgesia in Group II, with no difference in duration of labour, ambulation, incidence of instrumentation and caesarean section or foetal outcome. Also clonidine gave dose sparing effect to bupivacaine and there was better patient satisfaction without any significant side effects in Group II. Conclusion: Clonidine is a useful adjunct to bupivacaine for epidural labour analgesia and can be considered as alternative to opioids. PMID:21804714

Morning versus evening induction of labour for improving outcomes.

PubMed

Bakker, Jannet J H; van der Goes, Birgit Y; Pel, Maria; Mol, Ben Willem J; van der Post, Joris A M

2013-02-28

Induction of labour is a common intervention in obstetric practice. Traditionally, in most hospitals induction of labour with medication starts early in the morning, with the start of the working day for the day shift. In human and animal studies spontaneous onset of labour is proven to have a circadian rhythm with a preference for start of labour in the evening. Moreover, when spontaneous labour starts in the evening, the total duration of labour and delivery shortens and fewer obstetric interventions are needed. Based on these observations one might assume that starting induction of labour in the evening, in harmony with the circadian rhythm of natural birth, is more beneficial for both mother and child. To assess whether induction of labour starting in the evening, coinciding with the endogenous circadian rhythm, improves the outcome of labour compared with induction of labour starting in the early morning, organised to coincide with office hours. We contacted the Trials Search Co-ordinator to search the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012). In addition, we searched MEDLINE (1966 to 16 February 2012) and EMBASE (1980 to 16 February 2012). We included all published and unpublished randomised controlled trials. We excluded trials that employed quasi-random methods of treatment allocation. Two review authors independently assessed trials for inclusion and risk of bias. Two review authors independently extracted data. Data were checked for accuracy. Where necessary, we contacted study authors for additional information. The search resulted in 2693 articles that we screened on title and abstract for eligibility.Thirteen studies were selected for full text assessment. We included three randomised trials involving 1150 women. Two trials compared the administration of prostaglandins in the morning versus the evening in women with an unfavourable cervix, and one trial compared induction of labour in the morning versus the evening

A Review of New Labour's Policy on School Exclusion: The Political Challenge of School Disaffection in England

ERIC Educational Resources Information Center

Reed, Jodie

2003-01-01

Shortly after coming to power, Tony Blair's New Labour government expressed its strong commitment to tackling the problem of school expulsion. The Treasury's 1998 Spending Review included the bold target to achieve "a reduction by one third in... exclusions (from 12,500 to 8,400 permanent exclusions a year) by 2002". This article gives…

Division of labour in the yeast: Saccharomyces cerevisiae.

PubMed

Wloch-Salamon, Dominika M; Fisher, Roberta M; Regenberg, Birgitte

2017-10-01

Division of labour between different specialized cell types is a central part of how we describe complexity in multicellular organisms. However, it is increasingly being recognized that division of labour also plays an important role in the lives of predominantly unicellular organisms. Saccharomyces cerevisiae displays several phenotypes that could be considered a division of labour, including quiescence, apoptosis and biofilm formation, but they have not been explicitly treated as such. We discuss each of these examples, using a definition of division of labour that involves phenotypic variation between cells within a population, cooperation between cells performing different tasks and maximization of the inclusive fitness of all cells involved. We then propose future research directions and possible experimental tests using S. cerevisiae as a model organism for understanding the genetic mechanisms and selective pressures that can lead to the evolution of the very first stages of a division of labour. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Maternal positions and mobility during first stage labour

PubMed Central

Lawrence, Annemarie; Lewis, Lucy; Hofmeyr, G Justus; Dowswell, Therese; Styles, Cathy

2014-01-01

Background It is more common for women in the developed world, and those in low-income countries giving birth in health facilities, to labour in bed. There is no evidence that this is associated with any advantage for women or babies, although it may be more convenient for staff. Observational studies have suggested that if women lie on their backs during labour this may have adverse effects on uterine contractions and impede progress in labour. Objectives The purpose of the review is to assess the effects of encouraging women to assume different upright positions (including walking, sitting, standing and kneeling) versus recumbent positions (supine, semi-recumbent and lateral) for women in the first stage of labour on length of labour, type of delivery and other important outcomes for mothers and babies. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (November 2008). Selection criteria Randomised and quasi-randomised trials comparing women randomised to upright versus recumbent positions in the first stage of labour. Data collection and analysis We used methods described in the Cochrane Handbook for Systematic Reviews of Interventions for carrying out data collection, assessing study quality and analysing results. A minimum of two review authors independently assessed each study. Main results The review includes 21 studies with a total of 3706 women. Overall, the first stage of labour was approximately one hour shorter for women randomised to upright as opposed to recumbent positions (MD −0.99, 95% CI −1.60 to −0.39). Women randomised to upright positions were less likely to have epidural analgesia (RR 0.83 95% CI 0.72 to 0.96).There were no differences between groups for other outcomes including length of the second stage of labour, mode of delivery, or other outcomes related to the wellbeing of mothers and babies. For women who had epidural analgesia there were no differences between those randomised to upright

Altered gene expression in human placenta after suspected preterm labour.

PubMed

Oros, D; Strunk, M; Breton, P; Paules, C; Benito, R; Moreno, E; Garcés, M; Godino, J; Schoorlemmer, J

2017-07-01

Suspected preterm labour occurs in around 9% of pregnancies. However, almost two-thirds of women admitted for threatened preterm labour ultimately deliver at term and are considered risk-free for fetal development. We examined placental and umbilical cord blood samples from preterm or term deliveries after threatened preterm labour as well as term deliveries without threatened preterm labour. We quantitatively analysed the mRNA expression of inflammatory markers (IL6, IFNγ, and TNFα) and modulators of angiogenesis (FGF2, PGF, VEGFA, VEGFB, and VEGFR1). A total of 132 deliveries were analysed. Preterm delivery and term delivery after suspected preterm labour groups showed similar increases in TNFα expression compared with the term delivery control group in umbilical cord blood samples. Placental samples from preterm and term deliveries after suspected preterm labour exhibited significantly increased expression of TNFα and IL6 and decreased expression of IFNγ. Suspected preterm labour was also associated with altered expression of angiogenic factors, although not all differences reached statistical significance. We found gene expression patterns indicative of inflammation in human placentas after suspected preterm labour regardless of whether the deliveries occurred preterm or at term. Similarly, a trend towards altered expression of angiogeneic factors was not limited to preterm birth. These findings suggest that the biological mechanisms underlying threatened preterm labour affect pregnancies independently of gestational age at birth. Copyright © 2017 Elsevier Ltd. All rights reserved.

Labour analgesia: Recent advances

PubMed Central

Pandya, Sunil T

2010-01-01

Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) pumps and computer-integrated drug delivery pumps have improved the overall maternal satisfaction rate and have enabled us to customize a suitable analgesic regimen for each parturient. Recent randomized controlled trials and Cochrane studies have concluded that the association of epidurals with increased caesarean section and long-term backache remains only a myth. Studies have also shown that the newer, low-dose regimes do not have a statistically significant impact on the duration of labour and breast feeding and also that these reduce the instrumental delivery rates thus improving maternal and foetal safety. Advances in medical technology like use of ultrasound for localizing epidural space have helped the clinicians to minimize the failure rates, and many novel drug delivery modalities like PCEA and computer-integrated PCEA have contributed to the overall maternal satisfaction and safety. PMID:21189877

Labour epidural analgesia in Poland in 2009 - a survey.

PubMed

Furmanik, Jacek

2013-01-01

Labour analgesia in most developed countries is funded by the state, available to every woman in labour, and plays an important role in the everyday activities of most anaesthetists. This paper presents the second part of an Obstetric Anaesthesia Survey which was conducted in 2009. The first part of the Survey, relating to anaesthesia for caesarean sections, was published in 2010. The author sent out 432 questionnaires containing questions about hospital size and location, staffing levels and numbers of deliveries per year. There were also questions regarding regional and other pain relief methods used in labour, ways of administration, drugs used and monitoring of patients. The response rate was 24%. Around 45% of responding hospitals had only 1-3 deliveries per year, which makes it difficult to provide separate obstetric anaesthetic cover. Only ten hospitals (11%) employed an anaesthetist for the labour ward. Epidural analgesia was used in 55% of hospitals but only 20% provided the service for 24 hours per day and free of charge. Entonox was used very occasionally, but the most common means of pain relief was pethidine injection. There were marked differences in the medication used for labour epidurals, with 18% of units using high concentrations of local anaesthetics which could result in motor block. Despite a lack of regulations in Polish law and a lack of proper training in 50% of units, midwives were looking after the patients with established labour epidural which could create medico-legal consequences. There was also a marked variation in the parameters monitored during labour analgesia. Epidural labour analgesia was offered for 24 hours per day and free of charge in only 20% of hospitals. Without public pressure it will be difficult to get more funding from the National Health Fund (NFZ) to enable other hospitals, especially those with small obstetric units, to introduce regional labour analgesia. Although the 2009 guidelines addressed most of the issues

Addressing the challenges of diagnostics demand and supply: insights from an online global health discussion platform.

PubMed

Engel, Nora; Wachter, Keri; Pai, Madhukar; Gallarda, Jim; Boehme, Catharina; Celentano, Isabelle; Weintraub, Rebecca

2016-01-01

Several barriers challenge development, adoption and scale-up of diagnostics in low and middle income countries. An innovative global health discussion platform allows capturing insights from the global health community on factors driving demand and supply for diagnostics. We conducted a qualitative content analysis of the online discussion 'Advancing Care Delivery: Driving Demand and Supply of Diagnostics' organised by the Global Health Delivery Project (GHD) (http://www.ghdonline.org/) at Harvard University. The discussion, driven by 12 expert panellists, explored what must be done to develop delivery systems, business models, new technologies, interoperability standards, and governance mechanisms to ensure that patients receive the right diagnostic at the right time. The GHD Online (GHDonline) platform reaches over 19 000 members from 185 countries. Participants (N=99) in the diagnostics discussion included academics, non-governmental organisations, manufacturers, policymakers, and physicians. Data was coded and overarching categories analysed using qualitative data analysis software. Participants considered technical characteristics of diagnostics as smaller barriers to effective use of diagnostics compared with operational and health system challenges, such as logistics, poor fit with user needs, cost, workforce, infrastructure, access, weak regulation and political commitment. Suggested solutions included: health system strengthening with patient-centred delivery; strengthened innovation processes; improved knowledge base; harmonised guidelines and evaluation; supply chain innovations; and mechanisms for ensuring quality and capacity. Engaging and connecting different actors involved with diagnostic development and use is paramount for improving diagnostics. While the discussion participants were not representative of all actors involved, the platform enabled a discussion between globally acknowledged experts and physicians working in different countries.

Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial

PubMed Central

Bolbol-Haghighi, Nahid; Masoumi, Seyedeh Zahra

2016-01-01

Introduction Childbirth experience is a process throughout women’s life and the most important consequence of labour. Support is the key factor to have a positive experience of childbirth. In order to improve and reduce the stress and anxiety levels in women during labour and cope with the childbirth pain, the emotional, physical and educational support of doulas can be used. Aim This study was aimed to evaluate the effect of continued support of midwifery students in labour on the childbirth and labour consequences. Materials and Methods The present study was conducted using a randomized controlled clinical trial design on 100 pregnant women referred to the maternity ward at Fatemieh Hospital, Shahroud, Iran. The participants were assigned to the supportive or non-supportive group based on allocation sequence using a randomized block design and table of computer-generated random numbers prior to beginning the study. Supportive care was provided by the trained midwifery students. Childbirth and labour consequences were analysed by chi-square test, Fisher-exact test, independent t-test, Mann-Whitney U-test using SPSS-21 software. Results The results showed a significantly lower duration of the first stage of labour in the supportive group, as compared to that in the non-supportive group (p <0.001). Moreover, Apgar scores in the supportive group, compared to those in the non-supportive group, significantly increased at minutes 1 and 5 (p <0.001 and p = 0.04, respectively). Conclusion The findings of this study showed that the supportive care provided by the midwifery students shortens duration of the first stage of labour and improves the Apgar scores in the first and fifth minutes. PMID:27790526

A Review of the Participation of Disabled Persons in the Labour Force: The Kenyan Context

ERIC Educational Resources Information Center

Opini, Bathseba M.

2010-01-01

This paper presents a review of the challenges that disabled people experience in participating in the Kenyan labour market. It draws on existing literature and on a narrative of the experiences of one disabled academic in a Kenyan university to highlight some of the forms of discrimination that disabled people have to cope with in their…

Effect of child labour on growth of children.

PubMed

Ambadekar, N N; Wahab, S N; Zodpey, S P; Khandait, D W

1999-11-01

This community based group comparison study was undertaken to assess the effect of child labour on the growth of children. The study subjects were 223 child labourers aged between 8-15 y who were matched by age to an equal number of controls and pair matched for gender. The mean weight of the male child labourers and the controls increased from 23.8 (+/-5.9) to 41.2 (+/-9.7) kg and 23.9 (+/-4.8) to 44.4 (+/-10.3) kg respectively, while mean height increased from 121.5 (+/-12.6) to 151.9 (+/-10.6) cm and 122.0 (+/-8.4) to 154.8 (+/-10.8) cm respectively from 8-15 y. At older ages (12 y and above for weight and 14 y and above for height) the difference was statistically significant. The same was not observed for the female study subjects. Similarly standard deviation (s.d.) scores for weight for age and height for age of male comparison subjects was significantly (P<0.01) nearer to National Centre for Health Statistics (NCHS) standard than that of the child labourers. Body mass index (BMI) below normal value, that is, 18.5 was observed in significantly (P=0.0261) more child labourers 180 (80.7%) than controls 160 (71.1%). With increasing duration of employment BMI decreased from 18.1 (+/-3.5) to 17.3 (+/-2.2). Genital development was observed to be delayed significantly in male child labourers. Therefore, it can be concluded that labouring at a young age has a deleterious effect on the growth of the child.

Learning as Sociocultural Practice: Chinese Immigrant Professionals Negotiating Differences and Identities in the Canadian Labour Market

ERIC Educational Resources Information Center

Shan, Hongxia; Guo, Shibao

2013-01-01

The last few decades have witnessed both an expansion and a transformation of immigration flows, which pose significant challenges with respect to how people work with differences across culture and space. Against this background, this paper explores how some Chinese immigrant engineers respond to differences in the Canadian labour market. It not…

Future Supply and Demand for Oncologists : Challenges to Assuring Access to Oncology Services

PubMed Central

Erikson, Clese; Salsberg, Edward; Forte, Gaetano; Bruinooge, Suanna; Goldstein, Michael

2007-01-01

include any alterations based on changes in practice patterns, service use, or cancer treatments. Various alternate scenarios were also developed to show how supply and demand might change under different assumptions. Conclusions ASCO, policy makers, and the public have major challenges ahead of them to forestall likely shortages in the capacity to meet future demand for oncology services. A multifaceted strategy will be needed to ensure that Americans have access to oncology services in 2020, as no single action will fill the likely gap between supply and demand. Among the options to consider are increasing the number of oncology fellowship positions, increasing use of nonphysician clinicians, increasing the role of primary care physicians in the care of patients in remission, and redesigning service delivery. PMID:20859376

Knowledge and decision-making for labour analgesia of Australian primiparous women.

PubMed

Raynes-Greenow, Camille H; Roberts, Christine L; McCaffery, Kirsten; Clarke, Judith

2007-06-01

to assess and investigate knowledge of labour pain management options and decision-making among primiparous women. a semi-structured guide was used in focus groups to gather pregnant women's knowledge concerning labour analgesia. Attitudes to labour and pain relief, knowledge of pain relief, trustworthiness of knowledge sources, and plans and expectations for labour pain relief were investigated. a major tertiary obstetric hospital in metropolitan Sydney, Australia. twenty five primiparous women, who were 25 weeks or more gestation, and planning a vaginal birth. although women considered themselves knowledgeable, they were unable to describe labour analgesic risks or benefits. There was a large discrepancy between perception and actual knowledge. The main source of knowledge was anecdotal information. Late in pregnancy was considered the ideal time to be given information about labour analgesia. Women described their labour pain relief plans as flexible in relation to their labour circumstances; however, most women wanted to take an active role in decision-making. the large discrepancy between perceived knowledge and actual knowledge of the likely consequences of labour analgesia suggests that women rely too heavily on anecdotal information. clinicians should be aware that some women overestimate their knowledge and understanding of analgesic options, which is often based on anecdotal information. Standardised labour analgesia information at an appropriate time in their pregnancy may benefit some women and assist health-care providers and women to practice shared decision-making.

Increased xanthine oxidase during labour--implications for oxidative stress.

PubMed

Many, A; Roberts, J M

1997-11-01

Xanthine dehydrogenase/oxidase (XDH/XO) produces uric acid. When in the oxidase form, this production is coupled with the generation of free radicals. Hypoxia-reperfusion enhances conversion of XDH to XO. Since the placenta is exposed to short periods of hypoxia reperfusion during labour, 17 placentae of pregnancy terminated by elective caesarean section and five placentae of pregnancies terminated by caesarean section during labour were examined for XDH/XO activity. It was found that XO activity was higher in the placentae of labouring women (P = 0.003), which suggests that labour enhances conversion of XDH to XO, facilitating free radical production.

Pain relief in labour: a qualitative study to determine how to support women to make decisions about pain relief in labour

PubMed Central

2014-01-01

Background Engagement in decision making is a key priority of modern healthcare. Women are encouraged to make decisions about pain relief in labour in the ante-natal period based upon their expectations of what labour pain will be like. Many women find this planning difficult. The aim of this qualitative study was to explore how women can be better supported in preparing for, and making, decisions during pregnancy and labour regarding pain management. Methods Semi-structured interviews were conducted with 13 primiparous and 10 multiparous women at 36 weeks of pregnancy and again within six weeks postnatally. Data collection and analysis occurred concurrently to identify key themes. Results Three main themes emerged from the data. Firstly, during pregnancy women expressed a degree of uncertainty about the level of pain they would experience in labour and the effect of different methods of pain relief. Secondly, women reflected on how decisions had been made regarding pain management in labour and the degree to which they had felt comfortable making these decisions. Finally, women discussed their perceived levels of control, both desired and experienced, over both their bodies and the decisions they were making. Conclusion This study suggests that the current approach of antenatal preparation in the NHS, of asking women to make decisions antenatally for pain relief in labour, needs reviewing. It would be more beneficial to concentrate efforts on better informing women and on engaging them in discussions around their values, expectations and preferences and how these affect each specific choice rather than expecting them to make to make firm decisions in advance of such an unpredictable event as labour. PMID:24397421

Sexual intercourse for cervical ripening and induction of labour.

PubMed

Kavanagh, J; Kelly, A J; Thomas, J

2001-01-01

The role of prostaglandins for cervical ripening and induction of labour has been examined extensively. Human semen is the biological source that is presumed to contain the highest prostaglandin concentration. The role of sexual intercourse in the initiation of labour is uncertain. The action of sexual intercourse in stimulating labour is unclear, it may in part be due to the physical stimulation of the lower uterine segment, or endogenous release of oxytocin as a result of orgasm or from the direct action of prostaglandins in semen. Furthermore nipple stimulation may be part of the process of initiation. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. To determine the effects of sexual intercourse for third trimester cervical ripening or induction of labour in comparison with other methods of induction. The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and bibliographies of relevant papers. Last searched: November 2000. (1) clinical trials comparing sexual intercourse for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods; (2) random allocation to the treatment or control group; (3) adequate allocation concealment; (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusion. A strategy has been developed to deal with the large volume and complexity of trial data relating to labour induction. This involves a two-stage method of data extraction. There was one included study of 28 women which reported very limited data, from which no meaningful conclusions can be drawn. The role of sexual intercourse as a method of induction

What is the prevalence of and associations with forced labour experiences among male migrants from Dolakha, Nepal? Findings from a cross-sectional study of returnee migrants

PubMed Central

Mak, Joelle; Abramsky, Tanya; Sijapati, Bandita; Kiss, Ligia; Zimmerman, Cathy

2017-01-01

Objectives Growing numbers of people are migrating outside their country for work, and many experience precarious conditions, which have been linked to poor physical and mental health. While international dialogue on human trafficking, forced labour and slavery increases, prevalence data of such experiences remain limited. Methods Men from Dolakha, Nepal, who had ever migrated outside of Nepal for work were interviewed on their experiences, from predeparture to return (n=194). Forced labour was assessed among those who returned within the past 10 years (n=140) using the International Labour Organization's forced labour dimensions: (1) unfree recruitment; (2) work and life under duress; and (3) impossibility to leave employer. Forced labour is positive if any one of the dimensions is positive. Results Participants had worked in India (34%), Malaysia (34%) and the Gulf Cooperation Council countries (29%), working in factories (29%), as labourers/porters (15%) or in skilled employment (12%). Among more recent returnees (n=140), 44% experienced unfree recruitment, 71% work and life under duress and 14% impossibility to leave employer. Overall, 73% experienced forced labour during their most recent labour migration. Forced labour was more prevalent among those who had taken loans for their migration (PR 1.23) and slightly less prevalent among those who had migrated more than once (PR 0.87); however the proportion of those who experienced forced labour was still high (67%). Age, destination and duration of stay were associated with only certain dimensions of forced labour. Conclusion Forced labour experiences were common during recruitment and at destination. Migrant workers need better advice on assessing agencies and brokers, and on accessing services at destinations. As labour migration from Nepal is not likely to reduce in the near future, interventions and policies at both source and destinations need to better address the challenges migrants face so they can

Development of a multidimensional labour satisfaction questionnaire: dimensions, validity, and internal reliability

PubMed Central

Smith, L

2001-01-01

Background—No published quantitative instrument exists to measure maternal satisfaction with the quality of different models of labour care in the UK. Methods—A quantitative psychometric multidimensional maternal satisfaction questionnaire, the Women's Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ), was developed using principal components analysis with varimax rotation of successive versions. Internal reliability and content and construct validity were assessed. Results—Of 300 women sent the first version (WOMBLSQ1), 120 (40%) replied; of 300 sent WOMBLSQ2, 188 (62.7%) replied; of 500 women sent WOMBLSQ3, 319 (63.8%) replied; and of 2400 women sent WOMBLSQ4, 1683 (70.1%) replied. The latter two versions consisted of 10 dimensions in addition to general satisfaction. These were (Cronbach's alpha): professional support in labour (0.91), expectations of labour (0.90), home assessment in early labour (0.90), holding the baby (0.87), support from husband/partner (0.83), pain relief in labour (0.83), pain relief immediately after labour (0.65), knowing labour carers (0.82), labour environment (0.80), and control in labour (0.62). There were moderate correlations (range 0.16–0.73) between individual dimensions and the general satisfaction scale (0.75). Scores on individual dimensions were significantly related to a range of clinical and demographic variables. Conclusion—This multidimensional labour satisfaction instrument has good validity and internal reliability. It could be used to assess care in labour across different models of maternity care, or as a prelude to in depth exploration of specific areas of concern. Its external reliability and transferability to care outside the South West region needs further evaluation, particularly in terms of ethnicity and social class. Key Words: Women's Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ); labour; questionnaire PMID:11239139

Intracutaneous sterile water for back pain in labour.

PubMed Central

Reynolds, J. L.

1994-01-01

Intracutaneous sterile water appears to be a simple, effective, and harmless technique for relieving back pain. This technique has been used to relieve pain of renal colic, whiplash, and back pain in labour. Family doctors often practise obstetrics in small or isolated units that have limited options for pain relief in labour. This technique is simple, is easy to learn, and appears effective for relieving back pain, which complicates about one third of all labours. Images Figures 1-2 Figures 3-4 PMID:7950471

The Impact of Training-Intensive Labour Market Policies on Labour and Educational Prospects of NEETS: Evidence from Catalonia (Spain)

ERIC Educational Resources Information Center

Alegre, Miquel Àngel; Casado, David; Sanz, Jordi; Todeschini, Federico A.

2015-01-01

Background: The literature has shown that the way active labour market policies (ALMP) aimed at youth are designed and implemented can influence the labour and educational prospects of youngsters. The evaluation of the Catalan PQPIs (initial vocational qualification programmes) presented here seeks to provide new evidence on the effectiveness of…

Caring labour, intersectionality and worker satisfaction: an analysis of the National Nursing Assistant Study (NNAS).

PubMed

Rakovski, Carter C; Price-Glynn, Kim

2010-03-01

Caring labour in long-term care settings is increasingly important as the US population ages. Ethnographic research on nursing assistants (NAs) portrays nursing home care as routine and fast paced in facilities that emphasise life maintenance more than care. Recent interview-based and small quantitative studies describe a mix of positive and negative aspects of NA work, including the rewards of caring, despite shortcomings in working conditions and pay. The current study continues this research but, for the first time, using national data. The 2004 Centers for Disease Control and Prevention's National Nursing Assistant Study (NNAS) provides survey data from 3,017 NAs working in long-term care facilities across the US. The NNAS results confirm the importance and centrality of caring to NAs' work. NAs motivated by caring for others were significantly more satisfied with their jobs than those motivated by other reasons, such as convenience or salary. Overall, NAs report surprisingly high job satisfaction, particularly with learning new skills, doing challenging work, and organisational support for caring labour. Areas of dissatisfaction were salary, time for reproductive labour, and turnover. Intersectional analysis revealed race and citizenship played a stronger role than gender in worker satisfaction.

Ethnic variation between white European women in labour outcomes in a setting in which the management of labour is standardised-a healthy migrant effect?

PubMed

Walsh, J; Mahony, R; Armstrong, F; Ryan, G; O'Herlihy, C; Foley, M

2011-05-01

To test the hypothesis that women from Eastern European countries have lower caesarean delivery rates and higher spontaneous labour rates relative to Irish women in a setting in which the management of labour is standardised. A retrospective review of prospectively collected data. Tertiary referral centre, Dublin, Ireland. All Irish and Eastern European term nulliparous women who laboured and delivered in 2008. A comparison of labour outcomes between women from Ireland and women from Eastern European countries. The principal outcomes measured were the gestational age at onset of labour, whether labour was spontaneous or induced, the need for oxytocin augmentation, duration of labour, mode of delivery, epidural use and birthweight. Of 2556 Irish (n = 2041) and Eastern European (n = 511) term cephalic singleton labours in the calendar year 2008, women from Eastern Europe were significantly more likely to labour spontaneously (74.6% versus 65.9%, P < 0.001), required less epidural analgesia (68.4% versus 59.7%) and were significantly less likely to require delivery by caesarean section (8.6% versus 15.7%, P < 0.001) than Irish women. This is despite no significant difference between the two groups with regard to mean birthweight (3581 g versus 3569 g, P = 0.6) or macrosomia (birthweight over 4000 g) (18% versus 16%, P = 0.4). There were significant differences in maternal age at delivery (27.2 years versus 29.2 years, P < 0.001) and body mass index (BMI) (24.1 kg/m² versus 25.4 kg/m², P < 0.001) between the two groups. These findings confirm our hypothesis that economic migrants from Eastern European countries exhibit a so-called 'healthy migrant effect' in terms of obstetric outcomes. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Emotional labour and stress within mental health nursing.

PubMed

Mann, S; Cowburn, J

2005-04-01

For many within the nursing profession, the work role involves a great deal of emotional work or 'emotional labour'. Such emotional work can be performed through 'surface acting' in which the individual simply feigns an appropriate emotion, or through 'deep acting' in which they actually try to feel the required emotion. The current study aims to aid understanding of the complex relationship between components of emotional labour and stress within the mental health nursing sector. Thirty-five mental health nurses completed questionnaires relating to a total of 122 nurse-patient interactions. Data were collected in relation to: (1) the duration and intensity of the interaction; (2) the variety of emotions expressed; (3) the degree of surface or deep acting the nurse performed; and (4) the perceived level of stress the interaction involved. Nurses also completed Daily Stress Indicators. Results suggest that: (1) emotional labour is positively correlated with both 'interaction stress' and daily stress levels; (2) the deeper the intensity of interactions and the more variety of emotions experienced, the more emotional labour was reported; and (3) surface acting was a more important predictor of emotional labour than deep acting. Implications for mental health nurses are outlined.

The Emotional Labour of Caring in Teaching

ERIC Educational Resources Information Center

Isenbarger, Lynn; Zembylas, Michalinos

2006-01-01

This article is based on a collaborative action research study between one teacher and a teacher educator and provides an account of the emotional labour in enacting caring teaching in an inclusive classroom. The emotional labour demanded in caring relationships is an area of research that has not received much attention. Results from this case…

Evolving understanding and treatment of labour dystocia.

PubMed

Karaçam, Zekiye; Walsh, Denis; Bugg, George John

2014-11-01

The objective of the review is to critically review the diagnosis and management of dystocia in the first stage of labour. We conducted a narrative review of research since 1998. Eight studies were identified, four about the onset and duration of active phase of the first stage of labour, one on the diagnosis of dystocia, and three focused on the treatment of dystocia. The review demonstrates that current understandings of dystocia rest on outdated definitions of active first stage of labour, its progress and on treatments with an equivocal evidence base. These include the cervical dilatation threshold for active first stage, uncertainty over whether a reduced rate of dilatation and reduced strength of uterine contractions always represent pathology and the effectiveness of amniotomy/oxytocin for treating dystocia. Prospective studies should evaluate the impact of defining the active phase of the first stage of labour as commencing at 6 cm dilated and should test this definition in combination with Zhang's revised partogram. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Epidural analgesia in labour and risk of caesarean delivery.

PubMed

Bannister-Tyrrell, Melanie; Ford, Jane B; Morris, Jonathan M; Roberts, Christine L

2014-09-01

A Cochrane Systematic Review of randomised controlled trials of epidural analgesia compared with other or no analgesia in labour reported no overall increased risk of caesarean delivery. However, many trials were affected by substantial non-compliance, and there are concerns about the external validity of some trials for contemporary maternity populations. We aimed to explore the association between epidural analgesia in labour and caesarean delivery in clinical practice and compare with findings from randomised controlled trials. Population-based cohort of pregnant women (n = 210 708) without major obstetrical complications who delivered a singleton live infant in hospitals in New South Wales, Australia, 2007-10. Data were obtained from linked, validated population-based data collections. Propensity score matching was used to examine the association between epidural analgesia in labour and caesarean delivery. Epidural analgesia in labour was used by a third (31.5%, n = 66 317) of the women, and 9.8% (n = 20 531) had a caesarean delivery. Epidural analgesia in labour was associated with increased risk of caesarean delivery {risk ratio [RR] 2.5, [95% confidence interval (CI) 2.5, 2.6]}. The association with epidural analgesia in labour was higher for caesarean delivery for failure to progress {RR 3.0, [95% CI 2.9, 3.0]} than for caesarean delivery for fetal distress {RR 1.9, [95% CI 1.8, 2.0]}. Epidural analgesia in labour is associated with caesarean delivery in a large maternity population. Population-based studies contribute important data about obstetrical care, when research settings and participants may not represent the clinical settings or broader population in which obstetrical interventions in labour are applied. © 2014 John Wiley & Sons Ltd.

The ethics of surrogacy: women's reproductive labour.

PubMed Central

van Niekerk, A; van Zyl, L

1995-01-01

The aim of this article is to establish whether there is anything intrinsically immoral about surrogacy arrangements from the perspective of the surrogate mother herself. Specific attention is paid to the claim that surrogacy is similar to prostitution in that it reduces women's reproductive labour to a form of alienated and/or dehumanized labour. PMID:8778458

[The role of emotional labour in oncology].

PubMed

Szluha, Kornélia; Lazányi, Kornélia; Molnár, Péter

2007-01-01

Oncologists and related health care professionals (HCPs) do not only have to follow professional protocols in their everyday work, but also have to communicate proper attitudes towards patients suffering from malignant diseases. This task is often a heavier load than the implementation of professional activities themselves. The present article is based on a survey on HCP work motivation, employment parameters and correlations with emotional labour. Fifty oncology HCPs at Debrecen University Medical Health Sciences Centre volunteered to participate in this survey containing 20 simple-choice questions. More than 90 percent of HCPs make an effort to hide their emotional state, giving way to possible negative side effects. The survey showed significant differences between the level of emotional labour of those working in the field of oncology longer or shorter than ten years. Surface and deep emotional labour is more frequent among professionals already working in oncology for a longer period of time. This can serve us with explanation to the burn-out syndrome so frequent in this profession. To diminish the load of emotional labour, healthcare institutes have to aim at hiring employees that spontaneously fit the emotional and behavioural norms facing them, and do not need officially prescribed behavioural norms for everyday work. Their constant need for respect and appreciation of their values must be kept in mind, because the capability of genuine emotional labour diminishes parallel to the number of years spent in work.

A neoliberalisation of civil society? Self-help groups and the labouring class poor in rural South India.

PubMed

Pattenden, Jonathan

2010-01-01

This paper notes the prominence of self-help groups (SHGs) within current anti-poverty policy in India, and analyses the impacts of government- and NGO-backed SHGs in rural North Karnataka. It argues that self-help groups represent a partial neoliberalisation of civil society in that they address poverty through low-cost methods that do not challenge the existing distribution of power and resources between the dominant class and the labouring class poor. It finds that intra-group savings and loans and external loans/subsidies can provide marginal economic and political gains for members of the dominant class and those members of the labouring classes whose insecure employment patterns currently provide above poverty line consumption levels, but provide neither material nor political gains for the labouring class poor. Target-oriented SHG catalysts are inattentive to how the social relations of production reproduce poverty and tend to overlook class relations and socio-economic and political differentiation within and outside of groups, which are subject to interference by dominant class local politicians and landowners.

Women's perceptions, expectations and satisfaction with induced labour--a questionnaire-based study.

PubMed

Shetty, Ashalatha; Burt, Rhona; Rice, Pat; Templeton, Allan

2005-11-01

To evaluate the understanding and expectations of women undergoing labour induction, to assess their actual experience of the process and to compare their satisfaction with labour to those labouring spontaneously. Four hundred and fifty women at term undergoing induction of labour and cervical ripening with prostaglandinE2 vaginal tablets and 450 women labouring spontaneously were recruited into the study. The induction group were requested to complete a questionnaire prior to the start of their induction process and another questionnaire post-delivery. The post-delivery questionnaire contained two sections, one pertaining to issues to do with the induction and the second with the actual labour process. The spontaneously labouring group was requested to complete a questionnaire post-delivery, which only contained the section pertaining to the actual labour process. The main outcome measures were satisfaction with labour, perception of pain and length of labour between the induced and spontaneous labour groups, and issues that the women might wish changed about their induction. In the induction group, 34.7% were not satisfied with the information they received about the induction prior to the procedure and 27.2% expected to deliver within 12h of the administration of the inducing agent. Post-induction, 40% of the women felt the most important aspect they would like to change about their induction were they to have another one, would be the speed of the induction, 13.6% felt they might wish to take the inducing agent orally, 7% to have fewer vaginal examinations and 9% to have fewer complications. Among the women who returned questionnaires, 26.3% had a caesarean delivery in the induction group and 21.4% in the spontaneous labour group. Significantly more women were satisfied with their labour in the spontaneous labour group 79.5% versus 70.4%, RR 0.89, 95% CI 0.8-0.96, P=0.006). Labour that is artificially induced does result in lower satisfaction rates as compared

Controlling supply expenses through capitated supply contracting.

PubMed

Kowalski, J C

1997-07-01

Some providers dealing with the financial challenges of managed care are attempting to control supply expenses through capitated supply contracting and similar risk/reward sharing arrangements. Under such arrangements, a supplier sells products and services to a provider for a fixed, prospective price in exchange for the provider's exclusive business. If expenses exceed the prospectively established amount, the supplier and provider share the loss. Conversely, if expenses are less than the fixed amount, they share the savings. For a capitated supply arrangement to be successful, providers must be able to identify and track supply expense drivers, such as clinical pathways, technology utilization, and product selection and utilization. Sophisticated information systems are needed to capture data, such as total and per-transaction product usage/volume; unit price per item; average and cost per item; average and total cost per transaction; and total cost per outcome. Providers also will need to establish mutually cooperative relationships with the suppliers with whom they contract.

Type of Labour in the First Pregnancy and Cumulative Maternal Morbidity.

PubMed

Allen, Victoria M; Baskett, Thomas F; O'Connell, Colleen M

2015-08-01

To estimate cumulative maternal morbidity among women who delivered at term in their first pregnancy on the basis of type of labour in the first pregnancy. Using a 25-year population-based cohort (1988 to 2012) derived from the Nova Scotia Atlee Perinatal Database, we determined the type of labour in successive pregnancies in low-risk, nulliparous women at term in their first pregnancy (who had at least one subsequent pregnancy), and the maternal outcomes in subsequent deliveries based on the type of labour in the first pregnancy. A total of 36 871 pregnancies satisfied inclusion and exclusion criteria, 1346 of which were delivered by Caesarean section without labour in the first pregnancy. Rates of most adverse maternal outcomes were low (≤1%). The type of labour in the first pregnancy influenced the subsequent risk of postpartum hemorrhage and blood transfusion, and the risks increased with successive deliveries when labours were spontaneous in onset or were induced. The risks for abnormal placentation were low with subsequent deliveries, including following CS without labour in the first pregnancy, and risks for overall severe maternal morbidity were less than 10% for all subsequent deliveries. The absolute risks for severe maternal morbidity outcomes in a population of women without a high number of subsequent pregnancies were small (regardless of type of labour in the first pregnancy); this provides important information for women, families, and caregivers when considering pregnancy outcomes related to type of labour.

Modeling sustainability in renewable energy supply chain systems

NASA Astrophysics Data System (ADS)

Xie, Fei

This dissertation aims at modeling sustainability of renewable fuel supply chain systems against emerging challenges. In particular, the dissertation focuses on the biofuel supply chain system design, and manages to develop advanced modeling framework and corresponding solution methods in tackling challenges in sustaining biofuel supply chain systems. These challenges include: (1) to integrate "environmental thinking" into the long-term biofuel supply chain planning; (2) to adopt multimodal transportation to mitigate seasonality in biofuel supply chain operations; (3) to provide strategies in hedging against uncertainty from conversion technology; and (4) to develop methodologies in long-term sequential planning of the biofuel supply chain under uncertainties. All models are mixed integer programs, which also involves multi-objective programming method and two-stage/multistage stochastic programming methods. In particular for the long-term sequential planning under uncertainties, to reduce the computational challenges due to the exponential expansion of the scenario tree, I also developed efficient ND-Max method which is more efficient than CPLEX and Nested Decomposition method. Through result analysis of four independent studies, it is found that the proposed modeling frameworks can effectively improve the economic performance, enhance environmental benefits and reduce risks due to systems uncertainties for the biofuel supply chain systems.

Relation between induced labour indications and neonatal morbidity.

PubMed

Hernández-Martínez, Antonio; Pascual-Pedreño, Ana Isabel; Baño-Garnés, Ana Belén; Del Rocío Melero-Jiménez, Maria; Molina-Alarcón, Milagros

2014-12-01

To assess the main neonatal morbidity results in relation to induced labour indications. Historical groups from a total of 3,817 deliveries over a three year period (2009, 2010 and 2011) in "Mancha-Centro" Hospital (Alcázar de San Juan) formed the study group. All programmed and non-avoidable caesarean sections and pregnancies under 35 weeks were excluded. The main variable result was a neonatal morbidity variable made up of the Apgar score after 5 min, pH of umbilical artery <7.10 and the neonatal need for resuscitation type III-V. Multivariate analysis was used to control confounding variables. The incidence of induced labour was 22.6 % (862). The highest indication was premature rupture of membranes for more than 12 h 22.8 % (190), poorly controlled diabetes 22.6 % (189) and oligoamnios 16.2 % (135). The rate of pH lower than 7.10 was 2.8 % (22), the rate of the Apgar score lower than 7 after 5 min was 0.2 % (2) and the neonatal need for resuscitation type III-IV was 5.7 % (48) for induced labour. The relation between induced labour and neonatal morbidity indicators were not statistically significant. 10.1 % (4) of induced labour for suspected intrauterine growth restriction and 8.6 % (10) of postterm pregnancies required neonatal resuscitation type III-IV. No relation was found between induced labour and the neonatal morbidity indicators. The highest neonatal risk indicator is when a intrauterine growth restriction, hypertensión/preeclampsia or a postterm pregnancy is suspected.

International labour migration in the Asian-Pacific region: patterns, policies and economic implications.

PubMed

Athukorala, P

1993-11-01

"This paper reviews the literature on international labour migration from and within the Asian-Pacific region. It deals with patterns and characteristics of migration flows, government policies towards labour migration, and economic implications of labour migration for both labour-exporting and importing countries in the region. The indications are that, despite gradual slowing down of labour flows to the western industrial countries and the Middle East, labour migration will continue to be a major economic influence on surplus-labour countries in the region. As an integral part of the growth dynamism in the region, labour migration has now begun to take on a regional dimension, with immense implications for the process of industrial restructuring in high growth economies and the changing pattern of economic interdependence among countries." excerpt

Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment.

PubMed

Nystedt, Astrid; Hildingsson, Ingegerd

2014-07-16

Prolonged labour very often causes suffering from difficulties that may have lifelong implications. This study aimed to explore the prevalence and treatment of prolonged labour and to compare birth outcome and women's experiences of prolonged and normal labour. Women with spontaneous onset of labour, living in a Swedish county, were recruited two months after birth, to a cross-sectional study. Women (n = 829) completed a questionnaire that investigated socio-demographic and obstetric background, birth outcome and women's feelings and experiences of birth. The prevalence of prolonged labour, as defined by a documented ICD-code and inspection of partogram was calculated. Four groups were identified; women with prolonged labour as identified by documented ICD-codes or by partogram inspection but no ICD-code; women with normal labour augmented with oxytocin or not. Every fifth woman experienced a prolonged labour. The prevalence with the documented ICD-code was (13%) and without ICD-code but positive partogram was (8%). Seven percent of women with prolonged labour were not treated with oxytocin. Approximately one in three women (28%) received oxytocin augmentation despite having no evidence of prolonged labour. The length of labour differed between the four groups of women, from 7 to 23 hours.Women with a prolonged labour had a negative birth experience more often (13%) than did women who had a normal labour (3%) (P <0.00). The factors that contributed most strongly to a negative birth experience in women with prolonged labour were emergency Caesarean section (OR 9.0, 95% CI 1.2-3.0) and to strongly agree with the following statement 'My birth experience made me decide not to have any more children' (OR 41.3, 95% CI 4.9-349.6). The factors that contributed most strongly to a negative birth experience in women with normal labour were less agreement with the statement 'It was exiting to give birth' (OR 0.13, 95% CI 0.34-0.5). There is need for increased clinical skill in

Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment

PubMed Central

2014-01-01

Background Prolonged labour very often causes suffering from difficulties that may have lifelong implications. This study aimed to explore the prevalence and treatment of prolonged labour and to compare birth outcome and women’s experiences of prolonged and normal labour. Method Women with spontaneous onset of labour, living in a Swedish county, were recruited two months after birth, to a cross-sectional study. Women (n = 829) completed a questionnaire that investigated socio-demographic and obstetric background, birth outcome and women’s feelings and experiences of birth. The prevalence of prolonged labour, as defined by a documented ICD-code and inspection of partogram was calculated. Four groups were identified; women with prolonged labour as identified by documented ICD-codes or by partogram inspection but no ICD-code; women with normal labour augmented with oxytocin or not. Results Every fifth woman experienced a prolonged labour. The prevalence with the documented ICD-code was (13%) and without ICD-code but positive partogram was (8%). Seven percent of women with prolonged labour were not treated with oxytocin. Approximately one in three women (28%) received oxytocin augmentation despite having no evidence of prolonged labour. The length of labour differed between the four groups of women, from 7 to 23 hours. Women with a prolonged labour had a negative birth experience more often (13%) than did women who had a normal labour (3%) (P <0.00). The factors that contributed most strongly to a negative birth experience in women with prolonged labour were emergency Caesarean section (OR 9.0, 95% CI 1.2-3.0) and to strongly agree with the following statement ‘My birth experience made me decide not to have any more children’ (OR 41.3, 95% CI 4.9-349.6). The factors that contributed most strongly to a negative birth experience in women with normal labour were less agreement with the statement ‘It was exiting to give birth’ (OR 0.13, 95% CI 0

Division of labour and the evolution of extreme specialization.

PubMed

Cooper, Guy A; West, Stuart A

2018-05-28

Division of labour is a common feature of social groups, from biofilms to complex animal societies. However, we lack a theoretical framework that can explain why division of labour has evolved on certain branches of the tree of life but not others. Here, we model the division of labour over a cooperative behaviour, considering both when it should evolve and the extent to which the different types should become specialized. We found that: (1) division of labour is usually-but not always-favoured by high efficiency benefits to specialization and low within-group conflict; and (2) natural selection favours extreme specialization, where some individuals are completely dependent on the helping behaviour of others. We make a number of predictions, several of which are supported by the existing empirical data, from microbes and animals, while others suggest novel directions for empirical work. More generally, we show how division of labour can lead to mutual dependence between different individuals and hence drive major evolutionary transitions, such as those to multicellularity and eusociality.

Piracetam for fetal distress in labour.

PubMed

Hofmeyr, G Justus; Kulier, Regina

2012-06-13

Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

Emotional labour: learning from the past, understanding the present.

PubMed

Elliott, Chris

2017-10-26

The number of nurses considering leaving the profession has continued to rise, and in many areas there is a nursing shortfall. For many of those leaving the profession, the decision results from workplace stress. This article examines the concept of emotional labour, which has been linked to compassion fatigue and subsequent burnout. Emotional labour is the term used to describe the process of displaying outward emotion that may not match our internal emotion; this dissonance can lead to highly stressful situations. The concept is explored from a genealogical perspective, specifically focusing on how gender, socio-political and health cultures have influenced the evolution of the discourse that defines how emotional labour is perceived, understood and valued. This article will identify what has shaped the discourse and how the historical influences have influenced perceptions. The article identifies that emotional labour has traditionally been viewed as women's work and has been undervalued. The influence of male nurses and the gradual decline of heavy industry has served to improve the understanding and value of the concept. Lessons from the past can inform the management of the stresses of emotional labour. Emotional labour is a recognised component of workplace stress and this article makes a number of recommendations for further research or management strategies, which may assist in the recognition and management of the stresses nurses face when delivering emotionally demanding care.

Critically Challenging Some Assumptions in HRD

ERIC Educational Resources Information Center

O'Donnell, David; McGuire, David; Cross, Christine

2006-01-01

This paper sets out to critically challenge five interrelated assumptions prominent in the (human resource development) HRD literature. These relate to: the exploitation of labour in enhancing shareholder value; the view that employees are co-contributors to and co-recipients of HRD benefits; the distinction between HRD and human resource…

Early labour services: changes, triggers, monitoring and evaluation.

PubMed

Spiby, Helen; Green, Josephine M; Richardson-Foster, Helen; Hucknall, Clare

2013-04-01

to identify the changes to early labour services, their triggers and monitoring. a mixed methods approach in two stages, firstly a postal questionnaire survey of Heads of Midwifery (HoM) services in NHS Trusts in England (cover sheet to each HoM and questionnaire for each unit in their jurisdiction) and, secondly, semi-structured telephone interviews with a purposive sample of senior midwives. The interviews sought further information about reasons for change; the impact of changes and explored the unit's particular innovations. PARTICIPANTS AND RESPONSE RATE: 145 (89%) NHS Trusts provided data (cover sheet and/or questionnaire); responses were received from all areas and types of unit. Seventeen HoMs or designated senior midwives were interviewed. 83 of 170 units (49%) had made changes to early labour service provision during the past 5 years, including home assessment; the introduction of triage units and telephone assessment tools. Changes were more likely in high volume units and in consultant units with midwifery-led care areas. Further changes were planned by 93/178 (25%) units. Triggers for changes to early labour services comprised local or unit-based factors, including Category X (non-labour) admissions, response to service users and research evidence. The impact of Category X admissions on workload contributed to the triggers for change. Fifty-six (31%) could provide a confirmed figure or estimate for category X admissions. Experiences of introducing change included issues related to engagement of the workforce and the contribution of clinical leadership. Thirty-eight (48%) units did not routinely monitor use of early labour services. Overall monitoring of services was not significantly more likely in units that had made changes. Audit activity was reported more frequently in units that had made changes to their early labour services. early labour services had undergone significant changes following a range of triggers but the extent of change was not

Why do health labour market forces matter?

PubMed Central

McPake, Barbara; Araújo, Edson Correia; Lemiere, Christophe; El Maghraby, Atef; Cometto, Giorgio

2013-01-01

Abstract Human resources for health have been recognized as essential to the development of responsive and effective health systems. Low- and middle-income countries seeking to achieve universal health coverage face human resource constraints – whether in the form of health worker shortages, maldistribution of workers or poor worker performance – that seriously undermine their ability to achieve well-functioning health systems. Although much has been written about the human resource crisis in the health sector, labour economic frameworks have seldom been applied to analyse the situation and little is known or understood about the operation of labour markets in low- and middle-income countries. Traditional approaches to addressing human resource constraints have focused on workforce planning: estimating health workforce requirements based on a country’s epidemiological and demographic profile and scaling up education and training capacities to narrow the gap between the “needed” number of health workers and the existing number. However, this approach neglects other important factors that influence human resource capacity, including labour market dynamics and the behavioural responses and preferences of the health workers themselves. This paper describes how labour market analysis can contribute to a better understanding of the factors behind human resource constraints in the health sector and to a more effective design of policies and interventions to address them. The premise is that a better understanding of the impact of health policies on health labour markets, and subsequently on the employment conditions of health workers, would be helpful in identifying an effective strategy towards the progressive attainment of universal health coverage. PMID:24347708

What is the prevalence of and associations with forced labour experiences among male migrants from Dolakha, Nepal? Findings from a cross-sectional study of returnee migrants.

PubMed

Mak, Joelle; Abramsky, Tanya; Sijapati, Bandita; Kiss, Ligia; Zimmerman, Cathy

2017-08-11

Growing numbers of people are migrating outside their country for work, and many experience precarious conditions, which have been linked to poor physical and mental health. While international dialogue on human trafficking, forced labour and slavery increases, prevalence data of such experiences remain limited. Men from Dolakha, Nepal, who had ever migrated outside of Nepal for work were interviewed on their experiences, from predeparture to return (n=194). Forced labour was assessed among those who returned within the past 10 years (n=140) using the International Labour Organization's forced labour dimensions: (1) unfree recruitment ; (2) work and life under duress ; and (3) impossibility to leave employer . Forced labour is positive if any one of the dimensions is positive. Participants had worked in India (34%), Malaysia (34%) and the Gulf Cooperation Council countries (29%), working in factories (29%), as labourers/porters (15%) or in skilled employment (12%). Among more recent returnees (n=140), 44% experienced unfree recruitment , 71% work and life under duress and 14% impossibility to leave employer . Overall, 73% experienced forced labour during their most recent labour migration.Forced labour was more prevalent among those who had taken loans for their migration (PR 1.23) and slightly less prevalent among those who had migrated more than once (PR 0.87); however the proportion of those who experienced forced labour was still high (67%). Age, destination and duration of stay were associated with only certain dimensions of forced labour. Forced labour experiences were common during recruitment and at destination. Migrant workers need better advice on assessing agencies and brokers, and on accessing services at destinations. As labour migration from Nepal is not likely to reduce in the near future, interventions and policies at both source and destinations need to better address the challenges migrants face so they can achieve safer outcomes. © Article

Outcome of misoprostol and oxytocin in induction of labour

PubMed Central

Acharya, Trishna; Devkota, Ramesh; Bhattarai, Bimbishar; Acharya, Radha

2017-01-01

Background: Induction of labour is the process of initiating the labour by artificial means from 24 weeks of gestation. The main aim of this study is to find out the maternal and foetal outcomes after induction of labour with misoprostol and oxytocin beyond 37 weeks of gestation. Methods: This was a hospital-based observational study carried out at Paropakar Maternity and Women’s Hospital, Nepal. Misoprostol of 25 µg was inserted in posterior fornix of vagina or oxytocin infusion was started from 2.5 units on whom induction was decided. Maternal and foetal/neonatal outcomes were observed. Collected data were analysed using SPSS and MS Excel. Results: General induction rate was found to be 7.2%. In this study, post-term pregnancy was found to be the most common reason for induction of labour. Analysis of onset of labour led to the finding that mean onset of labour was much rapid in oxytocin (6.6 h) than misoprostol (13.6 h). However, there is similarity in induction–delivery interval in both groups. Overall, the rate of normal delivery and caesarean section was found to be 64.9% and 33.2%, respectively. Similarly, normal delivery within 12 h was seen in 18.4% of the patients given with misoprostol and 43.5% in oxytocin group. Foetal distress was found as the most common reason for caesarean section. The overall occurrence of maternal complication was found to be similar in misoprostol and oxytocin groups, nausea/vomiting being the most common (36.7%) complication followed by fever (24.1%). Besides this, the most common neonatal complication found in overall cases was meconium stained liquor (49.2%). Conclusion: It was found that misoprostol was used most frequently for induction of labour compared to oxytocin. The onset of labour was found to be rapid in oxytocin than misoprostol. However, the occurrence of side effects was found to be similar in both misoprostol and oxytocin groups. PMID:28540049

Complementary and alternative therapies for pain management in labour.

PubMed

Smith, C A; Collins, C T; Cyna, A M; Crowther, C A

2003-01-01

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. To examine the effectiveness of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group trials register (July 2002), the Cochrane Controlled Trials Register (The Cochrane Library Issue 2, 2002), MEDLINE (1966 to July 2002), EMBASE (1980 to July 2002) and CINAHL (1980 to July 2002). The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included. Meta-analysis was performed using relative risks for dichotomous outcomes and weighted mean differences for continuous outcomes. The outcome measures were maternal satisfaction, use of pharmacological pain relief and maternal and neonatal adverse outcomes. Seven trials involving 366 women and using different modalities of pain management were included in this review. The trials included one involving acupuncture (n = 100), one involving audio-analgesia (n = 25), one involving aromatherapy (n = 22), three trials of hypnosis (n = 189) and one trial of music (n = 30). The trial of acupuncture decreased the need for pain relief (relative risk (RR) 0.56, 95% confidence interval (CI) 0.39 to 0.81). Women receiving hypnosis were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.55 to 4.71). No differences were seen for women receiving aromatherapy, music or audio

New Labour's Policies for Schools: Raising the Standard?

ERIC Educational Resources Information Center

Docking, Jim, Ed.

This book, which is designed primarily for undergraduate and graduate students of education, contains 12 papers devoted the New Labour's policies for schools in the United Kingdom. "Introduction" (Jim Docking) presents an overview of the book's contents and lists questions to help evaluate the effectiveness of New Labour's educational…

Date fruit consumption at term: Effect on length of gestation, labour and delivery.

PubMed

Razali, Nuguelis; Mohd Nahwari, Siti Hayati; Sulaiman, Sofiah; Hassan, Jamiyah

2017-07-01

Labour induction and augmentation with Prostaglandin and Oxytocin are well established as standard practice worldwide. They are safe when used judiciously, but may be associated with maternal and neonatal morbidities. Other safer alternatives have been studied including dates consumption during late pregnancy with various outcomes. The aim of this randomised controlled trial was to investigate the effect of date fruit consumption during late pregnancy on the onset of labour and need for induction or augmentation of labour. A total of 154 nulliparous women with an uncomplicated singleton pregnancy were randomly allocated to either dates-consumer (77) or control group (77). The women in the dates-consumer group had significantly less need for augmentation of labour and longer intervention to delivery interval. There was no significant difference in the onset of spontaneous labour. Dates consumption reduces the need for labour augmentation but does not expedite the onset of labour. Impact statement • Dates fruit consumption during late pregnancy has been shown to positively affect the outcome of labour and delivery. In this study, date consumption reduced the need for labour augmentation with oxytocin but did not expedite the onset of labour. Therefore, dates consumption in late pregnancy is a safe supplement to be considered as it reduced the need for labour intervention without any adverse effect on the mother and child. This further supports the finding of earlier studies.

Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour.

PubMed

Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

2009-04-15

Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. The TENS unit is frequently operated by women, which may increase sense of control in labour. To assess the effects of TENS on pain in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised controlled trials comparing women receiving TENS for pain relief in labour versus routine care, alternative pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. The search identified 25 studies; we excluded six and included 19 studies including 1671 women. Fifteen examined TENS applied to the back, two to acupuncture points and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32 to 0.55). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No adverse events were reported. There is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact (either positive or

The Eastring gas pipeline in the context of the Central and Eastern European gas supply challenge

NASA Astrophysics Data System (ADS)

Mišík, Matúš; Nosko, Andrej

2017-11-01

Ever since the 2009 natural gas crisis, energy security has been a crucial priority for countries of Central and Eastern Europe. Escalating in 2014, the conflict between Ukraine and Russia further fuelled negative expectations about the future development of energy relations for the region predominantly supplied by Russia. As a response to the planned cessation of gas transit through the Brotherhood pipeline, which brings Russian gas to Europe via Ukraine and Slovakia, the Slovak transmission system operator Eustream proposed the Eastring pipeline. This Perspective analyses this proposal and argues that neither the perceived decrease in Slovak energy security nor the loss of economic rent from the international gas transit should be the main policy driver behind such a major infrastructure project. Although marketed as an answer to current Central and Eastern European gas supply security challenges, the Eastring pipeline is actually mainly focused on issues connected to the Slovak gas transit.

Medicines counterfeiting is a complex problem: a review of key challenges across the supply chain.

PubMed

Tremblay, Michael

2013-02-01

The paper begins by asking why there is a market for counterfeit medicines, which in effect creates the problem of counterfeiting itself. Contributing factors include supply chain complexity and the lack of whole-systems thinking. These two underpin the author's view that counterfeiting is a complex (i.e. wicked) problem, and that corporate, public policy and regulatory actions need to be mindful of how their actions may be causal. The paper offers a problem-based review of key components of this complexity, viz., the knowledge end-users/consumers have of medicines; whether restrictive information policies may hamper information provision to patients; the internet's direct access to consumers; internet-enabled distribution of unsafe and counterfeit medicines; whether the internet is a parallel and competitive supply chain to legitimate routes; organised crime as an emerging medicines manufacturer and supplier and whether substandard medicines is really the bigger problem. Solutions respect the perceived complexity of the supply chain challenges. The paper identifies the need to avoid technologically-driven solutions, calling for 'technological agnosticism'. Both regulation and public policy need to reflect the dynamic nature of the problem and avoid creating perverse incentives; it may be, for instance, that medicines pricing and reimbursement policies, which affect consumer/patient access may act as market signals to counterfeiters, since this creates a cash market in cheaper drugs.

Perception of labour pain among the Yoruba ethnic group in Nigeria.

PubMed

Kuti, O; Faponle, A F

2006-05-01

In Nigeria, it is generally assumed that labour is well tolerated and pain relief is not usually considered an important part of intra-partum care. This prospective study was carried out to assess mothers' perception of labour pain and determine any factor that may influence it. During the period of study, 281 women who delivered at Wesley Guild Hospital Ilesa, Nigeria were interviewed within 2 h of delivery to assess the severity of labour pain and desire for analgesia. Perception of labour pain was assessed using a 3-point verbal rating. The majority (68.3%) of women described labour pain as severe with only 5.3% describing it as mild. More than 86% of the women would want the pain relieved. Perception of pain was not influenced by age, parity and educational level. Management of pain in labour should form an important part of intra-partum care as is the case in developed countries.

The emotional labour of nursing -- Defining and managing emotions in nursing work.

PubMed

Gray, Benjamin

2009-02-01

Emotions in health organisations tend to remain tacit and in need of clarification. Often, emotions are made invisible in nursing and reduced to part and parcel of 'women's work' in the domestic sphere. Smith (1992) applied the notion of emotional labour to the study of student nursing, concluding that further research was required. This means investigating what is often seen as a tacit and uncodified skill. A follow-up qualitative study was conducted over a period of twelve months to re-examine the role of the emotional labour of nursing. Data were collected primarily from 16 in-depth and semi-structured interviews with nurses. Key themes elicited at interviews touch upon diverse topics in the emotional labour of nursing. In particular, this article will address nurse definitions of emotional labour; the routine aspects of emotional labour in nursing; traditional and modern images of nursing; and gender and professional barriers that involve emotional labour in health work. This is important in improving nurse training and best practice; investigating clinical settings of nurses' emotional labour; looking at changing techniques of patient consultation; and beginning to explore the potential therapeutic value of emotional labour.

Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet.

PubMed

Raynes-Greenow, Camille H; Nassar, Natasha; Torvaldsen, Siranda; Trevena, Lyndal; Roberts, Christine L

2010-04-08

Most women use some method of pain relief during labour. There is extensive research evidence available of pharmacological pain relief during labour; however this evidence is not readily available to pregnant women. Decision aids are tools that present evidence based information and allow preference elicitation. We developed a labour analgesia decision aid. Using a RCT design women either received a decision aid or a pamphlet. Eligible women were primiparous, > or = 37 weeks, planning a vaginal birth of a single infant and had sufficient English to complete the trial materials. We used a combination of affective (anxiety, satisfaction and participation in decision-making) and behavioural outcomes (intention and analgesia use) to assess the impact of the decision aid, which were assessed before labour. 596 women were randomised (395 decision aid group, 201 pamphlet group). There were significant differences in knowledge scores between the decision aid group and the pamphlet group (mean difference 8.6, 95% CI 3.70, 13.40). There were no differences between decisional conflict scores (mean difference -0.99 (95% CI -3.07, 1.07), or anxiety (mean difference 0.3, 95% CI -2.15, 1.50). The decision aid group were significantly more likely to consider their care providers opinion (RR 1.28 95%CI 0.64, 0.95). There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use. This decision aid improves women's labour analgesia knowledge without increasing anxiety. Significantly, the decision aid group were more informed of labour analgesia options, and considered the opinion of their care providers more often when making their analgesia decisions, thus improving informed decision making. Trial registration no: ISRCTN52287533.

Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour

PubMed Central

Cluett, Elizabeth R; Pickering, Ruth M; Getliffe, Kathryn; Saunders, Nigel James St George

2004-01-01

Objectives To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia. Design Randomised controlled trial. Setting University teaching hospital in southern England. Participants 99 nulliparous women with dystocia (cervical dilation rate < 1 cm/hour in active labour) at low risk of complications. Interventions Immersion in water in birth pool or standard augmentation for dystocia (amniotomy and intravenous oxytocin). Main outcome measures Primary: epidural analgesia and operative delivery rates. Secondary: augmentation rates with amniotomy and oxytocin, length of labour, maternal and neonatal morbidity including infections, maternal pain score, and maternal satisfaction with care. Results Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5). They showed no difference in rates of operative delivery (49% v 50%, 0.98 (0.65 to 1.47), NNT 98), but significantly fewer received augmentation (71% v 96%, 0.74 (0.59 to 0.88), NNT 4) or any form of obstetric intervention (amniotomy, oxytocin, epidural, or operative delivery) (80% v 98%, 0.81 (0.67 to 0.92), NNT 5). More neonates of women in the water group were admitted to the neonatal unit (6 v 0, P = 0.013), but there was no difference in Apgar score, infection rates, or umbilical cord pH. Conclusions Labouring in water under midwifery care may be an option for slow progress in labour, reducing the need for obstetric intervention, and offering an alternative pain management strategy. PMID:14744822

Victorian paramedics' encounters and management of women in labour: an epidemiological study.

PubMed

McLelland, Gayle; Morgans, Amee; McKenna, Lisa

2015-02-05

Although it is generally accepted that paramedics attend unexpected births, there is a paucity of literature about their management of women in labour. This study aimed to investigate the caseload of women in labour attended by a statewide ambulance service in Australia during one year and the management provided by paramedics. Retrospective clinical data collected on-scene by paramedics via in-field electronic patient care records were provided by Ambulance Victoria. Patient case reports were electronically extracted from the Ambulance Victoria's Clinical Data Warehouse via comprehensive filtering followed by manual sorting. Descriptive statistics were analysed using Statistical Package for Social Sciences (SPSS v.19). Over a 12-month period, paramedics were called to 1517 labouring women. Two thirds of women were at full-term gestation, and 40% of pre-term pregnancies were less than 32 weeks gestation. Paramedics documented 630 case reports of women in early labour and a further 767 in established labour. There were 204 women thought to be second stage labour, including 134 who progressed to childbirth under paramedic care. When paramedics assisted with births, the on-scene time was significantly greater than those patients transported in labour. Pain relief was provided significantly more often to women in established labour than in early labour. Oxygen was given to significantly more women in preterm labour. While paramedics performed a range of procedures including intravenous cannulation, administration of analgesia and oxygen, most women required minimal intervention. Paramedics needed to manage numerous obstetric and medical complications during their management. Paramedics provide emergency care and transportation for women in labour. Most of the women were documented to be at term gestation with minimal complications. To enable appropriate decision making about management and transportation, paramedics require a range of clinical assessment skills

Gove's Offensive and the Failure of Labour's Response

ERIC Educational Resources Information Center

Hatcher, Richard

2012-01-01

In this article the author examines the response of the Labour leadership to the Conservative-led Government's policies for restructuring and re-agenting the school system. His focus is on the role of local authorities and local democracy. He identifies two contradictory dynamics in Labour's current thinking. One promises to enhance local…

Production and supply of high-quality food protein for human consumption: sustainability, challenges, and innovations.

PubMed

Wu, Guoyao; Fanzo, Jessica; Miller, Dennis D; Pingali, Prabhu; Post, Mark; Steiner, Jean L; Thalacker-Mercer, Anna E

2014-08-01

The Food and Agriculture Organization of the United Nations estimates that 843 million people worldwide are hungry and a greater number suffer from nutrient deficiencies. Approximately one billion people have inadequate protein intake. The challenge of preventing hunger and malnutrition will become even greater as the global population grows from the current 7.2 billion people to 9.6 billion by 2050. With increases in income, population, and demand for more nutrient-dense foods, global meat production is projected to increase by 206 million tons per year during the next 35 years. These changes in population and dietary practices have led to a tremendous rise in the demand for food protein, especially animal-source protein. Consuming the required amounts of protein is fundamental to human growth and health. Protein needs can be met through intakes of animal and plant-source foods. Increased consumption of food proteins is associated with increased greenhouse gas emissions and overutilization of water. Consequently, concerns exist regarding impacts of agricultural production, processing and distribution of food protein on the environment, ecosystem, and sustainability. To address these challenging issues, the New York Academy of Sciences organized the conference "Frontiers in Agricultural Sustainability: Studying the Protein Supply Chain to Improve Dietary Quality" to explore sustainable innovations in food science and programming aimed at producing the required quality and quantity of protein through improved supply chains worldwide. This report provides an extensive discussion of these issues and summaries of the presentations from the conference. © 2014 New York Academy of Sciences.

Women's experiences of becoming a mother after prolonged labour.

PubMed

Nystedt, Astrid; Högberg, Ulf; Lundman, Berit

2008-08-01

This paper is a report of a study to explore women's experiences of becoming a mother after prolonged labour. The negativity associated with a complicated labour such as prolonged labour can lead to a struggle to become a healthy mother and could restrict the process of becoming a mother. Interviews were conducted in 2004 with 10 mothers who had been through a prolonged labour with assisted vaginal or caesarean delivery 1-3 months previously. Thematic content analysis was used. Three themes were formulated, describing women's experiences as fumbling in the dark, struggling for motherhood and achieving confidence in being a mother. The difficulties and suffering involved in becoming a mother after a prolonged labour were interpreted to be like 'fumbling in the dark'. Women experienced bodily fatigue, accompanied by feelings of illness and detachment from the child. Having the child when in this condition entailed a struggle to become a mother. In spite of these experiences and the desire to achieve confidence in being a mother, the reassurance of these women regarding their capacity for motherhood was crucial: it was central to their happiness as mothers, encouraged interaction and relationship with the child, and contributed to their adaptation to motherhood. Women experiencing prolonged labour may be comparable with the experience of and recovery from illness, which could contribute to difficulties transitioning to motherhood and limit a woman's ability to be emotionally available for the child.

Client perspective assessment of women's satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia.

PubMed

Dewana, Zeritu; Fikadu, Teshale; G/Mariam, Abebe; Abdulahi, Misra

2016-02-11

A woman's satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women's satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women's towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zone, southern Ethiopia. Facility based cross sectional study was conducted among women who gave birth at public health facility. A total 256 women who gave birth during the study period were included in the study. Data was collected using a structured questionnaire. Satisfaction level was measured using a 5 point-Likert scale questions. Data were entered using Epi data version 3.5.1 and analyzed using SPSS 20.0 statistical software. Factor analysis was employed for Likert scale questions to extract factor represented each of the scale which facilitate treatment of variable as continuous for further analysis. Bi-variate and multivariable logistic regression analysis was employed to identify association between women's satisfaction and predicator variables. Statistical significance was declared at P value <0.05 on final model. The strength of association was interpreted using the adjusted odds ratio and 95% CI. This study revealed that 90.2% of women who gave birth in public health facilities were satisfied with labour and delivery care. Factors associated with women's satisfaction with labour and delivery care services include: not attending formal education [AOR = 8.00, 95% CI = (1.52, 12.27)] attending antenatal care four times and more [AOR = 5.00, 95% CI = (1.76, 14.20)] waiting below 15 minutes to be seen by health professional [AOR = 3.37, 95% CI = (1.14, 9.97)] and not paying for drugs and supplies [AOR = 6.19, 95% CI = (1.34, 18.59)]. Although majority

Operating theatre nurses: emotional labour and the hostess role.

PubMed

Timmons, Stephen; Tanner, Judith

2005-04-01

Emotional labour has been established as a significant factor in nursing work, although no studies have been done looking at emotional labour specifically in an operating theatre nursing context. Theatre staff (17 nurses and three Operating Department Practitioners (technicians) were observed in practice over a period of nine months by one of the authors. Each of the staff was subsequently interviewed. The transcriptions of the observation fieldwork notes and the semistructured interviews were analysed for themes and content. The (predominantly female) nurses perceived that one of their responsibilities was 'looking after the surgeons'. We have described this as the 'hostess' role. This role consisted of two major areas of activity: 'keeping the surgeons happy' and 'not upsetting the surgeons'. Examples are given of how this was accomplished through talk and actions. The (predominantly male) operating department practitioners did not see this as part of their work. This 'hostess' role is a kind of emotional labour, but performed with coworkers rather than patients. Like other forms of emotional labour, it is strongly gendered. The emotional labour performed by the theatre nurses was necessary to maintain what has been called elsewhere the 'sentimental order'.

Do health-related labour costs weaken the competitiveness of the economy?

PubMed

Häussler, Bertram; Ecker, Thomas; Schneider, Markus

2006-12-01

At least in Germany, it is widely assumed that healthcare-related labour costs weaken the competitiveness of national industries. However, there is a lack of knowledge about the amount of employers' financial burden in Germany and in other competing countries, as well as the impact on market prices of German goods. To quantify the health-related labour costs for employers in seven countries and different industries, and identify the effects of current reforms in Germany on the financial burden of employers. We calculated the spending on health in Germany and the burden on German employers (by branch of production). We then compared the total burden with that of six other countries. A univariate analysis was then conducted to examine the connection between health-related labour costs and employment. In 2000, employers paid 41.2% of the total of 283.3 billion spent on health matters in Germany. These total costs account for 3.2% of the gross output (UK: 1.8%, Switzerland: 1.9%, Poland: 2.1%, US: 3.2%, France: 3.6%, The Netherlands: 3.7%). Health-related labour costs account for 10.6% of the total labour costs. The health-related labour costs per employee are on average 3013 (from 2752 to 4793 in healthcare and the chemical industry, respectively). In the UK and the US there are corresponding labour costs of 1836 and 4256 per employee, respectively. The current health reform (2003) would reduce the labour costs by only 0.7% after 4 years (based on 2000, with all factors remaining constant). Employment increased by 3.7% from 1995 to 2000 (textile industry: -26.8%, vehicle manufacture: +18.3%). There is no empirical connection between employment and health-related labour costs. Labour costs increased by a higher amount than the health-related labour costs. The burden on German employers is moderate when compared internationally. The current reform of the German health system is not expected to improve companies' financial situation or

Nitric oxide donors for cervical ripening and induction of labour.

PubMed

Kelly, Anthony J; Munson, Christopher; Minden, Lucy

2011-06-15

Sometimes it is necessary to bring on labour artificially because of safety concerns for the mother or baby. This review is one of a series of reviews of methods of labour induction using a standardised protocol.Induction of labour occurs in approximately 20% of pregnancies in the UK. The ideal agent for induction of labour would induce cervical ripening without causing uterine contractions. Currently most commonly used cervical ripening or induction agents result in uterine activity or contractions, or both. Cervical ripening without uterine contractility could occur safely in an outpatient setting and it may be expected that this would result in greater maternal satisfaction and lower costs. To determine the effects of nitric oxide (NO) donors for third trimester cervical ripening or induction of labour, in comparison with placebo or no treatment or other treatments from a predefined hierarchy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010) and the reference lists of trial reports and reviews. Clinical trials comparing NO donors for cervical ripening or labour induction to other methods listed above it on a predefined list of methods of labour induction. The trials include some form of random allocation to either group; and report one or more of the prestated outcomes. NO donors (isosorbide mononitrate, nitroglycerin and sodium nitroprusside) are compared to other methods listed above it on a predefined list of methods of labour induction. This review is part of a series of reviews focusing on methods of induction of labour. Three review authors independently assessed trials for inclusion, assessed risk of bias and extracted data. We considered 19 trials; we included 10 (including a total of 1889 women) trials, excluded eight trials and one trial report is awaiting classification. Included studies compared NO donors to placebo, vaginal prostaglandin E2, intracervical PGE2 and vaginal misoprostol. All included studies

The Complementary Therapies for Labour and Birth Study making sense of labour and birth - Experiences of women, partners and midwives of a complementary medicine antenatal education course.

PubMed

Levett, K M; Smith, C A; Bensoussan, A; Dahlen, H G

2016-09-01

to gain insight into the experiences of women, partners and midwives who participated in the Complementary Therapies for Labour and Birth Study, an evidence based complementary medicine (CM) antenatal education course. qualitative in-depth interviews and a focus group as part of the Complementary Therapies for Labour and Birth Study. thirteen low risk primiparous women and seven partners who had participated in the study group of a randomised controlled trial of the complementary therapies for labour and birth study, and 12 midwives caring for these women. The trial was conducted at two public hospitals, and through the Western Sydney University in Sydney, Australia. the Complementary Therapies for Labour and Birth (CTLB) protocol, based on the She Births® course and the Acupressure for labour and birth protocol, incorporated six evidence-based complementary medicine (CM) techniques; acupressure, relaxation, visualisation, breathing, massage, yoga techniques and incorporated facilitated partner support. Randomisation to the trial occurred at 24-36 weeks' gestation, and participants attended a two-day antenatal education programme, plus standard care, or standard care alone. the overarching theme identified in the qualitative data was making sense of labour and birth. Women used information about normal birth physiology from the course to make sense of labour, and to utilise the CM techniques to support normal birth and reduce interventions in labour. Women's, partners' and midwives' experience of the course and its use during birth gave rise to supporting themes such as: working for normal; having a toolkit; and finding what works. the Complementary Therapies for Labour and Birth Study provided women and their partners with knowledge to understand the physiology of normal labour and birth and enabled them to use evidence-based CM tools to support birth and reduce interventions. the Complementary Therapies for Labour and Birth Study introduces concepts of what

Re-thinking skilled international labour migration: world cities and banking organisations.

PubMed

Beaverstock, J V

1994-08-01

"Highly skilled professional and managerial labour migration has become an important facet of the contemporary world economy. The operations of transnational corporations have created more opportunities for skilled migrants to work abroad.... There is a growing interest amongst economic geographers to examine this form of migration through an appreciation of global economic restructuring, labour market change and world cities. Consequently, this paper introduces a new conceptual framework...[which] is based on the rationale that world cities, and the patterns of labour market demand that exist within them, are of paramount importance in influencing highly skilled professional and managerial labour migration within the world economy. The author uses an example of highly skilled labour migration within the transnational banking sector [in London] to illustrate this new conceptual framework." excerpt

Transcutaneous electrical nerve stimulation (TENS) for pain management in labour

PubMed Central

Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

2014-01-01

Background Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. TENS machines are frequently operated by women, which may increase a sense of control in labour. Objectives To assess the effects of TENS on pain in labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 April 2011) and reference lists of retrieved papers. Selection criteria Randomised controlled trials comparing women receiving TENS for pain management in labour versus routine care, alternative non-pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Data collection and analysis Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. Main results Seventeen trials with 1466 women contribute data to the review. Thirteen examined TENS applied to the back, two to acupuncture points, and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (average risk ratio 0.41, 95% confidence interval 0.31 to 0.54; measured in two studies). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No

New Labour and Education: An Evidence-Based Analysis

ERIC Educational Resources Information Center

Galton, Maurice

2007-01-01

This article looks at the evidence concerning performance and progress in the primary school over the lifetime of New Labour's tenure in government since 1997. It examines the claims made by New Labour that the Literacy and Numeracy Strategies have been an outstanding success and have changed the ways that teachers teach. On the evidence of the…

PROM and Labour Effects on Urinary Metabolome: A Pilot Study

PubMed Central

Meloni, Alessandra; Palmas, Francesco; Mereu, Rossella; Deiana, Sara Francesca; Fais, Maria Francesca; Mussap, Michele; Ragusa, Antonio; Pintus, Roberta; Fanos, Vassilios; Melis, Gian Benedetto

2018-01-01

Since pathologies and complications occurring during pregnancy and/or during labour may cause adverse outcomes for both newborns and mothers, there is a growing interest in metabolomic applications on pregnancy investigation. In fact, metabolomics has proved to be an efficient strategy for the description of several perinatal conditions. In particular, this study focuses on premature rupture of membranes (PROM) in pregnancy at term. For this project, urine samples were collected at three different clinical conditions: out of labour before PROM occurrence (Ph1), out of labour with PROM (Ph2), and during labour with PROM (Ph3). GC-MS analysis, followed by univariate and multivariate statistical analysis, was able to discriminate among the different classes, highlighting the metabolites most involved in the discrimination. PMID:29511388

Castor oil for induction of labour: a retrospective study.

PubMed

Neri, Isabella; Dante, Giulia; Pignatti, Lucrezia; Salvioli, Chiara; Facchinetti, Fabio

2018-08-01

The aim of this study is to investigate the safety and efficacy of castor oil to induce labour. A retrospective observational case control study was conducted over five years. Castor oil was proposed to women referred to the Birth Centre (Castor Oil group (COG)). They were compared to women who chose to be followed by the traditional doctor-led unit (control group (CG)). Castor oil was administered in a 60 ml single dose in 200 ml of warm water. Inclusion criteria were gestational age between 40 and 41 weeks plus premature rupture of membranes between 12 and 18 hours or amniotic fluid index ≤4 or Bishop Score of ≤4 or absence of spontaneous labour over 41 + 4 weeks. Pharmacological induction of labour was required for 18 women in the COG (45%) and 36 in the CG (90%) (p < .001). The mode of delivery differed significantly between groups: women assuming castor oil showed a higher incidence of vaginal delivery, whereas the incidence of caesarean section was lower in the COG, but no statistical significance was reached. The use of castor oil is related to a higher probability of labour initiation within 24 hours. Castor oil can be considered a safe non-pharmacological method for labour induction.

Usefulness of elastography in predicting the outcome of Foley catheter labour induction.

PubMed

Wozniak, Slawomir; Czuczwar, Piotr; Szkodziak, Piotr; Paszkowski, Tomasz

2015-06-01

Incorrect selection of women for labour induction may increase the risk of caesarean section and other postpartum and neonatal complications. It has been recently shown that elastography of the uterine cervix holds the potential to predict the outcome of pharmacological labour induction. There are no data on the usefulness of elastography in predicting the outcome of mechanical induction of labour. To assess the usefulness of elastographic cervical assessment in predicting the success of Foley catheter labour induction. This prospective observational study included 39 pregnant women at term with an unfavourable cervix (Bishop score ≤ 6) suitable for Foley catheter labour induction. Before labour induction the following data were recorded: Bishop score, cervical length (measured by ultrasound) and the stiffness of cervical internal os, canal and external os assessed by elastography (elastography index - EI). Statistical relationships between pre-interventional assessment of the cervix and outcome of Foley catheter labour induction (successful induction, time to delivery and route of delivery) were analysed. EI's of internal cervical os and cervical canal were significantly lower (softer) in women with successful labour induction and vaginal delivery, while EI's of the external cervical os, Bishop score and cervix length were not significantly different. Time to vaginal delivery was significantly correlated with the EI's of internal cervical os, cervical canal and Bishop score, but not with EI's of the external cervical os and cervix length. Elastography has the potential to predict the outcome of Foley catheter labour induction. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Labour Market Driven Learning Analytics

ERIC Educational Resources Information Center

Kobayashi, Vladimer; Mol, Stefan T.; Kismihók, Gábor

2014-01-01

This paper briefly outlines a project about integrating labour market information in a learning analytics goal-setting application that provides guidance to students in their transition from education to employment.

Influence of timing of admission in labour and management of labour on method of birth: results from a randomised controlled trial of caseload midwifery (COSMOS trial).

PubMed

Davey, Mary-Ann; McLachlan, Helen L; Forster, Della; Flood, Margaret

2013-12-01

to explore the relationship between the degree to which labour is established on admission to hospital and method of birth. a recent randomised controlled trial found fewer caesarean sections (CS) in women allocated to caseload midwifery (19.4%) compared with standard care (24.9%). There is interest in exploring what specific aspects of the care might have resulted in this reduction. a large tertiary-level maternity service in Melbourne, Australia. English-speaking women with no previous caesarean section at low risk of complications in pregnancy were recruited to a randomised controlled trial. Trial participants whose management did not include a planned caesarean and who were admitted to hospital in spontaneous labour were included in this secondary analysis of trial data (n=1532). this secondary analysis included women admitted to hospital in spontaneous labour who were randomised to caseload midwifery compared with those randomised to standard care with regard to timing of admission in labour, augmentation of labour and use of epidural analgesia. In a further analysis randomised groups were pooled to examine predictors of caesarean section for first births only using multiple logistic regression. nulliparous women randomised to standard care were more likely to have labour augmented than those having caseload care (54.2% and 45.5% respectively, p=0.008), but were no more likely to use epidural analgesia. They were admitted earlier in labour, spending 1.1 hours longer than those in the caseload arm in hospital before the birth (p=0.003). Parous women allocated to standard care were more likely than those in the caseload arm to use epidural analgesia (10.0% and 5.3% respectively, p=0.047), but were no more likely to have labour augmented. They were also admitted earlier in labour, with a median cervical dilatation of 4 cm compared with 5 cm in the caseload arm (p=0.012). Pooling the two randomised groups of nulliparous women, and after adjusting for randomised

The pathway of obstructed labour as perceived by communities in south-western Uganda: a grounded theory study

PubMed Central

Kabakyenga, Jerome K.; Östergren, Per-Olof; Emmelin, Maria; Kyomuhendo, Phionah; Odberg Pettersson, Karen

2011-01-01

Background Obstructed labour is still a major cause of maternal and perinatal morbidity and mortality in Uganda, where many women give birth at home alone or assisted by non-skilled birth attendants. Little is known of how the community view obstructed labour, and what actions they take in cases where this complication occurs. Objective The objective of the study was to explore community members’ understanding of and actions taken in cases of obstructed labour in south-western Uganda. Design Grounded theory (GT) was used to analyse data from 20 focus group discussions (FGDs), 10 with women and 10 with men, which were conducted in eight rural and two urban communities. Results A conceptual model based on the community members’ understanding of obstructed labour and actions taken in response is presented as a pathway initiated by women's desire to ‘protecting own integrity’ (core category). The pathway consisted of six other categories closely linked to the core category, namely: (1) ‘taking control of own birth process’; (2) ‘reaching the limit – failing to give birth’ (individual level); (3) ‘exhausting traditional options’; (4) ‘partner taking charge’; (5) ‘facing challenging referral conditions’ (community level); and finally (6) ‘enduring a non-responsive healthcare system’ (healthcare system level). Conclusions There is a need to understand and acknowledge women's reluctance to involve others during childbirth. However, the healthcare system should provide acceptable care and a functional referral system closer to the community, thus supporting the community's ability to seek timely care as a response to obstructed labour. Easy access to mobile phones may improve referral systems. Upgrading of infrastructure in the region requires a multi-sectoral approach. Testing of the conceptual model through a quantitative questionnaire is recommended. PMID:22216018

The future population and the future labour force.

PubMed

Young, C

1994-01-01

"The combination of two recent publications by the Australian Bureau of Statistics (ABS) provides a useful insight into feasible future trends in the population, the labour force and dependency ratios. In addition, earlier ABS census data and its regular publications from the Labour Force Surveys clarify the historical trends in the relative number of dependants and nondependants. These various sources of data are brought together in this paper.... Official population projections...highlight the fact that the combination of annual zero net migration and 10 per cent below replacement fertility would not produce an immediate decline in Australia's population.... The conventional labour-force dependency ratio suggests that the dependency situation in Australia in 2041 will be no worse than it was in the early 1980s." excerpt

[Child labour].

PubMed

Marsella, L T; Savastano, L; Saracino, V; Del Vecchio, R

2005-01-01

The authors emphasize the violation of children's and adolescents' rights as a result of the exploitation of child labour. Besides the legal aspect, they pointed out the medical features related to the delicate growing process of the child in the phases of development and adaptation of the main organs to hard work. Currently the problem is being supervised by those states that recognize the right for minors to be protected against any kind of physical, mental, spiritual and moral risk.

Use of Non-invasive Uterine Electromyography in the Diagnosis of Preterm Labour

PubMed Central

Lucovnik, M.; Novak-Antolic, Z.; Garfield, R.E.

2012-01-01

Predictive values of methods currently used in the clinics to diagnose preterm labour are low. This leads to missed opportunities to improve neonatal outcomes and, on the other hand, to unnecessary hospitalizations and treatments. In addition, research of new and potentially more effective preterm labour treatments is hindered by the inability to include only patients in true preterm labour into studies. Uterine electromyography (EMG) detects changes in cell excitability and coupling required for labour and has higher predictive values for preterm delivery than currently available methods. This methodology could also provide a better means to evaluate various therapeutic interventions for preterm labour. Our manuscript presents a review of uterine EMG studies examining the potential clinical value that this technology possesses over what is available to physicians currently. We also evaluated the impact that uterine EMG could have on investigation of preterm labour treatments by calculating sample sizes for studies using EMG vs. current methods to enrol women. Besides helping clinicians to make safer and more cost-effective decisions when managing patients with preterm contractions, implementation of uterine EMG for diagnosis of preterm labour would also greatly reduce sample sizes required for studies of treatments. PMID:24753891

75 Years of the International Labour Review: A Retrospective.

ERIC Educational Resources Information Center

Thomas, Albert; And Others

1996-01-01

Contains 18 articles published in International Labour Review from 1921-1975 that discuss the International Labour Organisation, international labor movement and law, economics and the labor market, family security, full employment, population growth, industrial welfare, trade policy and employment growth, and income expectations and rural-urban…

Gender and migration on the labour market: Additive or interacting disadvantages in Germany?

PubMed

Fleischmann, Fenella; Höhne, Jutta

2013-09-01

Despite substantial differences in labour market attainment according to gender and migration status, gender and ethnic differences in labour market behaviour are most often studied separately. In contrast, this study describes and analyses interactions between gender, ethnic background and immigrant generation with regard to labour market participation, part-time work, and occupational status. The double comparison aims to reveal whether gender gaps in these labour market outcomes among the majority population generalise to ethnic minorities. Moreover, we ask whether variation in gender gaps in labour market behaviour follows the patterns in migrants' origin countries, and whether gender gaps show signs of intergenerational assimilation. Our heterogeneous choice and OLS regressions of 2009 German Microcensus data reveal considerable variation in gender gaps in labour market behaviour between East and West Germany, across ethnic groups and across generations. Intergenerational comparisons show that most ethnic minorities assimilate towards German patterns of gendered labour market attainment. Copyright © 2013 Elsevier Inc. All rights reserved.

Women's experiences of outpatient induction of labour with remote continuous monitoring.

PubMed

O'Brien, Ediri; Rauf, Zubair; Alfirevic, Zarko; Lavender, Tina

2013-04-01

to gain insight into women's experiences and preferences for induction in the home as part of a trial investigating the feasibility and acceptability of outpatient induction of labour with remote monitoring. a qualitative study using semi-structured individual interviews. Interview transcripts were subjected to thematic analysis to identify the dominant themes regarding women's experiences of outpatient induction. a large maternity hospital in the North West of England. fifteen women who participated in the main trial of outpatient induction of labour with remote continuous monitoring. three main themes were identified; the need for women to 'labour within their comfort zone'; their desire to achieve 'the next best thing to a normal labour' and the importance of a 'virtual presence' to offer remote reassurance. women's preference for the outpatient setting of induction of labour is dominated by their need to labour within their comfort zone. Outpatient induction offered women the familiarity and freedom of the home environment, and the resulting physical and emotional comforts helped women cope better with their labour and improved their birth experiences. While remote monitoring offered some reassurance, women still depended on effective communication from hospital staff to provide the virtual presence of a health professional in the home. the combination of slow-release prostaglandin and a remote monitoring device may provide low risk women with an improved induction and labour experience. While ongoing studies continue to explore further the safety of interventions at home, this study has importantly considered women's views and confirmed that induction at home is not only acceptable to women but also that the outpatient experience is preferable to long inpatient inductions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preterm labour: an overview of current and emerging therapeutics.

PubMed

Schwarz, Matthias K; Page, Patrick

2003-08-01

Preterm labour is a major cause of perinatal mortality and morbidity. However, during the past 40 years of clinical studies and despite the use of multiple therapeutic agents, the rate of preterm birth has not drastically declined. In 1991, it was estimated that in the US approximately 116,000 women admitted with acute episodes of preterm labour were treated each year with ritodrine, which is the first drug approved by the US FDA and still remains the standard therapy for treating preterm labour. Ritodrine (Yutopar( trade mark )) stimulates the beta(2)-adrenergic receptor throughout the body, causing an inhibitory action in different tissues that, among other side effects, also leads to an attenuation of uterine contractility. More recently, a new therapeutic agent, atosiban (Tractocile( trade mark )), a peptidic oxytocin receptor antagonist, has been introduced to the market. However, the use of the various pharmacological agents to treat preterm labour remains restricted, due to lack of uterine selectivity, low efficacy and potentially serious side effects for the mother or the foetus. Therefore, there is an urgent need to develop drugs with myometrial selectivity that would allow long-lasting inhibition of labour and prolong pregnancy up to a stage when good foetal maturation raises the chances of survival. One of the major obstacles hampering the development of new therapeutic agents is the marked inter-species difference in terms of preterm labour physiology, which complicates the preclinical evaluation of new candidate molecules in animal models of disease. In this review, the authors will provide a comprehensive update of past, current and new approaches for the management of preterm labour, including beta(2)-adrenergic agonists, calcium channel blockers, oxytocin antagonists, prostaglandin antagonists and other potential therapeutics. For each of the therapies used today, the review will cover the mechanism of action, benefit and adverse effects, and

Immersion in water during labour and birth.

PubMed

Cluett, Elizabeth R; Burns, Ethel; Cuthbert, Anna

2018-05-16

Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (18 July 2017), and reference lists of retrieved trials. We included randomised controlled trials (RCTs) comparing water immersion with no immersion, or other non-pharmacological forms of pain management during labour and/or birth in healthy low-risk women at term gestation with a singleton fetus. Quasi-RCTs and cluster-RCTs were eligible for inclusion but none were identified. Cross-over trials were not eligible for inclusion. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two review authors assessed the quality of the evidence using the GRADE approach. This review includes 15 trials conducted between 1990 and 2015 (3663 women): eight involved water immersion during the first stage of labour; two during the second stage only; four during the first and second stages of labour, and one comparing early versus late immersion during the first stage of labour. No trials evaluated different baths/pools, or third-stage labour management. All trials were undertaken in a hospital labour ward setting, with a varying degree of medical intervention considered as routine practice. No study was carried out in a midwifery-led care setting. Most trial authors did not specify the

Social Security Contribution to Productivity and Wages in Labour Organization Perspective

NASA Astrophysics Data System (ADS)

Supriadi, Y. N.

2017-03-01

This research is investigating the discrepancy fulfilment of the right to social security and decent wages to increase labour productivity in the perspective of labour organizations, in which the company provides social security, and wages have not been able to meet the needs of workers, on the other hand, the workers are always required to increase productivity. Therefore, this study aims to identify the social security and wages that affect labour productivity. So this research will provide input to the company to undertake effective measures and efficient for the company’s sustainability. This research was conducted using a survey method approach and quantitative data analysis techniques that are causal comparative sample of 223 respondents from 504 study population includes all labour organization’s District and municipal in Banten Province. The results showed the significant influence of social security and wages to increase labour productivity. Therefore, companies are required to act strategically in maintaining prohibitionists labour through re-design of the work environment, increase workers’ participation, intervention, and satisfy the needs of workers whose impact will be realized understanding between workers and companies in maintaining the company’s business.

Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.

PubMed

Novikova, Natalia; Hofmeyr, G Justus; Essilfie-Appiah, George

2012-09-12

Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. The objective of this review was to assess the effects of prophylactic amnioinfusion for women in labour with oligohydramnios, but not fetal heart deceleration, compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012). Randomised trials comparing prophylactic amnioinfusion in women in labour with oligohydramnios but not fetal heart rate deceleration in labour with therapeutic amnioinfusion. The authors assessed trial quality and extracted data. One randomized trial of 116 women was included. No differences were found in the rate of caesarean section (risk ratio 1.29, 95% confidence interval 0.60 to 2.74). There were no differences in cord arterial pH, oxytocin augmentation, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (risk ratio 3.48, 95% confidence interval 1.21 to 10.05). There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.

Sociodemographic differences in women's experience of early labour care: a mixed methods study.

PubMed

Henderson, Jane; Redshaw, Maggie

2017-07-13

To explore women's experiences of early labour care focusing on sociodemographic differences, and to examine the effect of antenatal education, using mixed methods. England, 2014. Women who completed postal questionnaires about their experience of maternity care, including questions about antenatal education, early labour and sociodemographic factors, included space for free-text comments. Worries about labour, contact with midwives in early labour and subsequent care. This study was based on secondary analysis of a national maternity survey carried out in England in 2014. Quantitative data were analysed using descriptive statistics and binary logistic regression; qualitative data were analysed using a thematic content analytic approach. Completed questionnaires were received from 4578 women (47% response rate). There were significant differences by sociodemographic factors, particularly ethnicity, in women's worries about early labour. Compared with white women, women from black or minority ethnic groups had an adjusted OR of 1.93 (95% CI 1.56 to 2.39) of feeling worried about not knowing when labour would start. Among women who contacted a midwife at the start of labour, 84% perceived their advice as appropriate, more in older and multiparous women. Overall, 64% of women were asked to come to the hospital at this time, more in multiparous women (adjusted OR 1.63, 95% CI 1.35 to 1.96). Those who did not have access to antenatal education experienced greater worry about early labour. Five themes emerged from the qualitative analysis: 'Differentiating between early and active labour', 'Staff attitudes', 'Not being allowed…', 'Previous labours' and 'Perceived consequences for women'. These findings reinforce the importance of providing reassurance to women in early labour, taking care that women do not feel neglected or dismissed. In particular, primiparous and ethnic minority women reported greater worry about early labour and require additional reassurance. �

First-time mothers' experiences of early labour in Italian maternity care services.

PubMed

Cappelletti, Giulia; Nespoli, Antonella; Fumagalli, Simona; Borrelli, Sara E

2016-03-01

The aim of this study is to explore first-time mothers' experiences of early labour in Italian maternity care services when admitted to hospital or advised to return home after maternity triage assessment. The study was conducted in a second-level maternity hospital in northern Italy with an obstetric unit for both low- and high-risk women. The participants included 15 first-time mothers in good general health with spontaneous labour at term of a low-risk pregnancy who accessed maternity triage during early labour, and were either admitted to hospital or advised to return home. A qualitative interpretive phenomenological study was conducted. A face-to-face recorded semi-structured interview was conducted with each participant 48-72h after birth. Four key themes emerged from the interviews: (a) recognising signs of early labour; (b) coping with pain at home; (c) seeking reassurance from healthcare professionals; and (d) being admitted to hospital versus returning home. Uncertainty about the progression of labour and the need for reassurance were cited by women as the main reasons for hospital visit in early labour. An ambivalent feeling was reported by the participants when admitted to hospital in early labour. In fact, while the women felt reassured in the first instance, some women subsequently felt dissatisfied due to the absence of one-to-one dedicated care during early labour. When advised to return home, a number of women reported feelings of disappointment, anger, fear, discouragement and anxiety about not being admitted to hospital; however, some of these women reported a subsequent feeling of comfort due to being at home and putting in place the suggestions made by the midwives during the maternity triage assessment. The guidance provided by midwives during triage assessment seemed to be the key factor influencing women׳s satisfaction when advised either to return home or to stay at the hospital during early labour. During antenatal classes and clinics

Complementary and alternative therapies for pain management in labour.

PubMed

Smith, C A; Collins, C T; Cyna, A M; Crowther, C A

2006-10-18

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. To examine the effects of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006) and CINAHL (1980 to February 2006). The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies (but not biofeedback) with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included. Meta-analysis was performed using relative risks for dichotomous outcomes and mean differences for continuous outcomes. The outcome measures were maternal satisfaction, use of pharmacological pain relief and maternal and neonatal adverse outcomes. Fourteen trials were included in the review with data reporting on 1537 women using different modalities of pain management; 1448 women were included in the meta-analysis. Three trials involved acupuncture (n = 496), one audio-analgesia (n = 24), two trials acupressure (n = 172), one aromatherapy (n = 22), five trials hypnosis (n = 729), one trial of massage (n = 60), and relaxation (n = 34). The trials of acupuncture showed a decreased need for pain relief (relative risk (RR) 0.70, 95% confidence interval (CI) 0.49 to 1.00, two trials 288 women). Women taught self-hypnosis had decreased requirements for pharmacological

Exploiting Patient Labour at Kew Cottages, Australia, 1887-1950

ERIC Educational Resources Information Center

Monk, Lee-Ann

2010-01-01

This article examines the exploitation of patient labour at Kew Cottages, Australia's first purpose-built state institution for people with learning disabilities. Analysing historical evidence for the period 1887-1950 shows that unpaid patient labour contributed significantly to the economy of the Cottages and so to the government department of…

International labour migration statistics in Asia: an appraisal.

PubMed

Athukorala, P C; Wickramasekara, P

1996-01-01

"The present paper attempts a critical review of the data systems of seven major labour-exporting countries--Bangladesh, India, Indonesia, Pakistan, Philippines, Sri Lanka and Thailand--which account for over 90 per cent of labour outflows from Asia....Data...are discussed under separate sections focusing on limitations as well as potential for further exploitation.... For all countries reviewed here, these data significantly understate total labour outflows, and the magnitude of the error seems to vary between countries and reflect both differences relating to the coverage and efficiency of the approval and monitoring procedure. This throws serious doubts on the appropriateness of official outmigration series for cross country comparison. Frequent changes in reporting procedures also make for discrete changes and spurious shifts in data which render trend analysis quite hazardous." (SUMMARY IN FRE AND SPA) excerpt

Restricting oral fluid and food intake during labour.

PubMed

Singata, Mandisa; Tranmer, Joan; Gyte, Gillian M L

2013-08-22

Restricting fluids and foods during labour is common practice across many birth settings with some women only being allowed sips of water or ice chips. Restriction of oral intake may be unpleasant for some women, and may adversely influence their experience of labour. To determine the benefits and harms of oral fluid or food restriction during labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2013) and reference lists of retrieved studies. Randomised controlled trials (RCTs) and quasi-RCTs of restricting fluids and food for women in labour compared with women free to eat and drink. Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We identified 19 studies of which we included five, involving 3130 women. We excluded eight studies, one awaits classification and five are ongoing studies. All the included studies looked at women in active labour and at low risk of potentially requiring a general anaesthetic. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.When comparing any restriction of fluids and food versus women given some nutrition in labour, the meta-analysis was dominated by one study undertaken in a highly medicalised environment. There were no statistically significant differences identified in: caesarean section (average risk ratio (RR) 0.89, 95% confidence interval (CI) 0.63 to 1.25, five studies, 3103 women), operative vaginal births (average RR 0.98, 95% CI 0.88 to 1.10, five studies, 3103 women) and Apgar scores less than seven at five minutes (average RR 1.43, 95% CI 0.77 to 2.68, four studies, 2902 infants), nor in any of the other outcomes assessed. Women's views were not assessed. The pooled data were insufficient to assess the

Understanding your supply chain to reduce the risk of supply chain disruption.

PubMed

Wildgoose, Nick; Brennan, Patrick; Thompson, Simon

2012-01-01

Supply chains are at the heart of the way in which organisations operate and compete today; they also play a critical role in overall organisation performance. In the context of increasingly complex and global supply chains, the actions taken to drive down costs are likely to drive risk into the supply chain. The frequency of supply chain disruptions is high and this paper offers practical advice to help reduce the frequency and cost associated with these. There is advice to help with the understanding of how to identify critical suppliers. The reader is guided through comprehensive risk assessment and mitigation approaches and a selection of practical risk solutions and tools that you can use is described. There is a section on the 'dos and don'ts' relating to supplier due diligence. For those organisations facing the challenge of drawing up a business case relating to investment in improving supply chain resiliency, there is also a section outlining some of the business benefits of improving supply chain resiliency.

Chronic disease and labour force participation among older Australians.

PubMed

Schofield, Deborah J; Shrestha, Rupendra N; Passey, Megan E; Earnest, Arul; Fletcher, Susan L

2008-10-20

To examine the association between long-term health conditions and being out of the labour force among older Australians. Retrospective analysis of cross-sectional data from the Australian Bureau of Statistics 2003 Survey of Disability, Ageing and Carers for people aged 45-64 years. Rates of premature retirement associated with ill health; odds ratios of being out of the labour force associated with each long-term health condition and number of conditions; weighted population estimates; estimates of gross domestic product lost as a result. 9198 people surveyed were aged 45-64 years, 3010 of whom were not in the labour force. Of these, 1373 (45.6%) had retired because of a chronic health condition, most commonly a back problem (10.4%), or arthritis and related disorders (8.6%). When adjusted for age and sex, all conditions studied except diseases of the ear and mastoid process, other endocrine/nutritional and metabolic disorders, noise-induced deafness or hearing loss, and high cholesterol were significantly associated with being out of the labour force. Extrapolating from these results, an estimated 663 235 older Australians were not working because of ill health, reducing Australia's gross domestic product by around $14.7 billion per annum. Prevention of long-term health conditions may help older Australians remain in the labour force longer, thereby increasing revenue to fund health care for the ageing population.

China: surplus labour and migration.

PubMed

Banister, J; Taylor, J R

1989-12-01

Surplus labor force and migration trends in China are examined, with emphasis on the impact of underemployment in rural areas. "Government policy encourages surplus labourers to transfer out of crop farming into agricultural sidelines or non-agricultural work. Peasants are urged to stay where they are, shifting jobs without shifting location; however, many rural areas are poorly endowed for providing alternative employment, so their surplus workers must also leave the village to find work. Many do not formally migrate, but rather move on a seasonal basis or set up 'temporary' residence in an urban place. This 'floating' population has been escalating rapidly in recent years....[The authors argue] that China's cities and towns can absorb millions of surplus labourers from rural areas each year, to the mutual benefit of sending and receiving areas." excerpt

Combining scientific and societal challenges: a water supply case study from the Koster Islands, Sweden

NASA Astrophysics Data System (ADS)

Barthel, Roland; Ekström, Linda Louise; Ljungkvist, Andreas; Granberg, Maria; Merisalu, Johanna; Pokorny, Sebastian; Banzhaf, Stefan

2017-04-01

Until now, groundwater in coastal areas has not received much attention in Sweden, neither from water authorities nor the research community. Extractable volumes from bedrock aquifers are too small for the public water supply of larger permanent settlements. However, of the 450,000 private wells in Sweden, many are located in attractive coastal areas or on islands, creating pressure on groundwater resources during the summer months as periods with low or no natural groundwater recharge. This situation is exacerbated as municipalities receive increasing applications to build summerhouses, or to convert existing ones into permanent residencies. In view of such rising demands, as well as the growing awareness of potential environmental impacts and climate change, Swedish municipalities recognize groundwater usage in coastal areas is a major concern. However, the responsibility for private wells is left almost exclusively to their owners, and obligations in the water sector are distributed over a wide range of authorities which operate on local, regional, and national scales (1). Therefore, it remains unclear how to deal with and administer the related challenging questions which are of varying legal, social, economic, environmental, and hydrological natures. Here, we present intermediate results of an ongoing investigation on the "Koster" archipelago which forms an "in-a-nutshell" example of a coastal zone with such groundwater use. With around 300 annual permanent residents, but up to 6000 summer overnight guests in peak season, water supply, largely based on 800 private wells, is at its limit. Water availability forms an obstacle to future development and even the current operation is considered unsustainable, leaving the municipality to decide how to secure future supply. The municipality favors a "large scale technical solution" (either a pipeline from the mainland or a large desalination plant) while many locals prefer to keep the existing private wells. While

Born in another country: women's experience of labour and birth in Queensland, Australia.

PubMed

Hennegan, Julie; Redshaw, Maggie; Miller, Yvette

2014-06-01

Women born outside Australia make up more than a fifth of the Queensland birthing population and like migrants in other parts of the world face the challenges of cultural dislocation and possible language barriers. Recognising that labour and birth are major life events the aim was to investigate the experiences of these women in comparison to native-born English speaking women. Secondary analysis of data from a population based survey of women who had recently birthed in Queensland. Self-reported clinical outcomes and quality of interpersonal care of 481 women born outside Australia who spoke a language other than English at home were compared with those of 5569 Australian born women speaking only English. After adjustment for demographic factors and type of birthing facility, women born in another country were less likely to be induced, but more likely to have constant electronic fetal monitoring (EFM), to give birth lying on their back or side, and to have an episiotomy. Most women felt that they were treated as an individual and with kindness and respect. However, women born outside Australia were less likely to report being looked after 'very well' during labour and birth and to be more critical of some aspects of care. In comparing the labour and birth experiences of women born outside the country who spoke another language with native-born English speaking women, the present study presents a largely positive picture. However, there were some marked differences in both clinical and interpersonal aspects of care. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Aromatherapy for pain management in labour.

PubMed

Smith, Caroline A; Collins, Carmel T; Crowther, Caroline A

2011-07-06

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of aromatherapy for pain management in labour. To examine the effects of aromatherapy for pain management in labour on maternal and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2010), The Cochrane Complementary Medicine Field's Trials Register (October 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 4), MEDLINE (1966 to 31 October 2010), CINAHL (1980 to 31 October 2010), the Australian and New Zealand Trials Registry (31 October 2010), Chinese Clinical Trial Register (31 October 2010), Current Controlled Trials (31 October 2010), ClinicalTrials.gov (31 October 2010), ISRCTN Register (31 October 2010), National Center for Complementary and Alternative Medicine (NCCAM) (31 October 2010) and the WHO International Clinical Trials Registry Platform (31 October 2010). Randomised controlled trials comparing aromatherapy with placebo, no treatment or other non-pharmacological forms of pain management in labour. Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We included two trials (535 women) in the review. The trials found no difference between groups for the primary outcomes of pain intensity, assisted vaginal birth (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.48 to 2.28, one trial, 513 women; RR 0.83, 95% CI 0.06 to 11.70, one trial, 22 women), and caesarean section (RR 0.98, 95% CI 0.49 to 1.94, one trial, 513 women; RR 2.54, 95% CI 0.11 to 56.25, one trial, 22 women); there were more babies admitted to neonatal intensive care in the control group of one trial (RR 0.08, 95% CI 0.00 to 1.42, one trial, 513 women) but this

The Impact of Learning on Women's Labour Market Transitions

ERIC Educational Resources Information Center

Haasler, Simone R.

2014-01-01

Women play an increasingly important role in the labour market and as wage earners. Moreover, in many countries, young women have outperformed men in terms of educational attainment and qualification. Still, women's human capital investment does not pay off as it does for men as they are still significantly disadvantaged on the labour market.…

Global Skills and Mobility Challenges and Possibilities for VET: A Crossborder Cross-Sectoral Case Study

ERIC Educational Resources Information Center

Cameron, Roslyn; O'Hanlon-Rose, Terry

2011-01-01

The complex interplay of technological advances, global demographic trends and macroeconomic forces has seen the emergence of global markets, economies, supply chains and labour markets. The use of skilled migration policy and initiatives for many countries feeling the effects of aging populations and skill shortages adds another dimension to this…

Labour market income inequality and mortality in North American metropolitan areas.

PubMed

Sanmartin, C; Ross, N A; Tremblay, S; Wolfson, M; Dunn, J R; Lynch, J

2003-10-01

To investigate relations between labour market income inequality and mortality in North American metropolitan areas. An ecological cross sectional study of relations between income inequality and working age (25-64 years) mortality in 53 Canadian (1991) and 282 US (1990) metropolitan areas using four measures of income inequality. Two labour market income concepts were used: labour market income for households with non-trivial attachment to the labour market and labour market income for all households, including those with zero and negative incomes. Relations were assessed with weighted and unweighted bivariate and multiple regression analyses. US metropolitan areas were more unequal than their Canadian counterparts, across inequality measures and income concepts. The association between labour market income inequality and working age mortality was robust in the US to both the inequality measure and income concept, but the association was inconsistent in Canada. Three of four inequality measures were significantly related to mortality in Canada when households with zero and negative incomes were included. In North American models, increases in earnings inequality were associated with hypothetical increases in working age mortality rates of between 23 and 33 deaths per 100 000, even after adjustment for median metropolitan incomes. This analysis of labour market inequality provides more evidence regarding the robust nature of the relation between income inequality and mortality in the US. It also provides a more refined understanding of the nature of the relation in Canada, pointing to the role of unemployment in generating Canadian metropolitan level health inequalities.

Elective induction versus spontaneous labour in Latin America

PubMed Central

Guerra, Gláucia Virgínia; Souza, João Paulo; Faúndes, Aníbal; Morais, Sirlei Siani; Gülmezoglu, Ahmet Metin; Passini, Renato; Parpinelli, Mary Angela; Carroli, Guillermo

2011-01-01

Abstract Objective To assess the frequency of elective induction of labour and its determinants in selected Latin America countries; quantify success in attaining vaginal delivery, and compare rates of caesarean and adverse maternal and perinatal outcomes after elective induction versus spontaneous labour in low-risk pregnancies. Methods Of 37 444 deliveries in women with low-risk pregnancies, 1847 (4.9%) were electively induced. The factors associated with adverse maternal and perinatal outcomes among cases of spontaneous and induced onset of labour were compared. Odds ratios for factors potentially associated with adverse outcomes were calculated, as were the relative risks of having an adverse maternal or perinatal outcome (both with their 95% confidence intervals). Adjustment using multiple logistic regression models followed these analyses. Findings Of 11 077 cases of induced labour, 1847 (16.7%) were elective. Elective inductions occurred in 4.9% of women with low-risk pregnancies (37 444). Oxytocin was the most common method used (83% of cases), either alone or combined with another. Of induced deliveries, 88.2% were vaginal. The most common maternal adverse events were: (i) a higher postpartum need for uterotonic drugs, (ii) a nearly threefold risk of admission to the intensive care unit; (iii) a fivefold risk of postpartum hysterectomy, and (iv) an increased need for anaesthesia/analgesia. Perinatal outcomes were satisfactory except for a 22% higher risk of delayed breastfeeding (i.e. initiation between 1 hour and 7 days postpartum). Conclusion Caution is mandatory when indicating elective labour induction because the increased risk of maternal and perinatal adverse outcomes is not outweighed by clear benefits. PMID:21897486

School Supplies on a Budget

ERIC Educational Resources Information Center

Dyrli, Kurt O.

2008-01-01

This article reports on the challenge that parents, teachers, and district administrators face in continuing to provide essential school supplies to their students despite budget cuts. At the Verona Area (Wisconsin) School District, administrators, teachers, and parents have recently faced this common challenge. Increasingly dependent on funding…

[Situations regarding the labour market for people suffering from chronic diseases].

PubMed

Saliba, B; Paraponaris, A; Ventelou, B

2007-08-01

This paper is aimed at investigating the extents to which illness modifies labour supply and employment conditions of people with chronic diseases (defined as severe diseases giving rise to 100% coverage of health expenditures by the Sickness Fund). It is based on the data of 35073 individuals interviewed in the 2002-2003 French Decennial Health Survey, reporting their health, health care consumption and socioeconomic characteristics, and collected by the French National Institute of Statistics and Economic Studies. Models have been estimated with logistic strategies. Participation in labour market appears, all other things being equal, to be less important for people with chronic diseases. Chronic diseases are more deleterious for blue collar than for white collars workers. The probability to have a part-time job is raised by 60% for people with chronic diseases (100% for men, 50% for women). Suffering from chronic diseases raises the probability to have a desired part-time job rather than a full-time job by 80% (170% for men, 60% for women) and the probability to have an undesired part-time job rather than a full-time job by 50% (30% for men, 50% for women). For the elderly (50-65 years), chronic diseases multiply by three the probability to be out-of-work (and not retired), by two the probability to be retired and by 1.5 the probability to be unemployed compared to being employed. The consequences of chronic diseases on the workplace are not negligible, creating new social inequalities that the French social protection system does not seem to be able to completely cover.

Massage, reflexology and other manual methods for pain management in labour.

PubMed

Smith, Caroline A; Levett, Kate M; Collins, Carmel T; Jones, Leanne

2012-02-15

Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of manual healing methods including massage and reflexology for pain management in labour. To examine the effects of manual healing methods including massage and reflexology for pain management in labour on maternal and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2 of 4), MEDLINE (1966 to 30 June 2011), CINAHL (1980 to 30 June 2011), the Australian and New Zealand Clinical Trial Registry (30 June 2011), Chinese Clinical Trial Register (30 June 2011), Current Controlled Trials (30 June 2011), ClinicalTrials.gov, (30 June 2011) ISRCTN Register (30 June 2011), National Centre for Complementary and Alternative Medicine (NCCAM) (30 June 2011) and the WHO International Clinical Trials Registry Platform (30 June 2011). Randomised controlled trials comparing manual healing methods with standard care, no treatment, other non-pharmacological forms of pain management in labour or placebo. Two authors independently assessed trial quality and extracted data. We attempted to contact study authors for additional information. We included six trials, with data reporting on five trials and 326 women in the meta-analysis. We found trials for massage only. Less pain during labour was reported from massage compared with usual care during the first stage of labour (standardised mean difference (SMD) -0.82, 95% confidence interval (CI) -1.17 to -0.47), four trials, 225 women), and labour pain was reduced in one trial of massage compared with music (risk ratio (RR) 0.40, 95% CI 0.18 to 0.89, 101 women). One trial of massage compared with usual care found reduced anxiety during

Hypnosis for pain management during labour and childbirth.

PubMed

Madden, Kelly; Middleton, Philippa; Cyna, Allan M; Matthewson, Mandy; Jones, Leanne

2012-11-14

This review is one in a series of Cochrane Reviews investigating pain management for childbirth. These reviews all contribute to an overview of systematic reviews of pain management for women in labour, and share a generic protocol. We examined the current evidence regarding the use of hypnosis for pain management during labour and childbirth. This review updates the findings regarding hypnosis from an earlier review of complementary and alternative therapies for pain management in labour into a stand-alone review. To examine the effectiveness and safety of hypnosis for pain management during labour and childbirth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (11 January 2012) and the reference lists of primary studies and review articles. Randomised controlled trials and quasi-randomised controlled trials comparing preparation for labour using hypnosis and/or use of hypnosis during labour, with or without concurrent use of pharmacological or non-pharmacological pain relief methods versus placebo, no treatment or any analgesic drug or technique. Two assessors independently extracted data and assessed trial quality. Where possible we contacted study authors seeking additional information about data and methodology. We included seven trials randomising a total of 1213 women. All but one of the trials were at moderate to high risk of bias. Although six of the seven trials assessed antenatal hypnotherapy, there were considerable differences between these trials in timing and technique. One trial provided hypnotherapy during labour. No significant differences between women in the hypnosis group and those in the control group were found for the primary outcomes: use of pharmacological pain relief (average risk ratio (RR) 0.63, 95% confidence interval (CI) 0.39 to 1.01, six studies, 1032 women), spontaneous vaginal birth (average RR 1.35, 95% CI 0.93 to 1.96, four studies, 472 women) or satisfaction with pain relief (RR 1.06, 95% CI 0.94 to 1

Emotional Labour of Caregivers Confronted With Aggressive Brain-injured Patients.

PubMed

Huet, Magali; Dany, Lionel; Apostolidis, Thémistoklis

2018-06-01

Aggressive behaviours are common with people who have suffered brain injuries and induce difficult emotions among certified nursing assistants and medical-psychological assistants who take care of them. These caregivers carry out emotional labour whose content and strategies are little known. The study explores the emotional labour of certified nursing assistants and medical-psychological assistants faced with the aggressive behaviours of brain-injured patients. Semi-structured interviews were conducted with 37 caregivers. Interviews were analysed via a thematic content analysis. The analysis shows that the emotional labour of caregivers varies in accordance with the state of "consciousness" or "non-consciousness" that they attribute to the brain-injured patient with regard to this aggressive behaviour. This is a deep acting strategy. Moreover, caregivers shut off their emotions in order not to transmit them to the patient. This surface acting has the first objective for the caregiver of maintaining control of the situation and a second objective of protecting the patient emotionally and therefore of being perceived as a "good" caregiver. Emotional labour also meets a need to preserve the professional self-image and professional status negatively affected in the interaction with the aggressive brain-injured patient. Our study specifies the different strategies of the emotional labour of caregivers and their circumstances of use when they are confronted with aggressive behaviour by brain-injured patients. Targeted support for this emotional labour, such as training and practical analysis, is essential for the development of care practices promoting a caring relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

Incoherence in the South African Labour Market for Intermediate Skills

ERIC Educational Resources Information Center

Kraak, Andre

2008-01-01

This article is concerned with the production and employment of technically skilled labour at the intermediate level in South Africa. Three differing labour market pathways to intermediate skilling are identified. These are: the traditional apprenticeship route, the new "Learnerships" pathway (similar to the "modern…

Reductions in labour capacity from heat stress under climate warming

NASA Astrophysics Data System (ADS)

Dunne, John P.; Stouffer, Ronald J.; John, Jasmin G.

2013-06-01

A fundamental aspect of greenhouse-gas-induced warming is a global-scale increase in absolute humidity. Under continued warming, this response has been shown to pose increasingly severe limitations on human activity in tropical and mid-latitudes during peak months of heat stress. One heat-stress metric with broad occupational health applications is wet-bulb globe temperature. We combine wet-bulb globe temperatures from global climate historical reanalysis and Earth System Model (ESM2M) projections with industrial and military guidelines for an acclimated individual's occupational capacity to safely perform sustained labour under environmental heat stress (labour capacity)--here defined as a global population-weighted metric temporally fixed at the 2010 distribution. We estimate that environmental heat stress has reduced labour capacity to 90% in peak months over the past few decades. ESM2M projects labour capacity reduction to 80% in peak months by 2050. Under the highest scenario considered (Representative Concentration Pathway 8.5), ESM2M projects labour capacity reduction to less than 40% by 2200 in peak months, with most tropical and mid-latitudes experiencing extreme climatological heat stress. Uncertainties and caveats associated with these projections include climate sensitivity, climate warming patterns, CO2 emissions, future population distributions, and technological and societal change.

The Right to Education for Children in Domestic Labour: Empirical Evidence from Kenya

NASA Astrophysics Data System (ADS)

Munene, Ishmael I.; Ruto, Sara J.

2010-02-01

Since 1948, various UN conventions have recognised basic education as a human right. Yet this right continues to be denied to many child labourers across the world. This articles draws on the results of a study examining how children in domestic labour in Kenya access and participate in education. Three issues were explored: (1) the correlates of child domestic labourers; (2) their working conditions and contexts; and (3) the right to education. Interviews and group discussions held in one city and two rural districts elicited data from 91 child domestic labourers and 84 adults. The results indicated that child labour was both poverty-induced and adult-initiated, and that children worked in hazardous environments characterised by economic exploitation. Most did not attend school; those who did had to contend with a rigid school structure and an authoritarian class environment. Children in domestic labour often skipped school, and their participation in classes was low.

From Labour Market to Labour Process: Finding a Basis for Curriculum in TVET

ERIC Educational Resources Information Center

Gamble, Jeanne

2016-01-01

In the sociology of education the relation between education and work is analysed in many ways and, since the rise of neoliberalism, increasingly in market terms. Skills are the dominant labour market currency, described in terms of competence profiles that seek to link educational qualifications directly to work. Contrary to the widespread appeal…

Maintaining power: women's experiences from labour onset before admittance to maternity ward.

PubMed

Carlsson, Ing-Marie; Ziegert, Kristina; Sahlberg-Blom, Eva; Nissen, Eva

2012-02-01

In Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward. Interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used. 'Maintaining power' was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: 'to share the experience with another', 'to listen to the rhythm of the body', 'to distract oneself' and 'to be encased in a glass vessel', explained how the women coped and thereby maintained power. The first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process. Copyright © 2010 Elsevier Ltd. All rights reserved.

Intrauterine resuscitation during the second stage of term labour by maternal hyperoxygenation versus conventional care: study protocol for a randomised controlled trial (INTEREST O2).

PubMed

Bullens, Lauren M; Hulsenboom, Alexandra D J; Moors, Suzanne; Joshi, Rohan; van Runnard Heimel, Pieter J; van der Hout-van der Jagt, M Beatrijs; van den Heuvel, Edwin R; Guid Oei, S

2018-03-23

Perinatal asphyxia is, even in developed countries, one the major causes of neonatal morbidity and mortality. Therefore, if foetal distress during labour is suspected, one should try to restore foetal oxygen levels or aim for immediate delivery. However, studies on the effect of intrauterine resuscitation during labour are scarce. We designed a randomised controlled trial to investigate the effect of maternal hyperoxygenation on the foetal condition. In this study, maternal hyperoxygenation is induced for the treatment of foetal distress during the second stage of term labour. This study is a single-centre randomised controlled trial being performed in a tertiary hospital in The Netherlands. From among cases of a suboptimal or abnormal foetal heart rate pattern during the second stage of term labour, a total of 116 patients will be randomised to the control group, where normal care is provided, or to the intervention group, where before normal care 100% oxygen is supplied to the mother by a non-rebreathing mask until delivery. The primary outcome is change in foetal heart rate pattern. Secondary outcomes are Apgar score, mode of delivery, admission to the neonatal intensive care unit and maternal side effects. In addition, blood gas values and malondialdehyde are determined in umbilical cord blood. This study will be the first randomised controlled trial to investigate the effect of maternal hyperoxygenation for foetal distress during labour. This intervention should be recommended only as a treatment for intrapartum foetal distress, when improvement of the foetal condition is likely and outweighs maternal and neonatal side effects. EudraCT, 2015-001654-15; registered on 3 April 2015. Dutch Trial Register, NTR5461; registered on 20 October 2015.

Outcomes of elective induction of labour compared with expectant management: population based study

PubMed Central

Ferguson, Evelyn; Duffy, Andrew; Ford, Ian; Chalmers, James; Norman, Jane E

2012-01-01

Objective To determine neonatal outcomes (perinatal mortality and special care unit admission) and maternal outcomes (mode of delivery, delivery complications) of elective induction of labour compared with expectant management. Design Retrospective cohort study using an unselected population database. Setting Consultant and midwife led obstetric units in Scotland 1981-2007. Participants 1 271 549 women with singleton pregnancies of 37 weeks or more gestation. Interventions Outcomes of elective induction of labour (induction of labour with no recognised medical indication) at 37, 38, 39, 40, and 41 weeks’ gestation compared with those of expectant management (continuation of pregnancy to either spontaneous labour, induction of labour or caesarean section at a later gestation). Main outcome measures Extended perinatal mortality, mode of delivery, postpartum haemorrhage, obstetric anal sphincter injury, and admission to a neonatal or special care baby unit. Outcomes were adjusted for age at delivery, parity, year of birth, birth weight, deprivation category, and, where appropriate, mode of delivery. Results At each gestation between 37 and 41 completed weeks, elective induction of labour was associated with a decreased odds of perinatal mortality compared with expectant management (at 40 weeks’ gestation 0.08% (37/44 764) in the induction of labour group versus 0.18% (627/350 643) in the expectant management group; adjusted odds ratio 0.39, 99% confidence interval 0.24 to 0.63), without a reduction in the odds of spontaneous vertex delivery (at 40 weeks’ gestation 79.9% (35 775/44 778) in the induction of labour group versus 73.7% (258 665/350 791) in the expectant management group; adjusted odds ratio 1.26, 1.22 to 1.31). Admission to a neonatal unit was, however, increased in association with elective induction of labour at all gestations before 41 weeks (at 40 weeks’ gestation 8.0% (3605/44 778) in the induction of labour group compared

Labour analgesia with intrathecal fentanyl decreases maternal stress.

PubMed

Cascio, M; Pygon, B; Bernett, C; Ramanathan, S

1997-06-01

Lumbar epidural analgesia (LEA) decreases maternal stress as measured by maternal circulating plasma catecholamine concentrations. Intrathecal fentanyl (ITF) provides effective labour analgesia but its effect on maternal epinephrine (Epi) and norepinephrine (NE) concentrations is not known. This study assesses whether ITF reduces maternal stress in the same manner as conventional LEA. Twenty-four healthy women in active labour received either 25 micrograms ITF (n = 12) or epidural lidocaine 1.5% (n = 12) for analgesia. Venous blood samples were collected before anaesthesia and at five minute intervals for 30 min following anaesthesia for the measurement of plasma Epi and NE by high performance liquid chromatography. Maternal blood pressure (BP), heart rate (HR), visual analog scores (VAS) to pain and pruritus were recorded at the same time. Both ITF and LEA decreased pain VAS scores, maternal BP, and plasma Epi concentrations with only minimal effects on plasma NE concentrations. Intrathecal fentanyl (ITF) and LEA reduced plasma epi to a similar extent, with ITF reducing the levels slightly faster than LEA. Intrathecal fentanyl(ITF) and LEA reduced plasma Epi concentrations by 52% and 51%, respectively (P value < 0.01). We conclude that ITF is as effective as LEA in producing pain relief in the labouring patient. Intrathecal Fentanyl (ITF) is also capable of reducing maternal plasma epinephrine concentration, thus avoiding the possibly deleterious side effects of excess amounts of this catecholamine during labour.

Performing Labour in Look Left Look Right's "Above and Beyond"

ERIC Educational Resources Information Center

Alston, Adam

2015-01-01

This article looks at the theme of "performing labour" in Look Left Look Right's "Above and Beyond" (2013). In this performance, individual audience members participate as a generic staff member in a fully functioning five star hotel in London. I consider three modes of performing labour in "Above and Beyond":…

The influence of labour on the pharmacokinetics of intravenously administered amoxicillin in pregnant women

PubMed Central

Muller, Anouk E; Dörr, P Joep; Mouton, Johan W; De Jongh, Joost; Oostvogel, Paul M; Steegers, Eric A P; Voskuyl, Rob A; Danhof, Meindert

2008-01-01

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECTExamples exist that pharmacokinetics of drugs in pregnant women can differ from that in non-pregnant individuals.In pregnant women before the onset of labour, the pharmacokinetics of amoxicillin is similar to that in non-pregnant individuals, but for women during labour this is unknown. WHAT THIS STUDY ADDSLabour influences the pharmacokinetics of amoxicillin.During labour and even more in the immediate postpartum period, the peripheral volume of distribution was decreased compared with pregnant women before the onset of labour.The volume of distribution increases with an increasing amount of oedema. AIMS Many physiological changes take place during pregnancy and labour. These might change the pharmacokinetics of amoxicillin, necessitating adjustment of the dose for prevention of neonatal infections. We investigated the influence of labour on the pharmacokinetics of amoxicillin. METHODS Pregnant women before and during labour were recruited and treated with amoxicillin intravenously. A postpartum dose was offered. Blood samples were obtained and amoxicillin concentrations were determined using high-pressure liquid chromatography. The pharmacokinetics were characterized by nonlinear mixed-effects modelling using NONMEM. RESULTS The pharmacokinetics of amoxicillin in 34 patients was best described by a three-compartment model. Moderate interindividual variability was identified in CL, central and peripheral volumes of distribution. The volume of distribution (V) increased with an increasing amount of oedema. Labour influenced the parameter estimate of peripheral volume of distribution (V2). V2 was decreased during labour, and even more in the immediate postpartum period. For all patients the population estimates (mean ± SE) for CL and V were 21.1 ± 4.1 l h−1 (CL), 8.7 ± 6.6 l (V1), 11.8 ± 7.7 l (V2) and 20.5 ± 15.4 l (V3) respectively. CONCLUSIONS The peripheral distribution volume of amoxicillin in pregnant women during

Computing Careers and Irish Higher Education: A Labour Market Anomaly

ERIC Educational Resources Information Center

Stephens, Simon; O'Donnell, David; McCusker, Paul

2007-01-01

This paper explores the impact of developments in the Irish economy and labour market on computing course development in the higher education (HE) sector. Extant computing courses change, or new courses are introduced, in attempts to match labour market demands. The conclusion reached here, however, is that Irish HE is producing insufficient…

Stress, pre-term labour and birth outcomes.

PubMed

MacKey, M C; Williams, C A; Tiller, C M

2000-09-01

Stress, pre-term labour and birth outcomes Preliminary studies have suggested that stress may be associated with the onset, treatment and outcomes of pre-term labour; however, a systematic comparison of the stress of women with and without pre-term labour has not been reported. Therefore, the purpose of this exploratory study was to compare the stress (daily hassles and mood states) and birth outcomes of black and white women who experienced pre-term labour (PTL) during pregnancy with those who did not. The convenience sample consisted of 35 pregnant women hospitalized in 1996-1997 for the treatment of PTL (24-35 weeks gestation) and 35 controls matched on age, race, parity, gestational age and method of hospital payment. Women in the PTL group had significantly higher tension-anxiety and depression-dejection on the Profile of Mood States (POMS), lower mean birthweight and mean gestational age, and a higher percentage of babies born <37 weeks and weighing 2500 g or less. Black women in the PTL group and white women in the control group had significantly higher scores on the fatigue sub-scale of the POMS and the work and future security sub-scales of the Daily Hassles Scale. Women in the PTL group whose babies weighed 2500 g or less had significantly higher scores on the health, inner concern and financial responsibility sub-scales of the Daily Hassles Scale. The findings from this study indicate the need for further exploration of the interaction of race and stress in understanding and preventing PTL and low birthweight and the need to examine the role of social support in preventing pre-term birth after an episode of PTL.

South Carolina Shipyards: Labour, Logistics, Lumber and Ladies

NASA Astrophysics Data System (ADS)

Harris, Lynn

2010-10-01

Southern shipyards, like Hobcaw and Mars Bluff, were established at locations chosen primarily for convenient access to transportation networks, building materials, clientele and labour. The historical record reveals a home front role played by local plantation owners and slaves as shipyard labour. Women served as project fundraisers, shipyard dilettantes, shipwright’s wives and possibly slave mistresses with a paucity of material culture to confirm their presence in the archaeological record. Archaeological investigations on land and underwater yield evidence of artefacts associated with diet, shipbuilding, warfare and ethnicity.

Online detection of fetal acidemia during labour by testing synchronization of EEG and heart rate: a prospective study in fetal sheep.

PubMed

Wang, Xiaogang; Durosier, L Daniel; Ross, Michael G; Richardson, Bryan S; Frasch, Martin G

2014-01-01

Severe fetal acidemia during labour can result in life-lasting neurological deficits, but the timely detection of this condition is often not possible. This is because the positive predictive value (PPV) of fetal heart rate (FHR) monitoring, the mainstay of fetal health surveillance during labour, to detect concerning fetal acidemia is around 50%. In fetal sheep model of human labour, we reported that severe fetal acidemia (pH<7.00) during repetitive umbilical cord occlusions (UCOs) is preceded ∼60 minutes by the synchronization of electroencephalogram (EEG) and FHR. However, EEG and FHR are cyclic and noisy, and although the synchronization might be visually evident, it is challenging to detect automatically, a necessary condition for bedside utility. Here we present and validate a novel non-parametric statistical method to detect fetal acidemia during labour by using EEG and FHR. The underlying algorithm handles non-stationary and noisy data by recording number of abnormal episodes in both EEG and FHR. A logistic regression is then deployed to test whether these episodes are significantly related to each other. We then apply the method in a prospective study of human labour using fetal sheep model (n = 20). Our results render a PPV of 68% for detecting impending severe fetal acidemia ∼60 min prior to pH drop to less than 7.00 with 100% negative predictive value. We conclude that this method has a great potential to improve PPV for detection of fetal acidemia when it is implemented at the bedside. We outline directions for further refinement of the algorithm that will be achieved by analyzing larger data sets acquired in prospective human pilot studies.

Emotional Labour in University Lecturers: Considerations for Higher Education Institutions

ERIC Educational Resources Information Center

Berry, Karen; Cassidy, Simon

2013-01-01

Emotional labour is a state that exists when there is a discrepancy between the emotional demeanour that an individual displays and the genuinely felt emotions that would be inappropriate to display (Mann 1999b).The study examined levels of emotional labour in university lecturers and compared these data to other occupations. Employing a mixed…

Human Capital Linkages to Labour Productivity: Implications from Thai Manufacturers

ERIC Educational Resources Information Center

Rukumnuaykit, Pungpond; Pholphirul, Piriya

2016-01-01

Human capital investment is a necessary condition for improving labour market outcomes in most countries. Empirical studies to investigate human capital and its linkages on the labour demand side are, however, relatively scarce due to limitations of firm-level data-sets. Using firm-level data from the Thai manufacturing sector, this paper aims to…

Heat supply from municipal solid waste incineration plants in Japan: Current situation and future challenges.

PubMed

Tabata, Tomohiro; Tsai, Peii

2016-02-01

The use of waste-to-energy technology as part of a municipal solid waste management strategy could reduce the use of fossil fuels and contribute to prevention of global warming. In this study, we examined current heat and electricity production by incineration plants in Japan for external use. Herein, we discuss specific challenges to the promotion of heat utilisation and future municipal solid waste management strategies. We conducted a questionnaire survey to determine the actual conditions of heat production by incineration plants. From the survey results, information of about 498 incineration plants was extracted. When we investigated the relationship between heat production for external use and population density where incineration plants were located, we found that regions with a population density <1000 persons (km(2))(-1) produce <500 MJ t(-1) of heat. We also found that external use of such energy for factories, markets, and related use, was noted in cities with a population density of 2000 to 4000 persons (km(2))(-1). Several incineration plants have poor performance for heat production because there are few facilities near them to provide demand for the energy. This is the result of redundant capacity, and is reflected in the heat production performance. Given these results, we discussed future challenges to creating energy demand around incineration plants where there is presently none. We also examined the challenges involved in increasing heat supply beyond the present situation. © The Author(s) 2015.

Parenteral opioids for maternal pain management in labour

PubMed Central

Ullman, Roz; Smith, Lesley A; Burns, Ethel; Mori, Rintaro; Dowswell, Therese

2014-01-01

Background Parenteral opioids are used for pain relief in labour in many countries throughout the world. Objectives To assess the acceptability, effectiveness and safety of different types, doses and modes of administration of parenteral opioids given to women in labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 April 2011) and reference lists of retrieved studies. Selection criteria We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient controlled analgesia) for women in labour. We looked at studies comparing an opioid with another opioid, placebo, other non-pharmacological interventions (TENS) or inhaled analgesia. Data collection and analysis At least two review authors independently assessed study eligibility, collected data and assessed risk of bias. Main results We included 57 studies involving more than 7000 women that compared an opioid with placebo, another opioid administered intramuscularly or intravenously or compared with TENS to the back. The 57 studies reported on 29 different comparisons, and for many outcomes only one study contributed data. Overall, the evidence was of poor quality regarding the analgesic effect of opioids, satisfaction with analgesia, adverse effects and harm to women and babies. There were few statistically significant results. Many of the studies had small sample sizes, and low statistical power. Overall findings indicated that parenteral opioids provided some pain relief and moderate satisfaction with analgesia in labour, although up to two-thirds of women who received opioids reported moderate or severe pain and/or poor or moderate pain relief one or two hours after administration. Opioid drugs were associated with maternal nausea, vomiting and drowsiness, although different opioid drugs were associated with different adverse effects. There was no clear evidence of adverse effects of opioids on the newborn. We

Pain management for women in labour: an overview of systematic reviews.

PubMed

Jones, Leanne; Othman, Mohammad; Dowswell, Therese; Alfirevic, Zarko; Gates, Simon; Newburn, Mary; Jordan, Susan; Lavender, Tina; Neilson, James P

2012-03-14

compared with placebo or standard care. Relaxation was associated with fewer assisted vaginal births and acupuncture was associated with fewer assisted vaginal births and caesarean sections.INSUFFICIENT EVIDENCEThere is insufficient evidence to make judgements on whether or not hypnosis, biofeedback, sterile water injection, aromatherapy, TENS, or parenteral opioids are more effective than placebo or other interventions for pain management in labour. In comparison with other opioids more women receiving pethidine experienced adverse effects including drowsiness and nausea.  Most methods of non-pharmacological pain management are non-invasive and appear to be safe for mother and baby, however, their efficacy is unclear, due to limited high quality evidence. In many reviews, only one or two trials provided outcome data for analysis and the overall methodological quality of the trials was low. High quality trials are needed.There is more evidence to support the efficacy of pharmacological methods, but these have more adverse effects. Thus, epidural analgesia provides effective pain relief but at the cost of increased instrumental vaginal birth.It remains important to tailor methods used to each woman's wishes, needs and circumstances, such as anticipated duration of labour, the infant's condition, and any augmentation or induction of labour.A major challenge in compiling this overview, and the individual systematic reviews on which it is based, has been the variation in use of different process and outcome measures in different trials, particularly assessment of pain and its relief, and effects on the neonate after birth. This made it difficult to pool results from otherwise similar studies, and to derive conclusions from the totality of evidence. Other important outcomes have simply not been assessed in trials; thus, despite concerns for 30 years or more about the effects of maternal opioid administration during labour on subsequent neonatal behaviour and its influence on

Primiparous women's preferences for care during a prolonged latent phase of labour.

PubMed

Ängeby, Karin; Wilde-Larsson, Bodil; Hildingsson, Ingegerd; Sandin-Bojö, Ann-Kristin

2015-10-01

To investigate primiparous women's preferences for care during a prolonged latent phase of labour. A qualitative study based on focus groups and individual interviews and analysed with inductive content analysis. Sixteen primiparous women with a prolonged latent phase of labour >18 hours were interviewed in five focus groups (n = 11) or individually (n = 5). One main category emerged "Beyond normality - a need of individual adapted guidance in order to understand and manage an extended latent phase of labour" which covers the women's preferences during the prolonged latent phase. Five categories were generated from the data: "A welcoming manner and not being rejected", "Individually adapted care", "Important information which prepares for reality and coping", "Participation and need for feedback" and "Staying nearby the labour ward or being admitted for midwifery support". Women with a prolonged latent phase of labour sought to use their own resources, but their needs for professional support increased as time passed. A welcoming attitude from an available midwife during the latent phase created a feeling of security, and personally adapted care was perceived positively. Women with a prolonged latent phase of labour preferred woman-centred care. Midwives play an important role in supporting these women. Women's need for midwifery-support increases as the time spent in latent phase increases. Copyright © 2015 Elsevier B.V. All rights reserved.

Educational Aspirations, Child Labour Imperatives and Structural Inequality in the South African Agricultural Sector

ERIC Educational Resources Information Center

Duncan, Norman; Bowman, Brett

2008-01-01

Despite the widespread condemnation of the practice of child labour, it remains a pervasive phenomenon in developing countries. In such contexts, labour and education often represent competing activities for children. Drawing on a study of child labour located within the critical social science tradition, this article explores insider accounts of…

Landlordism, Rent Regulation and the Labour Party in mid-twentieth century Britain, 1950-64.

PubMed

Child, Phil

2018-03-01

This article examines the politics of private renting in 1950s and early 1960s Britain, through the radical approach taken by Labour Party towards private landlords. Through setting the radical aims of Labour in a mid-twentieth-century context of decrepit housing, rising rents and sluggish public housing programmes, Labour's rationale in arguing for the 'abolition' of the private landlord is more transparent. This article takes a chronological approach, investigating what actions Labour actors took, at local and national level, and what effect this had on the wider housing market. Part one takes a long view of Labour attitudes to the private rented sector. Part two explores the policy of 'municipalization'-the attempt to place rented homes under local authority control. Part three discusses the post-1962 policy shift to state-sponsored 'improvement' of private rented housing, prior to Labour's victory at the 1964 general election. Three key arguments are made: that Labour's radicalism hastened the collapse of the post-war private rented sector; that rental market weaknesses indicated the confused place of renting in the 'tenurial pattern'; and that the proposed 'abolition' of private landlords had a direct effect on slum clearance and the composition of British cities. The conclusion suggests that Labour's pursuit of the private landlord can shed light on the vast urban transformations of the post-war period. It invites greater attention to be paid to the effects that political ideas had on the composition of the twentieth-century British housing market.

Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers.

PubMed

Liu, Yu-Hsiang; Chang, Mei-Yueh; Chen, Chung-Hey

2010-04-01

The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour. Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women. Randomised controlled trial. Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately. Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase. This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour. The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.

Refuting the "Nimble Fingers" Argument [and] Working Together against Child Labour.

ERIC Educational Resources Information Center

World of Work, 1996

1996-01-01

An International Labour Organization study refutes one of the most common arguments of apologists for child labor in the hand-woven carpet industry--the so-called nimble fingers argument. Excerpts from presentations at an International Labour Organization meeting highlight the commitment to eradicating child labor. (JOW)

Domestic labour, paid employment and women's health: analysis of life course data.

PubMed

Blane, D; Berney, L; Montgomery, S M

2001-03-01

The relationship between the amount of domestic labour performed by a woman during her lifetime and a variety of self-reported and objective measures of her health in early old age was examined in the female members (n = 155) of a data set containing considerable life course information, including full household, residential and occupational histories. Domestic labour, on its own, proved a weak predictor of health. The relationship strengthened when domestic labour was combined with the hazards of the formal paid employment which the woman had performed. This suggests that it is the combination of domestic labour plus paid employment which influences women's health. The robustness of this conclusion is indicated by its agreement with other studies which reached the same conclusion through an analysis of data with markedly different characteristics.

Who cares? Offering emotion work as a 'gift' in the nursing labour process.

PubMed

Bolton, S C

2000-09-01

Who cares? Offering emotion work as a 'gift' in the nursing labour process The emotional elements of the nursing labour process are being recognized increasingly. Many commentators stress that nurses' 'emotional labour' is hard and productive work and should be valued in the same way as physical or technical labour. However, the term 'emotional labour' fails to conceptualize the many occasions when nurses not only work hard on their emotions in order to present the detached face of a professional carer, but also to offer authentic caring behaviour to patients in their care. Using qualitative data collected from a group of gynaecology nurses in an English National Health Service (NHS) Trust hospital, this paper argues that nursing work is emotionally complex and may be better understood by utilizing a combination of Hochschild's concepts: emotion work as a 'gift' in addition to 'emotional labour'. The gynaecology nurses in this study describe their work as 'emotionful' and therefore it could be said that this particular group of nurses represent a distinct example. Nevertheless, though it is impossible to generalize from limited data, the research presented in this paper does highlight the emotional complexity of the nursing labour process, expands the current conceptual analysis, and offers a path for future research. The examination further emphasizes the need to understand and value the motivations behind nurses' emotion work and their wish to maintain caring as a central value in professional nursing.

The Mismeasure of Academic Labour

ERIC Educational Resources Information Center

Papadopoulos, Angelika

2017-01-01

In quantifying and qualifying the scope of academic labour, workload models serve multiple ends. They are intended to facilitate equitable and transparent divisions of academic work, to provide academics with a sense of whether their workload is reasonable relative to their colleagues, and universities with a mechanism for rationalising the…

Labour market entries and exits of women from different origin countries in the UK.

PubMed

Khoudja, Yassine; Platt, Lucinda

2018-01-01

Labour force participation rates of women differ strongly by ethnic origin. Even though existing research using cross-sectional studies has demonstrated that part of these differences can be attributed to compositional differences in human capital, household conditions and gender attitudes, residual 'ethnic effects' typically remain. To further our understanding of women's labour market behaviour across ethnic groups, we use a large-scale longitudinal study and apply a dynamic perspective to examine how far relevant life-course events in addition to individual characteristics, gender attitudes and religiosity contribute to the explanation of ethnic differences in women's labour force entries and exits in the UK. Our findings show that, adjusting for all these factors, Indian and Caribbean women do not differ from White majority women in their labour force entry and exit probabilities but that Pakistani and Bangladeshi women are less likely to enter and more likely to exit the labour market, whereas Black African women have higher entry rates. We also find that relations between life-course events and labour market transitions differ by ethnic group. Most notably, Pakistani and Bangladeshi women's labour market transitions are less sensitive to child-bearing and Caribbean women's transitions less sensitive to partnership changes than other women's. Copyright © 2017 Elsevier Inc. All rights reserved.

Sociodemographic differences in women’s experience of early labour care: a mixed methods study

PubMed Central

Henderson, Jane; Redshaw, Maggie

2017-01-01

Objectives To explore women’s experiences of early labour care focusing on sociodemographic differences, and to examine the effect of antenatal education, using mixed methods. Setting England, 2014. Participants Women who completed postal questionnaires about their experience of maternity care, including questions about antenatal education, early labour and sociodemographic factors, included space for free-text comments. Outcome measures Worries about labour, contact with midwives in early labour and subsequent care. Methods This study was based on secondary analysis of a national maternity survey carried out in England in 2014. Quantitative data were analysed using descriptive statistics and binary logistic regression; qualitative data were analysed using a thematic content analytic approach. Results Completed questionnaires were received from 4578 women (47% response rate). There were significant differences by sociodemographic factors, particularly ethnicity, in women’s worries about early labour. Compared with white women, women from black or minority ethnic groups had an adjusted OR of 1.93 (95% CI 1.56 to 2.39) of feeling worried about not knowing when labour would start. Among women who contacted a midwife at the start of labour, 84% perceived their advice as appropriate, more in older and multiparous women. Overall, 64% of women were asked to come to the hospital at this time, more in multiparous women (adjusted OR 1.63, 95% CI 1.35 to 1.96). Those who did not have access to antenatal education experienced greater worry about early labour. Five themes emerged from the qualitative analysis: ‘Differentiating between early and active labour’, ‘Staff attitudes’, ‘Not being allowed…’, ‘Previous labours’ and ‘Perceived consequences for women’. Conclusion These findings reinforce the importance of providing reassurance to women in early labour, taking care that women do not feel neglected or dismissed. In particular, primiparous and

Macroeconomic susceptibility, inflation, and aggregate supply

NASA Astrophysics Data System (ADS)

Hawkins, Raymond J.

2017-03-01

We unify aggregate-supply dynamics as a time-dependent susceptibility-mediated relationship between inflation and aggregate economic output. In addition to representing well various observations of inflation-output dynamics this parsimonious formalism provides a straightforward derivation of popular representations of aggregate-supply dynamics and a natural basis for economic-agent expectations as an element of inflation formation. Our formalism also illuminates questions of causality and time-correlation that challenge central banks for whom aggregate-supply dynamics is a key constraint in their goal of achieving macroeconomic stability.

Debate: Race, Labour and the Archbishop, or the Currency of Race.

ERIC Educational Resources Information Center

Stanford, Jacqui

2001-01-01

Explores how race is exploited to serve political agendas in Britain, examining the Labour Government's orientation to race. Argues that the Labour Government manipulates issues to suggest concern while actually removing race from the policy agenda in education. Reflects on the Archbishop of Canterbury's "Jesus 2000" to support the…

Aggregate Timber Supply: From the Forest to the Market

Treesearch

David N. Wear; Subhrendu K. Pattanayak

2003-01-01

Timber supply modeling is a means of formalizing the production behavior of heterogeneous landowners managing a wide variety of forest types and vintages within a region. The critical challenge of timber supply modeling is constructing theoretically valid and empirically practical aggregate descriptions of harvest behavior. Understanding timber supply is essential for...

Progression of the first stage of spontaneous labour: A prospective cohort study in two sub-Saharan African countries

PubMed Central

Fawole, Bukola; Mugerwa, Kidza; Alves, Domingos; Souza, Hayala; Reis, Rodrigo; Oliveira-Ciabati, Livia; Maiorano, Alexandre; Akintan, Adesina; Alu, Francis E.; Oyeneyin, Lawal; Adebayo, Amos; Byamugisha, Josaphat; Idris, Hadiza A.; Okike, Ola; Althabe, Fernando; Hundley, Vanora; Pattinson, Robert; Sanghvi, Harshadkumar C.; Tunçalp, Özge; Vogel, Joshua P.; Stanton, Mary Ellen; Liljestrand, Jerker; ten Hoope-Bender, Petra; Mathai, Matthews; Bahl, Rajiv

2018-01-01

Background Escalation in the global rates of labour interventions, particularly cesarean section and oxytocin augmentation, has renewed interest in a better understanding of natural labour progression. Methodological advancements in statistical and computational techniques addressing the limitations of pioneer studies have led to novel findings and triggered a re-evaluation of current labour practices. As part of the World Health Organization's Better Outcomes in Labour Difficulty (BOLD) project, which aimed to develop a new labour monitoring-to-action tool, we examined the patterns of labour progression as depicted by cervical dilatation over time in a cohort of women in Nigeria and Uganda who gave birth vaginally following a spontaneous labour onset. Methods and findings This was a prospective, multicentre, cohort study of 5,606 women with singleton, vertex, term gestation who presented at ≤ 6 cm of cervical dilatation following a spontaneous labour onset that resulted in a vaginal birth with no adverse birth outcomes in 13 hospitals across Nigeria and Uganda. We independently applied survival analysis and multistate Markov models to estimate the duration of labour centimetre by centimetre until 10 cm and the cumulative duration of labour from the cervical dilatation at admission through 10 cm. Multistate Markov and nonlinear mixed models were separately used to construct average labour curves. All analyses were conducted according to three parity groups: parity = 0 (n = 2,166), parity = 1 (n = 1,488), and parity = 2+ (n = 1,952). We performed sensitivity analyses to assess the impact of oxytocin augmentation on labour progression by re-examining the progression patterns after excluding women with augmented labours. Labour was augmented with oxytocin in 40% of nulliparous and 28% of multiparous women. The median time to advance by 1 cm exceeded 1 hour until 5 cm was reached in both nulliparous and multiparous women. Based on a 95th percentile threshold

Previous anxiety and depression as risk factors for early labour force exit.

PubMed

Rudolph, Kara E; Eaton, William W

2016-04-01

Individuals with a history of mental illness have lower earnings than individuals without. A possible reason is that those with prior anxiety or depression may be more likely to exit the labour force prior to retirement age, but evidence has been mixed and limited. Our objective was to compare risk of early labour force exit between employed adults with a history of depression or anxiety versus those without, separately for men and women. We used data from the Baltimore Epidemiological Catchment Area Follow-up Cohort, which collected baseline data in 1981 and follow-up data 1993-1996 and 2004-2005. Cox proportional hazards models estimated the relative risk of labour force exit comparing those with versus without prior history of anxiety or depressive disorders. Women with prior anxiety or depression are at 37% increased risk of dropping out of the labour force as compared to women without, controlling for age, socioeconomic status, race and marital status (HR: 1.37, 95% CI 1.04 to 1.79). Men with prior anxiety or depression are 18% more likely to subsequently drop out of the labour force as compared to men without, controlling for the above confounders as well as veteran status, but this association is not statistically significant (HR: 1.18, 95% CI 0.72 to 1.27). Prior anxiety or depression increases risk of early labour force exit for women. These findings may help explain previously reported lower earnings among female individuals with a history of mental illness and highlight the importance of considering anxiety and depressive disorders in policies supporting labour force participation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The effect of colour and design in labour and delivery: A scientific approach

NASA Astrophysics Data System (ADS)

Duncan, Jane

2011-03-01

This study was part of a broader three year research project at London's Chelsea and Westminster Hospital, "A Study of the Effect of the Visual and Performing Arts in Healthcare", exploring whether visual and performing arts have any measurable effect on physiological, psychological and biological outcomes of clinical significance on patient recovery, and providing a potential cost saving benefit to the NHS. In this specific study of women in labour, two measurements were identified as having clinical significance for achieving optimal outcomes during labour and delivery: length of labour and frequency of requirement for analgesia. A screen was designed to hide emergency equipment with the joint aim of reducing women's anxieties and (through visual art) acting as a focal point of attention and distraction during labour, thus diminishing requirements for analgesia. Results demonstrated, in the presence of the screen, a statistically significant shortening of the duration of labour by 2.1h with frequency of requests for epidural analgesia 7% lower in the study group than in the control group. The significant clinical outcomes of this research provide the evidence of the value of integrating visual art into the environment of a labour and delivery room, improving the quality of the maternity service and potentially delivering real cost savings benefits to Hospitals.

Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour.

PubMed

Levett, Kate M; Smith, C A; Bensoussan, A; Dahlen, H G

2016-07-12

To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. Open-label, assessor blind, randomised controlled trial. 2 public hospitals in Sydney, Australia. 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support. Randomisation occurred at 24-36 weeks' gestation, and participants attended a 2-day antenatal education programme plus standard care, or standard care alone. Rate of analgesic epidural use. Secondary: onset of labour, augmentation, mode of birth, newborn outcomes. There was a significant difference in epidural use between the 2 groups: study group (23.9%) standard care (68.7%; risk ratio (RR) 0.37 (95% CI 0.25 to 0.55), p≤0.001). The study group participants reported a reduced rate of augmentation (RR=0.54 (95% CI 0.38 to 0.77), p<0.0001); caesarean section (RR=0.52 (95% CI 0.31 to 0.87), p=0.017); length of second stage (mean difference=-0.32 (95% CI -0.64 to 0.002), p=0.05); any perineal trauma (0.88 (95% CI 0.78 to 0.98), p=0.02) and resuscitation of the newborn (RR=0.47 (95% CI 0.25 to 0.87), p≤0.015). There were no statistically significant differences found in spontaneous onset of labour, pethidine use, rate of postpartum haemorrhage, major perineal trauma (third and fourth degree tears/episiotomy), or admission to special care nursery/neonatal intensive care unit (p=0.25). The Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section. This study provides evidence for integrative medicine as an effective adjunct to antenatal education, and contributes

Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour

PubMed Central

Levett, Kate M; Smith, C A; Bensoussan, A; Dahlen, H G

2016-01-01

Objective To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. Design Open-label, assessor blind, randomised controlled trial. Setting 2 public hospitals in Sydney, Australia. Population 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. Methods and intervention The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support. Randomisation occurred at 24–36 weeks’ gestation, and participants attended a 2-day antenatal education programme plus standard care, or standard care alone. Main outcome measures Rate of analgesic epidural use. Secondary: onset of labour, augmentation, mode of birth, newborn outcomes. Results There was a significant difference in epidural use between the 2 groups: study group (23.9%) standard care (68.7%; risk ratio (RR) 0.37 (95% CI 0.25 to 0.55), p≤0.001). The study group participants reported a reduced rate of augmentation (RR=0.54 (95% CI 0.38 to 0.77), p<0.0001); caesarean section (RR=0.52 (95% CI 0.31 to 0.87), p=0.017); length of second stage (mean difference=−0.32 (95% CI −0.64 to 0.002), p=0.05); any perineal trauma (0.88 (95% CI 0.78 to 0.98), p=0.02) and resuscitation of the newborn (RR=0.47 (95% CI 0.25 to 0.87), p≤0.015). There were no statistically significant differences found in spontaneous onset of labour, pethidine use, rate of postpartum haemorrhage, major perineal trauma (third and fourth degree tears/episiotomy), or admission to special care nursery/neonatal intensive care unit (p=0.25). Conclusions The Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section. This

Conception, complicated pregnancy, and labour of gods and heroes in Greek mythology.

PubMed

Iavazzo, Christos; Trompoukis, Constantinos; Sardi, Thalia; Falagas, Matthew E

2008-01-01

Pregnancy and labour are holy moments in a woman's life. Even in Greek mythology we can find descriptions of them. We searched in the Greek myths to find descriptions of labours of ancient heroes and gods. We identified descriptions of extracorporeal fertilization, superfecundation, ectopic pregnancy, preterm labour, prolonged pregnancy and Caesarean section. The use of imagination could help the reader to find similarities in present or future developments in the field of obstetrics. It could be concluded that various aspects of modern obstetrical practice are described in Greek mythology.

[Attitude of pregnant women towards labour--study of forms of preparation and preferences].

PubMed

Kosińska, Katarzyna; Krychowska, Alina; Wielgoś, Mirosław; Myszewska, Aleksandra; Przyboś, Andrzej

2005-12-01

The aim of this study was to assess the knowledge of alternative delivery techniques among pregnant women and their preferences concerning the course of labour. 275 woman hospitalizated in obstetric wards in Puck and Ist Clinic in Warsaw were questionnaired in the period of July 2003 - February 2004. The mean age of women was 26 +/- 4.9. 55.7% of them were nulliparous, 44.3% multiparous. T-Student test was used for statistical analysis. The majority of questionnaired women knew alternative positions during delivery and possible analgetic techniques. 25.1% of women attended labour school. 81.2% wanted to give birth in the hospital, 10% at home and 8.8% in the delivery room. 51.1% preferred waterbirth and 22.5% obstetric chair--most of them came from the big cities, were better educated and attended labour school. Almost half of all women are in favour of epidural anaesthesia of delivery. Caesarean section on request was supported by 13.8%. For 67.4% the presence of intimates during labour was important. Labour school has a significant influence on women's knowledge and their preferences. Waterbirth and other modern delivery techniques are very popular among better educated women from big cities, while those with lower education from small cities and villages prefer "classic" labour. Therefore promotion of modern delivery methods and active participation in labour should be concentrated on these groups of women. Nowadays obstetric departments should ensure not only safety of giving birth but also complete personal comfort for pregnant women.

University and Vocational Education, and Youth Labour Market Outcomes in Australia

ERIC Educational Resources Information Center

Marks, Gary N.

2017-01-01

The purpose of this study is to examine the effects of university and vocational education, and other influences on a variety of labour market outcomes for Australian youths aged between 16 and 25. The six labour market outcomes investigated are: occupational status, hourly and weekly earnings, employment, unemployment and full-time work. The…

Impact of social factors on labour discrimination of disabled women.

PubMed

Mondéjar-Jiménez, José; Vargas-Vargas, Manuel; Meseguer-Santamaría, María-Leticia; Mondéjar-Jiménez, Juan-Antonio

2009-01-01

Disabled women suffer from a double labour discrimination due to their gender and their disability. In rural areas, in addition, they also suffer from a lack of specific services, the isolation of the disabled associations, problems with public transport, the dispersion of population centres, and a limited access to information that could improve their chances of entering the labour market. The current work adopts a constructivist perspective on disability and offers a preliminary examination of the influence of social factors, such as the rural or urban nature of the disabled women's place of residence, the assistance they receive from their family or outside the family, the quantity of information they receive about the labour market, and their educational level, on the activity and employment status of this group of people.

Placental heat shock proteins: no immunohistochemical evidence for a differential stress response in preterm labour.

PubMed

Divers, M J; Bulmer, J N; Miller, D; Lilford, R J

1995-01-01

The aetiology of idiopathic preterm labour remains obscure. The hypothesis that a stress response induced by low-grade bacterial infection in utero-placental tissues was investigated. Distribution of cognate and inducible isoforms of heat shock proteins (HSP) 70 kD, HSP 60 kD and HSP 90 kD were investigated in an immunohistochemical study of placental and decidual tissues before and after labour at varying gestations. Subjects were pregnant women undergoing singleton delivery after idiopathic preterm labour at less than 34 weeks' gestation (n = 23); spontaneous term labour at 37-42 weeks' gestation (n =24); preterm caesarean sections at less than 34 weeks' gestation for preeclampsia or intrauterine growth retardation (n=14); elective caesarean section at 37-42 weeks' gestation for cephalopelvic disproportion (n = 6). HSP expression was constant throughout the third trimester of pregnancy and did not change following the onset of labour, regardless of gestational age. A stress response in decidual tissues as determined by immunohistochemical analysis is apparently not associated with preterm labour.

Teaching Supply Chain Management Complexities: A SCOR Model Based Classroom Simulation

ERIC Educational Resources Information Center

Webb, G. Scott; Thomas, Stephanie P.; Liao-Troth, Sara

2014-01-01

The SCOR (Supply Chain Operations Reference) Model Supply Chain Classroom Simulation is an in-class experiential learning activity that helps students develop a holistic understanding of the processes and challenges of supply chain management. The simulation has broader learning objectives than other supply chain related activities such as the…

Inter-institutional Variation in Use of Caesarean Delivery for Labour Dystocia.

PubMed

Riddell, Corinne A; Hutcheon, Jennifer A; Strumpf, Erin C; Abenhaim, Haim A; Kaufman, Jay S

2017-11-01

To establish the degree of variation across hospitals in the use of Caesarean delivery for the indication of labour dystocia before and after accounting for maternal, fetal, and hospital characteristics. This study was a retrospective, population-based cohort study of nulliparous women delivering term singletons in cephalic position following labour. Delivery visits were extracted from three provincial perinatal registries in the Canadian provinces of Ontario, Alberta, and British Columbia, from 2008-2012. Crude hospital-specific rates of Caesarean delivery for labour dystocia were reported, and these rates were then stabilized to account for hospitals with low delivery volumes. Rates were then adjusted for maternal, fetal, and hospital characteristics using hierarchical logistic regression. Among 403 205 women delivering at 170 hospitals, the overall Caesarean delivery rate was 21.0%, and the rate of Caesarean delivery for labour dystocia was 12.7%, indicating that 60% of all Caesarean deliveries were performed in part for this indication. The middle 95% of hospitals had Caesarean delivery rates for labour dystocia ranging from 4.5% to 24.7%. Differences in maternal case mix and hospital characteristics explained only a small proportion of this variation (95% central range 6.3%-21.7%). Considerable inter-hospital variation in rates of Caesarean delivery for labour dystocia remained after accounting for differences in maternal and hospital factors. Reporting systems that monitor variation in inter-institutional rates should incorporate stabilization and adjustment for case-mix differences and consider indication-specific rates of Caesarean delivery to more fairly compare hospital performance and better target interventions to reduce Caesarean delivery for specific indications. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Continuous Flow in Labour-Intensive Manufacturing Process

NASA Astrophysics Data System (ADS)

Pacheco Eng., Jhonny; Carbajal MSc., Eduardo; Stoll-Ing., Cesar, Dr.

2017-06-01

A continuous-flow manufacturing represents the peak of standard production, and usually it means high production in a strict line production. Furthermore, low-tech industry demands high labour-intensive, in this context the efficient of the line production is tied at the job shop organization. Labour-intensive manufacturing processes are a common characteristic for developing countries. This research aims to propose a methodology for production planning in order to fulfilment a variable monthly production quota. The main idea is to use a clock as orchestra director in order to synchronize the rate time (takt time) of customer demand with the manufacturing time. In this way, the study is able to propose a stark reduction of stock in process, over-processing, and unnecessary variability.

Learning to Adapt: Does Returning to Education Improve Labour Market Outcomes?

ERIC Educational Resources Information Center

Chesters, Jenny

2014-01-01

The transition into a post-industrial economy changed the nature of the Australian labour market extinguishing jobs in traditional industries and creating jobs in new industries. Workers displaced from the manufacturing sector and women seeking to re-enter the labour market after taking time out for family reasons need to retrain in order to…

Obstetric and psychological characteristics of women choosing epidural analgesia during labour: A cohort study.

PubMed

Sitras, Vasilis; Šaltytė Benth, Jūratė; Eberhard-Gran, Malin

2017-01-01

To investigate the obstetric and psychological characteristics of women who opt to use epidural analgesia (EDA) during labour and the impact of participating in labour preparation courses on women's decisions to use EDA. Longitudinal cohort study. Akershus University Hospital, Norway. 2596 women with singleton pregnancies and intended vaginal delivery. Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ). Symptoms of anxiety were measured by the Hopkins Symptom Check List (SCL-25) and depression by the Edinburgh Postnatal Depression Scale (EPDS). Obstetric and socio-demographic information was retrieved from birth records at the maternity ward. Preference for EDA was indicated by the questionnaire item "I would prefer an epidural regardless" on a 4-point scale (1 = highly agree, 4 = highly disagree) at pregnancy week 32. Twenty-one percent of the women (540/2596) answered that they would choose EDA as the only alternative method of analgesia during labour. Counselling for fear of childbirth [OR 3.23 (95%CI 2.12; 4.92)] and W-DEQ sum score ≥ 85 [OR 2.95 (95%CI 2.06; 4.23)] were significantly (p<0.001) associated with choice of EDA. Participation in labour preparation courses was significantly (p = 0.008) associated with a reduction of intended use of EDA during labour [OR 0.67 (95%CI 0.49; 0.90)]. Fear of childbirth is significantly associated with women's choice of EDA during labour. On the other hand, women that participate in labour preparation courses would rather consider other methods of analgesia during labour.

Social Cohesion and the Labour Market: Societal Regimes of Civic Attitudes and Labour Market Regimes

ERIC Educational Resources Information Center

Dimeglio, Isabelle; Janmaat, Jan Germen; Mehaut, Philippe

2013-01-01

The aim of this paper is to test the connections between the indicators used in the literature on social cohesion, which usually reflect "general" values or behaviours, and indicators specific to a particular space, namely the labour market. A key question is the stability of the social cohesion's indicators when moving from a societal…

How Do Households Respond to Unreliable Water Supplies? A Systematic Review.

PubMed

Majuru, Batsirai; Suhrcke, Marc; Hunter, Paul R

2016-12-09

Although the Millennium Development Goal (MDG) target for drinking water was met, in many developing countries water supplies are unreliable. This paper reviews how households in developing countries cope with unreliable water supplies, including coping costs, the distribution of coping costs across socio-economic groups, and effectiveness of coping strategies in meeting household water needs. Structured searches were conducted in peer-reviewed and grey literature in electronic databases and search engines, and 28 studies were selected for review, out of 1643 potentially relevant references. Studies were included if they reported on strategies to cope with unreliable household water supplies and were based on empirical research in developing countries. Common coping strategies include drilling wells, storing water, and collecting water from alternative sources. The choice of coping strategies is influenced by income, level of education, land tenure and extent of unreliability. The findings of this review highlight that low-income households bear a disproportionate coping burden, as they often engage in coping strategies such as collecting water from alternative sources, which is labour and time-intensive, and yields smaller quantities of water. Such alternative sources may be of lower water quality, and pose health risks. In the absence of dramatic improvements in the reliability of water supplies, a point of critical avenue of enquiry should be what coping strategies are effective and can be readily adopted by low income households.

How Do Households Respond to Unreliable Water Supplies? A Systematic Review

PubMed Central

Majuru, Batsirai; Suhrcke, Marc; Hunter, Paul R.

2016-01-01

Although the Millennium Development Goal (MDG) target for drinking water was met, in many developing countries water supplies are unreliable. This paper reviews how households in developing countries cope with unreliable water supplies, including coping costs, the distribution of coping costs across socio-economic groups, and effectiveness of coping strategies in meeting household water needs. Structured searches were conducted in peer-reviewed and grey literature in electronic databases and search engines, and 28 studies were selected for review, out of 1643 potentially relevant references. Studies were included if they reported on strategies to cope with unreliable household water supplies and were based on empirical research in developing countries. Common coping strategies include drilling wells, storing water, and collecting water from alternative sources. The choice of coping strategies is influenced by income, level of education, land tenure and extent of unreliability. The findings of this review highlight that low-income households bear a disproportionate coping burden, as they often engage in coping strategies such as collecting water from alternative sources, which is labour and time-intensive, and yields smaller quantities of water. Such alternative sources may be of lower water quality, and pose health risks. In the absence of dramatic improvements in the reliability of water supplies, a point of critical avenue of enquiry should be what coping strategies are effective and can be readily adopted by low income households. PMID:27941695

Endoplasmic reticulum stress is induced in the human placenta during labour

PubMed Central

Veerbeek, J.H.W.; Tissot Van Patot, M.C.; Burton, G.J.; Yung, H.W.

2015-01-01

Placental endoplasmic reticulum (ER) stress has been postulated in the pathophysiology of pre-eclampsia (PE) and intrauterine growth restriction (IUGR), but its activation remains elusive. Oxidative stress induced by ischaemia/hypoxia-reoxygenation activates ER stress in vitro. Here, we explored whether exposure to labour represents an in vivo model for the study of acute placental ER stress. ER stress markers, GRP78, P-eIF2α and XBP-1, were significantly higher in laboured placentas than in Caesarean-delivered controls localised mainly in the syncytiotrophoblast. The similarities to changes observed in PE/IUGR placentas suggest exposure to labour can be used to investigate induction of ER stress in pathological placentas. PMID:25434970

Combination of three-dimensional ultrasound measurement of foetal adrenal gland enlargement and placental alpha microglobulin-1 for the prediction of the timing of delivery within seven days in women with threatened preterm labour and preterm labour.

PubMed

Santipap, Monchai; Phupong, Vorapong

2018-03-23

The aim of this study was to predict the timing of delivery within seven days in singleton pregnant women with threatened preterm labour and preterm labour by using a three-dimensional (3D) ultrasound measurement of foetal adrenal gland volume enlargement, a foetal zone enlargement and cervicovaginal placental alpha microglobulin-1 (PAMG-1) test. This prospective cohort study included singleton pregnant women at 22-36 +6  weeks of gestation who presented with threatened preterm labour and with preterm labour. Transabdominal 3D ultrasound measurement of the whole foetal adrenal gland and of the foetal adrenal zone were performed. Qualitative cervicovaginal PAMG-1 detection was performed at the same time. One hundred and fifty-four pregnant women were included into the study. Eighty-four pregnant women had threatened preterm labour and seventy pregnant women had preterm labour. Twenty-nine pregnant women (18%) delivered within seven days. Use of foetal adrenal gland volume enlargement, foetal zone enlargement and the PAMG-1 test in combination increased sensitivity; if one parameter was positive, the sensitivity, specificity, positive predictive value and negative predictive value were 82.8%, 27.2%, 20.9% and 87.2%, respectively, in the prediction of the timing of delivery within seven days. The combination of foetal adrenal gland enlargement and PAMG-1 increased sensitivity for the prediction of the timing of delivery within seven days in pregnant women presenting with threatened preterm labour and preterm labour. Impact Statement What is already known on this subject? An increased foetal adrenal gland volume is significantly correlated with the risk of preterm birth. What do the results of this study add? The combination of a foetal adrenal gland enlargement and a placental alpha microglobulin-1 increased sensitivity for the prediction of the timing of delivery within seven days in pregnant women presenting with threatened preterm labour and preterm labour

U.S. Offshore Wind Manufacturing and Supply Chain Development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamilton, Bruce

2013-02-22

This report seeks to provide an organized, analytical approach to identifying and bounding uncertainties around offshore wind manufacturing and supply chain capabilities; projecting potential component-level supply chain needs under three demand scenarios; and identifying key supply chain challenges and opportunities facing the future U.S. market and current suppliers of the nation’s landbased wind market.

Labour force participation and the influence of having arthritis on financial status.

PubMed

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Percival, Richard; Kelly, Simon J; Passey, Megan E

2015-07-01

The objective of this study was to quantify the impact that having arthritis has on income poverty status and accumulated wealth in Australia. Cross-sectional analysis of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. Across all categories of labour force participation status (employed full time, part time or not in the labour force at all), those with arthritis were significantly more likely to be in poverty. Those employed full time with no health condition had 0.82 times the odds of being in income poverty (95 % CI 0.80-0.84) compared with those employed full time with arthritis. Those not in the labour force with no chronic health conditions had 0.36 times the odds of being in income poverty compared with those not in the labour force due to arthritis (95 % CI 0.36-0.37). For people not in the labour force with no long-term health condition, the total value of their wealth was 211 % higher (95 % CI 38-618 %) than the amount of wealth accumulated by those not in the labour force due to arthritis. Similarly, those employed part time with no chronic health condition had 50 % more wealth than those employed part time with arthritis (95 % CI 3-116 %). Arthritis has a profound impact upon the economic circumstances of individuals, which adds a further dimension to the detrimental living standards of older individuals suffering from the condition.

Factors and outcomes associated with the induction of labour in Latin America.

PubMed

Guerra, G V; Cecatti, J G; Souza, J P; Faúndes, A; Morais, S S; Gülmezoglu, A M; Parpinelli, M A; Passini, R; Carroli, G

2009-12-01

To describe the prevalence of labour induction, together with its risk factors and outcomes in Latin America. Analysis of the 2005 WHO global survey database. Eight selected Latin American countries. All women who gave birth during the study period in 120 participating institutions. Bivariate and multivariate analyses. Indications for labour induction per country, success rate per method, risk factors for induction, and maternal and perinatal outcomes. Of the 97,095 deliveries included in the survey, 11,077 (11.4%) were induced, with 74.2% occurring in public institutions, 20.9% in social security hospitals and 4.9% in private institutions. Induction rates ranged from 5.1% in Peru to 20.1% in Cuba. The main indications were premature rupture of membranes (25.3%) and elective induction (28.9%). The success rate of vaginal delivery was very similar for oxytocin (69.9%) and misoprostol (74.8%), with an overall success rate of 70.4%. Induced labour was more common in women over 35 years of age. Maternal complications included higher rates of perineal laceration, need for uterotonic agents, hysterectomy, ICU admission, hospital stay>7 days and increased need for anaesthetic/analgesic procedures. Some adverse perinatal outcomes were also higher: low 5-minute Apgar score, very low birthweight, admission to neonatal ICU and delayed initiation of breastfeeding. In Latin America, labour was induced in slightly more than 10% of deliveries; success rates were high irrespective of the method used. Induced labour is, however, associated with poorer maternal and perinatal outcomes than spontaneous labour.

Information flow in the pharmaceutical supply chain.

PubMed

Yousefi, Nazila; Alibabaei, Ahmad

2015-01-01

Managing the supply chain plays an important role in creating competitive advantages for companies. Adequate information flow in supply chain is one of the most important issues in SCM. Therefore, using certain Information Systems can have a significant role in managing and integrating data and information within the supply chain. Pharmaceutical supply chain is more complex than many other supply chains, in the sense that it can affect social and political perspectives. On the other hand, managing the pharmaceutical supply chain is difficult because of its complexity and also government regulations in this field. Although, Iran has progressed a lot in pharmaceutical manufacturing, still there are many unsolved issues in managing the information flow in the pharmaceutical supply chain. In this study, we reviewed the benefits of using different levels of an integrated information system in the supply chain and the possible challenges ahead.

Information flow in the pharmaceutical supply chain

PubMed Central

Yousefi, Nazila; Alibabaei, Ahmad

2015-01-01

Managing the supply chain plays an important role in creating competitive advantages for companies. Adequate information flow in supply chain is one of the most important issues in SCM. Therefore, using certain Information Systems can have a significant role in managing and integrating data and information within the supply chain. Pharmaceutical supply chain is more complex than many other supply chains, in the sense that it can affect social and political perspectives. On the other hand, managing the pharmaceutical supply chain is difficult because of its complexity and also government regulations in this field. Although, Iran has progressed a lot in pharmaceutical manufacturing, still there are many unsolved issues in managing the information flow in the pharmaceutical supply chain. In this study, we reviewed the benefits of using different levels of an integrated information system in the supply chain and the possible challenges ahead. PMID:26664401

Early versus late initiation of epidural analgesia for labour.

PubMed

Sng, Ban Leong; Leong, Wan Ling; Zeng, Yanzhi; Siddiqui, Fahad Javaid; Assam, Pryseley N; Lim, Yvonne; Chan, Edwin S Y; Sia, Alex T

2014-10-09

Pain during childbirth is arguably the most severe pain some women may experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour. Many women have concerns regarding its safety. Furthermore, epidural services and anaesthetic support may not be available consistently across all centres. Observational data suggest that early initiation of epidural may be associated with an increased risk of caesarean section, but the same findings were not seen in recent randomised controlled trials. More recent guidelines suggest that in the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labour. The choice of analgesic technique, agent, and dosage is based on many factors, including patient preference, medical status, and contraindications. There is no systematically reviewed evidence on the maternal and foetal outcomes and safety of this practice. This systematic review aimed to summarise the effectiveness and safety of early initiation versus late initiation of epidural analgesia in women. We considered the obstetric and fetal outcomes relevant to women and side effects of the treatments, including risk of caesarean section, instrumental birth and time to birth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (12 February 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE (January 1966 to February 2014), Embase (January 1980 to February 2014) and reference lists of retrieved studies. We included all randomised controlled trials involving women undergoing epidural labour analgesia that compared early initiation versus late initiation of epidural labour analgesia. Two review authors independently assessed trials for inclusion, extracted the data and assessed the trial quality. Data were checked for accuracy. We included nine studies with a total of 15,752 women.The overall risk of bias of

Panamanian women׳s experience of vaginal examination in labour: A questionnaire validation.

PubMed

Bonilla-Escobar, Francisco J; Ortega-Lenis, Delia; Rojas-Mirquez, Johanna C; Ortega-Loubon, Christian

2016-05-01

to validate a tool that allows healthcare providers to obtain accurate information regarding Panamanian women׳s thoughts and feelings about vaginal examination during labour that can be used in other Latin-American countries. validation study based on a database from a cross-sectional study carried out in two tertiary care hospitals in Panama City, Panama. Women in the immediate postpartum period who had spontaneous labour onset and uncomplicated deliveries were included in the study from April to August 2008. Researchers used a survey designed by Lewin et al. that included 20 questions related to a patient׳s experience during a vaginal examination. five constructs (factors) related to a patient׳s experience of vaginal examination during labour were identified: Approval (Alpha Cronbach׳s 0.72), Perception (0.67), Rejection (0.40), Consent (0.51), and Stress (0.20). it was demonstrated the validity of the scale and its constructs used to obtain information related to vaginal examination during labour, including patients' experiences with examination and healthcare staff performance. utilisation of the scale will allow institutions to identify items that need improvement and address these areas in order to promote the best care for patients in labour. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reducing stillbirths: interventions during labour

PubMed Central

Darmstadt, Gary L; Yakoob, Mohammad Yawar; Haws, Rachel A; Menezes, Esme V; Soomro, Tanya; Bhutta, Zulfiqar A

2009-01-01

Background Approximately one million stillbirths occur annually during labour; most of these stillbirths occur in low and middle-income countries and are associated with absent, inadequate, or delayed obstetric care. The low proportion of intrapartum stillbirths in high-income countries suggests that intrapartum stillbirths are largely preventable with quality intrapartum care, including prompt recognition and management of intrapartum complications. The evidence for impact of intrapartum interventions on stillbirth and perinatal mortality outcomes has not yet been systematically examined. Methods We undertook a systematic review of the published literature, searching PubMed and the Cochrane Library, of trials and reviews (N = 230) that reported stillbirth or perinatal mortality outcomes for eight interventions delivered during labour. Where eligible randomised controlled trials had been published after the most recent Cochrane review on any given intervention, we incorporated these new trial findings into a new meta-analysis with the Cochrane included studies. Results We found a paucity of studies reporting statistically significant evidence of impact on perinatal mortality, especially on stillbirths. Available evidence suggests that operative delivery, especially Caesarean section, contributes to decreased stillbirth rates. Induction of labour rather than expectant management in post-term pregnancies showed strong evidence of impact, though there was not enough evidence to suggest superior safety for the fetus of any given drug or drugs for induction of labour. Planned Caesarean section for term breech presentation has been shown in a large randomised trial to reduce stillbirths, but the feasibility and consequences of implementing this intervention routinely in low-/middle-income countries add caveats to recommending its use. Magnesium sulphate for pre-eclampsia and eclampsia is effective in preventing eclamptic seizures, but studies have not demonstrated impact

Short and long-term labour market consequences of coronary heart disease: a register-based follow-up study.

PubMed

Kruse, Marie; Sørensen, Jan; Davidsen, Michael; Gyrd-Hansen, Dorte

2009-06-01

The aim of this study was to analyse to what extent individuals with coronary heart disease (CHD) leave the labour market earlier than individuals without CHD and to discuss the implications for rehabilitation. Individuals with CHD were identified from the Danish National Cohort study and were followed from the year of their first hospital admission for CHD and onwards for up to 23 years. Individuals with CHD were individually matched with individuals without CHD. We analysed their short-term labour market participation and compared the long-term withdrawal risk for the two groups through Cox regression. In the year after the first CHD-related admission, 79% of individuals with CHD maintained their labour force participation compared with 93% of individuals without CHD. Individuals with CHD had a hazard ratio of 1.32 for withdrawal compared with their matched counterparts. This means that the individuals with CHD were on the labour market, on average, for 0.8 years less than the individuals without CHD. Stratified analyses showed that, in particular, individuals with CHD aged below 60 years and individuals employed as manual labour may benefit from cardiac rehabilitation, which aims to maintain labour market participation. Individuals with CHD have a significantly increased risk of withdrawing from the labour market. Especially younger individuals and those employed as manual labour seem to have greater problems in maintaining labour market participation. This suggests that greater focus in cardiac rehabilitation on returning these individuals to the labour market might be worthwhile.

Digital labour and development: impacts of global digital labour platforms and the gig economy on worker livelihoods.

PubMed

Graham, Mark; Hjorth, Isis; Lehdonvirta, Vili

2017-05-01

As ever more policy-makers, governments and organisations turn to the gig economy and digital labour as an economic development strategy to bring jobs to places that need them, it becomes important to understand better how this might influence the livelihoods of workers. Drawing on a multi-year study with digital workers in Sub-Saharan Africa and South-east Asia, this article highlights four key concerns for workers: bargaining power, economic inclusion, intermediated value chains, and upgrading. The article shows that although there are important and tangible benefits for a range of workers, there are also a range of risks and costs that unduly affect the livelihoods of digital workers. Building on those concerns, it then concludes with a reflection on four broad strategies - certification schemes, organising digital workers, regulatory strategies and democratic control of online labour platforms - that could be employed to improve conditions and livelihoods for digital workers.

Labour management and Obstetric outcomes among pregnant women admitted in latent phase compared to active phase of labour at Bugando Medical Centre in Tanzania.

PubMed

Chuma, Clotrida; Kihunrwa, Albert; Matovelo, Dismas; Mahendeka, Marietha

2014-02-12

Interventions given to women admitted in latent or active phase of labor may influence the outcomes of labor and ameliorate complications which can affect the mother and fetus. Labour management, maternal and fetal outcomes among low risk women presenting both in latent phase and active phase of labour in Tanzania have not recently been explored. This was a descriptive cross-sectional study. It was done from February to April 2013. Case notes were collected serially until the sample size was reached. A structured checklist was used to extract data. Data was analyzed using SPSS version 17. A p < 0.05 was considered significant at 95% confidence interval. Five hundred case notes of low risk pregnant women were collected, half of each presented in latent phase and active phase of labour. Key interventions including augmentation with oxytocin, artificial rupture of membranes and caesarean section were significantly higher in the latent phase group than the active phase group 84(33.6%) versus 52(20.8%) p < 0.05; 96(38.6%) versus 56(22.4%) p < 0.05 and 87(34.8%) versus 60(24.0%) p < 0.05 respectively. Spontaneous vertex delivery was higher among pregnant women admitted initially in active phase than in latent phase groups 180(72.0%), versus 153(61.2%) p > 0.01). There were more women in the active phase group who sustained genital tract tear and postpartum haemorrhage than in the latent phase group 101(18.6%), versus 38(15.6%) p < 0.01 and 46(18.4%), versus 17(6.6%) p < 0.05 respectively. Pregnant women admitted at BMC in latent phase of labour are subjected to more obstetric interventions than those admitted in the active phase. There is need to produce guidelines on management of women admitted in latent phase of labour at BMC to reduce the risk of unnecessary interventions.

Randomised trial of amnioinfusion during labour with meconium stained amniotic fluid.

PubMed

Rathor, Asmita Muthal; Singh, Ruchira; Ramji, S; Tripathi, Reva

2002-01-01

To assess the effect of amnioinfusion during labour with meconium stained amniotic fluid on caesarean section rate and perinatal outcome. Prospective randomised controlled study. A tertiary care teaching hospital in India. Women in labour at term with meconium stained amniotic fluid. Two hundred women in labour with > or = 37 weeks gestation, single cephalic presentation with moderate or thick meconium were randomised to control and amnioinfusion groups at a 1:1 ratio. Amnioinfusion was performed using 500 mL of normal saline over a period of 30 minutes in a study group. The control group received routine care. Both groups had intermittent auscultation of fetal heart rate during labour. The primary outcome measure was caesarean section rate. Secondary outcome measures were meconium aspiration syndrome, 1 minute and 5 minute apgar < 7, hypoxic ischaemic encephalopathy, neonatal intensive care unit admission, meconium at the level of vocal cords. The caesarean section rate in the amnioinfusion group was less than the control group (RR 0.47; 95% CI 0.24-0.93). Amnioinfusion was associated with a significant decrease in the incidence of meconium at the vocal cords (P = 0.001); improvement in 1 minute apgar scores (P < 0.05), respiratory distress (P = 0.002) and fewer admissions to nursery compared with the controls. This sample size was inadequate to study the impact on meconium aspiration syndrome. Amnioinfusion in an under resourced labour ward decreases caesarean section rates and fetal morbidity.

Temporary agency work, migration and the crisis in Greece: labour market segmentation intensified.

PubMed

Maroukis, Thanos

2016-05-01

This article focuses on the under-researched temporary agency employment in Greece. It shows that the development of the temporary employment agency sector has gone hand in hand with the flow of undocumented and exploitable migrant labour in Greece over the past 25 years, reflecting the segmentation of the Greek labour market along ethnic lines. Using empirical research evidence on the operation of temporary employment agencies in the Greek hospitality and health care sectors, the article highlights the precarious or even illicit nature of agency employment in a context in which labour outsourcing and flexible employment are promoted by policy-makers. Last but not least, it suggests that the segmented landscape of the Greek labour market has become more complex during the economic crisis, with more and more Greeks drawn to agency-mediated precarious employment.

The importance of illness duration, age at diagnosis and the year of diagnosis for labour participation chances of people with chronic illness: results of a nationwide panel-study in The Netherlands.

PubMed

Rijken, Mieke; Spreeuwenberg, Peter; Schippers, Joop; Groenewegen, Peter P

2013-09-04

Compared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals' well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain insight into the role of three age related characteristics that may relate to labour participation chances of people with chronic illness: the duration of their illness, how old they were when the chronic disease was diagnosed and the historical year in which the diagnosis was established. We analyzed data of one (first) measurement of several cohorts of people diagnosed with a somatic chronic disease, who (had) participated in the Dutch 'National Panel of people with Chronic illness or Disability' since 1998 (N = 4634 in total). Multi-level logistic regression analyses were conducted to estimate random effects of the age at diagnosis and the year of diagnosis and fixed effects of illness duration on labour participation, while correcting for the effects of socio-demographic and disease characteristics and socio-economic indicators. A significant part of the variation in labour participation among people with chronic illness relates to the age they had when they were diagnosed. Furthermore, a longer illness duration is significantly associated with a lower chance of being economically active. This is more the case for men than for women. Labour participation of cancer survivors depends on the phase of the illness they find themselves in. No evidence was found that the year in which the diagnosis was established matters for employment chances later in life. Age at diagnosis and illness duration relate to chronically ill people's chances to participate in the labour market, but how and how

The importance of illness duration, age at diagnosis and the year of diagnosis for labour participation chances of people with chronic illness: results of a nationwide panel-study in the Netherlands

PubMed Central

2013-01-01

Background Compared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals’ well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain insight into the role of three age related characteristics that may relate to labour participation chances of people with chronic illness: the duration of their illness, how old they were when the chronic disease was diagnosed and the historical year in which the diagnosis was established. Methods We analyzed data of one (first) measurement of several cohorts of people diagnosed with a somatic chronic disease, who (had) participated in the Dutch ‘National Panel of people with Chronic illness or Disability’ since 1998 (N = 4634 in total). Multi-level logistic regression analyses were conducted to estimate random effects of the age at diagnosis and the year of diagnosis and fixed effects of illness duration on labour participation, while correcting for the effects of socio-demographic and disease characteristics and socio-economic indicators. Results A significant part of the variation in labour participation among people with chronic illness relates to the age they had when they were diagnosed. Furthermore, a longer illness duration is significantly associated with a lower chance of being economically active. This is more the case for men than for women. Labour participation of cancer survivors depends on the phase of the illness they find themselves in. No evidence was found that the year in which the diagnosis was established matters for employment chances later in life. Conclusion Age at diagnosis and illness duration relate to chronically ill people’s chances to

Induction of labour for improving birth outcomes for women at or beyond term

PubMed Central

Gülmezoglu, A Metin; Crowther, Caroline A; Middleton, Philippa; Heatley, Emer

2014-01-01

Background As a pregnancy continues beyond term the risks of babies dying inside the womb or in the immediate newborn period increase. Whether a policy of labour induction at a predetermined gestational age can reduce this increased risk is the subject of this review. Objectives To evaluate the benefits and harms of a policy of labour induction at term or post-term compared with awaiting spontaneous labour or later induction of labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (31 March 2012). Selection criteria Randomised controlled trials conducted in women at or beyond term. The eligible trials were those comparing a policy of labour induction with a policy of awaiting spontaneous onset of labour. Cluster-randomised trials and cross-over trials are not included. Quasi-random allocation schemes such as alternation, case record numbers or open random-number lists were not eligible. Data collection and analysis Two review authors independently assessed trials for inclusion. Two review authors independently assessed trial quality and extracted data. Data were checked for accuracy. Outcomes are analysed in two main categories: gestational age and cervix status. Main results We included 22 trials reporting on 9383 women. The trials were generally at moderate risk of bias. Compared with a policy of expectant management, a policy of labour induction was associated with fewer (all-cause) perinatal deaths: risk ratio (RR) 0.31, 95% confidence interval (CI) 0.12 to 0.88; 17 trials, 7407 women. There was one perinatal death in the labour induction policy group compared with 13 perinatal deaths in the expectant management group. The number needed to treat to benefit (NNTB) with induction of labour in order to prevent one perinatal death was 410 (95% CI 322 to 1492). For the primary outcome of perinatal death and most other outcomes, no differences between timing of induction subgroups were seen; the majority of trials adopted

Educational Technology and the Enclosure of Academic Labour inside Public Higher Education

ERIC Educational Resources Information Center

Hall, Richard

2013-01-01

Across higher education in the United Kingdom, the procurement and deployment of educational technology increasingly impacts the practices of academic labour, in terms of administration, teaching and research. Moreover the relationships between academic labour and educational technology are increasingly framed inside the practices of neoliberal,…

Nurses' views on challenging doctors' practice in an acute hospital.

PubMed

Churchman, J J; Doherty, C

To explore the extent to which nurses are willing to challenge doctors' practice in everyday situations in an acute NHS hospital. Qualitative data were collected using in-depth interviews with 12 nurses in an acute NHS hospital in England. Participants believed that they challenged doctors' practice and acted as patients' advocates. However, data revealed that nurses questioned doctors' practice only under specific circumstances. Nurses would not challenge doctors if they perceived that this would result in conflict or stress, if they were afraid of the doctor or feared reprisal. Nurses are discouraged from challenging doctors' practice by the structural inequality arising from the gender division of labour and doctors' expert knowledge and status (medical dominance) in the workplace.

New Heroines of Labour: Domesticating Post-feminism and Neoliberal Capitalism in Russia

PubMed Central

Salmenniemi, Suvi; Adamson, Maria

2015-01-01

In recent years, post-feminism has become an important element of popular media culture and the object of feminist cultural critique. This article explores how post-feminism is domesticated in Russia through popular self-help literature aimed at a female audience. Drawing on a close reading of self-help texts by three best-selling Russian authors, the article examines how post-feminism is made intelligible to the Russian audience and how it articulates with other symbolic frameworks. It identifies labour as a key trope through which post-feminism is domesticated and argues that the texts invite women to invest time and energy in the labour of personality, the labour of femininity and the labour of sexuality in order to become ‘valuable subjects’. The article demonstrates that the domestication of post-feminism also involves the domestication of neoliberal capitalism in Russia, and highlights how popular psychology, neoliberal capitalism and post-feminism are symbiotically related. PMID:26663947

New Heroines of Labour: Domesticating Post-feminism and Neoliberal Capitalism in Russia.

PubMed

Salmenniemi, Suvi; Adamson, Maria

2015-02-01

In recent years, post-feminism has become an important element of popular media culture and the object of feminist cultural critique. This article explores how post-feminism is domesticated in Russia through popular self-help literature aimed at a female audience. Drawing on a close reading of self-help texts by three best-selling Russian authors, the article examines how post-feminism is made intelligible to the Russian audience and how it articulates with other symbolic frameworks. It identifies labour as a key trope through which post-feminism is domesticated and argues that the texts invite women to invest time and energy in the labour of personality, the labour of femininity and the labour of sexuality in order to become 'valuable subjects'. The article demonstrates that the domestication of post-feminism also involves the domestication of neoliberal capitalism in Russia, and highlights how popular psychology, neoliberal capitalism and post-feminism are symbiotically related.

Exploring gender differences in the relationships between eldercare and labour force participation.

PubMed

Lee, Yeonjung; Tang, Fengyan; Kim, Kevin H; Albert, Steven M

2015-03-01

This study investigated the reciprocal relationship between parental caregiving and labour force participation to determine whether (1) caregiving related to subsequent employment; (2) employment related to subsequent caregiving; (3) caregiving and labour force participation had a reciprocal relationship across time; and (4) gender differences existed in these relationships. A cross-lagged panel design was applied with structural equation modeling. The study sample included adult children aged 51 or older with living parents or parents-in-law. No reciprocal relationship was found between caregiving and labour force participation, but gender differences were evident. Women caregivers in 2006 were less likely to be working in 2008, whereas employment status was not related to subsequent caregiving. In contrast, men working in 2008 were less likely to be caregiving in 2010, whereas caregiving was not related to subsequent employment status. Findings suggest that gender plays an important role in the relationship between caregiving and labour force participation.

Donning the mask: effects of emotional labour strategies on burnout and job satisfaction in community healthcare.

PubMed

Pandey, Jatin; Singh, Manjari

2016-06-01

Emotional labour involves management of one's emotions to match the demands of their roles. This emotion display involves just expression (surface-level emotional labour) or experience in addition to expression (deep-level emotional labour) of the desired emotions. Emotional labour is required in the effective, efficient and successful healthcare service delivery. Burnout associated with emotional labour is an important factor that decides how satisfied frontline service providers with their job are. This empirical study investigates the link between surface and deep-level emotional labour, burnout and job satisfaction in women community health workers from India. Our results from the structural equation modelling of 177 accredited social health activists (ASHAs) indicate a negative relation between surface and deep-level emotional labour, clearly demarcating them as two different strategies for performance of emotional labour in community health care setting. Surface-level emotional labour is associated with higher job satisfaction, and burnout partially mediates this relation. Deep-level emotional labour is associated with lower job satisfaction; burnout fully mediates this relation. Qualitative post hoc analysis based on interviews of 10 ASHAs was done to understand the findings of the quantitative study. Surface-level emotional labour was found to be a more desirable strategy for community health care workers for the effective and efficient performance of their work roles. Our results have a significant contribution to design, redesign, and improvement of employment practices in community healthcare. This study brings forth the neglected issues of emotions and their implications for these healthcare workers in low and middle-income countries who are a vital link that delivers healthcare to weaker section of the society. The findings have relevance not merely for the individual providing this service but the beneficiary and the organization that facilitates this

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries

PubMed Central

2012-01-01

Background An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context. Methods Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System. Results Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries.

PubMed

Muntaner, Carles; Chung, Haejoo; Benach, Joan; Ng, Edwin

2012-04-18

An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context. Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System. Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent with their labour market

Monitoring fetal electrocortical activity during labour for predicting worsening acidemia: a prospective study in the ovine fetus near term.

PubMed

Frasch, Martin G; Keen, Ashley E; Gagnon, Robert; Ross, Michael G; Richardson, Bryan S

2011-01-01

Severe fetal acidemia during labour with arterial pH below 7.00 is associated with increased risk of hypoxic-ischemic brain injury. Electronic fetal heart rate (FHR) monitoring, the mainstay of intrapartum surveillance, has poor specificity for detecting fetal acidemia. We studied brain electrical activity measured with electrocorticogram (ECOG) in the near term ovine fetus subjected to repetitive umbilical cord occlusions (UCO) inducing FHR decelerations, as might be seen in human labour, to delineate the time-course for ECOG changes with worsening acidemia and thereby assess the potential clinical utility of fetal ECOG. Ten chronically catheterized fetal sheep were studied through a series of mild, moderate and severe UCO until the arterial pH was below 7.00. At a pH of 7.24 ± 0.04, 52 ± 13 min prior to the pH dropping <7.00, spectral edge frequency (SEF) increased to 23 ± 2 Hz from 3 ± 1 Hz during each FHR deceleration (p<0.001) and was correlated to decreases in FHR and in fetal arterial blood pressure during each FHR deceleration (p<0.001). The UCO-related changes in ECOG occurred in advance of the pH decreasing below 7.00. These ECOG changes may be a protective mechanism suppressing non-essential energy needs when oxygen supply to the fetal brain is decreased acutely. By detecting such "adaptive brain shutdown," the need for delivery in high risk pregnant patients may be more accurately predicted than with FHR monitoring alone. Therefore, monitoring fetal electroencephalogram (EEG, the human equivalent of ECOG) during human labour may be a useful adjunct to FHR monitoring.

Monitoring Fetal Electrocortical Activity during Labour for Predicting Worsening Acidemia: A Prospective Study in the Ovine Fetus Near Term

PubMed Central

Frasch, Martin G.; Keen, Ashley E.; Gagnon, Robert; Ross, Michael G.; Richardson, Bryan S.

2011-01-01

Background Severe fetal acidemia during labour with arterial pH below 7.00 is associated with increased risk of hypoxic-ischemic brain injury. Electronic fetal heart rate (FHR) monitoring, the mainstay of intrapartum surveillance, has poor specificity for detecting fetal acidemia. We studied brain electrical activity measured with electrocorticogram (ECOG) in the near term ovine fetus subjected to repetitive umbilical cord occlusions (UCO) inducing FHR decelerations, as might be seen in human labour, to delineate the time-course for ECOG changes with worsening acidemia and thereby assess the potential clinical utility of fetal ECOG. Methodology/Principal Findings Ten chronically catheterized fetal sheep were studied through a series of mild, moderate and severe UCO until the arterial pH was below 7.00. At a pH of 7.24±0.04, 52±13 min prior to the pH dropping <7.00, spectral edge frequency (SEF) increased to 23±2 Hz from 3±1 Hz during each FHR deceleration (p<0.001) and was correlated to decreases in FHR and in fetal arterial blood pressure during each FHR deceleration (p<0.001). Conclusions/Significance The UCO-related changes in ECOG occurred in advance of the pH decreasing below 7.00. These ECOG changes may be a protective mechanism suppressing non-essential energy needs when oxygen supply to the fetal brain is decreased acutely. By detecting such “adaptive brain shutdown,” the need for delivery in high risk pregnant patients may be more accurately predicted than with FHR monitoring alone. Therefore, monitoring fetal electroencephalogram (EEG, the human equivalent of ECOG) during human labour may be a useful adjunct to FHR monitoring. PMID:21789218

Optometry services in Ontario: supply - and demand-side factors from 2011 to 2036.

PubMed

Leonard, Philip Sj; Sweetman, Arthur; Zhang, Xue Helen

2014-01-01

Optometric labour market projections are provided. First, population growth and ageing-based estimates of the rate of increase of eye-care services in Ontario from 2011 to 2$ are presented, holding the age-sex structure of utilization constant. Then, using data on the 2011 supply and working hours of Ontario's optometrists, the number of optometrists needed to keep the level of optometric services per age-sex-adjusted person comparable over time is estimated. The projections suggest that the number of Ontario optometrists should grow by approximately 30-40 full-time equivalents per year; to offset retirements and account for decreasing work hours, this suggests 77-90 new practitioners are required each year. However, in recent years, the number of Ontario optometrists has been growing faster than this, suggesting either that demand has exceeded supply and/or surpluses will accumulate if this trend continues. Copyright © 2014 Longwoods Publishing.

Supply and demand challenges to modern contraceptive use in Azerbaijan.

PubMed

Bradley, Janet; Mursagulova, Nabat; Nosa, Marianna; Searing, Hannah

2007-06-01

We conducted a survey of health facilities and household members to determine supply and demand aspects of contraceptive use in Azerbaijan. In June 2005, we conducted interviews with 758 women and 253 men in a community-based survey in 40 communities in five districts. We also surveyed a sample of health facilities and pharmacies and conducted interviews with key informants. Both men and women in these communities desire small families, yet significant supply and demand impediments exist. Despite community interest, lack of knowledge of contraception is prevalent. Fear of side effects plays a role in non-use and discontinuation of modern methods, although little opportunity exists for counselling on side effects, since few health workers are trained. An obstacle to use is legislation that only allows contraception to be prescribed by gynaecologists, who are mostly concentrated in the hospitals of urban centres. However, the main handicap to increased use of modern contraception, is insufficient contraceptive supply. Not only is there a lack of method choice nationally, but few of the facilities we surveyed had any contraceptives available. This situation threatens to worsen as the United Nations Population Fund (UNFPA) retracts commodities' funding. The lack of knowledge of modern contraception, lack of trained staff and poor commodity availability signals that much remains to be done for the people of Azerbaijan to achieve their fertility control goals.

New Labour and Higher Education

ERIC Educational Resources Information Center

Watson, David

2006-01-01

This paper is the second part of an edited version of a Keynote Presentation delivered at the 2006 AUA Annual Conference at Queen's University Belfast on 11 April. The first part was published in perspectives 10.3 in July 2006. In the Presentation Sir David commented on three areas of unfinished business with which New Labour has struggled; in the…

The Birth of New Labour and the Death of Comprehensive Education

ERIC Educational Resources Information Center

Chitty, Clyde

2012-01-01

It is argued that the creation of something called "New Labour" in the mid-1990s marked the death of the comprehensive school in England--or, rather, the end of any attempt to create a nationwide system of comprehensive schools. The election of Tony Blair as Labour Party Leader in July 1994 can be viewed as THE defining year in post-war…

Quality assurance of herbal raw materials in supply chain: challenges and opportunities.

PubMed

Govindaraghavan, Suresh

2008-01-01

The herbal medicine industry is presently adopting modern scientific tools to substantiate the guarantee of efficacy that, in the past, rested only on anecdotal evidence derived from traditional knowledge systems. This is particularly true for the processes of identification of herbal raw materials adopting modern tools for phytochemical fingerprinting. The successful adaptation of available technologies and practices depends on an understanding of the phytochemical complexity and variability innate in biological material. It challenges the "mainstream medicinal mindset" that "tend(s) to reject …. therapies for which mechanisms of action do not fit within Newtonian, biochemical orientation" (Dumoff, 2003). The herbal medicinal industry is independently evolving its own rigid quality assurance and control systems using Good Manufacturing Practice (GMP) and Good Laboratory Practice (GLP) guidelines, but it faces unique difficulties. These include lack of Good Agricultural and Collection Practice (GACP), lack of transparency in the raw material supply chain so as to preclude the use of unsafe practices, problems in the authentication of herbal raw materials, and a general lack of understanding of the need to reduce phytochemical variability in these materials. This paper explores these difficulties and outlines strategies to overcome them, but these strategies will require coordinated international government regulations to be fully effective.

Differential labour market impacts from disability onset.

PubMed

Polidano, Cain; Vu, Ha

2015-03-01

We estimate the causal labour market impacts of disability onset by gender, age and education levels up to 4 years after onset using longitudinal data from the Household Income and Labour Dynamics Australia survey and difference-in-difference propensity score matching techniques. We find lasting negative impacts on employment, especially full-time employment, which is due more to reduced movement into full-time employment than downshifting from full-time to part-time work following onset. Those without post-school education qualifications are particularly vulnerable to the impacts of onset and are more likely to be out of work and on income support than those with qualifications up to 4 years after onset, due in part because they have greater difficulty adjusting. Copyright © 2013 John Wiley & Sons, Ltd.

Endoplasmic reticulum stress is induced in the human placenta during labour.

PubMed

Veerbeek, J H W; Tissot Van Patot, M C; Burton, G J; Yung, H W

2015-01-01

Placental endoplasmic reticulum (ER) stress has been postulated in the pathophysiology of pre-eclampsia (PE) and intrauterine growth restriction (IUGR), but its activation remains elusive. Oxidative stress induced by ischaemia/hypoxia-reoxygenation activates ER stress in vitro. Here, we explored whether exposure to labour represents an in vivo model for the study of acute placental ER stress. ER stress markers, GRP78, P-eIF2α and XBP-1, were significantly higher in laboured placentas than in Caesarean-delivered controls localised mainly in the syncytiotrophoblast. The similarities to changes observed in PE/IUGR placentas suggest exposure to labour can be used to investigate induction of ER stress in pathological placentas. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mediating effects of workplace violence on the relationships between emotional labour and burnout among clinical nurses.

PubMed

Kim, Hyejin; Kim, Ji-Su; Choe, Kwisoon; Kwak, Yeunhee; Song, Jae-Seok

2018-06-05

To test a model of the relationship between nurses' burnout and emotional labour using structural equation modelling to identify the mediating effects of workplace violence. Nurses are a group that experiences high emotional labour and are exposed to various types of violence in the clinical setting. Burnout is related to emotional labour as well as exposure of workplace violence, but alternatives to reduce burnout in the context of emotional labour (e.g. reduction of workplace violence) have not been extensively investigated. This study adopted a cross-sectional design. A convenience sample comprising 400 nurses from 4 university hospitals in Korea was selected from 10 - 30 October 2016. Data on nurses' level of emotional labour, burnout and workplace violence were collected from participants. A composite-indicator structural equation model was used to examine the mediation model. Overall, 356 nurses (89.0%) returned the completed questionnaires. Burnout was significantly and positively associated with emotional labour and workplace violence. In addition, workplace violence mediated the relationship between emotional labour and burnout related to the nursing job. The findings suggest that, to alleviate burnout in clinical nurses due to emotional labour, various programs and policy measures should be adopted to prevent their exposure to workplace violence and to enhance the organizational management of violence. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Relaxation techniques for pain management in labour.

PubMed

Smith, Caroline A; Levett, Kate M; Collins, Carmel T; Crowther, Caroline A

2011-12-07

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of relaxation therapies for pain management in labour. To examine the effects of relaxation methods for pain management in labour on maternal and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2010), The Cochrane Complementary Medicine Field's Trials Register (November 2011), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 4), MEDLINE (1966 to 30 November 2010), CINAHL (1980 to 30 November 2010), the Australian and New Zealand Clinical Trial Registry (30 November 2010), Chinese Clinical Trial Register (30 November 2010), Current Controlled Trials (30 November 2010), ClinicalTrials.gov, (30 November 2010) ISRCTN Register (30 November 2010), National Centre for Complementary and Alternative Medicine (NCCAM) (30 November 2010) and the WHO International Clinical Trials Registry Platform (30 November 2010). Randomised controlled trials comparing relaxation methods with standard care, no treatment, other non-pharmacological forms of pain management in labour or placebo. Three review authors independently assessed trials for inclusion and extracted data. Data were checked for accuracy. Two review authors independently assessed trial quality. We attempted to contact study authors for additional information. We included 11 studies (1374 women) in the review. Relaxation was associated with a reduction in pain intensity during the latent phase (mean difference (MD) -1.25, 95% confidence interval (CI) -1.97 to -0.53, one trial, 40 women) and active phase of labour (MD -2.48, 95% CI -3.13 to 0.83, two trials, 74 women). There was evidence of improved outcomes from relaxation instruction with increased satisfaction with pain

Impact of maternal age on delivery outcomes following spontaneous labour at term.

PubMed

Omih, Edwin Eseoghene; Lindow, Stephen

2016-10-01

Pregnancy in women of advancing maternal age is linked to incrementally worsening perinatal outcome. The aim of this study is to assess the impact of maternal age on delivery outcome in women that spontaneously labour at term. This was a retrospective study of women that spontaneously labour at term. Women with singletons in spontaneous onset labour beyond 37 weeks of gestation were divided into five maternal age groups: <19 years, 20-24 years, 25-29 years, 30-34 years and >35 years by their age at delivery. The main outcome variables are augmentation of labour, caesarean section, assisted vaginal delivery, and perineal trauma, while admission of the newborn into the neonatal unit within 24 h following delivery was the secondary outcome measure. A total of 30,022 met the inclusion criteria with primiparae and multiparae accounting for 46 and 54%, respectively. Increasing age in primiparae was associated with; augmentation of labour OR 2.05 (95% CI 1.73-2.43), second degree perineal tear 1.35 (1.12-1.61), assisted vaginal delivery 1.92 (1.53-2.41) and caesarean section 4.23 (3.19-5.12). While that for multiparae; augmentation of labour OR 1.93 (1.05-3.52), perineal trauma 2.50 (1.85-3.34), assisted vaginal delivery 4.95 (91.82-13.35) and caesarean section 1.64 (1.13-2.38). The secondary outcome measure did not reach statistical significance. Increasing maternal age is an independent risk factor for operative delivery, and perineal trauma. However, maternal age has no significant effect on admission of infants into the NICU during the first 24 h following delivery.

KLF5 regulates infection- and inflammation-induced pro-labour mediators in human myometrium.

PubMed

Lappas, Martha

2015-05-01

The transcription factor Kruppel-like factor 5 (KLF5) has been shown to associate with nuclear factor kappa B (NFκB) to regulate genes involved in inflammation. However, there are no studies on the expression and regulation of KLF5 in the processes of human labour and delivery. Thus, the aims of this study were to determine the effect of i) human labour on KLF5 expression in both foetal membranes and myometrium; ii) the pro-inflammatory cytokine interleukin 1 beta (IL1β), bacterial product flagellin and the viral dsRNA analogue poly(I:C) on KLF5 expression and iii) KLF5 knockdown by siRNA in human myometrial primary cells on pro-inflammatory and pro-labour mediators. In foetal membranes, there was no effect of term or preterm labour on KLF5 expression. In myometrium, the term labour was associated with an increase in nuclear KLF5 protein expression. Moreover, KLF5 expression was also increased in myometrial cells treated with IL1β, flagellin or poly(IC), likely factors contributing to preterm birth. KLF5 silencing in myometrial cells significantly decreased IL1β-induced cytokine expression (IL6 and IL8 mRNA expression and release), COX2 mRNA expression, and subsequent release of prostaglandins PGE2 and PGF2 α. KLF5 silencing also significantly reduced flagellin- and poly(I:C)-induced IL6 and IL8 mRNA expression. Lastly, IL1β-, flagellin- and poly(I:C)-stimulated NFκB transcriptional activity was significantly suppressed in KLF5-knockout myometrial cells. In conclusion, this study describes novel data in which KLF5 is increased in labouring myometrium, and KLF5 silencing decreased inflammation- and infection-induced pro-labour mediators. © 2015 Society for Reproduction and Fertility.

Status of small water supplies in the Nordic countries: Characteristics, water quality and challenges.

PubMed

Gunnarsdottir, Maria J; Persson, Kenneth M; Andradottir, Hrund O; Gardarsson, Sigurdur M

2017-11-01

Access to safe water is essential for public health and is one of the most important prerequisites for good living and safe food production. Many studies have shown that non-compliance with drinking water quality standards in small water supply systems is much higher than in large systems. Nevertheless, people served by small water supply systems have the right to the same level of health protection. Actions are therefore needed to improve the situation. The objective of the present study was to carry out a baseline analysis of the situation in the Nordic region and provide recommendations for governmental policy and actions. Data were gathered on number of water supplies, population served, compliance with regulations and waterborne disease outbreaks from various sources in the Nordic countries. The collected data showed that there are about 12500 regulated water supplies, 9400 of which serve fewer than 500 persons. The number of unregulated and poorly regulated supplies is unknown, but it can be roughly estimated that these serve 10% of the Nordic population on a permanent basis or 2.6 million people. However, this does not tell the whole story as many of the very small water supplies serve transient populations, summerhouse dwellers and tourist sites, with many more users. Non-compliance regarding microbes is much higher in the small supplies. The population weighted average fecal contamination incidence rate in the Nordic region is eleven times higher in the smaller supplies than in the large ones, 0.76% and 0.07%, respectively. Registered waterborne disease outbreaks were also more frequent in the small supplies than in the large ones. Copyright © 2017 Elsevier GmbH. All rights reserved.

Emotional labour, job satisfaction and organizational commitment amongst clinical nurses: a questionnaire survey.

PubMed

Yang, Feng-Hua; Chang, Chen-Chieh

2008-06-01

According to Hochschild's (1983. The Managed Heart. Berkeley: University of California Press) classification of emotional labour, nursing staff express high emotional labour. This paper investigates how nursing staff influence job satisfaction and organizational commitment when they perform emotional labour. This paper examines the relationship between emotional labour, job satisfaction, and organizational commitment from the perspective of nursing staff. A questionnaire survey was carried out to explore these interrelationships. Teaching hospital in Taiwan. Questionnaires were distributed to 500 nursing staff; 295 valid questionnaires were collected and analysed-a 59% response rate. The questionnaires contained items on emotional labour, job satisfaction, and organizational commitment as well as some basic socio-demographics. In addition, descriptive statistics, correlation and linear structure relation (LISREL) were computed. Emotional display rule (EDR) was significantly and negatively related to job satisfaction. Surface acting (SA) was not significantly related to job satisfaction but demonstrated a significantly negative relationship with organizational commitment. Deep acting (DA) significantly and positively correlated with job satisfaction but demonstrated no significance with organizational commitment. The variety of emotions required (VER) was not significantly related to job satisfaction; frequency and duration of interaction (FDI) and negatively related to job satisfaction; and job satisfaction significantly and positively correlated with organizational commitment. We found that some dimensions of emotional labour significantly relate to job satisfaction. Job satisfaction positively affects organizational commitment and has an intervening effect on DA and organizational commitment.

Economic Competencies and Situation-Specific Commercial Competencies: Reflections on Conceptualization and Measurement

ERIC Educational Resources Information Center

Seeber, Susan

2016-01-01

From a societal perspective, vocational education and training must enable young adults to meet the challenges of the labour market in a globalized world, reduce the mismatch of supply and demand of qualifications (e.g. youth unemployment leading to disadvantages for individuals, society and national economies) and improve social cohesion. From an…

Temporary agency work, migration and the crisis in Greece: labour market segmentation intensified

PubMed Central

2016-01-01

This article focuses on the under-researched temporary agency employment in Greece. It shows that the development of the temporary employment agency sector has gone hand in hand with the flow of undocumented and exploitable migrant labour in Greece over the past 25 years, reflecting the segmentation of the Greek labour market along ethnic lines. Using empirical research evidence on the operation of temporary employment agencies in the Greek hospitality and health care sectors, the article highlights the precarious or even illicit nature of agency employment in a context in which labour outsourcing and flexible employment are promoted by policy-makers. Last but not least, it suggests that the segmented landscape of the Greek labour market has become more complex during the economic crisis, with more and more Greeks drawn to agency-mediated precarious employment. PMID:27499601

Epidural analgesia during labour, routinely or on request: a cost-effectiveness analysis.

PubMed

Bonouvrié, Kimberley; van den Bosch, Anouk; Roumen, Frans J M E; van Kuijk, Sander M; Nijhuis, Jan G; Evers, Silvia M A A; Wassen, Martine M L H

2016-12-01

To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum. Effectiveness was defined as a non-operative, spontaneous vaginal delivery without EA-related maternal adverse effects. Incremental cost-effectiveness ratio (ICER) was defined as the ratio of the difference in costs and the difference in effectiveness between both groups. Data were analysed according to intention to treat and divided into a base case analysis and a sensitivity analysis. Total delivery costs in the routine EA group (n=233) were higher than in the labour on request group (n=255) (difference -€ 322, 95% CI -€ 60 to € 355) due to more medication costs (including EA), a longer stay in the labour ward, and more operations including caesarean sections. Total postpartum hospital costs in the routine EA group were lower (difference -€ 344, 95% CI -€ 1338 to € 621) mainly due to less neonatal admissions (difference -€ 472, 95% CI -€ 1297 to € 331), whereas total postpartum home and others costs were comparable (difference -€ 20, 95% CI -€ 267 to € 248, and -€ 1, 95% CI -€ 67 to € 284, respectively). As a result, the overall mean costs per woman were comparable between the routine EA group and the analgesia on request group (€ 8.708 and € 8.710, respectively, mean difference -€ 2, 95% CI -€ 1.012 to € 916). Routine labour EA resulted in more deliveries with maternal adverse effects, nevertheless the ICER remained low (€ 8; bootstrap 95% CI -€ 6.120 to € 8.659). The cost-effectiveness acceptability curve indicated a low probability that

Relaxation techniques for pain management in labour.

PubMed

Smith, Caroline A; Levett, Kate M; Collins, Carmel T; Armour, Mike; Dahlen, Hannah G; Suganuma, Machiko

2018-03-28

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an update of a review first published in 2011. To examine the effects of mind-body relaxation techniques for pain management in labour on maternal and neonatal well-being during and after labour. We searched Cochrane Pregnancy and Childbirth's Trials Register (9 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 5 2017), MEDLINE (1966 to 24 May 2017), CINAHL (1980 to 24 May 2017), the Australian New Zealand Clinical Trials Registry (18 May 2017), ClinicalTrials.gov (18 May 2017), the ISRCTN Register (18 May 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (18 May 2017), and reference lists of retrieved studies. Randomised controlled trials (including quasi randomised and cluster trials) comparing relaxation methods with standard care, no treatment, other non-pharmacological forms of pain management in labour or placebo. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We attempted to contact study authors for additional information. We assessed evidence quality with GRADE methodology. This review update includes 19 studies (2519 women), 15 of which (1731 women) contribute data. Interventions examined included relaxation, yoga, music and mindfulness. Approximately half of the studies had a low risk of bias for random sequence generation and attrition bias. The majority of studies had a high risk of bias for performance and detection bias, and unclear risk of bias for, allocation concealment, reporting bias and other bias. We assessed the evidence from these studies as ranging from low to very low quality, and

The impact of Chernobyl on health and labour market performance.

PubMed

Lehmann, Hartmut; Wadsworth, Jonathan

2011-09-01

Using longitudinal data from Ukraine we examine the extent of any long-lasting effects of exposure to the Chernobyl disaster on the health and labour market performance of the adult workforce. Variation in the local area level of radiation fallout from the Chernobyl accident is considered as a random exogenous shock with which to try to establish its causal impact on poor health, labour force participation, hours worked and wages. There appears to be a significant positive association between local area-level radiation dosage and perception of poor health, though much weaker associations between local area-level dosage and other specific self-reported health conditions. There is also some evidence to suggest that those who lived in areas more exposed to Chernobyl-induced radiation have significantly lower levels of labour market performance 20 years on. Copyright © 2011 Elsevier B.V. All rights reserved.

Somatic Complaints in Adolescence and Labour Market Participation in Young Adulthood.

PubMed

Winding, Trine Nøhr; Andersen, Johan Hviid

2018-05-01

The primary aim was to investigate the association between somatic symptoms at ages 15 or 18 and reduced labour market participation at age 23, when socioeconomic, social, and mental health risk factors were taken into account. The study included 3223 participants from the West Jutland Cohort Study with questionnaire information on somatic symptoms at ages 15 or 18 and with register information on labour market participation at age 23, gathered from a national register on all public transfer benefits for a 52-week period. The analyses included additional information about socioeconomic background, number of negative life events, social climate in the family, social relations with friends, and depressive symptoms. Logistic regression analyses yielded odds ratios with 95% confidence intervals. Among the males, associations between reporting somatic symptoms at age 18 and low labour market participation was seen in both crude and adjusted analyses (odds ratio: 1.66; 95% confidence intervals: 1.01-2.75), whereas the association among the females disappeared after adjustments (odds ratio: 0.97; 95% confidence intervals: 0.63-1.52). The males that reported somatic symptoms in late adolescence appeared to be the most vulnerable to future reduced labour market participation.

Exploring Heat Stress Relief Measures among the Australian Labour Force

PubMed Central

Zander, Kerstin K.; Mathew, Supriya; Garnett, Stephen T.

2018-01-01

Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%), 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected temperature

Exploring Heat Stress Relief Measures among the Australian Labour Force.

PubMed

Zander, Kerstin K; Mathew, Supriya; Garnett, Stephen T

2018-02-26

Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%), 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected temperature

Psychosocial stress in pregnancy and its relation to the onset of premature labour.

PubMed Central

Newton, R W; Webster, P A; Binu, P S; Maskrey, N; Phillips, A B

1979-01-01

A modified life events inventory was presented over a four-month period to 132 consecutive women going into spontaneous labour in Hull and Manchester. Three study groups were identified according to the duration of pregnancy. The levels of psychosocial stress in pregnancy were found to be particularly high in the mothers whose babies were born preterm. Stressful events may precipitate preterm labour in some women. The concept of antenatal care may have to be broadened if the incidence of premature labour and resulting perinatal mortality are to be reduced. PMID:486966

Psychosocial stress in pregnancy and its relation to the onset of premature labour.

PubMed

Newton, R W; Webster, P A; Binu, P S; Maskrey, N; Phillips, A B

1979-08-18

A modified life events inventory was presented over a four-month period to 132 consecutive women going into spontaneous labour in Hull and Manchester. Three study groups were identified according to the duration of pregnancy. The levels of psychosocial stress in pregnancy were found to be particularly high in the mothers whose babies were born preterm. Stressful events may precipitate preterm labour in some women. The concept of antenatal care may have to be broadened if the incidence of premature labour and resulting perinatal mortality are to be reduced.

Labour Law in Canadian Higher Education

ERIC Educational Resources Information Center

Barnetson, Bob

2006-01-01

The legislative framework for academic and nonacademic unionization and collective bargaining in Canadian public colleges, universities and technical institutes is set out and compared with mainstream labour law. Significant deviations affecting academic staff in the province of Alberta are explored to understand their effect and the factors which…

Digital labour and development: impacts of global digital labour platforms and the gig economy on worker livelihoods

PubMed Central

Hjorth, Isis; Lehdonvirta, Vili

2017-01-01

As ever more policy-makers, governments and organisations turn to the gig economy and digital labour as an economic development strategy to bring jobs to places that need them, it becomes important to understand better how this might influence the livelihoods of workers. Drawing on a multi-year study with digital workers in Sub-Saharan Africa and South-east Asia, this article highlights four key concerns for workers: bargaining power, economic inclusion, intermediated value chains, and upgrading. The article shows that although there are important and tangible benefits for a range of workers, there are also a range of risks and costs that unduly affect the livelihoods of digital workers. Building on those concerns, it then concludes with a reflection on four broad strategies – certification schemes, organising digital workers, regulatory strategies and democratic control of online labour platforms – that could be employed to improve conditions and livelihoods for digital workers. PMID:28781494

Fetal electrocardiogram (ECG) for fetal monitoring during labour.

PubMed

Neilson, James P

2015-12-21

Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment. Technical systems have therefore been developed to monitor the fetal ECG during labour as an adjunct to continuous electronic fetal heart rate monitoring with the aim of improving fetal outcome and minimising unnecessary obstetric interference. To compare the effects of analysis of fetal ECG waveforms during labour with alternative methods of fetal monitoring. The Cochrane Pregnancy and Childbirth Group's Trials Register (latest search 23 September 2015) and reference lists of retrieved studies. Randomised trials comparing fetal ECG waveform analysis with alternative methods of fetal monitoring during labour. One review author independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. One review author assessed the quality of the evidence using the GRADE approach. Seven trials (27,403 women) were included: six trials of ST waveform analysis (26,446 women) and one trial of PR interval analysis (957 women). The trials were generally at low risk of bias for most domains and the quality of evidence for ST waveform analysis trials was graded moderate to high. In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no obvious difference to primary outcomes: births by caesarean section (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.96 to 1.08; six trials, 26,446 women; high quality evidence); the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (average RR 0.72, 95% CI 0.43 to 1.20; six trials, 25,682 babies; moderate quality evidence); or babies with neonatal encephalopathy (RR 0.61, 95% CI 0.30 to 1.22; six trials, 26,410 babies; high quality evidence). There were, however, on average

Massage, reflexology and other manual methods for pain management in labour.

PubMed

Smith, Caroline A; Levett, Kate M; Collins, Carmel T; Dahlen, Hannah G; Ee, Carolyn C; Suganuma, Machiko

2018-03-28

Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012. To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour. For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 6), MEDLINE (1966 to 30 June 2017, CINAHL (1980 to 30 June 2017), the Australian New Zealand Clinical Trials Registry (4 August 2017), Chinese Clinical Trial Registry (4 August 2017), ClinicalTrials.gov, (4 August 2017), the National Center for Complementary and Integrative Health (4 August 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (4 August 2017) and reference lists of retrieved trials. We included randomised controlled trials comparing manual methods with standard care, other non-pharmacological forms of pain management in labour, no treatment or placebo. We searched for trials of the following modalities: massage, warm packs, thermal manual methods, reflexology, chiropractic, osteopathy, musculo-skeletal manipulation, deep tissue massage, neuro-muscular therapy, shiatsu, tuina, trigger point therapy, myotherapy and zero balancing. We excluded trials for pain management relating to hypnosis, aromatherapy, acupuncture and acupressure; these are included in other Cochrane reviews. Two review authors independently assessed trial quality, extracted data and checked data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included a total of 14 trials; 10 of these (1055 women

Emotional labour and aboriginal maternal infant care workers: The invisible load.

PubMed

Kirkham, R; Rumbold, A; Hoon, E; Stuart-Butler, D; Moore, V

2018-04-01

The term 'emotional labour' has been used to describe the competing demands on midwives to empathize with clients whilst maintaining a level of professional detachment. Previous research indicates that when individuals experience difficulty managing these emotions, burnout may result. Aboriginal health care workers often have roles with large emotional demands, as they are relied upon heavily to engage clients in care. However, the concept of emotional labour has received little attention in relation to this group. To explore potential sources of emotional labour for Aboriginal Maternal Infant Care workers in a maternity care program for Aboriginal women in South Australia. The program involves these workers providing care for women in partnership with midwives. We employed a phenomenological approach. Thirty in-depth interviews were conducted with staff and clients of the program. Recorded interviews were transcribed and coded and emerging themes identified. This workforce undertakes extensive emotional labour. Key sources include the cultural and family obligations they have to clients, complex social needs of many clients, and potential for community backlash when poor perinatal outcomes occur. A lack of respect for the role within the workplace further contributes to these experiences. This study found that the responsibilities inherent to the role as both cultural broker and carer create significant emotional labour for workers. Recommendations to address this and enhance the sustainability of this workforce include: recognition and valuing of emotional work by management and other staff, enhancing cultural awareness training, and building stress-relieving activities into the workplace. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The Challenge of Measurement: Statistics for Planning Human Resource Development. Conference Paper

ERIC Educational Resources Information Center

Karmel, Tom

2011-01-01

This presentation was made to a breakout session at the 2011 Skills Australia and Industry Skills Councils joint conference, "Putting Skills at the Heart of Economy". The paper addresses the challenge of measurement in workforce development planning and discusses the role of the various players in the labour and training…

[Reform steps toward networking sheltered workshops and the general labour market].

PubMed

Wendt, S

2010-02-01

Only 0.16% of disabled employees are enabled to change from sheltered workshops to the general labour market. At the same time the number of disabled employees in sheltered workshops is increasing more than anticipated. Investigations into the growing admissions to sheltered workshops resulted in recommendations to improve the practice of change over. More and more admissions of students having finished special schools could be reduced by improved cooperation between special schools and the local employment market. Special schools should offer suitable job trainings and support students to develop an understanding of the requirements of specific jobs and of their opportunities to develop their skills to do these jobs. In 2009, supported employment has been regulated in social security law, lasting up to three years and aimed at qualifying disabled youngsters for employment in the general labour market instead of entering sheltered workshops. The majority of admissions to sheltered workshops in the meantime concern people with psychological handicaps, with more than 30% however leaving the workshops later on. For this population, "virtual sheltered workshops" are offering more suitable means for reintegration in the general labour market, such as temporary employment in the general labour market or in occupations with small earnings. The personal budget for work is meant to be a model project within the German Länder, to transfer personal support from the sheltered workshop into the general labour market. The conference of German Länder Ministers of Social Affairs has been active since 2007 to develop a concept for reform of the social security law concerning integration assistance for disabled people, which in future is to concentrate on individual needs, removal of obstacles in the law to facilitate the transition from sheltered workshops into the general labour market. The "Deutsche Verein für öffentliche und private Fürsorge" (German association for public

A View of Aesthetic Labour Practice in Higher Technical and Vocational Education

ERIC Educational Resources Information Center

Yang, Cheng-Hua

2017-01-01

Even though aesthetic labour has gradually revealed social and economic value in the employment market, little research has been carried out on the connection and practice of aesthetic labour in technical and vocational education. Front-line ground staffs account for the largest proportion of the employees of airlines and can provide colleges with…

Stakeholders Integration in Higher Education: Supply Chain Approach

ERIC Educational Resources Information Center

Al-Turki, U. M.; Duffuaa, S.; Ayar, T.; Demirel, O.

2008-01-01

Supply chain management principles have emerged in the last decade as a strategic option to meet new challenges in global business environment. Viewing business environment as part of a chain, starting from raw material suppliers to end customers passing by producers, is at the heart of supply-chain management. Many management principles have…

Elective repeat caesarean section versus induction of labour for women with a previous caesarean birth.

PubMed

Dodd, Jodie M; Crowther, Caroline A; Grivell, Rosalie M; Deussen, Andrea R

2014-12-19

When a woman has had a previous caesarean birth and requires induction of labour in a subsequent pregnancy there are two options for her care, an elective repeat caesarean or planned induction of labour. While there are risks and benefits for both elective repeat caesarean birth and planned induction of labour, current sources of information are limited to non-randomised cohort studies. Studies designed in this way have significant potential for bias and consequently any conclusions based on these results are limited in their reliability and should be interpreted with caution. To assess, using the best available evidence, the benefits and harms of elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth, who require induction of labour in a subsequent pregnancy. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (31 October 2014). Randomised controlled trials with reported data that compared outcomes in mothers and babies for women who planned an elective repeat caesarean section with outcomes in women who planned induction of labour, where a previous birth had been by caesarean. There was no data extraction performed. There were no randomised controlled trials identified. Both planned elective repeat caesarean section and planned induction of labour for women with a prior caesarean birth are associated with benefits and harms. Evidence for these care practices is drawn from non-randomised studies that are associated with potential bias. Any results and conclusions must therefore be interpreted with caution. Randomised controlled trials are required to provide the most reliable evidence regarding the benefits and harms of both planned elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth.

Flexibility evaluation of multiechelon supply chains.

PubMed

Almeida, João Flávio de Freitas; Conceição, Samuel Vieira; Pinto, Luiz Ricardo; de Camargo, Ricardo Saraiva; Júnior, Gilberto de Miranda

2018-01-01

Multiechelon supply chains are complex logistics systems that require flexibility and coordination at a tactical level to cope with environmental uncertainties in an efficient and effective manner. To cope with these challenges, mathematical programming models are developed to evaluate supply chain flexibility. However, under uncertainty, supply chain models become complex and the scope of flexibility analysis is generally reduced. This paper presents a unified approach that can evaluate the flexibility of a four-echelon supply chain via a robust stochastic programming model. The model simultaneously considers the plans of multiple business divisions such as marketing, logistics, manufacturing, and procurement, whose goals are often conflicting. A numerical example with deterministic parameters is presented to introduce the analysis, and then, the model stochastic parameters are considered to evaluate flexibility. The results of the analysis on supply, manufacturing, and distribution flexibility are presented. Tradeoff analysis of demand variability and service levels is also carried out. The proposed approach facilitates the adoption of different management styles, thus improving supply chain resilience. The model can be extended to contexts pertaining to supply chain disruptions; for example, the model can be used to explore operation strategies when subtle events disrupt supply, manufacturing, or distribution.

Potable water supply in U.S. manned space missions

NASA Technical Reports Server (NTRS)

Sauer, Richard L.; Straub, John E., II

1992-01-01

A historical review of potable water supply systems used in the U.S. manned flight program is presented. This review provides a general understanding of the unusual challenges these systems have presented to the designers and operators of the related flight hardware. The presentation concludes with the projection of how water supply should be provided in future space missions - extended duration earth-orbital and interplanetary missions and lunar and Mars habitation bases - and the challenges to the biomedical community that providing these systems can present.

Are All Children Equal? Causative Factors of Child Labour in Selected Districts of South Punjab, Pakistan

ERIC Educational Resources Information Center

Haider, Syed Zubair; Qureshi, Ayesha

2016-01-01

The present study investigates the causative factors of child labour in selected districts of South Punjab, Pakistan. As a member of the International Labour Organization (ILO) Pakistan has a responsibility to stamp out child labour from its regions. Our sample was selected from seven working environments (workshops, hotels, tea stalls,…

Higher Education Teachers and Emotional Labour

ERIC Educational Resources Information Center

Constanti, Panikkos; Gibbs, Paul

2004-01-01

Service organizations are encouraged to consider the manner in which employees perform at the customer/front-line employee interface, as a means to gain competitive advantage. The employee's behaviour requires "emotional labour" where the front-line employee (academic), has to either conceal or manage actual feelings for the benefit of a…

Use of active management of the third stage of labour in seven developing countries.

PubMed

Stanton, Cynthia; Armbruster, Deborah; Knight, Rod; Ariawan, Iwan; Gbangbade, Sourou; Getachew, Ashebir; Portillo, Jose Angel; Jarquin, Douglas; Marin, Flor; Mfinanga, Sayoka; Vallecillo, Jesus; Johnson, Hope; Sintasath, David

2009-03-01

To document the use of active management of the third stage of labour for preventing postpartum haemorrhage and to explore factors associated with such use in seven developing countries. Nationally representative samples of facility-based deliveries were selected and observed to determine the use of active management of the third stage of labour and associated factors. Policies on active management were assessed through document review and interviews with relevant professionals. Use of a uterotonic during the third or fourth stages of labour was nearly universal. Correct use of active management of the third stage of labour was found in only 0.5% to 32% of observed deliveries due to multiple deficiencies in practice. In every country except Indonesia, policies regarding active management were conflicting. Developing countries have not targeted decreasing postpartum haemorrhage as an achievable goal; there is little use of active management of the third stage of labour, and policies regarding such management often conflict. Studies are needed to identify the most effective components of active management so that the most efficient package of practices can be promoted.

Labour and Hospitals in Urban Yorkshire: Middlesbrough, Leeds and Sheffield, 1919–1938

PubMed Central

Doyle, Barry

2010-01-01

In the debates over the politics of National Health Service foundation, there has been little investigation of the attitudes of the inter-war labour movement to a state-run hospital system. In particular, there has been limited assessment of views outside parliament in provincial Labour parties and trade unions. Drawing on a case study of Middlesbrough, Leeds and Sheffield, this article examines the politics of hospital provision prior to the National Health Service (NHS). It focuses on the involvement of the labour movement in hospital provision within localities and on the extent to which the dominant form of labour politics—labourist or socialist—shaped hospital policy. It suggests that, in the heavy industrial towns of Middlesbrough and Sheffield, close involvement with voluntary hospitals through workers contributory schemes dampened the enthusiasm for a state system. However, such a policy was heavily promoted by socialists in more economically diverse Leeds.

The Labour Welfare Fund Laws (Amendment) Act, 1987 (No. 15 of 1987), 22 May 1987.

PubMed

1987-01-01

This Act authorizes funds constituted under the Mica Mines Labour Welfare Fund Act, 1946, the Limestone and Dolomite Mines Labour Welfare Fund Act, 1972, the Iron Ore Mines, Manganese Ore Mines and Chrome Mines Labour Welfare Fund Act, 1976, and the Beedi Workers Welfare Fund Act, 1976, to be applied for the provision of family welfare, including family planning education and services. full text

Does Social Labelling Encourage Child Schooling and Discourage Child Labour in Nepal?

ERIC Educational Resources Information Center

Chakrabarty, Sayan; Grote, Ulrike; Luchters, Guido

2011-01-01

This paper explores the determinants of child labour vis-a-vis child schooling. It further examines the influence of non-governmental organisations (NGOs) which are engaged in social labelling, on the incidence of child labour and schooling trade-off. The empirical results show that the probability of child schooling increases as well as child…

Maternal obesity and its effect on labour duration in nulliparous women: a retrospective observational cohort study.

PubMed

Ellekjaer, Karen Louise; Bergholt, Thomas; Løkkegaard, Ellen

2017-07-12

Obesity is increasing among primipara women. We aimed to describe the association between body mass index (BMI) during early-pregnancy and duration of labour in nulliparous women. Retrospective observational cohort study of 1885 nulliparous women with a single cephalic presentation from 37 0/7 to 42 6/7 weeks of completed gestation and spontaneous or induced labour at Nordsjællands Hospital, University of Copenhagen, Denmark, in 2011 and 2012. Total duration of labour and the first and second stages of labour were compared between early-pregnancy normal-weight (BMI <25 kg/m 2 ), overweight (BMI 25-29.9 kg/m 2 ), and obese (BMI ≥30 kg/m 2 ) women. Proportional hazards and multiple logistic regression models were applied. Early pregnancy BMI classified 1246 (66.1%) women as normal weight, 350 (18.6%) as overweight and 203 (10.8%) as obese. No difference in the duration of total or first stage of active labour was found for overweight (adjusted HR = 1.01, 95% CI 0.88-1.16) or obese (adjusted HR = 1.07, 95% CI 0.90-1.28) compared to normal weight women. Median active labour duration was 5.83 h for normal weight, 6.08 h for overweight and 5.90 h for obese women. The risk of caesarean delivery increased significantly for overweight and obese compared to normal weight women (odds ratios (OR) 1.62; 95%CI 1.18-2.22 and 1.76; 95%CI 1.20-2.58, respectively). Caesarean deliveries were performed earlier in labour in obese than normal-weight women (HR = 1.80, 95%CI 1.28-2.54). BMI had no significant effect on total duration of active labour. Risk of caesarean delivery increased with increasing BMI. Caesarean deliveries are undertaken earlier in obese women compared to normal weight women following the onset of active labour, shortening the total duration of active labour.

Implementing the European Quality Assurance in Vocational Education and Training (EQAVET) at National Level: Some Insights from the PEN Leonardo Project

ERIC Educational Resources Information Center

Gatt, Suzanne; Faurschou, Kim

2016-01-01

EQAVET, the quality assurance tool in vocational and educational training, was developed in response to the need for a supply of a trained workforce for labour market needs. Implementation of EQAVET at national level, however, remains a challenge. The research reported here focused on the implementation of QA processes by VET providers in 4…

The Complexities of Implementing Cluster Supply Chain - Case Study of JCH

NASA Astrophysics Data System (ADS)

Xue, Xiao; Zhang, Jibiao; Wang, Yang

As a new type of management pattern, "cluster supply chain" (CSC) can help SMEs to face the global challenges through all kinds of collaboration. However, a major challenge in implementing CSC is the gap between theory and practice in the field. In an effort to provide a better understanding of this emerging phenomenon, this paper presents the implementation process of CSC in the context of JingCheng Mechanical & Electrical Holding co., ltd.(JCH) as a case study. The cast study of JCH suggests that the key problems in the practice of cluster supply chain: How do small firms use cluster supply chain? Only after we clarify the problem, the actual construction and operation of cluster supply chain does show successful results as it should be.

Marital status, labour force activity and mortality: a study in the USA and six European countries.

PubMed

Van Hedel, Karen; Van Lenthe, Frank J; Avendano, Mauricio; Bopp, Matthias; Esnaola, Santiago; Kovács, Katalin; Martikainen, Pekka; Regidor, Enrique; Mackenbach, Johan P

2015-07-01

Labour force activity and marriage share some pathways through which they potentially influence health. In this paper, we examine whether marriage and labour force participation interact in the way they influence mortality in the USA and six European countries. We used data from the US National Health Interview Survey linked to the National Death Index, and national mortality registry data for Austria, England/Wales, Finland, Hungary, Norway and Spain (specifically, the Basque country) during 1999-2007, for men and women aged 30-59 years at baseline. We used Poisson regression to estimate both the additive (relative excess risk due to interaction) and multiplicative interactions between marriage and labour force activity on mortality. Labour force inactivity was associated with higher mortality, but this association was stronger for unmarried, rather than married, individuals. Likewise, being unmarried was associated with higher mortality, but this association was stronger for inactive than for active individuals. To illustrate, among US women out of the labour force, being unmarried was associated with a 3.98 times (95%CI 3.28-4.82) higher risk of dying than being married; whereas the relative risk (RR) was 2.49 (95%CI 2.10-2.94), for women who were active in the labour market. Although this interaction between marriage and labour force activity was only significant for women on a multiplicative scale, there was a significant additive interaction for both men and women. The pattern was similar across all countries. Marriage attenuated the increased mortality risk associated with labour force inactivity; while labour force activity attenuated the mortality risk associated with being unmarried. Our study emphasizes the importance of public health and social policies that improve the health and well-being of unmarried and inactive men and women. © 2015 the Nordic Societies of Public Health.

The Role of Qualifications in Foreign Labour Mobility in Australia. Research Report

ERIC Educational Resources Information Center

Misko, Josie

2012-01-01

Australia has had a long history of using migrants to fill skill gaps and labour shortages, and continues to target skilled foreign workers for permanent and temporary migration. The purpose of this report is to investigate the role of qualifications in the labour mobility of these foreign workers, especially as those who do not have employer…

Supply chain optimization for pediatric perioperative departments.

PubMed

Davis, Janice L; Doyle, Robert

2011-09-01

Economic challenges compel pediatric perioperative departments to reduce nonlabor supply costs while maintaining the quality of patient care. Optimization of the supply chain introduces a framework for decision making that drives fiscally responsible decisions. The cost-effective supply chain is driven by implementing a value analysis process for product selection, being mindful of product sourcing decisions to reduce supply expense, creating logistical efficiency that will eliminate redundant processes, and managing inventory to ensure product availability. The value analysis approach is an analytical methodology for product selection that involves product evaluation and recommendation based on consideration of clinical benefit, overall financial impact, and revenue implications. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Labour management and Obstetric outcomes among pregnant women admitted in latent phase compared to active phase of labour at Bugando Medical Centre in Tanzania

PubMed Central

2014-01-01

Background Interventions given to women admitted in latent or active phase of labor may influence the outcomes of labor and ameliorate complications which can affect the mother and fetus. Labour management, maternal and fetal outcomes among low risk women presenting both in latent phase and active phase of labour in Tanzania have not recently been explored. Methods This was a descriptive cross-sectional study. It was done from February to April 2013. Case notes were collected serially until the sample size was reached. A structured checklist was used to extract data. Data was analyzed using SPSS version 17. A p < 0.05 was considered significant at 95% confidence interval. Results Five hundred case notes of low risk pregnant women were collected, half of each presented in latent phase and active phase of labour. Key interventions including augmentation with oxytocin, artificial rupture of membranes and caesarean section were significantly higher in the latent phase group than the active phase group 84(33.6%) versus 52(20.8%) p < 0.05; 96(38.6%) versus 56(22.4%) p < 0.05 and 87(34.8%) versus 60(24.0%) p < 0.05 respectively. Spontaneous vertex delivery was higher among pregnant women admitted initially in active phase than in latent phase groups 180(72.0%), versus 153(61.2%) p > 0.01). There were more women in the active phase group who sustained genital tract tear and postpartum haemorrhage than in the latent phase group 101(18.6%), versus 38(15.6%) p < 0.01 and 46(18.4%), versus 17(6.6%) p < 0.05 respectively. Conclusions Pregnant women admitted at BMC in latent phase of labour are subjected to more obstetric interventions than those admitted in the active phase. There is need to produce guidelines on management of women admitted in latent phase of labour at BMC to reduce the risk of unnecessary interventions. PMID:24521301

A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent.

PubMed

Tutschek, B; Braun, T; Chantraine, F; Henrich, W

2011-01-01

Intrapartum translabial ultrasound (ITU) has the potential to objectively and quantitatively assess the progress of labour. The relationships between the different ITU parameters and their development during normal term labour have not been studied. Observational study. University teaching hospital. Labouring women with normal term fetuses in cephalic presentation. Intrapartum translabial ultrasound measurements for 'head station', 'head direction', and 'angle of descent' (AoD) were taken in 50 labouring women, compared, studied for repeatability, and correlated with the progress of labour. Reproducibility and correlation of ITU parameters and their pattern of changes during labour. All three ITU parameters were clinically well reproducible. AoD and head station were interchangeable, and could be calculated from each other. Head station and head direction changed in a typical pattern along the birth canal. Time to delivery correlated with ITU head station. Intrapartum translabial ultrasound is a simple technique that improves the understanding of normal and abnormal labour, enables the objective measurement of birth progress and provides a more scientific basis for assessing labour. © 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.

Preliminary evaluation of a coping strategy enhancement method of preparation for labour.

PubMed

Escott, Diane; Slade, Pauline; Spiby, Helen; Fraser, Robert B

2005-09-01

To compare the use and effects of enhanced pre-existing coping strategies with the use and effects of coping strategies usually taught in National Health Service (NHS) antenatal education on women's experience of pain and emotions during labour. A between-group comparison of women who chose to attend NHS antenatal education where courses of preparation were randomly assigned to include either a new method of coping strategy enhancement (CSE) or standard taught coping strategies. Two large maternity units in one city in the North of England. 20 women participated in antenatal classes incorporating the CSE method and 21 women participated in antenatal classes incorporating the standard approach to developing coping strategies for labour. Women who attended CSE classes used enhanced coping strategies for a larger proportion of their labour than women who attended standard classes who used taught coping strategies. Birth companions were more involved in women's use of enhanced than taught strategies. Self-efficacy for use of coping strategies and subsequent experiences of pain and emotions during labour were equivalent between groups. An approach based on enhancing pre-existing coping strategies was associated with greater coping strategy use and involvement from the birth companion, and provided benefits to women's overall experience of labour at least equivalent to that associated with standard preparation. Further research should explore this novel approach in larger groups, and for women who may choose not to attend group antenatal preparation.

More Policies, Greater Inclusion? Exploring the Contradictions of New Labour Inclusive Education Policy

ERIC Educational Resources Information Center

Roulstone, Alan; Prideaux, Simon

2008-01-01

The era of New Labour government has witnessed unprecedented growth in inclusive education policies. There is, however, limited evidence that policies have increased disabled children's inclusion. This article explores reasons for this contradiction. Drawing on sociological insights, it is argued that New Labour policies on inclusive education…

Emotional Demands, Emotional Labour and Occupational Outcomes in School Principals: Modelling the Relationships

ERIC Educational Resources Information Center

Maxwell, Aimee; Riley, Philip

2017-01-01

Most research into emotional labour is focussed on front-line service staff and health professionals, in short-term interactions. Little exists exploring the emotional labour involved in repeated on-going interactions by educational leaders with key stakeholders. This study explored the relationships between emotional demands, three emotional…

Do labour market status transitions predict changes in psychological well-being?

PubMed

Flint, Ellen; Bartley, Mel; Shelton, Nicola; Sacker, Amanda

2013-09-01

The objective of this study was to establish the direction of causality in the relationship between labour market status and psychological well-being by investigating how transitions between secure employment, insecure employment, unemployment, permanent sickness and other economic inactivity predict changes in psychological well-being over a 16-year period. This study used data from the British Household Panel Survey (1991-2007). Psychological well-being was measured using the 12-item General Health Questionnaire (GHQ-12). Fixed effects models were utilised to investigate how transitions between labour market statuses predicted GHQ-12 score, adjusting for current labour market status and a range of covariates. After taking account of the contemporaneous effects of joblessness on psychological well-being, and the impact of a range of confounding factors, experiencing a transition from employment to joblessness was significantly predictive of poorer psychological well-being. Transitions into employment were not found to have equal and opposite effects: the positive effects of moving into work from unemployment were not as large as the negative effects of job loss. Transitions between secure and insecure employment did not independently predict changes in psychological well-being. A causal relationship between labour market status and psychological well-being is indicated.

Mental illness and its effects on labour market outcomes.

PubMed

Cornwell, Katy; Forbes, Catherine; Inder, Brett; Meadows, Graham

2009-09-01

Mental illness can impact all stages of labour market engagement: lower rates of participation in the labour market, higher rates of unemployment and employment in low-skill or low-earning occupations relative to qualifications. Systematic mental health surveys provide an opportunity to examine the scale of such impacts. Though usually cross sectional in nature, such surveys commonly include historical data by self report that can be used to construct a retrospective cohort study, within which it is possible to examine temporal sequence of illness and employment experience and thereby explore issues of causality. The 1997 National Survey of Mental Health and Wellbeing of Adults contains comprehensive questions relating to prevalence and level of disability associated with major mental disorders. Here we employ secondary analyses of the survey data to develop three models capturing workforce participation, unemployment and occupational level. Different versions of these models employ either broad diagnostic classes or numbers of disorders as indicators of mental disorder status. After reporting findings from these models we use them in combination to estimate labour market costs for Australia. Each disorder reduces the chance of participation in the labour market by 1.3 percentage points, an appreciable amount given that most individuals suffering from mental disorders have multiple disorders. There is a strongly significant effect of mental illness on employment and clear evidence of reduced occupational skill level. The impact of mental illness is very strong at every stage of engagement. Limitations include the self report nature of the assessments and lack of specific income data collection within the survey instrument. Other work based on this survey shows poor accessibility of recovery based and rehabilitation orientated services. These are the very services that have a role to play in increasing workforce participation, employment and occupational level. This

Evaluating Labour's market reforms, 2002-10.

PubMed

Mays, Nicholas; Tan, Stefanie

2012-01-01

Starting in 2002, the UK Labour government of 1997-2010 introduced a series of changes to the National Health Service (NHS) in England designed to increase individual NHS patient choice of place of elective hospital care and competition among public and private providers of elective hospital services for NHS-funded patients. In 2006, the Department of Health initiated the Health Reform Evaluation Programme (HREP) to assess the impact of the changes. The changes broadly had the effects that proponents had predicted but the effects were mostly modest. Most of the undesirable impacts feared by critics appeared not to have materialized to any discernible extent, at least by early in 2010. Labour's market appeared to have generated stronger incentives for quality and efficiency than its 1990 s predecessor with no obvious detriment to equity of access. However, this high level conclusion conceals a far more nuanced and complex picture of both the process of implementation and the impact of the changes, as the papers in this supplement drawn from the HREP show.

TVET Initiatives in Southeast Asian Countries in Response to Increasing Labour Mobility within the Region and beyond

ERIC Educational Resources Information Center

Paryono

2011-01-01

The International Labour Organisation (ILO) report (2007) highlights that labour productivity, education and migration play important roles in shaping competitiveness, growth and development in Southeast Asia. The statistics also reveal interesting aspects of labour mobility. Thirteen and a half million migrants originate from countries in the…

Cost implications in the management of induction of labour.

PubMed

Taylor, S J; Armour, C L

1997-11-01

For many years the standard treatment of induction of labour has been amniotomy followed by intravenous oxytocin. More recently prostaglandin E2 (PGE2; dinoprostone), in various preparations, has been used to both ripen the cervix before amniotomy and administration of oxytocin, and to induce labour on its own. Since the acquisition cost of PGE2 is approximately 15 times that of oxytocin, it is important to justify the use of PGE2. In this paper, literature from 1970 to 1996 has been reviewed and outcomes following the use of PGE2, plus amniotomy and oxytocin if necessary, have been compared with outcomes following the use of amniotomy plus oxytocin alone. No significant differences in the mode of delivery and no serious adverse effects in mothers or babies were detected. Three economic analyses of these approaches to induction of labour have been reviewed. While under certain conditions there may be some cost savings associated with the use of PGE2, neither of the studies reviewed showed substantial, reliable cost savings. Further research is required to identify the patients who would gain most benefit from the use of PGE2.

Outcomes of physiological and active third stage labour care amongst women in New Zealand.

PubMed

Dixon, Lesley; Tracy, Sally K; Guilliland, Karen; Fletcher, Lynn; Hendry, Chris; Pairman, Sally

2013-01-01

during the third stage of labour there are two approaches for care provision - active management or physiological (expectant) care. The aim of this research was to describe, analyse and compare the midwifery care pathway and outcomes provided to a selected cohort of New Zealand women during the third stage of labour between the years 2004 and 2008. These women received continuity of care from a midwife Lead Maternity Carer and gave birth in a variety of birth settings (home, primary, secondary and tertiary maternity units). retrospective aggregated clinical information was extracted from the New Zealand College of Midwives research database. Factors such as type of third stage labour care provided; estimated blood loss; rate of treatment (separate to prophylaxis) with a uterotonic; and placental condition were compared amongst women who had a spontaneous onset of labour and no further assistance during the labour and birth. The results were adjusted for age, ethnicity, parity, place of birth, length of labour and weight of the baby. the rates of physiological third stage care (expectant) and active management within the cohort were similar (48.1% vs. 51.9%). Women who had active management had a higher risk of a blood loss of more than 500mL, the risk was 2.761 when a woman was actively managed (95% CI: 2.441-3.122) when compared to physiological management. Women giving birth at home and in a primary unit were more likely to have physiological management. A longer labour and higher parity increased the odds of having active management. Manual removal of the placenta was more likely with active management (0.7% active management - 0.2% physiological p<0.0001). For women who were given a uterotonic drug as a treatment rather than prophylaxis a postpartum haemorrhage of more than 500mL was twice as likely in the actively managed group compared to the physiological managed group (6.9% vs. 3.7%, RR 0.54, CI: 0.5, 0.6). the use of physiological care during the third

Social Predictors of Unsuccessful Entrance into the Labour Market--A Socialization Process Perspective

ERIC Educational Resources Information Center

Ek, Ellen; Sovio, Ulla; Remes, Jouko; Jarvelin, Marjo-Riitta

2005-01-01

Social determinants over the life course, including childhood family characteristics, were studied in predicting unsuccessful entrance into the labour market at the age of 31 years. Among men, unsuccessful entrance into the labour market was predicted prospectively by the mother's receptive attitude towards receiving social aid and contentment…

Women's labour force participation and socioeconomic development: influences of local context and individual characteristics in Brazil.

PubMed

Evans, M D; Saraiva, H U

1993-03-01

We address several key hypotheses about the effects of socioeconomic development on women's labour force participation during the transition from agriculture to industrialism. To this end, we explore differences in women's labour force participation in Brazil by education, marital status, age, and urban or rural residence. We also show how socioeconomic development affects the overall level of women's participation and the differentials by education, etc. Our data are drawn from a large 1973 PNAD (Pequisa Nacional por Amostra de Domicilos) survey conducted by the Brazilian census bureau. Socioeconomic development in different parts of Brazil ranges from pre-industrial agriculture to heavy industry. Using logistic regression, we show that the general level of women's labour force participation does not change with the level of development. Highly educated women are much more likely than the less educated to be in the labour force (net of other influences); this difference is substantially greater than in post-industrial societies. Somewhat surprisingly, the influence of education is the same across the range of development levels in Brazil. Single women are more likely to be in the labour force than married women, and the difference grows during development. Age has a curvilinear relationship to labour force participation, and the old are much less likely to participate in more developed places. Rural women are slightly more likely to be in the labour force at all levels of development.

Recruitment criteria and attraction strategies for local trained labour in Malaysia’s construction industry

NASA Astrophysics Data System (ADS)

Manap, N.; Noh, NH Mohd; Syahrom, N.

2017-12-01

Development in Malaysia is booming which can be witnessed by the various construction projects that currently in progress, especially in the state of Johor which has the highest value of construction work completed for the third quarter of 2016. This necessarily requires skilled labours in a high number especially among the locals since it has been reported that Malaysia’s construction industry is having problems related to the shortage of local skilled labour. In addition, the local workers have been reported unable to fulfil the demand of construction market. Hence, it caused the contractor to import foreign workers to meet the needs and requirement of labour market in construction sector. This study aims of two objectives; to determine the criteria set by the construction company in recruiting local skilled labour and to study the strategies that can attract local skilled labour to join construction industry. Questionnaire has been distributed to G7 contractor in the state of Johor in order to achieve the objectives of this study. Collected data was then evaluated and tested for its reliability using the SPSS 20.0 software before it can be analysed in order to obtain the mean value, frequencies and percentage. The outcome of this study indicates that the prospective employer prefers to work with man and they require young, experienced, knowledgeable and skilled workers in doing the job. Most of the strategies that have been selected are mainly related to money namely salary increment, bonus, allowance and overtime payment, apart from upgrading labours welfare and providing a better accommodation. This study can be a guideline to both skills institution and contractor to improve on what they are lacking in order to encourage the local trained skills labour to join the industry.

Geographically differentiated pay in the labour market for nurses.

PubMed

Elliott, Robert F; Ma, Ada H Y; Scott, Anthony; Bell, David; Roberts, Elizabeth

2007-01-01

This novel application of spatial wage theory to health service labour markets analyses the competitiveness of nurse's pay and how this differs between local labour markets in Britain. A switching regression model is estimated to derive standardised spatial wage differentials (SSWDs) for nurses and their comparators. An SSWD gap is constructed and its relationship to vacancies estimated. A reduction in the gap in a local area is shown to result in an increase in the long-term vacancy rate for National Health Service (NHS) nurses. The competitiveness of nursing pay is shown to have a strong effect on the ability of the NHS to attract and retain nurses.

Does ultrasonographic foetal head position prior to induction of labour predict the outcome of delivery?

PubMed

Verhoeven, Corine J M; Mulders, Leon G M; Oei, S Guid; Mol, Ben Willem J

2012-10-01

To examine the capacity of pre-induction sonographic assessment of occipital position of the foetal head to predict the outcome of delivery, and to assess whether sonographic foetal head position before induction of labour is related to foetal presentation at delivery. A prospective cohort study was conducted in the Máxima Medical Centre, The Netherlands. We included consecutive women in whom labour was induced. Immediately prior to induction a transabdominal ultrasound was performed to determine the position of the foetal occiput. The primary outcome was mode of delivery. We recorded maternal demographics, labour and delivery characteristics, maternal and neonatal outcomes. The association between position of the foetal head before induction of labour and the occurrence of caesarean section was addressed using univariable and logistic regression analysis. From the 50 of the 183 foetuses that started labour in occipitoposterior position, 11 persisted in occipitoposterior position until birth, whereas from the 120 foetuses that were in occipitoanterior position before induction, three children were born in an occipitoposterior position. Although we found a difference in caesarean section rate between OP position and OA position of the foetal head at sonography prior to induction, this was not statistically significant (14% versus 6.7%, OR 2.3, 95% CI 0.78-6.7). Our study demonstrates that OP position prior to labour induction does not affect mode of delivery. Sonographic assessment of the position of the foetal head prior to labour induction should not be introduced in clinical practice. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Chain migration through the social network: experience of labour migrants in Kuwait.

PubMed

Shah, N M; Menon, I

1999-01-01

"Labour migration to the Gulf countries is predominantly contract based and a majority of workers fall below the salary ceiling necessary for sponsoring family members. Despite this, social networks have expanded in Kuwait, primarily in the form of sponsorship of additional labour migrants by those already in the country. The objectives of the article are to describe how the process of arranging sponsorship works, to delineate the predictors of moving through a friend or relative, or arranging sponsorship for a subsequent labour migrant, and to assess the ¿multiplier' effect of the above process. The article is based on a survey among 800 South Asian skilled and unskilled male migrants, 200 each from Bangladesh, India, Pakistan and Sri Lanka." (EXCERPT)

Assessment and support during early labour for improving birth outcomes.

PubMed

Kobayashi, Shinobu; Hanada, Nobutsugu; Matsuzaki, Masayo; Takehara, Kenji; Ota, Erika; Sasaki, Hatoko; Nagata, Chie; Mori, Rintaro

2017-04-20

The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. To investigate the effectiveness of assessment and support interventions for women during early labour.In order to measure the effectiveness of the interventions, we compared the duration of labour, the rate of obstetrical interventions, and the rate of other maternal or neonatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (31 October 2016) and reference lists of retrieved studies. Randomised controlled trials of any assessment or support intervention in the latent phase of labour. We planned to include cluster-randomised trials if they were eligible. We did not include quasi-randomised trials. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We resolved any disagreement by discussion or by involving a third assessor. The quality of the evidence was assessed using the GRADE approach. We included five trials with a total of 10,421 pregnant women in this review update. The trials were conducted in the UK, Canada and America. The trials compared interventions in early labour versus usual care. We examined three comparisons: early labour assessment versus immediate admission to hospital; home visits by midwives versus usual care (telephone triage); and one-to-one structured midwifery care versus usual care. These trials were at moderate- risk of bias mainly because blinding women and staff to these interventions is not generally feasible. For important outcomes we assessed evidence using

Flexibility evaluation of multiechelon supply chains

PubMed Central

Conceição, Samuel Vieira; Pinto, Luiz Ricardo; de Camargo, Ricardo Saraiva; Júnior, Gilberto de Miranda

2018-01-01

Multiechelon supply chains are complex logistics systems that require flexibility and coordination at a tactical level to cope with environmental uncertainties in an efficient and effective manner. To cope with these challenges, mathematical programming models are developed to evaluate supply chain flexibility. However, under uncertainty, supply chain models become complex and the scope of flexibility analysis is generally reduced. This paper presents a unified approach that can evaluate the flexibility of a four-echelon supply chain via a robust stochastic programming model. The model simultaneously considers the plans of multiple business divisions such as marketing, logistics, manufacturing, and procurement, whose goals are often conflicting. A numerical example with deterministic parameters is presented to introduce the analysis, and then, the model stochastic parameters are considered to evaluate flexibility. The results of the analysis on supply, manufacturing, and distribution flexibility are presented. Tradeoff analysis of demand variability and service levels is also carried out. The proposed approach facilitates the adoption of different management styles, thus improving supply chain resilience. The model can be extended to contexts pertaining to supply chain disruptions; for example, the model can be used to explore operation strategies when subtle events disrupt supply, manufacturing, or distribution. PMID:29584755

Profitability of Qualified-Labour-Power Production

ERIC Educational Resources Information Center

Baldino, Roberto Ribeiro; Cabral, Tânia Cristina Baptista

2015-01-01

In Baldino and Cabral (2013) we introduced the concept of qualified labour-power as the commodity produced by the school system. In the present article we outline a quantitative model to evaluate the profit rate of educational programmes. We compare a medical school programme with a teacher education programme at a public university in Brazil,…

Activation of AMPK in human fetal membranes alleviates infection-induced expression of pro-inflammatory and pro-labour mediators.

PubMed

Lim, R; Barker, G; Lappas, M

2015-04-01

In non-gestational tissues, the activation of adenosine monophosphate (AMP)-activated kinase (AMPK) is associated with potent anti-inflammatory actions. Infection and/or inflammation, by stimulating pro-inflammatory cytokines and matrix metalloproteinase (MMP)-9, play a central role in the rupture of fetal membranes. However, no studies have examined the role of AMPK in human labour. Fetal membranes, from term and preterm, were obtained from non-labouring and labouring women, and after preterm pre-labour rupture of membranes (PPROM). AMPK activity was assessed by Western blotting of phosphorylated AMPK expression. To determine the effect of AMPK activators on pro-inflammatory cytokines, fetal membranes were pre-treated with AMPK activators then stimulated with bacterial products LPS and flagellin or viral dsDNA analogue poly(I:C). Primary amnion cells were used to determine the effect of AMPK activators on IL-1β-stimulated MMP-9 expression. AMPK activity was decreased with term labour. There was no effect of preterm labour. AMPK activity was also decreased in preterm fetal membranes, in the absence of labour, with PROM compared to intact membranes. AMPK activators AICAR, phenformin and A769662 significantly decreased IL-6 and IL-8 stimulated by LPS, flagellin and poly(I:C). Primary amnion cells treated with AMPK activators significantly decreased IL-1β-induced MMP-9 expression. The decrease in AMPK activity in fetal membranes after spontaneous term labour and PPROM indicates an anti-inflammatory role for AMPK in human labour and delivery. The use of AMPK activators as possible therapeutics for threatened preterm labour would be an exciting future avenue of research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Issues and Challenges in Self-Sustaining Response Supply Chains

DTIC Science & Technology

2013-09-28

2013). Supply chain management: Strategy, planning, and operation (5th ed.). Pearson Education. Coombs , W. T. (1999). Ongoing crisis communication ...United States has entered after the 2008 financial crisis . The U.S. DoD budget is tighter, so it must be able to maintain the same capabilities as...Kleindorfer, Singhal, and Van Wassenhove (2005) helped focus the operations community on the “Triple Bottom Line”—profit, people, and planet. They argued

Community resiliency through recovery resource supply chain planning.

PubMed

Franklin, Charlotte; Todt, Kiersten

2014-01-01

Information in this paper is the result of recommendations and remedies developed at 'Local Supply Chain Capacity in a Crisis Summit Exercise' held in Arlington, VA on 30th-31st January,2013. At the event, which was funded through the Regional Catastrophic Preparedness Grant Program, national private sector and not-for-profit essential resource provider experts in sectors such as transportation, communication systems, energy/power, financial resources, medical supplies and other vital supplies, together with emergency managers, discussed best practices, major challenges and exchanged remedy recommendations.

Insulin pump use compared with intravenous insulin during labour and delivery: the INSPIRED observational cohort study.

PubMed

Drever, E; Tomlinson, G; Bai, A D; Feig, D S

2016-09-01

To assess the safety and efficacy of pump therapy (continuous subcutaneous insulin infusion; CSII) during labour and delivery in women with Type 1 diabetes. A retrospective cohort study of 161 consecutive Type 1 diabetic pregnancies delivered during 2000-2010 at Mount Sinai Hospital, Toronto, Canada. Capillary blood glucose levels during labour and delivery and time in/out of target (target: 4-6 mmol/l) were compared along with neonatal outcomes for three groups: (1) women on pumps who stayed on pumps during labour (pump/pump n = 31), (2) women on pumps who switched to intravenous (IV) insulin infusion during labour (pump/IVn = 25), and (3) women on multiple daily injections who switched to IV insulin infusion during labour (MDIn = 105). There were no significant differences between the mean or median glucose values during labour and delivery across all three groups, and no significant difference in time spent hypoglycaemic. However, women in the pump/pump group had significantly better glycaemic control as defined by mean glucose (5.5 vs. 6.4 mmol/l; P = 0.01), median glucose (5.4 vs. 6.3 mmol/l; P = 0.02), and more time spent in target (60.9% vs. 39.2%; P = 0.06) compared with women in the pump/IV group (after removing one outlier). This study demonstrates that the continuation of CSII therapy during labour and delivery appears safe and efficacious. Moreover, women who choose to continue CSII have better glucose control during delivery than those who switch to IV insulin, suggesting that it should be standard practice to allow women the option of continuing CSII during labour and delivery. © 2016 Diabetes UK.

Computerised electronic foetal heart rate monitoring in labour: automated contraction identification.

PubMed

Georgieva, A; Payne, S J; Redman, C W G

2009-12-01

The foetal heart rate (FHR) response to uterine contractions is crucial to detect foetal distress by electronic FHR monitoring during labour. We are developing a new automated system (OxSys) for decision support in labour, using the Oxford database of intrapartum FHR records. We describe here a novel technique for automated detection of uterus contractions. In addition, we present a comparison of the new method with four other computerised approaches. During training, OxSys achieved sensitivity above 95% and positive predictive value (PPV) of up to 90% for traces of good quality. During testing, OxSys achieved sensitivity = 87% and PPV = 75%. For comparison, a second clinical expert obtained sensitivity = 93% and PPV = 80%, and all other computerised approaches achieved lower values. It was concluded that the proposed method can be employed with confidence in our study on foetal health assessment in labour and future OxSys development.

Improving the quality of obstetric care for women with obstructed labour in the national referral hospital in Uganda: lessons learnt from criteria based audit.

PubMed

Kayiga, Herbert; Ajeani, Judith; Kiondo, Paul; Kaye, Dan K

2016-07-11

Obstructed labour remains a major cause of maternal morbidity and mortality whose complications can be reduced with improved quality of obstetric care. The objective was to assess whether criteria-based audit improves quality of obstetric care provided to women with obstructed labour in Mulago hospital, Uganda. Using criteria-based audit, management of obstructed labour was analyzed prospectively in two audits. Six standards of care were compared. An initial audit of 180 patients was conducted in September/October 2013. The Audit results were shared with key stakeholders. Gaps in patient management were identified and recommendations for improving obstetric care initiated. Six standards of care (intravenous fluids, intravenous antibiotics, monitoring of maternal vital signs, bladder catheterization, delivery within two hours, and blood grouping and cross matching) were implemented. A re-audit of 180 patients with obstructed labour was conducted four months later to evaluate the impact of these recommendations. The results of the two audits were compared. In-depth interviews and focus group discussions were conducted among healthcare providers to identify factors that could have influenced the audit results. There was improvement in two standards of care (intravenous fluids and intravenous antibiotic administration) 58.9 % vs. 86.1 %; p < 0.001 and 21.7 % vs. 50.5 %; P < 0.001 respectively after the second audit. There was no improvement in vital sign monitoring, delivery within two hours or blood grouping and cross matching. There was a decline in bladder catheterization (94 % vs. 68.9 %; p < 0.001. The overall mean care score in the first and second audits was 55.1 and 48.2 % respectively, p = 0.19. Healthcare factors (negative attitude, low numbers, poor team work, low motivation), facility factors (poor supervision, stock-outs of essential supplies, absence of protocols) and patient factors (high patient load, poor compliance to

Miss Congeniality Meets the New Managerialism: Feminism, Contingent Labour, and the New University

ERIC Educational Resources Information Center

Webber, Michelle

2008-01-01

In Canada, non-permanent faculty are no longer simply a reserve, flexible labour pool available for administrators to draw on when needed (e.g. during times of fluctuating enrollments); rather, they represent a strategy utilized by universities to reduce overall labour costs. In this article I bring together Women's Studies, feminism, contingent…

Childhood Sporting Activities and Adult Labour-Market Outcomes

PubMed Central

Cabane, Charlotte; Clark, Andrew E.

2017-01-01

We here ask whether childhood sport participation is positively correlated with adult labour-market outcomes. There are many potential channels for this effect, although, as usual, identifying a causal relationship is difficult. We appeal to two widely-separated waves of Add Health data to map out the correlation between childhood sports and a number of adult labour-market outcomes. We show that different types of childhood sports are associated with both managerial responsibilities and autonomy at work when adult. We take the endogeneity of sport seriously, and appeal to a variety of techniques, including the use of data on siblings, in order to obtain estimates that are as close to unbiased as possible. Last, we compare the effect of sporting activities to that of other leisure activities.* PMID:28798886

What makes clinical labour different? The case of human guinea pigging.

PubMed

Różyńska, Joanna

2018-05-24

Each year thousands of individuals enrol in clinical trials as healthy volunteers to earn money. Some of them pursue research participation as a full-time or at least a part-time job. They call themselves professional or semiprofessional guinea pigs. The practice of paying healthy volunteers raises numerous ethical concerns. Different payment models have been discussed in literature. Dickert and Grady argue for a wage-payment model. This model gives research subjects a standardised hourly wage, and it is based on an assumption that research participation is morally indistinguishable from other forms of unskilled labour. In this paper, I will challenge this assumption. I will argue that human guinea pigging has particular characteristics which taken together make it significantly different from other forms of labour. (1) Participation in research is skill-independent. Healthy volunteers are valuable not because they are skilful persons, but because they are human bodies. (2) The role of research volunteers is mainly passive. They are not asked to produce goods or deliver services. They are paid for enduring unpleasant, painful and risky interventions performed by investigators. (3) Research volunteering involves inherent risks and uncertainties, and subjects have little or no control over their minimisation and materialisation. I conclude that participation in clinical research is a specific kind of activity. It is more like renting out one's body to strangers, than working. Thus, research participation should not be treated on par with other forms of employment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Profile of English salaried GPs: labour mobility and practice performance.

PubMed

Ding, Alexander; Hann, Mark; Sibbald, Bonnie

2008-01-01

Recent national policy changes have provided greater flexibility in GPs' contracts. One such policy is salaried employment, which offers reduced hours and freedom from out-of-hours and administrative responsibilities, aimed at improving recruitment and retention in a labour market facing regional shortages. To profile salaried GPs and assess their mobility within the labour market. Serial cross-sectional study. All GPs practising in England during the years 1996/1997, 2000/2001, and 2004/2005. Descriptive analyses, logistic regression. Salaried GPs tended to be either younger (<35 years) or older (> or =65 years), female, or overseas-qualified; they favoured part-time working and personal medical services contracts. Salaried GPs were more mobile than GP principals, and have become increasingly so, despite a trend towards reduced overall mobility in the GP workforce. Practices with salaried GPs scored more Quality and Outcomes Framework points and were located in slightly more affluent areas. Salaried status appears to have reduced limitations in the labour market, leading to better workforce deployment from a GP's perspective. However, there is no evidence to suggest it has relieved inequalities in GP distribution.

Precarious Learning and Labour in Financialized Times

ERIC Educational Resources Information Center

Magnusson, Jamie

2013-01-01

Our current globalized economic regimes of financialized capital have systematically altered relations of learning and labour through the dynamics of precarity, debt, and the political economy of new wars. The risks of these regimes are absorbed unevenly across transnational landscapes, creating cartographies of violence and dispossession,…

Effects of Epidural Labour Analgesia in Mother and Foetus.

PubMed

Deshmukh, Varsha Laxmikant; Ghosh, Shaswatee S; Yelikar, Kanan A; Gadappa, Shreeniwas N

2018-04-01

Aim of study was to determine effect of epidural analgesia on progress of labour and mode of delivery, to find out its complications in labour and puerperium and to evaluate neonatal outcome in terms of APGAR score. The present study was conducted in Department of Obstetrics and Gynaecology at Government Medical College Aurangabad over period of 2 years from June 2014 to June 2016 after taking approval from institutional ethical board. Hundred low-risk primigravidas were included in the study, 50 women received epidural analgesia for relief of labour pain at 3-4 cm and 50 women served as control. The important  outcome  FACTORS studied were the following : (1) duration of active phase of I stage, and II stage, (2) mode of delivery, (3) APGAR scores, (4) untoward reactions and intrapartum complications, (5) overall satisfaction of the mother. The operative delivery rates were not significantly different in both the groups (8% in the control group and 6% in the study group: p value NS, i.e. > 0.05). The duration of first stage (our study showed no significant difference in the duration of first stage in both the study and control groups p value > 0.05) and second stage of labour ( p value NS > 0.05) and the need for oxytocin were comparable in the two groups. The side effects observed were minimal. It has given excellent pain relief and improved neonatal outcome (5 min). EA is associated with rates of vaginal delivery (88 v/s 84%) and LSCS rate (8 v/s 6%) which are comparable with control group. Epidural analgesia is a very promising, safe and effective method of pain relief. No major complications and a good APGAR score make it a good option of care in modern obstetrics.

Marital status, labour force activity and mortality: A study of the United States and 6 European countries

PubMed Central

van Hedel, Karen; van Lenthe, Frank J; Avendano, Mauricio; Bopp, Matthias; Esnaola, Santiago; Kovács, Katalin; Martikainen, Pekka; Regidor, Enrique; Mackenbach, Johan P

2015-01-01

Aims Labour force activity and marriage share some of the pathways through which they potentially influence health. In this paper, we examine whether marriage and labour force participation interact in the way they influence mortality in the United States and six European countries. Methods We used data from the US National Health Interview Survey linked to the National Death Index, and national mortality registry data for Austria, England/Wales, Finland, Hungary, Norway and Spain (Basque country) during 1999-2007 for men and women aged 30-59 at baseline. Poisson regression was used to estimate both additive (the relative excess risk due to interaction) and multiplicative interactions between marriage and labour force activity on mortality. Results Labour force inactivity was associated with higher mortality, but this association was stronger for unmarried than married individuals. Likewise, being unmarried was associated with higher mortality, but this association was stronger for inactive than for active individuals. To illustrate, among US women out of the labour force, being unmarried was associated with a 3.98 (95%CI:3.28-4.82) times higher risk of dying than being married, whereas the relative risk was 2.49 (95%CI:2.10-2.94) for women active in the labour market. Although this interaction between marriage and labour force activity was only significant for women on a multiplicative scale, there was a significant additive interaction for both men and women. The pattern was similar across all countries. Conclusions Marriage attenuates the increased mortality risk associated with labour force inactivity, while labour force activity attenuates the mortality risk associated with being unmarried. Our study emphasizes the importance of public health and social policies that improve the health and well-being of men and women who are both unmarried and inactive. PMID:25868643

Special Features of the Finnish Labour Market and Challenges for Education.

ERIC Educational Resources Information Center

Rouhelo, Anne; Ruoholinna, Tarita

Research synthesized from three studies of the Finnish labor market indicates that a rapidly changing working life in Finland (and the rest of Europe) sets many different challenges for the workforce. In Finland, the population is even more aged than in the other European Union (EU) member states, and the transition of older workers to retirement…

Valuing Diversity: Guidance for Labour Market Integration of Migrants. Working Paper No 24

ERIC Educational Resources Information Center

Moreno da Fonseca, Pedro

2014-01-01

Europe faces an increase in the age of its natural population and a reduction in available labour force. The retirement of a highly qualified workforce, alongside a rise in demand for medium- and high-skilled workers, will likely result in labour shortages in several sectors and countries. The movement of qualified, third-country immigrants into…

Economic Returns to Speaking "Standard Mandarin" among Migrants in China's Urban Labour Market

ERIC Educational Resources Information Center

Gao, Wenshu; Smyth, Russell

2011-01-01

This article uses data from the China Urban Labour Survey administered across 12 cities in 2005 to estimate the economic returns to speaking standard Mandarin among internal migrants in China's urban labour market. The article builds on studies that estimate the economic returns to international immigrants of being fluent in the major language of…

Hypnosis for pain management during labour and childbirth.

PubMed

Madden, Kelly; Middleton, Philippa; Cyna, Allan M; Matthewson, Mandy; Jones, Leanne

2016-05-19

This review is one in a series of Cochrane reviews investigating pain management for childbirth. These reviews all contribute to an overview of systematic reviews of pain management for women in labour, and share a generic protocol. This review updates an earlier version of the review of the same title. To examine the effectiveness and safety of hypnosis for pain management during labour and childbirth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2015) and the reference lists of primary studies and review articles. Randomised controlled trials (RCTs) and quasi-RCTS comparing preparation for labour using hypnosis and/or use of hypnosis during labour, with or without concurrent use of pharmacological or non-pharmacological pain relief methods versus placebo, no treatment or any analgesic drug or technique. Two review authors independently extracted data and assessed trial quality. Where possible we contacted study authors seeking additional information about data and methodology. We included nine trials randomising a total of 2954 women. The risk of bias in trials was variable, there were several well-designed large trials and some trials where little was reported about trial design. Although eight of the nine trials assessed antenatal hypnotherapy, there were considerable differences between these trials in timing and technique. One trial provided hypnotherapy during labour. In this updated review we compared hypnosis interventions with all control groups (main comparison) and also with specific control conditions: standard care (nine RCTs), supportive counselling (two RCTs) and relaxation training (two RCTs).In the main comparison, women in the hypnosis group were less likely to use pharmacological pain relief or analgesia than those in the control groups, (average risk ratio (RR) 0.73, 95% CI 0.57 to 0.94, eight studies, 2916 women; very low-quality evidence; random-effects model). There were no clear differences between

Cue acquisition: A feature of Malawian midwives decision making process to support normality during the first stage of labour.

PubMed

Chodzaza, Elizabeth; Haycock-Stuart, Elaine; Holloway, Aisha; Mander, Rosemary

2018-03-01

to explore Malawian midwives decision making when caring for women during the first stage of labour in the hospital setting. this focused ethnographic study examined the decision making process of 9 nurse-midwives with varying years of clinical experience in the real world setting of an urban and semi urban hospital from October 2013 to May 2014.This was done using 27 participant observations and 27 post-observation in-depth interviews over a period of six months. Qualitative data analysis software, NVivo 10, was used to assist with data management for the analysis. All data was analysed using the principle of theme and category formation. analysis revealed a six-stage process of decision making that include a baseline for labour, deciding to admit a woman to labour ward, ascertaining the normal physiological progress of labour, supporting the normal physiological progress of labour, embracing uncertainty: the midwives' construction of unusual labour as normal, dealing with uncertainty and deciding to intervene in unusual labour. This six-stage process of decision making is conceptualised as the 'role of cue acquisition', illustrating the ways in which midwives utilise their assessment of labouring women to reason and make decisions on how to care for them in labour. Cue acquisition involved the midwives piecing together segments of information they obtained from the women to formulate an understanding of the woman's birthing progress and inform the midwives decision making process. This understanding of cue acquisition by midwives is significant for supporting safe care in the labour setting. When there was uncertainty in a woman's progress of labour, midwives used deductive reasoning, for example, by cross-checking and analysing the information obtained during the span of labour. Supporting normal labour physiological processes was identified as an underlying principle that shaped the midwives clinical judgement and decision making when they cared for women in

The influence of cold pack on labour pain relief and birth outcomes: a randomised controlled trial.

PubMed

Shirvani, Marjan Ahmad; Ganji, Zhila

2014-09-01

(1) To evaluate the influence of local cold on severity of labour pain and (2) to identify the effect of local cold on maternal and neonatal outcomes. Fear of labour pain results in an increase in pain and duration of labour, maternal discontent and demand for caesarean section. Regarding maternal and foetal complications of analgesic medications, the attention to application of nonpharmacological methods including cold therapy is increased. Randomised controlled trial. Sixty-four pregnant women, at initiation of active phase of labour, were allocated randomly to cold therapy and control groups (n = 64). Null parity, term pregnancy, presence of single foetus, cephalic presentation and completing informed consent were considered as inclusion criteria. Administration of analgesic and anaesthesia, foetal distress, skin lesions in regions of cold therapy and high-risk pregnancy provided exclusion criteria. Cold pack was applied over abdomen and back, for 10 minutes every 30 minutes during first phase of labour. Additionally, cold pack was placed over perineum, for 5 minutes every 15 minutes during second phase. Pain severity was assessed based on the visual analogue scale. The two groups were not significantly different considering demographic data, gestational age, foetal weight, rupture of membranes and primary severity of pain. Degree of pain was lower in cold therapy group during all parts of active phase and second stage. Duration of all phases was shorter in cold therapy group in all phases. Foetal heart rate, perineal laceration, type of birth, application of oxytocin and APGAR score were not significantly different between two groups. Labour pain is probably reduced based on gate theory using cold. Pain control by cold maybe improves labour progression without affecting mother and foetus adversely. Local cold therapy could be included in labour pain management. © 2013 John Wiley & Sons Ltd.

Emotional labour and work engagement among nurses: examining perceived compassion, leadership and work ethic as stress buffers.

PubMed

Mauno, Saija; Ruokolainen, Mervi; Kinnunen, Ulla; De Bloom, Jessica

2016-05-01

The study examined whether three resources, that is, compassion, transformational leadership and work ethic feasibility, buffer against the negative effects of emotional labour on work engagement. Emotional labour is a common job stressor among nurses, but little is known about whether certain personal and work resources buffer against it in relation to work engagement. Revealing buffers of emotional labour would help organizations to design tailored interventions. Cross-sectional online survey conducted in 2014. Participants were 3466 Finnish nurses. Hypotheses were tested via hierarchical moderated regression analyses. Higher emotional labour related to lower engagement. Two interaction effects were found. First, work ethic feasibility buffered against emotional labour: the nurses who perceived work ethic feasibility as high in a situation of high emotional labour, scored higher on engagement compared with those nurses who in this stress situation perceived work ethic feasibility to be low. Second, high compassion was detrimental to engagement in the presence of high emotional labour. Transformational leadership did not act as a buffer but showed a positive relationship with engagement. Work ethic feasibility (being able to work according to high ethical standards) is an important resource in nursing as it protects an employee against the negative effects of emotional labour and as it also directly promotes engagement. However, compassion may not always be beneficial in nursing, especially if co-occurring with high job stress. Transformational leadership has potential to improve engagement in nursing although it may not operate as a stress buffer. © 2016 John Wiley & Sons Ltd.

Does labour epidural slow the progress of labour and lead to complications? Obstetricians' perception working in private and public sector teaching hospitals in a developing country.

PubMed

Sohaib, Muhammad; Ismail, Samina

2015-12-01

Obstetricians play a major role in the decision making for provision of analgesia for the woman in labour. As epidural analgesia (EA) is the most preferred technique, it is important to know obstetricians' perception regarding its effect on progress of labour and associated complications. The 6 months cross-sectional study included 114 obstetricians from teaching hospitals. After informed consent, obstetricians were asked to fill a predesigned questionnaire containing 13 close ended questions regarding their perception on the effect of EA on progress of labour, EA complications and whether they would recommend EA to their patients or not. Other variables included age, gender, training in EA, practice type and hospital settings (private or public sector). Majority of the obstetricians had the perception of EA prolonging the first stage (89.5%) and second stage (98.2%) of labour, increasing the rate of caesarean section (87.7%), instrumental delivery (58.8%) and increasing the incidence of backache (85.5%). None of the obstetricians received any formal training in EA. Majority (84.2%) were not sure if they would recommend EA to their patients. When these responses were compared between public and private sector, a statistically higher percentage (P < 0.001) of public sector obstetricians had negative perception of EA. Perception of obstetrician regarding EA is contrary to the current evidence. There is a need to introduce formal curriculum on EA in obstetric training program and conduct regular refresher courses.

Opinion, Dialogue, Review: The New ILO Report on Child Labour--A Success Story, or the ILO Still at a Loss?

ERIC Educational Resources Information Center

Liebel, Manfred

2007-01-01

With this year's Global Report on Child Labour, the International Labour Organization (ILO) adopts a stance of victory. With confidence and pride, it announces that "the worldwide movement against child labour" led by the ILO itself has brought "the end of child labour--within reach". However, no convincing proof is given for this surprising…

The Right to Education for Children in Domestic Labour: Empirical Evidence from Kenya

ERIC Educational Resources Information Center

Munene, Ishmael I.; Ruto, Sara J.

2010-01-01

Since 1948, various UN conventions have recognised basic education as a human right. Yet this right continues to be denied to many child labourers across the world. This articles draws on the results of a study examining how children in domestic labour in Kenya access and participate in education. Three issues were explored: (1) the correlates of…

An End to Selection at Eleven: The Long Battle to Make Labour Listen

ERIC Educational Resources Information Center

Hayton, Carol

2015-01-01

The author is a long-time advocate inside the Labour Party for ending selective education and the 11-plus. She outlines how Labour Party frontbenchers routinely ignore or deflect calls from Party members to stand up for comprehensive education in both word and deed. As UKIP, whose policy is to extend selective education more widely, rises in the…

The Relationship between Higher Education and Labour Market in Greece: The Weakest Link?

ERIC Educational Resources Information Center

Livanos, Ilias

2010-01-01

The high level of graduate unemployment, even though it is acknowledged as one of the most distinctive characteristics of the Greek labour market, it has not attracted enough attention in the academic literature. This paper utilizes micro-data from the Labour Force Survey in order to investigate how the employment situation of young (aged 35 and…

Antiretroviral procurement and supply chain management.

PubMed

Ripin, David J; Jamieson, David; Meyers, Amy; Warty, Umesh; Dain, Mary; Khamsi, Cyril

2014-01-01

Procurement, the country-level process of ordering antiretrovirals (ARVs), and supply chain management, the mechanism by which they are delivered to health-care facilities, are critical processes required to move ARVs from manufacturers to patients. To provide a glimpse into the ARV procurement and supply chain, the following pages provide an overview of the primary stakeholders, principal operating models, and policies and regulations involved in ARV procurement. Also presented are key challenges that need to be addressed to ensure that the supply chain is not a barrier to the goal of universal coverage. This article will cover the steps necessary to order and distribute ARVs, including different models of delivery, key stakeholders involved, strategic considerations that vary depending on context and policies affecting them. The single drug examples given illustrate the complications inherent in fragmented supply and demand-driven models of procurement and supply chain management, and suggest tools for navigating these hurdles that will ultimately result in more secure and reliable ARV provision. Understanding the dynamics of ARV supply chain is important for the global health community, both to ensure full and efficient treatment of persons living with HIV as well as to inform the supply chain decisions for other public health products.

Robot Design Challenge: This Design Challenge Is a Mirror on the World

ERIC Educational Resources Information Center

Roman, Harry T.

2004-01-01

A fun design challenge that can be used in the classroom and across the grades is presented in this article. No special tools, hardware, or supplies are needed, only imagination and teamwork. It is a fun exercise that illustrates technology education principles. This design challenge is a mirror on the world, very similar to how projects are…

HIV testing in re-education through labour camps in Guangxi Autonomous Region, China (a cross-sectional survey)

PubMed Central

Yap, Lorraine; Reekie, Joanne; Liu, Wei; Chen, Yi; Wu, Zunyou; Li, Jianghong; Zhang, Lei; Wand, Handan; Donovan, Basil; Butler, Tony

2015-01-01

Objective HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studies have reported on the process. Methods The survey response rate was 100% although 29 detainees were excluded because they were under 18 years of age. A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, located in the south-western region of China. Results Of the 755 detainees surveyed, 725 (96%) reported having a blood test in the labour camps of whom 493 (68%) thought this included an HIV test. 61 detainees self-reported they were HIV infected, their status confirmed by medical records, if available. Of these, 53 (87%) recalled receiving post-test HIV education, and 15 (25%) were currently receiving HIV antiretroviral therapy. Pretest education on HIV was provided to 233/725 (32%) detainees. The study further reports on detainees’ reactions and feelings towards non-disclosure and disclosure of their HIV test results in the labour camps. Conclusions Mandatory testing is almost universal in the labour camps although a proportion of detainees were unaware that this included an HIV test. HIV test results should be disclosed to all labour camp detainees to reduce their distress of not knowing and prevent misconceptions about their HIV status. Labour camps provide another opportunity to implement universal treatment (‘Test and Treat’) to prevent the spread of HIV. PMID:25739879

Nutritional status and physical abuse among the children involved in domestic labour in Karachi Pakistan: a cross-sectional survey.

PubMed

Zainab, Saima; Kadir, Masood

2016-10-01

To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi. A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique. The overall prevalence of physical abuse among domestic child labour in Karachi was found to be 8.3 %. Over 9 % had low weight and about 90% were stunted. This study also highlighted that 95% of the children involved in domestic labour perform overtime work in their employer's home, more than once per week. There is high burden of physical abuse among the domestic child labour and these children are malnourished. There is a need to recognize and regulate this form of labour in Pakistan.

A novel role for GSK3 in the regulation of the processes of human labour.

PubMed

Lim, Ratana; Lappas, Martha

2015-02-01

Preterm birth remains the largest single cause of neonatal death and morbidity. Infection and/or inflammation are strongly associated with preterm delivery. Glycogen synthase kinase 3 (GSK3) is known to be a crucial mediator of inflammation homeostasis. The aims of this study were to determine the effect of spontaneous human labour in foetal membranes and myometrium on GSK3α/β expression, and the effect of inhibition of GSK3α/β on pro-labour mediators in foetal membranes and myometrium stimulated with Toll-like receptor (TLR) ligands and pro-inflammatory cytokines. Term and preterm labour in foetal membranes was associated with significantly decreased serine phosphorylated GSK3α and β expression, and thus increased GSK3 activity. There was no effect of term labour on serine phosphorylated GSK3β expression in myometrium. The specific GSK3α/β inhibitor CHIR99021 significantly decreased lipopolysaccharide (ligand to TLR4)-stimulated pro-inflammatory cytokine gene expression and release; COX2 gene expression and prostaglandin release; and MMP9 gene expression and pro MMP9 release in foetal membranes and/or myometrium. CHIR99021 also decreased FSL1 (TLR2 ligand) and flagellin (TLR5 ligand)-induced pro-inflammatory cytokine gene expression and release and COX2 mRNA expression and prostaglandin release. GSK3β siRNA knockdown in primary myometrial cells was associated with a significant decrease in IL1β and TNFα-induced pro-inflammatory cytokine and prostaglandin release. In conclusion, GSK3α/β activity is increased in foetal membranes after term and preterm labour. Pharmacological blockade of the kinase GSK3 markedly reduced pro-inflammatory and pro-labour mediators in human foetal membranes and myometrium, providing a possible therapeutics for the management of preterm labour. © 2015 Society for Reproduction and Fertility.

Understanding and learning from the diversification of cannabis supply laws.

PubMed

Kilmer, Beau; Pacula, Rosalie Liccardo

2017-07-01

Prohibitions on producing, distributing and selling cannabis are loosening in various jurisdictions around the world. This paper describes the diversification of cannabis supply laws and discusses the challenges to and opportunities for learning from these changes. We document changes in cannabis supply laws that de jure legalized cannabis production for medical and/or non-medical purposes (excluding industrial hemp) in Australasia, Europe, North America and South America. We also highlight challenges to evaluating these legal changes based on our experiences studying cannabis laws and policies in the United States. As of August 2016, two countries have passed laws to legalize large-scale cannabis production for non-medical purposes at the national (Uruguay) or subnational level (four US states). At least nine other countries legally allow (or will soon allow) cannabis to be supplied for medicinal purposes. Most of the changes in cannabis supply laws have occurred since 2010. The data available in most countries are inadequate for rigorously evaluating the changes in cannabis supply laws. The evidence base for assessing changes in cannabis supply laws remains weak. Efforts should focus upon collecting information about quantities consumed and market transactions as well as validating self-report surveys. © 2016 Society for the Study of Addiction.

Impact of a personalised active labour market programme for persons with disabilities.

PubMed

Adamecz-Völgyi, Anna; Lévay, Petra Zsuzsa; Bördős, Katalin; Scharle, Ágota

2018-02-01

The paper estimates the impact of a supported employment programme implemented in Hungary. This is a non-experimental evaluation using a matching identification strategy supported by rich data on individual characteristics, personal employment and unemployment history and the local labour market situation. We use a time-window approach to ensure that programme participants and matched controls entered unemployment at the same point in time, and thus faced very similar labour market conditions. We find that the programme had a positive effect of 16 percentage points on the probability of finding a job among men and 25 percentage points among women. The alternative outcome indicator of not re-entering the unemployment registry shows somewhat smaller effects in the case of women. In comparison to similarly costly programmes that do not facilitate employment in the primary labour market, rehabilitation services represent a viable alternative.

Parenteral opioids for maternal pain management in labour.

PubMed

Smith, Lesley A; Burns, Ethel; Cuthbert, Anna

2018-06-05

Parenteral opioids (intramuscular and intravenous drugs including patient-controlled analgesia) are used for pain relief in labour in many countries throughout the world. This review is an update of a review first published in 2010. To assess the effectiveness, safety and acceptability to women of different types, doses and modes of administration of parenteral opioid analgesia in labour. A second objective is to assess the effects of opioids in labour on the baby in terms of safety, condition at birth and early feeding. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (11 May 2017) and reference lists of retrieved studies. We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient-controlled analgesia) for women in labour. Cluster-randomised trials were also eligible for inclusion, although none were identified. We did not include quasi-randomised trials. We looked at studies comparing an opioid with another opioid, placebo, no treatment, other non-pharmacological interventions (transcutaneous electrical nerve stimulation (TENS)) or inhaled analgesia. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the quality of each evidence synthesis using the GRADE approach. We included 70 studies that compared an opioid with placebo or no treatment, another opioid administered intramuscularly or intravenously or compared with TENS applied to the back. Sixty-one studies involving more than 8000 women contributed data to the review and these studies reported on 34 different comparisons; for many comparisons and outcomes only one study contributed data. All of the studies were conducted in hospital settings, on healthy women with uncomplicated pregnancies at 37 to 42 weeks' gestation. We excluded studies focusing on women with pre

Methods for estimating the labour force insured by the Ontario Workplace Safety and Insurance Board: 1990-2000.

PubMed

Smith, Peter M; Mustard, Cameron A; Payne, Jennifer I

2004-01-01

This paper presents a methodology for estimating the size and composition of the Ontario labour force eligible for coverage under the Ontario Workplace Safety & Insurance Act (WSIA). Using customized tabulations from Statistics Canada's Labour Force Survey (LFS), we made adjustments for self-employment, unemployment, part-time employment and employment in specific industrial sectors excluded from insurance coverage under the WSIA. Each adjustment to the LFS reduced the estimates of the insured labour force relative to the total Ontario labour force. These estimates were then developed for major occupational and industrial groups stratified by gender. Additional estimates created to test assumptions used in the methodology produced similar results. The methods described in this paper advance those previously used to estimate the insured labour force, providing researchers with a useful tool to describe trends in the rate of injury across differing occupational, industrial and gender groups in Ontario.

Unemployment Benefits and Parental Resources: What Helps the Young Unemployed with Labour Market Integration?

ERIC Educational Resources Information Center

Jacob, Marita

2008-01-01

This article deals with the question of how different resources affect the labour market integration of the young unemployed. Previous research has often focused on the effects of unemployment compensation benefits on labour market outcomes. However, for young unemployed people additional parental resources may be even more important. The article…

Education and the Labour Market in Brazil

ERIC Educational Resources Information Center

de Oliveira, Alberto; Filho, Gilberto Abrantes

2011-01-01

The aim of this article is to compare the schooling levels of individuals with the demands of the Brazilian labour market. The results demonstrate the high probability of compatibility between occupation and schooling levels. But high propensities for under-education were identified associated with the skin colour and position in the family. The…

Race, Ethnicity and Education under New Labour

ERIC Educational Resources Information Center

Tomlinson, Sally

2005-01-01

From 1997 the New Labour government was eager to affirm a commitment to social justice and racial equality, and initially there were moves to address some long-standing educational grievances. But a continuation of Conservative market policies of choice and diversity in schooling and a targeting of 'failing' schools exacerbated school segregation…

Planning the bioterrorism response supply chain: learn and live.

PubMed

Brandeau, Margaret L; Hutton, David W; Owens, Douglas K; Bravata, Dena M

2007-01-01

Responses to bioterrorism require rapid procurement and distribution of medical and pharmaceutical supplies, trained personnel, and information. Thus, they present significant logistical challenges. On the basis of a review of the manufacturing and service supply chain literature, the authors identified five supply chain strategies that can potentially increase the speed of response to a bioterrorism attack, reduce inventories, and save money: effective supply chain network design; effective inventory management; postponement of product customization and modularization of component parts; coordination of supply chain stakeholders and appropriate use of incentives; and effective information management. The authors describe how concepts learned from published evaluations of manufacturing and service supply chains, as well as lessons learned from responses to natural disasters, naturally occurring outbreaks, and the 2001 US anthrax attacks, can be applied to design, evaluate, and improve the bioterrorism response supply chain. Such lessons could also be applied to the response supply chains for disease outbreaks and natural and manmade disasters.

Analysis of labour risks in the Spanish industrial aerospace sector.

PubMed

Laguardia, Juan; Rubio, Emilio; Garcia, Ana; Garcia-Foncillas, Rafael

2016-01-01

Labour risk prevention is an activity integrated within Safety and Hygiene at Work in Spain. In 2003, the Electronic Declaration for Accidents at Work, Delt@ (DELTA) was introduced. The industrial aerospace sector is subject to various risks. Our objective is to analyse the Spanish Industrial Aerospace Sector (SIAS) using the ACSOM methodology to assess its labour risks and to prioritise preventive actions. The SIAS and the Services Subsector (SS) were created and the relevant accident rate data were obtained. The ACSOM method was applied through double contrast (deviation and translocation) of the SIAS or SS risk polygon with the considered pattern, accidents from all sectors (ACSOM G) or the SIAS. A list of risks was obtained, ordered by action phases. In the SIAS vs. ACSOM G analysis, radiation risks were the worst, followed by overstrains. Accidents caused by living beings were also significant in the SS vs. SIAE, which will be able to be used to improve Risk Prevention. Radiation is the most significant risk in the SIAS and the SS. Preventive actions will be primary and secondary. ACSOM has shown itself to be a valid tool for the analysis of labour risks.

The mediating effect of emotional intelligence between emotional labour, job stress, burnout and nurses' turnover intention.

PubMed

Hong, Eunyoung; Lee, Young Sook

2016-12-01

This study was designed to construct and test the structural equation modelling on nurses' turnover intention including emotional labour, job stress, emotional intelligence and burnout in order to identify the mediating effect of emotional intelligence between those variables. Emotional labour, job stress and burnout increase turnover intention of nurses. However, emotional intelligence is negatively correlated with emotional labour and reduces job stress, burnout and turnover intention. Structural equation modelling was used to analyse the goodness of fit of the hypothetical model of nurses' turnover intention. Research data were collected via questionnaires from 4 to 22 August 2014 and analysed using SPSS version 18.0 and AMOS version 20.0. The model fit indices for the hypothetical model were suitable for recommended. Emotional intelligence has decreasing effect on turnover intention through burnout, although its direct effect on turnover intention is not significant. Emotional intelligence has mediation effect between emotional labour and burnout. This study's results suggest that increasing emotional intelligence might critically decrease nurses' turnover intention by reducing the effect of emotional labour on burnout. © 2016 John Wiley & Sons Australia, Ltd.

Contemporary specificities of labour in the health care sector: introductory notes for discussion

PubMed Central

Campos, Francisco Eduardo; Albuquerque, Eduardo da Motta e

2005-01-01

Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD). Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. Conclusion The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel. PMID:16109174

Contemporary specificities of labour in the health care sector: introductory notes for discussion.

PubMed

Campos, Francisco Eduardo; Albuquerque, Eduardo da Motta e

2005-08-18

This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. METHOD AND FRAMEWORK: The starting point is the investigation of the economic peculiarities of medical care. This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD). Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel.

Inverse roles of emotional labour on health and job satisfaction among long-term care workers in Japan.

PubMed

Tsukamoto, Erika; Abe, Takeru; Ono, Michikazu

2015-01-01

Emotional labour increases among long-term care workers because providing care and services to impaired elders causes conflicting interpersonal emotions. Thus, we investigated the associations between emotional labour, general health and job satisfaction among long-term care workers. We conducted a cross-sectional study among 132 established, private day care centres in Tokyo using a mail survey. The outcome variables included two health-related variables and four job satisfaction variables: physical and psychological health, satisfaction with wages, interpersonal relationships, work environment and job satisfaction. We performed multiple regression analyses to identify significant factors. Directors from 36 facilities agreed to participate. A total of 123 responses from long-term care workers were analysed. Greater emotional dissonance was associated with better physical and psychological health and worse work environment satisfaction (partial regression coefficient: -2.93, p = .0389; -3.32, p = .0299; -1.92, p = .0314, respectively). Fewer negative emotions were associated with more job satisfaction (partial regression coefficient: -1.87, p = .0163). We found that emotional labour was significantly inversely associated with health and job satisfaction. Our findings indicated that the emotional labour of long-term care workers has a negative and positive influence on health and workplace satisfaction, and suggests that care quality and stable employment among long-term care workers might affect their emotional labour. Therefore, we think a programme to support emotional labour among long-term care workers in an organized manner and a self-care programme to educate workers regarding emotional labour would be beneficial.

Diamorphine for pain relief in labour : a randomised controlled trial comparing intramuscular injection and patient-controlled analgesia.

PubMed

McInnes, Rhona J; Hillan, Edith; Clark, Diana; Gilmour, Harper

2004-10-01

To compare the efficacy of diamorphine administered by a patient-controlled pump (patient-controlled analgesia) with intramuscular administration for pain relief in labour. Randomised controlled trial. The South Glasgow University Hospitals NHS Trust. Primigravidae and multigravidae in labour at term (37-42 weeks). Women were randomised in labour to the study (patient-controlled analgesia) or control group (intramuscular). Randomisation was achieved through a random permuted block design stratified by parity. Study group women were given a loading dose of 1.2 mg diamorphine intravenously and then attached to the pump. Control group women received intramuscular diamorphine as per hospital protocol. Participants were also given 3 mg of buccal Stemetil. Data were collected throughout labour and at six postnatal weeks. Analgesia requirements during labour and women's satisfaction with the method of pain relief. Women in the study group (patient-controlled analgesia) used significantly less diamorphine than women in the control group (intramuscular) but were significantly more likely to state that they were very dissatisfied with their use of diamorphine and were significantly more likely to opt out of the trial before the birth of the baby. The majority of women in both groups used other analgesia concurrent with diamorphine such as Entonox, aromatherapy or TENS. Patient-controlled analgesia administration of diamorphine for the relief of pain in labour offers no significant advantages over intramuscular administration. The results also suggest that diamorphine is a poor analgesic for labour pain irrespective of the mode of administration.

Navigating Difficult Waters: Learning for Career and Labour Market Transitions. Research Paper No 42

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2014

2014-01-01

This report analyses how learning supports labour market transitions and career changes of adult workers across five countries (Denmark, Germany, Spain, France and Italy). To make the most of career and labour market opportunities, individuals have to rely on their own resources and their agency but also know how to navigate the institutional…

Fields of Education, Gender and the Labour Market. Education Indicators in Focus. No. 45

ERIC Educational Resources Information Center

OECD Publishing, 2016

2016-01-01

More and more adults are earning a tertiary qualification, but not all tertiary degrees have the same value on the labour market. In general, postgraduate degrees such as master's and doctoral degrees are associated with higher employment rates and earnings than bachelor's degrees. Labour market outcomes also vary by field of education. Some…

The impact of chronic conditions of care recipients on the labour force participation of informal carers in Australia: which conditions are associated with higher rates of non-participation in the labour force?

PubMed Central

2014-01-01

Background Little is known about the effects of personal and other characteristics of care recipients on the behaviour of carers. The aim of this study is to examine the association between the main chronic (disabling) condition of care recipients and the likelihood of their (matched) primary carers aged 15–64 years being out of the labour force. Methods We conducted a retrospective analysis of cross-sectional data from the Australian Bureau of Statistics 2009 Survey of Disability, Ageing and Carers (SDAC) for people aged 15–64 years. We estimated the rates of exit from the labour force for primary carers and non-carers; rates of chronic disease occurrence for care recipients living with their main carers; odds ratios of primary carers being out of the labour force associated with the main chronic condition of their care recipient who lives with them. Results From the 2009 SDAC, we identified 1,268 out of 37,186 eligible participants who were primary carers of a care recipient who lived with them. Of these, 628 (49.5%) were out of the labour force. Most common diseases of care recipients were: back problems (12%); arthritis and related disorders (10%); diseases of the nervous system (such as multiple sclerosis, epilepsy, cerebral palsy) (7.4%); and conditions originating in the perinatal period or congenital malformations, deformations and chromosomal abnormalities (5.1%). When adjusted for age, sex, education and whether have a long term chronic condition of informal carers, the five conditions of care recipients associated with the highest odds of their carers being out of the labour force were: head injury/acquired brain damage; neoplasms, blood diseases, disorders of the immune system; leg/knee/foot/hip damage from injury/accident; dementia, Parkinson’s disease, Alzheimer’s disease; and diseases of the musculoskeletal system and connective tissue (osteoporosis). Conclusions This study identifies the type of conditions that have the greatest impact on

'A Labour of Love': A King's College London Psychiatry Society Event to challenge the stigma attached to mental health problems in post-natal women.

PubMed

Hankir, Ahmed; Brothwood, Phillipa; Crocker, Bethany; Lim, Mao Fong; Lever, Isabel; Carrick, Frederick; Zaman, Rashid; Jones, Charlotte Wilson

2017-09-01

On the 9 th October 2000, Dr Daksha Emson, a London based psychiatrist with bipolar affective disorder, tragically killed herself and her three-month-old baby daughter during a psychotic episode. An independent inquiry into Dr Emson's death concluded that mental health stigma in the National Health Service was a factor that contributed to her death. Despite the morbidity and mortality attributed to the stigma attached to post-natal mental health problems there are very few programmes that have been developed to challenge it. King's College London Undergraduate Psychiatry Society organized an event entitled, 'A Labour of Love': Perinatal Mental Health to address this issue. The event included a talk from an expert by experience, a mother who developed post-partum mental health problems. We conducted a single-arm, pre-post comparison study on participants who attended the KCL Psych Soc event. Validated stigma scales on knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes towards the Mentally Ill (CAMI)) and behaviour (Reported and Intended Behaviour Scale (RIBS)) were administered before and immediately after exposure to the event. 27/27 (100%) of participants recruited responded. There was a statistically significant difference in the pre-MAKS score compared to the post-MAKS score (p=0.0003), the pre-RIBS score compared to the post-RIBS score (p=0.0068) and in the pre-CAMI score compared to the post-CAMI score (p=0.0042). There were statistically significant reductions in stigma in the domains of knowledge, attitude and behavior following exposure to the KCL Psych Soc event and no adverse effects were reported. Our study revealed that a brief intervention made a highly significant impact and maybe useful in challenging the stigma around post-natal mental illness. However, more research in this area is required to determine if the changes are sustained before we can consider rolling out and scaling up such an initiative nationally and

Drivers, challenges and opportunities of forage technology adoption by smallholder cattle households in Cambodia.

PubMed

Ashley, K; Wilson, S; Young, J R; Chan, H P; Vitou, S; Suon, S; Windsor, P A; Bush, R D

2018-01-01

Forage technology has been successfully introduced into smallholder cattle systems in Cambodia as an alternative feed source to the traditional rice straw and native pastures, improving animal nutrition and reducing labour requirements of feeding cattle. Previous research has highlighted the positive impacts of forage technology including improved growth rates of cattle and household time savings. However, further research is required to understand the drivers, challenges and opportunities of forage technology for smallholder cattle households in Cambodia to facilitate widespread adoption and identify areas for further improvement. A survey of forage-growing households (n = 40) in July-September 2016 examined forage technology adoption experiences, including reasons for forage establishment, use of inputs and labour requirements of forage plot maintenance and use of forages (feeding, fattening, sale of grass or seedlings and silage). Time savings was reported as the main driver of forage adoption with household members spending approximately 1 h per day maintaining forages and feeding it to cattle. Water availability was reported as the main challenge to this activity. A small number of households also reported lack of labour, lack of fencing, competition from natural grasses, cost of irrigation and lack of experience as challenges to forage growing. Cattle fattening and sale of cut forage grass and seedlings was not found to be a widespread activity by interviewed households, with 25 and 10% of households reporting use of forages for these activities, respectively. Currently, opportunities exist for these households to better utilise forages through expansion of forage plots and cattle activities, although assistance is required to support these households in addressing current constraints, particularly availability of water, if the sustainability of this feed technology for smallholder cattle household is to be established in Cambodia.

The effects of epidural analgesia on the course and outcome of labour.

PubMed

Finster, M; Santos, A C

1998-09-01

The potential effects of epidural analgesia on the progress and outcome of labour have been the subject of lasting controversy. Retrospective reviews indicate that epidurals are associated with longer labours and/or an increase in the incidence of instrumental or operative delivery. Similar results were obtained in non-randomized prospective studies. None of them established a causal relationship, because without randomization the selection bias cannot be ruled out. Other factors, such as premature rupture of membranes and maternal socioeconomic status, may affect the outcome of labour. It was also reported that introduction of the on-demand epidural service did not increase the primary caesarean section rate. The few prospective randomized studies are contradictory and not very reliable owing to small patient populations and high cross-over rates. There is, however, unanimity among the authors regarding the superiority of pain relief provided by epidural blocks over systemically administered opioids.

Sustainable Supply Chain Management Programs in the 21st Century

ERIC Educational Resources Information Center

Neureuther, Brian D.; O'Neill, Kevin

2011-01-01

One of the most difficult challenges for an undergraduate supply chain management program at smaller universities is to create an environment of sustainability. Supply chain management is not at the tip of tongue for many graduating high school students and few undergraduate curriculums require a course in the content area. This research addresses…

A physiological exploration on operational stance and occupational musculoskeletal problem manifestations amongst construction labourers of West Bengal, India.

PubMed

Chatterjee, Arijit; Sahu, Subhashis

2018-03-29

A huge number of labourers engaged in construction industry in India both in organized and unorganized sectors. The construction labourers most often work for an extended period of time and they are compelled to uphold altered static and dynamic operational stance in awkward positions during the complete period of work which raises the demand on the musculoskeletal system and may lead to work related musculoskeletal disorders (WRMSDs). This study is intended to explore the operational stance and occupation related musculoskeletal manifestations amongst the construction labourers. One sixty four male labourers from different construction sites of West Bengal was randomly taken for this study. A modified Nordic questionnaire on MSD and the 12 item General Health Questionnaire (GHQ12) were administered on the construction labourers. Rapid Entire Body Assessment [REBA] and Ovako Work Analysis System [OWAS] methods were applied to analyze the operational stance. Finally, discomfort levels of the specific operational stance were calculated by the use of risk level and BPD scale. From the study it was revealed that most of the construction labourers habitually in awkward operational stance and were affected by altering musculoskeletal manifestations like pain in low back, neck, and wrist. It has been also found that there is a significant (p< 0.05) association between the intensity of pain feeling, age, year of working experience and risk level of the individual working postures of the labourers. Appropriate work-rest schedule, amendments of some working techniques and use of some ergonomically designed equipment may lessen the WRMSDs and improve the health eminence of construction labourers in unorganized sectors.

Labour and the Grammar Schools: A History

ERIC Educational Resources Information Center

Gillard, Derek

2017-01-01

This article outlines the Labour Party's attitude to selective secondary education from the creation of the party in 1900 to the present day. It notes early calls for comprehensive schools; seeks to explain why the post-war Attlee government was so committed to the tripartite system of secondary schools; recounts the failure of the Wilson…

Labour force participation and the influence of having CVD on income poverty of older workers.

PubMed

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Percival, Richard; Kelly, Simon J; Passey, Megan E

2012-04-05

In addition to being the leading cause of death, cardiovascular disease (CVD) also impacts upon the ability of individuals to function normally in everyday activities, which is likely to affect individuals' employment. This paper will quantify the relationship between labour force participation, CVD and being in poverty. The 2003 Survey of Disability, Ageing and Carers (SDAC) data were used to assess the impact of having CVD on being in poverty amongst the older working aged (aged 45 to 64) population in Australia. Those not in the labour force with no chronic health condition are 93% less likely to be in poverty than those not in the labour force due to CVD (OR 0.07, 95%CI: 0.07-0.07, p<.0001). The likelihood of being in poverty varies with labour force status for those with CVD: those who were either in full time (OR 0.04, 95% CI: 0.04-0.05, p<.0001) or part time (OR 0.19, 95% CI: 0.18-0.19) employment are significantly less likely to be in poverty than those who have had to retire because of the condition. The efforts to increase the labour force participation of individuals with CVD, or ideally prevent the onset of the condition will likely improve their living standards. This study has shown that having CVD and not being in the labour force because of the condition drastically increases the chances of living in poverty. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Prolonging the duration of single-shot intrathecal labour analgesia with morphine: A systematic review.

PubMed

Al-Kazwini, Hadeel; Sandven, Irene; Dahl, Vegard; Rosseland, Leiv Arne

2016-10-01

Single-shot spinal with bupivacaine plus fentanyl or sufentanil is commonly used as analgesia during labour, but the short duration limits the clinical feasibility. Different drugs have been added to prolong the analgesic duration. The additional effect of intra-thecal morphine has been studied during labour pain as well as after surgery. We assessed whether adding morphine to intra-thecal bupivacaine+fentanyl or sufentanil prolongs pain relief during labour. Meta-analysis of placebo-controlled randomized clinical trials of analgesia prolongation after single-shot intrathecal morphine ≤250μg during labour when given in combination with bupivacaine+fentanyl or sufentanil. After identifying 461 references, 24 eligible studies were evaluated after excluding duplicate publications, case reports, studies of analgesia after caesarean delivery, and epidural labour analgesia. Mean duration in minutes was the primary outcome measure and was included in the calculation of the standardized mean difference. Duration was defined as the time between a single shot spinal until patient request of rescue analgesia. All reported side effects were registered. Results of individual trials were combined using a random effect model. Cochrane tool was used to assess risk of bias. Five randomized placebo-controlled clinical trials (286 patients) were included in the meta-analysis. A dose of 50-250μg intrathecal morphine prolonged labour analgesia by a mean of 60.6min (range 3-155min). Adding morphine demonstrated a medium beneficial effect as we found a pooled effect of standardized mean difference=0.57 (95% CI: -0.10 to 1.24) with high heterogeneity (I 2 =88.1%). However, the beneficial effect was statistically non-significant (z=1.66, p=0.096). The lower-bias trials showed a small statistically non-significant beneficial effect with lower heterogeneity. In influential analysis, that excluded one study at a time from the meta-analysis, the effect size appears unstable and the results

‘Left out in the Cold: Village Women and Agricultural Labour in England and Wales during the First World War’.

PubMed

Verdon, Nicola

2016-01-01

The Women’s Land Army (WLA), formed in 1917, has featured prominently in recent academic and popular account of First World War Britain. This interest reflects the attention the WLA drew from politicians, government reporters and contemporary commentators during and immediately after the war itself. Yet, the WLA, which at its peak had 16,000 women working on the land, was just one strand of wartime female agricultural labour, an auxiliary to the thousands of village women who worked throughout the war. Whilst the WLA received numerous plaudits for their participation, village women were ‘left out in the cold’, as one correspondent to The Times put it, in recognition of their wartime service. This article will place the rural woman worker back to centre stage. It will revisit the often-contradictory wartime estimates of the number of women working in agriculture in England and Wales before moving on to examine how regional farming structures and seasonal demands for labour shaped the use of women workers. It will show that even at the very local level, here utilizing records from the Bedfordshire Women’s War Agricultural Committee, demand and supply issues produced a fractured pattern. It will show that concentrating exclusively on the WLA leads to a distorted picture of women’s work on the land during the First World War.

Child labour and health: a systematic review.

PubMed

Batomen Kuimi, Brice Lionel; Oppong-Nkrumah, Oduro; Kaufman, Jay; Nazif-Munoz, Jose Ignacio; Nandi, Arijit

2018-06-01

This study aimed to synthesise the available knowledge, identify unexplored areas and discuss general limits of the published evidence. We focused on outcomes commonly hypothesised to be affected by child labour: nutritional status, harmful exposures and injuries. Four electronic databases (EMBASE, MEDLINE, Scopus, ISI Web of Science) were searched in November 2017. All articles published since 1996, without restrictions on language, were considered for inclusion. Out of the 1090 abstracts initially identified by the search, 78 articles were selected for inclusion and reviewed. Most of the studies were conducted in Asia and South America, and only a third of them compared working children to a control group of non-working children. Child labour appears to be associated with poor nutritional status, diseases due to harmful exposures, and a higher prevalence of injuries. Despite evidence for a negative relation between child work and health, the cross-sectional design of most studies limits the causal interpretation of existing findings. More rigorous observational studies are needed to confirm and better quantify these associations.

Emotional Labour and Wellbeing: What Protects Nurses?

PubMed Central

Kinman, Gail; Leggetter, Sandra

2016-01-01

Although compassionate care has wide-ranging benefits for patients, it can be emotionally demanding for healthcare staff. This may be a particular problem for those with little experience in a caring role. This study utilises the job demands-resources model to examine links between “emotional labour” and emotional exhaustion in student nurses. In line with the triple-match principle—whereby interactive effects are more likely when job demands, resources, and outcomes are within the same qualitative domain—the protective role of emotional support and emotion-focused coping (i.e., emotional venting) in the relationship between emotional labour and exhaustion is also explored. An online questionnaire was completed by 351 student nurses with experience working in healthcare settings. A strong positive relationship was found between emotional labour and emotional exhaustion, and some support was found for the moderating effects of emotional support and emotion-focused coping. Ways to help student and qualified nurses develop the emotional resilience required to protect their wellbeing, while providing high-quality compassionate care to patients are considered. PMID:27916880

[Information and facilities recommendations concerning trial of labour in the context of scarred womb].

PubMed

Gallot, D; Delabaere, A; Desvignes, F; Vago, C; Accoceberry, M; Lémery, D

2012-12-01

To precise key elements concerning facilities and patient information prior to trial of labour in the context of scarred womb. Bibliographic search restricted to French and English languages using Medline database and recommendations of medical societies. Only expert's opinions are available. Patient information should present both trial of labour and elective cesarean section. Counselling should be influenced by individual risk of failed vaginal birth and uterine rupture. Mode of delivery should be planned the latest at 8 months of gestation. Patient should be aware of obstetrical and anesthetic facilities. Trial of labour should be presented as the first option for patients with no additional risk factors. Immediate presence of obstetrician and anesthesiologist is not required except in the context of increased risk for failed trial of labour or uterine rupture. Elective cesarean section on maternal request is acceptable after extensive counselling and delay of reflexion. Individual patient information should be initiated early and mode of delivery should be planned at 8 months of gestation. Resources and facilities recommendations aim to facilitate prompt cesarean section. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Is collectivism good for health promotion? Experiences of day labourers in Japan.

PubMed

Kawabata, Makie

2013-12-01

Collectivist values such as social trust and reciprocity are usually associated with positive health outcomes. Few studies have explored how collectivism influences individual and community capacity to engage health promotion practices. This paper explores how collectivism excludes people who do not conform to societal expectations and negatively affects individuals and communities as they practise health promotion. Data were collected through interviews with day labourers in Japan. Using critical ethnography, participants' accounts were examined focusing on the normative claims, which were principally about what behaviours are proper, appropriate and conventional among day labourers in order to understand the cultural norms and values that influence their behaviours. Findings show that day labourers are often denied public support and their social disadvantages are ignored when they seek support. Day labourers often accept their exclusions as inevitable because they accept the dominant social norms. These findings indicate that collectivist norms prevent individuals and communities from developing their capacities for health promotion practices. Individual needs tend to be obscured when prioritizing collective interests, which are also used as a tool for justifying inadequate social programmes. In a collectivist society, burdens that should be shared equally by all may not be equitably distributed, falling disproportionately on the disadvantaged. An uncritical adoption of a collectivist ethos in examining health promotion is not warranted and more investigation is needed to determine when collectivism is helpful and when harmful.

Experiences of non-progressive and augmented labour among nulliparous women: a qualitative interview study in a Grounded Theory approach

PubMed Central

Kjaergaard, Hanne; Foldgast, Anne Maria; Dykes, Anna-Karin

2007-01-01

Background Non-progressive labour is the most common complication in nulliparas and is primarily treated by augmentation. Augmented labour is often terminated by instrumental delivery. Little qualitative research has addressed experiences of non-progressive and augmented deliveries. The aim of this study was to gain a deeper understanding of the experience of non-progressive and augmented labour among nulliparas and their experience of the care they received. Methods A qualitative study was conducted using individual interviews. Data was collected and analysed according to the Grounded Theory method. The participants were a purposive sample of ten women. The interviews were conducted 4–15 weeks after delivery. Results The women had contrasting experiences during the birth process. During labour there was a conflict between the expectation of having a natural delivery and actually having a medical delivery. The women experienced a feeling of separation between mind and body. Interacting with the midwife had a major influence on feelings of losing and regaining control. Reconciliation between the contrasting feelings during labour was achieved. The core category was named Dialectical Birth Process and comprised three categories: Balancing natural and medical delivery, Interacting, Losing and regaining control. Conclusion A dialectical process was identified in these women's experiences of non-progressive labour. The process is susceptible to interaction with the midwife; especially her support to the woman's feeling of being in control. Midwives should secure that the woman's recognition of the fact that the labour is non-progressive and augmentation is required is handled with respect for the dialectical process. Augmentation of labour should be managed as close to the course of natural labour and delivery as possible. PMID:17662152

Extreme Forms of Child Labour in Turkey

ERIC Educational Resources Information Center

Degirmencioglu, Serdar M.; Acar, Hakan; Acar, Yuksel Baykara

2008-01-01

Two little known forms of child labour in Turkey are examined. The process through which these children are made to work has parallels with the experiences of slaves. First, a long-standing practice from Northwestern Turkey of parents hiring children to better-off farmers is examined. Further, a more recent problem is examined where children are…

Single-Sex Schooling and Labour Market Outcomes

ERIC Educational Resources Information Center

Sullivan, Alice; Joshi, Heather; Leonard, Diana

2011-01-01

One quarter of the 1958 British Birth cohort attended single-sex secondary schools. This paper asks whether sex-segregated schooling had any impact on the experience of gender differences in the labour market in mid-life. We examine outcomes at age 42, allowing for socio-economic origins and abilities measured in childhood. We find no net impact…

The Labour Party and the Need for Change: Values, Education and Emotional Literacy/Intelligence

ERIC Educational Resources Information Center

Matthews, Brian

2012-01-01

The author argues that when the Labour Party has analysed its values emotional development has been neglected. He shows the importance of emotional literacy and uses education as a vehicle to show how Labour when in power reinforced right-wing ideology. Ways of changing education policy are indicated. It is hoped that this article will promote a…

The politics of agenda setting at the global level: key informant interviews regarding the International Labour Organization Decent Work Agenda.

PubMed

Di Ruggiero, Erica; Cohen, Joanna E; Cole, Donald C

2014-07-01

Global labour markets continue to undergo significant transformations resulting from socio-political instability combined with rises in structural inequality, employment insecurity, and poor working conditions. Confronted by these challenges, global institutions are providing policy guidance to protect and promote the health and well-being of workers. This article provides an account of how the International Labour Organization's Decent Work Agenda contributes to the work policy agendas of the World Health Organization and the World Bank. This qualitative study involved semi-structured interviews with representatives from three global institutions--the International Labour Organization (ILO), the World Health Organization and the World Bank. Of the 25 key informants invited to participate, 16 took part in the study. Analysis for key themes was followed by interpretation using selected agenda setting theories. Interviews indicated that through the Decent Work Agenda, the International Labour Organization is shaping the global policy narrative about work among UN agencies, and that the pursuit of decent work and the Agenda were perceived as important goals with the potential to promote just policies. The Agenda was closely linked to the World Health Organization's conception of health as a human right. However, decent work was consistently identified by World Bank informants as ILO terminology in contrast to terms such as job creation and job access. The limited evidence base and its conceptual nature were offered as partial explanations for why the Agenda has yet to fully influence other global institutions. Catalytic events such as the economic crisis were identified as creating the enabling conditions to influence global work policy agendas. Our evidence aids our understanding of how an issue like decent work enters and stays on the policy agendas of global institutions, using the Decent Work Agenda as an illustrative example. Catalytic events and policy

The politics of agenda setting at the global level: key informant interviews regarding the International Labour Organization Decent Work Agenda

PubMed Central

2014-01-01

Background Global labour markets continue to undergo significant transformations resulting from socio-political instability combined with rises in structural inequality, employment insecurity, and poor working conditions. Confronted by these challenges, global institutions are providing policy guidance to protect and promote the health and well-being of workers. This article provides an account of how the International Labour Organization’s Decent Work Agenda contributes to the work policy agendas of the World Health Organization and the World Bank. Methods This qualitative study involved semi-structured interviews with representatives from three global institutions – the International Labour Organization (ILO), the World Health Organization and the World Bank. Of the 25 key informants invited to participate, 16 took part in the study. Analysis for key themes was followed by interpretation using selected agenda setting theories. Results Interviews indicated that through the Decent Work Agenda, the International Labour Organization is shaping the global policy narrative about work among UN agencies, and that the pursuit of decent work and the Agenda were perceived as important goals with the potential to promote just policies. The Agenda was closely linked to the World Health Organization’s conception of health as a human right. However, decent work was consistently identified by World Bank informants as ILO terminology in contrast to terms such as job creation and job access. The limited evidence base and its conceptual nature were offered as partial explanations for why the Agenda has yet to fully influence other global institutions. Catalytic events such as the economic crisis were identified as creating the enabling conditions to influence global work policy agendas. Conclusions Our evidence aids our understanding of how an issue like decent work enters and stays on the policy agendas of global institutions, using the Decent Work Agenda as an illustrative

Fuzzy Entropy Method for Quantifying Supply Chain Networks Complexity

NASA Astrophysics Data System (ADS)

Zhang, Jihui; Xu, Junqin

Supply chain is a special kind of complex network. Its complexity and uncertainty makes it very difficult to control and manage. Supply chains are faced with a rising complexity of products, structures, and processes. Because of the strong link between a supply chain’s complexity and its efficiency the supply chain complexity management becomes a major challenge of today’s business management. The aim of this paper is to quantify the complexity and organization level of an industrial network working towards the development of a ‘Supply Chain Network Analysis’ (SCNA). By measuring flows of goods and interaction costs between different sectors of activity within the supply chain borders, a network of flows is built and successively investigated by network analysis. The result of this study shows that our approach can provide an interesting conceptual perspective in which the modern supply network can be framed, and that network analysis can handle these issues in practice.

A randomized clinical trial of care for women with preterm labour: home management versus hospital management.

PubMed

Goulet, C; Gévry, H; Lemay, M; Gauthier, R J; Lepage, L; Fraser, W; Polomeno, V

2001-04-03

Preterm labour occurs in about 10% of all pregnancies and is the most important cause of premature birth. Women with preterm labour are admitted to hospital to have the contractions stopped. Thereafter, many women remain in hospital until delivery. We conducted a randomized clinical trial to compare hospital care with home care of women who had been admitted to hospital for preterm labour. After they had received treatment for an acute episode of premature labour, women at 2 regional perinatal centres associated with teaching hospitals were randomly assigned to home care or hospital care. Eligible women (n = 250) were aged 18 years or older, lived within 50 km of the hospital, had a gestational age between 20 and 35 weeks, had no prior preterm delivery and were experiencing their first episode of preterm labour and first admission to hospital for preterm labour. Analysis was by intention to treat. There were no significant differences between the 2 groups in mean gestational age at delivery (home: 37.52 weeks, hospital: 37.50 weeks) or in mean birth weight (home: 2974 g, hospital: 3020 g). There were no significant differences between the 2 groups with respect to the proportions of babies born before term or the mean duration of neonatal hospital stay, neonatal intensive care unit stay and intermediate care nursery stay. The mean duration of the first stay in hospital for the women in the home group (3.8 days) was significantly shorter than the mean duration for women in the hospital group (6.1 days). In addition, the mean duration of all maternal stays in hospital was significantly shorter for the women in the home group (3.7 days) than in the hospital group (5.0 days). Home care management is an efficient and acceptable alternative to hospital care for women experiencing preterm labour.

Contribution of family labour to the profitability and competitiveness of small-scale dairy production systems in central Mexico.

PubMed

Posadas-Domínguez, Rodolfo Rogelio; Arriaga-Jordán, Carlos Manuel; Martínez-Castañeda, Francisco Ernesto

2014-01-01

The objective of this work was to determine the effect of family labour on the profitability and competitiveness of small-scale dairy farms in the highlands of Central Mexico. Economic data from 37 farms were analysed from a stratified statistical sampling with a Neyman assignment. Three strata were defined taking herd size as criterion. Stratum 1: herds from 3 to 9 cows plus replacements, Stratum 2: herds from 10 to 19 cows and Stratum 3: herds from 20 to 30 cows. The policy analysis matrix was used as the method to determine profitability and competitiveness. The coefficient of private profitability (CPP) when the economic cost of family labour is included in the cost structure was 8.0 %, 31.0 % and 46.0 %. When the economic cost of family labour is not included, CPP increase to 47.0 %, 57.0 % and 66.0 % for each strata, respectively. The private cost ratio (PCR) when family labour is included was 0.79, 0.51 and 0.42 for strata 1, 2 and 3, respectively. When family labour is not included, the PCR was 0.07, 0.25 and 0.26. Net profit per litre of milk including family labour was US$0.03 l(-1) for Stratum 1, US$0.09 for Stratum 2 and US$0.12 l(-1) for Stratum 3; but increased to $0.12, 0.14 and 0.15, respectively, when the economic cost of family labour is not included. It is concluded that family labour is a crucial factor in the profitability and competitiveness of small-scale dairy production.

[Loss of labour productivity caused by premature mortality in Spain in 2005].

PubMed

Oliva, Juan

2009-01-01

Jointly with deaths, loss of quality of life and pain of patients and families, there are complementary indicators that help to reveal the social impact caused by illnesses and accidents. In the analysis, loss of labour productivity due to premature mortality in 2005 is estimated. The aim of this work is to estimate a part of the non health care costs caused by illnesses and accidents in the economy. A simulation model based in the human capital approach is developed using several available Spanish data bases (Death Registry According to Cause of Death, Structural Wage Survey, Labour Force Survey). A loss of production up to 9,100 millions of Euros due to premature mortality is estimated in Spain for the base year. This figure is equivalent to a 1.01% of the Spanish Gross Domestic Product, or to an 18.25% of the Public Health Care Expenditure of 2005. Premature mortality caused a very high labour cost.

Labour's New Education Policy Document: Tensions, Ambivalences and Silences

ERIC Educational Resources Information Center

Hatcher, Richard

2015-01-01

This article critically examines the Labour Party's policies for local school systems, focusing on its proposals for regional Directors of School Standards, for academies and free schools, and for local democracy, and offers an alternative approach.

Transnational labour migration and the politics of care in the Southeast Asian family

PubMed Central

Hoang, Lan Anh; Yeoh, Brenda S.A.; Wattie, Anna Marie

2012-01-01

Recent increases in female labour migration in and from Asia have triggered a surge of interest in how the absence of the mother and wife for extended periods of time affects the left-behind family, particularly children, in labour-sending countries. While migration studies in the region have shown that the extended family, especially female relatives, is often called on for support in childcare during the mother’s absence it is not yet clear how childcare arrangements are made. Drawing on in-depth interviews with non-parent carers of left-behind children in Indonesia and Vietnam, the paper aims to unveil complexities and nuances around care in the context of transnational labour migration. In so doing it draws attention to the enduring influence of social norms on the organisation of family life when women are increasingly drawn into the global labour market. By contrasting a predominantly patrilineal East Asian family structure in Vietnam with what is often understood as a bilateral South-East Asian family structure in Indonesia, the paper seeks to provide interesting comparative insights into the adaptive strategies that the transnational family pursues in order to cope with the reproductive vacuum left behind by the migrant mother. PMID:22984293

Employability and work ability: returning to the labour market after long-term absence.

PubMed

Nilsson, Staffan; Ekberg, Kerstin

2013-01-01

The aim of this study was to analyse how people who return to the labour market after long-term sickness absenteeism and subsequent job loss differ in employability, work ability, health, educational level, age, and gender, compared to those who do not. The cohort consisted of 191 individuals, 20 men and 171 women, whose employment was terminated because they had not been able to return to their regular work after taking a long-term sick leave and rehabilitation measures. This study is based on a postal questionnaire sent out to a cohort of previous employees in a Swedish municipality in 2008. At the time of the survey, 39% of the respondents had returned to the labour market and the remaining 61% had not. Return to the labour market after a long-term sick leave was positively associated with male gender, young age, and work ability, i.e. the ability to work with respect to health and work-related demands. Employability, educational level, and health were not significantly associated with a return to the labour market. In the discourse on employability, work ability is often neglected even though it is a central aspect of an individual's ability to obtain new employment.

Intravenous fluids for reducing the duration of labour in low risk nulliparous women.

PubMed

Dawood, Feroza; Dowswell, Therese; Quenby, Siobhan

2013-06-18

Several factors may influence the progression of normal labour. It has been postulated that the routine administration of intravenous fluids to keep women adequately hydrated during labour may reduce the period of contraction and relaxation of the uterine muscle, and may ultimately reduce the duration of the labour. It has also been suggested that intravenous fluids may reduce caesarean sections (CS) for prolonged labour. However, the routine administration of intravenous fluids to labouring women has not been adequately elucidated although it is a widely-adopted policy, and there is no consensus on the type or volume of fluids that are required, or indeed, whether intravenous fluids are at all necessary. Women may be able to adequately hydrate themselves if they were allowed oral fluids during labour.Furthermore, excessive volumes of intravenous fluids may pose risks to both the mother and her newborn and different fluids are associated with different risks. To evaluate whether the routine administration of intravenous fluids to low-risk nulliparous labouring women reduces the duration of labour and to evaluate the safety of intravenous fluids on maternal and neonatal health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (13 February 2013). Randomised controlled trials of intravenous fluid administration to spontaneously labouring low-risk nulliparous women. The review authors independently assessed trials for inclusion, trial quality and extracted data. We included nine randomised trials with 1781 women. Three trials had more than two treatment arms and were included in more than one comparison.Two trials compared women randomised to receive up to 250 mL/hour of Ringer's lactate solution as well as oral intake versus oral intake only. For women delivering vaginally, there was a reduction in the duration of labour in the Ringer's lactate group (mean difference (MD) -28.86 minutes, 95% confidence interval (CI) -47.41 to -10.30). There

Fundal pressure during the second stage of labour.

PubMed

Verheijen, Evelyn C; Raven, Joanna H; Hofmeyr, G Justus

2009-10-07

Fundal pressure during the second stage of labour involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal in an attempt to assist spontaneous vaginal delivery and avoid prolonged second stage or the need for operative delivery. Fundal pressure has also been applied using an inflatable girdle. A survey in the United States found that 84% of the respondents used fundal pressure in their obstetric centres.There is little evidence to demonstrate that the use of fundal pressure is effective to improve maternal and/or neonatal outcomes. Several anecdotal reports suggest that fundal pressure is associated with maternal and neonatal complications: for example, uterine rupture, neonatal fractures and brain damage. There is a need for objective evaluation of the effectiveness and safety of fundal pressure in the second stage of labour. To determine the benefits and adverse effects of fundal pressure in the second stage of labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised and quasi-randomised controlled trials of fundal pressure versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Three review authors independently assessed for inclusion all the potential studies. We extracted the data using a pre-designed form. We entered data into Review Manager software and checked for accuracy. We excluded two of three identified trials from the analyses for methodological reasons. This left no studies on manual fundal pressure. We included one study (500 women) of fundal pressure by means of an inflatable belt versus no fundal pressure to reduce operative delivery rates. The methodological quality of the included study was good.Use of the inflatable belt did not change the rate of operative deliveries (RR 0.94, 95% CI 0.80 to 1.11). Fetal outcomes in terms of five-minute Apgar scores below seven (RR 4.62, 95% CI 0.22 to 95

Modeling methodology for supply chain synthesis and disruption analysis

NASA Astrophysics Data System (ADS)

Wu, Teresa; Blackhurst, Jennifer

2004-11-01

The concept of an integrated or synthesized supply chain is a strategy for managing today's globalized and customer driven supply chains in order to better meet customer demands. Synthesizing individual entities into an integrated supply chain can be a challenging task due to a variety of factors including conflicting objectives, mismatched incentives and constraints of the individual entities. Furthermore, understanding the effects of disruptions occurring at any point in the system is difficult when working toward synthesizing supply chain operations. Therefore, the goal of this research is to present a modeling methodology to manage the synthesis of a supply chain by linking hierarchical levels of the system and to model and analyze disruptions in the integrated supply chain. The contribution of this research is threefold: (1) supply chain systems can be modeled hierarchically (2) the performance of synthesized supply chain system can be evaluated quantitatively (3) reachability analysis is used to evaluate the system performance and verify whether a specific state is reachable, allowing the user to understand the extent of effects of a disruption.

Outpatient versus inpatient induction of labour for improving birth outcomes.

PubMed

Kelly, Anthony J; Alfirevic, Zarko; Ghosh, Arpita

2013-11-12

More than 20% of women undergo induction of labour in some countries. The different methods used to induce labour have been the focus of previous reviews, but the setting in which induction takes place (hospital versus outpatient settings) may have implications for maternal satisfaction and costs. It is not known whether some methods of induction that are effective and safe in hospital are suitable in outpatient settings. To assess the effects on outcomes for mothers and babies of induction of labour for women managed as outpatients versus inpatients. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2013). Published and unpublished randomised and quasi-randomised trials in which inpatient and outpatient methods of cervical ripening or induction of labour have been compared. Two review authors independently assessed trial reports for inclusion. Two review authors carried out data extraction and assessment of risk of bias independently. We included four trials, with a combined total of 1439 women in the review; each trial examined a different method of induction and we were unable to pool the results from trials.1. Vaginal PGE2 (two studies including 1028 women). There were no differences between women managed as outpatients versus inpatients for most review outcomes. There was no evidence of a difference between the likelihood of women requiring instrumental delivery in either setting (risk ratio (RR) 1.29; 95% confidence interval (CI) 0.79 to 2.13). The overall length of hospital stay was similar in the two groups.2. Controlled release PGE2 10 mg (one study including 300 women). There was no evidence of differences between groups for most review outcomes, including success of induction. During the induction period itself, women in the outpatient group were more likely to report high levels of satisfaction with their care (satisfaction rated seven or more on a nine-point scale, RR 1.42; 95% CI 1.11 to 1.81), but satisfaction scores

Outpatient versus inpatient induction of labour for improving birth outcomes.

PubMed

Kelly, Anthony J; Alfirevic, Zarko; Dowswell, Therese

2009-04-15

More than 20% of women undergo induction of labour in some countries. The different methods used to induce labour have been the focus of previous reviews, but the setting in which induction takes place (hospital versus outpatient settings) may have implications for maternal satisfaction and costs. It is not known whether some methods of induction that are effective and safe in hospital are suitable in outpatient settings. To assess the effects on outcomes for mothers and babies of induction of labour for women managed as outpatients versus inpatients. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2008). Published and unpublished randomised and quasi-randomised trials in which inpatient and outpatient methods of cervical ripening or induction of labour have been compared. Two review authors independently assessed trial reports for inclusion. Two review authors carried out data extraction and assessment of risk of bias independently. We included three trials, with a combined total of 612 women in the review; each examined a different method of induction and we were unable to pool the results from trials.1. Vaginal PGE2 (One study including 201 women). There were no differences between women managed as out- versus inpatients for most review outcomes. Women in the outpatient group were more likely to have instrumental deliveries (risk ratio (RR) 1.74; 95% confidence interval (CI) 1.03 to 2.93). The overall length of hospital stay was similar in the two groups.2. Controlled release PGE2 10mg (one study including 300 women). There was no evidence of differences between groups for most review outcomes, including success of induction. During the induction period itself, women in the outpatient group were more likely to report high levels of satisfaction with their care (satisfaction rated seven or more on a nine-point scale RR 1.42; 95% CI 1.11 to 1.81), but satisfaction scores measured postnatally were similar in the two groups.3

A New Direction for Schools and Labour

ERIC Educational Resources Information Center

Audsley, Jamie; O'Connell, Jim

2011-01-01

The authors argue that it is time to get radical about the Left's vision for education and develop a direction that communities can really own. The Labour Party being out of government for the first time in 13 years gives us a chance to consider what education means to the Left, and allows us to be innovative in how the Party can approach…

Perineal massage in labour and prevention of perineal trauma: randomised controlled trial

PubMed Central

Stamp, Georgina; Kruzins, Gillian; Crowther, Caroline

2001-01-01

Objective To determine the effects of perineal massage in the second stage of labour on perineal outcomes. Design Randomised controlled trial. Participants At 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progressed to full dilatation of the cervix or 8 cm or more if nulliparous or 5 cm or more if multiparous. 1340 were randomised into the trial. Intervention Massage and stretching of the perineum during the second stage of labour with a water soluble lubricant. Main outcome measures Primary outcomes: rates of intact perineum, episiotomies, and first, second, third, and fourth degree tears. Secondary outcomes: pain at three and 10 days postpartum and pain, dyspareunia, resumption of sexual intercourse, and urinary and faecal incontinence and urgency three months postpartum. Results Rates of intact perineums, first and second degree tears, and episiotomies were similar in the massage and the control groups. There were fewer third degree tears in the massage group (12 (1.7%) v 23 (3.6%); absolute risk 2.11, relative risk 0.45; 95% confidence interval 0.23 to 0.93, P<0.04), though the trial was underpowered to measure this rarer outcome. Groups did not differ in any of the secondary outcomes at the three assessment points. Conclusions The practice of perineal massage in labour does not increase the likelihood of an intact perineum or reduce the risk of pain, dyspareunia, or urinary and faecal problems. What is already known on this topicPerineal trauma during vaginal birth and its sequelae, including urinary and faecal incontinence, dyspareunia, and persistent pain, have a negative impact on the sexuality, self esteem, and quality of life of countless women each yearPerineal massage conducted antenatally has some benefit in reducing the risk of perineal traumaPerineal massage in the second stage of labour has been promoted and practised without sound evidence of

[Prognostic value of chosen parameters of mechanical and bioelectrical uterine activity in prediction of threatening preterm labour].

PubMed

Zietek, Jerzy; Sikora, Jerzy; Horoba, Krzysztof; Matonia, Adam; Jezewski, Janusz; Magnucki, Jacek; Kobielska, Lucyna

2009-03-01

To record and analyse bioelectrical activity of the uterine muscle in the course of physiological pregnancy, labour and threatening premature labour; to define which parameters from the analysis of both electrohysterogram and mechanical activity signal allow us to predict threatening premature labour. Material comprised 62 pregnant women: Group I--27 patients in their first physiological pregnancy, Group II--21 patients in their first pregnancy with symptoms of threatening premature labour, and Group III--14 patients in the first labour period. The on-line analysis of the mechanical (TOCO) and electrical (EHG) contraction activity relied on determination of quantitative parameters of detected uterine contractions. The obtained statistical results demonstrated a possibility to differentiate between Group I and II through the amplitude and contraction area for EHG signal, and only the contraction amplitude for TOCO signal. Additionally, significant differentiating parameters for electrohysterogram are: contraction power and its median frequency. Analyzing Group I and III, significant differences were noted for contraction amplitude and area obtained both from EHG and TOCO signals. Similarly, the contraction power (from EHG) enables us to assign the contractions either to records from Group I or to labour type. There was no significant difference noted between Group II and III. Identification of pregnant women at risk of premature labour should lead to their inclusion in rigorous perinatal surveillance. This requires novel, more sensitive methods that are able to detect early symptoms of the uterine contraction activity increase. Electrohysterography provides complete information on principles of bioelectrical uterine activity. Quantitative parameters of EHG analysis enable the detection of records (contractions) with the symptoms of premature uterine contraction activity.

Perineal massage in labour and prevention of perineal trauma: randomised controlled trial.

PubMed

Stamp, G; Kruzins, G; Crowther, C

2001-05-26

To determine the effects of perineal massage in the second stage of labour on perineal outcomes. Randomised controlled trial. At 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progressed to full dilatation of the cervix or 8 cm or more if nulliparous or 5 cm or more if multiparous. 1340 were randomised into the trial. Massage and stretching of the perineum during the second stage of labour with a water soluble lubricant. rates of intact perineum, episiotomies, and first, second, third, and fourth degree tears. pain at three and 10 days postpartum and pain, dyspareunia, resumption of sexual intercourse, and urinary and faecal incontinence and urgency three months postpartum. Rates of intact perineums, first and second degree tears, and episiotomies were similar in the massage and the control groups. There were fewer third degree tears in the massage group (12 (1.7%) v 23 (3.6%); absolute risk 2.11, relative risk 0.45; 95% confidence interval 0.23 to 0.93, P<0.04), though the trial was underpowered to measure this rarer outcome. Groups did not differ in any of the secondary outcomes at the three assessment points. The practice of perineal massage in labour does not increase the likelihood of an intact perineum or reduce the risk of pain, dyspareunia, or urinary and faecal problems.

Maternal positioning affects fetal heart rate changes after epidural analgesia for labour.

PubMed

Preston, R; Crosby, E T; Kotarba, D; Dudas, H; Elliott, R D

1993-12-01

Adverse fetal heart rate (FHR) changes suggestive of fetal hypoxia are seen in patients with normal term pregnancies after initiation of epidural block for labour analgesia. It was our hypothesis that, in some parturients, these changes were a consequence of concealed aortocaval compression resulting in decreased uterine blood flow. We expected that the full lateral position compared with the wedged supine position would provide more effective prophylaxis against aortocaval compression. To test our hypothesis we studied the role of maternal positioning on FHR changes during onset of epidural analgesia for labour. Eighty-eight ASA Class I or II term parturients were randomized into two groups: those to be nursed in the wedged supine position and those to be nursed in the full lateral position during induction of an epidural block. External FHR monitoring was employed to assess the fetal response to initiation of labour epidural analgesia. Epidural catheters were sited with the parturients in the sitting position and the patients then assumed the study position. After a negative test dose, a standardized regimen of bupivacaine 0.25% was employed to provide labour analgesia. The quality and efficacy of the block were assessed using VAS pain scores, motor block scores and sensory levels. The results demonstrated that there was no difference in the quality of analgesia provided nor in the incidence of asymmetric blocks. There was no difference in the observed incidence of FHR changes occurring during the initiation of the epidural block.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of obstetric gel on the process and duration of labour in pregnant women: Randomised controlled trial.

PubMed

Seval, Mehmet Murat; Yüce, Tuncay; Yakıştıran, Betül; Şükür, Yavuz Emre; Özmen, Batuhan; Atabekoğlu, Cem; Koç, Acar; Söylemez, Feride

2017-08-01

The present study investigated maternal and neonatal outcomes in pregnant women who used obstetric lubricant gels during active labour. This prospective randomised controlled study included 180 pregnant women. Women were randomly assigned to two groups during the first-stage of labour. Pregnant women in the obstetric gel group received standard antepartum care plus vaginal application of obstetric gel. Women in the control group received standard antepartum care without obstetric gel. Mean duration of the second stage of labour was significantly shorter in the obstetric gel group than control group (45 ± 34 min vs. 58 ± 31 min, respectively; p = .005). Mean APGAR values at 5 min were significantly higher in the obstetric gel group (9.5 ± 0.6 vs. 9.2 ± 0.7; p = .0014). Among nulliparous women, mean duration of the second stage of labour was significantly shorter in the gel group than control group (53 ± 52 min vs. 83 ± 45 min, respectively; p = .003). Using obstetric gel at the beginning of the first stage decreases the length of the second stage of labour, particularly in nulliparous women, and may be associated with an improved APGAR score at 5 min. Impact statement A limited number of studies in the literature have demonstrated that obstetric gels shorten the second stage of labour and are protective for the pelvic floor. The results of this study show that using obstetric gel shortens the second stage of labour in only nulliparous, but not multiparous women. In addition, a significant improvement in the 5 min APGAR score was seen in the neonates of women who used obstetric gel. The application of obstetric gels during the labour of nulliparous women may be a useful clinical practice and may have a widespread use in the future.

The influence of women's attachment style on the chronobiology of labour pain, analgesic consumption and pharmacological effect.

PubMed

Costa-Martins, José Manuel; Pereira, Marco; Martins, Henriqueta; Moura-Ramos, Mariana; Coelho, Rui; Tavares, Jorge

2014-07-01

Circadian variation in biological rhythms has been identified as affecting both labour pain and the pharmacological properties of analgesics. In the context of pain, there is also a growing body of evidence suggesting the importance of adult attachment. The purpose of this study was to examine whether labour pain, analgesic consumption and pharmacological effect are significantly affected by the time of day and to analyse whether this circadian variation is influenced by women's attachment style. This prospective observational study included a sample of 81 pregnant women receiving patient-controlled epidural analgesia (PCEA). Attachment was assessed with the Adult Attachment Scale - Revised. The perceived intensity of labour pain in the early stage of labour (3 cm of cervical dilatation and before the administration of PCEA) was measured using a visual analogue scale (VAS). Pain was also indirectly assessed by measuring the consumption of anaesthetics. The latency period and the duration of effect were recorded for a chronopharmacology characterisation. Pain, as assessed with the VAS, was significantly higher in the night-time group than in the daytime group. An insecure attachment style was significantly associated with greater labour pain at 3 cm of cervical dilatation (p < 0.001) and before the beginning of analgesia (p < 0.001) as well as with higher analgesic consumption and lower pharmacological efficacy (p < 0.05). The time of day was significantly associated with the pharmacological effect: the latency period was longer at night, and the duration of the pharmacological effect was longer during the daytime. The interaction between time of day and attachment style was not significant for any of the study variables. Our results provide evidence of the importance of circadian variation in studying labour pain and the pharmacological effect of labour analgesia involving epidural blockage with a PCEA regimen. Moreover, although there was no

Service-Learning in Supply Chain Management: Benefits, Challenges and Best Practices

ERIC Educational Resources Information Center

Schoenherr, Tobias

2015-01-01

Service-learning (SL) is a pedagogical approach in which students are assigned a course-related project in a not-for-profit organization, and are tasked to apply course content to execute the project. While the benefits are multifarious, only recently have supply chain management (SCM) courses adapted this innovative teaching methodology. The…

When biological scientists become health-care workers: emotional labour in embryology.

PubMed

Fitzgerald, R P; Legge, M; Frank, N

2013-05-01

Can biological scientists working in medically assisted reproduction (MAR) have a role as health-care workers and, if so, how do they engage in the emotional labour commonly associated with health-care work? The scientists at Fertility Associates (FA) in New Zealand perform the technical and emotional cares associated with health-care work in an occupationally specific manner, which we refer to as a hybrid care style. Their emotional labour consists of managing difficult patients, 'talking up' bad news, finding strategies to sustain hope and meaning, and 'clicking' or 'not clicking' with individual patients. Effective emotional labour is a key component of patient-centred care and is as important to the experience of high-quality MAR as excellent clinical and scientific technique. This is a qualitative study based on open-ended interviews and ethnographic observations with 14 staff in 2 laboratories conducted over 2 separate periods of 3 weeks duration in 2007. Analysis of fieldnotes and interviews was conducted using thematic analysis and an NVivo qualitative database and compared for consistency across each interviewer. The participants were consenting biological scientists working in one of the two laboratories. Semi-structured interviews were conducted in 'quiet' work times, and supervised access was allowed to all parts of the laboratories and meeting places. Opportunities for participant review of results and cross comparison of independent analysis by authors increases the faithfulness of fit of this account to laboratory life. The study suggests that emotional labour is a part of routinized scientific labour in MAR laboratories for FA. This is a qualitative study and thus the findings are not generalizable to populations beyond the study participants. While little has been published of the emotional component of scientist's working lives, there may be a New Zealand style of doing scientific work in MAR laboratories which is patient centred and which

The Labour Party's Blunkett Review: A Comprehensive Disappointment

ERIC Educational Resources Information Center

Lichman, Keith

2014-01-01

David Blunkett's "Review of Education Structures" for the Labour Party recognises that there is a chaotic and unsatisfactory situation in the English education system but its response is ambiguous and self-contradictory. Its proposals seek to normalise and regulate rather than remedy a system in which lack of democratic accountability,…

Studies on Labour Safety in Construction Sites

PubMed Central

Kanchana, S.; Sivaprakash, P.; Joseph, Sebastian

2015-01-01

Construction industry has accomplished extensive growth worldwide particularly in past few decades. For a construction project to be successful, safety of the structures as well as that of the personnel is of utmost importance. The safety issues are to be considered right from the design stage till the completion and handing over of the structure. Construction industry employs skilled and unskilled labourers subject to construction site accidents and health risks. A proper coordination between contractors, clients, and workforce is needed for safe work conditions which are very much lacking in Indian construction companies. Though labour safety laws are available, the numerous accidents taking place at construction sites are continuing. Management commitment towards health and safety of the workers is also lagging. A detailed literature study was carried out to understand the causes of accidents, preventive measures, and development of safe work environment. This paper presents the results of a questionnaire survey, which was distributed among various categories of construction workers in Kerala region. The paper examines and discusses in detail the total working hours, work shifts, nativity of the workers, number of accidents, and type of injuries taking place in small and large construction sites. PMID:26839916

Studies on Labour Safety in Construction Sites.

PubMed

Kanchana, S; Sivaprakash, P; Joseph, Sebastian

2015-01-01

Construction industry has accomplished extensive growth worldwide particularly in past few decades. For a construction project to be successful, safety of the structures as well as that of the personnel is of utmost importance. The safety issues are to be considered right from the design stage till the completion and handing over of the structure. Construction industry employs skilled and unskilled labourers subject to construction site accidents and health risks. A proper coordination between contractors, clients, and workforce is needed for safe work conditions which are very much lacking in Indian construction companies. Though labour safety laws are available, the numerous accidents taking place at construction sites are continuing. Management commitment towards health and safety of the workers is also lagging. A detailed literature study was carried out to understand the causes of accidents, preventive measures, and development of safe work environment. This paper presents the results of a questionnaire survey, which was distributed among various categories of construction workers in Kerala region. The paper examines and discusses in detail the total working hours, work shifts, nativity of the workers, number of accidents, and type of injuries taking place in small and large construction sites.

Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis

PubMed Central

Mishanina, Ekaterina; Rogozinska, Ewelina; Thatthi, Tej; Uddin-Khan, Rehan; Khan, Khalid S.; Meads, Catherine

2014-01-01

Background: Induction of labour is common, and cesarean delivery is regarded as its major complication. We conducted a systematic review and meta-analysis to investigate whether the risk of cesarean delivery is higher or lower following labour induction compared with expectant management. Methods: We searched 6 electronic databases for relevant articles published through April 2012 to identify randomized controlled trials (RCTs) in which labour induction was compared with placebo or expectant management among women with a viable singleton pregnancy. We assessed risk of bias and obtained data on rates of cesarean delivery. We used regression analysis techniques to explore the effect of patient characteristics, induction methods and study quality on risk of cesarean delivery. Results: We identified 157 eligible RCTs (n = 31 085). Overall, the risk of cesarean delivery was 12% lower with labour induction than with expectant management (pooled relative risk [RR] 0.88, 95% confidence interval [CI] 0.84–0.93; I2 = 0%). The effect was significant in term and post-term gestations but not in preterm gestations. Meta-regression analysis showed that initial cervical score, indication for induction and method of induction did not alter the main result. There was a reduced risk of fetal death (RR 0.50, 95% CI 0.25–0.99; I2 = 0%) and admission to a neonatal intensive care unit (RR 0.86, 95% CI 0.79–0.94), and no impact on maternal death (RR 1.00, 95% CI 0.10–9.57; I2 = 0%) with labour induction. Interpretation: The risk of cesarean delivery was lower among women whose labour was induced than among those managed expectantly in term and post-term gestations. There were benefits for the fetus and no increased risk of maternal death. PMID:24778358

Novel application of the matched case-control design to compare food supply chains during an Escherichia coli O157 outbreak, United Kingdom, 2016.

PubMed

Inns, Thomas; Cleary, Paul; Bundle, Nick; Foulkes, Sarah; Sharp, Ashley; Utsi, Lara; McBrien, Chris; Teagle, Rehman; Waldram, Alison; Williams, Chris; McCann, Cathy; Smith, Rob; Saleh, Sepeedeh; McCarthy, Noel; Vivancos, Roberto; Hawker, Jeremy; Decraene, Valerie

2018-05-01

There is a need for innovative methods to investigate outbreaks of food-borne infection linked to produce with a complex distribution network. The investigation of a large outbreak of Escherichia coli O157 PT34 infection in the United Kingdom in 2016 indicated that catering venues associated with multiple cases had used salad leaves sourced from one supplier. Our aim was to investigate whether catering venues linked to cases were more likely to have used salad leaves from this supplier. We conducted a matched case-control study, with catering venues as the units of analysis. We compared venues linked to cases to those without known linked cases. We included 43 study pairs and obtained information on salad leaf products received by each venue. The odds of a case venue being supplied with salad leaves by Supplier A were 7.67 times (95% confidence interval: 2.30-25.53) those of control venues. This association provided statistical evidence to support the findings of the other epidemiological investigations undertaken for this outbreak. This is a novel approach which is labour-intensive but which addresses the challenge of investigating exposures to food across a complex distribution network.