Rising U.S. Earnings Inequality and Family Labor Supply: The Covariance Structure of Intrafamily Earnings

OpenAIRE

Dean R. Hyslop

2001-01-01

This paper studies the labor supply contributions to individual and family earnings inequality during the period of rising wage inequality in the early 1980's. Working couples have positively correlated labor market outcomes, which are almost entirely attributable to permanent factors. An intertemporal family labor supply model with this feature is used to estimate labor supply elasticities for husbands of 0.05, and wives of 0.40. This implies that labor supply explains little of the rising a...

Female labor supply and housing decisions

NARCIS (Netherlands)

Aldershof, T.

1999-01-01

The focus of this thesis is on the labor supply decisions of married and cohabiting women in relation to the housing tenure choice decision. The main motivation for a joint analysis has been the relaxation of the mortgage qualification constraint. Since 1992 households can take out a mortgage on the

Maternal labor force participation and differences by education in an urban birth cohort study - 1998-2010

Directory of Open Access Journals (Sweden)

Natasha Pilkauskas

2016-03-01

Full Text Available Background: Maternal labor force participation has increased dramatically over the last 40 years, yet surprisingly little is known about longitudinal patterns of maternal labor force participation in the years after a birth, or how these patterns vary by education. Objective: We document variation by maternal education in mothers' labor force participation (timing, intensity, non-standard work, multiple job-holding over the first nine years after the birth of a child. Methods: We use the Fragile Families and Child Wellbeing Study (N~3000 to predict longitudinal labor force participation in a recent longitudinal sample of mothers who gave birth in large US cities between 1998 and 2000. Families were followed until children were age 9, through 2010. Results: Labor force participation gradually increases in the years after birth for mothers with high school or less education, whereas for mothers with some college or more, participation increases between ages 1 and 3 and then remains mostly stable thereafter. Mothers with less than high school education have the highest rates of unemployment (actively seeking work, which remain high compared with all other education groups, whose unemployment declines over time. Compared with all other education groups, mothers with some college have the highest rates of labor force participation, but Contribution: Simple conceptualizations of labor force participation do not fully capture the dynamics of labor force attachment for mothers in terms of intensity, timing of entry, and type of work hours, as well as differences by maternal education.

Labor supply of engineers and scientists for nuclear electric utilities, 1987-1992

International Nuclear Information System (INIS)

Blair, L.M.

1988-01-01

An assessment of the adequacy of the supply of health physicists, nuclear engineers, and other engineers for the nuclear electric utility industry is based on job openings for scientists and engineers in broader nuclear-power-related fields, which include engineering and design, manufacturing, fabrication, supporting services, and government. In assessing the likely adequacy of labor supplies for commercial nuclear power job openings over the next 5 yr, consideration has been given to competing sources of labor demands, including nuclear energy research and development activities, nuclear defense, and the total US economy, and to the likely supply of new graduates. In particular, over the last 3 yr, the number of degrees awarded and enrollments in nuclear engineering programs have declined 12 and 14%, respectively, and in health physics programs, 5 and 14%, respectively. For health physics and nuclear engineers, tight labor market conditions (i.e. labor supplies and demand balanced at relatively high salaries) are expected over the next 5 yr because of declining enrollments and slowly growing employment levels plus job replacement needs. The commercial nuclear power field is expected to face tight labor markets for electrical and materials engineers because of strong competing demands in the economy. Other engineering occupations are likely to have adequate supplies for the nuclear power field but at salaries that continue to be relatively higher than salaries for other professional occupations

An examination of pharmacists' labor supply and wages.

Science.gov (United States)

Polgreen, Linnea A; Mott, David A; Doucette, William R

2011-12-01

For the last decade, there has been a shortage of pharmacists for most of the United States. This shortage is in part because of demand-side phenomena (eg, increasing prescription drug use, increases in the complexity of drug regimens, and an aging population). However, there also may be supply-side causes. Although the number of pharmacy school graduates has increased, most graduates are women, many of whom may choose to work part-time. Because of the change in sex composition of the workforce, some researchers conclude that pharmacist shortages will be even more critical in the future. The goals of this article are to model pharmacists' decisions to work, estimate pharmacists' wages, and identify influences on the number of hours worked by pharmacists in the United States. Pharmacist labor supply is examined using a static, 3-step, empirical labor supply model that estimates the decision to work, hourly wages, and number of hours worked for U.S. pharmacists. Pharmacists have high starting wages but flat wage trajectories. Although many pharmacists are working part-time, this is true for women and men. Income effects do not dominate substitution effects, even at the high level of compensation found here. Results indicate that previous predictions brought about by the changing sex composition of the pharmacist labor force might not come to pass, and additional pharmacists may be attracted to the profession by higher wages and flexible schedules. Copyright © 2011 Elsevier Inc. All rights reserved.

The effect of state dependent mandate laws on the labor supply decisions of young adults.

Science.gov (United States)

Depew, Briggs

2015-01-01

Prior to the Affordable Care Act, the majority of states in the U.S. had already implemented state laws that extended the age that young adults could enroll as dependents on their parent's employer-based health insurance plans. Because of the fundamental link between health insurance and employment in the U.S., such policies may effect the labor supply decisions of young adults. Although the interaction between labor supply and health insurance has been extensively studied for other subpopulations, little is known about the role of health insurance in the labor supply decisions of young adults. I use the variation from the implementation and changes in state policies that expanded dependent health insurance coverage to examine how young adults adjusted their labor supply when they were able to be covered as a dependent on their parent's plan. I find that these state mandates led to a decrease in labor supply on the intensive margin. Copyright © 2014 Elsevier B.V. All rights reserved.

The impact of a new standard labor protocol on maternal and neonatal outcomes.

Science.gov (United States)

Wang, Dingran; Ye, Shenglong; Tao, Liyuan; Wang, Yongqing

2017-12-01

To analyze the clinical outcomes following the implementation of a new standard labor procedure. This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention. We also compared the average number of days spent in the hospital, the incidence of medical disputes and hospitalization expenses. The cesarean section rates for the study and control groups were 19.29% (401/2079) and 33.53% (753/2246), respectively (P labor, fetal distress and intrapartum fever; the percentages of each indication were significantly different from those of the control group (P labor protocol reduced the cesarean section rate without negatively impacting maternal and neonatal outcomes. In practice, bed turnover and the hospital utilization rate should be better controlled, patient-doctor communication should be strengthened and the quality of obstetrical service should be improved.

A Model of U.S. Army Recruit Labor Supply

National Research Council Canada - National Science Library

Wargelin, Mark

1997-01-01

.... This paper reviews previous military manpower research and critically examines two recruit labor supply experiments the Multiple Option Recruiting Experiment of 1979, and the Educational Assistance Test Program of 1981...

Husband’s Unemployment and Wife’s Labor Supply

DEFF Research Database (Denmark)

Bredtmann, Julia; Otten, Sebastian; Rulff, Christian

This paper investigates the responsiveness of women’s labor supply to their husband’s loss of employment – the so-called added worker effect. While previous empirical literature on this topic mainly concentrates on a single country, we take an explicit internationally comparative perspective and ...

Maternal and neonatal outcomes after induction of labor: a population-based study.

Science.gov (United States)

Zenzmaier, Christoph; Leitner, Hermann; Brezinka, Christoph; Oberaigner, Willi; König-Bachmann, Martina

2017-05-01

To evaluate maternal and neonatal outcomes at and beyond term associated with induction of labor compared to spontaneous onset of labor stratified by week of gestational age. In this retrospective cohort study, data form 402,960 singleton pregnancies from the Austria Perinatal Registry were used to estimate odds ratios of secondary cesarean delivery, operative vaginal delivery, epidural analgesia, fetal scalp blood testing, episiotomy, 3rd/4th-degree lacerations, retained placenta, 5-min APGAR neonatal intensive care unit. Multivariate logistic regression models based on deliveries with gestational age ≥37 + 0 were applied for adjustment for possible confounders. Induction of labor was associated with increased odds for cesarean delivery (adjusted OR; 99% confidence interval: 1.53; 1.45-1.60), operative vaginal delivery (1.21; 1.15-1.27), epidural analgesia (2.12; 2.03-2.22), fetal scalp blood testing (1.40; 1.28-1.52), retained placenta (1.32; 1.22-1.41), 5-min APGAR neonatal intensive care unit (1.41; 1.31-1.51). In a subgroup of induction of labor with the indication, "post-term pregnancy" induction was similarly associated with adverse outcomes. In Austria, induction of labor is associated with increased odds of adverse maternal and neonatal outcomes. However, due to residual confounding, currently, no recommendations for treatment can be derived.

Optimal life-cycle profiles of fertility and labor supply.

Science.gov (United States)

Moffitt, R

1984-01-01

A model of life cycle fertility is developed using the language and framework of optimal control theory. The chief characteristic of children that distinguishes them from other consumer durables is, in the language of the optimal growth theory, the "irreversibility of investment." As the good does not depreciate in the ordinary sense, the stock must be monotonically nondecreasing over time. The optimal profile of fertility is, for this reason, characterized by the same type of "bang-bang" behavior found in many optimal growth problems. Yet, the fertility decision is complicated considerably by several other factors. Chief among these is the intrinsic relation to the labor-supply decision, for having children implies inevitable constraints on the mother's or father's time. Thus, optimal labor-supply decisions also must be considered. The model is developed in stages, proceeding from very simple to the more complex models. 1 section introduces the impact of fertility on the future demands for home time. It is shown that optimal fertility profiles follow turnpike paths similar to those in the growth-theory literature. A subsequent section introduces labor-supply and human-captial considerations. As the models become more complex, solutions become harder to derive and are often only outlined. The analysis provides some theoretical basis for expecting certain shapes of the life-cycle profiles of fertility, labor supply, and wages. Fertility profiles may be of 2 shapes--one beginning at a high rate, falling to a lower rate, then to zero; and one beginning at zero, rising to a moderate rate, then falling back down to zero. Labor supply profiles can be of a number of different shapes, but the impact of childbearing is to lower hours worked during the early childrearing period. As the children mature, hours worked rise (or at least fall more slowly) as home time responsibilities lessen, although the level to which they rise will probably be lower than before the 1st birth

Labor Supply Flexibility and Portfolio Choice

OpenAIRE

Zvi Bodie; William Samuelson

1989-01-01

This paper develops a model showing that people who have flexibility in choosing how much to work will prefer to invest substantially more of their money in risky assets than if they had no such flexibility. Viewed in this way, labor supply flexibility offers insurance against adverse investment outcomes. The model provides support for the conventional wisdom that the young can tolerate more risk in their investment portfolios than the old. The model has other implications for the study of ho...

Labor supply after transition: evidence from the Czech Republic

Czech Academy of Sciences Publication Activity Database

Bičáková, Alena; Slačálek, J.; Slavík, M.

-, č. 887 (2008), s. 1-36 ISSN 1725-2806 Institutional research plan: CEZ:AV0Z70850503 Keywords : labor supply * transition * welfare system Subject RIV: AH - Economics http://www.ecb.europa.eu/pub/pdf/scpwps/ecbwp887.pdf

Maternity Leave and Women’s Labor Market Status in Kosovo : Five Key Messages

OpenAIRE

Davalos, Maria E.; Elezaj, Ereblina; Flanagan Thurau, Julianna; Rodriguez-Chamussy, Lourdes

2015-01-01

Labor market engagement of women is very low in Kosovo - only 12.5 percent of women of working age are employed compared to 41.3 percent of men - suggesting that women face obstacles to work and or being hired. These barriers can be related to a multiplicity of factors, including labor regulations - such as maternity provisions - but also others such as disincentives to work from taxes and ...

The Supply and Demand for College Educated Labor.

Science.gov (United States)

Nollen, Stanley D.

In this study a model for the supply of college educated labor is developed from human capital theory. A demand model is added, derived from neoclassical production function theory. Empirical estimates are made for white males and white females, using cross-sectional data on states of the U.S., 1960-70. In human capital theory, education is an…

Intersectionality at Work: Determinants of Labor Supply among Immigrant Latinas.

Science.gov (United States)

Flippen, Chenoa

2014-06-01

This article borrows from the intersectionality literature to investigate how legal status, labor market position, and family characteristics structure the labor supply of immigrant Latinas in Durham, NC, a new immigrant destination. The analysis takes a broad view of labor force participation, analyzing the predictors of whether or not women work; whether and how the barriers to work vary across occupations; and variation in hours and weeks worked among the employed. I also explicitly investigate the extent to which family constraints interact with other social characteristics, especially legal status, in shaping women's labor market position. Results highlight that immigrant Latinas experience multiple, interrelated constraints on employment owing to their position as low-skill workers in a labor market highly segregated by gender and nativity, to their status as members of a largely undocumented population, and as wives and mothers in an environment characterized by significant work-family conflict.

Labor supply after transition: evidence from the Czech Republic

Czech Academy of Sciences Publication Activity Database

Bičáková, Alena; Slačálek, J.; Slavík, M.

2011-01-01

Roč. 61, č. 4 (2011), s. 327-347 ISSN 0015-1920 Institutional research plan: CEZ:AV0Z70850503 Keywords : labor supply * transition * welfare system Subject RIV: AH - Economics Impact factor: 0.346, year: 2011 http://journal.fsv.cuni.cz/ storage /1217_str_327_347_-_slacalek.pdf

The Effects of Progressive Taxation on Labor Supply when Hours and Wages Are Jointly Determined

Science.gov (United States)

Aaronson, Daniel; French, Eric

2009-01-01

This paper extends a standard intertemporal labor supply model to account for progressive taxation as well as the joint determination of hourly wages and hours worked. We show that these two factors can have implications for both estimating labor supply elasticities as well as for using these elasticities in tax analysis. Failure to account for…

Characterization Of Obstetric Assistance At Labor And Childbirth In Low-Risk Women On A Maternity Of Reference To Maternal And Child Health

Directory of Open Access Journals (Sweden)

Maxsuenia Queiroz Medeiros

2017-04-01

Full Text Available Objectives: To describe the prevalence of the implementation of obstetric interventions for labor and birth in normal-risk women in reference to maternity Stork Network. Methodology: cross-sectional study was performed from April 2014 to January 2015, with 421 participants in the Maternity School Assis Chateaubriand - UFC, admitted during spontaneous or induced labor with a live fetus and single pregnancy term and their fetuses weighing between 2,500 and 4.499g. The data collection instrument was divided into blocks with sociodemographic and clinical characteristics, obstetric, data care during labor, delivery and birth, maternal morbidity, maternal outcome and obstetric practices in categories A and B from WHO and perinatal outcomes. The values ​​are presented as mean ± standard deviation. Results: The age ranged from 13 to 44; the average gestational age at admission was 38.9 ± 1.1 weeks; 52.2% with only one child; 8.6% had a previous cesarean section. There was 96.2% of pre-natal coverage with an average of 6.4 consultations. 76.2% had vaginal delivery. Obstetric practices in category A were more prevalent oxytocin in the third stage (97.1%, partograph (95%, non-invasive methods for pain relief (87.2%, companion (84.6%. While in section B were more of a vaginal examination at 2 hours (50.4% and intravenous infusion (44.9% and oxytocin in the expansion phase (28.8%. The present study had as limitations the loss of some data, which depended on the filling of third parties, which are characteristic of searches in medical records, or any documentary archive because it is a collection of secondary data. Conclusions: It was possible to identify that the "Good labor assistance practices" has been developed in a good proportion considered; however some practices that should be discouraged are still performed relatively frequently.

Children's emotional and behavioral problems and their mothers' labor supply.

Science.gov (United States)

Richard, Patrick; Gaskin, Darrell J; Alexandre, Pierre K; Burke, Laura S; Younis, Mustafa

2014-01-01

It has been documented that about 20% of children and adolescents suffer from a diagnosable mental or addictive disorder in the United States. The high prevalence of children's emotional and behavioral problems (EBP) might have a negative effect on their mothers' labor market outcomes because children with EBP require additional time for treatment. However, these children may require additional financial resources, which might promote mothers' labor supply. Previous studies have only considered chronic conditions in analyzing the impact of children's health on parental work activities. Moreover, most of these studies have not accounted for endogeneity in children's health. This article estimates the effects of children's EBP on their mothers' labor supply by family structure while accounting for endogeneity in children's health. We used the 1997 and 2002 Child Development Supplements (CDS) to the Panel Study of Income Dynamics (PSID). We used probit and bivariate probit models to estimate mothers' probability of employment, and tobit and instrumental variable tobit models to estimate the effects of children's EBP on their mothers' work hours. Findings show negative effects of children's EBP on their married mothers' employment and on their single mothers' work hours. © The Author(s) 2014.

Alcohol and labor supply: the case of Iceland.

Science.gov (United States)

Asgeirsdottir, Tinna Laufey; McGeary, Kerry Anne

2009-10-01

At a time when the government of Iceland is considering privatization of alcohol sales and a reduction of its governmental fees, it is timely to estimate the potential effects of this policy change. Given that the privatization of sales coupled with a tax reduction should lead to a decrease in the unit price of alcohol, one would expect the quantity consumed to increase. While it is of interest to project the impact of the proposed bill on the market for alcohol, another important consideration is the impact that increased alcohol consumption and, more specifically, probable alcohol misuse would have on other markets in Iceland. The only available study on this subject using Icelandic data yields surprising results. Tómasson et al. (Scand J Public Health 32:47-52, 2004) unexpectedly found no effect of probable alcohol abuse on sick leave. A logical next step would be to examine the effect of probable alcohol abuse on other important labor-market outcomes. Nationally representative survey data from 2002 allow for an analysis of probable misuse of alcohol and labor-supply choices. Labor-supply choices are considered with reference to possible effects of policies already in force, as well as proposed changes to current policies. Contrary to intuition, but in agreement with the previously mentioned Icelandic study, the adverse effects of probable misuse of alcohol on employment status or hours worked are not confirmed within this sample. The reasons for the results are unclear, although some suggestions are hypothesized. Currently, data to test those theories convincingly are not available.

Pay or conditions? The role of workplace characteristics in nurses' labor supply.

Science.gov (United States)

Eberth, Barbara; Elliott, Robert F; Skåtun, Diane

2016-07-01

Empirically rigorous studies of nursing labor supply have to date relied on extant secondary data and focused almost exclusively on the role of pay. Yet the conditions under which nurses work and the timing and convenience of the hours they work are also important determinants of labor supply. Where there are national pay structures and pay structures are relatively inflexible, as in nursing in European countries, these factors become more important. One of the principal ways in which employers can improve the relative attractiveness of nursing jobs is by changing these other conditions of employment. This study uses new primary data to estimate an extended model of nursing labor supply. It is the first to explore whether and how measures of non-pecuniary workplace characteristics and observed individual (worker) heterogeneity over non-pecuniary job aspects impact estimates of the elasticity of hours with respect to wages. Our results have implications for the future sustainability of an adequately sized nurse workforce and patient care especially at a time when European healthcare systems are confronted with severe financial pressures that have resulted in squeezes in levels of healthcare funding.

Neonatal neurobehavioral organization after exposure to maternal epidural analgesia in labor.

Science.gov (United States)

Bell, Aleeca F; White-Traut, Rosemary; Medoff-Cooper, Barbara

2010-01-01

To explore relationships between maternal epidural analgesia and two measures of neurobehavioral organization in infants at the initial feeding 1 hour after birth. Prospective comparative design. Inner-city community hospital, Chicago, Illinois. Convenience sample of 52 low-risk, mainly Black and Latino, mother/infant dyads. Mothers self-selected to labor with epidural or no labor pain medication. Neonatal neurobehavioral organization was measured in term infants at the initial feeding 1 hour after birth. A nutritive sucking apparatus generated data on total number of sucks and sucking pressure. Video recordings of infants (before and after the initial feeding) were coded for behavioral states, with analysis on frequency of alertness. Total number of sucks and sucking pressure were not related to epidural exposure, although an epidural drug dosage effect on total number of sucks was evident when gender was a factor. Unmedicated girls demonstrated more sucks than girls in the high-dosage epidural group (p=.027). Overall, girls exhibited stronger sucking pressure than boys (p=.042). Frequency of alertness was not related to epidural exposure, although longer labor was related to greater alertness (p=.003), and Latino infants were more alert than Black infants (p=.002). Results suggest attenuated neonatal nutritive sucking organization in girls after exposure to high maternal epidural dosages. In comparison to boys, girls may have enhanced neurobehavioral organization at birth. Race/ethnicity and alertness may have spurious associations in which hidden factors drive the relationship.

Choice in maternity care: associations with unit supply, geographic accessibility and user characteristics

Science.gov (United States)

2012-01-01

Background Despite national policies to promote user choice for health services in many European countries, current trends in maternity unit closures create a context in which user choice may be reduced, not expanded. Little attention has been paid to the potential impact of closures on pregnant women’s choice of maternity unit. We study here how pregnant women’s choices interact with the distance they must travel to give birth, individual socioeconomic characteristics and the supply of maternity units in France in 2003. Results Overall, about one-third of women chose their maternity units based on proximity. This proportion increased steeply as supply was constrained. Greater distances between the first and second closest maternity unit were strongly associated with increasing preferences for proximity; when these distances were ≥ 30 km, over 85% of women selected the closest unit (revealed preference) and over 70% reported that proximity was the reason for their choice (expressed preference). Women living at a short distance to the closest maternity unit appeared to be more sensitive to increases in distance between their first and second closest available maternity units. The preference for proximity, expressed and revealed, was related to demographic and social characteristics: women from households in the manual worker class chose a maternity unit based on its proximity more often and also went to the nearest unit when compared with women from professional and managerial households. These sociodemographic associations held true after adjusting for supply factors, maternal age and socioeconomic status. Conclusions Choice seems to be arbitrated in both absolute and relative terms. Taking changes in supply into consideration and how these affect choice is an important element for assessing the real impact of maternity unit closures on pregnant women’s experiences. An indicator measuring the proportion of women for whom the distance between the first

Family labor supply and proposed tax reforms in the Netherlands

NARCIS (Netherlands)

van Soest, A.H.O.; Das, J.W.M.

2000-01-01

This paper presents a discrete choice static neo-classical labor supply model for married or cohabiting couples in the Netherlands. The model simultaneously explains the participation decision and the desired number of hours worked. Due to its discrete nature, institutional details of the tax system

Intersectionality at Work: Determinants of Labor Supply among Immigrant Latinas1

Science.gov (United States)

Flippen, Chenoa

2015-01-01

This article borrows from the intersectionality literature to investigate how legal status, labor market position, and family characteristics structure the labor supply of immigrant Latinas in Durham, NC, a new immigrant destination. The analysis takes a broad view of labor force participation, analyzing the predictors of whether or not women work; whether and how the barriers to work vary across occupations; and variation in hours and weeks worked among the employed. I also explicitly investigate the extent to which family constraints interact with other social characteristics, especially legal status, in shaping women’s labor market position. Results highlight that immigrant Latinas experience multiple, interrelated constraints on employment owing to their position as low-skill workers in a labor market highly segregated by gender and nativity, to their status as members of a largely undocumented population, and as wives and mothers in an environment characterized by significant work-family conflict. PMID:26843783

Optimal Life-Cycle Investing with Flexible Labor Supply: A Welfare Analysis of Life-Cycle Funds

OpenAIRE

Francisco J. Gomes; Laurence J. Kotlikoff; Luis M. Viceira

2008-01-01

We investigate optimal consumption, asset accumulation and portfolio decisions in a realistically calibrated life-cycle model with flexible labor supply. Our framework allows for wage rate uncertainly, variable labor supply, social security benefits and portfolio choice over safe bonds and risky equities. Our analysis reinforces prior findings that equities are the preferred asset for young households, with the optimal share of equities generally declining prior to retirement. However, variab...

Public Preschooling and Maternal Labor Force Participation in Rural India.

OpenAIRE

Jain, Monica

2013-01-01

Mothers from poor families in India have a compelling need to work, but childcare for their young children is a constraint. This paper examines how far the public daycare helps in loosening this constraint. Todo this, I look at the effect on maternal labor force participation, of daycare implicit in the preschooling provided to young children, through India’s largest child development program - Integrated Child Development Scheme (ICDS). Besides preschooling, the ICDS program provides a whole...

Elective induction of labor at 39 weeks among nulliparous women: The impact on maternal and neonatal risk.

Science.gov (United States)

Sinkey, Rachel G; Lacevic, Jasmin; Reljic, Tea; Hozo, Iztok; Gibson, Kelly S; Odibo, Anthony O; Djulbegovic, Benjamin; Lockwood, Charles J

2018-01-01

Optimal management of pregnancies at 39 weeks gestational age is unknown. Therefore, we sought to perform a comparative effectiveness analysis of elective induction of labor (eIOL) at 39 weeks among nulliparous women with non-anomalous singleton, vertex fetuses as compared to expectant management (EM) which included IOL for medical or obstetric indications or at 41 weeks in undelivered mothers. A Monte Carlo micro-simulation model was constructed modeling two mutually exclusive health states: eIOL at 39 weeks, or EM with IOL for standard medical or obstetrical indications or at 41 weeks if undelivered. Health state distribution probabilities included maternal and perinatal outcomes and were informed by a review of the literature and data derived from the Consortium of Safe Labor. Analyses investigating preferences for maternal versus infant health were performed using weighted utilities. Primary outcome was determining which management strategy posed less maternal and neonatal risk. Secondary outcomes were rates of cesarean deliveries, maternal morbidity and mortality, stillbirth, neonatal morbidity and mortality, and preferences regarding the importance of maternal and perinatal health. A management strategy of eIOL at 39 weeks resulted in less maternal and neonatal risk as compared to EM with IOL at 41 weeks among undelivered patients. Cesarean section rates were higher in the EM arm (35.9% versus 13.9%, p39 week eIOL still resulted in fewer cesarean deliveries as compared to EM (8.0% versus 26.1%, p39 week eIOL was favored over EM. Mathematical modeling revealed that eIOL at 39 weeks resulted in lower population risks as compared to EM with induction of labor at 41 weeks. Specifically, eIOL at 39 weeks resulted in a lower cesarean section rate, lower rates of maternal morbidity, fewer stillbirths and neonatal deaths, and lower rates of neonatal morbidity.

Intra-operative maternal complications of emergency cesarean section done in advanced labor

International Nuclear Information System (INIS)

Nisa, M.U.

2013-01-01

-sections, 402 (59%) were done on laboring mothers and 198 (41%) were done on non-laboring mothers for indications like placenta previa, eclampsia, etc. Out of 402 C-sections done on laboring mothers, 241 (60%) were done in advanced labor and 161 (40%) in early labpr. The intra-operative complication rate was 19.8% versus 11% (p-value 0.001) in the study and control group respectively. The main indications for cesarean section in labor were prolonged labor, deep transverse arrest of fetal head and fetal distress. The main complications noticed were the cervico - uterine lacerations and intra-operative hemorrhage. Factors associated with increased maternal complications were; un-booked cases (p-value 0.01), stat-ion of the fetal head (p-value 0.02), good size baby (p-value 0.01) and experience of surgeon (p-value 0.04). Conclusion: Emergency cesarean section done in advanced labor is a high risk operation with significant maternal morbidity in terms of cervico - uterine tears and intra-operative bleeding. (author)

Medium- and long-term consequences of pollution on labor supply: evidence from Indonesia

Directory of Open Access Journals (Sweden)

Younoh Kim

2017-04-01

Full Text Available Abstract We use a natural experiment in Indonesia to study the medium- and long-term effects of air pollution on labor supply. We find that exposure to air pollution reduces hours worked and while the medium-term effects are larger in magnitude, some effects do persist in the long term. More interestingly, we are able to provide some insight regarding the underlying channels that contribute to the reduced labor supply. Own health seems to be the only responsible channel in the long term, while in the medium term, a different channel based on dependent caregiving is the most important. JEL Classification: J22, Q53

Slutsky Equation and Negative Elasticity of Labor Supply: Behavioral Bias or Optimal Consumption-Leisure Choice?

Directory of Open Access Journals (Sweden)

Sergey MALAKHOV

2014-08-01

Full Text Available One of the applications of the prospect theory is the behavioral phenomenon of the negative elasticity of the individual labor supply. This paper argues that the negative elasticity of labor supply can be understood better with the help of the interpretation of the Slutsky equation with regard to the common consumption-leisure choice. The interpretation of the Slutsky equation corresponds to the empirical evidence that leisure is a net complement for an important part of consumption.

Own-wage labor supply elasticities: variation across time and estimation methods

Directory of Open Access Journals (Sweden)

Olivier Bargain

2016-10-01

Full Text Available Abstract There is a huge variation in the size of labor supply elasticities in the literature, which hampers policy analysis. While recent studies show that preference heterogeneity across countries explains little of this variation, we focus on two other important features: observation period and estimation method. We start with a thorough survey of existing evidence for both Western Europe and the USA, over a long period and from different empirical approaches. Then, our meta-analysis attempts to disentangle the role of time changes and estimation methods. We highlight the key role of time changes, documenting the incredible fall in labor supply elasticities since the 1980s not only for the USA but also in the EU. In contrast, we find no compelling evidence that the choice of estimation method explains variation in elasticity estimates. From our analysis, we derive important guidelines for policy simulations.

Education, Health, and Labor Force Supply: Broadening Human Capital for National Development in Malawi

Science.gov (United States)

Smith, William C.; Ikoma, Sakiko; Baker, David P.

2016-01-01

Education and health are both capital investments in national development, often viewed as independent factors on a country's labor force supply and productivity. This study uses the 2010-2011 Third Integrated Household Survey in Malawi to propose an Education-enhanced Health Human Capital (EHHC) model where education influences labor force supply…

Does Social Security Affect Retirement and Labor Supply? Using the Chilean Experience as an Experiment

OpenAIRE

Rodrigo Cerda

2002-01-01

The paper explores the effects of the social security system over retirement and labor supply decision of individuals aged 55 to 65 in Chile. We use the 1998 CASEN survey elaborated by the Chilean government. Due to regulations established by the current social security law, two social security systems coexist on 1998: the .Pay-as-you-go. and the individual account system. This property of the dataset, allows us to disentangle the effects of those two systems over retirement and labor supply....

Labor supply consequences of family taxation: evidence from the Czech Republic

Czech Academy of Sciences Publication Activity Database

Kalíšková, Klára

2014-01-01

Roč. 30, October (2014), s. 234-244 ISSN 0927-5371 R&D Projects: GA ČR GB14-36154G Institutional support: RVO:67985998 Keywords : joint tax ation * labor supply * diffrence-in-differences Subject RIV: AH - Economics Impact factor: 0.916, year: 2014

Money vs. time: Family income, maternal labor supply, and child development

OpenAIRE

Agostinelli, Francesco; Sorrenti, Giuseppe

2018-01-01

We study the effect of family income and maternal hours worked on child development. Our instrumental variable analysis suggests different results for cognitive and behavioral development. An additional 1,000 USD in family income improves cognitive development by 4.4 percent of a standard deviation but has no effect on behavioral development. A yearly increase of 100 work hours negatively affects both outcomes by approximately 6 percent of a standard deviation. The quality of parental investm...

Children’s Emotional and Behavioral Problems and Their Mothers’ Labor Supply

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Patrick Richard PhD

2014-11-01

Full Text Available It has been documented that about 20% of children and adolescents suffer from a diagnosable mental or addictive disorder in the United States. The high prevalence of children’s emotional and behavioral problems (EBP might have a negative effect on their mothers’ labor market outcomes because children with EBP require additional time for treatment. However, these children may require additional financial resources, which might promote mothers’ labor supply. Previous studies have only considered chronic conditions in analyzing the impact of children’s health on parental work activities. Moreover, most of these studies have not accounted for endogeneity in children’s health. This article estimates the effects of children’s EBP on their mothers’ labor supply by family structure while accounting for endogeneity in children’s health. We used the 1997 and 2002 Child Development Supplements (CDS to the Panel Study of Income Dynamics (PSID. We used probit and bivariate probit models to estimate mothers’ probability of employment, and tobit and instrumental variable tobit models to estimate the effects of children’s EBP on their mothers’ work hours. Findings show negative effects of children’s EBP on their married mothers’ employment and on their single mothers’ work hours.

Demand and supply of labor by education towards 2030. Linking demographic and macroeconomic models for Norway

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Bjørnstad, Roger; Gjelsvik, Marit Linnea; Godøy, Anna; Holm, Inger; Stølen, Nils Martin

2010-01-01

Because of globalization and technological progress, most OECD-countries have seen a considerable growth in the demand for labor with higher skills and educational levels the past decades. In many countries, supply has not grown correspondingly. This has resulted in increasing differences either in unemployment or in wages between high and low skilled workers. In Norway, labor supply has followed demand more closely, and unemployment and wages have stayed relatively equal. The ...

No-Fault Divorce Laws and the Labor Supply of Women with and without Children

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Genadek, Katie R.; Stock, Wendy A.; Stoddard, Christiana

2007-01-01

We use a difference-in-difference-in-difference estimator to compare changes in labor force participation, weeks, and hours of work associated with no-fault divorce laws, allowing for differential responses for married women with and without children. Although other research has found that the labor supply of women in general does not respond to…

Female Labor Supply and Fertility in Iran: A Comparison Between Developed, Semi Developed and Less Developed Regions.

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Emamgholipour Sefiddashti, Sara; Homaie Rad, Enayatollah; Arab, Mohamad; Bordbar, Shima

2016-02-01

Female labor supply has been changed dramatically in the recent yr. In this study, we examined the effects of development on the relationship between fertility and female labor supply. We used data of population and housing census of Iran and estimated three separate models. To do this we employed Logistic Regressions (BLR). The estimation results of our study showed that there was a negative relationship between fertility rate and female labor supply and there are some differences for this relationship in three models. When fertility rate increases, FLS would decreases. In addition, for higher fertility rates, the woman might be forced to work more because of the economic conditions of her family; and negative coefficients of the fertility rate effects on FLS would increase with a diminishing rate.

New Evidence on Teacher Labor Supply. NBER Working Paper No. 16802

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Engel, Mimi; Jacob, Brian A.

2011-01-01

Recent evidence on the large variance in teacher effectiveness has spurred renewed interest in teacher labor market policies. A substantial body of prior research documents that more highly qualified teachers tend to work in more advantaged schools, although this literature cannot determine the relative importance of supply versus demand factors…

Labor supply consequences of family taxation: evidence from the Czech Republic

Czech Academy of Sciences Publication Activity Database

Kalíšková, Klára

2014-01-01

Roč. 30, October (2014), s. 234-244 ISSN 0927-5371 R&D Projects: GA MŠk(CZ) SVV260126 Grant - others:UK(CZ) GAUK 595812 Institutional support: PRVOUK-P23 Keywords : joint tax ation * labor supply * diffrence-in-differences Subject RIV: AH - Economics Impact factor: 0.916, year: 2014

Realizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions

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Jansen C

2014-11-01

Full Text Available Christel Jansen,1 Laurence Codjia,2 Giorgio Cometto,3 Mohamed Lamine Yansané,4 Marjolein Dieleman1 1Health Unit, Royal Tropical Institute, Amsterdam, the Netherlands; 2Health Workforce, World Health Organization, Geneva, Switzerland; 3Global Health Workforce Alliance, World Health Organization, Geneva, Switzerland; 4Health Focus GmbH, Conakry, Guinea Background: Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. Methods: A needs-based approach was used to project human resources for health (HRH requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a “policy rich” scenario B which allowed for analysis of their potential impact. Results: In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary

Reforming Family Taxation in Germany - Labor Supply vs. Insurance Effects

OpenAIRE

Hans Fehr; Manuel Kallweit; Fabian Kindermann

2013-01-01

The present paper quantifies the economic consequences of eliminating the system of income splitting in Germany. We apply a dynamic simulation model with overlapping generations where single and married agents have to decide on labor supply and homework facing income and lifespan risk. The numerical exercise computes the resulting welfare changes across households and isolates aggregate efficiency effects of a move towards either individual taxation or family splitting. Our results indicate s...

Maternal and neonatal effects of adding morphine to low-dose bupivacaine for epidural labor analgesia.

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Dostbil, A; Celik, M; Alici, H A; Erdem, A F; Aksoy, M; Ahiskalioglu, A

2014-01-01

Labor is one of the most painful experiences a woman may face during her lifetime. One of the most effective methods used for eliminating this pain is epidural analgesia. The aim of this study to determine the impact of adding morphine to low-dose bupivacaine epidural anesthesia on labor and neonatal outcomes, and maternal side effects. This is a prospective randomized double-blind study comparing two regimens of anesthetic agents used for epidural anesthesia in labor. A total of 120 pregnant women were randomized into two groups with 60 subjects in each study arm. A catheter was inserted, and 0.1% bupivacaine + 2 μg/mL fentanyl in 15 mL saline were given to Group bupivacaine-fentanyl (Group BF), while 0.0625% bupivacaine + 2 μg/ml fentanyl + 2 mg morphine in 15 mL saline were given to Group bupivacaine-fentanyl-morphine (Group BFM) with no test dosing from the needle. No morphine was added to the subsequent epidural injections in Group BFM. The total dose of bupivacaine was significantly lower in Group BFM relative to Group BF (P = 0.0001). The visual analogu scalescores at 15, 30, and 45 min were significantly lower in Group BF compared to thosein Group BFM (P = 0.0001, P = 0.001, and P = 0.006, respectively). The second stage of labor was significantly shorter in Group BFM relative to Group BF (P = 0.027 and P = 0.003, respectively). The satisfaction with analgesia following the first dose was higher in the nonmorphine group (P = 0.0001). However, maternal postpartum satisfaction was similar in both groups. Either nausea or vomiting was recorded in eight patients in Group BFM. We believe that epidural analgesia comprised of a low-dose local anaesthetic and 2 mg morphine provides a painless labor that significantly reducesthe use of local anesthetic without changing the efficiency of the analgesic, ensuring the mother's satisfaction without leading to an adverse effect on the mother or foetus, while mildly (but significantly) shortening the second stage of

Female Labor Supply and Fertility. Causal Evidence for Latin America

OpenAIRE

Darío Tortarolo

2014-01-01

In this paper I study the causal relationship between fertility and female labor supply using census data from 14 Latin American countries and the U.S. over the span of three decades (1980, 1990 and 2000). Parental preferences for a gender-balanced family (mixed-sex children) is exploited as a source of exogenous variation in fertility. Although OLS estimates suggest a statistically signi cant negative relationship in the 39 censuses used, instrumental variables approach fails to identify a c...

The effects of labor and delivery on maternal and neonatal outcomes in term twins: a retrospective cohort study.

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Wenckus, D J; Gao, W; Kominiarek, M A; Wilkins, I

2014-08-01

To compare maternal and neonatal outcomes in twins undergoing a trial of labor versus pre-labor caesarean. Retrospective cohort study. 19 US hospitals from the Consortium on Safe Labor. Of 2225 twin sets ≥36 weeks' gestation. Maternal (abruption, estimated blood loss, postpartum haemorrhage, transfusion, chorioamnionitis, hysterectomy, ICU admission, death) and neonatal outcomes (birth injury, 5-minute Apgar <7, NICU admission, RDS, TTN, sepsis, asphyxia, NICU length of stay, death) were compared between the trial of labour and pre-labour caesarean groups with univariate and multivariate logistic and linear regression analyses. Similar analyses were performed for actual delivery modes. Maternal and neonatal outcomes. Among the 2225 twin sets, 1078 had a trial of labour, and 65.9% of those delivered vaginally. There was an increased risk for postpartum haemorrhage [OR 2.5, 95% confidence interval (CI) 1.4-4.5] and blood transfusion (OR 1.9, 95%CI 1.2-3.2) for the trial of labour compared with pre-labour caesarean groups. Birth injury only occurred in the trial of labour group, 1% Twin A, 0.4% Twin B. Both twins had a higher risk of 5-minute Apgar <7 with trial of labour compared to pre-labour caesarean (A: OR 3.9, 95%CI 1.05-14.5; B: OR 3.9, 95%CI 1.3-12.3). Term twins undergoing a trial of labour have increased maternal haemorrhage and transfusions along with neonatal birth trauma and lower Apgar scores, but these absolute neonatal occurrences were rare. Trial of labour in twins remains a safe and reasonable option in appropriately selected cases. © 2014 Royal College of Obstetricians and Gynaecologists.

Effects of labor analgesia on maternal and neonatal outcome by epidural low concentration of bupivacaine combined with anisodamine

Institute of Scientific and Technical Information of China (English)

无

2008-01-01

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivacaine and anisodamine was in...

Labor Supply Heterogeneity and Demand for Child Care of Mothers with Young Children

NARCIS (Netherlands)

Apps, Patricia F.; Kabátek, J.; Rees, Ray; van Soest, A.H.O.

2012-01-01

This paper introduces a static structural model of hours of market labor supply, time spent on child care and other domestic work, and bought in child care for married or cohabiting mothers with pre-school age children. The father's behavior is taken as given. The main goal is to analyze the

The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women.

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Moraloglu, Ozlem; Kansu-Celik, Hatice; Tasci, Yasemin; Karakaya, Burcu Kısa; Yilmaz, Yasar; Cakir, Ebru; Yakut, Halil Ibrahim

2017-01-01

To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women. This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n = 51), or a supine position modified to 45 degree of semi-fowler (n = 51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups. The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p < 0.05). There were no significant differences with regard to postpartum blood loss, neonatal birth weight, Apgar score at one and five minutes, or admission to the Neonatal Intensive Care Unit. In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.

Do wages matter?: a backward bend in the 2004 California RN labor supply.

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Tellez, Michelle; Spetz, Joanne; Seago, Jean Ann; Harrington, Charlene M; Kitchener, Martin

2009-08-01

Using data from the 2004 California Board of Registered Nursing Survey, a two-stage least-square equation was estimated to examine the effect of wages on hours worked by female registered nurses. Wages were found to have a nonlinear effect on hours worked, with a backward bending supply curve. Wages had a positive effect on the average hours worked per week up to $24.99 per hour and a negative effect between $30.00 and $100.00 per hour when compared with the wage category of $25.00 to $29.99. Results suggest that wages are important to secure the labor supply but do not increase aggregate supply beyond a wage threshold.

Supply/Demand in Radiology: A Historical Perspective and Comparison to other Labor Markets.

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Sharafinski, Mark E; Nussbaum, David; Jha, Saurabh

2016-02-01

There has been attention on the job market recently and on radiology's supply/demand calculus. Supply is influenced by the number of trained radiologists, while demand is driven by demographics and technological innovation. We analyze the supply of radiologists historically and compare to other labor markets-medical and non-medical, domestic and foreign. We review National Resident Matching Program data in radiology and several other specialties from 1991 to 2015. We also review surveys, physician recruitment data, and peer-reviewed commentaries on medical specialty job markets. Trends are compared across specialties. The regulation of American medical training is compared to that in the United Kingdom and to a nonmedical labor market, unionized theatrical stage employees. Radiology residency positions have increased since 1998 despite a downturn in the job market. This expansion coincides with a decreasing percentage of positions filled by domestic graduates. A similar trend has been seen in pathology, a notoriously oversupplied specialty. Conversely, other specialties have maintained their proportion of domestic graduates by way of limited supply or implicit demand. The radiology job market is currently oversupplied, primarily a result of increasing residency positions despite indicators of decreasing demand. The percentage of residency positions filled by domestic graduates has decreased during the same period, suggesting that medical student interest is responsive to the market. Other specialties, particularly pathology, demonstrate the dangers of chronic oversupply. We advocate a reduction of radiology residency positions such that supply closely approximates demand without exceeding it. Additional measures may be taken, if necessary, to restore market equilibrium in the event of a mild undersupply. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Efficiency of the modified Sims maternal position in the rotation of persistent occiput posterior position during labor: A randomized clinical trial.

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Bueno-Lopez, Vanessa; Fuentelsaz-Gallego, Carmen; Casellas-Caro, Manel; Falgueras-Serrano, Ana Maria; Crespo-Berros, Silvia; Silvano-Cocinero, Ana Maria; Alcaine-Guisado, Carolina; Zamoro Fuentes, Manuela; Carreras, Elena; Terré-Rull, Carmen

2018-03-14

Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. This is an open, randomized controlled, clinical trial. One hundred and twenty women in labor with fetuses in POP position were included. The diagnosis was performed through digital vaginal examination and confirmed with an ultrasound scan. Women were randomized into the free position group or the modified Sims on the side of the fetal spine. The primary outcome was rotation to occiput anterior, and secondary outcomes were type of delivery, postpartum perineal condition, perinatal results, and maternal satisfaction. In pregnant women undergoing labor in the Sims position, fetuses in POP rotated to occiput anterior in 50.8% of cases, whilst in the free position group, the rotation occurred in 21.7% (P = .001). The rate of vaginal deliveries was higher in the Sims group compared with the free position group (84.7% vs 68.3%, P = .035). The modified Sims position is a maternal posture intervention efficient in POP rotation, which decreases cesarean delivery rate. It is a simple and noninvasive intervention, reproducible, and well tolerated by pregnant women. © 2018 Wiley Periodicals, Inc.

Migrant labor supply in a booming non-renewable resource economy: Cure and transmission mechanism for de-industrialization?

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Nulle, Grant Mark

This paper challenges the determinism that booming resource economies suffer from de-industrialization, the "Dutch Disease". For several decades, economists have attempted to explain how a sudden surge in mineral and energy extraction affects an economy's output and employment from an aggregate and sectoral perspective. Economic theory shows that a "boom" in mineral and energy production is welfare enhancing to the economy experiencing it. However, the phenomenon also induces inter-sectoral adjustments among non-renewable resource (NRR), traditional traded, and non-traded industries that tend to crowd out traditional export sectors such as agriculture and manufacturing. In turn, this paper asks two fundamental questions: 1) Can the inter-sectoral adjustments wrought by a boom in NRR production be mitigated in the resource-abundant economy experiencing it; 2) Can the inter-sectoral adjustments be exported to a neighboring non-resource economy by movements in migrant labor supply? The theoretical model and empirical estimation approach presented in this paper introduces an endogenous migrant labor supply response to booms in NRR output to test the extent traditional tradable sectors shrink in the NRR-abundant economy during the boom and if such effects are exported to a neighboring jurisdiction. Using data at the U.S. county level, the empirical results show that booming economies experience positive and statistically significant rates of real income and traded sector job growth during the boom, attributable to the influx of migrant labor. By contrast, little evidence is found that non-booming counties adjacent to the booming counties experience declines in income or job growth because of labor supply outflows. Instead, the results suggest the larger the number of potential "donor" counties that can supply labor to the booming economies, the more likely the transmission of booming economy effects, namely evidence of de-industrialization, is diffused across all of the

Use of routine interventions in vaginal labor and birth: findings from the Maternity Experiences Survey.

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Chalmers, Beverley; Kaczorowski, Janusz; Levitt, Cheryl; Dzakpasu, Susie; O'Brien, Beverley; Lee, Lily; Boscoe, Madeline; Young, David

2009-03-01

Intervention rates in maternity practices vary considerably across Canadian provinces and territories. The objective of this study was to describe the use of routine interventions and practices in labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Rates of interventions and practices are considered in the light of current evidence and both Canadian and international recommendations. A sample of 8,244 estimated eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census and stratified primarily by province and territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews averaged 45 minutes long and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Women frequently reported electronic fetal monitoring, a health care practitioner starting or speeding up their labor (or trying to do so), epidural anesthesia, episiotomy, and a supine position for birth. Some women also reported pubic or perineal shaves, enemas, and pushing on the top of their abdomen. Several practices and interventions were commonly reported in labor and birth in Canada, although evidence and Canadian and international guidelines recommend against their routine use. Practices not recommended for use at all, such as shaving, were also reported.

Labor Supply and Optimization Frictions

DEFF Research Database (Denmark)

Søgaard, Jakob Egholt

In this paper I investigate the nature of optimization frictions by studying the labor market of Danish students. This particular labor market is an interesting case study as it features a range of special institutional settings that affect students’ incentive to earn income and comparing outcomes...... theory. More concretely I find the dominate optimization friction to be individuals’ inattention about their earnings during the year, while real adjustment cost and gradual learning appears to be of less importance....

Trial of Labor Compared With Cesarean Delivery in Superobese Women.

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Grasch, Jennifer L; Thompson, Jennifer L; Newton, J Michael; Zhai, Amy W; Osmundson, Sarah S

2017-11-01

To examine whether labor compared with planned cesarean delivery is associated with increased maternal and neonatal morbidity. We conducted a retrospective cohort study of all women with body mass indexes (BMIs) at delivery of 50 or greater delivering a live fetus at 34 weeks of gestation of greater between January 1, 2008, and December 31, 2015. Pregnancies with multiple gestations and major fetal anomalies were excluded. The primary outcome was a composite of maternal and neonatal morbidity and was estimated to be 50% in superobese women based on institutional data. A sample size of 338 women determined the study period and was selected to show a 30% difference in the incidence of the primary outcome between the two groups. Multivariate logistic regression adjusted for potential confounders. There were 344 women with BMIs of 50 or greater who met eligibility criteria, of whom 201 (58%) labored and 143 (42%) underwent planned cesarean delivery. Women who labored were younger, more likely to be nulliparous, and less likely to have pre-existing diabetes. Among women who labored, 45% underwent a cesarean delivery, most commonly for labor arrest (61%) or nonreassuring fetal status (28%). Composite maternal and neonatal morbidity was reduced among women who labored even after adjusting for age, parity, pre-existing diabetes, and prior cesarean delivery (adjusted odds ratio 0.42, 95% CI 0.24-0.75). In the subgroup of women (n=234) who underwent a cesarean delivery, whether planned (n=143) or after labor (n=91), there were no differences in maternal and neonatal morbidity except that severe maternal morbidity was increased in women (n=12) who labored (8.8% compared with 2.1%, relative risk 4.2, 95% CI 1.14-15.4). Despite high rates of cesarean delivery in women with superobesity, labor is associated with lower composite maternal and neonatal morbidity. Severe maternal morbidity may be higher in women who require a cesarean delivery after labor.

Effects of labor analgesia on maternal and neonatal outcome by epidural low concentration of bupivacaine combined with anisodamine

Institute of Scientific and Technical Information of China (English)

Yang Xiaoli; Zhou Chunqin; Li Xiaogang; Shen Xiaodong; Zou Yuliang

2008-01-01

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivaeaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8 %), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar's score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocla and complications of delivery.

Labor analgesia: An update on the effect of epidural analgesia on labor outcome

Directory of Open Access Journals (Sweden)

Samina Ismail

2013-01-01

Full Text Available Following the introduction of epidural for labor analgesia, debate has centered on the issue of its effect on outcome of labor; in terms of length of labor and increase in the rate of instrumental vaginal delivery and cesarean section (CS. There is no ideal study on the effect of epidural analgesia (EA on the outcome of labor due to logistic problems in randomization, blinding and getting a control group; as a result these queries are partly answered. Despite these problems, it has been established that labor epidural has minimal effect on progress of established labor and maternal request should be a sufficient indication to start an epidural. Although instrumental vaginal delivery is probably increased with epidural but obstetrician practice, pain free patient and teaching opportunity are likely factors increasing the incidence. Maternal-fetal factors and obstetric management and not the use of EA are the most important determinants of the CS rate. The purpose of this review is to summarize data from controlled trials addressing the question of whether neuraxial labor analgesia causes an increased risk of CS or rate of instrumental delivery. In addition, the review discusses whether the timing of initiation of analgesia infl uences the mode of delivery.

Aggregate Effects in Local Labor Markets of Supply and Demand Shocks. Upjohn Institute Staff Working Paper No. 99-57.

Science.gov (United States)

Bartik, Timothy J.

A study estimated the aggregate effects of antipoverty policies on wages and unemployment of different groups. The context was one in which emphasis was on labor supply policies, such as welfare reform or job training, and not on policies to increase labor demand for the poor, such as public employment or subsidizing private employers to hire the…

Labor Force

Science.gov (United States)

Occupational Outlook Quarterly, 2010

2010-01-01

The labor force is the number of people aged 16 or older who are either working or looking for work. It does not include active-duty military personnel or institutionalized people, such as prison inmates. Quantifying this total supply of labor is a way of determining how big the economy can get. Labor force participation rates vary significantly…

Factors associated with higher oxytocin requirements in labor.

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Frey, Heather A; Tuuli, Methodius G; England, Sarah K; Roehl, Kimberly A; Odibo, Anthony O; Macones, George A; Cahill, Alison G

2015-09-01

To identify clinical characteristics associated with high maximum oxytocin doses in women who achieve complete cervical dilation. A retrospective nested case-control study was performed within a cohort of all term women at a single center between 2004 and 2008 who reached the second stage of labor. Cases were defined as women who had a maximum oxytocin dose during labor >20 mu/min, while women in the control group had a maximum oxytocin dose during labor of ≤20 mu/min. Exclusion criteria included no oxytocin administration during labor, multiple gestations, major fetal anomalies, nonvertex presentation, and prior cesarean delivery. Multiple maternal, fetal, and labor factors were evaluated with univariable analysis and multivariable logistic regression. Maximum oxytocin doses >20 mu/min were administered to 108 women (3.6%), while 2864 women received doses ≤20 mu/min. Factors associated with higher maximum oxytocin dose after adjusting for relevant confounders included maternal diabetes, birthweight >4000 g, intrapartum fever, administration of magnesium, and induction of labor. Few women who achieve complete cervical dilation require high doses of oxytocin. We identified maternal, fetal and labor factors that characterize this group of parturients.

Predicting early epidurals: association of maternal, labor, and neonatal characteristics with epidural analgesia initiation at a cervical dilation of 3 cm or less.

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Moore, Albert R; Shan, William Li Pi; Hatzakorzian, Roupen

2013-01-01

Retrospective studies have associated early epidural analgesia with cesarean delivery, but prospective studies do not demonstrate a causal relationship. This suggests that there are other variables associated with early epidural analgesia that increase the risk of cesarean delivery. This study was undertaken to determine the characteristics associated with early epidural analgesia initiation. Information about women delivering at 37 weeks or greater gestation with epidural analgesia, who were not scheduled for cesarean delivery, was extracted from the McGill Obstetric and Neonatal Database. Patients were grouped into those who received epidural analgesia at a cervical dilation of ≤3 cm and >3 cm. Univariable and multivariable logistic regression was used to determine the maternal, neonatal, and labor characteristics that increased the risk of inclusion in the early epidural group. Of the 13,119 patients analyzed, multivariable regression demonstrated odds ratios (OR) of 2.568, 5.915 and 10.410 for oxytocin augmentation, induction, and dinoprostone induction of labor (P analgesia (OR 0.780, P analgesia (P neonatal weight (OR 0.943, P analgesia. Labor augmentation and induction, nulliparity, rupture of membranes spontaneously and before labor starts, increasing maternal weight, and decreasing neonatal weight are associated with early epidural analgesia. Many of these variables are also associated with cesarean delivery.

Economic implications of labor induction.

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Garcia-Simon, Raquel; Montañes, Antonio; Clemente, Jesús; Del Pino, María D; Romero, Manuel A; Fabre, Ernesto; Oros, Daniel

2016-04-01

To assess health service costs associated with labor induction according to different clinical situations in a tertiary-level hospital. In a prospective study, individual patient cost data were assessed for women admitted for induction of labor at a tertiary hospital in Spain between November 1, 2012, and August 31, 2013. The costs of labor induction were estimated according to maternal and neonatal outcomes, method of delivery, cervical condition at admission, and obstetric indication. Direct costs including professional fees, epidural, maternal stay, consumables, and drugs were calculated. Overall, 412 women were included in the final cost analysis. The mean total cost of labor induction was €3589.87 (95% confidence interval [CI] 3475.13-3704.61). Cesarean delivery after labor induction (€4830.45, 95% CI 4623.13-5037.58) was significantly more expensive than spontaneous delivery (€3037.45, 95% CI 2966.91-3179.99) and instrumental vaginal delivery (€3344.31, 95%CI 3151.69-3536.93). The total cost for patients with a very unfavorable cervix (Bishop score Labor induction for hypertensive disorders of pregnancy was the most expensive obstetric indication for induction of labor (€4347.32, 95% CI 3890.45-4804.18). Following the induction of labor, a number of patient- and treatment-related factors influence costs associated with delivery. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Failed labor induction: toward an objective diagnosis.

LENUS (Irish Health Repository)

Rouse, Dwight J

2011-02-01

To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes.

Kinky Choices, Dictators and Split Might : A Non-Cooperative Model for Household Consumption and Labor Supply

NARCIS (Netherlands)

Boone, J.; van der Wiel, K.M.; Vermeulen, F.M.P.

2009-01-01

It is unlikely that husbands and wives always agree on exactly what public goods to buy. Nor do they necessarily agree on how many hours to work with obvious consequences for the household budget. We therefore model consumption and labor supply behavior of a couple in a non-cooperative setting by

Spontaneous Pushing in Lateral Position versus Valsalva Maneuver During Second Stage of Labor on Maternal and Fetal Outcomes: A Randomized Clinical Trial.

Science.gov (United States)

Vaziri, Farideh; Arzhe, Amene; Asadi, Nasrin; Pourahmad, Saeedeh; Moshfeghy, Zeinab

2016-10-01

There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor. Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes. Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus with vertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications. The intervention group pushed spontaneously while they were in the lateral position, whereas the control group pushed using Valsalva method while in the supine position at the onset of the second stage of labor. Maternal outcomes such as pain and fatigue severity and fetal outcomes such as pH and pO2 of the umbilical cord blood were measured. Data pertaining to 69 patients, divided into the intervention group (35 subjects) and control group (34 subjects), were analyzed statistically. The mean pain (7.80 ± 1.21 versus 9.05 ± 1.11) and fatigue scores (46.59 ± 21 versus 123.36 ± 43.20) of the two groups showed a statistically significant difference (P pushing in the lateral position reduced fatigue and pain severity of the mothers. Also, it did not worsen fetal outcomes. Thus, it can be used as an alternative method for the Valsalva maneuver.

The Labor Supply and Tax Revenue Consequences of Federal Same-Sex Marriage Legalization

OpenAIRE

Stevenson, Adam

2012-01-01

The issue of same-sex marriage legalization is increasingly part of the national political dialogue. This legalization would have a number of economic impacts, one of the most direct being a change in income tax payments, through the so-called marriage penalty. I estimate the effects of same-sex marriage legalization on federal income tax revenue. These estimates rely critically on the responsiveness of labor supply and marital choice to changes in the tax code. I present new evidence on both...

A prospective population-based study of maternal, fetal, and neonatal outcomes in the setting of prolonged labor, obstructed labor and failure to progress in low- and middle-income countries.

Science.gov (United States)

Harrison, Margo S; Ali, Sumera; Pasha, Omrana; Saleem, Sarah; Althabe, Fernando; Berrueta, Mabel; Mazzoni, Agustina; Chomba, Elwyn; Carlo, Waldemar A; Garces, Ana; Krebs, Nancy F; Hambidge, K; Goudar, Shivaprasad S; Dhaded, S M; Kodkany, Bhala; Derman, Richard J; Patel, Archana; Hibberd, Patricia L; Esamai, Fabian; Liechty, Edward A; Moore, Janet L; Koso-Thomas, Marion; McClure, Elizabeth M; Goldenberg, Robert L

2015-01-01

This population-based study sought to quantify maternal, fetal, and neonatal morbidity and mortality in low- and middle-income countries associated with obstructed labor, prolonged labor and failure to progress (OL/PL/FTP). A prospective, population-based observational study of pregnancy outcomes was performed at seven sites in Argentina, Guatemala, India (2 sites, Belgaum and Nagpur), Kenya, Pakistan and Zambia. Women were enrolled in pregnancy and delivery and 6-week follow-up obtained to evaluate rates of OL/PL/FTP and outcomes resulting from OL/PL/FTP, including: maternal and delivery characteristics, maternal and neonatal morbidity and mortality and stillbirth. Between 2010 and 2013, 266,723 of 267,270 records (99.8%) included data on OL/PL/FTP with an overall rate of 110.4/1000 deliveries that ranged from 41.6 in Zambia to 200.1 in Pakistan. OL/PL/FTP was more common in women aged 3500g, and women with a BMI >25 (RR 1.4, 95% CI 1.3 - 1.5), with the suggestion of OL/PL/FTP being less common in preterm deliveries. Protective characteristics included parity of ≥3, having an infant birth vaginally were more likely to become infected, to have an infected neonate, to hemorrhage in the antepartum and postpartum period, and to die, have a stillbirth, or have a neonatal demise. Women with OL/PL/FTP were far more likely to deliver in a facility and be attended by a physician or other skilled provider than women without this diagnosis. Women with OL/PL/FTP in the communities studied were more likely to be primiparous, younger than age 20, overweight, and of higher education, with an infant with birthweight of >3500g. Women with this diagnosis were more likely to experience a maternal, fetal, or neonatal death, antepartum and postpartum hemorrhage, and maternal and neonatal infection. They were also more likely to deliver in a facility with a skilled provider. CS may decrease the risk of poor outcomes (as in the case of antepartum hemorrhage), but unassisted vaginal

Global Metabolomics of the Placenta Reveals Distinct Metabolic Profiles between Maternal and Fetal Placental Tissues Following Delivery in Non-Labored Women

Directory of Open Access Journals (Sweden)

Jacquelyn M. Walejko

2018-01-01

Full Text Available We evaluated the metabolic alterations in maternal and fetal placental tissues from non-labored women undergoing cesarean section using samples collected from 5 min to 24 h following delivery. Using 1H-NMR, we identified 14 metabolites that significantly differed between maternal and fetal placental tissues (FDR-corrected p-value < 0.05, with 12 metabolites elevated in the maternal tissue, reflecting the flux of these metabolites from mother to fetus. In the maternal tissue, 4 metabolites were significantly altered at 15 min, 10 metabolites at 30 min, and 16 metabolites at 1 h postdelivery, while 11 metabolites remained stable over 24 h. In contrast, in the fetal placenta tissue, 1 metabolite was significantly altered at 15 min, 2 metabolites at 30 min, and 4 metabolites at 1 h postdelivery, while 22 metabolites remained stable over 24 h. Our study provides information on the metabolic profiles of maternal and fetal placental tissues delivered by cesarean section and reveals that there are different metabolic alterations in the maternal and fetal tissues of the placenta following delivery.

Does Lean Improve Labor Standards? Management and Social Performance in the Nike Supply Chain

OpenAIRE

Distelhorst, Greg; Hainmueller, Jens; Locke, Richard M.

2016-01-01

This study tests the hypothesis that lean manufacturing improves the social performance of manufacturers in emerging markets. We analyze an intervention by Nike Inc. to promote the adoption of lean manufacturing in its apparel supply chain across eleven developing countries. Using difference-in-differences estimates from a panel of over three hundred factories, we find that lean adoption was associated with a 15 percentage point reduction in noncompliance with labor standards t...

Health Insurance and the Labor Supply Decisions of Older Workers: Evidence from a U.S. Department of Veterans Affairs Expansion.

Science.gov (United States)

Boyle, Melissa A; Lahey, Joanna N

2010-08-01

This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we employ a difference-in-differences strategy to compare the labor market behavior of older veterans and non-veterans before and after the VA health benefits expansion to test the impact of public health insurance on labor supply. We find that older workers are significantly more likely to decrease work both on the extensive and intensive margins after receiving access to non-employer based insurance. Workers with some college education or a college degree are more likely to transition into self-employment, a result consistent with "job-lock" effects. However, less-educated workers are more likely to leave self-employment, a result suggesting that the positive income effect from receiving public insurance dominates the "job-lock" effect for these workers. Some relatively disadvantaged sub-populations may also increase their labor supply after gaining greater access to public insurance, consistent with complementary positive health effects of health care access or decreased work disincentives for these groups. We conclude that this reform has affected employment and retirement decisions, and suggest that future moves toward universal coverage or expansions of Medicare are likely to have significant labor market effects.

Prevalence and Maternal Risk Factors of Preterm Laboring in Qom, 2007

Directory of Open Access Journals (Sweden)

Sadeghi Moghaddam P

2011-03-01

Full Text Available Background and Objectives: Prematurity remains the most significant cause of neonatal morbidity and mortality. Knowing which group of women is at risk for developing preterm labor will define a target population for better prenatal care and preventive modalities. The aim of this study was to determine the prevalence of premature birth and compare the maternal risk factors among premature and term newborns.Methods: In this descriptive cross-sectional study, 400 pregnant women were assessed 200 of whom were patients with preterm delivery and the other 200 were women with the term delivery. The data were gathered through interview and patients’ medical record. Finally The results were compared by statistical tests. In order to determine the prevalence of premature birth all deliveries were taken under study from 86/4/1 to 86/9/30 in hospitals of Qom.Results: The prevalence of preterm delivery in Qom hospitals was (%5/6.This evaluation showed a significant statistical difference between the preterm delivery and the following determining factors: number of delivery, emotional stress, prenatal care, ante partum hemorrhage and surgery, infectious diseases, diabetes, anemia, history premature birth and UTI. There was no significant statistical difference between the preterm delivery and maternal age, BMI, employment, history of abortion, infertility, route of contraception, drug use during pregnancy, preclamcy and patient's medical history. Conclusion: Addressing prematurity in this population will require earlier initiation of prenatal care to allow for early detection and management of complications of pregnancy.

Labor allocation in transition: evidence from Chinese rural households

NARCIS (Netherlands)

Wang, X.; Herzfeld, T.; Glauben, T.

2007-01-01

Empirical models are developed in this paper to quantitatively analyze households' participation in decisions on hiring labor and supplying labor off the farm, hired labor demand and off-farm labor supply of rural Chinese households. Econometric estimates use micro-level data from Zhejiang province

The Effect of a First Child on Female Labor Supply: Evidence from Women Seeking Fertility Services

Science.gov (United States)

Cristia, Julian P.

2008-01-01

Estimating the causal effect of a first child on female labor supply is complicated by the endogeneity of fertility. This paper addresses this problem by focusing on a sample of women from the National Survey of Family Growth (NSFG) who sought help to become pregnant. After a certain period, only some of these women gave birth. Results using this…

Maternal Supply of Cas9 to Zygotes Facilitates the Efficient Generation of Site-Specific Mutant Mouse Models

Science.gov (United States)

Cebrian-Serrano, Alberto; Zha, Shijun; Hanssen, Lars; Biggs, Daniel; Preece, Christopher

2017-01-01

Genome manipulation in the mouse via microinjection of CRISPR/Cas9 site-specific nucleases has allowed the production time for genetically modified mouse models to be significantly reduced. Successful genome manipulation in the mouse has already been reported using Cas9 supplied by microinjection of a DNA construct, in vitro transcribed mRNA and recombinant protein. Recently the use of transgenic strains of mice overexpressing Cas9 has been shown to facilitate site-specific mutagenesis via maternal supply to zygotes and this route may provide an alternative to exogenous supply. We have investigated the feasibility of supplying Cas9 genetically in more detail and for this purpose we report the generation of a transgenic mice which overexpress Cas9 ubiquitously, via a CAG-Cas9 transgene targeted to the Gt(ROSA26)Sor locus. We show that zygotes prepared from female mice harbouring this transgene are sufficiently loaded with maternally contributed Cas9 for efficient production of embryos and mice harbouring indel, genomic deletion and knock-in alleles by microinjection of guide RNAs and templates alone. We compare the mutagenesis rates and efficacy of mutagenesis using this genetic supply with exogenous Cas9 supply by either mRNA or protein microinjection. In general, we report increased generation rates of knock-in alleles and show that the levels of mutagenesis at certain genome target sites are significantly higher and more consistent when Cas9 is supplied genetically relative to exogenous supply. PMID:28081254

The effect of adding a background infusion to patient-controlled epidural labor analgesia on labor, maternal, and neonatal outcomes: a systematic review and meta-analysis.

Science.gov (United States)

Heesen, Michael; Böhmer, Johannes; Klöhr, Sven; Hofmann, Thomas; Rossaint, Rolf; Straube, Sebastian

2015-07-01

Patient-controlled epidural analgesia (PCEA) has gained popularity, but it is still unclear whether adding a background infusion confers any benefit. A systematic literature search in PubMed, Embase, CINAHL, LILACS, CENTRAL, Clinicaltrials.gov, and ISI WOS was performed to identify randomized controlled double-blind trials that compare PCEA-only with PCEA combined with a continuous infusion (PCEA + CI) in parturients. The data were subjected to meta-analyses using the random-effects model. Our primary outcome was the incidence of instrumental vaginal delivery. Secondary outcomes were incidences of spontaneous vaginal and cesarean deliveries, duration of labor, analgesic outcomes, maternal outcomes (visual analog scale scores for pain, maternal satisfaction, nausea, pruritus, hypotension), and neonatal outcomes (Apgar score, umbilical artery pH). We identified 7 trials with a low risk of bias, reporting on 891 parturients, for inclusion in our systematic review. The risk of instrumental vaginal delivery was increased in the PCEA + CI group, risk ratio (RR) 1.66 (95% confidence interval 1.08-2.56, P = 0.02; I = 0%); the RR for cesarean delivery was 0.83 (95% confidence interval 0.61-1.13, I = 0%). The second stage of labor was prolonged (weighted mean difference 12.3 minutes, 95% confidence interval 5.1-19.5 minutes, P = 0.0008; I = 0%) in the PCEA + CI group. Fewer patients in the PCEA + CI group required physician-administered boluses (RR 0.35 [95% confidence interval 0.25-0.47, P neonatal outcomes (Apgar scores analgesia. Further high-quality studies involving a sufficient number of patients are required.

Labor market modeling recognizing latent job attributes and opportunity constraints : an empirical analysis of labor market behavior of Eritrean women

OpenAIRE

Arneberg, Marie W.; Dagsvik, John K.; Jia, Zhiyang

2002-01-01

Abstract: This paper analyzes labor market behavior of urban Eritrean women with particular reference to the impact of education, earnings and labor market opportunities. Unlike traditional models of labor supply, which assume that work can be supplied freely in the labor market, we develop a framework that explicitly takes into account the notion of job opportunities and observable sets of feasible jobs. The framework is formulated within a random utility setting in which unob...

Tax Policy and Labor Market Performance

NARCIS (Netherlands)

Bovenberg, A.L.

2003-01-01

In exploring the impact of tax policy on labor-market performance, the paper first investigates how tax reform impacts labor supply and equilibrium unemployment in representative agent models.The impact of tax policy on labor market performance depends importantly on various other labor-market

What can be done about child labor ? - An overview of recent research and its implications for designing programs to reduce child labor

OpenAIRE

Grimsrud, Bjorne

2001-01-01

This paper examines the research on child labor, and places the phenomenon in a broader development agenda. It explains the demand for, and supply of child labor, linking these factors to others, such as the supply of education. Then it looks into the private, and social costs of, and benefits from child labor. Against this background, strategies fore reducing child labor are debated.

29 CFR 1470.33 - Supplies.

Science.gov (United States)

2010-07-01

.... If there is a residual inventory of unused supplies exceeding $5,000 in total aggregate fair market... 29 Labor 4 2010-07-01 2010-07-01 false Supplies. 1470.33 Section 1470.33 Labor Regulations... Changes, Property, and Subawards § 1470.33 Supplies. (a) Title. Title to supplies acquired under a grant...

Rates of interventions in labor and birth across Canada: findings of the Canadian Maternity Experiences Survey.

Science.gov (United States)

Chalmers, Beverley; Kaczorowski, Janusz; O'Brien, Beverley; Royle, Cathie

2012-09-01

Rates of interventions in labor and birth should be similar across a country if evidence-based practice guidelines are followed. This assumption is tested by comparison of some practices across the 13 provinces and territories of Canada. The objective of this study was to describe the wide provincial and territorial variations in rates of routine interventions and practices during labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. A sample of 8,244 eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census. The sample was stratified by province and territory. Computer-assisted telephone interviews were conducted with participating birth mothers by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews took an average of 45 minutes and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Provincial and territorial variations in rates of routine intervention used during labor and birth are reported. The percentage range of mothers' experience of induction (range 30.9%), epidural (53.7%), continuous electronic fetal monitoring (37.9%), and medication-free pain management during labor (40.7%) are provided, in addition to the use of episiotomy (14.1%) or "stitches" (48.3%), being in a "flat lying position" (42.2%), and having their legs in stirrups for birth (35.7%). Wide variations in the use of most of the interventions were found, ranging from 14.1 percent to 53.7 percent. Rates of intervention in labor and birth showed considerable variation across Canada, suggesting that usage is not always evidence based but may be influenced by a variety of other factors. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

Elderly Labor Supply: Work or Play

National Research Council Canada - National Science Library

Haider, Steven

2001-01-01

.... However, very little research has examined labor market behavior in this population. In this paper, we examine a series of questions in an attempt to better understand why the elderly continue to work...

Maternal Body Mass Index and Anovaginal Distance in Active Phase of Term Labor

Directory of Open Access Journals (Sweden)

Linda Hjertberg

2018-01-01

Full Text Available Introduction. To evaluate if there was a difference in the anovaginal distance (AVD measured by transperineal ultrasound between obese and normal weight women. Material and Methods. A prospective observational study including 207 primiparous women at term in first stage of labor. Transperineal ultrasound with a vaginal probe was used to measure the AVD. Maternal, pregnancy, and delivery characteristics potentially associated with perineal thickness were extracted from woman’s medical records. The participants were divided into three BMI groups based on maternal weight in early pregnancy: normal weight (BMI < 25, overweight (BMI 25–29.9, and obesity (BMI ≥ 30. Obese and overweight women were compared with normal weight women regarding the AVD. Results. The mean AVD was 24.3, 24.9, and 27.0 mm in the normal weight, overweight, and obesity group, respectively. There were no group differences in background characteristics. The AVD was significantly longer in obese women compared with normal weight women (p=0.018. Conclusions. The observed longer AVD in obese women might be protective of the anal sphincter complex, explaining lower rates of anal sphincter injuries in this group. Further studies are indicated to evaluate whether the length of the AVD plays a role in the risk assessment of obstetric anal sphincter injury. The trial is registered in ClinicalTrials.gov and the trial registration ID is NCT03149965.

Structural Estimation of Family Labor Supply with Taxes: Estimating a Continuous Hours Model Using a Direct Utility Specification

Science.gov (United States)

Heim, Bradley T.

2009-01-01

This paper proposes a new method for estimating family labor supply in the presence of taxes. This method accounts for continuous hours choices, measurement error, unobserved heterogeneity in tastes for work, the nonlinear form of the tax code, and fixed costs of work in one comprehensive specification. Estimated on data from the 2001 PSID, the…

Tax policy and labor market performance

NARCIS (Netherlands)

A.L. Bovenberg (Lans)

2003-01-01

textabstractIn exploring the impact of tax policy on labor-market performance, the paper first investigates how tax reform impacts labor supply and equilibrium unemployment in representative agent models. The impact of tax policy on labor market performance depends importantly on various other

The effects of Children’s ADHD on Parents’ Relationship Dissolution and Labor Supply

DEFF Research Database (Denmark)

Kvist, Anette Primdal; Nielsen, Helena Skyt; Simonsen, Marianne

This paper uses Danish register-based data for the population of children born in 1990-1997 to investigate the effects on parents of having a child with attention-deficit/hyperactivity-disorder (ADHD). Ten years after birth, parents of children diagnosed with ADHD have a 75 % higher probability...... of having dissolved their relationship and a 7-13 % lower labor supply. Exploiting detailed information about documented risk factors behind ADHD, we find that roughly half of this gap is due to selection. However, a statistically and economically significant gap is left, which is likely related...... to the impact of high psychic costs of coping with a child with ADHD....

The assessment of labor: a brief history.

Science.gov (United States)

Cohen, Wayne R; Friedman, Emanuel A

2018-01-26

In the 1930s, investigators in the US, Germany and Switzerland made the first attempts to quantify the course of labor in a clinically meaningful way. They emphasized the rupture of membranes as a pivotal event governing labor progress. Attention was also placed on the total number of contractions as a guide to normality. Beginning in the 1950s, Friedman determined that changes in cervical dilatation and fetal station over time were the most useful parameters for the assessment of labor progress. He showed all normal labors had similar patterns of dilatation and descent, differing only in the durations and slopes of their component parts. These observations led to the formulation of criteria that elevated the assessment of labor from a rather arbitrary exercise to one guided by scientific objectivity. Researchers worldwide confirmed the basic nature of labor curves and validated their functionality. This system allows us to quantify the effects of parity, analgesia, maternal obesity, prior cesarean, maternal age, and fetal presentation and position on labor. It permits analysis of outcomes associated with labor aberrations, quantifies the effectiveness of treatments and assesses the need for cesarean delivery. Also, dysfunctional labor patterns serve as indicators of short- and long-term risks to offspring. We still lack the necessary translational research to link the physiologic manifestations of uterine contractility with changes in dilatation and descent. Recent efforts to interpret electrohysterographic patterns hold promise in this regard, as does preliminary exploration into the molecular basis of dysfunctional labor. For now, the clinician is best served by a system of labor assessment proposed more than 60 years ago and embellished upon in considerable detail since.

29 CFR 97.33 - Supplies.

Science.gov (United States)

2010-07-01

... aggregate fair market value upon termination or completion of the award, and if the supplies are not needed... 29 Labor 1 2010-07-01 2010-07-01 true Supplies. 97.33 Section 97.33 Labor Office of the Secretary... GOVERNMENTS Post-Award Requirements Changes, Property, and Subawards § 97.33 Supplies. (a) Title. Title to...

Prevalence and Maternal Risk Factors of Preterm Laboring in Qom, 2007

Directory of Open Access Journals (Sweden)

Z Khalaji Nia

2012-05-01

Full Text Available

Background and Objectives: Prematurity remains the most significant cause of neonatal morbidity and mortality. Knowing which group of women is at risk for developing preterm labor will define a target population for better prenatal care and preventive modalities. The aim of this study was to determine the prevalence of premature birth and compare the maternal risk factors among premature and term newborns.

Methods: In this descriptive cross-sectional study, 400 pregnant women were assessed 200 of whom were patients with preterm delivery and the other 200 were women with the term delivery. The data were gathered through interview and patients’ medical record. Finally The results were compared by statistical tests. In order to determine the prevalence of premature birth all deliveries were taken under study from 86/4/1 to 86/9/30 in hospitals of Qom.

Results: The prevalence of preterm delivery in Qom hospitals was (%5/6.This evaluation showed a significant statistical difference between the preterm delivery and the following determining factors: number of delivery, emotional stress, prenatal care, ante partum hemorrhage and surgery, infectious diseases, diabetes, anemia, history premature birth and UTI. There was no significant statistical difference between the preterm delivery and maternal age, BMI, employment, history of abortion, infertility, route of contraception, drug use during pregnancy, preclamcy and patient's medical history.

Conclusion: Addressing prematurity in this population will require earlier initiation of prenatal care to allow for early detection and management of complications of pregnancy.

Deliveries in maternity homes in Norway: results from a 2-year prospective study.

Science.gov (United States)

Schmidt, Nina; Abelsen, Birgit; Øian, Pål

2002-08-01

The study aims to report the short-term outcome for the mothers and newborns for all pregnancies accepted for birth at maternity homes in Norway. A 2-year prospective study of all mothers in labor in maternity homes, i.e. all births including women and newborns transferred to hospital intra partum or the first week post partum. The study included 1275 women who started labor in the maternity homes in Norway; 1% of all births in Norway during this period. Of those who started labor in a maternity home, 1217 (95.5%) also delivered there while 58 (4.5%) women were transferred to hospital during labor. In the post partum period there were 57 (4.7%) transferrals of mother and baby. Nine women had a vacuum extraction, one had a forceps and three had a vaginal breech (1.1% operative vaginal births in the maternity homes). Five babies (0.4%) had an Apgar score below 7 at 5 min. There were two (0.2%) neonatal deaths; both babies were born with a serious group B streptococcal infection. Midwives and general practitioners working in the districts can identify a low-risk population (estimated at 35%) of all pregnant women in the catchment areas who can deliver safely at the maternity homes in Norway. Only 4.5% of those who started labor in the maternity homes had to be transferred to hospital during labor.

[Oxytocin administration during labor. Results from the 2010 French National Perinatal Survey].

Science.gov (United States)

Belghiti, J; Coulm, B; Kayem, G; Blondel, B; Deneux-Tharaux, C

2013-11-01

To estimate the frequency of oxytocin administration during labor, in all women in labor, in low-risk women, and in women with a previous cesarean delivery. Our objectives were also to identify characteristics of women and of maternity units associated with this practice in France. Analysis of the 2010 French Perinatal Survey data (n=14,681 women who delivered in continental France). The frequency of oxytocin administration during labor was estimated in all women in labor (n=12,845) and in low-risk women (n=9798). The independent associations between oxytocin administration during labor and characteristics of women and units were quantified with multivariate logistic regression modeling. Sixty-four percent of laboring women received oxytocin during labor, and 58% of women with a spontaneous onset of labor. In the population of low-risk women with spontaneous labor and epidural, nulliparity and over-weight, as well as the private status and small size of the maternity unit, were independently associated with a more frequent administration of oxytocin during labor. Oxytocin administration during labor is very frequent in France, probably beyond classical indications. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes.

Science.gov (United States)

Tavares, Sara; Cavaco-Gomes, João; Moucho, Marina; Severo, Milton; Mateus, Mário; Ramalho, Carla; Visser, Gerard H A; Montenegro, Nuno

2017-05-01

Objective  The objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff. Design  This was a retrospective study conducted over 5 years between 2008 and 2012. Setting  This study was set at the obstetric delivery unit in a tertiary hospital. Population  A total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections. Materials and Methods  Data were collected using the hospital electronic medical records. Time periods of 8 hours were defined (daytime between 8 am and 4 pm, evening time between 4 pm and 12 pm, and nighttime between 12 pm and 8 am). Differences between the three time periods were assessed using software R Core Team (2013). Main outcome measures were neonatal birth asphyxia, neonatal intensive care unit admission, and neonatal death. Results  There were no differences in perinatal and maternal outcomes in the course of the day, apart from a higher incidence of third- and fourth-degree tears during the evening. Neonatal outcome after obstetric emergencies (uterine rupture, partial placental abruption, and cord prolapse) also showed no day-night differences. Conclusion  Adverse nighttime-related outcomes may be avoided by the 24/7 presence of experienced medical staff. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contemporary labor patterns: the impact of maternal body mass index.

Science.gov (United States)

Kominiarek, Michelle A; Zhang, Jun; Vanveldhuisen, Paul; Troendle, James; Beaver, Julie; Hibbard, Judith U

2011-09-01

We sought to compare labor patterns by body mass index (BMI). A total of 118,978 gravidas with a singleton term cephalic gestation were studied. Repeated-measures analysis constructed mean labor curves by parity and BMI categories for those who reached 10 cm. Interval-censored regression analysis determined median traverse times, adjusting for covariates in vaginal deliveries and intrapartum cesareans. In the labor curves, the time difference to reach 10 cm was 1.2 hours from the lowest to highest BMI category for nulliparas. Multiparas entered active phase by 6 cm, but reaching this point took longer for BMI ≥40.0 (3.4 hours) compared to BMI .05) but decreased as BMI increased for multiparas (P < .001). Labor proceeds more slowly as BMI increases, suggesting that labor management be altered to allow longer time for these differences. Copyright © 2011 Mosby, Inc. All rights reserved.

Analysis of preventability of hypertensive disorder in pregnancy-related maternal death using the nationwide registration system of maternal deaths in Japan.

Science.gov (United States)

Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

2018-04-26

Hypertensive disorder of pregnancy (HDP) is a major cause of maternal death. The goal of this study was to investigate factors associated with maternal death due to HDP. HDP-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor and Welfare from 2010 to 2015 were examined. Out of 47 cases of HDP, 30 were identified as the major cause of maternal death. The median maternal age was 34 years (range 24-45) and the mortality in women aged ≥40 years was seven times higher that than in women aged deaths in Japan. Mothers aged ≥40 years are most at risk for HDP-related maternal death. Major concerns for preventabilities were late hospitalization, maternal transportation, and termination of pregnancy for term or near-term HDP. Regular vital checks and prompt lowering of BP were lacked during labor in most cases. HELLP syndrome should be managed at a general hospital with sufficient medical resources.

Kinky Choices, Dictators and Split Might : A Non-Cooperative Model for Household Consumption and Labor Supply

OpenAIRE

Boone, J.; van der Wiel, K.M.; Vermeulen, F.M.P.

2009-01-01

It is unlikely that husbands and wives always agree on exactly what public goods to buy. Nor do they necessarily agree on how many hours to work with obvious consequences for the household budget. We therefore model consumption and labor supply behavior of a couple in a non-cooperative setting by adopting a Nash approach. Using minimal assumptions, we prove that demand for public goods is characterized by three regimes. It is either determined by the preferences of one of the partners only (H...

Does “Convenience Agriculture” Affect Off‐farm Labor Allocation Decisions?

OpenAIRE

Uematsu, Hiroki; Mishra, Ashok K.; Chintawar, Sachin

2010-01-01

The objective of this study is to examine the effect of adoption intensity of GM crops on off‐farm labor supply by farm households. Using ARMS data in 2004, 2005 and 2006, we estimate a two stage simultaneous Tobit model and find that adoption intensity of GM crops has a negative impact on off‐farm labor supply by operators and a positive impact on off‐farm labor supply by spouse. This may be due to the comparative advantage of operators and spouses. Our results find that GM crops adoption ha...

Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

Science.gov (United States)

Boyle, Melissa A; Lahey, Joanna N

2016-01-01

Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. Copyright © 2015 Elsevier B.V. All rights reserved.

Requests for cesarean deliveries: The politics of labor pain and pain relief in Shanghai, China.

Science.gov (United States)

Wang, Eileen

2017-01-01

Cesarean section rates have risen dramatically in China within the past 25 years, particularly driven by non-medical factors and maternal requests. One major reason women request cesareans is the fear of labor pain, in a country where a minority of women are given any form of pain relief during labor. Drawing upon ethnographic fieldwork and in-depth interviews with 26 postpartum women and 8 providers at a Shanghai district hospital in June and July of 2015, this article elucidates how perceptions of labor pain and the environment of pain relief constructs the cesarean on maternal request. In particular, many women feared labor pain and, in a context without effective pharmacological pain relief or social support during labor, they came to view cesarean sections as a way to negotiate their labor pain. In some cases, women would request cesarean sections during labor as an expression of their pain and a call for a response to their suffering. However, physicians, under recent state policy, deny such requests, particularly as they do not view pain as a reasonable indication for a cesarean birth. This disconnect leads to a mismatch in goals for the experience of birth. To reduce unnecessary C-sections, policy makers should instead address the lack of pain relief during childbirth and develop other means of improving the childbirth experience that may relieve maternal anxiety, such as allowing family members to support the laboring woman and integrating a midwifery model for low-risk births within China's maternal-services system. Copyright © 2016 Elsevier Ltd. All rights reserved.

Maternal satisfaction as an outcome criterion in research on labor analgesia: data analysis from the recent literature.

Science.gov (United States)

Dualé, Christian; Nicolas-Courbon, Aurélie; Gerbaud, Laurent; Lemery, Didier; Bonnin, Martine; Pereira, Bruno

2015-03-01

To investigate whether maternal satisfaction (MS) is taken into consideration as an outcome criterion in clinical research on analgesia for labor. A systematic review of articles reporting analgesia for labor from a panel of 17 influential journals was undertaken. A total of 116 articles were analyzed, including 282 within-study groups. The scope of MS, the type of outcome measure used, and the time of measurement were noted. Each available observation was assigned an ordinal value of MS (ordMS), according to data distribution. The factors influencing ordMS were identified by multivariable analysis. The methods used to assess MS were very variable, even within the different measurement tools reported. The weighted distribution of ordMS was 17.8%, 21.8%, 31.2%, and 29.3% for levels "poor," "fair," "good," and "excellent," respectively. In comparative studies, statistical differences for analgesia were related to statistical differences for MS (Pvalue was high (0.87). Power to detect a difference in MS between treatment groups was low in general, but it influenced reporting of a significant difference for MS (Pinitial cervical dilatation, and the within-study percentage of nulliparous women. The techniques alternative to epidural analgesia negatively influenced ordMS. A standard and validated tool to assess MS in clinical research on analgesia for labor is still to be developed. Power should be improved by acting on sample sizes or sensitivity of the outcome.

Timing of induction of labor.

Science.gov (United States)

Bacak, Stephen J; Olson-Chen, Courtney; Pressman, Eva

2015-10-01

Determining the optimal timing for induction of labor is critical in minimizing the risks to maternal and fetal health. While data are available to guide us in some clinical situations, such as hypertension and diabetes, many gaps in knowledge still exist in others, including cholestasis of pregnancy, fetal anomalies, and placental abruption. This review of the currently available literature assesses the risks and benefits of preterm and early term induction in a wide variety of maternal and fetal conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

Maternal mortality following caesarean sections.

Science.gov (United States)

Sikdar, K; Kundu, S; Mandal, G S

1979-08-01

A study of 26 maternal deaths following 3647 caesarean sections was conducted in Eden Hospital from 1974-1977. During the time period there were 35,544 births and 308 total maternal deaths (8.74/1000). Indications for Caesarean sections included: 1) abnormal presentation; 2) cephalopelvic disproportion; 3) toxemia; 4) prolonged labor; 5) fetal distress; and 6) post-caesarean pregnancies. Highest mortality rates were among cephalopelvic disproportion, toxemia, and prolonged labor patients. 38.4% of the patients died due to septicaemia and peritonitis, but other deaths were due to preclampsia, shock, and hemorrhage. Proper antenatal care may have prevented anemia and preclampsia and treated other pre-existing or superimposed diseases.

Misguided guidelines for managing labor.

Science.gov (United States)

Cohen, Wayne R; Friedman, Emanuel A

2015-06-01

In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation. Even if they were correct, however, it still does not follow that the ACOG/SMFM guidelines should recommend replacing the coherent system of identifying and managing labor aberrations described by Friedman. That system is grounded in well-established clinical principles based on decades of use and the objectively documented association of some labor abnormalities with poor fetal and maternal outcomes. Recommendations for new clinical management protocols should require the demonstration of superior outcomes through extensive, preferably prospective, assessment. Using untested guidelines for the management of labor may adversely affect women and children. Even if those guidelines were to reduce the currently excessive cesarean delivery rate, the price of that benefit is likely to be a trade-off in harm to parturients and their offspring. The nature and degree of that harm needs to be documented before considering adoption of the guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Cell-free DNA, inflammation, and the initiation of spontaneous term labor.

Science.gov (United States)

Herrera, Christina A; Stoerker, Jay; Carlquist, John; Stoddard, Gregory J; Jackson, Marc; Esplin, Sean; Rose, Nancy C

2017-11-01

Hypomethylated cell-free DNA from senescent placental trophoblasts may be involved in the activation of the inflammatory cascade to initiate labor. To determine the changes in cell-free DNA concentrations, the methylation ratio, and inflammatory markers between women in labor at term vs women without labor. In this prospective cohort study, eligible participants carried a nonanomalous singleton fetus. Women with major medical comorbidity, preterm labor, progesterone use, aneuploidy, infectious disease, vaginal bleeding, abdominal trauma, or invasive procedures during the pregnancy were excluded. Maternal blood samples were collected at 28 weeks, 36 weeks, and at admission for delivery. Total cell-free DNA concentration, methylation ratio, and interleukin-6 were analyzed. The primary outcome was the difference in methylation ratio in women with labor vs without labor. Secondary outcomes included the longitudinal changes in these biomarkers corresponding to labor status. A total of 55 women were included; 20 presented in labor on admission and 35 presented without labor. Women in labor had significantly greater methylation ratio (P = .001) and interleukin-6 (P < .001) on admission for delivery than women without labor. After we controlled for body mass index and maternal age, methylation ratio (adjusted relative risk, 1.38; 95% confidence interval, 1.13 to 1.68) and interleukin-6 (adjusted relative risk, 1.12, 95% confidence interval, 1.07 to 1.17) remained greater in women presenting in labor. Total cell-free DNA was not significantly different in women with labor compared with women without. Longitudinally, total cell-free DNA (P < .001 in labor, P = .002 without labor) and interleukin-6 (P < .001 in labor, P = .01 without labor) increased significantly across gestation in both groups. The methylation ratio increased significantly in women with labor from 36 weeks to delivery (P = .02). Spontaneous labor at term is associated with a greater cell-free DNA

Randomized comparison of oral misoprostol and oxytocin for labor induction in term prelabor membrane rupture.

Science.gov (United States)

Butt, K D; Bennett, K A; Crane, J M; Hutchens, D; Young, D C

1999-12-01

To compare labor induction intervals between oral misoprostol and intravenous oxytocin in women who present at term with premature rupture of membranes. One hundred eight women were randomly assigned to misoprostol 50 microg orally every 4 hours as needed or intravenous oxytocin. The primary outcome measure was time from induction to vaginal delivery. Sample size was calculated using a two-tailed alpha of 0.05 and power of 80%. Baseline demographic data, including maternal age, gestation, parity, Bishop score, birth weight, and group B streptococcal status, were similar. The mean time +/-standard deviation to vaginal birth with oral misoprostol was 720+/-382 minutes compared with 501+/-389 minutes with oxytocin (P = .007). The durations of the first, second, and third stages of labor were similar. There were no differences in maternal secondary outcomes, including cesarean birth (eight and seven, respectively), infection, maternal satisfaction with labor, epidural use, perineal trauma, manual placental removal, or gastrointestinal side effects. Neonatal outcomes including cord pH, Apgar scores, infection, and admission to neonatal intensive care unit were not different. Although labor induction with oral misoprostol was effective, oxytocin resulted in a shorter induction-to-delivery interval. Active labor intervals and other maternal and neonatal outcomes were similar.

Vaginal birth after cesarean: new insights on maternal and neonatal outcomes.

Science.gov (United States)

Guise, Jeanne-Marie; Denman, Mary Anna; Emeis, Cathy; Marshall, Nicole; Walker, Miranda; Fu, Rongwei; Janik, Rosalind; Nygren, Peggy; Eden, Karen B; McDonagh, Marian

2010-06-01

To systematically review the evidence about maternal and neonatal outcomes relating to vaginal birth after cesarean (VBAC). Relevant studies were identified from multiple searches of MEDLINE, DARE, and the Cochrane databases (1980 to September 2009) and from recent systematic reviews, reference lists, reviews, editorials, Web sites, and experts. Inclusion criteria limited studies to the English-language and human studies conducted in the United States and developed countries specifically evaluating birth after previous cesarean delivery. Studies focusing on high-risk maternal or neonatal conditions, including breech vaginal delivery, or fewer than 10 patients were excluded. Poor-quality studies were not included in analyses. We identified 3,134 citations and reviewed 963 articles for inclusion; 203 articles met the inclusion criteria and were quality rated. Overall rates of maternal harms were low for both trial of labor and elective repeat cesarean delivery. Although rare in both elective repeat cesarean delivery and trial of labor, maternal mortality was significantly increased for elective repeat cesarean delivery at 0.013% compared with 0.004% for trial of labor. The rates of maternal hysterectomy, hemorrhage, and transfusions did not differ significantly between trial of labor and elective repeat cesarean delivery. The rate of uterine rupture for all women with prior cesarean was 0.30%, and the risk was significantly increased for trial of labor (0.47% compared with 0.03% for elective repeat cesarean delivery). Perinatal mortality was also significantly increased for trial of labor (0.13% compared with 0.05% for elective repeat cesarean delivery). Overall the best evidence suggests that VBAC is a reasonable choice for the majority of women. Adverse outcomes were rare for both elective repeat cesarean delivery and trial of labor. Definitive studies are lacking to identify patients who are at greatest risk for adverse outcomes.

Disability Insurance Benefits and Labor Supply

OpenAIRE

Jonathan Gruber

2000-01-01

Disability Insurance (DI) is a public program that provides income support to persons unable to continue work due to disability. The difficulty of defining disability, however, has raised the possibility that this program may be subsidizing the early retirement of workers who are not truly disabled. A critical input for assessing the optimal size of the DI program is therefore the elasticity of labor force participation with respect to benefits generosity. Unfortunately, this parameter has be...

[A comparison of maternal psychosocial adaptation among pregnant women with different gravidity].

Science.gov (United States)

Lin, Chun-Ting; Chou, Fan-Hao

2008-12-01

The purpose of this study was to examine women's psychosocial adaptation during different trimesters of pregnancy and to compare maternal psychosocial adaptation between primigravida and multigravida. A cross-sectional and comparative research design was conducted. A convenience sample consisting of 717 pregnant women who made a prenatal clinical visit in southern Taiwan were recruited for this study. The sample included 369 primigravida and 348 multigravida. A Demographic Inventory and the Chinese version of the Prenatal Self-Evaluation Questionnaire (PSEQ) were used to collect data. Results found that (1) the subscale "relationship with husband" for multigravida showed statistically significant differences between the three trimesters, with scores for the third trimester higher than those for the first. Also, multigravida had poorer adaptation on "relationship with husband" in the third trimester than in the first; (2) Analysis of covariance was used to adjust for age, marital status and planned pregnancy, as the distribution of such variables was significantly different between primigravida and multigravida. Results showed significant differences between the two sample groups in terms of PSEQ total scores and scores for "concern for well-being of self and baby," "preparation for labor," and "fear of helplessness, and loss of control in labor." This indicates that primigravida had poorer maternal psychosocial adaptation than multigravida and worried more about "concern for well-being of self and baby," "preparation for labor," and "fear of helplessness, and loss of control in labor." The findings of this study provide evidence-based data to help nursing professionals provide more suitable nursing care to pregnant women. Nurses should assess pregnant women's psychosocial adaptation during their prenatal visiting and then assist them to better understand the process of childbirth and enhance their level of control during labor. In addition, nurses should appraise

Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset

DEFF Research Database (Denmark)

Kjaergaard, Hanne; Olsen, Jørn; Ottesen, Bent

2009-01-01

OBJECTIVE: To estimate the incidence of dystocia among nulliparous women without apparent co-morbidity and to examine maternal and fetal short-term outcomes after dystocia. DESIGN: A multi-center cohort study with prospectively collected data. SETTING: Nine obstetric departments with annual birth...... rates between 850 and 5,400. POPULATION: Low-risk nulliparous women in term spontaneous labor with a singleton fetus in cephalic presentation. METHODS: Follow-up of 2,810 nulliparas using self-administered questionnaires supplemented with clinical records. CRITERIA FOR DYSTOCIA: Cervical dilatation...... OUTCOME MEASURES: Incidences of dystocia, maternal, and fetal outcomes. RESULTS: The cumulative incidence of dystocia was 37% and of the diagnoses 61% were given in the second stage of labor. Women with dystocia treated by augmentation had more cesarean and ventouse deliveries, more often non...

Does delayed pushing in the second stage of labor impact perinatal outcomes?

Science.gov (United States)

Frey, Heather A; Tuuli, Methodius G; Cortez, Sarah; Odibo, Anthony O; Roehl, Kimberly A; Shanks, Anthony L; Macones, George A; Cahill, Alison G

2012-11-01

To estimate maternal, neonatal, and labor outcomes associated with delayed pushing. A retrospective cohort study of all consecutive women admitted to a single institution in labor at term who reached the second stage of labor. Pregnancies with multiple fetuses or major anomalies were excluded. Delayed pushing was defined as initiation of pushing ≥60 minutes after complete dilatation. Primary outcome was mode of delivery. Multivariable logistic regression was used to control for confounding. Of the 5290 women who met inclusion criteria, 471 (8.9%) employed delayed pushing, and 4819 (91.1%) pushed immediately. Delayed pushing was associated with increased rates of cesarean, operative vaginal delivery, maternal fever, and lower arterial cord pH. Duration of the second stage and length of time spent pushing were significantly longer with delayed pushing. Delayed pushing is associated with lower rates of spontaneous vaginal delivery and increased adverse maternal and neonatal outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Is the Bishop-score significant in predicting the success of labor induction in multiparous women?

Science.gov (United States)

Navve, D; Orenstein, N; Ribak, R; Daykan, Y; Shechter-Maor, G; Biron-Shental, T

2017-05-01

To determine whether the Bishop-score upon admission effects mode of delivery, maternal or neonatal outcomes of labor induction in multiparous women. A retrospective study including 600 multiparous women with a singleton pregnancy, 34 gestational weeks and above who underwent labor induction for maternal, fetal or combined indications. Induction was performed with one of three methods- oxytocin, a slow release vaginal prostaglandin E2 insert (10 mg dinoprostone) or a transcervical double balloon catheter. The women were divided into two groups-Bishop-score manual lysis, uterine revision, perineal tear grade 3-4, need for blood transfusions, relaparotomy, prolonged hospitalization) and neonatal outcomes (Apgar score, cord pH, hospitalization in the neonatal intensive care unit, prolonged hospitalization). Both groups had a high rate of vaginal deliveries-93.7% and 94.9%, respectively. There was no difference between the two groups in terms of maternal or neonatal outcomes. Labor induction in multiparous women is safe and successful regardless of the initial Bishop-score. In multiparous women the Bishop-score is not a good predictor for the success of labor induction, nor is it a predictor for maternal of neonatal adverse outcomes and complications.

A Study on Internal Labor Movement and Policy Multiplier in Thailand

Directory of Open Access Journals (Sweden)

Autsawin Suttiwichienchot

2014-12-01

Full Text Available The main objective of this paper is trying to measure the effectiveness of selected supply side and demand side policies on Thai economy by using Computable General Equilibrium (CGE model. We found that there is a special characteristic of the unskilled labor movement among agricultural sector and other sectors in Thailand and this characteristic can represented by Harris-Todaro expected wage equation. Therefore, we developed the CGE model incorporating Harris-Todaro expected wage equilibrium for the labor market. The simulation result shows that, for selected supply side policy, the reduction of switching cost, increasing labor productivity (which are selected supply side policy, increasing in government spending and export promotion (which are selected demand side policy can contribute positive impacts to Thai economy. Interestingly, we found that if both the reduction of switching cost and the increasing labor productivity are implemented together, they will generate even more positive impacts to Thai economy than separately implemented. This finding suggests policy maker should implement both the reduction of switching cost and the increasing labor productivity together in order to gain more benefit to Thai economy. These two policies are supply side policy and related to labor market, thus improving labor market is a great choice for Thailand. Lastly, we found that all policies have the similar non-linear characteristic.

Analysis of preventability of stroke-related maternal death from the nationwide registration system of maternal deaths in Japan.

Science.gov (United States)

Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

2018-08-01

The number of stroke-related maternal deaths is increasing in Japan. We investigated methods to reduce maternal death from stroke. We analyzed stroke-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor, and Welfare from 2010 to 2014 inclusive. A total of 35 cases were identified. The median maternal age was 35 years (range 22-45) and the incidence of stoke in women ≥40 was seven-fold higher than in death from stroke.

Freedom of Movement and Position in the First Stage of Labor

Directory of Open Access Journals (Sweden)

Ana Cristina Canhoto Ferrão

2017-04-01

Full Text Available Objective: To analyse the scientific evidence, in the literature published between january 2007 and february 2016, about the benefits of freedmon of movement and position in the first stage of labor. Method: Review of literature with articles researched in selected databases on plataforms b-On and EBSCOhost, using descriptors: first stage of labour/labor, ambulation, upright positions, benefits and midwife/midwives. Results: Sample with 15 studies that showed, almost unanimously, that the free movement associated with the vertical position provides numerous benefits, especially in the progression of the first stage of labor, reduction of pain and increased maternal satisfaction, in the quality of uterine contractions and maternal-fetal circulation compared to the dorsal lithotomy position. Conclusion: Woman should have the right of choice as to freedom of movement and position during first stage of labor, being informed about the benefits of this intervention by the nurse midwife who cares for her.

Labor market trends for nuclear engineers through 2000

International Nuclear Information System (INIS)

Seltzer, N.; Blair, L.M.; Baker, J.G.

1995-01-01

Throughout most of the 1980s, both private organizations and government agencies were concerned about the availability of an adequate supply of qualified nuclear engineers. This concern was primarily the result of a number of nuclear engineering academic programs being eliminated coupled with a continuous decline in graduate and undergraduate enrollments and degrees. By the early 1990s, the number of degrees and available supply had declined to new lows, but cutbacks in funding for the nuclear weapons program and nuclear energy R ampersand D, and in hiring by the electric utility industry, offset in large measure the declining supply. Recently, concerns about environment and waste management and about nuclear safety have again generated questions about the adequacy of supply of qualified personnel for nuclear energy activities. This report briefly examines the nuclear engineering labor market. Trends in employment, new graduates, job openings, and salaries are reviewed as a basis for understanding the current labor market. This review is then used as a basis for assessing future employment needs and new graduate supply to provide an outlook for future labor market conditions through 2000

Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor.

Science.gov (United States)

Kaur Makkar, Jeetinder; Jain, Kajal; Bhatia, Nidhi; Jain, Vanita; Mal Mithrawal, Sanwar

2015-03-01

To evaluate the efficacy and safety profile of paracetamol in comparison with tramadol for pain relief during active labor. Prospective, randomized, double-blind study. Maternity Wing of the Postgraduate Institute of Medical Education and Research, Chandigarh. Sixty laboring, primiparous, full-term parturients with uncomplicated, singleton pregnancy in spontaneous labor and cervical dilatation of 3-5 cm. Parturients were randomized into 2 groups to receive either 1 mg/kg of tramadol intramuscularly (group T; n = 29) or 1 g of paracetamol intravenously (group P; n = 30). Same doses of the drugs were repeated after 4 hours of initial dose. Primary outcome of the study was to assess the analgesic efficacy of the 2 drugs as measured by visual analog scale (VAS) score. Secondary outcome recorded was duration of labor, presence of any maternal, or fetal adverse events during the study. Both the groups showed comparable VAS scores at all times of observation. Lower mean VAS scores were reported in both the groups till 120 minutes only. The duration of first stage of labor was shorter in group P (248.00 ± 98.171 vs 340.63 ± 111.592 minutes; P = .003). The duration of second stage of labor was comparable between the 2 groups. Higher incidence of maternal side effects such as nausea/vomiting and sedation was associated with the use of tramadol. Neonatal outcome was comparable. Intravenous paracetamol provides comparable analgesia as intramuscular tramadol during active labor. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of efficacy of bupivacaine and fentanyl with bupivacaine and sufentanil for epidural labor analgesia

Directory of Open Access Journals (Sweden)

Kalra Sumit

2010-01-01

Full Text Available Objectives: A study to compare the efficacy between fentanyl and sufentanil combined with low concentration (0.0625% of bupivacaine for epidural labor analgesia in laboring women. Materials and Methods: Fifty full term parturients received an initial bolus dose of a 10 ml solution containing 0.125% bupivacaine. The patients were randomly divided into two: group F received 0.0625% bupivacaine with 2.5 mcg/ml fentanyl and group S received 0.0625% bupivacaine with 0.25 mcg/ml sufentanil. Verbal analogue pain scores, need of supplementary/rescue boluses dose of bupivacaine consumed, mode of delivery, maternal satisfaction, and neonatal Apgar scores were recorded. No significant difference was observed between both groups. Results: Both the groups provided equivalent labor analgesia and maternal satisfaction. The chances of cesarean delivery were also not increased in any group. No difference in the cephalad extent of sensory analgesia, motor block or neonatal Apgar score were observed. Although mean pain scores throughout the labor and delivery were similar in both groups, more patients in fentanyl group required supplementary boluses though not statistically significant. Conclusion: We conclude that both 0.0625% bupivacaine-fentanyl (2.5 μg/ml and 0.0625% bupivacaine-sufentanil (0.25 μg/ml were equally effective by continuous epidural infusion in providing labor analgesia with hemodynamic stability achieving equivalent maternal satisfaction without serious maternal or fetal side effects. We found that sufentanil was 10 times more potent than fentanyl as an analgesic for continuous epidural labor analgesia.

Maternal obesity and obstetric outcomes in a tertiary referral center

Directory of Open Access Journals (Sweden)

Gitana Ramonienė

2017-01-01

Conclusions: Maternal obesity is significantly associated with an increased risk of gestational hypertension, preeclampsia, gestational diabetes, dystocia, labor induction, failed induction of labor, large-for-gestational-age newborns and cesarean delivery.

Systematic Review of Hydrotherapy Research: Does a Warm Bath in Labor Promote Normal Physiologic Childbirth?

Science.gov (United States)

Shaw-Battista, Jenna

Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices. Studies examined more than 30 fetal and neonatal outcomes, and no benefit or harm of hydrotherapy was identified. Two trials had anomalous findings of increased newborn resuscitation or nursery admission after hydrotherapy, which were not supported by additional results in the same or other studies. Review findings demonstrate that intrapartum immersion hydrotherapy is a helpful and benign practice. Hydrotherapy facilitates physiologic childbirth and may increase satisfaction with care. Maternity care providers are recommended to include hydrotherapy among routine labor pain management options and consider immersion to promote progress of normal or protracted labor, particularly among women with preferences to avoid obstetric medications and procedures.

Labor-force participation patterns of older self-employed workers.

Science.gov (United States)

Quinn, J F

1980-04-01

Self-employed persons work in a less constrained environment than do most wage-and-salary employees. Generally they are not subject to compulsory retirement nor are they affected by institutional rules concerning labor supply. Data from the 1969 and 1971 interviews of the Retirement History Study show that the labor supply and retirement patterns of the self-employed are distinct from those of other workers. The self-employed (espeically "career" self-employed) nearing retirement age are less likely to be out of the labor force, and those who continue in the labor force have a wider variation in the number of hours worked per year. Downward flexibility in hours (the option for gradual retirement) may be an extremely valuable aspect of self-employed status, and one wonders whether other older workers would also choose this pattern if more flexible opportunities were available. Despite these differences, labor-supply decisions of the self-employed are found to be influenced by many of the same factors that affect the rest of the workforce--health, eligibility for social security and pension benefits, the wage rate, and the flow of asset.

Risk of labor dystocia increases with maternal age irrespective of parity: a population-based register study.

Science.gov (United States)

Waldenström, Ulla; Ekéus, Cecilia

2017-09-01

Advanced maternal age is associated with labor dystocia (LD) in nulliparous women. This study investigates the age-related risk of LD in first, second and third births. All live singleton cephalic births at term (≥ 37 gestational weeks) recorded in the Swedish Medical Birth Register from 1999 to 2011, except elective cesarean sections and fourth births and more, in total 998 675 pregnancies, were included in the study. LD was defined by International Classification of Diseases, version 10 codes (O620, O621, O622, O629, O630, O631 and O639). In each parity group risks of LD at age 25-29 years, 30-34 years, 35-39 years and ≥ 40 years compared with age < 25 years were investigated by logistic regression analyses. Analyses were adjusted for year of delivery, education, country/region of birth, smoking in early pregnancy, maternal height, body mass index, week of gestation, fetal presentation and infant birthweight. Rates of LD were 22.5%, 6.1% and 4% in first, second and third births, respectively. Adjusted odd ratios (OR) for LD increased progressively from the youngest to the oldest age group, irrespective of parity. At age 35-39 years the adjusted OR (95% CI) was approximately doubled compared with age 25 and younger: 2.13 (2.06-2.20) in first birth; 2.05 (1.91-2.19) in second births; and 1.81 (1.49-2.21) in third births. Maternal age is an independent risk factor for LD in first, second and third births. Although age-related risks by parity are relatively similar, more nulliparous than parous women will be exposed to LD due to the higher rate. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Impact of the mode of delivery on maternal and neonatal outcome in spontaneous-onset breech labor at 32+0-36+6 weeks of gestation: A retrospective cohort study.

Science.gov (United States)

Toivonen, Elli; Palomäki, Outi; Korhonen, Päivi; Huhtala, Heini; Uotila, Jukka

2018-03-30

To compare neonatal and maternal outcomes in spontaneously onset preterm breech deliveries after trial of labor (BTOL) and intended cesarean section (BCS), and between BTOL and vertex control deliveries, in singleton fetuses at 32 +0 -36 +6  weeks of gestation. Retrospective single center cohort study in a Finnish University Hospital including all spontaneous-onset preterm breech deliveries with 32 completed gestational weeks in 2003-2015. The study population comprised a total of 176 preterm breech and 103 vertex control deliveries, matched by gestational age and whether the mother had given birth vaginally before or not. Infants with severe malformations and antepartum fetal distress were excluded. Subgroup analyses were made in two cohorts according to gestational age. Main outcome measures were maternal and neonatal mortality and morbidity, low cord pH and Apgar score. No mortality was observed, and severe morbidity was rare. No difference in incidence of low cord pH or five-minute Apgar score was observed between the groups. Apgar scores at the age of one minute were comparable in the breech groups but more often low in the BTOL group compared to the vertex control group. 16.5% of neonates in the BTOL group, 23.3% in the BCS group and 7.8% in the vertex group needed intensive care. In logistic regression analysis, lower gestational age and being small for gestational age were associated with the need for neonatal intensive care. Being allowed a trial of labor was not associated with the need for neonatal intensive care. Maternal morbidity was similar across the groups, but median blood loss was more pronounced in the BCS group compared to the BTOL group. In breech deliveries at 32 +0 -36 +6 gestational weeks, trial of labor did not increase neonatal morbidity compared to intended cesarean delivery. Infants born after a trial of labor in breech presentation display low one-minute Apgar score and need intensive care more often compared to vertex controls

Relationship Between Advanced Maternal Age, Hiesho (Sensitivity to Cold) and Abnormal Delivery in Japan

Science.gov (United States)

Nakamura, Sachiyo; Horiuchi, Shigeko

2013-01-01

Background: In Japan, the proportion of women aged 35 and older giving birth has greatly increased in recent years, and maternal age is continuing to increase. Advanced maternal age is a risk factor for abnormal delivery, as is hiesho (sensitivity to cold). Research Question: This study aimed to assess whether advanced maternal age and hiesho precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. Method: The study design was a descriptive comparative study with a retrospective cohort group design. Subjects in this study were 2,810 Japanese women in hospital after childbirth. The research methods employed were a paper questionnaire and extraction of data from medical records. Results: Comparing the rate of occurrence of abnormal delivery among women aged 35 to 39 according to whether or not they had hiesho, results were premature delivery OR: 3.51 (95% CI: 1.66-7.43), premature rupture of membranes OR: 1.25 (95% CI: 0.90-1.74), weak labor pains OR: 2.94 (95% CI: 1.65-5.24), prolonged labor OR: 2.56 (95% CI: 1.23-5.26), and atonic bleeding, OR: 1.65 (95% CI: 0.14-2.40) when hiesho was present. Among women aged 40 and over, results were premature delivery OR: 5.09 (95% CI: 1.16-22.20), premature rupture of membranes OR: 1.60 (95% CI: 0.73-3.46), weak labor pains OR: 7.02 (95% CI: 1.56-31.55), prolonged labor OR:7.19 (95% CI: 1.49-34.60) and atonic bleeding OR: 2.00 (95% CI: 0.64-6.23). Conclusions: Regardless of maternal age, the presence of hiesho is a risk factor that can precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. Furthermore, hiesho coupled with advanced maternal age increases the incidence of premature delivery, weak labor pains and prolonged labor. PMID:24062862

Delayed versus immediate pushing in second stage of labor.

Science.gov (United States)

Kelly, Mary; Johnson, Eileen; Lee, Vickie; Massey, Liz; Purser, Debbie; Ring, Karen; Sanderson, Stephanye; Styles, Juanita; Wood, Deb

2010-01-01

Comparison of two different methods for management of second stage of labor: immediate pushing at complete cervical dilation of 10 cm and delayed pushing 90 minutes after complete cervical dilation. This study was a randomized clinical trial in a labor and delivery unit of a not-for-profit community hospital. A sample of 44 nulliparous mothers with continuous epidural anesthesia were studied after random assignment to treatment groups. Subjects were managed with either immediate or delayed pushing during the second stage of labor at the time cervical dilation was complete. The primary outcome measure was the length of pushing during second stage of labor. Secondary outcomes included length of second stage of labor, maternal fatigue and perineal injuries, and fetal heart rate decelerations. Two-tailed, unpaired Student's t-tests and Chi-square analysis were used for data analysis. Level of significance was set at p pushing; N = 16 delayed pushing). The delayed pushing group had significantly shorter amount of time spent in pushing compared with the immediate pushing group (38.9 +/- 6.9 vs. 78.7 +/- 7.9 minutes, respectively, p = .002). Maternal fatigue scores, perineal injuries, and fetal heart rate decelerations were similar for both groups. Delaying pushing for up to 90 minutes after complete cervical dilation resulted in a significant decrease in the time mothers spent pushing without a significant increase in total time in second stage of labor.In clinical practice, healthcare providers sometimes resist delaying the onset of pushing after second stage of labor has begun because of a belief it will increase labor time. This study's finding of a 51% reduction in pushing time when mothers delay pushing for up to 90 minutes, with no significant increase in overall time for second stage of labor, disputes that concern.

Efficacy and Safety of Remifentanil as an Alternative Labor Analgesic

Directory of Open Access Journals (Sweden)

Sandeep Devabhakthuni

2013-01-01

Full Text Available The objective of this review was to evaluate the clinical efficacy and safety of remifentanil in the management of labor pain. Although neuraxial analgesia is the best option during labor, alternative analgesic options are needed for patients with contraindications. Using a systematic literature search, clinical outcomes of remifentanil for labor pain have been summarized. Also, comparisons of remifentanil to other options including meperidine, epidural analgesia, fentanyl, and nitrous oxide are provided. Based on the literature review, remifentanil is associated with high overall maternal satisfaction and favorable side-effect profile. However, due to the low reporting of adverse events, large, randomized controlled trials are needed to evaluate maternal and neonatal safety adequately and determine the optimal dosing needed to provide effective analgesia. While remifentanil is a feasible alternative for patients who cannot or do not want to receive epidural analgesia, administration should be monitored closely for potential adverse effects.

Risk Factors for Cesarean Delivery following Labor Induction in Multiparous Women

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Corine J. Verhoeven

2013-01-01

Full Text Available Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the data of two successful inductions as controls. Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position. Results. Between 1995 and 2010, labor was induced in 2548 parous women, of whom 80 had a cesarean delivery (3%. These 80 cases were compared to the data of 160 parous women with a successful induction of labor. In the multivariate analysis history of preterm delivery (odds ratio (OR 5.3 (95% CI 1.1 to 25, maternal height (OR 0.87 (95% CI 0.80 to 0.95 and dilatation at the start of induction (OR 0.43 (95% CI 0.19 to 0.98 were associated with failed induction. Conclusion. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction.

Outcomes of Operative Vaginal Delivery during Trial of Labor after Cesarean Delivery.

Science.gov (United States)

Brock, Clifton O; Govindappagari, Shravya; Gyamfi-Bannerman, Cynthia

2017-07-01

Objective  The objective of this study is to determine the maternal and neonatal morbidity associated with attempting operative vaginal delivery (OVD) compared with the alternative of a laboring repeat cesarean delivery (LRCD) in women attempting a trial of labor after cesarean delivery (TOLAC). Methods  This is a secondary analysis of a multicenter prospective study designed to assess perinatal outcomes of OVD in women with a prior uterine scar. The study includes women who attempted TOLAC and reached +2 station with a fully dilated cervix. Composites on neonatal and maternal morbidity were compared between women in whom OVD was attempted and those who underwent LRCD by fitting multivariate logistic regression models. Results  In total, 6,489 women attempting TOLAC reached 2+ station with a fully dilated cervix. Of these, 5,640 (86.9%) had a spontaneous vaginal delivery, 762 (11.7%) underwent attempted OVD, and 87 (1.3%) had an LRCD. Compared with attempting OVD, LRCD was associated with greater neonatal morbidity (odds ratio [OR]: 2.41; 95% confidence interval [CI]: 1.13-5.15) and less maternal morbidity (OR: 0.28; 95% CI: 0.14-0.55). Maternal morbidity of OVD is driven by perineal injury. Conclusion  In laboring women with a previous uterine scar, attempting OVD is associated with greater maternal and less neonatal morbidity than LRCD. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of delivery on maternal & neonatal irisin levels in normal and preeclamptic pregnant women.

Science.gov (United States)

Foda, Ashraf A; Foda, Engy A

2017-10-01

The aim of this work was to measure the irisin levels in maternal and umbilical cord serums at cesarean section and vaginal delivery. This is a case-control study conducted at the Obstetric Department of the Mansoura University Hospital, Mansoura University, Egypt. The 150 nulliparous cases were divided into three groups. Serum irisin concentrations were assayed by enzyme-linked immunosorbent assay (ELISA) method. Unpaired t-test and correlation were done by using the Statistical Package for Social Scientists (SPSS). The maternal irisin levels in cases with mild preeclampsia were found to be significantly lower than that of the normal cases. In cases with mild preeclampsia, the maternal irisin levels early in labor for vaginal deliveries were significantly higher than that during cesarean section. The maternal irisin levels after vaginal deliveries were significantly higher than the levels early in labor. The maternal serum irisin was a significantly correlated with the duration of the first stage. The umbilical cord serum irisin levels were significantly correlated with the neonatal weight and with the duration of the first stage of labor. Labor is a strong stimulus to the release of irisin into the maternal and fetal circulations. Neonatal serum irisin levels are positively correlated with the birth weight and with the duration of the first stage. The neonatal birth weight and the duration of the first stage of labor are positively correlated with the umbilical cord serum irisin levels. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Effects of aromatherapy with Rosa damascena on nulliparous women's pain and anxiety of labor during first stage of labor.

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Hamdamian, Sepideh; Nazarpour, Soheila; Simbar, Masoumeh; Hajian, Sepideh; Mojab, Faraz; Talebi, Atefeh

2018-03-01

Reducing labor pain and anxiety is one of the most important goals of maternity care. This study aimed to assess the effects of aromatherapy with Rosa damascena on pain and anxiety in the first stage of labor among nulliparous women. This was a randomized clinical trial of 110 nulliparous women. The eligible participants were randomly assigned to two groups of aromatherapy and control in an Iranian maternity hospital. The participants received 0.08 mL of Rosa damascena essence in the aromatherapy group and 0.08 mL of normal saline in the control group, every 30 min. Pain was measured 3 times, once each at three stages of cervical dilation (4-5, 6-7, and 8-10 cm). Anxiety was measured twice, once each at two stages of cervical dilation (4-7 and 8-10 cm). The tools for data collection were the Spielberger anxiety questionnaire, numerical pain rating scale, demographic and obstetric questionnaire, and an observational checklist. Data analyses included the t-test, Mann-Whitney U test and Chi-square test. Severity of labor pain and severity of anxiety were used as primary outcome measures. Labor and delivery characteristics (including number of contractions, duration of contractions in second stage, Bishop score, augmentation by oxytocin, Apgar score, and mode of delivery), demographic characteristics, and fertility information were used as secondary outcome measures. Pain severity in the group receiving aromatherapy with R. damascena was significantly lower than in the control group after treatment at each pain assessment (cervical dilation of 4-5, 6-7, and 8-10 cm; P labor. Aromatherapy with R. damascena is a convenient and effective method for pain and anxiety reduction during the first stage of labor. Iranian Registry of Clinical Trial: IRCT201306258801N3. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

Toward an Understanding of Reference-Dependent Labor Supply

DEFF Research Database (Denmark)

Andersen, Steffen; Brandon, Alec; Gneezy, Uri

Perhaps the most powerful form of framing arises through reference dependence, wherein choices are made recognizing the starting point or a goal. In labor economics, for example, a form of reference dependence, income targeting, has been argued to represent a serious challenge to traditional...

Labor Market Trends for Health Physicists through 2005

International Nuclear Information System (INIS)

1997-10-01

This report reviews past, current, and projected future labor market trends for health physicists through 2005. Information is provided on degrees granted, available supply of new graduates, employment, job openings for new graduates, and salaries. Job openings for new graduates are compared to the available supply of new graduates to assess relative job opportunities in the health physics labor market. The report is divided into three sections: trends during 1983-1993, trends during the mid-1990s, and projected trends for 1997 through 2005

Obstetrical and perinatal outcomes in patients with or without obstetric analgesia during labor

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Piedrahíta-Gutiérrez, Dany Leandro

2016-07-01

Full Text Available Objective: To describe and compare the obstetric and perinatal outcomes in patients with or without obstetric analgesia during labor, and to determine whether such analgesia is associated with adverse maternal or perinatal outcomes. Methodology: Comparative, retrospective, descriptive study, between January and November 2014, that included 502 healthy patients with normal pregnancies, out of which 250 received obstetric analgesia. The groups were compared as to maternal and perinatal outcomes. Results: Young, single and nulliparous mothers predominated; delivery was vaginal in 86 % of the cases, and by caesarean section in 14 %. Obstetric analgesia was associated with longer duration of the second stage of labor, instrumental delivery and cesarean section due to arrest of dilatation or fetal bradycardia; however, it was not related with higher incidence of postpartum hemorrhage or adverse perinatal outcomes such as meconium-stained amniotic fluid, Apgar under 5 at one minute or under 7 at 5 minutes, the need for neonatal resuscitation or for admission to NICU. Conclusion: Obstetric analgesia increases the duration of the second stage of labor and can increase the rate of caesarean sections and instrumental delivery, but it is not associated with adverse maternal or perinatal outcomes. Therefore, its use in labor is justified.

The orgasmic history of oxytocin: Love, lust, and labor

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Navneet Magon

2011-01-01

Full Text Available Oxytocin has been best known for its roles in female reproduction. It is released in large amounts during labor, and after stimulation of the nipples. It is a facilitator for childbirth and breastfeeding. However, recent studies have begun to investigate oxytocin′s role in various behaviors, including orgasm, social recognition, bonding, and maternal behaviors. This small nine amino acid peptide is now believed to be involved in a wide variety of physiological and pathological functions such as sexual activity, penile erection, ejaculation, pregnancy, uterine contraction, milk ejection, maternal behavior, social bonding, stress and probably many more, which makes oxytocin and its receptor potential candidates as targets for drug therapy. From an innocuous agent as an aid in labor and delivery, oxytocin has come a long way in being touted as the latest party drug. The hormone of labor during the course of the last 100 years has had multiple orgasms to be the hormone of love. Many more shall be seen in the times to come!

[Management of threatening preterm labor with intact membranes: indications for antibiotics].

Science.gov (United States)

Winer, N

2002-11-01

To analyse the benefits and disadvantages of systematic antibiotic therapy in patient presenting a preterm labor with intact membranes. We reviewed French and English reports on Medline using to the following key words: "antibiotic therapy and preterm labor, preterm labor, streptococcus B, vaginose, mycoplasma, antenatal infection". The systematic prescription of antibiotics is not recommended for patients presenting preterm labor who have intact membranes and no symptoms of infection. The benefit of antibiotics is small and shows a tendency to prolong the pregnancy and the reduction of maternal infection. No benefit has been shown for neonatal results. When early-onset neonatal sepsis develops in a case in which antepartum chemoprophylaxis was used, the isolated bacteria will present an increasing risk of bacterial drug resistance. Local treatment (cream or pessary) do not belong in the treatment of threatening preterm labor and are not recommended for the prevention of prematurity or materno fetal infection. Risk groups of patients who present a positive vaginal colonization are subject to discussion. Studies do not allow us to ascertain that antibiotics have a beneficial effect on prematurity in these groups. Antibiotics are recommended for the treatment of asymptomatic bacteriuria. This treatment reduces prematurity and maternal infections. Despite poor consensus criteria, if threatening preterm labor is associated with a bacteriuria, experts usually recommend treatment.

Fetomaternal outcome in obstructed labor in a peripheral tertiary care hospital

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Sabyasachi Mondal

2013-01-01

Full Text Available Background: Obstructed labor is the leading cause of hospitalization, comprising up to 39% of all obstetric patients in developing countries. It is the single most important cause of maternal death and is one of the three leading causes of perinatal mortality. Objectives: To study the different parameters of obstructed labor cases, like its frequency, etiology, management, and complications. This will help to formulate a positive strategy to prevent obstructed labor and its consequences. Materials and Methods: 313 patients admitted with features of obstructed labor were studied. By clinical examination, diagnosis of cephalopelvic disproportion, malposition, malpresentation, obstruction in birth canal, overdistended bladder, hematuria, rupture of uterus, and supermolding of fetal head was done. Screening for maternal exhaustion, dehydration, genital sepsis, pyrexia, rupture of uterus, postpartum hemorrhage, vesico-vaginal fistula, and shock was carried out. Deaths as a consequence of obstructed labor were noted. Diagnosis of asphyxiated or dead fetus or neonatal death was done. Mode of delivery and time interval between referral, admission, intervention done, and related feto-maternal outcome were noted. Statistical analysis was done using Epi Info software. Results: Majority of the patients (87.86% were from low socioeconomic group, 88.82% were from rural areas, 16.16% were illiterate, and 27.79% were unbooked. The commonest cause of obstructed labor was cephalopelvic disproportion (55.59%. Other causes were malposition (23%, malpresentation (18.21%, fetal congenital abnormality (1.28%, myoma (0.32%, and non-dilatation of cervix (1.60%. The commonest mode of delivery was cesarean section (85.94%. Instrumental deliveries formed 9.58%. Destructive operation was done in 1.92% cases. Rupture uterus was seen in 8 (2.56% cases, out of which hysterectomy was done in 5 cases and repair in 3 cases. The common maternal complications were sepsis [pyrexia

Maritime Policy and the Seafaring Labor Market

DEFF Research Database (Denmark)

Lobrigo, Enrico; Pawlik, Thomas

2015-01-01

The reports highlighting the foreseen lack of merchant marine officers for the expanding world’s fleet calls for a review in evaluating the impact of maritime policy in the seafaring labor market. This paper aims to clarify the particular characteristics of the seafaring labor market and how it can...... be shaped by specific maritime labor policies. The seafaring labor market in the Philippines, Poland, Germany, and Brazil as well as the general maritime labor policies in these countries is discussed. The focus on these countries leads to a comparative observation of maritime labor as a factor...... of production in an exporting market, in an importing market, and in a closed market, respectively, as shaped by various relevant maritime policies. Since a global policy that can regulate the maritime labor market does not exist, the trend on maritime labor supply is dynamic on a per country basis wherein crew...

[Miserable labor pain? Myths and nursing care].

Science.gov (United States)

Gau, Meei-Ling; Kao, Chien-Huei

2013-12-01

Pain is a common, normal, and healthy physical phenomenon during childbirth. However, widely held public and clinical perspectives treat pain as a pathologic process and consider labor pain in a negative context. These perspectives ignore the positive effects of pain in the domains of protection, new life, expectation, purpose, preparation, and progression. The pain interpretation and pain experience of new mothers deeply impact their mental health, maternal-infant relationship, and transition to motherhood. This paper introduces the common myths related to labor pain, the three stages of pain transmission, and the current approaches to pain management. The authors hope childbirth caregivers may accept labor pain as a meaningful, pleasant, and positive gift, which is the first and most important step toward effective pain management.

Maternal Confidence for Physiologic Childbirth: A Concept Analysis.

Science.gov (United States)

Neerland, Carrie E

2018-06-06

Confidence is a term often used in research literature and consumer media in relation to birth, but maternal confidence has not been clearly defined, especially as it relates to physiologic labor and birth. The aim of this concept analysis was to define maternal confidence in the context of physiologic labor and childbirth. Rodgers' evolutionary method was used to identify attributes, antecedents, and consequences of maternal confidence for physiologic birth. Databases searched included Ovid MEDLINE, CINAHL, PsycINFO, and Sociological Abstracts from the years 1995 to 2015. A total of 505 articles were retrieved, using the search terms pregnancy, obstetric care, prenatal care, and self-efficacy and the keyword confidence. Articles were identified for in-depth review and inclusion based on whether the term confidence was used or assessed in relationship to labor and/or birth. In addition, a hand search of the reference lists of the selected articles was performed. Twenty-four articles were reviewed in this concept analysis. We define maternal confidence for physiologic birth as a woman's belief that physiologic birth can be achieved, based on her view of birth as a normal process and her belief in her body's innate ability to birth, which is supported by social support, knowledge, and information founded on a trusted relationship with a maternity care provider in an environment where the woman feels safe. This concept analysis advances the concept of maternal confidence for physiologic birth and provides new insight into how women's confidence for physiologic birth might be enhanced during the prenatal period. Further investigation of confidence for physiologic birth across different cultures is needed to identify cultural differences in constructions of the concept. © 2018 by the American College of Nurse-Midwives.

Adjustment Costs, Firm Responses, and Micro vs. Macro Labor Supply Elasticities: Evidence from Danish Tax Records*

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Chetty, Raj; Friedman, John N.; Olsen, Tore; Pistaferri, Luigi

2011-01-01

We show that the effects of taxes on labor supply are shaped by interactions between adjustment costs for workers and hours constraints set by firms. We develop a model in which firms post job offers characterized by an hours requirement and workers pay search costs to find jobs. We present evidence supporting three predictions of this model by analyzing bunching at kinks using Danish tax records. First, larger kinks generate larger taxable income elasticities. Second, kinks that apply to a larger group of workers generate larger elasticities. Third, the distribution of job offers is tailored to match workers' aggregate tax preferences in equilibrium. Our results suggest that macro elasticities may be substantially larger than the estimates obtained using standard microeconometric methods. PMID:21836746

Vaginal delivery among women who underwent labor induction with vaginal dinoprostone (PGE2) insert: a retrospective study of 1656 women in China.

Science.gov (United States)

Zhao, Lei; Lin, Ying; Jiang, Ting-Ting; Wang, Ling; Li, Min; Wang, Ying; Sun, Guo-Qiang; Xiao, Mei

2017-12-21

This study aimed to qualify relevant factors for vaginal delivery among women who underwent labor induction with vaginal dinoprostone (PGE2) insert in a Chinese tertiary maternity hospital. A retrospective study was conducted in Hubei Maternal and Child Health Hospital. A total of 1656 pregnancies that underwent labor induction with vaginal dinoprostone insert between January and August 2016 were finally included in this study. Data were analyzed using univariate and multivariable regression modeling. Of 1656 women with PGE2-induced labor at term, 396 (23.91%) gave birth by cesarean section, 1260 (76.09%) had a vaginal delivery among which 921 (55.61%) delivered vaginally within 24 h. Multivariable regression analysis showed that maternal age (p labor induction, which was markedly higher than the overall annual vaginal delivery rate of 65.1% in China during 2014. Maternal age, parity, baseline fetal heart rate, and birth weight were significant factors for vaginal delivery. This study enables us to better understand the efficiency of dinoprostone and the potential predictors of vaginal delivery in dinoprostone-induced labor, which may be helpful to guide the clinical use of dinoprostone and therefore provide better service clinically.

Labor tax reform and equilibrium unemployment : a search and matching approach

NARCIS (Netherlands)

Heijdra, Ben J.; Ligthart, Jenny E.

2004-01-01

The paper studies simple strategies of labor tax reform in a search and matching model of the labor market featuring endogenous labor supply. Changing the composition of the tax wedge---that is, reducing a payroll tax and increasing a progressive wage tax such that the marginal tax wedge remains

Labor Tax Reform and Equilibrium Unemployment : A Search and Matching Approach

NARCIS (Netherlands)

Heijdra, B.J.; Ligthart, J.E.

2004-01-01

The paper studies simple strategies of labor tax reform in a search and matching model of the labor market featuring endogenous labor supply.Changing the composition of the tax wedge|that is, reducing a payroll tax and increasing a progressive wage tax such that the marginal tax wedge remains

Labor stimulation with oxytocin: effects on obstetrical and neonatal outcomes

Directory of Open Access Journals (Sweden)

Pedro Hidalgo-Lopezosa

Full Text Available Abstract Objective: to evaluate the effects of labor stimulation with oxytocin on maternal and neonatal outcomes. Method: descriptive and analytical study with 338 women who gave birth at a tertiary hospital. Obstetric and neonatal variables were measured and compared in women submitted and non-submitted to stimulation with oxytocin. Statistics were performed using Chi-square test, Fisher exact test, Student t-test; and crude Odds Ratio with 95% confidence interval were calculated. A p < 0.05 was considered statistically significant. Results: stimulation with oxytocin increases the rates of cesarean sections, epidural anesthesia and intrapartum maternal fever in primiparous and multiparous women. It has also been associated with low pH values of umbilical cord blood and with a shorter duration of the first stage of labor in primiparous women. However, it did not affect the rates of 3rd and 4th degree perineal lacerations, episiotomies, advanced neonatal resuscitation, 5-minute Apgar scores and meconium. Conclusion: stimulation with oxytocin should not be used systematically, but only in specific cases. These findings provide further evidence to health professionals and midwives on the use of oxytocin during labor. Under normal conditions, women should be informed of the possible effects of labor stimulation with oxytocin.

Contemporary second stage labor patterns in Taiwanese women with normal neonatal outcomes.

Science.gov (United States)

Hung, Tai-Ho; Chen, Szu-Fu; Lo, Liang-Ming; Hsieh, T'sang-T'ang

2015-08-01

To compare the duration of second stage labor among modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes and women who delivered during the early 1990 s. Data were collected from women who underwent spontaneous labor and vaginally delivered cephalic singleton fetuses with normal neonatal outcomes at the Taipei Chang Gung Memorial Hospital, Taipei, Taiwan from 1991-1995 (Cohort 1, n = 10,721) and 2010-2014 (Cohort 2, n = 3734). We calculated the median duration and 95th percentiles of second stage labor. The women were stratified according to analgesia and parity. Multiple linear regression analysis was used to determine the association between the maternal/pregnancy characteristics and second stage labor duration. The median second stage labor duration was significantly longer for Cohort 2 than for Cohort 1. For nulliparous women, the 95th percentile second stage labor thresholds were 255 minutes and 152 minutes (Cohort 2) and 165 minutes and 107 minutes (Cohort 1) for women with and without epidural analgesia, respectively. For multiparous women, the 95th percentile second stage labor thresholds were 136 minutes and 43 minutes (Cohort 2) and 125 minutes and 39 minutes (Cohort 1) for women with and without epidural analgesia, respectively. Birth weight, maternal age at delivery, and time period (2010-2014 vs. 1991-1995) were significant factors associated with the duration of second stage labor. Modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes experienced longer second stage labors than women 25 years ago. The 95th percentile thresholds differed between nulliparous and multiparous women with and without epidural analgesia. Copyright © 2015. Published by Elsevier B.V.

Diminishing availability of trial of labor after cesarean delivery in New Mexico hospitals.

Science.gov (United States)

Leeman, Lawrence M; Beagle, Melissa; Espey, Eve; Ogburn, Tony; Skipper, Betty

2013-08-01

To examine the availability of trial of labor after cesarean delivery (TOLAC) in New Mexico from 1998 to 2012 and maternity care providers' perception of barriers to TOLAC. Hospital maternity unit directors were surveyed regarding TOLAC availability from 1998 to 2012. Maternity care providers (obstetrician-gynecologists, certified nurse-midwives, and family medicine physicians) were surveyed in 2008 regarding resources and barriers to providing TOLAC and emergency cesarean delivery. Trial of labor after cesarean delivery was available in 100% of counties with maternity care units in 1998 (22/22); by 2008, availability decreased to 32% (7/22). After changes in national guidelines, availability increased slightly to 9 of 22 (41%) in 2012. Barriers to TOLAC included anesthesia availability (88%), hospital and medical malpractice policies (80%), malpractice cost (69%), and obstetric surgeon availability (59%). In hospitals without TOLAC services, 73% of maternity care providers indicated a surgeon could be present in the hospital within 20 minutes of the emergency delivery decision; only 43% indicated obstetric anesthesia personnel could be present within 20 minutes (PMexico has decreased dramatically. Policy changes are needed to support TOLAC access in rural and community hospitals. III.

Effects of maternal mortality on gross domestic product (GDP) in the ...

African Journals Online (AJOL)

Effects of maternal mortality on gross domestic product (GDP) in the WHO ... capital (K), educational enrolment (EN) and exports (X) had a positive sign; while labor ... Maternal mortality of a single person was found to reduce per capita GDP by ...

[Family planning can reduce maternal mortality].

Science.gov (United States)

Potts, M

1987-01-01

Although the maternal mortality rate receives no newspaper headlines, the number of mothers dying throughout the world is equivalent to a full jumbo jet crashing every 5 hours. Population surveys carried out between 1981-83 by Family Health International indicated maternal mortality rates of 1.9/1000 live births in Menoufia, Egypt, and 7.2/1000 in Bali, Indonesia. 20-25% of all deaths in women aged 15-49 were directly related to pregnancy and delivery, compared to 1% in western countries where there is better prenatal care, medical assistance in almost all deliveries, and elimination of most high risk pregnancies through voluntary fertility control. Maternal mortality could be controlled by teaching traditional midwives to identify high risk patients at the beginning of their pregnancies and to refer them to appropriate health services. Maternal survival would also be improved if all women were in good health at the beginning of pregnancy. Families should be taught to seek medical care for the mother in cases of prolonged labor; many women arrive at hospitals beyond hope of recovery after hours or days of futile labor. Health policy makers should set new priorities. Sri Lanka, for example, has a lower per capita income than Pakistan, but also a lower maternal mortality rate because of better use of family planning services, more emphasis on prenatal care, and a tradition of care and attention on the part of the public health services.

Labor induction and cesarean delivery: A prospective cohort study of first births in Pennsylvania, USA.

Science.gov (United States)

Kjerulff, Kristen H; Attanasio, Laura B; Edmonds, Joyce K; Kozhimannil, Katy B; Repke, John T

2017-09-01

Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. A prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted. We used nested logistic regression models and multiple mediational analyses to investigate the role of three groups of variables in explaining the association between labor induction and unplanned cesarean delivery-the confounders of maternal characteristics and indications for induction, and the mediating (intrapartum) factors-including cervical dilatation, labor augmentation, epidural analgesia, dysfunctional labor, dystocia, fetal intolerance of labor, and maternal request of cesarean during labor. More than a third of the women were induced (34.3%) and 24.8% underwent cesarean delivery. Induced women were more likely to deliver by cesarean (35.9%) than women in spontaneous labor (18.9%), unadjusted OR 2.35 (95% CI 1.97-2.79). The intrapartum factors significantly mediated the association between labor induction and cesarean delivery (explaining 76.7% of this association), particularly cervical dilatation <3 cm at hospital admission, fetal intolerance of labor, and dystocia. The indications for labor induction only explained 6.2%. Increased risk of cesarean delivery after labor induction among nulliparous women is attributable mainly to lower cervical dilatation at hospital admission and higher rates of labor complications. © 2017 Wiley Periodicals, Inc.

The Labor Market and the Second Economy in the Soviet Union

Science.gov (United States)

1991-01-01

thanks to Marjorie McElroy for encouraging my efforts to adapt the theory and techniques of Western labor economics to the case of the Soviet Union. All...34 Journal of Labor Economics 3:1, pt. 2 (January 1985): S328-S354. SCHULTZ, T. Paul. "Testing the Neoclassical Model of Family Labor Supply and...FemaJe Labor Force Participation and Wage Determination in a Developing Country." Paper presented at the Duke University Labor Economics Workshop

ACUTE CEREBROVASCULAR ACCIDENTS IN PREGNANCY, LABOR AND POSTPARTUM

Directory of Open Access Journals (Sweden)

R. R. Arustamyan

2016-01-01

Full Text Available Background: Acute cerebrovascular accidents are rare and serious complication of pregnancy, labor and puerperium, leading to an increase in maternal and perinatal morbidity and mortality. More than 12% of maternal mortality is related to stroke. Aim: To assess the impact of pregnancy on the incidence of stroke, as well as the impact of cerebrovascular disorders on pregnancy, labor and puerperium. Materials and methods: We retrospectively and prospectively analyzed the course of pregnancy, labor and puerperium in 136 female patients with strokes of various etiologies. The diagnosis of stroke and cerebrovascular disorders was verified with magnetic resonance imaging, angiography, conventional and multiaxial computerized tomography, ophthalmoscopy, electroencephalography, electrocardiography and echocardiography (trans-thoracic and trans-esophageal, 24-hour blood pressure monitoring and electrocardiogram monitoring, ultrasound assessment of extra and intracranial vasculature with duplex scanning, cerebral angiography and laboratory assessments. Results: The analysis of 92 strokes that occurred during pregnancy, labor and postpartum showed that 38% of the cases (n=35 were caused by various cerebrovascular abnormalities. In 18.5% of the cases (n=17, acute cerebrovascular accidents occurred in patients with preeclampsia/eclampsia. Most often (84.8%, or 78/97 of cases strokes or other cerebrovascular accidents developed in II and III trimesters. The most severe cases were patients with intracranial hemorrhages (n=31. In this group, there were 5  deaths of mothers, 1  antenatal and 1  neonatal fetal deaths. In 90% of these cases (28/31, intracranial hemorrhage in pregnancy was related to manifestation of intracerebral vascular abnormality (arteriovenous malformations, arterial aneurysms, cavernomas. We observed a 4-fold rate of arteriovenous malformation ruptures during pregnancy (21 cases vs. 5. The rates of arterial aneurysm and cavernoma ruptures

SLC9B1 methylation predicts fetal intolerance of labor.

Science.gov (United States)

Knight, Anna K; Conneely, Karen N; Kilaru, Varun; Cobb, Dawayland; Payne, Jennifer L; Meilman, Samantha; Corwin, Elizabeth J; Kaminsky, Zachary A; Dunlop, Anne L; Smith, Alicia K

2018-01-01

Fetal intolerance of labor is a common indication for delivery by Caesarean section. Diagnosis is based on the presence of category III fetal heart rate tracing, which is an abnormal heart tracing associated with increased likelihood of fetal hypoxia and metabolic acidemia. This study analyzed data from 177 unique women who, during their prenatal visits (7-15 weeks and/or 24-32 weeks) to Atlanta area prenatal care clinics, consented to provide blood samples for DNA methylation (HumanMethylation450 BeadChip) and gene expression (Human HT-12 v4 Expression BeadChip) analyses. We focused on 57 women aged 18-36 (mean 25.4), who had DNA methylation data available from their second prenatal visit. DNA methylation patterns at CpG sites across the genome were interrogated for associations with fetal intolerance of labor. Four CpG sites (P value intolerance of labor. DNA methylation and gene expression were negatively associated when examined longitudinally during pregnancy using a linear mixed-effects model. Positive predictive values of methylation of these four sites ranged from 0.80 to 0.89, while negative predictive values ranged from 0.91 to 0.92. The four CpG sites were also associated with fetal intolerance of labor in an independent cohort (the Johns Hopkins Prospective PPD cohort). Therefore, fetal intolerance of labor could be accurately predicted from maternal blood samples obtained between 24-32 weeks gestation. Fetal intolerance of labor may be accurately predicted from maternal blood samples obtained between 24-32 weeks gestation by assessing DNA methylation patterns of SLC9B1. The identification of pregnant women at elevated risk for fetal intolerance of labor may allow for the development of targeted treatments or management plans.

Policy options and system supplies on socialization standard management of city agricultural laborers

Institute of Scientific and Technical Information of China (English)

SUN Yujuan

2007-01-01

It is a social system engineering to solve problems of city agricultural laborers, inevitably concerning series of social phenomenon and the social issues of the city and countryside relations, the government function, the city management, the fair efficiency, the population flows, the labor employment, the social security, and so on. Furthermore, it also involves the profoundly political and economic system reforms, the transformation of government functions, the system perfection, legal administration, the social stability in China. The city government, as the direct superintendent of the agricultural laborers, should adopt the conception of the system engineering to construct anew mechanism of the city agricultural laborers socialization standard management, which has a profound theoretical and practical significance.

Evaluation of duration of active phase of labor and the factors influencing it in Shariatti Hospital, Tehran

Directory of Open Access Journals (Sweden)

Eslamian L

1997-08-01

Full Text Available In a descriptive study on 791 cases of normal vaginal deliveries within the period of 6 months (20th Sept 1994-20th March 1995 in Shariatti hospital, the duration of active phase of labor was evaluated. In 140 pregnant women (69 primigravida and 71 multipara which had the inclusion criteria (single fetus, cephalic presentation, 37 to 42 weeks of pregnancy, admission before cervical dilatation of 3-4 cm, no need for augmentation of labor, forceps-vaccum or cesarean section the mean duration for 1st stage was 2.31 hrs in primigravid and 1.56 hrs in multipara, for 2nd stage was 35 minutes in primigravid and 17.5 minutes in multipara. Maternal age, parity and fetal birth weight had influence on the duration of labor. Maternal age and parity each had independent and also additive effects on the duration of labor. Fetal birth weight of >3500 gr in multipara and >4000 gr in primipara caused lengthening of the duration of labor.

Immune cells in term and preterm labor

Science.gov (United States)

Gomez-Lopez, Nardhy; StLouis, Derek; Lehr, Marcus A; Sanchez-Rodriguez, Elly N; Arenas-Hernandez, Marcia

2014-01-01

Labor resembles an inflammatory response that includes secretion of cytokines/chemokines by resident and infiltrating immune cells into reproductive tissues and the maternal/fetal interface. Untimely activation of these inflammatory pathways leads to preterm labor, which can result in preterm birth. Preterm birth is a major determinant of neonatal mortality and morbidity; therefore, the elucidation of the process of labor at a cellular and molecular level is essential for understanding the pathophysiology of preterm labor. Here, we summarize the role of innate and adaptive immune cells in the physiological or pathological activation of labor. We review published literature regarding the role of innate and adaptive immune cells in the cervix, myometrium, fetal membranes, decidua and the fetus in late pregnancy and labor at term and preterm. Accumulating evidence suggests that innate immune cells (neutrophils, macrophages and mast cells) mediate the process of labor by releasing pro-inflammatory factors such as cytokines, chemokines and matrix metalloproteinases. Adaptive immune cells (T-cell subsets and B cells) participate in the maintenance of fetomaternal tolerance during pregnancy, and an alteration in their function or abundance may lead to labor at term or preterm. Also, immune cells that bridge the innate and adaptive immune systems (natural killer T (NKT) cells and dendritic cells (DCs)) seem to participate in the pathophysiology of preterm labor. In conclusion, a balance between innate and adaptive immune cells is required in order to sustain pregnancy; an alteration of this balance will lead to labor at term or preterm. PMID:24954221

Castor oil as a natural alternative to labor induction: A retrospective descriptive study.

Science.gov (United States)

DeMaria, Andrea L; Sundstrom, Beth; Moxley, Grace E; Banks, Kendall; Bishop, Ashlan; Rathbun, Lesley

2018-04-01

To describe birthing outcomes among women who consumed castor oil cocktail as part of a freestanding birth center labor induction protocol. De-identified data from birth logs and electronic medical records were entered into SPSS Statistics 22.0 for analysis for all women who received the castor oil cocktail (n=323) to induce labor between January 2008 and May 2015 at a birth center in the United States. Descriptive statistics were analyzed for trends in safety and birthing outcomes. Of the women who utilized the castor oil cocktail to stimulate labor, 293 (90.7%) birthed vaginally at the birth center or hospital. The incidence of maternal adverse effects (e.g., nausea, vomiting, extreme diarrhea) was less than 7%, and adverse effects of any kind were reported in less than 15% of births. An independent sample t-test revealed that parous women were more likely to birth vaginally at the birth center after using the castor oil cocktail than their nulliparous counterparts (poil cocktail to induce labor were able to give birth vaginally with little to no maternal or fetal complications. Findings indicate further research is needed to compare the safety and effectiveness of natural labor induction methodologies, including castor oil, to commonly used labor induction techniques in a prospective study or clinical trial. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

[Costs of maternal-infant care in an institutionalized health care system].

Science.gov (United States)

Villarreal Ríos, E; Salinas Martínez, A M; Guzmán Padilla, J E; Garza Elizondo, M E; Tovar Castillo, N H; García Cornejo, M L

1998-01-01

Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities.

A randomized trial of the effects of antibiotic prophylaxis on epidural-related fever in labor.

Science.gov (United States)

Sharma, Shiv K; Rogers, Beverly B; Alexander, James M; McIntire, Donald D; Leveno, Kenneth J

2014-03-01

It has been suggested that the development of maternal fever during epidural analgesia could be due to intrapartum infection. We investigated whether antibiotic prophylaxis before epidural placement decreases the rate of epidural-related fever. In this double-blind, placebo-controlled trial, 400 healthy nulliparous women requesting epidural analgesia were randomly assigned to receive either cefoxitin 2 g or placebo immediately preceding initiation of epidural labor analgesia. Maternal tympanic temperature was measured hourly, and intrapartum fever was defined as a maternal temperature of ≥38°C. Neonates born to women with fever were evaluated for possible sepsis, and available placentas were evaluated for the presence of neutrophilic inflammation. The primary outcome was maternal fever during epidural analgesia. Thirty-eight percent of women in the cefoxitin group and 40% of women in the placebo group developed fever (P = 0.68). The risk difference (95% confidence interval) for fever ≥38°C during labor (antibiotic versus placebo) was -2.0% (-11.5 to 7.5), and for fever >39°C during labor was -1.5% (-4.7 to 1.7). Approximately half of each study group had placental neutrophilic inflammation, but administration of cefoxitin had no significant effect on any grade of neutrophilic inflammation. Fever developed significantly more often in the women with placental neutrophilic inflammation compared with those without such inflammation (73/158 vs 33/144, P labor epidural analgesia is associated with placental inflammation, but fever and placental inflammation were not reduced with antibiotic prophylaxis. This finding suggests that infection is unlikely to be the cause in its development.

A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States.

Science.gov (United States)

Aaronson, Jaime; Abramovitz, Sharon; Smiley, Richard; Tangel, Virginia; Landau, Ruth

2017-04-01

Remifentanil is most commonly offered when neuraxial labor analgesia is contraindicated. There is no consensus regarding the optimal administration, dosing strategy, or requirements for maternal monitoring, which may pose a patient safety issue. This exploratory survey evaluated the current practices regarding remifentanil use for labor analgesia at academic centers in the United States. Of 126 obstetric anesthesia directors surveyed, 84 (67%) responded. In 2014 to 2015, an estimated 36% (95% confidence interval: 25.7-46.3) of centers used remifentanil, most of which did so less than 5 times. Some serious maternal and neonatal respiratory complications occurred, emphasizing that clinical protocols and adequate monitoring are key to ensure maternal and neonatal safety.

Specially trained registered nurses can safely manage epidural analgesia infusion in laboring patients.

Science.gov (United States)

Charles, Lenore A; Korejwa, Elise; Kent, Donna Curtis; Raniero, Debbie

2015-06-01

To discover evidence for defining the registered nurse's (RN's) role in the management of epidural analgesia in the labor and delivery setting. The Labor Epidural Nurse Safety (LENS) study consisted of two parts. The first part was a 10-year retrospective review of the outcomes of 2,568 laboring women for whom epidural catheters had been placed and verified by an anesthesiologist or certified registered nurse anesthetist, then continuous epidural infusion initiated, and basal rate or patient-controlled epidural analgesia (PCEA) dose increased, if needed, within specified parameters by specially trained labor and delivery RNs. The second part compared the outcomes of the neonates born to the 2,568 women in the first part of the study with neonates born to mothers who received PCEA with a continuous infusion initiated and managed exclusively by anesthesiologists and/or certified registered nurse anesthetists at two control sites. Maternal outcomes were quantified by incidences of clinically significant hypotension and sentinel events, such as respiratory distress, cardio/respiratory distress, loss of consciousness, and seizures. Evidence of neonatal outcomes was collected by comparing Apgar scores. No sentinel events occurred, and there was no increase in maternal hypotensive events in the RN-managed group. There were no statistically significant differences in Apgar scores between the experimental and control groups. Specially trained RNs can safely initiate continuous infusions and increase the basal rate of epidural analgesia infusions or PCEA doses administered to laboring women, after insertion and confirmation of correct catheter placement by a qualified anesthesia provider, without adversely affecting maternal and fetal/neonatal outcomes. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

An Internatioal Comparison and Assessment of Maternity Leave Regulation

OpenAIRE

Dorothea Alewell, Kerstin Pull

2001-01-01

Provisions for maternity leave are common among industrialized countries, but their institutional design varies distinctly from country to country. Developing our theory on the impact on maternity leave regulations on women's labor market situation, we argue that a woman on leave creates a re-organization problem for her employer. The costs of re-organization will not simply increase with the duration of maternity leave, but display a hump-shaped curvature which peeks at medium-leave duration...

Labor immigration in the Arab Gulf states: patterns, trends and problems.

Science.gov (United States)

Ali, A

1986-09-01

This is an overview of recent labor immigration in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Attention is given to factors contributing to the dependence of these countries on migrant labor, the impact of the decline in oil revenues, and future trends in the size and skill composition of the foreign labor supply.

What Caused the Recession of 2008? Hints from Labor Productivity

OpenAIRE

Casey Mulligan

2009-01-01

A labor market tautology says that any change in labor usage can be decomposed into a movement along a marginal productivity schedule and a shift of the schedule. I calculate this decomposition for the recession of 2008, assuming an aggregate Cobb-Douglas marginal productivity schedule, and find that all of the decline in employment and hours since December 2007 is a movement along the schedule. This finding suggests that a reduction in labor supply and/or an increase in labor market distorti...

Visual Biofeedback using trans-perineal ultrasound during the second stage of labor.

Science.gov (United States)

Gilboa, Yinon; Frenkel, Tahl I; Schlesinger, Yael; Rousseau, Sofie; Hamiel, Daniel; Achiron, Reuven; Perlman, Sharon

2017-11-20

to assess the obstetrical and psychological effect of visual biofeedback using trans-perineal ultrasound (TPU) during the second stage of labor. Visual biofeedback using TPU was performed prospectively during the second stage of labor in twenty-six low risk nulliparous women. Pushing efficacy was assessed by the angle of progression at rest and during pushing efforts before and after observing the ultrasound screen. Obstetrical outcomes included level of perineal tearing, mode of delivery and length of the second stage. Psychological outcomes were assessed via self-report measures during the postnatal hospital stay. These included measures of perceived control and maternal satisfaction with childbirth as well as level of maternal feelings of connectedness toward her newborn. Obstetrical and psychological results were compared to a control group (n=69) who received standard obstetrical coaching by midwifes. Pushing efficacy significantly increased following visual biofeedback by TPU (p = 0.01). A significant association was found between the visual biofeedback and an intact perineum following delivery (p = 0.03). No significant differences were found in regard to mode of delivery or the length of the second stage. Feelings of maternal connectedness towards the newborn were significantly higher in the visual biofeedback group relative to non-biofeedback controls (p = 0.003). The results of this pilot study implicate that TPU may serve as a complementary tool to coached maternal pushing during the second stage of labor with obstetrical as well as psychological benefits. Further studies are required to confirm our findings and define the exact timing for optimal results. This article is protected by copyright. All rights reserved.

Pain Relief in Labor: A Randomized Controlled Trial Comparing ...

African Journals Online (AJOL)

Conclusions: This study showed that 600 mg intramuscular paracetamol provides similar and modest pain relief in labor when compared to 100 mg intramuscular tramadol. It also has fewer maternal adverse effects and favorable neonatal outcome such as tramadol. It is concluded that intramuscular paracetamol is simple, ...

Maternal Parity and Blood Oxidative Stress in Mother and Neonate

OpenAIRE

Golalizadeh; Shobeiri; Ranjbar; Nazari

2016-01-01

Background Parturition has been associated with free radicals, itself linked with poor pregnancy outcome. Objectives This study aimed to investigate the relationship between oxidative stress biomarkers levels of maternal and cord blood samples at the second stage of labor with the maternal parity number. Materials and Methods In this analytical cross-sectional study, subjects were ...

Inventory strategies to manage supply disruptions

NARCIS (Netherlands)

Atan, Z.; Snyder, L.V.; Gurnani, H.; Mehrotra, H.; Ray, S.

2012-01-01

Disruptions in supply chains occur routinely—both large ones, due to natural disasters, labor strikes, or terrorist attacks, and small ones, due to machine breakdowns, supplier stockouts, or quality problems (to name a few examples). Companies whose supply processes are affected by disruptions may

Effect of psychoprophylaxis (Lamaze preparation) on labor and delivery in primiparas.

Science.gov (United States)

Scott, J R; Rose, N B

1976-05-27

To investigate whether "prepared-childbirth" courses offer measurable physical advantages, we compared the labor and delivery characteristics of 129 primiparas who had completed ante-partum Lamaze-training psychoprophylaxis classes with an equal number of matched controls who had not. The former were given narcotics less frequently during labor (P less than 0.001), received conduction anesthesia less often (P less than 0.001), and had a higher frequency of spontaneous vaginal deliveries (P less than 0.001) than the control patients. However, these differences had no apparent effects on the length of labor, number or type of maternal complications, frequency of fetal distress, mean Apgar scored, or neonatal problems.

The Length of Maternity Leave and Family Health

DEFF Research Database (Denmark)

Beuchert-Pedersen, Louise Voldby; Humlum, Maria Knoth; Vejlin, Rune Majlund

We study the relationship between the length of maternity leave and the physical and psychological health of the family. Using a reform of the parental leave scheme in Denmark that increased the number of weeks of leave with full benefit compensation, we estimate the effect of the lenght...... of maternity leave on a range of health indicators including the number of hospital admissions for both mother and child and the probability of the mother receiving antidepressants. The reform led to an increase in average post-birth maternity leave matters for child or maternal health outcomes and thus we...... complement the existing evidence on maternity leave expansions that tends to find limited effects on children's later deveopmental, educational, and labor market outcomes. Our results suggest that any beneficial effects of increasing the lenght of maternity leave are greater for low-resource families....

Hip Dislocation and Dystocia in Early Medieval Times: Possible Evidence of Labor Maneuver.

Science.gov (United States)

Malgosa, Assumpció; Carrascal, Susana; Piga, Giampaolo; Isidro, Albert

2016-12-01

In ancient times, maternal mortality would occur frequently, particularly during labor. Evidence of dystocia resulting in the death of a pregnant woman is very infrequent in paleopathologic literature, with only a few cases being demonstrated. In the early medieval site of Casserres, the skeleton of a young woman with a fetus in the pelvic region was found. Some abnormal findings of the maternal skeleton were evaluated, including a sacral anomaly, femoral head wound, the rare position of the lower left limb with the femoral head dislodged anteriorly and cephalad from the socket, and a fibular fracture. Examining the anomalies all together, a case of anterior hip dislocation related to a McRoberts-like maneuver performed during labor is a plausible explanation of the findings.

Health, Enterprise, and Labor Complementarity in the Household.

Science.gov (United States)

Adhvaryu, Achyuta; Nyshadham, Anant

2017-05-01

We study the role of household enterprise as a coping mechanism after health shocks. Using variation in the cost of traveling to formal sector health facilities to predict recovery from acute illness in Tanzania, we show that individuals with prolonged illness switch from farm labor to enterprise activity. This response occurs along both the extensive (entry) and intensive (capital stock and labor supply) margins. Family members who are not ill exhibit exactly the same pattern of responses. Deriving a simple extension to the canonical agricultural household model, we show that our results suggest complementarities in household labor.

Social Determinants of Maternal Health in Afghanistan: A Review.

Science.gov (United States)

Najafizada, Said Ahmad Maisam; Bourgeault, Ivy Lynn; Labonté, Ronald

2017-01-01

Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature. This narrative review was conducted using Arksey and O'Malley's framework of (1) defining the question, (2) searching the literature, (3) assessing the studies, (4) synthesizing selected evidence in context, and (5) summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care) is the long-term solution to the maternal health problems in Afghanistan. National and international organizations' long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

GROWTH EFFECTS OF CONSUMPTION AND LABOR-INCOME TAXATION IN AN OVERLAPPING-GENERATIONS LIFE-CYCLE MODEL

NARCIS (Netherlands)

Heijdra, B.J.; Mierau, J.O.

2010-01-01

We study labor-income and consumption taxation in an overlapping-generations model featuring endogenous growth clue to interfirm investment externalities. Consumption, saving, and labor supply display life-cycle features because mortality and labor productivity are age-dependent and because annuity

Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

Directory of Open Access Journals (Sweden)

Ogboli-Nwasor E

2011-08-01

Full Text Available E Ogboli-Nwasor1, SE Adaji2, SB Bature2, OS Shittu21Department of Anesthesia, 2Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, NigeriaBackground: The purpose of this study was to assess the attitudes of maternal health care providers to pain relief during labor in Zaria, Nigeria.Methods: This was a multicenter, collaborative, cross-sectional pilot study of provider perspectives concerning pain relief during labor. A structured, self-administered, questionnaire was completed by 95 consenting maternal health care providers at three high-volume facilities in Zaria, an ancient northern Nigerian city. Descriptive statistics was performed on the data.Results: Most respondents (94.8% agreed that pain relief is needed during labor. Only 2.1% of respondents were undecided about the provision of pain relief during labor and 3.2% were of the opinion that pain relief was not necessary during labor. Most respondents (93.7% had attended a woman in labor in the 4 weeks preceding the survey. Of these, 56.8% had counseled a parturient in labor. Most of the counseling (42.1% took place during labor. Less than half of the respondents (48.4% had administered pain relief in labor in the preceding 4 weeks and systemic opioids was the most commonly form of pain relief. Among the respondents who did not offer pain relief agents in labor, the majority (54.5% had no reason for not offering it. Unavailability of methods, inability to afford the cost of pain relief, lack of knowledge and skills, as well as lack of essential equipment to provide the procedure were also given by respondents as reasons for not offering pain relief.Conclusion: Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. There exists a gap between provider attitudes to pain relief in labor and practice of the same, with many providers

Lower Serum Catalase Level is Associated with Preterm Labor among Pregnant Women at Sanglah Hospital Denpasar, Bali-Indonesia

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I Ketut Surya Negara

2016-09-01

Full Text Available Background: Preterm labor is still become a serious health problem in Obstetric and Perinatology with no sensitive biomarker currently approved. Several studies show that decrease antioxidant activity may play significant role in preterm labor. However, only few studies had been conducted to evaluate blood catalase level in preterm labor and assess its role in preterm labor. Objective: The aim this study was to identify the differences of maternal serum catalase level in preterm labor compared with preterm pregnancy. Methods: An observational analytic cross sectional study was conducted from February to December 2014 using pregnant women with 28-36 weeks’ gestational age. Blood catalase level was evaluated by colorimetric method and the data was analyzed by SPPS for Windows 17.0 program. Results: 12 subjects were enrolled and divided into preterm and control group. No significant differences between mean age, gestational age, and parity between preterm and control group. However, blood catalase level was significantly lower in preterm group compared with control group (81.82 ± 20.38 vs 159.38 ± 35.79; p=0.001. Conclusion: Serum maternal catalase level were significantly lower in preterm labor compared with preterm normal pregnancy.

What the '90s Labor Shortage Will Mean to You.

Science.gov (United States)

Dunn, Samuel L.

1985-01-01

Discusses a number of forces that will determine the labor supply and demand in the United States in the 1990s: growth in the economy, automation, national policy, immigration policies, changing family, and technical advances. Examines steps a company can take in relation to these forces and makes suggestions concerning future labor needs. (CT)

Physical violence during pregnancy: maternal complications and birth outcomes.

Science.gov (United States)

Cokkinides, V E; Coker, A L; Sanderson, M; Addy, C; Bethea, L

1999-05-01

To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes. We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of "partner-inflicted physical hurt and being involved in a physical fight." Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes. The prevalence of physical violence was 11.1%. Among women who experienced physical violence, 54% reported having been involved in physical fights only and 46% had been hurt by husbands or partners. In the latter group, 70% also reported having been involved in fighting. Compared with those not reporting physical violence, women who did were more likely to deliver by cesarean and be hospitalized before delivery for maternal complications such as kidney infection, premature labor, and trauma due to falls or blows to the abdomen. Physical violence during the 12 months before delivery is common and is associated with adverse maternal conditions. The findings support the need for research on how to screen for physical violence early in pregnancy and to prevent its consequences.

Epidural analgesia during labor: impact on delivery outcome, neonatal well-being, and early breastfeeding.

Science.gov (United States)

Gizzo, Salvatore; Di Gangi, Stefania; Saccardi, Carlo; Patrelli, Tito Silvio; Paccagnella, Gianluca; Sansone, Laura; Barbara, Favaron; D'Antona, Donato; Nardelli, Giovanni Battista

2012-08-01

The effect of epidural analgesia on labor and effective breastfeeding is still being debated. The aim of this study is to define its impact on the trend of labor, the newborns' well-being, and early breastfeeding. We considered first-term physiologic pregnant women who delivered by the vaginal route. We divided them into two groups: group A received epidural analgesia during labor, whereas group B received no analgesia. We recorded maternal age, gestational age, modality of delivery, length of labor, and length of active labor. All newborns received skin-to-skin contact; early breastfeeding was encouraged. We recorded data on birth weight and length, Apgar score at minutes 1 and 5, type of crying, neonatal reactivity, and time between birth and exposure to the breast. Statistical significance was considered for panalgesia, and 245 patients agreed to participate in our study. Only 128 patients met inclusion criteria. We randomized them in 64 women in group A and 64 women in group B. Data on maternal age, gestational age, type of delivery, neonatal birth weight and length, and Apgar score showed no significant differences. Total length of labor was 363.58±62.20 minutes in Group A versus 292.30±64.75 minutes in group B (pneonatal parameters we found a statistically significant difference only for length of first breastfeeding, with a mean duration of analgesia has little effect on trend of labor and duration of first breastfeed and none on neonatal outcome. A new protocol of epidural analgesia may solve these side effects.

PENENTU UPAH REGIONAL: TENAGA KERJA TERDIDIK (SKILLED LABOR DAN TIDAK TERDIDIK (UNSKILLED LABOR DI INDONESIA

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Dyah Maya Nihayah

2015-12-01

Full Text Available The wage have impacts on poverty, living standards and the incentive to improve labor productivity (human capital, in particular, for economic growth. Regional decentralization has implications, which, they must be developed regional endowment to get the efficiency in production process. So it is interesting to examine the importance of regional characteristics in the observed variability of regional wage in Indonesia. Based on this idea, the objective of this study is to examine the contribution of regional characteristics to the regional wage differential in Indonesia. Data supplied by the Indonesian Central Bureau of Statistics during 2003 – 2007. In this study used 3 model; Ordinary Least Square (OLS, Co-Varian Model and Generalized Least Squared (GLS. Then, the most effective model based on the smallest standard error was chosen to estimate regional characteristics in the observed variability of regional wage inIndonesia. The result showed that the regional characteristics, particularly skilled or unskilled labor, play an important role in determining the wage differentials in region. The empirical evidence presented that regional economic growth and the existing of high skilled labor in labor market have positive impact toward spatial wage. Then, skilled labor and unskilled will give negative influence in regional wage. The points out is laboring existence with level education or skilled level, despite not works or was working have influence toward the regional wage. Therefore, labor's policy is expected gets focused on given specialization corresponds to that region characteristics.

Maternal morbidities affect tens of millions.

Science.gov (United States)

Finger, W R

1994-02-01

Various separate studies indicate maternal morbidity is more common than had been believed. A Safe Motherhood Survey was conducted in 1993 in the Philippines among 9000 women, as part of efforts to study women's language and perceptions about pregnancy and symptoms of morbidity. In El Salvador, interviews were conducted among 2000 women on morbidity issues. Preliminary results from a Family Health International (FHI) five-country survey of 16,000 women revealed that 7 out of every 10 women reported a health problem related to maternity or chronic conditions stemming from pregnancy or childbirth. Conditions ranged from obstructed labor, complications from unsafe abortions, and bacterial infections, to anemia, hemorrhage, and eclampsia. The quality of care determines whether the health problems are life threatening. Less serious morbidity cases involve fatigue or back pain, which is exacerbated by poor nutrition and hard physical labor. Other reproductive morbidities are sexually transmitted diseases, side effects from contraceptives, and general gynecological problems. The FHI results from Ghana, Indonesia, and Egypt showed 240-300 morbidities for every maternal death; maternal mortality worldwide is estimated at 500,000 annually. A study of fistula (an injury during labor to the vagina and bladder that results in urinary or fecal incontinence) found that Nigerian community norms and limited access to emergency health care were factors. The women reported costs, poor roads, and transportation problems. A study in Ethiopia found that, in an Addis Ababa hospital between 1983-88, 600 fistulas were repaired every year, of which almost 66% occurred at first delivery. A study in Cairo in 1988 found that nearly 6 out of every 10 women reported a prolapsed uterus. Women in the studies were able to talk openly and willingly about their problems, when concepts and language were appropriate and interviewers were trained. A small study in India confirmed the correlation between

Data Warehouse for Professional Skills Required on the IT Labor Market

Directory of Open Access Journals (Sweden)

Cristian GEORGESCU

2012-11-01

Full Text Available This paper represents a research regarding informatics graduates professional level adjustment to specific requirements of the IT labor market. It uses techniques and models for data warehouse technology to allow a comparative analysis between the supply competencies and the skills demand on the IT labor market.

Immunology of term and preterm labor

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Peltier Morgan R

2003-12-01

Full Text Available Abstract During pregnancy there is an alteration in maternal immunity within the uterus where innate, proinflammatory immune responses are tightly regulated to prevent immunological rejection of the fetal allograft. Disruption of the delicate balance of cytokines by bacteria or other factors increases the production of proinflammatory cytokines at the maternal-fetal interface and activates the parturition mechanism prematurely. Despite years of searching, there is still no broadly effective strategy for preventing preterm labor and most therapies are directed at inhibiting myometrial contractions and improving neonatal outcome. Recent studies with progestins and interleukin-10 (IL-10, however, are showing promise in randomized clinical trials and animal studies. Furthermore, the identification of the Toll-like receptors as upstream mediators of inflammation may offer alternative therapeutic targets for preventing this common pregnancy complication.

Urinary tract infection during pregnancy affects the level of leptin, ghrelin and insulin in maternal and placental blood.

Science.gov (United States)

Piatek, Jacek; Gibas-Dorna, Magdalena; Budzynski, Wlodzimierz; Krauss, Hanna; Marzec, Ewa; Olszewski, Jan; Zukiewicz-Sobczak, Wioletta

2014-03-01

We examined ghrelin, leptin and insulin in maternal blood during normal pregnancy and pregnancy complicated by urinary tract infection (UTI), as well as in cord blood at labor. A total of 36 delivering women with history of UTI during the third trimester of pregnancy were enrolled in the study; 12 healthy pregnant women served as a control. Infection markers (CRP and procalcitonin) were determined in maternal blood during the course of UTI and at labor. Ghrelin, leptin and insulin were determined during labor in venous maternal and in umbilical cord blood. We found negative correlation between infection markers in maternal blood during UTI, and level of tested hormones in cord blood, indicating potential risk of placental impairment due to energetic imbalance. We noted lower level of leptin in mothers with UTI and no change in leptin from umbilical blood comparing subjects with and without UTI. Low level of ghrelin was observed in maternal and cord blood when pregnancy was complicated by UTI. Insulin concentrations were high in mothers with UTI and low in their newborn's cord blood. Increased maternal insulin level could indicate peripheral insulin resistance caused by the infection. UTI during pregnancy affects the concentration of hormones responsible for regulating energetic homeostasis within the placenta.

Female Schooling, Non-Market Productivity, and Labor Market Participation in Nigeria

OpenAIRE

Aromolaran, Adebayo B.

2004-01-01

Economists have argued that increasing female schooling positively influences the labor supply of married women by inducing a faster rise in market productivity relative to non-market productivity. I use the Nigerian Labor Force Survey to investigate how own and husband's schooling affect women's labor market participation. I find that additional years of postsecondary education increases wage market participation probability by as much as 15.2%. A marginal increase in primary schooling has n...

Analyzing female labor supply - evidence from a Dutch tax reform

NARCIS (Netherlands)

Bosch, N.; van der Klaauw, B.

2012-01-01

Among OECD countries, the Netherlands has an average female labor force participation, but by far the highest rate of part-time work. This paper investigates the extent to which married women respond to financial incentives. We exploit exogenous variation caused by a substantial Dutch tax reform in

Impact of recommended changes in labor management for prevention of the primary cesarean delivery.

Science.gov (United States)

Thuillier, Claire; Roy, Sophie; Peyronnet, Violaine; Quibel, Thibaud; Nlandu, Aurélie; Rozenberg, Patrick

2018-03-01

The dramatic rise in cesarean delivery rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary cesarean delivery rate safely. This is a before-and-after retrospective cohort study at a university referral hospital. In March 2014, the threshold for defining active labor changed from 4 to >6 cm and arrest of first-stage labor from lack of cervical change despite regular contractions after 3 hours of oxytocin administration with amniotomy and epidural anesthesia to no change after 4 hours of adequate or 6 hours of inadequate contractions in women with an epidural. The definition of second-stage arrest of labor changed simultaneously from lack of progress for 3 hours with adequate contractions in women with epidural anesthesia to no progress for ≥4 hours in nulliparas or 3 hours in multiparas with an epidural. We compared maternal and neonatal outcomes over two 1 year periods: from March 2013 to February 2014 (before, preguideline) and from June 2014 to May 2015 (after, postguideline). We included all women with singleton pregnancies at ≥37 weeks' gestation, in vertex presentation, in spontaneous or induced labor, and with epidural anesthesia. We excluded women with an elective or previous cesarean delivery and those with obstetric or fetal complications. This study included 3283 and 3068 women in the before and after periods, respectively. The groups had similar general and obstetric characteristics. The global cesarean delivery rate decreased significantly from 9.4% in the preguideline to 6.9% in

The effects of labor on differential gene expression in parturient women, placentas, and fetuses at term pregnancy

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Hsiu-Huei Peng

2011-11-01

Full Text Available Labor and its associated pain are thought to have unique impacts on parturient women. The goal of this study was to investigate the effects of labor and associated pain on differential gene expression profiles in the maternal, fetal, and placental compartments. We used microarrays to analyze maternal blood (MB, fetal cord blood (CB, and placental tissue samples in pregnant women after term vaginal deliveries (laboring group and in term pregnant women after scheduled Ceasarean sections (nonlaboring group. The upregulated genes in the MB of the laboring group are involved in cytokine and nuclear factor-kappa B signaling pathways, regulation of the networks of toll-like receptor 4, and suppressor of cytokine signaling 3. Upregulated genes in the CB of the laboring group are involved in responding to stress and stimuli by regulating the network genes of the T-cell receptor beta locus and the FK506 binding protein 8. Differentially expressed genes in the placenta of the laboring group are involved in nitric oxide transport, gas transport, response to hydrostatic pressure, oxygen transport, acute phase responses, and the tumor necrosis factor-mediated signaling pathway, which are important during the transient hypoxemia and hypoperfusion that occur in the placenta during uterine contractions. Interestingly, few of the genes exhibited simultaneous changes in all three compartments, indicating that different pathways and complex interactions may be involved in human labor. In conclusion, human labor and its associated pain elicit unique gene regulatory changes in MB, placenta, and CB.

Effect of moving dairy cows at different stages of labor on behavior during parturition

DEFF Research Database (Denmark)

Proudfoot, K. L.; Jensen, M. B.; Heegaard, Peter M. H.

2013-01-01

of labor would influence calving behavior or the length of the second stage of labor. Seventy-nine multiparous Holstein dairy cows were moved from 1 of 2 group pens to 1 of 10 maternity pens adjacent to each group pen either 3 d before expected calving date or when one or more behavioral or physical signs...... of labor were observed. These signs were noted, and were used to retrospectively categorize cows into 1 of 3 movement categories: (1) moved before labor, (2) moved during early stage I labor (signs of suddenly tense and enlarged udder, raised tail or relaxed pelvic ligaments; could also be immediately...... prelabor), or (3) moved during late stage I labor (signs of viscous, bloody mucus or abdominal contractions; could also be transitioning to stage II labor). Calves were weighed within 12h of birth and remained with their dam for 3 d. The length of the second stage of labor (the time between first abdominal...

Gender Identity and Labor Division In Norwegian Households

OpenAIRE

Hafzi, Kamran

2016-01-01

Master's thesis in Economic analysis We investigate if gender identity has any effect on the division of household labor among Norwegian couples. By deriving the potential income distribution of the Norwegian population, we compare couples’ comparative advantage in market work. Our results indicate that women who have higher potential income than their spouse are more likely to increase their labor supply and work full-time, rather than reduce their hours allocated to market work in order ...

Neonatal morbidity after spontaneous labor onset prior to intended cesarean delivery at term: a cohort study.

Science.gov (United States)

Glavind, Julie; Milidou, Ioanna; Uldbjerg, Niels; Maimburg, Rikke; Henriksen, Tine B

2017-04-01

We aimed to investigate if labor onset before planned cesarean delivery (CD) affects the risk of neonatal admission, respiratory distress, or neonatal infectious morbidity. Our cohort included singleton term pregnant women with intended CD who delivered at Aarhus University Hospital from 1990 to 2012. Two groups of women were identified: women with intended CD performed before labor (nonlabor CD) and women with intended CD performed after spontaneous labor onset (labor-onset CD); in both groups there was no other maternal or fetal medical indication for an immediate CD or for early-term CD scheduling. Data were stratified in early-term (37-38 weeks) and full-term (39-40 weeks) deliveries. The main outcome measures were neonatal admission, respiratory distress and neonatal infectious morbidity. Among 103 919 live births, 5071 deliveries were nonlabor CDs and 731 were labor-onset CDs. Compared to nonlabor CD, labor-onset CD was associated with similar risks of neonatal admission and respiratory distress, both at early and full term, but with a two- to three-fold increased risk of newborn septicemia or antibiotic treatment at early term. Labor onset at early term was associated with a lower risk of maternal blood loss of more than 500 mL, but with a higher risk of postoperative antibiotic treatment and endometritis. Labor onset before planned CD was not associated with a decrease in neonatal respiratory morbidity, but may be associated with increased risks of neonatal infection. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

29 CFR 95.35 - Supplies and other expendable property.

Science.gov (United States)

2010-07-01

... supplies exceeding $5,000 in total aggregate value upon termination or completion of the project or program... 29 Labor 1 2010-07-01 2010-07-01 true Supplies and other expendable property. 95.35 Section 95.35... Requirements Property Standards § 95.35 Supplies and other expendable property. (a) Title to supplies and other...

Amnioinfusion for relief of recurrent severe and moderate variable decelerations in labor.

Science.gov (United States)

Regi, Annie; Alexander, Nancy; Jose, Ruby; Lionel, Jessie; Varghese, Lilly; Peedicayil, Abraham

2009-05-01

To determine whether intrapartum amnioinfusion (AI) relieves recurrent moderate and severe variable decelerations in laboring women with clear or grade I meconium-stained amniotic fluid and reduces cesarean section rate for fetal distress. A randomized controlled trial was conducted in labor unit of Christian Medical College Hospital, Vellore, India, between October 2003 and September 2004. Women were randomized to receive AI (group I) and not to receive it (group II). A total of 150 women (75 in each group) were included in the study. There was significant relief of variable decelerations in group I and no difference in overall cesarean section rate but significant reduction in cesarean section rate for fetal distress in group I, and significant reduction in cesarean section rate for fetal distress in nulliparous women of group I. Neonatal acidemia was also significantly reduced in the nulliparous women receiving AI. The duration of maternal postpartum hospital stay was significantly reduced in group I. There were no adverse maternal or neonatal outcomes. AI was a beneficial therapeutic intervention in women patients showing fetal distress in first stage of labor, and it reduced cesarean section for fetal distress and neonatal acidemia.

Combination of dexmedetomidine and remifentanil for labor analgesia: A double-blinded, randomized, controlled study

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Waleed Abdalla

2015-01-01

Full Text Available Background: Satisfactory analgesia is of great importance in the labor. The clinical efficacy and side effects of remifentanil in the management of labor pain had been evaluated. Dexmedetomidine (DMET demonstrates an antinociceptive effect in visceral pain conditions. Aims of the study were to assess whether the combination of DMET with remifentanil would produce a synergistic effect that results in lower analgesic requirements. Furthermore, whether this combination would have less maternal and neonatal adverse effects. Patients and Methods: Sixty American Society of Anesthesiologists physical status I-II pregnant women had been enrolled into this study. All were full term (37-40 weeks′ gestation, singleton fetus with cephalic presentation in the first stage of spontaneous labor. They were divided into two groups group (I Patient-controlled IV remifentanil analgesia (bolus dose 0.25 μg/kg, lockout interval 2 min increased by 0.25 μg/kg to a maximum bolus dose 1 μg/kg in addition to a loading dose of DMET 1 μg/kg over 20 min, followed by infusion at 0.5 μg/kg/h group (II Patient-controlled IV remifentanil analgesia (PCA (bolus dose 0.25 μg/kg, lockout interval 2 min increased by 0.25 μg/kg to a maximum bolus dose 1 μg/kg in addition to a the same volume of normal saline as a loading dose, followed by a continuous saline infusion. Visual analog scale score, maternal, and fetal complications and patients′ satisfaction were recorded. Results: Patients receiving a combination of PCA remifentanil and DMET had a lower pain score compared with remifentanil alone in the second stage of labor (P = 0.001. The Total consumption of remifentanil was reduced by 53.3% in group I. There was an increased incidence of maternal complications and a lower patient satisfaction score in group II. Conclusion: DMET has an opioid sparing effect; a combination of DMET and remifentanil produces a synergistic effect that results in lower analgesic requirements

Labor productivity and employment gaps in Sub-Saharan Africa.

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McCullough, Ellen B

2017-02-01

Drawing on a new set of nationally representative, internationally comparable household surveys, this paper provides an overview of key features of structural transformation - labor allocation and labor productivity - in four African economies. New, micro-based measures of sector labor allocation and cross-sector productivity differentials describe the incentives households face when allocating their labor. These measures are similar to national accounts-based measures that are typically used to characterize structural change. However, because agricultural workers supply far fewer hours of labor per year than do workers in other sectors in all of the countries analyzed, productivity gaps shrink by half, on average, when expressed on a per-hour basis. Underlying the productivity gaps that are prominently reflected in national accounts data are large employment gaps, which call into question the productivity gains that laborers can achieve through structural transformation. Furthermore, agriculture's continued relevance to structural change in Sub-Saharan Africa is highlighted by the strong linkages observed between rural non-farm activities and primary agricultural production.

Role of Prophylactic Oxytocin in the Third Stage of Labor: Physiologic Versus Pharmacologically Influenced Labor and Birth.

Science.gov (United States)

Erickson, Elise N; Lee, Christopher S; Emeis, Cathy L

2017-07-01

Maternity care providers administer oxytocin prophylactically to prevent postpartum hemorrhage (PPH). Prophylactic oxytocin is generally considered effective and safe and is promoted by national organizations for standardized use. In this article, the evidence supporting prophylactic oxytocin administration for women undergoing spontaneous labor and birth compared with women whose labors included administration of exogenous oxytocin for induction or augmentation is explored. Using data from randomized controlled trials included in 2 recent Cochrane meta-analyses papers, only studies with women in spontaneous labor were selected for inclusion (N = 4 studies). Outcomes of immediate postpartum bleeding volumes (≥ 500 mL or 1000 mL), risk for blood transfusion, and risk for administration of more uterotonic medication were pooled from these 4 studies. Focused random effects meta-analytics were used. Compared to women without prophylactic oxytocin, women who received prophylactic oxytocin had a lower risk of having a 500 mL or higher blood loss. However, prophylactic oxytocin did not lower risk of PPH (≥ 1000 mL), blood transfusion, or need for additional uterotonic treatment. Prophylactic oxytocin may not confer the same benefits to women undergoing spontaneous labor and birth compared to women laboring with oxytocin infusion. Reasons for this difference are explored from a pharmacologic perspective. In addition, the value of prophylactic oxytocin given recent changes in the definition of PPH from greater than or equal to 500 mL to 1000 mL or more after birth is discussed. Finally, gaps in research on adverse effects of prophylactic oxytocin are presented. More research is needed on reducing risk of PPH for women in spontaneous labor. © 2017 by the American College of Nurse-Midwives.

Occupational violence in pregnant women in Brazil: a sample of cases in the Labor Court.

Science.gov (United States)

Turatti, Bárbara de Oliveira; Moretti-Pires, Rodrigo Otávio

2017-07-27

Brazilian women are still a recurring target of discrimination in the workplace, facing violence related to gender relations and moral harassment, especially when they are pregnant. When the worker perceives discriminatory acts and attitudes or any violation of the rights guaranteed by law, she may appeal to the Labor Court to initiate legal action. This in turn exposes the worker to a number of issues, such as workplace persecution and future dismissal. The rights of pregnant women to temporary stability, free time for medical examinations, change of duties and maternity leave contrast with the usurpation of the administration's workforce. The rights of pregnant women to temporary stability, free time for medical examinations, change of duties and maternity leave contrast with the growing power of labor administration.

New labor management guidelines and changes in cesarean delivery patterns.

Science.gov (United States)

Rosenbloom, Joshua I; Stout, Molly J; Tuuli, Methodius G; Woolfolk, Candice L; López, Julia D; Macones, George A; Cahill, Alison G

2017-12-01

In 2010 the Consortium on Safe Labor published labor curves. It was proposed that the rate of cesarean delivery could be lowered by avoiding the diagnosis of arrest of dilation before 6 cm. However, there is little information on the uptake of the guidelines and on changes in cesarean delivery rates that may have occurred. The objective of the study was to test the following hypotheses: (1) among patients laboring at term, rates of arrest of dilation disorders have decreased, leading to a decrease in the rate of cesarean delivery; (2) in the second stage, pushing duration prior to diagnosis of arrest of descent has increased, also leading to a reduction in the rate of cesarean delivery for this indication. As a secondary aim, we investigated changes in maternal and neonatal morbidity. This was a secondary analysis of a prospective cohort study of all patients presenting at ≥37 weeks' gestation from 2010 through 2014 with a nonanomalous vertex singleton and no prior history of cesarean delivery. Rates of cesarean delivery, arrest of dilation, and changes in rates of maternal and neonatal morbidity were calculated in crude and adjusted models. Cervical dilation at diagnosis of the arrest of dilation, time spent at the maximal dilation prior to diagnosis of arrest of dilation, and time in the second stage prior to the diagnosis of arrest of descent were compared over the study period. There were 7845 eligible patients. The cesarean delivery rate in 2010 was 15.8% and, in 2014, 17.7% (P trend = .51). In patients undergoing cesarean delivery for the arrest of dilation, the median cervical dilation at the time of cesarean delivery was at 5.5 cm in 2010 and 6.0 cm in 2014 (P trend = .94). In these patients, there was an increase in the time spent at last dilation: 3.8 hours in 2010 to 5.2 hours in 2014 (P trend = .02). There was no change in the frequency of patients diagnosed with the arrest of dilation at labor management that have occurred over the initial years

Income and Wealth Distribution in a Neoclassical Two-Sector Heterogeneous-Households Growth Model with Elastic Labor Supply and Consumer Durable Goods

Directory of Open Access Journals (Sweden)

Wei-Bin ZHANG

2017-06-01

Full Text Available This paper proposes a two-sector two-group growth model with elastic labor supply and consumer durable goods. We study dynamics of wealth and income distribution in a competitive economy with capital accumulation as the main engine of economic growth. The model is built on the Uzawa two-sector model. It is also influenced by the neoclassical growth theory and the post-Keynesian theory of growth and distribution. We plot the motion of the economic system and determine the economic equilibrium. We carry out comparative dynamic analysis with regard to the propensity to save and improvements in human capital and technology.

Rollout of quality assurance interventions in labor room in two districts of Bihar, India

OpenAIRE

Jyoti Sharma; Sutapa B Neogi; Preeti Negandhi; Monika Chauhan; Siddharth Reddy; Ghanshyam Sethy

2016-01-01

Background: Quality of care at the facilities during childbirth remains a major concern. Improved quality could have the greatest dividend in saving maternal and newborn lives. Objective: The objective of this study was to implement quality assurance measures in the labor rooms of select public health facilities in two districts of Bihar. Methods: The labor room quality assurance intervention was implemented in two districts, Gaya and Purnea in Bihar. Health facilities having >200 deliveries/...

Comparison of delayed versus immediate pushing during second stage of labor for nulliparous women with epidural anesthesia.

Science.gov (United States)

Gillesby, Erica; Burns, Suzan; Dempsey, Amy; Kirby, Shirley; Mogensen, Kami; Naylor, Kelly; Petrella, Joann; Vanicelli, Rebecca; Whelan, Breon

2010-01-01

To determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and decreases maternal fatigue. Randomized clinical trial. Labor and delivery unit of a not-for-profit community hospital. Convenience sample of nulliparous laboring women with epidural anesthesia. Immediate or delayed pushing (2 hours) during the second stage of labor at the time of complete cervical dilatation. The length of pushing, total length of the second stage, and maternal fatigue. A total of 77 women were studied (immediate pushing group=39; delayed pushing=38). The immediate pushing group averaged 94 (± 57) minutes in active pushing, while the delayed pushing group averaged 68 (± 46) minutes, a statistically significant difference (p=.04). No significant differences were found in fatigue scores between the immediate and delayed pushing groups (p>.05). We found that by delaying the onset of active pushing for 2 hours after the beginning of the second stage of labor, the time that nulliparous women with epidural anesthesia spent in active pushing was significantly decreased by 27%. Although the delayed pushing group rested for up to 2 hours, the total time in the second stage of labor averaged only 59 minutes longer than the immediate pushing group. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Blame the Parents? How Financial Incentives Affect Labor Supply and Job Quality for Young Adults

OpenAIRE

Fradkin, Andrey; Panier, Frédéric; Tojerow, Ilan

2015-01-01

Young adults entering the labor force typically have little access to unemployment insurance or other formal insurance mechanisms. Instead, they rely on family insurance in the form of parental support to smooth consumption. We study the labor market response of Belgian young adults to decreases in parental support caused by parental job displacements. Our estimates correct for unobserved heterogeneity by using the timing of parental shocks before and after labor market entry. We find that a ...

Do childcare policies increase maternal employment?

OpenAIRE

Vuri, Daniela

2016-01-01

Women’s labor force participation has rapidly increased in most countries, but mothers still struggle to achieve a satisfactory work−life balance. Childcare allows the primary caregiver, usually the mother, to take time away from childrearing for employment. Family policies that subsidize childcare and increase its availability have different effects on female labor supply across countries. For policymakers to determine how well these policies work, they should consider that policy effectiven...

Labor Force Participation, Employment, and Earnings of Married Women: A Comparison of Military and Civilian Wives

Science.gov (United States)

1990-07-01

Participation of Married Women: A Study of Labor Supply," in NBER, Aspects of Labor Economics , Princeton: Princeton University Press. 8. (1975). "The...Carolina. 11. Rosen, Sherwin (1977). "Human Capital: A Survey of Empirical Research," in Ehrenberg, R., ed., Research in Labor Economics , Vol. 1

Optimal Differentiation of International Environmental Taxes in the Presence of National Labor Market Distortions

International Nuclear Information System (INIS)

Felder, S.; Schleiniger, R.

2000-01-01

We explore the implication of the 'double dividend' debate for international environmental taxes. In our scenario, small open economies with different labor market distortions follow a common environmental policy and use national environmental tax revenues to finance labor tax cuts. Since the double dividend hypothesis does not hold, a high labor tax implies a low environmental tax relative to other countries. The optimal differentiation of international environmental taxes is proven to be a function of the national labor tax rates and the uncompensated elasticities of labor supply. 20 refs

Epidural Labor Analgesia-Fentanyl Dose and Breastfeeding Success: A Randomized Clinical Trial.

Science.gov (United States)

Lee, Amy I; McCarthy, Robert J; Toledo, Paloma; Jones, Mary Jane; White, Nancy; Wong, Cynthia A

2017-10-01

Breastfeeding is an important public health concern. High cumulative doses of epidural fentanyl administered for labor analgesia have been reported to be associated with early termination of breastfeeding. We tested the hypothesis that breastfeeding success is adversely influenced by the cumulative epidural fentanyl dose administered for labor analgesia. The study was a randomized, double-blind, controlled trial of parous women at greater than 38 weeks gestation who planned to breastfeed, had successfully breastfed a prior infant, and who received neuraxial labor analgesia. Participants were randomized to receive one of three epidural maintenance solutions for labor analgesia (bupivacaine 1 mg/ml, bupivacaine 0.8 mg/ml with fentanyl 1 μg/ml, or bupivacaine 0.625 mg/ml with fentanyl 2 μg/ml). The primary outcome was the proportion of women breastfeeding at 6 weeks postpartum. Maternal and umbilical venous blood fentanyl and bupivacaine concentration at delivery were measured. A total of 345 women were randomized and 305 had complete data for analysis. The frequency of breastfeeding at 6 weeks was 97, 98, and 94% in the groups receiving epidural fentanyl 0, 1, and 2 μg/ml, respectively (P = 0.34). The cumulative fentanyl dose (difference: 37 μg [95% CI of the difference, -58 to 79 μg], P = 0.28) and maternal and umbilical cord venous fentanyl and bupivacaine concentrations did not differ between women who discontinued breastfeeding and those who were still breastfeeding at 6 weeks postpartum. Labor epidural solutions containing fentanyl concentrations as high as 2 μg/ml do not appear to influence breastfeeding rates at 6 weeks postpartum.

30 CFR 36.27 - Fuel-supply system.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fuel-supply system. 36.27 Section 36.27 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF... Construction and Design Requirements § 36.27 Fuel-supply system. (a) Fuel tank. (1) The fuel tank shall not...

Labor Supply of Wives with Husbands Employed Either Full Time or Part Time.

Science.gov (United States)

1980-02-01

Nantcy. Ka ,serg David. ’ New Technology and Naval Forces view, Vol. 30. No. 40. Jul 1977) "’Public Drug Treatmonfl adid Addict Crime." Jun in ihr South...husbands, the costs incidental to the wife’s workinq are money costs -- for suitable babysitters , for example. Evidence for this is the larqer absolute value...The Economics of Labor Force Particiioatlon. Princeton, New Jersey: Princeton University Pr e ss, 1969.7 Cailn, Glen. Mar ried Women in the Labor

Determinants of maternal mortality: a hospital based study from south India.

Science.gov (United States)

Rajaram, P; Agrawal, A; Swain, S

1995-01-01

During 1981-1986, 86 maternal deaths transpired at the obstetrics department of the Jawaharlal Institute of Postgraduate Medical Education and Research in Pondicherry, India. The maternal mortality rate stood at 5.8/1000 births. 31.4% were primigravidae. The percentage of maternal deaths characterized as gravidae 2-4, 5, and multigravidae was 42.9%, 9.3%, and 16.4%, respectively. The leading causes of death were sepsis (41.9%), especially septic abortion (30.2%); eclampsia-severe preeclampsia (10.5%); ruptured uterus (9.3%); and hemorrhage and prolonged labor (8.1% each). Direct obstetric causes of death accounted for 81.4% of all maternal deaths. Indirect obstetric causes of death were hepatitis (5.8%), heart disease (4.7%), and severe anemia (2.3%). Most of the women who died were illiterate (97.6%), poor (98.8%), and had received no prenatal care (94.2%). 47.7% traveled more than 60 km to the hospital. Quacks or untrained traditional birth attendants had excessively interfered with about 33% before they reached the hospital, especially the septic induced abortion, obstructed labor, and ruptured uterus cases. Among the 48 women who delivered before dying, there were 24 live births (5 of whom died during the early neonatal period) and 24 still births. These findings indicate a need for a cooperative effort to improve and expand maternal and child health care in the community.

Profiles of fertility, labour supply and wages of married women: a complete life-cycle model.

Science.gov (United States)

Moffitt, R

1984-01-01

Trends in fertility and female labor supply have changed dramatically since World War II. Fertility rates rose steadily from the 1940's until the early 1960's and thereafter declined, while female laborforce participation rates have continually grown since the 1950's. These 2 rates are closely linked. Labor supply and fertility decisions are also life-cycle decisions. In addition, wage and job prospects are related to job choice and in turn to fertility decisions. Labor supply, fertility, and wages are linked in an econometric model which takes into account the problems of heterogeneity of tastes, the problem of missing wage rates through nonworking, and the problem of simultaneous-equations bias. Past works are critiqued, mainly on the basis that few analyses recognize the interrelatedness of fertility and labor supply in any sense--static or dynamic. Nor do most researchers consider age-specific fertility equations in analyzing female labor supply. Moffitt's model is a beginning analysis of fertility and labor supply as a joint consumer-demand choice. Patterns of a couple's future consumption, wife's labor supply, and births are assumed to be planned at the beginning of marriage. These patterns depend on the constraints of budget, fertility, and of inverse production (the differing amounts of time it takes to care for a child as the child matures) as well as wage accumulation. Exogenous wealth and beginning wages are considered as well. This model does not account for a woman's work experience prior to marriage. According to the model, fertility rates rise in the 1st year of marriage and subsequently fall off. Employment rates drop off at an accelerating rate until the 6th year of marriage and then increase. A rise in wage level decreases the probability of birth and increases the probability ow working. Also, changes in fertility rates have more to do with wage changes than with a woman's cohort.

Risk factors for maternal mortality in the west of Iran: a nested case-control study

Directory of Open Access Journals (Sweden)

Jalal Poorolajal

2014-11-01

Full Text Available OBJECTIVES: With a gradual decline in maternal mortality in recent years in Iran, this study was conducted to identify the remaining risk factors for maternal death. METHODS: This 8-year nested case-control study was conducted in Hamadan Province, in the west of Iran, from April 2006 to March 2014. It included 185 women (37 cases and 148 controls. All maternal deaths that occurred during the study period were considered cases. For every case, four women with a live birth were selected as controls from the same area and date. Conditional logistic regression analysis was performed and the odds ratio (OR and its 95% confidence interval (CI were obtained for each risk factor. RESULTS: The majority of cases were aged 20-34 years, died in hospital, and lived in urban areas. The most common causes of death were bleeding, systemic disease, infection, and pre-eclampsia. The OR estimate of maternal death was 8.48 (95% CI=1.26-56.99 for advanced maternal age (≥35 years; 2.10 (95% CI=0.07-65.43 for underweight and 10.99 (95% CI=1.65-73.22 for overweight or obese women compared to those with normal weight; 1.56 (95% CI=1.08-2.25 for every unit increase in gravidity compared to those with one gravidity; 1.73 (95% CI=0.34-8.88 for preterm labors compared to term labors; and 17.54 (95% CI= 2.71-113.42 for women with systemic diseases. CONCLUSIONS: According to our results, advanced maternal age, abnormal body mass index, multiple gravidity, preterm labor, and systemic disease were the main risk factors for maternal death. However, more evidence based on large cohort studies in different settings is required to confirm our results.

INDIVIDUALIZATION, MATERNAL DILEMMAS AND LABOR DEVELOPMENT: CONTINUITIES AND CHANGE

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Castilla, María Victoria

2009-01-01

En este texto, se analizan los procesos de individualización y de reflexividad en relación con los límites entre los espacios público y privado, específicamente, los dilemas que enfrentan las mujeres entre la maternidad y el desarrollo laboral en el marco de las sociedades modernas contemporáneas. Se abordarán las transformaciones en la esfera de la intimidad de las mujeres madres trabajadoras de nivel socioeconómico medio y sus implicaciones en las relaciones familiares. El objetivo, consist...

Birth risk indicators for maternal and neonatal health: Songkla Center Hospital perspective.

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Kaewsuksai, Peeranan; Chandeying, Verapol

2012-02-01

The aim of the present study was to examine the maternal and neonatal birth risk indicator and their relationship with the outcome of pregnancy. This retrospective descriptive study was conducted in a selective month of 2008, 2009, and 2010. The birth risk indicators of maternal and neonatal health were collected from the medical records. There were 385, 349 and 334 deliveries in a selective month of 2008, 2009, and 2010. There was neither maternal mortality, nor cardiovascular failure in the present study period. Three main indication of inductions of labor were premature rupture of membrane (up to 4.0%), diabetes mellitus (up to 2.0%), and postdate (up to 1.3%). The first two conditions had statistical significance in September 2009 (p = 0.0334 and 0.0053 respectively). Whereas, the three major indications of cesarean section were previous cesarean section (12.5 to 21.9%), failure to progress due to protracted/arrest of labor pattern with/without rupture of membrane and augmented labor (2.4 to 7.5%), and fetal distress (1.1 to 4.2%). The rates of low birth weight, less than 2,500 grams, were varied from 5.2 to 6.9%. The respiratory distress syndrome (RDS) related to repeat cesarean section was encountered up to 3.6%, as well as the RDS related to induction of labor was up to 1.6%. The birth risk indicators reflect the outcome of pregnancy, however the development of additional key indicators for perinatal health care outcome are required.

Labor market in Serbia: 1990-2005

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Stojanović Božo

2006-01-01

Full Text Available Key problems in transitions in Serbia can be analyzed through the processes happening at the labor market. Labor market in Serbia is divided on the formal and informal one ("gray". The basic problem is mass unemployment. The unemployment in Serbia is not frictional unemployment resulting from decisions of workers to change their jobs. This kind of unemployment is considered normal at all labor markets. Since it is not frictional, unemployment in Serbia is not short-term one. This unemployment is by its nature structural and therefore long-term. Structural unemployment always arises as a result of the illadapted structure of labor supply and demand. There is a particularly high level of long-term unemployment among young people who practically do not have any work experience. The only realistic solution for mass unemployment and low wages in the Serbian economy is increasing of productivity and overall economic efficiency. Stimulating entrepreneurship and opening of new companies to absorb an enormous number of unemployed is the central issue of the economic reform. Instead of short-term passive measures, the state should adopt active measures aimed at stimulating of entrepreneurship and creating of new jobs.

Supply kits for antenatal and childbirth care: a systematic review.

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Aleman, Alicia; Tomasso, Giselle; Cafferata, María Luisa; Colomar, Mercedes; Betran, Ana Pilar

2017-12-13

It is critical to increase the uptake of interventions proven to be effective to improve maternal and perinatal outcomes. Supply kits have been suggested to be a feasible strategy designed to ensure timely availability and effective follow-up of care. We conducted a systematic review to summarize the evidence on the uptake, effectiveness and safety of supply kits for maternal care. MEDLINE, the Cochrane Pregnancy and Childbirth Group's Trials Register, Campbell Collaboration, Lilacs, Embase and unpublished studies were searched. Studies that reported the efficacy, safety and use of supply kits for maternal healthcare were eligible. Participants were pregnant women or in childbirth. Supply kits were defined as a collection of medicines, supplies or instruments packaged together with the aim of conducting a healthcare task. Two reviewers independently performed the screening, data extraction, and methodological and quality assessment. 24 studies were included: 4 of them were systematic reviews and 20 primary studies. Eighteen studies evaluated a so-called "clean delivery kit". In all but two studies, the kits were used by more than half of the participants. A meta-analysis was deemed inappropriate due to the heterogeneity in study design, in the components of the interventions implemented, in the content of the kits, and in outcomes. Nine studies assessed neonatal outcomes and found statistically significant reductions in cord infection, sepsis and tetanus-related mortality in the intervention group. Three studies showed evidence of reduced neonatal mortality (OR 0.52, 0.60 and 0.71) with statistically significant confidence intervals in all cases. Four studies reported odd ratios for maternal mortality, but only one showed evidence of a statistically significant decrease in this outcome but it was ascribed to hand washing prior to childbirth and not with the use of kits. This review suggests potential benefits in the use of supply kits to improve maternal and

[Labor market and health. SESPAS Report 2010].

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García, Ana M

2010-12-01

The labor market, where the supply of labor meets demand, determines employment and working conditions, with positive and negative effects on the active population's health and that of their families. Labor markets are also affected by national and international social and economic policies. Unemployment, precarious contracts and new types of employment have been shown to be related to exposure to living and working conditions that cause physical and mental health problems. Some collectives, such as manual, young or immigrant workers, are more vulnerable to labor market fluctuations and more frequently experience adverse employment and working conditions. The current situation in Spain is now highly worrysome. In Spain, in 2009, more than 1.2 million workers lost their jobs. The unemployment rate has doubled in 5 years, from 9% in 2005 to 18% in 2009. Temporary contracts account for 24% of all job contracts. Economic and employment policies are urgently needed to reverse this situation, which unquestionably has a negative effect on people's health and wellbeing. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Labor and Transfer Income and Older Women's Work: Estimates From the United States

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Philip de Jong; Robert Haveman; Barbara Wolfe

1988-01-01

This paper deals with the effects of labor and transfer incomes as determinants of older women's labor force participation. It examines the responsiveness of women aged 48-62 to the level of income available from both work and public transfer programs when deciding between work and nonwork options. The main focus is on whether the availability and generosity of disability-related transfers affects the labor supply of these women. A maximum-likelihood model is estimated separately for heads of...

Associations of maternal nutrition during pregnancy and postpartum with maternal cognition and caregiving

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Brain function depends on a continuous supply of nutrients, including micronutrients and fatty acids. Pregnancy and postpartum (pp) are periods of increased nutrient demands, during which optimal maternal cognition is important to prepare for a healthy birth and care for a young infant. However, few...

Description of inter-institutional referrals after admission for labor and delivery: a prospective population based cohort study in rural Maharashtra, India.

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Patel, Archana B; Prakash, Amber Abhijeet; Raynes-Greenow, Camille; Pusdekar, Yamini V; Hibberd, Patricia L

2017-05-19

In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India. Pregnant women from 20 rural Primary Health Centers near Nagpur, Maharashtra were followed throughout pregnancy and to day 42 post-partum. Inter- institutional referral was defined as transfer of a woman from a first or second level facility where she was admitted for labor and delivery to facility providing higher level of care, after admission to the day of delivery. Maternal mortality, stillbirth, early and late neonatal mortality were compared in mothers who were and were not referred. Factors associated with inter-institutional referral were analyzed using multivariable models with generalized estimating equations, adjusted for clustering at the level of the Primary Health Center. Between June 2009 and June 2013, 3236 (9.4%) of 34,319 women had inter-institutional referral. Factors associated with referrals were maternal age (adjusted Relative Risk or aRR 1.1; 1.0-1.2); moderate or severe anemia (aRR 1.2; 1.2-1.4), gestational age <37 weeks (aRR 1.16; 1.05-1.27), multiple gestation (aRR 1.6; 1.2-2.1), absent fetal heart rate (aRR 1.7; 1.3-2.2), primigravida (aRR 1.4; 1.3, 1.6), primigravida with any pregnancy related maternal condition such as obstructed or prolonged labor; major antepartum or post-partum hemorrhage, hypertension or preeclampsia and breech, transverse or oblique lie (aRR 4.7; 3.8, 5.8), multigravida with any pregnancy related conditions (aRR 4.2; 3.4-5.2). Stillbirths, early neonatal

Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

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Uma Srivastava

2009-01-01

Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

The representations puerperal women have about the care they received during labor

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Laura Pinto Torres de Melo

2018-01-01

Full Text Available Objective: to describe the social representations puerperal women have about the care they received during labor and delivery. Methodology: this is a descriptive study, based on the Theory of the Central Nucleus, which was undertaken with 119 women in the postpartum period in a public maternity hospital, located in the city of Fortaleza, Ceará, Brazil. The data were collected through the Free Word Association Test, which included as inductive stimuli: care, labor, delivery and care in labor and delivery. The data were transcribed and analyzed with Evoc software. Results: the structural analysis showed that the words “pain”, “happiness” and “guidance” ocurred more frequency as a central feature of the respective inducing terms. Conclusion: the results confirm that the moment of labor and delivery is crucial for nurses in the planning and implementation of adequate care during parturition insofar, as such measures lessen the impact of negative representations of childbirth.

Usefulness of maternal serum C-reactive protein with vaginal Ureaplasma urealyticum as a marker for prediction of imminent preterm delivery and chorioamnionitis in patients with preterm labor or preterm premature rupture of membranes.

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Kwak, Dong-Wook; Cho, Hee-Young; Kwon, Ja-Young; Park, Yong-Won; Kim, Young-Han

2015-07-01

To assess whether maternal serum C-reactive protein (CRP) and genital mycoplasmas measured can help predict imminent preterm delivery or chorioamnionitis in patients with preterm labor (PL) or preterm premature rupture of membranes (PPROM). The study group consisted of 165 women with PL or PPROM. Vaginal cultures for genital mycoplasmas and maternal blood for CRP were obtained when they were admitted for the management of PL or PPROM. An elevated level of serum CRP was defined as ≥0.8 mg/dL. Histologic evaluation of the placenta was performed after delivery. The prevalence of positive vaginal fluid cultures for Ureaplasma urealyticum (UU) was 63.0%, and elevated maternal serum CRP was 32.7%. No outcome variables were associated with vaginal UU infection in patients with lower CRP levels. However, among women with elevated CRP, the mean gestational age at birth was significantly reduced, and low Apgar score, neonatal intensive care unit admission, histologic chorioamnionitis, and delivery within 7 days of admission were significantly more common in patients with vaginal UU. Although vaginal UU in PL or PPROM cannot act as the sole predictor of imminent preterm delivery or chorioamnionitis, it can provide predictive information in patients with elevated maternal serum CRP levels.

Notes on the incorporation of third world women into wage-labor through immigration and off-shore production.

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Sassen-koob, S

1984-01-01

The different forms and geographic locations in which the expanded incorporation of Third World women into wage labor occur may be closely interrelated. 2 such instances examined in this article are: 1) the recruitment of young women, without previous labor force experience, into the new manufacturing and service jobs generated by export-led manufacturing in several Caribbean and Asian countries; and 2) the employment of immigrant women in large cities of highly industrialized countries which have undergone basic economic restructuring. While many of these women may have become domestic or international migrants as a function of their husbands' or family's migration, the more fundamental processes of this restructuring are the ones promoting the formation of a supply of women migrants and a demand for this type of labor. Examples are the shift of plants and offices to Third World countries, and the demand for immigrant women labor in large cities within the US. The latter is a manifestation of the general shift to a service economy, the downgrading of manufacturing, partly to keep it competitive with overseas plants, and the direct and indirect demand for low-wage labor generated by the expansion of management and control functions centered in these large cities, and necessary for the regulation of the global economy. The feminization of job supply and the need to secure a politically adequate labor supply, which combine to create a demand for the type of labor represented by migrant women, suggest that gender has to be considered in conjunction with the structural arrangements and that gender by itself cannot adequately describe the nature of migrant labor.

A theoretical framework for the interpretation of pharmacist workforce studies throughout the world: The labor supply curve.

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Carvajal, Manuel J

2017-12-02

Despite geographic, financial, and cultural diversity, publications dealing with the pharmacist workforce throughout the world share common concerns and focus on similar topics. Their findings are presented in the literature in a seemingly unrelated way even though they are connected to one another as parts of a comprehensive theoretical structure. The purpose of this paper is to develop a theoretical model that relates some of the most salient topics addressed in the international literature on pharmacist workforce. The model is developed along two fundamental ideas. The first identifies the shape and location of the pharmacist's labor supply curve as the driving force behind all workforce decisions undertaken by pharmacists; the second argues that gender and age differences are two of the most important factors determining the shape and location of this supply curve. The paper then discusses movements along the curve attributed to changes in the wage rate, as well as displacements of the curve attributed to disparities in personal characteristics, investments in human capital, job-related preferences, opinions and perceptions, and institutional rigidities. The focus is on the individual pharmacist, not on groups of pharmacists or the profession as a whole. Works in multiple countries that address each topic are identified. Understanding these considerations is critical as employers' failure to accommodate pharmacists' preferences for work and leisure are associated with negative consequences not only for them but also for the healthcare system as a whole. Possible consequences include excessive job turnover, absenteeism, decreased institutional commitment, and lower quality of work. Copyright © 2017. Published by Elsevier Inc.

Comparison of relaxation with counterpressure massage techniques for reduce pain first stage of labor

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Lisa, U. F.; Jalina, M.; Marniati

2017-09-01

Based on interviews of so me mother who entered the first stage of labor lack of care from health workers to the effort to reducing the acuteof labor. Health care workers appertain hospital in effective in implement maternity nursing interventions in reducing acute the first stage of labor. The reducing acute have two method are pharmacological and non-pharmacological. In this case, has several techniques there are: relaxation and counterpressure massage techniques that capable to reducing acute first stage of labor. The of non-pharmacological is one of authority which must be implemented by midwives especially breathing relaxation techniquesand massage. The research is Quasi Exsperimen with pretes-posttest design. The statistic test has T test paired and unpairedt test. To indicatea reducing the level of acute before and after given relaxation technique result p-value pain. Therefore, the health of workers, especially for a study to apply relaxation and massage to provide of mother care, mainly to the primigravida who in experienced in process of labor.

The Prevalence of Urogenital Infections in Pregnant Women Experiencing Preterm and Full-Term Labor

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Paulo César Giraldo

2012-01-01

Full Text Available Urogenital infections are extremely prevalent during pregnancy and are an important cause of premature labor. However, the prevalence of urogenital infections during childbirth is not well known. Objective. Identify urogenital infections present at the beginning of labor in both full-term and preterm pregnancies. Study Design. Ninety-four women were admitted to the inpatient maternity clinic of the Federal University of Rio Grande do Norte (UFRN. In total, 49 women in preterm labor and 45 women in full-term labor were included in the study, and samples of urinary, vaginal, and perianal material were collected for microbiological analysis. Results. The prevalences of general infections in the preterm labor group and the full-term labor group were 49.0% and 53.3% (P=0.8300, respectively. Urogenital infections in the preterm and full-term labor groups included urinary tract infection in 36.7% and 22.2% of women, vaginal candidiasis in 20.4% and 28.9% of women, bacterial vaginosis in 34.7% and 28.9% of women, and group B streptococcus in 6.1% and 15.6% of women, respectively. Conclusions. Urogenital infections were prevalent in women in preterm labor and full-term labor; however, significant differences between the groups were not observed.

Monopsony in the labor market: Profit vs. Wage maximization

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Šuvaković Đorđe, Olgin

2007-01-01

Full Text Available This paper compares the efficiency of profit- and wage-maximizing (PM and WM monopsony in the labor market. We show that, both locally and globally, a PM monopsony may well be dominated by its WM twin, where the local and global dominance are defined with respect to a single (inverse labor supply function and a single family of such functions. This family is always divided in the two disjoint (subfamilies of the PM and WM dominance. We also analyze some major factors that explain the size of these (subfamilies. .

Children and Careers: How Family Size Affects Parents' Labor Market Outcomes in the Long Run.

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Cools, Sara; Markussen, Simen; Strøm, Marte

2017-10-01

We estimate the effect of family size on various measures of labor market outcomes over the whole career until retirement, using instrumental variables estimation in data from Norwegian administrative registers. Parents' number of children is instrumented with the sex mix of their first two children. We find that having additional children causes sizable reductions in labor supply for women, which fade as children mature and even turn positive for women without a college degree. Among women with a college degree, there is evidence of persistent and even increasing career penalties of family size. Having additional children reduces these women's probability of being employed by higher-paying firms, their earnings rank within the employing firm, and their probability of being the top earner at the workplace. Some of the career effects persist long after labor supply is restored. We find no effect of family size on any of men's labor market outcomes in either the short or long run.

Collective labor supply of native Dutch and immigrant households in the Netherlands

NARCIS (Netherlands)

van Klaveren, C.; van Praag, B.; Maassen van den Brink, H.

2009-01-01

We estimate a collective time allocation model, where Dutch, Surinamese/Antillean and Turkish households behave as if both spouses maximize a household utility function. We assume that paid labor and housework are the endogenous choice variables and furthermore consider household production.

Labor analgesia with ropivacaine added to clonidine: a randomized clinical trial

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Giane Nakamura

Full Text Available CONTEXT AND OBJECTIVE: Previous studies have led to speculation that the association between ropivacaine and clonidine might be more effective than ropivacaine alone. We examined the maternal-fetal effects of two pharmacological approaches: a low dose of ropivacaine or a lower dose of ropivacaine plus clonidine for epidural analgesia during labor. DESIGN AND SETTING: Prospective study at Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Thirty-two pregnant women in American Society of Anesthesiologists physical status I and II randomly underwent epidural analgesia using 15 ml of ropivacaine 0.125% (R group or 15 ml of ropivacaine 0.0625% plus 75 µg clonidine (RC group. Pain intensity, sensory block level, latency time, motor block intensity, duration of labor analgesia and duration of epidural analgesia were evaluated. The newborns were evaluated using Apgar scores and the Amiel-Tison method (neurological and adaptive capacity score. RESULTS: There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination. RESULTS: There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination

Persisting rise in referrals during labor in primary midwife-led care in The Netherlands

NARCIS (Netherlands)

Offerhaus, P.M.; Hukkelhoven, C.W.P.M.; Jonge, A. de; Pal-de Bruin, K.M. van der; Scheepers, P.L.H.; Lagro-Janssen, A.L.M.

2013-01-01

Background: There are concerns about the Dutch maternity care system, characterized by a strict role division between primary and secondary care. The objective of this study was to describe trends in referrals and in perinatal outcomes among labors that started in primary midwife-led care. Methods:

Maternity Leave in Australia: Employee and Employer Experiences. Report of a Survey. Australian Institute of Family Studies Monograph No. 7.

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Glezer, Helen

A study was made to obtain a broad overview of the operation of maternity leave in Australia from the perspectives of employees and employers. The study included: (1) an employee survey exploring the use and non-use of maternity leave and identifying determinants of taking maternity leave and of retaining women in the labor force after childbirth;…

Likelihood of cesarean delivery after applying leading active labor diagnostic guidelines.

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Neal, Jeremy L; Lowe, Nancy K; Phillippi, Julia C; Ryan, Sharon L; Knupp, Amy M; Dietrich, Mary S; Thung, Stephen F

2017-06-01

Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons). Active labor diagnostic guidelines were retrospectively applied to cervical examination data from nulliparous women with spontaneous labor onset (n = 2573). Generalized linear models were used to determine outcome likelihoods within- and between-guideline groups. At admission, 15.7%, 48.3%, and 10.1% of nulliparous women were in active labor per Friedman, NICE, and ACOG/SMFM diagnostic guidelines, respectively. Cesarean delivery was more likely among women admitted before vs in active labor per the Friedman (AOR 1.75 [95% CI 1.08-2.82] or NICE guideline (AOR 2.55 [95% CI 1.84-3.53]). Between guidelines, cesarean delivery was less likely among women admitted in active labor per the NICE guideline, as compared with the ACOG/SMFM guideline (AOR 0.55 [95% CI 0.35-0.88]). Many nulliparous women are admitted to the hospital before active labor onset. These women are significantly more likely to have a cesarean delivery. Diagnosing active labor before admission or before intervention to speed labor may be one component of a multi-faceted approach to decreasing the primary cesarean rate in the United States. The NICE diagnostic guideline is more inclusive than Friedman or ACOG/SMFM guidelines and its use may be the most clinically useful for safely lowering cesarean rates. © 2017 Wiley Periodicals, Inc.

A historical review of the concept of labor support in technocratic, humanistic and holistic paradigms of childbirth.

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Najafi, Tahereh Fathi; Roudsari, Robab Latifnejad; Ebrahimipour, Hossein

2017-10-01

In the past century, maternal support during childbirth has been changed according to the different approaches suggested by various health care paradigms. The aim of this review was to argue the maternity supportive care paradigms of the past century and to closely analyze each paradigm. This is a historical review, in which published articles were retrieved from databases including Scopus, Science Direct, PubMed and Google Scholar. Sage Journals and Springer's publications were also searched due to the high citation rate of their articles. The keywords entered were "Labor support", "Normal delivery", "Birth attendance", "Supportive approaches", "Health care paradigms", and "Midwifery models of care". They were entered alone or in combinations using "AND". Also, Persian articles were searched in local databases including Irandoc, SID, IranMedex, and Magiran using the above-mentioned keywords in Persian. Sixty articles met inclusion criteria. The review revealed four main themes including the definitions of continuous labor support, the technocratic paradigm, the humanistic paradigm and the naturalistic paradigm as models of labor support. According to the evidence, labor support has changed from technocratic to humanistic and holistic approaches, which in turn, caused some changes in midwifery models of care used by midwives in the practice. Labor support based on the holistic approaches and the naturalistic paradigms could bring about remarkable outcomes, the most important being satisfied with the birth experience, increased mother's self-confidence, enhanced mother's ability in childbirth and better completion of the childbirth process.

Size doesn't matter!: gift exchange in experimental labor markets

NARCIS (Netherlands)

Brandts, J.; Gërxhani, K.; Schram, A.; Ygosse-Battisti, J.

2009-01-01

We study how the number of traders affects the interaction between a centralized exchange and bilateral negotiations in an experimental labor market with excess supply and incomplete contracts. In bilateral negotiations firms obtain information about employees’ performance in previous jobs. Though

Facility-Based Maternal Death in Western Africa: A Systematic Review

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Nathali Gunawardena

2018-02-01

Full Text Available BackgroundFor exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994. The model comprises delay in deciding to seek care (delay 1, delay in reaching the health facility (delay 2, and delay in receiving quality care once at the health facility (delay 3. Few studies have comprehensively dealt with the health systems delays that prevent the receipt of timely and appropriate obstetric care once a woman reaches a health facility (phase III delays. The objective of the present study was to identify facility-level barriers in West African health facilities.MethodsElectronic databases (Medline, cumulative index to nursing and allied health literature, Centre for Agriculture and Biosciences International Global Health, EMBASE were searched to identify original research articles from 1996 to 2016. Search terms (and synonyms related to (1 maternal health care (e.g., obstetric care, perinatal care, maternal health services; (2 facility level (e.g., maternity unit, health facility, phase III, hospital; and (3 Western Africa (e.g., Nigeria, Burkina Faso were combined. This review followed the preferred reporting items for systematic reviews and meta-analyses.ResultsOf the 2103 citations identified, 13 studies were eligible. Studies were conducted in Nigeria, Burkina Faso, Gambia, Guinea, Senegal, and Sierra Leone. 30 facility-level barriers were identified and grouped into 6 themes (human resources, supply and equipment, referral-related, infrastructure, cost-related, patient-related. The most obvious barriers included staff shortages, lack of maternal health services and procedures offered to patients, and lack of necessary medical equipment and supplies in the health-care facilities.ConclusionThis review emphasizes that phase I and phase II barriers are not the only factors preventing women from accessing proper emergency obstetric care. Health-care facilities in Western

Nitrous oxide for the management of labor pain: a systematic review.

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Likis, Frances E; Andrews, Jeffrey C; Collins, Michelle R; Lewis, Rashonda M; Seroogy, Jeffrey J; Starr, Sarah A; Walden, Rachel R; McPheeters, Melissa L

2014-01-01

We systematically reviewed evidence addressing the effectiveness of nitrous oxide for the management of labor pain, the influence of nitrous oxide on women's satisfaction with their birth experience and labor pain management, and adverse effects associated with nitrous oxide for labor pain management. We searched the MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for articles published in English. The study population included pregnant women in labor intending a vaginal birth, birth attendees or health care providers who may be exposed to nitrous oxide during labor, and the fetus/neonate. We identified a total of 58 publications, representing 59 distinct study populations: 2 studies were of good quality, 11 fair, and 46 poor. Inhalation of nitrous oxide provided less effective pain relief than epidural analgesia, but the quality of studies was predominately poor. The heterogeneous outcomes used to assess women's satisfaction with their birth experience and labor pain management made synthesis of studies difficult. Most maternal adverse effects reported in the literature were unpleasant side effects that affect tolerability, such as nausea, vomiting, dizziness, and drowsiness. Apgar scores in newborns whose mothers used nitrous oxide were not significantly different from those of newborns whose mothers used other labor pain management methods or no analgesia. Evidence about occupational harms and exposure was limited. The literature addressing nitrous oxide for the management of labor pain includes few studies of good or fair quality. Further research is needed across all of the areas examined: effectiveness, satisfaction, and adverse effects.

Clinical Risk Factors Associated With Peripartum Maternal Bacteremia.

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Easter, Sarah Rae; Molina, Rose L; Venkatesh, Kartik K; Kaimal, Anjali; Tuomala, Ruth; Riley, Laura E

2017-10-01

To evaluate risk factors associated with maternal bacteremia in febrile peripartum women. We performed a case-control study of women with fevers occurring between 7 days before and up to 42 days after delivery of viable neonates at two academic hospitals. Women with positive blood cultures were matched with the next two febrile women meeting inclusion criteria with negative blood cultures in the microbiology data without other matching parameters. We compared maternal and neonatal characteristics and outcomes between women in the case group and those in the control group with univariate analysis. We then used logistic regression to examine the association between clinical characteristics and maternal bacteremia. After excluding blood cultures positive only for contaminants, we compared 115 women in the case group with 285 in the control group. Bacteremic women were more likely to experience their initial fever during labor (40.9% compared with 22.8%, P<.01) and more likely to have fever at or above 102°F (62.6% compared with 31.6%, P<.01). These associations persisted in the adjusted analysis: multiparity (adjusted odds ratio [OR] 1.75, 95% CI 1.07-2.87), initial fever during labor (adjusted OR 2.82, 95% CI 1.70-4.70), and fever at or above 102°F (adjusted OR 3.83, 95% CI 2.37-6.19). In an analysis restricted to neonates whose mothers had initial fevers before or in the immediate 24 hours after delivery, neonates born to women in the case group had higher rates of bacteremia compared with those born to women in the control group (9.0% compared with 1.3%, P<.01). Eight of the nine bacteremic neonates born to bacteremic mothers (89%) grew the same organism as his or her mother in blood culture. Maternal bacteremia is associated with multiparity, initial fever during labor, and fever at or above 102°F; however, 37.5% of cases of bacteremia occurred in women with maximum fevers below this threshold. Obstetricians should maintain a heightened suspicion for an

Maternal employment and Mexican school-age children overweight in 2012: the importance of households features.

Science.gov (United States)

Espinosa, Alejandro Martínez

2018-01-01

International evidence regarding the relationship between maternal employment and school-age children overweight and obesity shows divergent results. In Mexico, this relationship has not been confirmed by national data sets analysis. Consequently, the objective of this article was to evaluate the role of the mothers' participation in labor force related to excess body weight in Mexican school-age children (aged 5-11 years). A cross-sectional study was conducted on a sample of 17,418 individuals from the National Health and Nutrition Survey 2012, applying binomial logistic regression models. After controlling for individual, maternal and contextual features, the mothers' participation in labor force was associated with children body composition. However, when the household features (living arrangements, household ethnicity, size, food security and socioeconomic status) were incorporated, maternal employment was no longer statically significant. Household features are crucial factors for understanding the overweight and obesity prevalence levels in Mexican school-age children, despite the mother having a paid job. Copyright: © 2018 Permanyer.

Maternal and neonatal effects of adding morphine to low‑dose ...

African Journals Online (AJOL)

2013-07-25

Jul 25, 2013 ... morphine to low‑dose bupivacaine epidural anesthesia on labor and neonatal outcomes, and maternal side effects. ... A total of 120 pregnant women were randomized into two groups with 60 .... a body mass index (BMI) >30, intrauterine growth ... BMI, satisfaction from analgesia following the first dose,.

Labor and skills gap analysis of the biomedical research workforce

Science.gov (United States)

Mason, Julie L.; Johnston, Elizabeth; Berndt, Sam; Segal, Katie; Lei, Ming; Wiest, Jonathan S.

2016-01-01

The United States has experienced an unsustainable increase of the biomedical research workforce over the past 3 decades. This expansion has led to a myriad of consequences, including an imbalance in the number of researchers and available tenure-track faculty positions, extended postdoctoral training periods, increasing age of investigators at first U.S. National Institutes of Health R01 grant, and exodus of talented individuals seeking careers beyond traditional academe. Without accurate data on the biomedical research labor market, challenges will remain in resolving these problems and in advising trainees of viable career options and the skills necessary to be productive in their careers. We analyzed workforce trends, integrating both traditional labor market information and real-time job data. We generated a profile of the current biomedical research workforce, performed labor gap analyses of occupations in the workforce at regional and national levels, and assessed skill transferability between core and complementary occupations. We conclude that although supply into the workforce and the number of job postings for occupations within that workforce have grown over the past decade, supply continues to outstrip demand. Moreover, we identify practical skill sets from real-time job postings to optimally equip trainees for an array of careers to effectively meet future workforce demand.—Mason, J. L., Johnston, E., Berndt, S., Segal, K., Lei, M., Wiest, J. S. Labor and skills gap analysis of the biomedical research workforce. PMID:27075242

Labor and skills gap analysis of the biomedical research workforce.

Science.gov (United States)

Mason, Julie L; Johnston, Elizabeth; Berndt, Sam; Segal, Katie; Lei, Ming; Wiest, Jonathan S

2016-08-01

The United States has experienced an unsustainable increase of the biomedical research workforce over the past 3 decades. This expansion has led to a myriad of consequences, including an imbalance in the number of researchers and available tenure-track faculty positions, extended postdoctoral training periods, increasing age of investigators at first U.S. National Institutes of Health R01 grant, and exodus of talented individuals seeking careers beyond traditional academe. Without accurate data on the biomedical research labor market, challenges will remain in resolving these problems and in advising trainees of viable career options and the skills necessary to be productive in their careers. We analyzed workforce trends, integrating both traditional labor market information and real-time job data. We generated a profile of the current biomedical research workforce, performed labor gap analyses of occupations in the workforce at regional and national levels, and assessed skill transferability between core and complementary occupations. We conclude that although supply into the workforce and the number of job postings for occupations within that workforce have grown over the past decade, supply continues to outstrip demand. Moreover, we identify practical skill sets from real-time job postings to optimally equip trainees for an array of careers to effectively meet future workforce demand.-Mason, J. L., Johnston, E., Berndt, S., Segal, K., Lei, M., Wiest, J. S. Labor and skills gap analysis of the biomedical research workforce. © FASEB.

Outcomes of labor epidural analgesia among women aged over 40: A single-institution retrospective study.

Science.gov (United States)

Okazaki, Atsuko; Fukushima, Risa; Nagashima, Sayuri; Mazda, Yusuke; Tamura, Kazumi; Terui, Katsuo; Tanaka, Motoshi

2016-12-01

The purpose of this study was to investigate the effects of labor epidural analgesia (LEA) on maternal and neonatal outcomes among parturients aged 40 years or older. We retrospectively reviewed medical records of all laboring, singleton and cephalic deliveries at ≥36 weeks' gestation at the Saitama Medical Center from April 2003 to September 2012. Women aged ≥40 years who received LEA (≥40 with LEA group) were compared with women aged ≥40 years who delivered without LEA (≥40 without LEA group) and women <40 years who received LEA (<40 with LEA group). Extracted outcomes included mode of delivery, oxytocin augmentation, duration of labor, amount of estimated blood loss, umbilical artery pH, Apgar scores, and neonatal intensive care unit admission. This study included 4441 women. There were 74 women in the ≥40 with LEA group, 369 in the ≥40 without LEA group, and 601 in the <40 with LEA group. The maternal outcomes of emergency cesarean delivery rate (9.5%, 12.5%, 9.0%), instrumental delivery rate (33.8%, 10.3%, 28.3%), duration of labor (521 min, 321 min, 565 min), and estimated blood loss (524 g, 351 g, 412 g) were reported for the ≥40 with LEA, ≥40 without LEA, and <40 with LEA groups, respectively. Neonatal outcomes were not different between these groups. LEA use was not associated with emergency cesarean delivery in the multivariable analysis. Our study showed that parturients aged ≥40 with LEA can expect similar LEA-associated labor outcomes to younger parturients with LEA. © 2016 Japan Society of Obstetrics and Gynecology.

Maternal mortality in India: current status and strategies for reduction.

Science.gov (United States)

Prakash, A; Swain, S; Seth, A

1991-12-01

The causes (medical, reproductive factors, health care delivery system, and socioeconomic factors) of maternal mortality in India and strategies for reducing maternal mortality are presented. Maternal mortality rates (MMR) are very high in Asia and Africa compared with Northern Europe's 4/100,000 live births. An Indian hospital study found the MMR to be 4.21/1000 live births. 50-98% of maternal deaths are caused by direct obstetric causes (hemorrhage, infection, and hypertensive disorders, ruptured uterus, hepatitis, and anemia). 50% of maternal deaths due to sepsis are related to illegal induced abortion. MMR in India has not declined significantly in the past 15 years. Age, primi and grande multiparity, unplanned pregnancy, and related illegal abortion are the reproductive causes. In 1985 WHO reported that 63-80% of maternal deaths due to direct obstetric causes and 88-98% of all maternal deaths could probably have been prevented with proper handling. In India, coordination between levels in the delivery system and fragmentation of care account for the poor quality of maternal health care. Mass illiteracy is another cause. Effective strategies for reducing the MMR are 1) to place a high priority on maternal and child health (MCH) services and integrate vertical programs (e.g., family planning) related to MCH; 2) to give attention to care during labor and delivery, which is the most critical period for complications; 3) to provide community-based delivery huts which can provide a clean and safe delivery place close to home, and maternity waiting rooms in hospitals for high risk mothers; 4) to improve the quality of MCH care at the rural community level (proper history taking, palpation, blood pressure and fetal heart screening, risk factor screening, and referral); 5) to improve quality of care at the primary health care level (emergency care and proper referral); 6) to include in the postpartum program MCH and family planning services; 7) to examine the

Child Care and the Labor Supply of Married Women: Reduced Form Evidence.

Science.gov (United States)

Ribar, David C.

1992-01-01

With data from the Survey of Income Program Participation, a three-equation, reduced-form econometric model is used to generate estimates revealing that the cost of market child care decreases the labor force participation of married women. High wages increase likelihood of working and use of paid child care. (SK)

ROMANIAN PENSION SYSTEMS AND LABOR SUPPLY OF OLDER WORKERS

Directory of Open Access Journals (Sweden)

Cristina CIURARU-ANDRICA

2013-11-01

Full Text Available Prolonging working lives, in the context of an ageing population, has been seen as a good way to improve, on the one hand, the financial sustainability of the public pension system and, on the other hand, the adequacy of the pension benefit. As the literature has shown, even when measures for extending working lives have been taken, the characteristics of the national pension system (especially those of public pension system deliberately or inherently affected the labor market exit of older workers. Thus, through an econometric analysis, we estimate the relationship between the participation rate of Romanian older workers and certain characteristics of the Romanian pension systems (but not only, hoping to complement a more general literature on the effects of pension systems on retirement decision.

[Adapting to a shortage of labor beyond the year 2000].

Science.gov (United States)

Blanchet, D; Marchand, O

1991-05-01

Future labor force trends in France are reviewed. The impact of these trends on the current disequilibrium between job supply and demand is assessed. Factors considered include increases in immigration, extension of working life, female employment, and increased productivity. (SUMMARY IN ENG AND SPA)

Recent Immigrants as Labor Market Arbitrageurs: Evidence from the Minimum Wage*

Science.gov (United States)

Cadena, Brian C.

2014-01-01

This paper investigates the local labor supply effects of changes to the minimum wage by examining the response of low-skilled immigrants’ location decisions. Canonical models emphasize the importance of labor mobility when evaluating the employment effects of the minimum wage; yet few studies address this outcome directly. Low-skilled immigrant populations shift toward labor markets with stagnant minimum wages, and this result is robust to a number of alternative interpretations. This mobility provides behavior-based evidence in favor of a non-trivial negative employment effect of the minimum wage. Further, it reduces the estimated demand elasticity using teens; employment losses among native teens are substantially larger in states that have historically attracted few immigrant residents. PMID:24999288

Recent Immigrants as Labor Market Arbitrageurs: Evidence from the Minimum Wage.

Science.gov (United States)

Cadena, Brian C

2014-03-01

This paper investigates the local labor supply effects of changes to the minimum wage by examining the response of low-skilled immigrants' location decisions. Canonical models emphasize the importance of labor mobility when evaluating the employment effects of the minimum wage; yet few studies address this outcome directly. Low-skilled immigrant populations shift toward labor markets with stagnant minimum wages, and this result is robust to a number of alternative interpretations. This mobility provides behavior-based evidence in favor of a non-trivial negative employment effect of the minimum wage. Further, it reduces the estimated demand elasticity using teens; employment losses among native teens are substantially larger in states that have historically attracted few immigrant residents.

Trends in female labor force participation in Sweden.

Science.gov (United States)

Gustafsson, S; Jacobsson, R

1985-01-01

The labor force participation of Swedish married women increased form 49.1% to 83.5% in the past 2 decades. Results from cross section analyses carried out on micro data from 3 standard of living investigations, done in 1968, 1974, and 1981, are used to predict changes over time. Women's real wages have increased over time more than men's real wages; in combination with estimated positve own wages elasticities, this change is the most important determinant of the increase in female labor supply. The labor force participation of married women ages 20-59 has increased from 49.1% in 1963 to 83.5% in 1982; the increase is especially large for women with children under 7. Over the decades 1920-1965, when real wages of woman increased more than real incomes of men, the labor force participation rates of married women increased even faster. From 1963-1981 a dramatic narrowing of the male-female wage gap occurred; most of the decrease is a result of factors other than the human capital variables accumulated at school and on the job. The effect of centralized collective bargaining and a strong union policy to increase low wages may be important explanatory factors. Generous parental leaves and subsidized day care may have an increasing effect on fertility; but instead, fertility has decreased, perhaps less than it might have done in the absence of such policies. By using individual cross section data from the 3 standard of living investigations, estimates of participation are performed. The own wage effects of the participation equation are positive and significant but decreasing over time. Important institutional changes between the sample periods are the extended parental leaves and the increased supply of government subsidized day care.

Association between prior vaginal birth after cesarean and subsequent labor outcome.

Science.gov (United States)

Krispin, Eyal; Hiersch, Liran; Wilk Goldsher, Yulia; Wiznitzer, Arnon; Yogev, Yariv; Ashwal, Eran

2018-04-01

To estimate the effect of prior successful vaginal birth after cesarean (VBAC) on the rate of uterine rupture and delivery outcome in women undergoing labor after cesarean. A retrospective cohort study of all women attempting labor after cesarean delivery in a university-affiliated tertiary-hospital (2007-2014) was conducted. Study group included women attempting vaginal delivery with a history of cesarean delivery and at least one prior VBAC. Control group included women attempting first vaginal delivery following cesarean delivery. Primary outcome was defined as the rate of uterine rupture. Secondary outcomes were delivery and maternal outcomes. Of 62,463 deliveries during the study period, 3256 met inclusion criteria. One thousand two hundred and eleven women had VBAC prior to the index labor and 2045 underwent their first labor after cesarean. Women in the study group had a significantly lower rate of uterine rupture 9 (0.7%) in respect to control 33 (1.6%), p = .036, and had a higher rate of successful vaginal birth (96 vs. 84.9%, p cesarean, prior VBAC appears to be associated with lower rate of uterine rupture and higher rate of successful vaginal birth.

Sustainability in Supply Chain Management: Aggregate Planning from Sustainability Perspective

OpenAIRE

T?rkay, Metin; Sara?o?lu, ?zt?rk; Arslan, Mehmet Can

2016-01-01

Supply chain management that considers the flow of raw materials, products and information has become a focal issue in modern manufacturing and service systems. Supply chain management requires effective use of assets and information that has far reaching implications beyond satisfaction of customer demand, flow of goods, services or capital. Aggregate planning, a fundamental decision model in supply chain management, refers to the determination of production, inventory, capacity and labor us...

Effects of an Interdisciplinary Practice Bundle for Second-Stage Labor on Clinical Outcomes.

Science.gov (United States)

Garpiel, Susan J

2018-04-09

There is renewed interest in second-stage labor practices as recent evidence has challenged historical perspectives on safe duration of secondstage labor. Traditional practices and routine interventions during second-stage have uncertain benefit for low-risk women and may result in cesarean birth. The purpose of this quality improvement project was to implement an interdisciplinary second-stage practice bundle to promote safe outcomes including method of birth and women's birth experience. Standardized second-stage labor evidence-based practice recommendations structured into a 5 Ps practice bundle (patience, positioning, physiologic resuscitation, progress, preventing urinary harm) were implemented across 34 birthing hospitals in Trinity Health system. Significant improvements were observed in second-stage practices. Association of Women's Health, Obstetric and Neonatal Nurses' perinatal nursing care quality measure Second-Stage of Labor: Mother-Initiated Spontaneous Pushing significantly improved [pre-implementation 43% (510/1,195), post-implementation 76% (1,541/2,028), p labor practices derived from the Association of Women's Health, Obstetric and Neonatal Nurses and American College of Nurse-Midwives professional guidelines achieved our goals of safely reducing primary cesarean birth among low-risk nulliparous women, and optimizing maternal and fetal outcomes associated with labor and birth. By minimizing routine interventions, nurses support physiologic birth and improve women's birth satisfaction.

Diagnostic accuracy of maternal anthropometric measurements as predictors for dystocia in nulliparous women

Science.gov (United States)

Alijahan, Rahele; Kordi, Masoumeh; Poorjavad, Munira; Ebrahimzadeh, Saeed

2014-01-01

Background: Dystocia is one of the important causes of maternal morbidity and mortality in low-income countries. This study was aimed to determine the diagnostic accuracy of maternal anthropometric measurements as predictors for dystocia in nulliparous women. Materials and Methods: This prospective cohort study was conducted on 447 nulliparous women who referred to Omolbanin hospital. Several maternal anthropometric measurements such as height, transverse and vertical diameters of Michaelis sacral rhomboid area, foot length, head circumference, vertebral and lower limb length, symphysio-fundal height, and abdominal girth were taken in cervical dilatation ≤ 5 cm. Labor progression was controlled by a researcher blind to these measurements. After delivery, the accuracy of individual and combined measurements in prediction of dystocia was analyzed. Dystocia was defined as cesarean section and vacuum or forceps delivery for abnormal progress of labor (cervical dilatation less than 1 cm/h in the active phase for 2 h, and during the second stage, beyond 2 h or fetal head descend less than 1 cm/h). Results: Among the different anthropometric measurements, transverse diameter of the Michaelis sacral rhomboid area ≤9.6 cm, maternal height ≤ 155 cm, height to symphysio-fundal height ratio ≤4.7, lower limb length ≤78 cm, and head circumference to height ratio ≥ 35.05 with accuracy of 81.2%, 68.2%, 65.5%, 63.3%, and 61.5%, respectively, were better predictors. The best predictor was obtained by combination of maternal height ≤155 cm or the transverse diameter of the Michaelis sacral rhomboid area ≤9.6 cm and Johnson's formula estimated fetal weight ≥3255 g, with an accuracy of 90.5%, sensitivity of 70%, and specificity of 93.7%. Conclusions: Combination of other anthropometric measurements and estimated fetal weight with maternal height in comparison to maternal height alone leads to a better predictor for dystocia. PMID:24554954

Apron strings of working mothers: Maternal employment and housework in cross-national perspective.

Science.gov (United States)

Treas, Judith; Tai, Tsui-O

2012-07-01

This paper asks whether maternal employment has a lasting influence on the division of household labor for married women and men. Employing multi-level models with 2002 ISSP survey data for 31 countries, we test the lagged accommodation hypothesis that a long societal history of maternal employment contributes to more egalitarian household arrangements. Our results find that living in a country with a legacy of high maternal employment is positively associated with housework task-sharing, even controlling for the personal socialization experience of growing up with a mother who worked for pay. In formerly socialist countries, however, there is less gender parity in housework than predicted by the high historical level of maternal employment. Copyright © 2012 Elsevier Inc. All rights reserved.

Factors That Influence the Practice of Elective Induction of Labor

Science.gov (United States)

Moore, Jennifer; Low, Lisa Kane

2012-01-01

Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth. The purpose of this investigation was to evaluate current trends in induction of labor scholarship focusing on evidence-based factors that influence the practice of elective induction. A key word search was conducted to identify studies on the practice of elective induction of labor. Analysis of the findings included clustering and identification of recurrent themes among the articles with 3 categories being identified. Under each category, the words/phrases were further clustered until a construct could be named. A total of 49 articles met inclusion criteria: 7 patient, 6 maternity care provider, and 4 organization factors emerged. Only 4 of the articles identified were evidence based. Patient factors were divided into preferences/convenience, communication, fear, pressure/influence, trust, external influences, and technology. Provider factors were then divided into practice preferences/convenience, lack of information, financial incentives, fear, patient desire/demand, and technology. Organization factors were divided into lack of enforcement/accountability, hospital culture, scheduling of staff, and market share issues. Currently, there is limited data-based information focused on factors that influence elective induction of labor. Despite patient and provider convenience/preferences being cited in the literature, the evidence does not support this practice. PMID:22843006

Maternity leave, women's employment, and marital incompatibility.

Science.gov (United States)

Hyde, J S; Essex, M J; Clark, R; Klein, M H

2001-09-01

This research investigated the relationship between the length of women's maternity leave and marital incompatibility, in the context of other variables including the woman's employment, her dissatisfaction with the division of household labor, and her sense of role overload. Length of leave, work hours, and family salience were associated with several forms of dissatisfaction, which in turn predicted role overload. Role overload predicted increased marital incompatibility for experienced mothers but did not for first-time mothers, for whom discrepancies between preferred and actual child care were more important. Length of maternity leave showed significant interactions with other variables, supporting the hypothesis that a short leave is a risk factor that, when combined with another risk factor, contributes to personal and marital distress.

The Growth of Private Regulation of Labor Standards in Global Supply Chains

DEFF Research Database (Denmark)

Knudsen, Jette Steen

2013-01-01

Multinational corporations (MNCs) have come under pressure to adopt private regulatory initiatives such as supplier codes of conduct in order to address poor working conditions in global supply chain factories. While a well-known literature explores drivers and outcomes of such monitoring schemes...... requirements in global supply chains even though compliance is a “mission impossible” for many smaller firms. As a result of this development, the private regulatory system is facing growing strain.......Multinational corporations (MNCs) have come under pressure to adopt private regulatory initiatives such as supplier codes of conduct in order to address poor working conditions in global supply chain factories. While a well-known literature explores drivers and outcomes of such monitoring schemes......, this literature focuses mainly on large firms and has ignored the growing integration of small- and medium-sized enterprises (SMEs) into global supply chains. Furthermore, the literature on corporate social responsibility (CSR) in SMEs primarily emphasizes domestic initiatives and not global challenges. Focusing...

A randomized, double-blinded, controlled trial of the effects of fluid rate and/or presence of dextrose in intravenous fluids on the labor course of nulliparas.

Science.gov (United States)

Fong, Alex; Serra, Allison E; Caballero, Deysi; Garite, Thomas J; Shrivastava, Vineet K

2017-08-01

Prolonged labor has been demonstrated to increase adverse maternal and neonatal outcome. A practice that may decrease the risk of prolonged labor is the modification of fluid intake during labor. Several studies demonstrated that increased hydration in labor as well as addition of dextrose-containing fluids may be associated with a decrease in length of labor. The purpose of our study was to characterize whether high-dose intravenous fluids, standard-dose fluids with dextrose, or high-dose fluids with dextrose show a difference in the duration of labor in nulliparas. Nulliparous subjects with singletons who presented in active labor were randomized to 1 of 3 groups of intravenous fluids: 250 mL/h of normal saline, 125 mL/h of 5% dextrose in normal saline, or 250 mL/h of 2.5% dextrose in normal saline. The primary outcome was total length of labor from initiation of intravenous fluid in vaginally delivered subjects. Secondary outcomes included cesarean delivery rate and length of second stage of labor, among other maternal and neonatal outcomes. In all, 274 subjects who met inclusion criteria were enrolled. There were no differences in baseline characteristics among the 3 groups. There was no difference in the primary outcome of total length of labor in vaginally delivered subjects among the 3 groups. First stage of labor duration, second stage of labor duration, and cesarean delivery rates were also equivalent. There were no differences identified in other secondary outcomes including clinical chorioamnionitis, postpartum hemorrhage, blood loss, Apgar scores, or neonatal intensive care admission. There is no difference in length of labor or delivery outcomes when comparing high-dose intravenous fluids, addition of dextrose, or use of high-dose intravenous fluids with dextrose in nulliparous women who present in active labor. Copyright © 2017 Elsevier Inc. All rights reserved.

Recent trends in the registered nurse labor market in the U.S.: short-run swings on top of long-term trends.

Science.gov (United States)

Buerhaus, Peter I; Auerbach, David I; Staiger, Douglas O

2007-01-01

Drawing from labor economics, background information is provided for a deeper understanding of recent changes in the nurse labor market. The difference between the short and long-run supply of RNs are distinguished, and the economic forces that determine RNs' decision to be active in the labor market are explained. The ways the nurse labor market may change in the next few years are discussed.

Maternal epidural use and neonatal sepsis evaluation in afebrile mothers.

Science.gov (United States)

Goetzl, L; Cohen, A; Frigoletto, F; Ringer, S A; Lang, J M; Lieberman, E

2001-11-01

Epidural use has been associated with a higher rate of neonatal sepsis evaluation. Epidural-related fever explains some of the increase but not the excess of neonatal sepsis evaluations in afebrile women We studied 1109 women who had singleton term pregnancies and who presented in spontaneous labor and were afebrile during labor (24 hours or sustained fetal heart rate of >160 beats per minute. Minor criteria included a maternal temperature of 99.6 degrees F to 100.4 degrees F, rupture of membranes for 12 to 24 hours, maternal admission white blood cell count of >15 000 cells/mL(3), or an Apgar score of 24 hours (6.2% vs 3.4%), low-grade fever of 99.6 degrees F to 100.4 degrees F (24.3% vs 5.2%), and rupture of membranes for 12 to 24 hours (21.4% vs 5.2%) than women without epidural. Epidural analgesia is associated with increased rates of major and minor criteria for neonatal sepsis evaluations in afebrile women.

Management of preterm labor: atosiban or nifedipine?

Directory of Open Access Journals (Sweden)

Roel de Heus

2010-05-01

Full Text Available Roel de Heus, Eduard J H Mulder, Gerard H A VisserDepartment of Woman and Baby, University Medical Centre Utrecht, The NetherlandsAbstract: Preterm birth is strongly associated with neonatal death and long-term neurological morbidity. The purpose of tocolytic drug administration is to postpone threatening preterm delivery for 48 hours to allow maximal effect of antenatal corticosteroids and maternal transportation to a center with specialized neonatal care facilities. There is uncertainty about the value of atosiban (oxytocin receptor antagonist and nifedipine (calcium channel blocker as first-line tocolytic drugs in the management of preterm labor. For nifedipine, concerns have been raised about unproven safety, lack of placebo-controlled trials, and its off-label use. The tocolytic efficacy of atosiban has also been questioned because of a lack of reduction in neonatal morbidity. This review discusses the available evidence, the pros and cons of either drug and aims to provide information to support a balanced choice of first-line tocolytic drug: atosiban or nifedipine?Keywords: atosiban, oxytocin receptor antagonist, nifedipine, calcium channel blocker, preterm birth, tocolytic drugs, preterm labor

Third delay of maternal mortality in a tertiary hospital

International Nuclear Information System (INIS)

Shah, N.; Khan, N.H.

2007-01-01

To assess the magnitude, causes and substandard care factors responsible for the third delay of maternal mortality seen in our unit III, Department of Obstetrics and Gynecology, Civil Hospital, Karachi. This Cross-sectional, retrospective study was carried out on 152 mothers who died over a period of eight years from 1997 to 2004 at Civil Hospital Karachi. Death summaries of all maternal deaths were reviewed from death registers and were studied for substandard care factors which could have been responsible for the third delay of maternal mortality. The frequency of maternal mortality was 1.3 per 100 deliveries. The mean age was 29+-6.49 years and mean parity was 3.24+-3.25. The main causes of death were hypertensive disorders in 52/152 (34.21%), hemorrhage in 40/152 (26.31%), unsafe abortion in 16/152 (10.52%), puerperal sepsis in 14/152 (9.21%) and obstructed labor in 11/152 (7.2%) cases. Substandard care factors were present in 76.7% of patients, which included inappropriate management of pulmonary edema, delay in arranging blood for hemorrhaging patients and delay in surgical intervention. Substandard care factors were present in majority of cases of maternal deaths. Improvement of maternity care services in Civil Hospital Karachi is needed on an urgent basis. (author)

Expanding the scope beyond mortality: burden and missed opportunities in maternal morbidity in Indonesia.

Science.gov (United States)

Widyaningsih, Vitri; Khotijah; Balgis

2017-01-01

Indonesia still faces challenges in maternal health. Specifically, the lack of information on community-level maternal morbidity. The relatively high maternal healthcare non-utilization in Indonesia intensifies this problem. To describe the burden of community-level maternal morbidity in Indonesia. Additionally, to evaluate the extent and determinants of missed opportunities in women with maternal morbidity. We used three cross-sectional surveys (Indonesian Demographic and Health Survey, IDHS 2002, 2007 and 2012). Crude and adjusted proportions of maternal morbidity burden were estimated from 43,782 women. We analyzed missed opportunities in women who experienced maternal morbidity during their last birth (n = 19,556). Multilevel mixed-effects logistic regressions were used to evaluate the determinants of non-utilization in IDHS 2012 (n = 6762). There were significant increases in the crude and adjusted proportion of maternal morbidity from IDHS 2002 to IDHS 2012 (p Indonesia. The prevalence of maternal morbidity in Indonesia is relatively high, especially during labor. This condition is amplified by the concerning missed opportunities in maternal healthcare. Efforts are needed to identify risk factors for maternal morbidity, as well as increasing healthcare coverage for the vulnerable population.

Maternity Leave in Turbulent Times: Effects on Labor Market Transitions and Fertility in Russia, 1985-2000

Science.gov (United States)

Gerber, Theodore P.; Perelli-Harris, Brienna

2012-01-01

Maternity leave policies are designed to ease the tension between women's employment and fertility, but whether they actually play such a role remains unclear. We analyze the individual-level effects of maternity leave on employment outcomes and on second conception rates among Russian first-time mothers from 1985-2000 using retrospective job and…

Irisin Maternal Plasma and Cord Blood Levels in Mothers with Spontaneous Preterm and Term Delivery

Directory of Open Access Journals (Sweden)

Tereza Pavlova

2018-01-01

Full Text Available Irisin, an adipomyokine identified in 2012, has been investigated in association with common pregnancy complications, including gestational diabetes mellitus, preeclampsia, and intrauterine growth restriction. The objective of this study is to examine the potential role of irisin in preterm birth (PTB by comparing its level between mothers with term and preterm labor. Maternal peripheral blood and cord blood samples were collected from 30 mothers who delivered prematurely and from 35 mothers who delivered at term. Irisin concentrations were measured in all samples using ELISA, and four common single nucleotide polymorphisms in the irisin gene were determined (rs16835198, rs726344, rs3480, and rs1746661. Univariable and multivariable regression modeling was applied to evaluate maternal and cord blood irisin concentrations in relation to preterm/term labor. Irisin concentration in umbilical cord blood was found to be associated with PTB in the univariable model (p=0.046. On the other hand, no differences in maternal blood irisin levels between mothers with preterm and term deliveries were established. To the best of our knowledge, this is the first study determining irisin levels in term and preterm deliveries in maternal peripheral blood and umbilical cord blood. Our study shows a possible association between cord blood irisin concentration and PTB occurrence.

"PREVALENCE, MATERNAL COMPLICATIONS AND BIRTH OUTCOME OF PHYSICAL, SEXUAL AND EMOTIONAL DOMESTIC VIOLENCE DURING PREGNANCY"

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M. Faramarzi

2005-05-01

Full Text Available The prevalence of physical violence during pregnancy varies widely in different societies. To assess the incidence of self-reported physical, emotional and sexual violence in pregnancy and describe the association with maternal complication and birth outcomes, 3275 women who gave birth to live-born infants from October 2002 to November 2003 were assessed for self-reported violence in postpartum units of Obstetrics Department of Babol university of Medical Sciences. Outcome data included maternal antenatal hospitalizations, labor and delivery complications and low birth weights and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the association between violence, maternal morbidity and birth outcomes. The prevalence of physical, sexual and emotional domestic violence was respectively 9.1%, 30.8% and 19.2%. Compared with those not reporting physical, sexual and emotional violence, women who did were more likely to deliver by cesarean and to have abnormal progress of labor, premature rupture of membranes, low birth weight, preterm birth and any hospitalization before delivery. Prevalence of physical, emotional or sexual violence during pregnancy was high and was associated with adverse fetal and maternal conditions. These findings support routine screening for physical, emotional and sexual violence in pregnancy and postpartum period to prevent consequences of domestic violence.

Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

Science.gov (United States)

Rossen, Janne; Klungsøyr, Kari; Albrechtsen, Susanne; Løkkegård, Ellen; Rasmussen, Steen; Bergholt, Thomas; Skjeldestad, Finn E

2018-03-07

Maternal age is an established risk factor for cesarean section; epidural analgesia and oxytocin augmentation may modify this association. We investigated the effects and interactions of oxytocin augmentation, epidural analgesia and maternal age on the risk of cesarean section. In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1]. In this case-control study the main exposure was maternal age; epidural analgesia, oxytocin augmentation, birthweight and time period were explanatory variables. Chi-square test and logistic regression were used to estimate associations and interactions. The cesarean section rate increased consistently with advancing maternal age, both overall and in strata of epidural analgesia and oxytocin augmentation. We observed strong interactions between maternal age, oxytocin augmentation and epidural analgesia for the risk of cesarean section. Women with epidural analgesia generally had a reduced adjusted odds ratio when oxytocin was used compared with when it was not used. In Norway, this applied to all maternal age groups but in Denmark only for women ≥30 years. Among women without epidural, oxytocin augmentation was associated with an increased odds ratio for cesarean section in Denmark, whereas no difference was observed in Norway. Oxytocin augmentation in nulliparous women with epidural analgesia is associated with a reduced risk of cesarean section in labor with spontaneous onset. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

Uterine Tonus Assessment by Midwives versus Patient self-assessment in the active management of the third stage of labor (UTAMP) : study protocol for a randomized controlled trial

NARCIS (Netherlands)

Browne, Joyce L; Damale, Nelson K R; Raams, Tessa M; Van der Linden, Eva L; Maya, Ernest T; Doe, Roseline; Rijken, Marcus J; Adanu, Richard; Grobbee, Diederick E; Franx, Arie; Klipstein-Grobusch, Kerstin

2015-01-01

BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and accounts for one third of maternal deaths in low-income and middle-income countries. PPH can be prevented by active management of the third stage of labor (AMTSL), a series of steps recommended by the

Comparison of remifentanil: Entonox with Entonox alone in labor analgesia

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Mojtaba Rahimi Varposhti

2013-01-01

Full Text Available Background: We designed a study to evaluate the effectiveness of continuous low dose infusion of remifentanil adding to self-administration of entonox administered for pain relief during the active phase of first stage of labor. Materials and Methods: Thirty healthy term pregnant women recruited in our randomized double-blind, cross over study. They received the study medicines during two 30-min periods with a 15-min wash-out sequence after each period. Fifteen parturient used remifentanil as a single bolus dose followed by constant low dose infusion and self-administration of entonox (group R during the first period and entonox and saline (group P during the second period, while the remainder of the parturient used the drugs in a reverse order. Pain and Ramsay score, maternal and fetal hemodynamic, and ventilation were assessed during each intervention. Results: In this study, mean pain severity scores were 8 ± 0.9 before and 5.4 ± 1.7 after intervention in group P, and 7.8 ± 0.1, 3.5 ± 1.3 in group R, respectively. Mean pain severity difference was 2.6 ± 1.5 in group P, while 4.3 ± 1.5 in group R; so, use of entonox and remifentanil can decrease labor pain two times more in comparison with entonox/placebo (normal saline. However, hemodynamic and ventilation parameter in remifentanil/entonox period were same as in entonox/placebo period. No statistical differences were seen in mean Ramsay score between group R and P. There was no episode of maternal bradycardia, hypotension, or hypoxemia. Conclusion: Not only adding low dose infusion of remifentanil to self-administration of entonox was notable in labor pain reduction, it did n′t make more parturient and neonatal side-effects.

The Main Trends in the Labor Market and their Influence on the Staff Policy of Enterprises in Ukraine

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Tsymbaliuk Svitlana O.

2018-03-01

Full Text Available The importance of a quick response to changes taking place in the labor market, adaptation to them of the staff policy of enterprises is determined by the need to maintain their competitiveness in the labor market. It is reasonable to monitor main trends in the labor market with a view to adapting the staff policy to changes in order to strengthen the competitive position and attract competent specialists. The aim of the article is to identify the main trends in the labor market and estimate their impact on the staff policy of enterprises in Ukraine. It is determined that the decrease in the number of economically active population, reduction in the supply of workplaces and increase in unemployment are characteristics of the Ukrainian modern labor market. At the same time, there observed a disproportionality between the supply of and demand for representatives of different professional categories. It is determined that the high turnover indices negatively characterize the staff policy and demonstrate that employers neither pay due attention to the issues of forming the employees’ engagement, loyalty nor create appropriate conditions for the fulfillment of their labor potential. The revealed tends lead to increased competition among employers in the labor market for competent specialists, which finally stimulates them to use various instruments for enhancing the enterprises’ attractiveness and the formation of a positive employer brand.

Lactate in Amniotic Fluid: Predictor of Labor Outcome in Oxytocin-Augmented Primiparas' Deliveries.

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Eva Wiberg-Itzel

Full Text Available One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL.To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries.A prospective multicentre study including 3000 healthy primiparous women all with a singleton pregnancy, gestational age 37 to 42 weeks and no maternal /fetal chronic and/or pregnancy-related conditions. A spontaneous onset of labor, regular contractions and cervical dilation ≥ 3 cm were required before the women were invited to take part in the study.AFL, analysed within 30 minutes before augmentation, provides information about delivery outcome. Sensitivity for an acute cesarean section according to high (≥10.1mmol/l or low (12h (p = 0.04, post-partum fever (>38°C, p = 0.01 and post-partum haemorrhage >1.5L (p = 0.04.The AFL is a good predictor of delivery outcome in arrested nulliparous deliveries. Low levels of AFL may support the decision to continue a prolonged vaginal labor by augmentation with oxytocin. A high level of AFL correlates with operative interventions and post-partum complications.

Labor market and demographic scenarios for ASEAN countries (2010-35). Education, skill development, manpower needs, migration flows and economic growth

OpenAIRE

Michele Bruni

2013-01-01

ASEAN countries have been moving at different speeds along the path of the so called Demographic transition and are at present at different stages of this complex process. As a consequence, starting in the very near future, some ASEAN countries will be affected by an increasing structural lack of labor supply, while in other a structural excess of labor supply will persist for at least 30-40 years. This situation has already contributed to divide ASEAN countries into two groups: departure cou...

Resources of the workers of small and medium business and their well-being in the labor market

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Yu Yu Chilipenok

2016-12-01

Full Text Available The article presents the results of the study aimed to describe the employee of small and medium business as a subject of the contemporary Russian social and labor relations in terms of his resource endowments. From the theoretical point of view, the study was conducted within the resource-based approach: the main resources of small and medium business employees, their behavior in the labor market as depending on the resource supply were analyzed on the data of the Russian monitoring of the economic situation and the health of the population (RLMS of the National Research University “Higher School of Economics”. The employees’ well-being in the labor market was measured by the fear to lose one’s jobs, and confidence in the ability and the desire to find a new job. Based on the empirical data the authors identify average, normal levels of resource endowments, and the features of the subject of social and labor relations in the light of particular levels of different resources supply. The authors note the low economic security of small and medium business employees as a reason for the financial factor to have a decisive influence on the behavior of this category of workers in the labor market. There also conclusions about the importance of information and innovative resource and workers’ health to realize their independent position in the labor market and get ready for the labor mobility.

[Precautionary maternity leave in Tirol].

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Ludescher, K; Baumgartner, E; Roner, A; Brezinka, C

1998-01-01

Under Austrian law, precautionary maternity leave is a decree issued by the district public health physician. It forbids a pregnant woman to work and mandates immediate maternity leave. Regular maternity leave for all women employed in all jobs begins at 32 weeks of gestation. Women who work in workplaces deemed dangerous and women with a history of obstetric problems such as premature or growth-retarded babies from previous pregnancies are regularly 'sent' into precautionary maternity leave. The public health physicians of Tirol's nine administrative districts were interviewed and supplied data on precautionary maternity leave from their districts. In 100 women who attended the clinic for pregnancies at risk of the Obstetrics/Gynecology Department of Innsbruck University Hospital and who had already obtained precautionary maternity leave, the medical/administrative procedure was studied in each case and correlated with pregnancy outcome. The town district of Innsbruck and the district that comprises the suburbs of the provincial capital had the highest rates of precautionary maternity leave. The town district of Innsbruck had a rate of 24.3% of all pregnant women (employed and not employed) in precautionary maternity leave in 1997, whereas the whole province of Tirol had 13.4%. More than 80% of decrees for precautionary maternity leave are issued by district public health physicians on the basis of written recommendations from gynecologists. One third of women who are sent into precautionary maternity leave are issued the decree prior to 12 weeks of gestation - mostly cases of multiple pregnancies and women with previous miscarriages. The present system of precautionary maternity leave appears to work in the sense that most working pregnant women with risk factors are correctly identified - with most errors on the side of caution. As the system also helps employers - the employee's pay is paid from the federal family support fund and state insurance once she is in

Factors predicting labor induction success: a critical analysis.

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Crane, Joan M G

2006-09-01

Because of the risk of failed induction of labor, a variety of maternal and fetal factors as well as screening tests have been suggested to predict labor induction success. Certain characteristics of the woman (including parity, age, weight, height and body mass index), and of the fetus (including birth weight and gestational age) are associated with the success of labor induction; with parous, young women who are taller and lower weight having a higher rate of induction success. Fetuses with a lower birth weight or increased gestational age are also associated with increased induction success. The condition of the cervix at the start of induction is an important predictor, with the modified Bishop score being a widely used scoring system. The most important element of the Bishop score is dilatation. Other predictors, including transvaginal ultrasound (TVUS) and biochemical markers [including fetal fibronectin (fFN)] have been suggested. Meta-analyses of studies identified from MEDLINE, PubMed, and EMBASE and published from 1990 to October 2005 were performed evaluating the use of TVUS and fFN in predicting labor induction success in women at term with singleton gestations. Both TVUS and Bishop score predicted successful induction [likelihood ratio (LR)=1.82, 95% confidence interval (CI)=1.51-2.20 and LR=2.10, 95%CI=1.67-2.64, respectively]. As well, fFN and Bishop score predicted successful induction (LR=1.49, 95%CI=1.20-1.85, and LR=2.62, 95%CI=1.88-3.64, respectively). Although TVUS and fFN predicted successful labor induction, neither has been shown to be superior to Bishop score. Further research is needed to evaluate these potential predictors and insulin-like growth factor binding protein-1 (IGFBP-1), another potential biochemical marker.

Motherhood and Female Labor Supply in the Developing World: Evidence from Infertility Shocks

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Aguero, Jorge M.; Marks, Mindy S.

2011-01-01

We introduce a new instrument for family size, infertility, to investigate the causal relationship between children and female labor force participation. Infertility mimics an experiment where nature assigns an upper bound for family size, independent of a woman's background. This new instrument allows us to investigate the differential labor…

External Supply of Skill Groups: A Case of Industrial Management in Taiwan.

Science.gov (United States)

Kao, Chiang; Chen, Liang-Hsuan; Wang, Tai-Yue; Lee, Hong-Tau

1997-01-01

Quantitative and qualitative analysis was conducted of the supply of skill groups and the output of junior colleges, colleges, and graduate schools in Taiwan. Discrepancies were identified between labor need of industry and numbers of graduates as well as between training expected by industry and supplied by schools. (SK)

78 FR 13897 - Bureau of International Labor Affairs; Office of Trade and Labor Affairs; Labor Affairs Council...

Science.gov (United States)

2013-03-01

... Public Session Meeting AGENCY: International Labor Affairs Bureau (ILAB), U.S. Department of Labor.... Department of Labor gives notice of the public session of the meeting of the Labor Affairs Council (``Council... DEPARTMENT OF LABOR Office of the Secretary Bureau of International Labor Affairs; Office of Trade...

Mother's time allocation, child care and child cognitive development

OpenAIRE

BRILLI, Ylenia

2015-01-01

This paper analyzes the effects of maternal employment and non-parental child care on child cognitive development, taking into account the mother's time allocation between leisure and child-care time. I estimate a behavioral model, in which maternal labor supply, non-parental child care, goods expenditure and time allocation decisions are considered to be endogenous choices of the mother. The child cognitive development depends on maternal and non-parental child care and on the goods bought f...

78 FR 72714 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

Science.gov (United States)

2013-12-03

... DEPARTMENT OF LABOR Child Labor, Forced Labor, and Forced or Indentured Child Labor in the... Child Labor AGENCY: The Bureau of International Labor Affairs, United States Department of Labor. ACTION..., 2013, regarding child labor and forced labor in foreign countries. Relevant information will be used by...

Oxytocin-augmented labor and risk for autism in males.

Science.gov (United States)

Weisman, Omri; Agerbo, Esben; Carter, C Sue; Harris, James C; Uldbjerg, Niels; Henriksen, Tine B; Thygesen, Malene; Mortensen, Preben B; Leckman, James F; Dalsgaard, Søren

2015-05-01

The use of synthetic oxytocin (OT) to induce and/or augment labor and delivery is on the rise. Maternal exposure to OT during birth may have adverse effects on the infant's development, including increased risk for autism. Yet, studies that test this biologically plausible association and whether it is modified by sex are limited and show inconsistent findings. To this end, we conducted an epidemiological analysis, including all singleton live births in Denmark between 2000 and 2009 (N = 557,040), with a follow-up through 2012. A total of 2110 children in this cohort were subsequently diagnosed with autistic disorder according to the ICD-10-DCR. Augmentation of labor with OT was modestly associated with an increased risk for autism in males (HR 1.13; 95% CI, 1.00-1.26; P = 0.04), but not in females (0.99; 0.77-1.27; P=0.95). Among males exposed to OT augmentation, 560 were subsequently diagnosed with autistic disorder, and among those not exposed, 1177 met criteria for autism (incidence rate 103.2 and 81.4 per 100,000 person-years, respectively). Our findings suggest a modest association between OT-augmented labor and risk for autism in males. However, given the known benefits of using synthetic OT during labor and delivery caution is warranted when interpreting the findings. Future studies should also investigate dose-dependent effect of OT on infant's development. Copyright © 2015 Elsevier B.V. All rights reserved.

Labor Induction

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f AQ FREQUENTLY ASKED QUESTIONS FAQ154 LABOR, DELIVERY, AND POSTPARTUM CARE Labor Induction • What is labor induction? • Why is labor induced? • What is the Bishop score? • What is “ripening ...

Study on Oxygen Supply Standard for Physical Health of Construction Personnel of High-Altitude Tunnels

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Chun Guo

2015-12-01

Full Text Available The low atmospheric pressure and low oxygen content in high-altitude environment have great impacts on the functions of human body. Especially for the personnel engaged in complicated physical labor such as tunnel construction, high altitude can cause a series of adverse physiological reactions, which may result in multiple high-altitude diseases and even death in severe cases. Artificial oxygen supply is required to ensure health and safety of construction personnel in hypoxic environments. However, there are no provisions for oxygen supply standard for tunnel construction personnel in high-altitude areas in current tunnel construction specifications. As a result, this paper has theoretically studied the impacts of high-altitude environment on human bodies, analyzed the relationship between labor intensity and oxygen consumption in high-altitude areas and determined the critical oxygen-supply altitude values for tunnel construction based on two different standard evaluation systems, i.e., variation of air density and equivalent PIO2. In addition, it has finally determined the oxygen supply standard for construction personnel in high-altitude areas based on the relationship between construction labor intensity and oxygen consumption.

Schooling, Child Labor, and the Returns to Healthcare in Tanzania

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Adhvaryu, Achyuta R.; Nyshadham, Anant

2012-01-01

We study the effects of accessing better healthcare on the schooling and labor supply decisions of sick children in Tanzania. Using variation in the cost of formal-sector healthcare to predict treatment choice, we show that accessing better healthcare decreases length of illness and changes children's allocation of time to school and work.…

Intrathecal isobaric ropivacaine-fentanyl versus intrathecal isobaric bupivacaine-fentanyl for labor analgesia: A controlled comparative double-blinded study

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Meenoti Pramod Potdar

2014-01-01

Full Text Available Context: Neuraxial analgesia and walking epidural is the popular method of practicing labor analgesia. The combination of local anesthetic and opioid is advantageous as it prolongs the duration of labor analgesia. Ropivacaine is the newer local anesthetic agent having lesser motor effects and toxic effects hence would be preferred for labor analgesia. Aims: The primary objective of the study was to assess the duration of analgesia of the intrathecal drug. The secondary objective was the assessment of onset, fixation of analgesia, motor weakness, ambulation, sedation, incidence of side-effects, maternal, and neonatal outcomes. Settings and Design: This is prospective, randomized, controlled, double-blinded, study of 120 patients consenting for labor analgesia. Subjects and Methods: A total of 120 primiparas with a singleton pregnancy in active labor who were given combined spinal epidural (CSE were included in the study. These patients were randomly allocated to three groups of 40 each and received CSE. Group F-received 25 μcg fentanyl intrathecally. Group BF-received 25 μcg fentanyl with 2.5 mg isobaric bupivacaine intrathecally. Group RF-received 25 μcg fentanyl with 2.5 mg isobaric ropivacaine intrathecally. Statistical Analysis Used: Correlations among different measurements were assessed using Pearson′s correlation coefficients, P <0.05 was considered to be statistically significant. Results: The three groups show comparable demographic data and obstetric parameters. The duration of spinal analgesia was significantly greater with Group RF 106.63 ± 17.99 min and Group BF 111.75 ± 23.58 min than the control Group F which was 60 ± 10.39 min with P = 0.001, but were comparable for Group BF and RF. The secondary outcome was comparable in all the three groups. Conclusions: The addition of bupivacaine or ropivacaine to fentanyl intrathecally increased duration and quality of analgesia, did not affect ambulation and bearing down. The

Elective repeat cesarean delivery compared with trial of labor after a prior cesarean delivery: a propensity score analysis

NARCIS (Netherlands)

Kok, N.; Ruiter, L.; Lindeboom, R.; de Groot, C.; Pajkrt, E.; Mol, B. W.; Kazemier, B. M.

2015-01-01

To determine neonatal and short term maternal outcomes according to intentional mode of delivery following a cesarean delivery (CD). Women pregnant after CD between January 2000 and December 2007 were categorized according to whether they had an elective repeat CD (ERCD) or a Trial of Labor (TOL).

Rural Hospital Employment of Physicians and Use of Cesareans and Nonindicated Labor Induction.

Science.gov (United States)

Prasad, Shailendra; Hung, Peiyin; Henning-Smith, Carrie; Casey, Michelle; Kozhimannil, Katy

2018-02-01

Workforce issues constrain obstetric care services in rural US hospitals, and one strategy hospitals use is to employ physicians to provide obstetric care. However, little is known about the relationship between hospital employment of maternity care physicians and use of obstetric care procedures in rural hospitals. We examined the association between obstetric physician employment and use of cesareans and nonindicated labor induction. We conducted a cross-sectional analysis of a telephone survey of all 306 rural hospitals providing obstetric care in 9 states from November 2013 to March 2014 and linked the survey data (N = 263, 86% response rate) to all-payer childbirth data on maternity care utilization from 2013 Statewide Inpatient Database (SID) hospital discharge data. Using logistic regression models, we assessed the proportion of a hospital's maternity care physicians employed by the hospital and estimated its association with utilization of low-risk and nonindicated cesareans, and nonindicated labor induction. Rural hospitals that employed family physicians but not obstetricians had lower cesarean rates among low-risk pregnancies. Rural hospitals that employed only obstetricians did not show a relationship between employment and procedure utilization. Across hospitals with both obstetricians and family physicians, a 10% higher proportion of obstetricians employed was associated with 4.6% higher low-risk cesarean rates (4.6% [0.7%-8.4%]), while no significant relationship was found for the proportion of family physicians employed by a hospital. In rural US hospitals, associations between physician employment and obstetric procedure use differed by physician mix and the types of physicians employed. © 2017 National Rural Health Association.

Mothers’ labor market choices and child development outcomes in Chile

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Sarah A. Reynolds

2017-12-01

Full Text Available This paper examines associations between labor market participation of Chilean mothers and the cognitive, language, and socio-economic development of their children. Using a nationally-representative sample of 3-year-old children, we test if mothers’ work intensity in the two previous years is associated with child development outcomes; data were collected in 2010 when children were one year old, and again in 2012, when they were three years old. We find that children who were three years old with mothers who worked for higher fractions of their children’s lives in the previous two years perform significantly better on all tests (cognitive, language, socio-emotional than children whose mothers had worked less, while controlling for baseline test performance. These main effects did not remain significant with the inclusion of a wide range of socio-economic, demographic control variables, however. Our results were similarly null when using an IV analysis or a propensity score matching approach. We provide descriptive information on theoretical pathways by which maternal work may influence child development. Though several of these pathways (e.g. preschool, toys, maternal stress seem to be associated with both maternal work and child development outcomes, the pathways are not sufficiently strong to generate an association between maternal work and child development. We conclude that Chilean mothers’ employment in early childhood generally does not have an effect on child development.

THE FORMATION OF THE PROFESSIONAL NURSE AND THE LABOR MARKET TODAY.

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José Milton Barros Neto

2014-02-01

Full Text Available The professional nursing practice has been constantly targeted for discussion, especially regarding the conditions of their work . The aim of this study was to understand the formation of this professional and the job market today, considering the changes in the curriculum of nursing, trends in the labor market , the demand and supply of labor this professional. It is a study of the literature review, based on a historical - critical perspective , using the databases SCIELO , VHL , BIREME , plus titles available in the library of the Centro Universitário de Maceió - CESMAC.O study was guiding question : how has initally vocational nurses face the determinations of the job market today ? It was felt that the training of nurses throughout their history, had fundamental influence of the labor market , whereas the changes in curricular courses were predetermined in the market trends that pointed according to each season . In recent decades , there has been a considerable increase in jobs , but disproportionate to the number of institutions of higher education in nursing in the country . Consequently , highlighted the growth of the informal labor relations , resulting in precarious jobs and the stagnation in labor income.

Social Determinants of Maternal Health in Afghanistan: A Review

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Said Ahmad Maisam Najafizada

2017-03-01

Methods: This narrative review was conducted using Arksey and O’Malley’s framework of (1 defining the question, (2 searching the literature, (3 assessing the studies, (4 synthesizing selected evidence in context, and (5 summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. Results: A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Conclusion: Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care is the long-term solution to the maternal health problems in Afghanistan. National and international organizations’ long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

Considerations of the Skilled Manpower Needs for Water Supply Systems.

Science.gov (United States)

Watters, Gregor

1981-01-01

General methods for determining skilled labor needs for water supply and wastewater treatment plant operation as applied in Turkey are outlined along with a model program for training personnel to meet these needs. (DC)

Recycling of carbon/energy taxes and the labor market. A general equilibrium analysis for the European Community

International Nuclear Information System (INIS)

Welsch, H.

1996-01-01

A quantitative assessment of a cost shift from labor to energy by means of a carbon/energy tax is provided. In the analysis a general equilibrium model for the European Community is utilized, focusing on the modelling of labor supply. The importance of the feedback from an induced increase in labor demand to wage formation is highlighted. (It is shown that the goals of C) 2 reduction and improved employment are complementary, provided that the reduction in labor costs, financed by the carbon/energy tax, is not offset by increased wage claims. Under this condition reduced CO 2 is consistent with an increase in GDP. 1 fig., 3 tabs., 17 refs

The Role of Domestic Abuse in Labor and Marriage Markets: Observing the Unobservables

OpenAIRE

Audra J. Bowlus; Shannon N. Seitz

1998-01-01

In this paper we study the effects of abusive behavior on the labor force and marital status decisions of women. Using a unique Canadian data set on domestic violence, we estimate the effects of abuse on the marital history as well as current employment using a sequential, multi-state model. In our model, spousal abuse affects labor supply through decreases in utility from leisure as well as through reductions in productivity at work and hence the market wage. In addition, abuse is treated as...

Economic crisis and women's labor force return after childbirth: Evidence from South Korea

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Li Ma

2014-08-01

Full Text Available Background: Most research on women's labor force return after childbirth concentrates on industrialized countries in the West; the link between economic swings and mothers' work-return behavior is rarely addressed. This study closes these gaps by focusing on South Korea, a developed society in East Asia that has in recent decades witnessed increases in female labor force participation and dramatic economic ups and downs. This is the first relevant study on South Korea. Objective: This study examines how women's labor force return after childbirth (with and without career interruption and their career prospects upon work return varied before, during, and after the Asian financial crisis in South Korea. Methods: Logistic and hazard regression models were applied to the Korea Labor and Income Panel Study (KLIPS waves 1-10. Results: The study reveals an increase in women's immediate work return after childbirth without career interruption since the 1980s. The Asian financial crisis boosted this immediate return pattern. The implementation of job-protected maternity leave further contributed to this pattern. Women who underwent career interruption at first birth were also more likely to re-enter the labor market during and after the crisis than before. Downward occupational moves were especially common during the period of financial crisis. Conclusions: The results suggest that the Asian financial crisis triggered a noticeable change in women's post-birth work-return behavior. The economic volatility pushed mothers to hold onto their role in the labor force more strongly than before.

Physicians’ engagement in dual practices and the effects on labor supply in public hospitals: results from a register-based study

Science.gov (United States)

2014-01-01

dual practice. Although our findings indicate that engagement in dual practice by public hospital physicians in a well-regulated market may increase the total labor supply, this may vary significantly between medical specialties. PMID:25011448

Questioning the role of pituitary oxytocin in parturition: spontaneous onset of labor in women with panhypopituitarism--a case series.

Science.gov (United States)

Shinar, Shiri; Many, Ariel; Maslovitz, Sharon

2016-02-01

Oxytocin, a nanopeptide secreted by the posterior pituitary gland, has well-established uterotonic activity. Its role in initiating the vigorous and regular contractions of the first stage of labor is still controversial. We report four cases of panhypopituitarism who had spontaneous onset of labor, undermining the role of maternal oxytocin in the first phase of labor. Four women with no residual pituitary function conceived through ovulation induction and were treated throughout pregnancy with thyroid replacement therapy, desmopressin and glucocorticoids. In all cases pituitary function was undetectable in repeated blood tests. We report their course of pregnancy and delivery. All four pregnancies progressed to term with hormonal replacement therapy. All cases went into spontaneous labor. Two women delivered vaginally unassisted by pharmacological intervention and two delivered by cesarean sections during active labor due to obstetrical indications. Three suffered postpartum hemorrhage. Lactation did not ensue in all four cases. Endogenous pituitary oxytocin is probably not obligatory for initiation of labor in the first phase of parturition. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Maternal obesity and breastfeeding intention, initiation, intensity and duration: a systematic review.

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Turcksin, Rivka; Bel, Sarah; Galjaard, Sander; Devlieger, Roland

2014-04-01

This systematic review investigates the relationship between maternal obesity and breastfeeding intention, initiation, intensity, duration and milk supply. A comprehensive search was performed through three major databases, including Medline, Cochrane Library and Cumulative Index For Nursing and Allied Health Literature, and by screening reference lists of the relevant publications. Selection criteria were: report of original research, studies on low-risk obese mothers and the comparison with normal weight mothers which met at least two of the following primary outcomes: breastfeeding intention; initiation; intensity; duration and/or milk supply. Furthermore, the included reports had to contain a clear definition of pre-pregnant obesity, use compensation mechanisms for potential confounding factors, have a prospective cohort design and had to have been published between 1997 and 2011 and in English, French or Dutch. Effects of obesity on breastfeeding intention, initiation, intensity, duration and milk supply were analysed, tabulated and summarised in this review. Studies have found that obese women are less likely to intend to breastfeed and that maternal obesity seems to be associated with a decreased initiation of breastfeeding, a shortened duration of breastfeeding, a less adequate milk supply and delayed onset of lactogenesis II, compared with their normal weight counterparts. This systematic review indicates therefore that maternal obesity is an adverse determinant for breastfeeding success. © 2012 JohnWiley & Sons Ltd.

A supply-demand model of fetal energy sufficiency predicts lipid profiles in male but not female Filipino adolescents.

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Kuzawa, C W; Adair, L S

2004-03-01

To test the hypothesis that the balance between fetal nutritional demand and maternal nutritional supply during pregnancy will predict lipid profiles in offspring measured in adolescence. A total of 296 male and 307 female Filipino offspring (aged 14-16 y) and mothers enrolled in a longitudinal birth cohort study (begun in 1983-84) had lipid profiles measured. Data on maternal height (as a proxy for offspring growth potential and thus fetal nutritional demand) and third trimester maternal arm fat area (as a proxy for maternal supply) were used to create four groups hypothesized to reflect a gradient of fetal energy sufficiency. As fetal energy sufficiency increased among males, there was a decrease in total cholesterol (TC) (Psupply-demand model did not predict any lipid outcome or clinical risk criteria. Our findings in males support the hypothesis that the balance between fetal nutritional demand and maternal nutritional supply has implications for future lipid profiles. The lack of significant associations in females adds to mounting evidence for sex differences in lipid metabolism programming, and may reflect sex differences in fetal nutritional demand. The National Science Foundation, the Mellon Foundation, the Nestle Foundation, and the Emory University Internationalization Program.

Efeito do Programa Bolsa Família sobre a oferta de trabalho das mães The impact of the Bolsa Família Program on the labor supply of working mothers

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Priscilla Albuquerque Tavares

2010-12-01

Full Text Available Este artigo investiga a existência de um possível incentivo adverso à oferta de trabalho (participação no mercado e jornada das mães beneficiadas pelo Programa Bolsa Família. Utiliza-se o procedimento de propensity score matching para encontrar mães não atendidas pelo programa comparáveis às mães atendidas, a partir de três grupos de controle. Os resultados apontam a existência de um efeito-renda associado ao valor do benefício, uma vez que quanto maior a transferência recebida, menor o engajamento da mãe no mercado de trabalho. Entretanto, o efeito líquido de ser beneficiário do programa é positivo, indicando a existência de um efeito-substituição, provavelmente decorrente da redução da oferta de trabalho dos filhos, da maior disponibilidade de tempo das mães para trabalhar ou mesmo do estigma em participar do programa.This paper investigates the existence of a possible adverse incentive on the labor supply and weekly working hours of beneficiary mothers of the Bolsa Família Program. Three control groups are analyzed using propensity-score matching to compare non-beneficiary mothers to beneficiary mothers. The results show that there is a wealth effect related to the value of the benefits, given that the larger the benefit, the less active beneficiary mothers are in the labor market. Nonetheless, the net effect is positive, showing that there is a substitution effect due to a reduction in the children´s labor supply, a rise in the mother's available time, as well as decreasing the stigma.

Associations between maternal early pregnancy body mass index (BMI) and placental DNA methylation at term

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The placenta serves as the definitive maternal-fetal interface and mediates exchange of nutrients, gases, and waste between mother and the developing fetus. The placenta integrates signals from both mother and baby, coordinating maternal nutrient supply with fetal demand and development. In epidemio...

Maternal vitamin C deficiency during pregnancy results in transient fetal and placental growth retardation in guinea pigs

DEFF Research Database (Denmark)

Schjoldager, Janne Gram; Paidi, Maya Devi; Lindblad, Maiken Marie

2015-01-01

PURPOSE: Recently, we reported that preferential maternal-fetal vitamin C (vitC) transport across the placenta is likely to be impaired by prolonged maternal vitC deficiency. Maintenance of a basal maternal vitC supply at the expense of the fetus may impair fetal development; however, the knowled......, the present data suggest that vitC plays a role in early fetal development. Low maternal vitC intake during pregnancy may compromise maternal weight gain, placental function and intrauterine development....

Maternal Mortality Ratio and Causes of Death in IRI Between 2009 and 2012

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Marzieh Vahiddastjerdy

2016-12-01

Full Text Available Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran.Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9 during pregnancy, labor, and 42 days after parturition.Results: During 3 years, there were 5094317 deliveries and 941 maternal deaths (MMR of 18.5 per 1000000 live births. We had access to pertained data of 896 cases (95.2% for review in our study. Of 896 reported deaths, 549 were classified as direct, 302 as indirect and 45 as unknown. Hemorrhage was the most common cause of maternal mortality, followed by Preeclampsia, Eclampsia and sepsis. Among all indirect causes, cardio -vascular diseases were responsible for 10% of maternal deaths, followed by thromboembolism, HTN and renal diseases.Conclusion: Although maternal mortality ratio in IRI could be comparable with the developed countries but its pattern is following developing countries and with this study we had provided reliable data for other prospective studies.

Quality of higher education and the labor market in developing countries

DEFF Research Database (Denmark)

Boccanfuso, Dorothée; Larouche, Alexandre; Trandafir, Mircea

2015-01-01

While many studies examine the effect of primary education quality on labor market outcomes in developing countries, little is known about the effects at higher levels. We exploit the quasi-experiment provided by a large-scale education reform launched in Senegal in 2000 to investigate how quality...... improvements at the university level affect employment. Our difference-in-difference estimates suggest that young high-skilled workers experienced a nine percentage-point employment gain relative to older workers. They are also more likely to have “better” jobs (in the service industry or government......), suggesting a reduction in the mismatch between the quality of high-skill labor demanded and supplied....

Entrepreneurial University Perspective: Tracking Labor Force Capacity to Support Industrialization Processes in the Emerging Markets, Evidence from Kazakhstan Data

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Dilara Orynbassarova

2017-01-01

Full Text Available Industrialisation is considered as main engine of growth in economic development of the most emerging markets. This is especially true for Central Asian transitional countries as Kazakhstan, which obtained independence from the Soviet Union in 1991. For enhancing country’s competitiveness potential, Kazakhstan National Program for 2010-2014 aimed to accelerate industrial-innovative development of the country. While many papers published about the importance of industrialization activities in Kazakhstan, few have focused on examining the current capacity of labor market to meet the industry demand. Main aim of this paper was to investigate if current manpower is adequate to maintain the planned rate of growth in the country. Higher level of economic production led to higher demand of engineering labor force. High demand with low frequency supply created an imbalance in the labor market that resulted what we see as shortage of technically skilled labor. Low frequency of supply is influenced by such factors as high engineers’ outflow rate, low students enrolment and graduation rates, and lack of practical skills of the graduates hired.

Signal functions for emergency obstetric care as an intervention for reducing maternal mortality: a survey of public and private health facilities in Lusaka District, Zambia.

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Tembo, Tannia; Chongwe, Gershom; Vwalika, Bellington; Sitali, Lungowe

2017-09-06

Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia. A descriptive cross sectional study was conducted between November 2014 and February 2015 at 35 public and private health facilities. The Service Availability and Readiness Assessment tool was adapted and administered to overall in-charges, hospital administrators or maternity ward supervisors at health facilities providing maternal and newborn health services. The survey quantified infrastructure, human resources, equipment, essential drugs and supplies and used the UN process indicators to determine availability, accessibility and quality of signal functions. Data on deliveries and complications were collected from registers for periods between June 2013 and May 2014. Of the 35 (25.7% private and 74.2% public) health facilities assessed, only 22 (62.8%) were staffed 24 h a day, 7 days a week and had provided obstetric care 3 months prior to the survey. Pre-eclampsia/ eclampsia and obstructed labor accounted for most direct complications while postpartum hemorrhage was the leading cause of maternal deaths. Overall, 3 (8.6%) and 5 (14.3%) of the health facilities had provided Basic and Comprehensive EmONC services, respectively. All facilities obtained blood products from the only blood bank at a government referral hospital. The UN process indicators can be adequately used to monitor progress towards maternal mortality reduction. Lusaka district had an unmet need for BEmONC as health facilities fell below the minimum UN standard

Labor migration, externalities and ethics: theorizing the meso-level determinants of HIV vulnerability.

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Hirsch, Jennifer S

2014-01-01

This paper discusses labor migration as an example of how focusing on the meso-level highlights the social processes through which structural factors produce HIV risk. Situating that argument in relation to existing work on economic organization and HIV risk as well as research on labor migration and HIV vulnerabilities, the paper demonstrates how analyzing the processes through which labor migration creates vulnerability can shift attention away from the proximate behavioral determinants of HIV risk and toward the community and policy levels. Further, it presents the concepts of externalities and the ethics of consumption, which underline how both producers and consumers benefit from low-waged migrant labor, and thus are responsible for the externalization of HIV risk characteristic of supply chains that rely on migrant labor. These concepts point to strategies through which researchers and advocates could press the public and private sectors to improve the conditions in which migrants live and work, with implications for HIV as well as other health outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

29 CFR 784.109 - Manufacture of supplies for named operations is not exempt.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Manufacture of supplies for named operations is not exempt... § 784.109 Manufacture of supplies for named operations is not exempt. Employment in the manufacture of..., the exemption is not applicable to the manufacture of boxes, barrels, or ice by a seafood processor...

Study of the Effects of Intravenous Injection of Hyoscine on Parturition (Labor

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H Bekhradi Nasab

2006-01-01

Full Text Available Introduction: Despite wide use of hyoscine by midwives and doctors as an adjunct to labor, the obstetrics literature contains few references to the effect of this drug. This study was a double blinded, randomized controlled trial of primigravidas in Iran to determine the effects of hyoscine intravenous injection on parturition (labor. Methods:One hundred primigravidas in uncomplicated spontaneous labor with cervical dilation less than 4 cm and cervical effacement < 50% were randomly assigned into two groups; the experimental group ( N = 50 receiving 20 mg hyoscine and the control group ( N = 50 receiving placebo, with predetermined codes injected at the beginning of the active phase of labor. The groups were compared for labor progress, fetal tachycardia and bradycardia after 0.5 and 1h of injection, Apgar score and birth weight. Statistical methods for normally distributed variables included 2- tailed student T test and chi- square analysis. The accepted level of significance was p < 0.05. Results:The two groups were similar in respect to maternal age, gestational age , initial cervical effacement & dilation and mean birth weight. The mean change in the cervical effacement and dilation after 1 & 2 h of injection was significantly higher in those receiving hyoscine (p< 0.0001. There was a significant difference in the duration of active phase and second stage of labor in the two groups ( p < 0.0001 . Fetal tachycardia and bradycardia occurred more frequently in patients in the hyoscine group as compared to the control group but the difference was not significant. The difference between the mean first and fifth- minute Apgar score was not significant, too. Conclusion: This small study suggests the benefits of a single dose of hyoscine for labor progress and represents the first attempt to evaluate this medication. However, larger randomized studies are needed to establish the efficacy, safety, and optimal dose of hyoscine .

76 FR 34271 - Hewlett Packard, Global Parts Supply Chain, Global Product Life Cycles Management Unit, Including...

Science.gov (United States)

2011-06-13

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,671] Hewlett Packard, Global Parts Supply Chain, Global Product Life Cycles Management Unit, Including Teleworkers Reporting to... Supply Chain, Global Product Life Cycles Management Unit, including teleworkers reporting to Houston...

Preterm Labor

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Preterm labor is labor that starts before 37 completed weeks of pregnancy. It can lead to premature birth. Premature babies may face serious health risks. Symptoms of preterm labor include Contractions every 10 minutes or more often ...

Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: results of DEXTRONS prospective randomized controlled trial.

Science.gov (United States)

Paré, Josianne; Pasquier, Jean-Charles; Lewin, Antoine; Fraser, William; Bureau, Yves-André

2017-05-01

Prolonged labor is a significant cause of maternal and fetal morbidity and very few interventions are known to shorten labor course. Skeletal muscle physiology suggests that glucose supplementation might improve muscle performance in case of prolonged exercise and this situation is analogous to the gravid uterus during delivery. Therefore, it seemed imperative to evaluate the impact of adding carbohydrate supplements on the course of labor. We sought to provide evidence as to whether intravenous glucose supplementation during labor induction in nulliparous women can reduce total duration of active labor. We performed a single-center prospective double-blind randomized controlled trial comparing the use of parental intravenous dextrose 5% with normal saline to normal saline in induced nulliparous women. The study was conducted in a tertiary-level university hospital setting. Participants, caregivers, and those assessing the outcomes were blinded to group assignment. Inclusion criteria were singleton pregnancy at term with cephalic presentation and favorable cervix. Based on blocked randomization, patients were assigned to receive either 250 mL/h of intravenous dextrose 5% with normal saline or 250 mL/h of normal saline for the whole duration of induction, labor, and delivery. The primary outcome studied was the total length of active labor. Secondary outcomes included duration of the active phase of second stage of labor, the mode of delivery, Apgar scores, and arterial cord pH. In all, 100 patients were randomized into each group. A total of 193 patients (96 in the dextrose with normal saline group and 97 in the normal saline group) were analyzed in the study. The median total duration of labor was significantly less in the dextrose with normal saline group (499 vs 423 minutes, P = .024) than in the normal saline group. The probabilities of a woman being delivered at 200 minutes and 450 minutes were 18.8% and 77.1% in the dextrose with normal saline group vs 8

Trial of labor compared to repeat cesarean section in women with no other risk factors than a prior cesarean delivery

DEFF Research Database (Denmark)

Studsgaard, Anne; Skorstengaard, Malene; Glavind, Julie

2013-01-01

OBJECTIVE: To compare outcomes with trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery on maternal request (ERCD-MR). DESIGN: Prospective cohort study. SETTING: Danish university hospital. POPULATION: Women with TOLAC (n = 1161) and women with ERCD-MR (n = 622) between 2003...... registration of the deliveries. MAIN OUTCOME MEASURES: Adverse neonatal outcomes, risk factors for emergency cesarean, and uterine rupture in case of TOLAC. RESULTS: TOLAC was associated with an increased risk of neonatal depression [odds ratio (OR) 3.6, 95% confidence interval (CI) 1.1-19.1] and neonatal...... vaginal delivery (adjusted OR 1.8, 95% CI 1.1-3.0), index emergency cesarean during labor (adjusted OR 3.0, 95% CI 2.3-4.1), maternal age ≥35 years (adjusted OR 1.9, 95% CI 1.3-2.8), pre-pregnancy body mass index ≥30 (adjusted OR 2.1, 95% CI 1.3-3.3), and birthweight 4000-4499 g (adjusted OR 1.5, 95% CI 1...

Variations on the European labor markets from gender point of view

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Savić Mirko

2010-01-01

Full Text Available In modern societies gender gap attracts significant attention. Scientists are trying to research this issue from different aspects: demographical, sociological, economic, etc. The goal of this paper is to define the basic variables that explain variation on the labor markets in Europe from the gender point of view and to compare labor market in Serbia with European countries in order to identify the countries with the most similar gender performances, with intention to overview their experiences concerning the policy measures for gender gap reduction. Analysis is conducted through observations of activity rates, employment rates, unemployment rates, inactivity rates, and long-term unemployment rates. With use of factor analysis we have identified the main factors on the labor markets in Europe and on the basis of cluster analysis we have conducted grouping of countries on the basis of discovered factors. Identification of cluster with Serbia was conducted and also the place of the Serbian labor market in the same cluster. On the basis of quantitative results qualitative analysis was conducted to overview the experience in the field of gender differences on the labor market in the countries from the same cluster as Serbia, with special attention to Italy. Contemporary researches define labor market policy measures oriented to reduction of inequalities in the field of paid and unpaid labor. Decrease of these inequalities will consequently lead to the increase of female labor supply on the market. Final result of this research is the recommendation of policy measures in order to reduce gender differences in economic activity with final goal of creating modern society in Serbia and convergence with the most advanced countries in that field.

Epidural analgesia during labor among immigrant women in Sweden.

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Ekéus, Cecilia; Cnattingius, Sven; Hjern, Anders

2010-01-01

To investigate differences in the use of epidural analgesia (EDA) during labor between native Swedish and immigrant women and whether such possible differences could be explained by other maternal factors or birthweight. Population-based register study. Nationwide study in Sweden. A total of 455,274 primiparous women, who gave birth to a singleton infant at 37-41 completed gestational weeks during 1992-2005. Of the 72,086 (16%) immigrants, data on 31,148 women from the eight most common countries of origin were analyzed to test our hypotheses. Register study with perinatal data from the Medical Birth Register and socio-demographic variables from national income and population registers. Use of EDA during vaginal delivery. Compared with native Swedish women, EDA was more often used by women from Chile, odds ratio (OR) 1.39 (95% confidence interval (CI) 1.23-1.57); Iran, OR 1.38 (1.26-1.53); Poland, OR 1.22 (1.08-1.37) and Finland, OR 1.10 (1.03-1.17) after adjustments for perinatal and socio-demographic confounders, while EDA was less often used among women from Somalia, OR 0.57 (0.46-0.70); Iraq, OR 0.71 (0.64-0.78); Turkey, OR 0.77(0.69-0.86) and Yugoslavia, OR 0.85 (0.79-0.91). Having a native Swedish partner increased the use of EDA in immigrant women. EDA use during labor varies more by maternal country of origin than by socio-economic factors. This suggests that expectations of care from the country of origin continue to influence the use of EDA after immigration to Sweden.

[Labor legislation reform: law 50 of 1990. The context of the reform].

Science.gov (United States)

Yanuzova, M

1991-12-01

Labor legislation reforms contained in Law 50 of 1990 were intended to facilitate international opening of Colombia's economy, which has been beset by external debt, an absence of foreign investment, technological backwardness, and low productivity. The weakness of the labor movement, aggravated by the failure of the socialist economic model and its power organization, made possible a dismantling of past labor victories. The labor reform is intended to combat stagnation in productivity which is believed by the government to result from labor instability; to create a climate permitting generation of employment, and to adapt internal labor laws to recommendations of the International Labour Organization. The effort to make labor legislation more flexible and more adaptable to market conditions removed some protectionist measures and facilitated firing or laying off of workers. Several categories of workers were removed from the jurisdiction of labor laws and placed under the jurisdiction of civil law and ultimately of market forces. The new labor law will lead to salary reductions for most workers. A 36-hour work week without overtime was created for new enterprises as a strategy to encourage job creation. The principle that labor laws should protect workers because of their unequal power relative to employers has been suppressed in the new legislation. Although it is too early to draw definite conclusions about the effect of the law on women workers, some effects are predictable. The liberating power of employment for married women has been limited in Colombia as in many other countries because women are expected to carry out their full traditional domestic role in addition to their paid employment. Women's status in the workplace has improved considerably over the past 50 years, but they still have higher unemployment rates than men, receive lower wages, and are concentrated in less skilled jobs and the informal sector. Employment in the informal sector allows

Why Should We Care about Child Labor? The Education, Labor Market, and Health Consequences of Child Labor

Science.gov (United States)

Beegle, Kathleen; Dehejia, Rajeev; Gatti, Roberta

2009-01-01

Despite the extensive literature on the determinants of child labor, the evidence on the consequences of child labor on outcomes such as education, labor, and health is limited. We evaluate the causal effect of child labor participation among children in school on these outcomes using panel data from Vietnam and an instrumental variables strategy.…

Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study.

Science.gov (United States)

Ekirapa-Kiracho, Elizabeth; Waiswa, Peter; Rahman, M Hafizur; Makumbi, Fred; Kiwanuka, Noah; Okui, Olico; Rutebemberwa, Elizeus; Bua, John; Mutebi, Aloysius; Nalwadda, Gorette; Serwadda, David; Pariyo, George W; Peters, David H

2011-03-09

Geographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services at tertiary hospitals. To demonstrate how reforms at Makerere University College of Health Sciences (MakCHS) can lead to making systemic changes that can improve maternal health services, a demand and supply side strategy was developed by working with local communities and national stakeholders. This quasi-experimental trial is conducted in two districts in Eastern Uganda. The supply side component includes health worker refresher training and additions of minimal drugs and supplies, whereas the demand side component involves vouchers given to pregnant women for motorcycle transport and the payment to service providers for antenatal, delivery, and postnatal care. The trial is ongoing, but early analysis from routine health information systems on the number of services used is presented. Motorcyclists in the community organized themselves to accept vouchers in exchange for transport for antenatal care, deliveries and postnatal care, and have become actively involved in ensuring that women obtain care. Increases in antenatal, delivery, and postnatal care were demonstrated, with the number of safe deliveries in the intervention area immediately jumping from Voucher revenues have been used to obtain needed supplies to improve quality and to pay health workers, ensuring their availability at a time when workloads are increasing. Transport and service vouchers appear to be a viable strategy for rapidly increasing maternal care. MakCHS can design strategies together with stakeholders using a learning-by-doing approach to take advantage of

Maternity Leave and Mothers' Long-Term Sickness Absence: Evidence From West Germany.

Science.gov (United States)

Guertzgen, Nicole; Hank, Karsten

2018-04-01

Exploiting unique German administrative data, we estimate the association between an expansion in maternity leave duration from two to six months in 1979 and mothers' postbirth long-term sickness absence over a period of three decades after childbirth. Adopting a difference-in-difference approach, we first assess the reform's labor market effects and, subsequently, prebirth and postbirth maternal long-term sickness absence, accounting for the potential role of the reform in mothers' selection into employment. Consistent with previous research, our estimates show that the leave extension caused mothers to significantly delay their return to work within the first year after childbirth. We then provide difference-in-difference estimates for the number and length of spells of long-term sickness absence among returned mothers. Our findings suggest that among those returned, mothers subject to the leave extension exhibit a higher incidence of long-term sickness absence compared with mothers who gave birth before the reform. This also holds true after we control for observable differences in prebirth illness histories. At the same time, we find no pronounced effects on mothers' medium-run labor market attachment following the short-run delay in return to work, which might rationalize a negative causal health effect. Breaking down the results by mothers' prebirth health status suggests that the higher incidence of long-term sickness absence among mothers subject to the reform may be explained by the fact that the reform facilitated the reentry of a negative health selection into the labor market.

The influence of preferred place of birth on the course of pregnancy and labor among healthy nulliparous women: a prospective cohort study

NARCIS (Netherlands)

T.M. van Haaren-ten Haken; M. Hendrix (Marijke); L.J. Smits (Luc); M.J. Nieuwenhuijze (Marianne); J.L. Severens (Hans); R.G. de Vries (Raymond); J.G. Nijhuis (Jan)

2015-01-01

markdownabstract__Abstract__ BACKGROUND: Most studies on birth settings investigate the association between planned place of birth at the start of labor and birth outcomes and intervention rates. To optimize maternity care it also is important to pay attention to the entire process of

Maternal Parity and Blood Oxidative Stress in Mother and Neonate

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Golalizadeh

2016-02-01

Full Text Available Background Parturition has been associated with free radicals, itself linked with poor pregnancy outcome. Objectives This study aimed to investigate the relationship between oxidative stress biomarkers levels of maternal and cord blood samples at the second stage of labor with the maternal parity number. Materials and Methods In this analytical cross-sectional study, subjects were selected from Fatemieh teaching hospital, Hamadan, Iran, and allocated into the two groups according to their number of parity: the primiparous group (n = 33, and multiparous group (n = 35. Maternal and umbilical cord blood samples were taken from all subjects and then assessed for catalas activity (CAT, total thiol molecules (TTM and total antioxidant capacity (TAC. Results Total antioxidant capacity levels were significantly higher in newborns of primiparous women compared to multiparous women (P = 0.006. The CAT levels were significantly lower (P = 0.04 and TAC levels significantly higher (P = 0.03 in maternal plasma of primiparous women compared to those of multiparous women. Conclusions Increment in the number of parity can lead to decrease antioxidant defense mechanisms in multiparous women and their newborns. So, control of oxidative stress is considered to be beneficial in multiparous women.

Comparison of Foley catheter and prostaglandin E2 tablets for the induction of labor at term

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Ana Daneva Markova

2013-12-01

Full Text Available The aim of the paper was to assess success rates and associated maternal and fetal risks, to determine the different methods of induction for labor at term, compare induction with Foley catheter and induction with naturally occurring prostaglandin E2 (PGE2 tablets in women with gestational age at term. Two hundred and twelve women at term were included into the study, one group with Foley catheter, the second group with PGE2 tablets, with a maximum of two doses. The primary outcome measures were the admission-to-delivery interval and the induction-to-delivery interval. Secondary outcomes included cesarean section rate, mode of delivery, and maternal and neonatal safety outcome. Results were calculated by applying the Fisher’s exact test, c2-test, t-test and calculating the P-value using an alpha level of 0.05 for Type I errors. The mean time from admission to delivery was 13.53h in the Foley catheter group and 12.30h in the PGE2 group (P=0.090. The induction-to-delivery interval was also comparable between the groups (10.75h vs 9.37h, while the cesarean section rate did not differ significantly between them (7.61% vs 15.30%. More women in the misoprostol group had an instrumental delivery (12.38% vs 2.94%. The only significant difference in neonatal outcome was a larger number of babies born with Apgar score < 7 at 1 min in the Foley group. Maternal outcomes were not significantly different, except for a higher number of digital examinations in the Foley group. Foley catheter is equally efficacious in labor induction and demonstrates a similar fetal and maternal safety profile to PGE2.

[Pregnancy and labor associated with encephalopathy in neonates during the early neonatal period].

Science.gov (United States)

Skrablin, S; Drazancić, A; Letica, N; Tadić, V

1992-01-01

Pregnancy complications, drugs and surgical interventions during pregnancy, fetal growth, medications and interventions during labor, labor complications as well as fetal heart activity during labor in a group of 114 term infants without malformations, but with signs of central nervous system (CNS) damage throughout early neonatal period are compared with paired group of term healthy infants born in the same presentation and mode of delivery. Among prelabor factors only maternal hypertension (found in 16.7% of encephalopathy children versus 0.8% in a control group) was significantly correlated with CNS damage. Fetal growth retardation and long term ritodrine administration were found more frequent in encephalopathy than in healthy group of infants, although statistical significance between the groups could not be demonstrated. A prolonged second stage of labor, high oxytocin dosage, too frequent uterine contractions and vacuum extractions were found significantly correlated with neonatal encephalopathy. CTG pattern during labor was normal in only 28.9% of children, with encepalopathy prepathologic in 46.4% and pathologic in 24.7%. The respective percentages for healthy newborns were: 82.5%, 16.25% and 1.2%. All differences between the groups were statistically significant. Mean duration of prepathologic CTG score in the group of infants with encephalopathy (78.8 minutes) as well as of pathologic score (51.7 minutes) was significantly longer than in healthy infants (23.7 minutes prepathologic and 7 minutes pathologic).(ABSTRACT TRUNCATED AT 250 WORDS)

Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study

Directory of Open Access Journals (Sweden)

Serwadda David

2011-03-01

Full Text Available Abstract Background Geographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services at tertiary hospitals. To demonstrate how reforms at Makerere University College of Health Sciences (MakCHS can lead to making systemic changes that can improve maternal health services, a demand and supply side strategy was developed by working with local communities and national stakeholders. Methods This quasi-experimental trial is conducted in two districts in Eastern Uganda. The supply side component includes health worker refresher training and additions of minimal drugs and supplies, whereas the demand side component involves vouchers given to pregnant women for motorcycle transport and the payment to service providers for antenatal, delivery, and postnatal care. The trial is ongoing, but early analysis from routine health information systems on the number of services used is presented. Results Motorcyclists in the community organized themselves to accept vouchers in exchange for transport for antenatal care, deliveries and postnatal care, and have become actively involved in ensuring that women obtain care. Increases in antenatal, delivery, and postnatal care were demonstrated, with the number of safe deliveries in the intervention area immediately jumping from Conclusions Transport and service vouchers appear to be a viable strategy for rapidly increasing maternal care. MakCHS can design strategies together with stakeholders using a learning-by-doing approach to take advantage of community resources.

Empirical Essays on the Labor Market Outcomes of PhD Graduates

DEFF Research Database (Denmark)

Pedersen, Heidi Skovgaard

that PhDs accelerate growth. A major objective has been to direct more PhDs to the industry to use their skills to monetize knowledge. However, we have limited evidence on how PhDs are absorbed into the labor market, how the market values PhD labor, and how PhDs value the possibility to work......During the past decade, policy makers have accentuated the need for more PhDs to drive innovation and use their research skills to push the technological frontier. The public sector in Denmark has financially supported a doubling of the number of enrolled PhD students based on a strong belief...... in the private sector. The dissertation investigates determinants of labor market decisions among recent cohorts of PhDs in Denmark to assess how the increasing number of PhDs is absorbed into the economy. Based on econometric models, it examines what factors trigger individual career decisions and supply...

Effect of maternal and post weaning folate supply on gene-specific DNA methylation in the small intestine of weaning and adult Apc+/Min and wild type mice.

Directory of Open Access Journals (Sweden)

Jill Ann Mckay

2011-05-01

Full Text Available Increasing evidence supports the developmental origins of adult health and disease hypothesis which argues for a causal relationship between adverse early life nutrition and increased disease risk in adulthood. Modulation of epigenetic marks, e.g. DNA methylation and consequential altered gene expression, has been proposed as a mechanism mediating these effects. Via its role as a methyl donor, dietary folate supply may influence DNA methylation. As aberrant methylation is an early event in colorectal cancer (CRC pathogenesis, we hypothesised low maternal and/or post-weaning folate intake may influence methylation of genes involved in CRC development. We investigated the effects of maternal folate depletion during pregnancy and lactation on selected gene methylation in the small intestine (SI of wild type (WT and Apc+/Min mice at weaning and as adults. We also investigated the effects of folate depletion post-weaning on gene methylation in adult mice. Female C57Bl6/J mice were fed low or normal folate diets from mating with Apc+/Min males to the end of lactation. A sub set of offspring were killed at weaning. Remaining offspring were weaned on to low or normal folate diets, resulting in 4 treatment groups of Apc+/Min and WT mice. p53 was more methylated in weaning and adult WT compared with Apc+/Min mice (p>0.001. Igf2 and Apc were hypermethylated in adult Apc+/Mi n compared with WT mice (p=0.004 & p=0.012 respectively. Low maternal folate reduced p53 methylation in adults (p=0.04. Low post-weaning folate increased Apc methylation in Apc+/Min mice only (p=0.008 for interaction. These observations demonstrate that folate depletion in early life can alter epigenetic marks in a gene specific manner. Also, the differential effects of altered folate supply on DNA methylation in WT and Apc+/Min mice suggest that genotype may modulate epigenetic responses to environmental cues and may have implications for the development of personalised nutrition.

Influence of Maternal Obesity and Gestational Weight Gain on Maternal and Foetal Lipid Profile.

Science.gov (United States)

Cinelli, Giulia; Fabrizi, Marta; Ravà, Lucilla; Ciofi Degli Atti, Marta; Vernocchi, Pamela; Vallone, Cristina; Pietrantoni, Emanuela; Lanciotti, Rosalba; Signore, Fabrizio; Manco, Melania

2016-06-15

Fatty acids (FAs) are fundamental for a foetus's growth, serving as an energy source, structural constituents of cellular membranes and precursors of bioactive molecules, as well as being essential for cell signalling. Long-chain polyunsaturated FAs (LC-PUFAs) are pivotal in brain and visual development. It is of interest to investigate whether and how specific pregnancy conditions, which alter fatty acid metabolism (excessive pre-pregnancy body mass index (BMI) or gestational weight gain (GWG)), affect lipid supply to the foetus. For this purpose, we evaluated the erythrocyte FAs of mothers and offspring (cord-blood) at birth, in relation to pre-pregnancy BMI and GWG. A total of 435 mothers and their offspring (237 males, 51%) were included in the study. Distribution of linoleic acid (LA) and α-linolenic acid (ALA), and their metabolites, arachidonic acid, dihomogamma linoleic (DGLA) and ecosapentanoic acid, was significantly different in maternal and foetal erythrocytes. Pre-pregnancy BMI was significantly associated with maternal percentage of MUFAs (Coeff: -0.112; p = 0.021), LA (Coeff: -0.033; p = 0.044) and DHA (Coeff. = 0.055; p = 0.0016); inadequate GWG with DPA (Coeff: 0.637; p = 0.001); excessive GWG with docosaexahenoic acid (DHA) (Coeff. = -0.714; p = 0.004). Moreover, pre-pregnancy BMI was associated with foetus percentage of PUFAs (Coeff: -0.172; p = 0.009), omega 6 (Coeff: -0.098; p = 0.015) and DHA (Coeff: -0.0285; p = 0.036), even after adjusting for maternal lipids. Our findings show that maternal GWG affects maternal but not foetal lipid profile, differently from pre-pregnancy BMI, which influences both.

Tracing shadows: How gendered power relations shape the impacts of maternal death on living children in sub Saharan Africa.

Science.gov (United States)

Yamin, Alicia Ely; Bazile, Junior; Knight, Lucia; Molla, Mitike; Maistrellis, Emily; Leaning, Jennifer

2015-06-01

Driven by the need to better understand the full and intergenerational toll of maternal mortality (MM), a mixed-methods study was conducted in four countries in sub-Saharan Africa to investigate the impacts of maternal death on families and children. The present analysis identifies gender as a fundamental driver not only of maternal, but also child health, through manifestations of gender inequity in household decision making, labor and caregiving, and social norms dictating the status of women. Focus group discussions were conducted with community members, and in depth qualitative interviews with key-informants and stakeholders, in Tanzania, Ethiopia, Malawi, and South Africa between April 2012 and October 2013. Findings highlight that socially constructed gender roles, which define mothers as caregivers and fathers as wage earners, and which limit women's agency regarding childcare decisions, among other things, create considerable gaps when it comes to meeting child nutrition, education, and health care needs following a maternal death. Additionally, our findings show that maternal deaths have differential effects on boy and girl children, and exacerbate specific risks for girl children, including early marriage, early pregnancy, and school drop-out. To combat both MM, and to mitigate impacts on children, investment in health services interventions should be complemented by broader interventions regarding social protection, as well as aimed at shifting social norms and opportunity structures regarding gendered divisions of labor and power at household, community, and society levels. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Social Responsibility in Tobacco Production? Tobacco Companies Use of Green Supply Chains to Obscure the Real Costs of Tobacco Farming

Science.gov (United States)

Otañez, Marty

2011-01-01

Background Tobacco companies have come under increased criticism because of environmental and labor practices related to growing tobacco in developing countries. Methods Analysis of tobacco industry documents, industry web sites 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. Results British American Tobacco and Philip Morris created supply chains in the 1990s to improve production efficiency, control, access to markets, and profits. In the 2000s, the companies used their supply chains in an attempt to legitimize their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labor 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 labor costs due to child labor and more than $64 million annually in costs that would have been made to avoid tobacco related deforestation in the top twelve tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices. Conclusions The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labor 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. PMID:21504915

Association Between Maternal Serum Total Oxidant Status Total Antioxidant Status and Preterm Labor: A Prospective - Controlled Clinical Study

OpenAIRE

Hakan Kalaycı; Mete Gürol Uğur; Ebru Öztürk; Özcan Balat; Özcan Erel

2011-01-01

OBJECTIVE: To measure the levels of individual antioxidant components of pregnants with preterm labor to evaluate their total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI). STUDY DESIGN: Prospectively-controlled 31 pregnants with a diagnosis of preterm labor (group Ι) and 32 controls (group ΙΙ) were evaluated for demographic data, general and obstetrical physical examination, obstetrical sonography, and routine laboratory tests. TAS, TOS and OSI leve...

Non-OPEC supply : delivering on growth

International Nuclear Information System (INIS)

Lynch, M.C.

2001-01-01

This PowerPoint slide show included several graphs depicting petroleum issues dealing with non-OPEC oil supply. A forecast for 2001 was included with particular focus on changes in non-OPEC supply and annual change in non-OPEC supply to 2005. The author described ways in which to judge oil supply forecasts. The driving factors for the first approach are: investment drilling, depletion, and other factors such as natural gas prices, labor relations, and weather. The second approach to forecasting oil supply is policy driven, as in the case of Mexico and Russia, maturity driven as in the case of the United States, North Sea and Canada, and lastly, it is inertia driven. It was noted that since most oil is from aging reservoirs, depletion drivers should be carefully considered, including different types of production, such as onshore, offshore and horizontal wells. The author concluded with his prediction that we can expect much more oil unless prices are weak. There will likely be more activity in the petroleum industry which will be good for the oil service industry. He also predicted improvements in productivity. 3 tabs., 12 figs

Labor induction in the patient with preterm premature rupture of membranes.

Science.gov (United States)

Packard, Roger Everett; Mackeen, Awathif Dhanya

2015-10-01

Preterm premature rupture of membranes (PPROM) affects up to one-third of all preterm births and confers serious maternal risks, including intra-amniotic infection, and an increased risk of neonatal complications, including respiratory distress and intraventricular hemorrhage. Management of PPROM is a highly individualized process that requires an accurate determination of gestational age and causal factors, as well as the balancing of maternal and fetal risks. In this review of the existing literature on induction of labor in PPROM, we examine the differences in appropriate management of patients with early (32 weeks 0 days to 33 weeks 6 days) and near term (34 weeks 0 days to 36 weeks 6 days) PPROM, and compare the safety and efficacy of available treatment options. This review of previous research findings provides general guidelines for clinical decision making and highlights the need for future research on management of PPROM. Copyright © 2015 Elsevier Inc. All rights reserved.

Maternal serum uric acid level and maternal and neonatal complications in preeclamptic women: A cross-sectional study.

Science.gov (United States)

Asgharnia, Maryam; Mirblouk, Fariba; Kazemi, Soudabeh; Pourmarzi, Davood; Mahdipour Keivani, Mina; Dalil Heirati, Seyedeh Fatemeh

2017-09-01

Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia. We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia. In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included. Hemoglobin, hematocrit, platelet count, liver and uric acid tests, and maternal and neonatal complications were assessed. The severity of preeclampsia, placental abruption, preterm labor, thrombocytopenia, elevated alanine aminotransferase and aspartate aminotransferase (ALT and AST), HELLP syndrome, eclampsia and required hospitalization in the ICU was considered as the maternal complication. Fetal complications were: small for gestational age (SGA), intrauterine fetal death, hospitalization in the neonatal intensive care unit, and Apgar score uric acid in women with severe preeclampsia was significantly higher than non-severe preeclampsia (p=0.031), also in those with an abnormal liver test (p=0.009). The mean level of uric acid in women with preterm delivery was significantly higher than women with term delivery (p=0.0001). Also, the level of uric acid had no effect on neonatal hospitalization in neonate invasive care unit. Based on logistic regression, the incidence of severe preeclampsia not affected by decreased or increased serum levels of uric acid. With higher level of uric acid in server preeclampsia we can expected more complications such as hepatic dysfunction and preterm delivery. Thus serum uric acid measurement can be helpful marker for severe preeclampsia.

Maternal health in Gujarat, India: a case study.

Science.gov (United States)

Mavalankar, Dileep V; Vora, Kranti S; Ramani, K V; Raman, Parvathy; Sharma, Bharati; Upadhyaya, Mudita

2009-04-01

Gujarat state of India has come a long way in improving the health indicators since independence, but progress in reducing maternal mortality has been slow and largely unmeasured or documented. This case study identified several challenges for reducing the maternal mortality ratio, including lack of the managerial capacity, shortage of skilled human resources, non-availability of blood in rural areas, and infrastructural and supply bottlenecks. The Gujarat Government has taken several initiatives to improve maternal health services, such as partnership with private obstetricians to provide delivery care to poor women, a relatively-short training of medical officers and nurses to provide emergency obstetric care (EmOC), and an improved emergency transport system. However, several challenges still remain. Recommendations are made for expanding the management capacity for maternal health, operationalization of health facilities, and ensuring EmOC on 24/7 (24 hours a day, seven days a week) basis by posting nurse-midwives and trained medical officers for skilled care, ensuring availability of blood, and improving the registration and auditing of all maternal deaths. However, all these interventions can only take place if there are substantially-increased political will and social awareness.

The effects of hydrotherapy on anxiety, pain, neuroendocrine responses, and contraction dynamics during labor.

Science.gov (United States)

Benfield, Rebecca D; Hortobágyi, Tibor; Tanner, Charles J; Swanson, Melvin; Heitkemper, Margaret M; Newton, Edward R

2010-07-01

Hydrotherapy (immersion or bathing) is used worldwide to promote relaxation and decrease parturient anxiety and pain in labor, but the psychophysiological effects of this intervention remain obscure. A pretest-posttest design with repeated measures was used to examine the effects of hydrotherapy on maternal anxiety and pain, neuroendocrine responses, plasma volume shift (PVS), and uterine contractions (CXs) during labor. Correlations among variables were examined at three time points (preimmersion and twice during hydrotherapy). Eleven term women (mean age 24.5 years) in spontaneous labor were immersed to the xiphoid in 37 degrees C water for 1 hr. Blood samples and measures of anxiety and pain were obtained under dry baseline conditions and repeated at 15 and 45 min of hydrotherapy. Uterine contractions were monitored telemetrically. Hydrotherapy was associated with decreases in anxiety, vasopressin (V), and oxytocin (O) levels at 15 and 45 min (all ps hydrotherapy for women with high baseline pain as for those with low baseline pain. beta-endorphin (betaE) levels increased at 15 min but did not differ between baseline and 45 min. During immersion, CX frequency decreased. A positive PVS at 15 min was correlated with contraction duration. Hydrotherapy during labor affects neuroendocrine responses that modify psychophysiological processes.

Maternal Education Gradients in Infant Health in Four South American Countries.

Science.gov (United States)

Wehby, George L; López-Camelo, Jorge S

2017-11-01

Objective We investigate gradients (i.e. differences) in infant health outcomes by maternal education in Argentina, Brazil, Chile, and Venezuela and explore channels related to father's education, household labor outcomes, and maternal health, fertility, and use of prenatal services and technology. Methods We employ secondary interview and birth record data similarly collected across a network of birth hospitals from the early 1980s through 2011 within the Latin American Collaborative Study of Congenital Anomalies (ECLAMC). Focusing on children without birth defects, we estimate gradients in several infant health outcomes including birth weight, gestational age, and hospital discharge status by maternal education using ordinary least squares regression models adjusting for several demographic factors. To explore channels, we add as covariates father's education, parental occupational activity, maternal health and fertility history, and use of prenatal services and technology and evaluate changes in the coefficient of maternal education. We use the same models for each country sample. Results We find important differences in gradients across countries. We find evidence for educational gradients in preterm birth in three countries but weaker evidence for gradients in fetal growth. The extent to which observed household and maternal factors explain these gradients based on changes in the regression coefficient of maternal education when controlling for these factors as covariates also varies between countries. In contrast, we generally find evidence across all countries that higher maternal education is associated with increased use of prenatal care services and technology. Conclusions Our findings suggest that differences in infant health by maternal education and their underlying mechanisms vary and are not necessarily generalizable across countries. However, the positive association between maternal education and use of prenatal services and technology is more

BALANCE OF SUPPLY AND DEMAND OF THE CEREAL AND INFLUENCING FACTORS IN CHINA: FROM THE PERSPECTIVE OF THE COST

Directory of Open Access Journals (Sweden)

Bingqiang Li

2017-09-01

Full Text Available The balanced supply and demand of the cereal is essential for achieving economic sustainable development in China. The wheat and products, the rice (including the milled equivalent, and the maize and products are three main cereals in China, the three cereals but the rice (including the milled equivalent in China were enerally seriously comparatively insufficient before 1997, and then became fully sufficient. The co-integrative test demonstrated that there existed long-term equilibrium between balance of supply and demand and influencing factors, and the correcting coefficient was about 2.2 percent. As for balance degree of supply and demand, increase of machinery cost, daily-average labor price and indirect cost would improve it, increase of fertilizer expenditure and labor-input quantity would deteriorate it at short-term. The Granger causality test implied that balance of supply and demand owned interactive effect with laborer-input quantity, but not with the other cost. The highlight of this article was evaluating hypothesis of “Who will feed China” and influencing factors from perspective of the cost, achieving that the above hypothesis was not a real problem in China.

MATERNAL AND FETAL OUTCOME IN PRE-ECLAMPSIA AND ECLAMPSIA

Directory of Open Access Journals (Sweden)

Sipra

2015-11-01

perinatal mortality was 28.57% in Pre-Eclampsia cases and 52.84% in Eclampsia cases. The most common cause of fetal mortality was Asphyxia. DISCUSSION Incidence of Eclampsia was high because of lack of awareness regarding antenatal check up. Period of gestation was >37 weeks and due to infrequent ANCs, diseases remained unrecognized and patients came to the hospital only after onset of labor pain or even trial of labor by untrained dais and quacks at home. Due to late detection of cases, maternal and fetal outcome was very poor. CONCLUSION There is a lack of awareness about significance of regular ANC and Pre-Eclampsia and Eclampsia are usually recognized late, mostly when they have already developed complications. Maternal and fetal outcome is still very poor in rural areas of the country.

Understanding barriers to maternal child health services utilisation ...

African Journals Online (AJOL)

The findings also indicate that although health facility delivery is high in the districts surveyed, only the well-to-do non-literate, urbanite women and the ... rural communities included the need to improve the quality of maternal and child health service through the supply of major logistic deficiencies, the need to provide ...

Parturients' need of continuous labor support in labor wards

African Journals Online (AJOL)

Administrator

Continuous labor support is practiced in different parts of the world. In Ethiopia ... Objective: The purpose of the study was to assess the attitude of women in response to labor support based at institutional ... The reasons given for wanting companion were emotional ..... mothers play vital role in labor and delivery while men.

77 FR 9267 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

Science.gov (United States)

2012-02-16

...), established a new eligibility criterion for receipt of trade benefits under the Generalized System of... Child Labor AGENCY: The Bureau of International Labor Affairs, United States Department of Labor. ACTION... information and/or comment on reports issued by the Bureau of International Labor Affairs (ILAB) October 3...

76 FR 22921 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

Science.gov (United States)

2011-04-25

... trade benefits under the Generalized System of Preferences (GSP), Caribbean Basin Trade and Partnership... Child Labor AGENCY: The Bureau of International Labor Affairs, United States Department of Labor. ACTION... information and/or comment on reports issued by the Bureau of International Labor Affairs (ILAB) on December...

The influence of preferred place of birth on the course of pregnancy and labor among healthy nulliparous women : a prospective cohort study

NARCIS (Netherlands)

Luc J.Smits; dr. Marianne Nieuwenhuijze; Jan G. Nijhuis; Johan L. Severens; Raymond G. de Vries; Tamar M. van Haaren-ten Haken; Marijke Hendrix

2015-01-01

Background: Most studies on birth settings investigate the association between planned place of birth at the start of labor and birth outcomes and intervention rates. To optimize maternity care it also is important to pay attention to the entire process of pregnancy and childbirth. This study

[Demography and labor shortage. Future challenges of labor market policy].

Science.gov (United States)

Fuchs, J

2013-03-01

For demographic reasons, the German labor force will decrease dramatically and it will be much older on average. However, labor demand, especially for qualified workers, is expected to remain high. This paper focuses on the possibilities of expanding the labor force by increasing the participation rates of women and older persons. Herein, the change in the labor force is decomposed with respect to population and labor participation and, moreover, the effects of higher participation rates are simulated. The decomposition and simulation scenarios are based on data published by the Institute for Employment Research. The analysis clearly reveals that the effect of a considerably higher labor participation of women and older workers will disappear over time when the working-age population shrinks more and more. In addition, individuals who are currently unemployed or out of the labor force are not skilled enough. Since it seems difficult to get more qualified workers in the short and even in the medium term, improving the conditions for women and older people to take up jobs should be tackled soon. This includes investments in education and health care.

Labor Force

Science.gov (United States)

Occupational Outlook Quarterly, 2012

2012-01-01

The labor force is the number of people ages 16 or older who are either working or looking for work. It does not include active-duty military personnel or the institutionalized population, such as prison inmates. Determining the size of the labor force is a way of determining how big the economy can get. The size of the labor force depends on two…

Risk Factors for Maternal Deaths in Unplanned Obstetric Admissions ...

African Journals Online (AJOL)

... (37.5%), and respiratory distress (12.5%). There were 12 deaths (48%). Organ dysfunction on admission, massive blood loss and late presentation were the risk factors for mortality. The high maternal mortality was mainly due to limited supply of blood products and inadequate prenatal care resulting in disease severity.

Antenatal Maternity Leave and Childbirth Using the First Baby Study: A Propensity Score Analysis.

Science.gov (United States)

Goodman, Julia M; Guendelman, Sylvia; Kjerulff, Kristen H

Most employed American women work during pregnancy and continue working through the month they deliver. Yet, few studies estimate the relationship between maternity leave taken during pregnancy and maternal health. We evaluate the association of antenatal leave (ANL) uptake with obstetric outcomes, assessing the potential role of protective and adverse selection pathways on this relationship. We sample 1,740 employed women who delivered at term from the First Baby Study, a prospective cohort of nulliparous women in Pennsylvania. We use propensity scores to estimate the relationship between ANL and negative delivery outcomes (labor induction, long labor duration, unplanned cesarean delivery, and self-reported negative birth experience). We estimated propensity scores using a range of employment, health, and sociodemographic variables. One-half of the sampled women worked until the day before or day of delivery. Women who stopped working at least 2 days before delivery experienced 16% more negative delivery outcomes, on average, than women who worked until delivery, driven largely by a 25% higher predicted probability of unplanned cesarean section deliveries. These robust findings hold up to a range of sensitivity analyses and demonstrate selective mechanisms operating in ANL uptake. Our findings suggest that, even after controlling for an extensive set of observable employment, health, and sociodemographic characteristics, women who take ANL continue to differ in unobserved characteristics that lead to negative delivery outcomes. Like most U.S. states, Pennsylvania does not grant paid maternity leave. In a context of limited maternity leave availability, only relatively unhealthy women take ANL. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Placental responses to changes in the maternal environment determine fetal growth

Directory of Open Access Journals (Sweden)

Kris Genelyn eDimasuay

2016-01-01

Full Text Available Placental responses to maternal perturbations are complex and remain poorly understood. Altered maternal environment during pregnancy such as hypoxia, stress, obesity, diabetes, toxins, altered nutrition, inflammation, and reduced utero-placental blood flow may influence fetal development, which can predispose to diseases later in life. The placenta being a metabolically active tissue responds to these perturbations by regulating the fetal supply of nutrients and oxygen and secretion of hormones into the maternal and fetal circulation. We have proposed that placental nutrient sensing integrates maternal and fetal nutritional cues with information from intrinsic nutrient sensing signaling pathways to balance fetal demand with the ability of the mother to support pregnancy by regulating maternal physiology, placental growth, and placental nutrient transport. Emerging evidence suggests that the nutrient-sensing signaling pathway mechanistic target of rapamycin (mTOR plays a central role in this process. Thus, placental nutrient sensing plays a critical role in modulating maternal-fetal resource allocation, thereby affecting fetal growth and the life-long health of the fetus.

Impact of Maternal Body Mass Index on Intrapartum and Neonatal Outcomes in Brisbane, Australia, 2007 to 2013.

Science.gov (United States)

Foo, Xin Y; Greer, Ristan M; Kumar, Sailesh

2016-12-01

The aim of this study was to evaluate the influence of maternal body mass index on intrapartum and neonatal outcomes at one of the largest maternity hospitals in Australia. A retrospective cross-sectional study of 55,352 term singleton deliveries at the Mater Mothers' Hospital in Brisbane, Australia, was conducted. The study cohort was stratified into six groups based on the World Health Organization's body mass index classification. The normal body mass index category was the reference group for all comparisons. Multivariate logistic regression was used to examine the effect of maternal body mass index, adjusted for maternal age, ethnicity, parity, and preexisting conditions (e.g., diabetes mellitus and hypertension), on selected intrapartum and neonatal outcomes. Women in the overweight and Obese I, II, and III categories were more likely to have chronic or gestational hypertension/preeclampsia, and preexisting or gestational diabetes mellitus. They also had an increased risk for induction of labor, elective and emergency cesarean, and postpartum hemorrhage. Underweight women were less likely to require induction of labor and emergency cesarean. Infants born to women with increased body mass index were more likely to require neonatal resuscitation, neonatal intensive care unit admission, and have lower Apgar scores at 5 minutes. There is an increased risk of adverse intrapartum and neonatal outcomes for women who are overweight and obese, with the risks increasing with rising body mass index. Appropriately targeted weight management strategies and health education may yield improved maternal and perinatal outcomes if effectively implemented before pregnancy. These may particularly be of benefit in the teenage cohort that has yet to embark on pregnancy. © 2016 Wiley Periodicals, Inc.

Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction

Directory of Open Access Journals (Sweden)

Solange da Cruz Chaves

2015-05-01

Full Text Available OBJECTIVE: To test whether the proposed features of the Obstetric Transition Model-a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality-are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework. METHODS: This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined. RESULTS: Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV. CONCLUSIONS: This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition.

Child labor, agricultural shocks and labor sharing in rural Ethiopia

NARCIS (Netherlands)

Z.Y. Debebe (Zelalem)

2010-01-01

textabstractThe author studies the effect of an agricultural shock and a labor sharing arrangement (informal social network) on child labor. Albeit bad parental preference to child labor (as the strand of literature claims), poor households face compelling situations to send their child to work.

The effect of uterine fundal pressure on the duration of the second stage of labor: a randomized controlled trial.

Science.gov (United States)

Api, Olus; Balcin, Muge Emeksiz; Ugurel, Vedat; Api, Murat; Turan, Cem; Unal, Orhan

2009-01-01

To determine the effect of uterine fundal pressure on shortening the second stage of labor and on the fetal outcome. Randomized controlled trial. Teaching and research hospital. One hundred ninety-seven women between 37 and 42 gestational weeks with singleton cephalic presentation admitted to the delivery unit. Random allocation into groups with or without manual fundal pressure during the second stage of labor. The primary outcome measure was the duration of the second stage of labor. Secondary outcome measures were umbilical artery pH, HCO3-, base excess, pO2, pCO2 values and the rate of instrumental delivery, severe maternal morbidity/mortality, neonatal trauma, admission to neonatal intensive care unit, and neonatal death. There were no significant differences in the mean duration of the second stage of labor and secondary outcome measures except for mean pO2 which was lower and mean pCO2 which was higher in the fundal pressure group. Nevertheless, the values still remained within normal ranges and there were no neonates with an Apgar score <7 in either of the groups. Application of fundal pressure on a delivering woman was ineffective in shortening the second stage of labor.

Maternal health service utilization in urban slums of selected towns ...

African Journals Online (AJOL)

EPHA USER33

Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; ... still women in urban settings do not use available maternal health services. Especially ... health services, safe water supplies, poor sanitation and .... selected cities are confined to crowded places, lack of.

When to stop pushing: effects of duration of second-stage expulsion efforts on maternal and neonatal outcomes in nulliparous women with epidural analgesia.

Science.gov (United States)

Le Ray, Camille; Audibert, François; Goffinet, François; Fraser, William

2009-10-01

The purpose of this study was to assess the influence of the duration of active second-stage labor on maternal and neonatal outcomes. Secondary analysis of the Pushing Early Or Pushing Late with Epidural trial that included 1862 nulliparous women with epidural analgesia who were in the second stage of labor. According to duration of active second-stage labor, we estimated the proportion of spontaneous vaginal deliveries (SVD) with a newborn infant without signs of asphyxia (5-minute Apgar score > or =7 and arterial pH >7.10). We also analyzed maternal and neonatal outcomes according to the duration of expulsive efforts. Relative to the first hour of expulsive efforts, the chances of a SVD of a newborn infant without signs of asphyxia decreased significantly every hour (1- to 2-hour adjusted odds ratio, 0.4; 95% confidence interval [CI], 0.3-0.6; 2- to 3-hour adjusted odds ratio, 0.1; 95% CI, 0.09-0.2; >3-hour adjusted odds ratio, 0.03; 95% CI, 0.02-0.05). The risk of postpartum hemorrhage and intrapartum fever increased significantly after 2 hours of pushing. Faced with a decreasing probability of SVD and increased maternal risk of morbidity after 2 hours, we raise the question as to whether expulsive efforts should be continued after this time.

Relationship between maternal serum zinc, cord blood zinc and ...

African Journals Online (AJOL)

Background: Adequate in utero supply of zinc is essential for optimal fetal growth because of the role of zinc in cellular division, growth and differentiation. Low maternal serum zinc has been reported to be associated with low birth weight and the later is associated with increased morbidity and mortality in newborns.

Reflections on the maternal mortality millennium goal.

Science.gov (United States)

Lawson, Gerald W; Keirse, Marc J N C

2013-06-01

Nearly every 2 minutes, somewhere in the world, a woman dies because of complications of pregnancy and childbirth. Every such death is an overwhelming catastrophe for everyone confronted with it. Most deaths occur in developing countries, especially in Africa and southern Asia, but a significant number also occur in the developed world. We examined the available data on the progress and the challenges to the United Nations' fifth Millennium Development Goal of achieving a 75 percent worldwide reduction in the maternal mortality by 2015 from what it was in 1990. Some countries, such as Belarus, Egypt, Estonia, Honduras, Iran, Lithuania, Malaysia, Romania, Sri Lanka and Thailand, are likely to meet the target by 2015. Many poor countries with weak health infrastructures and high fertility rates are unlikely to meet the goal. Some, such as Botswana, Cameroon, Chad, Congo, Guyana, Lesotho, Namibia, Somalia, South Africa, Swaziland and Zimbabwe, had worse maternal mortality ratios in 2010 than in 1990, partially because of wars and civil strife. Worldwide, the leading causes of maternal death are still hemorrhage, hypertension, sepsis, obstructed labor, and unsafe abortions, while indirect causes are gaining in importance in developed countries. Maternal death is especially distressing if it was potentially preventable. However, as there is no single cause, there is no silver bullet to correct the problem. Many countries also face new challenges as their childbearing population is growing in age and in weight. Much remains to be done to make safe motherhood a reality. © 2013, Copyright the Authors, Journal compilation © 2013, Wiley Periodicals, Inc.

Labor and birth care by nurse with midwifery skills in Brazil.

Science.gov (United States)

Gama, Silvana Granado Nogueira da; Viellas, Elaine Fernandes; Torres, Jacqueline Alves; Bastos, Maria Helena; Brüggemann, Odaléa Maria; Theme Filha, Mariza Miranda; Schilithz, Arthur Orlando Correa; Leal, Maria do Carmo

2016-10-17

The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections. Birth in Brazil is a national, population-based study consisting of 23,894 postpartum women, carried out in the period between February 2011 and October 2012, in 266 healthcare settings. The study included all vaginal births involving physicians or nurses/nurse-midwives. A logistic regression model was used to examine the association between the implementation of good practices and suitable interventions during labor and birth, and whether care was a physician or a nurse/nurse-midwife led care. We developed another model to assess the association between the use of obstetric interventions during labor and birth to the personnel responsible for the care of the patient, comparing hospitals with decisions revolving exclusively around a physician to those that also included nurses/nurse-midwives as responsible for vaginal births. 16.2 % of vaginal births were assisted by a nurse/nurse-midwife. Good practices were significantly more frequent in those births assisted by nurses/nurse-midwives (ad lib. diet, mobility during labor, non-pharmacological means of pain relief, and use of a partograph), while some interventions were less frequently used (anesthesia, lithotomy position, uterine fundal pressure and episiotomy). In maternity wards that included a nurse/nurse-midwife in labour and birth care, the incidence of cesarean section was lower. The results of this study illustrate the potential benefit of collaborative work between physicians and nurses/nurse-midwives in labor

A randomized controlled trial comparing parenteral normal saline with and without 5% dextrose on the course of labor in nulliparous women.

Science.gov (United States)

Sharma, Chanderdeep; Kalra, Jasvinder; Bagga, Rashmi; Kumar, Praveen

2012-12-01

The objective of this study was to compare intravenous normal saline with and without 5% dextrose on the course of labor in nulliparous women in active phase of spontaneous labor. In a randomized controlled trial, term, nulliparous women with singleton pregnancy in active labor were randomized into one of two groups receiving either normal saline or normal saline alternating with 5% dextrose at rate of 175 ml/h. The primary outcome was total length of labor from onset of study fluid in vaginally delivered women. Maternal and neonatal outcomes were also analyzed. Of 250 women enrolled, in vaginally delivered subjects, there was significant difference in the duration of labor (p=0.0) and prolonged labor (p=0.01), with favorable results for women in 5% dextrose alternating with normal saline. No statistically significant differences were observed in the cesarean section rates between the groups. The cord pH was significantly higher in neonates born to women in 5% dextrose alternating with normal saline infusion as compared to normal saline alone (p=0.01), however, no neonate in the study had acidemia. Administration of a 5% dextrose solution alternating with normal saline is a better parenteral fluid for significantly decreasing duration of labor in term vaginally delivered nulliparous women in spontaneous active labor as compared to normal saline alone.

Maternal mortality: a cross-sectional study in global health.

Science.gov (United States)

Sajedinejad, Sima; Majdzadeh, Reza; Vedadhir, AbouAli; Tabatabaei, Mahmoud Ghazi; Mohammad, Kazem

2015-02-12

Although most of maternal deaths are preventable, maternal mortality reduction programs have not been completely successful. As targeting individuals alone does not seem to be an effective strategy to reduce maternal mortality (Millennium Development Goal 5), the present study sought to reveal the role of many distant macrostructural factors affecting maternal mortality at the global level. After preparing a global dataset, 439 indicators were selected from nearly 1800 indicators based on their relevance and the application of proper inclusion and exclusion criteria. Then Pearson correlation coefficients were computed to assess the relationship between these indicators and maternal mortality. Only indicators with statistically significant correlation more than 0.2, and missing values less than 20% were maintained. Due to the high multicollinearity among the remaining indicators, after missing values analysis and imputation, factor analysis was performed with principal component analysis as the method of extraction. Ten factors were finally extracted and entered into a multiple regression analysis. The findings of this study not only consolidated the results of earlier studies about maternal mortality, but also added new evidence. Education (std. B = -0.442), private sector and trade (std. B = -0.316), and governance (std. B = -0.280) were found to be the most important macrostructural factors associated with maternal mortality. Employment and labor structure, economic policy and debt, agriculture and food production, private sector infrastructure investment, and health finance were also some other critical factors. These distal factors explained about 65% of the variability in maternal mortality between different countries. Decreasing maternal mortality requires dealing with various factors other than individual determinants including political will, reallocation of national resources (especially health resources) in the governmental sector, education

La Justicia Laboral

Directory of Open Access Journals (Sweden)

Montoya Melgar, Alfredo

2003-07-01

Full Text Available Iniciada en el último cuarto del siglo XIX nuestra legislación laboral, pronto se plantea la exigencia de que las reglas sustantivas del nuevo Derecho vayan acompañadas de normas jurisdiccionales y procesales específicas, atentas a las exigencias de la justicia laboral. Tras una etapa de justicia social paritaria, obrero-patronal, la jurisdicción laboral pasa a ser desempeñada por jueces profesionales centrándose en la Magistratura de Trabajo y consolidándose el diseño procesal en sucesivas Leyes de Procedimiento Laboral.
En la actualidad, y aunque la nueva Ley de Enjuiciamiento Civil ha incidido de modo relevante sobre el proceso laboral, es obvia la influencia que el modelo del proceso laboral ha ejercido con carácter previo sobre el nuevo proceso civil.

Management of preterm labor: atosiban or nifedipine?

Science.gov (United States)

de Heus, Roel; Mulder, Eduard J H; Visser, Gerard H A

2010-08-09

Preterm birth is strongly associated with neonatal death and long-term neurological morbidity. The purpose of tocolytic drug administration is to postpone threatening preterm delivery for 48 hours to allow maximal effect of antenatal corticosteroids and maternal transportation to a center with specialized neonatal care facilities. There is uncertainty about the value of atosiban (oxytocin receptor antagonist) and nifedipine (calcium channel blocker) as first-line tocolytic drugs in the management of preterm labor. For nifedipine, concerns have been raised about unproven safety, lack of placebo-controlled trials, and its off-label use. The tocolytic efficacy of atosiban has also been questioned because of a lack of reduction in neonatal morbidity. This review discusses the available evidence, the pros and cons of either drug and aims to provide information to support a balanced choice of first-line tocolytic drug: atosiban or nifedipine?

Emancipating Labor Internationalism

OpenAIRE

Waterman, Peter

2004-01-01

The secular trinity of c19th socialism was Labor-Internationalism-Emancipation. As early-industrial capitalism developed into a national-industrial-colonial capitalism, the internationalism of labor became literally international, and simultaneously lost its emancipatory aspiration and capacity (or vice versa). The dramatic – and labor-devastating – development of a globalised-networked-informatised capitalism is raising the necessity and possibility of a new kind of labor internationalis...

PREVALENCE OF PHYSICAL VIOLENCE AGAINST PREGNANT WOMEN AND EFFECTS ON MATERNAL AND BIRTH OUTCOMES

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M. Nojomi Z. Akrami

2006-06-01

Full Text Available Violence and the threat of violence against pregnant women are main barriers to women’s empowerment and equal participation in society. When stress and violence increase in developing societies, women’s safety in the home, workplace and community is often seriously affected. To determine the prevalence of physical abuse in pregnant women and to assess association between physical violence during pregnancy and maternal complications and birth outcomes, we used clinicbased data from a sample of 403 women who delivered live born infants during the summer of 2002 in our hospital. Data of physical violence against women’s during pregnancy and 3 months before that were based on questionnaire and interview. Outcomes data including antenatal hospitalization, labor and delivery complications were obtained from the records. Prevalence of physical violence during pregnancy was reported as 10.7%. Prevalence of experience of physical abuse 3 months before pregnancy was 11.9%. Women who experienced physical violence compared with those not reporting abuse were more likely to be smoker and hospitalized before delivery for maternal complications such as preterm labor, kidney infections, premature rupture of membranes and vaginal bleeding with pain. There was a significant association between physical violence and low birth weight and mother’s education. Physical violence during pregnancy is common and is associated with maternal complications and adverse birth outcomes. We suggest including methods to determine frequency of violence during pregnancy and assessment of violence in pregnancy by a screening program integrated in prenatal care.

Alternative demographic futures and the composition of the demand for labor, by industry and by occupation.

Science.gov (United States)

Serow, W J

1981-01-01

possible if the system of higher education proves sufficiently flexible to provide more occupational and retraining services than is currently the case. The findings also suggest the need for greater attention to be directed to the design of training programs intended to meet the need for specific occupations. Another problem is the adequacy of labor supply. A possible response to the potential supply-demand imbalances is a reconsideration of current immigration policies in order to allow larger numbers of migrants to enter the labor force.

Effects of maternal obesity on early and long-term outcomes for offspring

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Stirrat LI

2014-03-01

Full Text Available Laura I Stirrat,1,2 Rebecca M Reynolds2,3 1Medical Research Council Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK; 2Tommy's Centre for Maternal and Fetal Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK; 3Endocrinology Unit, University/British Heart Foundation Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK Abstract: The prevalence of maternal obesity has increased significantly in recent years, and obesity is currently the most common comorbidity of pregnancy. Pregnancies of obese women are often defined as "high-risk" for the purposes of clinical care, with many well documented risks to the mother and developing baby. Maternal physiology and metabolism is dysregulated in the context of obesity, which may contribute to some of the adverse outcomes during pregnancy. Furthermore, maternal obesity has been hypothesized to cause harmful effects for the developing baby through "early life programming." This review will examine evidence from human studies for outcomes of offspring from obese women during pregnancy, during labor, during the neonatal period, and later in life. Keywords: pregnancy, short-term, physiology, metabolism, early life programming, neonatal complications, adverse intrauterine environment

MERCADO LABORAL, EDUCACIÓN SUPERIOR Y FORMACIÓN DOCENTE EN COSTA RICA (LABOR MARKET, HIGHER EDUCATION AND TEACHERS’ TRAINING IN COSTA RICA

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Morales Zúñiga Luis Carlos

2011-04-01

Full Text Available Resumen:En este ensayo se analiza la relación que existe entre la educación superior, la dinámica del mercado laboral, y la formación de docentes, en un nuevo contexto histórico-social caracterizado por la liberalización de la economía, y el avance de una concepción mercantil de la educación en Costa Rica. Se describe la relación que existe entre la desregulación de la oferta de educación superior, sobre todo privada, y la consecuente saturación de profesionales en el mercado laboral. Se analiza con especial interés la situación de los profesionales de la educación en este contexto, sobre todo, las condiciones laborales que enfrenta este sector educativo, como consecuencia de la aplicación de la lógica de mercado.Abstract: This essay analyzes the relationship between higher education, labor market dynamics, and teacher training in a new historical and social context characterized by the liberalization of the economy, and advancing of a merchant conception of the education practice in Costa Rica. It describes the relationship between deregulation of the supply of higher education, especially private, and the resulting saturation of professional manpower in the labor market. It is analyzed with special interest, the status of the professionals of education in this context, especially the working conditions faced by this sector of the working class as a result of the application of market logic in the educational field.

Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.

Science.gov (United States)

Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M

2013-12-01

User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality

Detection of maternal DNA in placental/umbilical cord blood by locus-specific amplification of the noninherited maternal HLA gene.

Science.gov (United States)

Scaradavou, A; Carrier, C; Mollen, N; Stevens, C; Rubinstein, P

1996-08-15

bands, suggesting the presence of maternal genetic material. By hybridization, 81 (38%) samples were positive and 132 were negative for the noninherited maternal gene. Review of the clinical characteristics of the mothers (demographics and labor and delivery information), the newborns (birth weight, sex, and gestational age), and PCB collections (placental weight, white blood cell count, and collected volume) failed to show any significant differences between the units testing positive or negative for the noninherited maternal gene. Thus, transplantable PCB units carry a high probability of having maternal DNA in detectable amounts. Whether this DNA comes from potentially graft-versus-host disease-inducing maternal lymphocytes or whether the putatively transplacentally-acquired maternal cells are immunologically dysfunctional, as in most infants with severe combined immunodeficiency disease, remains to be shown.

Monitoring uterine activity during labor: a comparison of three methods

Science.gov (United States)

EULIANO, Tammy Y.; NGUYEN, Minh Tam; DARMANJIAN, Shalom; MCGORRAY, Susan P.; EULIANO, Neil; ONKALA, Allison; GREGG, Anthony R.

2012-01-01

Objective Tocodynamometry (Toco—strain gauge technology) provides contraction frequency and approximate duration of labor contractions, but suffers frequent signal dropout necessitating re-positioning by a nurse, and may fail in obese patients. The alternative invasive intrauterine pressure catheter (IUPC) is more reliable and adds contraction pressure information, but requires ruptured membranes and introduces small risks of infection and abruption. Electrohysterography (EHG) reports the electrical activity of the uterus through electrodes placed on the maternal abdomen. This study compared all three methods of contraction detection simultaneously in laboring women. Study Design Upon consent, laboring women were monitored simultaneously with Toco, EHG, and IUPC. Contraction curves were generated in real-time for the EHG and all three curves were stored electronically. A contraction detection algorithm was used to compare frequency and timing between methods. Seventy-three subjects were enrolled in the study; 14 were excluded due to hardware failure of one or more of the devices (12) or inadequate data collection duration(2). Results In comparison with the gold-standard IUPC, EHG performed significantly better than Toco with regard to Contractions Consistency Index (CCI). The mean CCI for EHG was 0.88 ± 0.17 compared to 0.69 ± 0.27 for Toco (pToco, EHG was not significantly affected by obesity. Conclusion Toco does not correlate well with the gold-standard IUPC and fails more frequently in obese patients. EHG provides a reliable non-invasive alternative regardless of body habitus. PMID:23122926

Monitoring uterine activity during labor: a comparison of 3 methods.

Science.gov (United States)

Euliano, Tammy Y; Nguyen, Minh Tam; Darmanjian, Shalom; McGorray, Susan P; Euliano, Neil; Onkala, Allison; Gregg, Anthony R

2013-01-01

Tocodynamometry (Toco; strain gauge technology) provides contraction frequency and approximate duration of labor contractions but suffers frequent signal dropout, necessitating repositioning by a nurse, and may fail in obese patients. The alternative invasive intrauterine pressure catheter (IUPC) is more reliable and adds contraction pressure information but requires ruptured membranes and introduces small risks of infection and abruption. Electrohysterography (EHG) reports the electrical activity of the uterus through electrodes placed on the maternal abdomen. This study compared all 3 methods of contraction detection simultaneously in laboring women. Upon consent, laboring women were monitored simultaneously with Toco, EHG, and IUPC. Contraction curves were generated in real-time for the EHG, and all 3 curves were stored electronically. A contraction detection algorithm was used to compare frequency and timing between methods. Seventy-three subjects were enrolled in the study; 14 were excluded due to hardware failure of 1 or more of the devices (n = 12) or inadequate data collection duration (n = 2). In comparison with the gold-standard IUPC, EHG performed significantly better than Toco with regard to the Contractions Consistency Index (CCI). The mean CCI for EHG was 0.88 ± 0.17 compared with 0.69 ± 0.27 for Toco (P Toco, EHG was not significantly affected by obesity. Toco does not correlate well with the gold-standard IUPC and fails more frequently in obese patients. EHG provides a reliable noninvasive alternative, regardless of body habitus. Copyright © 2013 Mosby, Inc. All rights reserved.

User fees and maternity services in Ethiopia.

Science.gov (United States)

Pearson, Luwei; Gandhi, Meena; Admasu, Keseteberhan; Keyes, Emily B

2011-12-01

To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia. The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008. Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively. Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under

Trade, Labor, Legitimacy

OpenAIRE

Guzman, Andrew

2003-01-01

The relationship between international trade and labor standards is one of several controversial issues facing the WTO. Proponents of a trade-labor link argue that labor is a human rights issue and that trade sanctions represent a critical tool in the effort to improve international working conditions. Opponents argue that a link between trade and labor would open the door to protectionist measures that would target low wage countries and harm the very workers the policy is intended to help. ...

Determination of Nursing Diagnoses in Children of Agricultural Laborer Families in South Eastern Regions of Turkey.

Science.gov (United States)

Karatas, Hulya; Müller-Staub, Maria; Erdemir, Firdevs

2018-01-01

Identifying functional health patterns and nursing diagnoses of migrant agricultural laborer families. Interpretative-qualitative study based on interviews with 162 mothers of 0- to 2-year-old children in two Turkish provinces. Health perception-health management: growth and development, risk for being delayed; health maintenance, ineffective; health behavior, risk-prone; risk for contamination; risk for sudden infant death syndrome; and risk for injury. Nutritional-metabolic: Risk for infection; and breastfeeding, interrupted. Self-perception: risk for chronic low self-esteem, disturbed self-esteem; and powerlessness. Role-relationship: impaired parenting; and dysfunctional family process. Coping-stress tolerance: coping, disabled family; violence, risk for other-directed. Cognitive-perceptive: knowledge deficit CONCLUSIONS: Nursing diagnoses of this population were reported for the first time. Addressing agricultural laborer families' diagnoses will positively affect maternal-child health. © 2016 NANDA International, Inc.

Are there any strategies to improve neonatal outcomes associated with epidural analgesia in labor?

Science.gov (United States)

Armani, Marta; Gaggiano, Carla; Dallaglio, Sara; Romanini, Enzo; Sospiri, Carmen; Magnani, Cinzia

2013-09-01

This study was aimed at evaluating the relationship between epidural analgesia and perinatal outcomes and at verifying the advisability of procedural changes in assistance to labor. From January to December 2012, we conducted a retrospective case-control study on 1,963 laboring pregnant women admitted to the Parma University Hospital. We considered two groups: Group 1 received epidural analgesia and Group 2 received no analgesia. Women with elective cesarean sections, multiple pregnancies or deliveries at <34 weeks were excluded. We recorded maternal data (age, type of delivery, obstetric procedures, premature rupture of membranes, screenings for Group-B Streptococcus) and neonatal data (birth weight, gestational age, 1- and 5-minute Apgar scores, diagnosis at discharge). Of the 1,963 laboring women, 287 requested analgesia and 1,676 did not. We found no significant differences between the two groups in the rates of cesarean section, clavicle fracture, and 1-minute Apgar score between 4 and 7. By contrast, we observed a higher rate of instrumental deliveries (p<0.01), fetal occiput posterior position (p<0.05), neonatal cephalohematoma (p=0.01) in Group 1 than in Group 2 . In Group 1 we also found a higher number of newborns with 1-minute Apgar score of 3 or less (p=0.016). In addition, a significantly higher number of women in Group 1 had fever during labor (p=0.003, odds ratio 5.01). Our results suggest that strategies should be activated to overcome or limit the side-effects of analgesia in labor through prospective and multidisciplinary studies. 

Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

DEFF Research Database (Denmark)

Rossen, Janne; Klungsøyr, Kari; Albrechtsen, Susanne

2018-01-01

was used compared with when it was not used. In Norway, this applied to all maternal age groups but in Denmark only for women ≥30 years. Among women without epidural, oxytocin augmentation was associated with an increased odds ratio for cesarean section in Denmark, whereas no difference was observed....... MATERIAL AND METHODS: In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1]. In this case-control study the main...... exposure was maternal age; epidural analgesia, oxytocin augmentation, birthweight and time period were explanatory variables. Chi-square test and logistic regression were used to estimate associations and interactions. RESULTS: The cesarean section rate increased consistently with advancing maternal age...

Immediate compared with delayed pushing in the second stage of labor: a systematic review and meta-analysis.

Science.gov (United States)

Tuuli, Methodius G; Frey, Heather A; Odibo, Anthony O; Macones, George A; Cahill, Alison G

2012-09-01

To estimate whether immediate or delayed pushing in the second stage of labor optimizes spontaneous vaginal delivery and other perinatal outcomes. We searched electronic databases MEDLINE and CINHAL through August 2011 without restrictions. The search terms used were MeSH headings, text words, and word variations of the words or phrases labor, laboring down, passive descent, passive second stage, physiologic second stage, spontaneous pushing, pushing, or bearing down. We searched for randomized controlled trials comparing immediate with delayed pushing in the second stage of labor. The primary outcome was spontaneous vaginal delivery. Secondary outcomes were instrumental delivery, cesarean delivery, duration of the second stage, duration of active pushing, and other maternal and neonatal outcomes. Heterogeneity was assessed using the Q test and I2. Pooled relative risks (RRs) and weighted mean differences were calculated using random-effects models. Twelve randomized controlled trials (1,584 immediate and 1,531 delayed pushing) met inclusion criteria. Overall, delayed pushing was associated with an increased rate of spontaneous vaginal delivery compared with immediate pushing (61.5% compared with 56.9%, pooled RR 1.09, 95% confidence interval [CI] 1.03-1.15). This increase was smaller and not statistically significant among high-quality studies (59.0% compared with 54.9%, pooled RR 1.07, 95% CI 0.98-1.26) but larger and statistically significant in lower-quality studies (81.0% compared with 71.0%%, pooled RR 1.13, 95% CI 1.02-1.24). Operative vaginal delivery rates were high in most studies and not significantly different between the two groups (33.7% compared with 37.4%, pooled RR 0.89, 95% CI 0.76-1.06). Delayed pushing was associated with prolongation of the second stage (weighted mean difference 56.92 minutes, 95% CI 42.19-71.64) and shortened duration of active pushing (weighted mean difference -21.98 minutes, 95% CI -31.29 to -12.68). Studies to date suggest

Combined Spinal-Epidural Analgesia for Laboring Parturient with Arnold-Chiari Type I Malformation: A Case Report and a Review of the Literature

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Clark K. Choi

2013-01-01

Full Text Available Anesthetic management of laboring parturients with Arnold-Chiari type I malformation poses a difficult challenge for the anesthesiologist. The increase in intracranial pressure during uterine contractions, coughing, valsalva maneuvers, and expulsion of the fetus can be detrimental to the mother during the process of labor and delivery. No concrete evidence has implicated high cerebral spinal fluid pressure on maternal and fetal complications. The literature on the use of neuraxial techniques for managing parturients with Arnold-Chiari is extremely scarce. While most anesthesiologists advocate epidural analgesia for management of labor pain and spinal anesthesia for cesarean section, we are the first to report the use of combined spinal-epidural analgesia for managing labor pain in a pregnant woman with Arnold-Chiari type I malformation. Also, we have reviewed the literature and presented information from case reports and case series to support the safe usage of neuraxial techniques in these patients.

Review: Fetal-maternal communication via extracellular vesicles - Implications for complications of pregnancies.

Science.gov (United States)

Adam, Stefanie; Elfeky, Omar; Kinhal, Vyjayanthi; Dutta, Suchismita; Lai, Andrew; Jayabalan, Nanthini; Nuzhat, Zarin; Palma, Carlos; Rice, Gregory E; Salomon, Carlos

2017-06-01

The maternal physiology experiences numerous changes during pregnancy which are essential in controlling and maintaining maternal metabolic adaptations and fetal development. The human placenta is an organ that serves as the primary interface between the maternal and fetal circulation, thereby supplying the fetus with nutrients, blood and oxygen through the umbilical cord. During gestation, the placenta continuously releases several molecules into maternal circulation, including hormones, proteins, RNA and DNA. Interestingly, the presence of extracellular vesicles (EVs) of placental origin has been identified in maternal circulation across gestation. EVs can be categorised according to their size and/or origin into microvesicles (∼150-1000 nm) and exosomes (∼40-120 nm). Microvesicles are released by budding from the plasmatic membrane, whereas exosome release is by fusion of multivesicular bodies with the plasmatic membrane. Exosomes released from placental cells have been found to be regulated by oxygen tension and glucose concentration. Furthermore, maternal exosomes have the ability to stimulate cytokine release from endothelial cells. In this review, we will discuss the role of EVs during fetal-maternal communication during gestation with a special emphasis on exosomes. Copyright © 2016. Published by Elsevier Ltd.

Maternal health among working women: A case study in the Mexican-U.S. border

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Norma Ojeda de la Peña

1996-01-01

Full Text Available This work is a description of the differences in maternal health among women of the wage-earning class along the Mexican/United States border in Tijuana, Baja California. The study analyzes the specific case of women using the services of the Mexican Institute of Social Security (IMSS, breaking up the sample according to their employment and level of physical labor on the job in industrial, business, and service sectors. The study is based on information from a survey titled, "Social Conditions of Women and Reproductive Health in Tijuana".This was a post-partum survey administered to a total of 2,596 obstetrical patients seen at the Gynecology-. Obstetrics hospital of the Tijuana IMSSoffice during the spring of 1993.The results indicate differing maternal health oonditions among workers, in relation to some of the factors considered risks for infant and maternal health.

Factors that influence the practice of elective induction of labor: what does the evidence tell us?

Science.gov (United States)

Moore, Jennifer; Low, Lisa Kane

2012-01-01

Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth. The purpose of this investigation was to evaluate current trends in induction of labor scholarship focusing on evidence-based factors that influence the practice of elective induction. A key word search was conducted to identify studies on the practice of elective induction of labor. Analysis of the findings included clustering and identification of recurrent themes among the articles with 3 categories being identified. Under each category, the words/phrases were further clustered until a construct could be named. A total of 49 articles met inclusion criteria: 7 patient, 6 maternity care provider, and 4 organization factors emerged. Only 4 of the articles identified were evidence based. Patient factors were divided into preferences/convenience, communication, fear, pressure/influence, trust, external influences, and technology. Provider factors were then divided into practice preferences/convenience, lack of information, financial incentives, fear, patient desire/demand, and technology. Organization factors were divided into lack of enforcement/accountability, hospital culture, scheduling of staff, and market share issues. Currently, there is limited data-based information focused on factors that influence elective induction of labor. Despite patient and provider convenience/preferences being cited in the literature, the evidence does not support this practice.

Employers and the Implementation of Active Labor Market Policies

Directory of Open Access Journals (Sweden)

Thomas Bredgaard

2016-03-01

Full Text Available Active labor market policies (ALMPs are an important instrument for governments in dealing with the new challenges of globalization, flexibilization, and individualization of labor markets. Politics and research has focused on the supply-side of the labor market, that is, regulating the rights and obligations of the target groups of ALMPs (mainly unemployed and inactive persons. The role and behavior of employers is under-researched and under-theorized in the vast literature on ALMPs and industrial relations. In this article, we analyze ALMPs from the employers’ perspective by examining the determinants of firms’ participation in providing wage subsidy jobs for the unemployed. First, we examine the historical background to the introduction and development of wage subsidy schemes as an important ALMP instrument in Denmark. Second, we derive theoretical arguments and hypotheses about employers’ participation in ALMPs from selected theories. Third, we use data from a survey of Danish firms conducted in 2013 to characterize the firms that are engaged in implementing wage subsidy jobs and hypotheses are tested using a binary logistical regression to establish why firms voluntarily engage in reintegrating unemployed back into the labor market. We find that the firms which are most likely to participate in the wage subsidy scheme are characterized by many unskilled workers, a higher coverage of collective agreements, a deteriorating economic situation, a Danish ownership structure, and are especially found in the public sector. This shows that the preference formation of firms is more complex than scholars often assume.

77 FR 70473 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

Science.gov (United States)

2012-11-26

... 106- 200 (2002), established a new eligibility criterion for receipt of trade benefits under the... of benefits under CBTPA and AGOA, respectively. In addition, the Andean Trade Preference Act, as... Child Labor AGENCY: The Bureau of International Labor Affairs, United States Department of Labor. ACTION...

Labor market trends for nuclear engineers through 2005

International Nuclear Information System (INIS)

Seltzer, N.; Blair, L.M.

1996-10-01

Between 1983 and 1989, employment of nuclear engineers in the nuclear energy field increased almost 40 percent while the annual number of nuclear engineering degrees awarded decreased by almost one-fourth. There were, on average, more job openings for new graduates than there were new graduates available to fill the jobs during the 1980s. This trend reversed in the l990s as nuclear engineering employment in the nuclear energy field decreased from 11,500 in 1991 to 9,400 in 1995. During roughly the same period, the annual number of nuclear engineering degrees increased by 11 percent. As a result, from 1990 through 1995, the number of new graduate nuclear engineers available in the labor supply far exceeded the number of job openings for new graduates in the nuclear energy field. This oversupply of new graduates was particularly acute for 1993 through 1995. During 1996--1997, a relative improvement is expected in job opportunities in the nuclear energy field for new graduates; however, a large oversupply is still expected (almost twice as many graduates available for employment as there are job openings). For 1998 through 2000, some improvement is expected in the relative number of job opportunities for new graduates in the nuclear energy field. Nuclear engineering jobs in the nuclear energy field are expected to decrease only slightly (by less than 150) during this period. Also a 10--15% decrease in the annual number of degrees and available supply of new graduates is expected. Overall, an oversupply is expected (140 graduates available per 100 job openings for new graduates in the nuclear energy field), but this is still a substantial improvement over the current period. For 2001 through 2005, if enrollments and degrees continue to decline, the labor market for new graduates is expected to be approximately balanced. This assumes, however, that the number of degrees and the available supply of new graduates will decrease by 25% from 1995 levels

Electricity, Gas and Water Supply. Industry Training Monograph No. 4.

Science.gov (United States)

Dumbrell, Tom

Australia's electricity, gas, and water supply industry employs only 0.8% of the nation's workers and employment in the industry has declined by nearly 39% in the last decade. This industry is substantially more dependent on the vocational education and training (VET) sector for skilled graduates than is the total Australian labor market. Despite…

Insurance-markets Equilibrium with Sequential Non-convex Straight-time and Over-time Labor Supply

OpenAIRE

Vasilev, Aleksandar

2016-01-01

This note describes the lottery- and insurance-market equilibrium in an economy with non-convex straight-time and overtime employment. In contrast to Hansen and Sargent (1988), the overtime-decision is a sequential one. This requires two separate insurance market to operate, one for straight-time work, and one for overtime. In addi- tion, given that the labor choice for regular and overtime hours is made in succession, the insurance market for overtime needs to open once the insurance market ...

Labor epidural analgesia is independent risk factor for neonatal pyrexia.

Science.gov (United States)

Agakidis, Charalampos; Agakidou, Eleni; Philip Thomas, Sumesh; Murthy, Prashanth; John Lloyd, David

2011-09-01

To explore whether epidural analgesia (EA) in labor is independent risk factor for neonatal pyrexia after controlling for intrapartum pyrexia. Retrospective observational study of 480 consecutive term singleton infants born to mothers who received EA in labor (EA group) and 480 term infants delivered to mothers who did not receive EA (NEA group). Mothers in the EA group had significantly higher incidence of intrapartum pyrexia [54/480 (11%) vs. 4/480 (0.8%), OR = 15.1, p neonatal pyrexia [68/480 (14.2%) vs. 15/480 (3.1%), OR = 5.1, p Neonates in the EA group had a median duration of pyrexia of 1 h (maximum 5 h) with a peak temperature within 1 h. Stepwise logistic regression analysis showed that maternal EA was independent risk factor for neonatal pyrexia (>37.5°C) after controlling for intrapartum pyrexia (>37.9°C) and other confounders (OR = 3.44, CI = 1.9-6.3, p neonates. It is unnecessary to investigate febrile offspring of mothers who have had epidurals unless pyrexia persists for longer than 5 h or other signs or risk factors for neonatal sepsis are present.

From Bad to Worse: Paraganglioma Diagnosis during Induction of Labor for Coexisting Preeclampsia

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Sasima Dusitkasem

2017-01-01

Full Text Available Pheochromocytomas and extra-adrenal paragangliomas are catecholamine-secreting tumors that rarely occur in pregnancy. The diagnosis of these tumors in pregnancy can be challenging given that many of the signs and symptoms are commonly attributed to preeclampsia or other more common diagnoses. Early diagnosis and appropriate management are essential in optimizing maternal and fetal outcomes. We report a rare case of a catecholamine-secreting tumor in which diagnosis occurring at the time labor was being induced for concomitant preeclampsia with severe features. Her initial presentation in hypertensive crisis with other symptoms led to diagnostic workup for secondary causes of hypertension and led to eventual diagnosis of paraganglioma. Obtaining this diagnosis prior to delivery was essential, as this led to prompt multidisciplinary care, changed the course of her clinical management, and ultimately enabled good maternal and fetal outcomes. This case highlights the importance of maintaining a high index of suspicion for secondary causes of hypertension and in obstetric patients and providing timely multidisciplinary care.

Satisfaction with care in labor and birth: a survey of 790 Australian women.

Science.gov (United States)

Brown, S; Lumley, J

1994-03-01

Data on satisfaction with care in labor and birth were gathered in a survey conducted in conjunction with a review of maternity services in Victoria, Australia. All women who gave birth in one week in 1989 (> 1000) were mailed questionnaires eight to nine months after the birth, with a response rate of 790 (71.4%). When adjusted for parity in a logistic regression model, the following factors were highly related to dissatisfaction with intrapartum care: lack of involvement in decision making (p maternal age, marital status, total family income, country of birth, or health insurance status. The survey results were influential in shaping final recommendations of the Ministerial Review of Birthing Services by countering stereotypes about women who become dissatisfied with their care, providing evidence of far greater dissatisfaction with intrapartum than antenatal care, and demonstrating the importance of information, participation in decision making, and relationships with caregivers to women's overall satisfaction with intrapartum care.

Supply and demand for radiographers in Lithuania: A prognosis for 2012–2030

Energy Technology Data Exchange (ETDEWEB)

Vanckaviciene, Aurika, E-mail: aurika.vanckaviciene@gmail.com [Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Radiology, Lithuanian University of Health Sciences, Medical Academy, Eivenių str. 2, LT-50009 Kaunas (Lithuania); Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Nursing and Care, Eivenių str. 2, LT-50009 Kaunas (Lithuania); Starkiene, Liudvika, E-mail: liudvika.starkiene@lsmuni.lt [Lithuanian University of Health Sciences, Medical Academy, Department of Preventive Medicine, Mickeviciaus str. 9, LT-44307 Kaunas (Lithuania); Macijauskiene, Jūrate, E-mail: jurate.macijauskiene@lsmuni.lt [Lithuanian University of Health Sciences, Medical Academy, Faculty of Nursing, Mickeviciaus str. 9, LT-44307 Kaunas (Lithuania)

2014-07-15

Background: This is the first ever study on the planning of the supply and demand for radiographers in Lithuania. The aim of this study was to analyze the supply and demand for radiographers in the labor market with respect to their number, structure, and services, and to provide a prognosis for the period of 2012–2030. Materials and methods: Supply was calculated using two scenarios with differing duration of studies, annual student drop-out rates, rates of failure to start working, the annual number of new entrants into the labor market, and emigration rates. Annual mortality rates, the number of first-year students, and retirement rates were evaluated equally in both scenarios. Two projections of the demand for radiographers, based on the population's differing (by age and gender), need for outpatient radiology services, computed tomography, and magnetic resonance scans. Subsequently, the supply and demand scenarios were compared. Results: Evaluation of the perspective supply and demand scenarios – which are the most probable – revealed a gap forming during the analyzed period, the predicted specialist shortage will reach 0.13 full-time equivalents per 10,000 population, and in 2030—0.37 full-time equivalents per 10,000 population. Conclusions: Considering the changes in education of radiographers, the socio-demographic characteristics of the staff, and the increasing need for radiographers’ services, the supply of radiographers during the next two decades will be insufficient. To meet the forecasted demand for radiographers in the perspective scenario, the number of students choosing this specialty from 2013 on should increase by up to 30%.

Supply and demand for radiographers in Lithuania: A prognosis for 2012–2030

International Nuclear Information System (INIS)

Vanckaviciene, Aurika; Starkiene, Liudvika; Macijauskiene, Jūrate

2014-01-01

Background: This is the first ever study on the planning of the supply and demand for radiographers in Lithuania. The aim of this study was to analyze the supply and demand for radiographers in the labor market with respect to their number, structure, and services, and to provide a prognosis for the period of 2012–2030. Materials and methods: Supply was calculated using two scenarios with differing duration of studies, annual student drop-out rates, rates of failure to start working, the annual number of new entrants into the labor market, and emigration rates. Annual mortality rates, the number of first-year students, and retirement rates were evaluated equally in both scenarios. Two projections of the demand for radiographers, based on the population's differing (by age and gender), need for outpatient radiology services, computed tomography, and magnetic resonance scans. Subsequently, the supply and demand scenarios were compared. Results: Evaluation of the perspective supply and demand scenarios – which are the most probable – revealed a gap forming during the analyzed period, the predicted specialist shortage will reach 0.13 full-time equivalents per 10,000 population, and in 2030—0.37 full-time equivalents per 10,000 population. Conclusions: Considering the changes in education of radiographers, the socio-demographic characteristics of the staff, and the increasing need for radiographers’ services, the supply of radiographers during the next two decades will be insufficient. To meet the forecasted demand for radiographers in the perspective scenario, the number of students choosing this specialty from 2013 on should increase by up to 30%

Psychoprophylaxis during labor: associations with labor-related outcomes and experience of childbirth.

Science.gov (United States)

Bergström, Malin; Kieler, Helle; Waldenström, Ulla

2010-06-01

To study whether use of psychoprophylaxis during labor affects course of labor and experience of childbirth in nulliparous women. Cohort study. Women were recruited from 15 antenatal clinics in Sweden between October 2005 and January 2007. A total of 857 nulliparous women with a planned vaginal delivery. Using data from a randomized controlled trial of antenatal education where the allocated groups were merged, we compared course of labor and experience of childbirth between women who used psychoprophylaxis during labor and those who did not. Data were collected by questionnaires in mid-pregnancy and three months after birth, and from the Swedish Medical Birth Register. Logistic regression was used to assess associations. Mode of delivery, augmentation of labor, length of labor, Apgar score, pain relief and experience of childbirth as measured by the Wijma Delivery Experience Questionnaire. Use of psychoprophylaxis during labor was associated with a lower risk of emergency cesarean section (adjusted odds ratio (OR) 0.57; 95% confidence interval (CI) 0.37-0.88), but an increased risk of augmentation of labor (adjusted OR 1.68; 95% CI 1.23-2.28). No statistical differences were found in length of labor (adjusted OR 1.32; 95% CI 0.95-1.83), Apgar score Psychoprophylaxis may reduce the rate of emergency cesarean section but may not affect the experience of childbirth.

Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections ,

Directory of Open Access Journals (Sweden)

Arnildo A. Hackenhaar

2014-04-01

Full Text Available OBJECTIVE:tthis study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections.METHODS:this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight > 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression.RESULTS:of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR] = 1.94, with lower level of schooling (PR = 2.43, age > 29 years (PR = 2.49, and smokers (PR = 2.04. It was also associated with threatened miscarriage (PR = 1.68 and preterm labor, (PR = 3.40. There was no association with maternal urinary tract infection or presence of genital discharge.CONCLUSIONS:the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach.

The effect of women's decision-making power on maternal health services uptake: evidence from Pakistan.

Science.gov (United States)

Hou, Xiaohui; Ma, Ning

2013-03-01

A large body of research has explored the links between women's decision making and their uptake of maternal health services, but the evidence so far is inconclusive. This study uses the Pakistan Social and Living Standards Measurement Survey to examine the influence of household decision making on women's uptake of maternal health services. We find that women's decision-making power has a significant positive correlation with maternal health services uptake and that influential males' decision-making power has the opposite effect, after controlling for socio-economic indicators and supply-side conditions. Our findings suggest that empowering women and increasing their ability to make decisions may increase their uptake of maternal health services. They also suggest that policies directed toward improving women's utilization of maternal health services in Pakistan must target men as well as women.

Supply and demand for radiographers in Lithuania: a prognosis for 2012-2030.

Science.gov (United States)

Vanckaviciene, Aurika; Starkiene, Liudvika; Macijauskiene, Jūrate

2014-07-01

This is the first ever study on the planning of the supply and demand for radiographers in Lithuania. The aim of this study was to analyze the supply and demand for radiographers in the labor market with respect to their number, structure, and services, and to provide a prognosis for the period of 2012-2030. Supply was calculated using two scenarios with differing duration of studies, annual student drop-out rates, rates of failure to start working, the annual number of new entrants into the labor market, and emigration rates. Annual mortality rates, the number of first-year students, and retirement rates were evaluated equally in both scenarios. Two projections of the demand for radiographers, based on the population's differing (by age and gender), need for outpatient radiology services, computed tomography, and magnetic resonance scans. Subsequently, the supply and demand scenarios were compared. Evaluation of the perspective supply and demand scenarios - which are the most probable - revealed a gap forming during the analyzed period, the predicted specialist shortage will reach 0.13 full-time equivalents per 10,000 population, and in 2030-0.37 full-time equivalents per 10,000 population. Considering the changes in education of radiographers, the socio-demographic characteristics of the staff, and the increasing need for radiographers' services, the supply of radiographers during the next two decades will be insufficient. To meet the forecasted demand for radiographers in the perspective scenario, the number of students choosing this specialty from 2013 on should increase by up to 30%. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

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Saliku Teresa

2009-03-01

Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden

Is automation labor-displacing? : Productivity growth, employment, and the labor share

NARCIS (Netherlands)

Autor, David; Salomons, A.M.|info:eu-repo/dai/nl/338041575

2018-01-01

Is automation a labor-displacing force? This possibility is both an age-old concern and at the heart of a new theoretical literature considering how labor immiseration may result from a wave of “brilliant machines,” which is in part motivated by declining labor shares in many developed countries.

Personality, preterm labor contractions, and psychological consequences.

Science.gov (United States)

Handelzalts, Jonathan E; Krissi, Haim; Levy, Sigal; Freund, Yael; Carmiel, Naama; Ashwal, Eran; Peled, Yoav

2016-03-01

Research of psychological factors associated with imminent preterm labor (PTL) is sparse, compared with considerable research of preterm birth. We explored state and trait psychological variables associated with PTL, both pre- and postpartum. During 2012-2014, 56 women hospitalized due to PTL, and 33 pregnant women without PTL, responded during gestational week 20-33, to a demographic questionnaire, the Big-Five Inventory (BFI), the Brief Symptom Inventory (BSI), the Fear of Childbirth Questionnaire, and the Maternal-Fetal Attachment Inventory (MFAS). At 4-6 weeks postpartum, 35 and 23 of the women in the respective groups responded online to the Edinburgh Postnatal Depression Scale (EPDS) and the Mother to Infant Bonding Scale (MIBS). Compared to women without PTL, women with PTL scored higher on neuroticism, openness to experience, and MFAS (p personality variables, but not with psychological consequences, other than elevated prepartum attachment to the fetus.

20% wind by 2030: Overcoming the challenge - U.S. wind supply chain bottlenecks

Energy Technology Data Exchange (ETDEWEB)

Shaw, Meghan

2010-09-15

The U.S. Department of Energy (DOE) provided PowerAdvocate with funding to evaluate the challenges facing the supply chain and provide strategic solutions to overcoming the short and long term supply chain challenges. PowerAdvocate conducted market research and interviews with wind developers, turbine and component suppliers and offshore wind development experts. PowerAdvocate created a comprehensive model. The model includes labor statistics, wind facility cost forecasting, and component supplier manufacturing investments in order to estimate the total cost to build a supply chain that supports the DOE's 20% by 2030 wind installation goal.

Nobody asked the mother: women and maternity on Simbo, western Solomon Islands.

Science.gov (United States)

Dureau, C

1993-09-01

This article's focus is on the role of mothers in Simbo, one of the New Georgia islands in the western Solomon Islands. Mother's role is examined from the standpoint of the actual experiences of motherhood and mother's perceptions and reactions to child rearing, child care, burdensome tasks, and social participation. Anthropological studies emphasize non-Western notions of maternity or romanticize the primitive. Obscured in the process is who these women really are. Western feminist accounts of Third World women emphasize the oppression and uniformity of the "natural" mother. This characterization of Simbo women is presented as a single non-Western view and is unrelated to a global vision. Simbo women as mothers feel oppressed and are envious of Western notions of parenting, yet at the same time feel that Western child rearing deprives the child. Maternity is a state of ambivalence, where women feel both love for and oppression by children, spouses, and other women. The tasks and responsibilities of childbearing are more difficult because of increased fertility and changes in social practices. Women without children are viewed with sympathy and mild condescension. Changes in social practices are in part due to the presence of missionaries after 1903 and the over 200 year involvement of the islands in world trading. The most significant impact on women post-Christianity is the change from the emphasis on female-child relationships to male-female relationships. Pre-Christianity, marriage ceremonies stressed equality of spouses and their kin groups. New customs emphasize brideprice and the husband's authority over women's bodies. The change in power affects fertility levels, child care, women's work, and contraception. Men today do less labor relative to women and, when husbands are absent due to temporary labor migration, women may not have any help. The nuclear family is responsible for all labor. Women specifically tend the gardens and house, care for children, and

Dynamic segmentation and linear prediction for maternal ECG removal in antenatal abdominal recordings

International Nuclear Information System (INIS)

Vullings, R; Sluijter, R J; Mischi, M; Bergmans, J W M; Peters, C H L; Oei, S G

2009-01-01

Monitoring the fetal heart rate (fHR) and fetal electrocardiogram (fECG) during pregnancy is important to support medical decision making. Before labor, the fHR is usually monitored using Doppler ultrasound. This method is inaccurate and therefore of limited clinical value. During labor, the fHR can be monitored more accurately using an invasive electrode; this method also enables monitoring of the fECG. Antenatally, the fECG and fHR can also be monitored using electrodes on the maternal abdomen. The signal-to-noise ratio of these recordings is, however, low, the maternal electrocardiogram (mECG) being the main interference. Existing techniques to remove the mECG from these non-invasive recordings are insufficiently accurate or do not provide all spatial information of the fECG. In this paper a new technique for mECG removal in antenatal abdominal recordings is presented. This technique operates by the linear prediction of each separate wave in the mECG. Its performance in mECG removal and fHR detection is evaluated by comparison with spatial filtering, adaptive filtering, template subtraction and independent component analysis techniques. The new technique outperforms the other techniques in both mECG removal and fHR detection (by more than 3%)

Can We Accurately Time the Administration of Antenatal Corticosteroids for Preterm Labor?

Directory of Open Access Journals (Sweden)

Paola Aghajanian

2016-01-01

Full Text Available Background. Accurate timing of antenatal corticosteroids (ACS has resulted in improved neonatal outcomes. Objectives. Our primary objective was to determine predictors for optimal timing of ACS in women presenting with spontaneous preterm labor. Study Design. A retrospective cohort study of women receiving ACS for spontaneous preterm birth was conducted. Women were included if they presented with preterm labor or preterm premature rupture of membranes. Accurate timing of ACS was defined as administration within 7 days of delivery. Maternal demographic and obstetrics characteristics were compared between the groups receiving ACS ≤7 days and >7 days from delivery. Statistical analyses were performed using parametric and nonparametric tests. P<0.05 was considered significant. Results. The study included 215 subjects. Median latency from ACS administration to delivery was 6 days (IQR 32. Accurate timing of ACS occurred in 113 (53% women and was associated with rupture of membranes (OR 13.8, 95% CI 5.9–32.6, cervical change (OR 7.1, 95% CI 3.0–17.1, and cervical dilation ≥ 2 cm (OR 3.9, 95% CI 1.5–10.3. Conclusions. Rupture of membranes, cervical change, and cervical dilation ≥ 2 cm were strong predictors of optimal timing. 53% of women with preterm labor received ACS optimally.

LABOR SUBSTITUTABILITY IN LABOR INTENSIVE AGRICULTURE AND TECHNOLOGICAL CHANGE IN THE PRESENCE OF FOREIGN LABOR

OpenAIRE

Napasintuwong, Orachos; Emerson, Robert D.

2004-01-01

The Morishima elasticity of substitution (MES) is estimated to address factor substitutability in Florida agriculture during 1960-1999. By adopting a profit maximization model of induced innovation theory, the MES's between hired and self-employed labor and the MES's between labor and capital provide implications for future immigration policies.

Effect of Health Insurance on the Use and Provision of Maternal Health Services and Maternal and Neonatal Health Outcomes: A Systematic Review

Science.gov (United States)

Peterson, Lauren A.; Hatt, Laurel E.

2013-01-01

Financial barriers can affect timely access to maternal health services. Health insurance can influence the use and quality of these services and potentially improve maternal and neonatal health outcomes. We conducted a systematic review of the evidence on health insurance and its effects on the use and provision of maternal health services and on maternal and neonatal health outcomes in middle- and low-income countries. Studies were identified through a literature search in key databases and consultation with experts in healthcare financing and maternal health. Twenty-nine articles met the review criteria of focusing on health insurance and its effect on the use or quality of maternal health services, or maternal and neonatal health outcomes. Sixteen studies assessed demand-side effects of insurance, eight focused on supply-side effects, and the remainder addressed both. Geographically, the studies provided evidence from sub-Saharan Africa (n=11), Asia (n=9), Latin America (n=8), and Turkey. The studies included examples from national or social insurance schemes (n=7), government-run public health insurance schemes (n=4), community-based health insurance schemes (n=11), and private insurance (n=3). Half of the studies used econometric analyses while the remaining provided descriptive statistics or qualitative results. There is relatively consistent evidence that health insurance is positively correlated with the use of maternal health services. Only four studies used methods that can establish this causal relationship. Six studies presented suggestive evidence of overprovision of caesarean sections in response to providers’ payment incentives through health insurance. Few studies focused on the relationship between health insurance and the quality of maternal health services or maternal and neonatal health outcomes. The available evidence on the quality and health outcomes is inconclusive, given the differences in measurement, contradictory findings, and

Korean Emotional Laborers' Job Stressors and Relievers: Focus on Work Conditions and Emotional Labor Properties.

Science.gov (United States)

Lee, Garam

2015-12-01

The present study aims to investigate job stressors and stress relievers for Korean emotional laborers, specifically focusing on the effects of work conditions and emotional labor properties. Emotional laborers are asked to hide or distort their real emotions in their interaction with clients. They are exposed to high levels of stress in the emotional labor process, which leads to serious mental health risks including burnout, depression, and even suicide impulse. Exploring job stressors and relieving factors would be the first step in seeking alternatives to protect emotional laborers from those mental health risks. Using the third wave data of Korean Working Conditions Survey, logistic regression analysis was conducted for two purposes: to examine the relations of emotional labor and stress, and to find out job stressors and relievers for emotional laborers. The chances of stress arousal are 3.5 times higher for emotional laborers; emotional laborers experience double risk-burden for stress arousal. In addition to general job stressors, emotional laborers need to bear burdens related to emotional labor properties. The effect of social support at the workplace is not significant for stress relief, unlike common assumptions, whereas subjective satisfaction (wage satisfaction and work-life balance) is proven to have relieving effects on emotional laborers' job stress. From the results, the importance of a balanced understanding of emotional labor for establishing effective policies for emotional laborer protection is stressed.

Effect of self-hypnosis on duration of labor and maternal and neonatal outcomes: a randomized controlled trial.

Science.gov (United States)

Werner, Anette; Uldbjerg, Niels; Zachariae, Robert; Nohr, Ellen A

2013-07-01

To examine the effect of a brief course in self-hypnosis for childbirth on duration of the labor and other birth outcomes. A randomized, controlled, single-blind trial. Aarhus University Hospital Skejby, Denmark. A total of 1222 healthy nulliparous women. A hypnosis group receiving three 1-h lessons in self-hypnosis with additional audio-recordings to ease childbirth, a relaxation group receiving three 1-h lessons in various relaxation methods and mindfulness with audio-recordings for additional training, and a usual-care group receiving only the usual antenatal care were compared. Duration of labor, birth complications, lactation success, caring for the child, and preferred future mode of delivery. No differences were found across the three groups on duration from arriving at the birth department until the expulsive phase of second stage of labor, the duration of the expulsive phase, or other birth outcomes. Fewer emergency and more elective cesarean sections occurred in the hypnosis group. No difference was seen across the groups for lactation success or caring for the child but fewer women in the hypnosis group preferred a cesarean section in future pregnancies because of fear of childbirth and negative birth experiences. Learning self-hypnosis to ease childbirth taught as a brief course failed to show any effects on duration of childbirth and other birth outcomes. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Labor migration in Asia.

Science.gov (United States)

Martin, P L

1991-01-01

"A recent conference sponsored by the United Nations Center for Regional Development (UNCRD) in Nagoya, Japan examined the growing importance of labor migration for four major Asian labor importers (Japan, Hong Kong, Malaysia, and Singapore) and five major labor exporters (Bangladesh, Korea, Pakistan, Philippines, and Thailand).... The conference concluded that international labor migration would increase within Asia because the tight labor markets and rising wages which have stimulated Japanese investment in other Asian nations, for example, have not been sufficient to eliminate migration push and pull forces...." excerpt

TODAY THE GLOBAL LABOR MARKET

Directory of Open Access Journals (Sweden)

D. G. Shchipanova

2013-01-01

Full Text Available The international movement of labor, including temporary impacts on the socio-economic development of the donor and recipient countries the labor force. In this regard, it is relevant and legitimate problems of the evolution of the global labor market, the need to examine the issues of labor mobility, the problems of international labor migration and its impact on the national markets of skilled labor in the context of globalization. Distribution and use of human resources becomes cross-border nature, and so an international study of the labor market.

The effect of self-hypnosis on duration of labor and maternal and neonatal outcomes

DEFF Research Database (Denmark)

Werner, Anette; Uldbjerg, Niels; Zachariae, Robert

2013-01-01

OBJECTIVE: To examine the effect of a brief course in self-hypnosis for childbirth on duration of the labor and other birth outcomes. DESIGN: A randomized, controlled, single-blind trial. SETTING: Aarhus University Hospital Skejby, Denmark. POPULATION: A total of 1222 healthy nulliparous women....... METHODS: A hypnosis group receiving three 1-h lessons in self-hypnosis with additional audio-recordings to ease childbirth, a relaxation group receiving three 1-h lessons in various relaxation methods and mindfulness with audio-recordings for additional training, and a usual-care group receiving only...

Anesthetic and Obstetric Management of Syringomyelia During Labor and Delivery: A Case Series and Systematic Review.

Science.gov (United States)

Garvey, Gráinne Patricia; Wasade, Vibhangini S; Murphy, Kellie E; Balki, Mrinalini

2017-09-01

Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken. Hospital records and electronic databases were interrogated using International Classification of Diseases, 10th Revision codes and the keywords "syringomyelia," "syringobulbia," and "pregnancy." Data regarding demographics, diagnosis, radiology reports, neurological symptoms, mode of delivery, anesthetic management, and maternal-fetal outcomes were collected. We collected and analyzed data on a total of 43 pregnancies in 39 patients. The most common location for syrinx was in the cervicothoracic region (41.9%). The large majority of patients (n = 34; 87%) demonstrated signs and symptoms associated with syringomyelia before delivery. Syringomyelia associated with Arnold Chiari malformation was documented in 49% (n = 21) cases. General anesthesia was the most commonly used (n = 21/30, 70%) anesthetic technique for cesarean delivery. The majority (n = 9/13, 69%) of patients had an epidural sited for labor analgesia. There were no maternal or neonatal complications associated with neuraxial anesthesia; however, 3 cases (14%) raised concerns regarding general anesthesia including difficult intubation, transient worsening of neurological symptoms postpartum, and prolonged muscle paralysis after atracurium. Despite concerns regarding aggravation of the syrinx with vaginal delivery, this mode of delivery has never caused any documented long-term worsening of neurological

Cerebro-placental ratio and fetal response to maternal extracorporal sFlt-1 removal.

Science.gov (United States)

Weber, Marie L; Schaarschmidt, Wiebke; Thadhani, Ravi; Stepan, Holger

2017-12-11

Preeclampsia (PE) is a serious complication in obstetrics that affects approximately 3-5% of all pregnancies and it constitutes the leading cause of maternal mortality and morbidity worldwide. Although PE appears to be a maternal disease, iatrogenic preterm birth shifts the burden on the neonate after delivery. Impaired throphoblast invasion and differentiation in the first trimester with high placental impedance is considered to be the pathogenetic pathway of early and severe PE. Maternal rise of blood pressure represents the counter-regulation to maintain fetal supply. The excessive release of anti-angiogenics by the preeclamptic placenta creates an angiogenic imbalance leading to endothelial damage and its consequences. This article is protected by copyright. All rights reserved.

Job Contract at Birth of the First Child as a Predictor of Women’s Labor Market Attachment: Trajectory Analyses over 11 Years

Directory of Open Access Journals (Sweden)

Laura Peutere

2015-03-01

Full Text Available There is a lot of evidence that pre-birth employment and access to parental leave are important predictors of mothers’ labor market attachment after childbirth. This register-based study from Finland aimed to analyze in which ways the type of job contract (none, temporary, or permanent at the start of maternity leave predicts labor market attachment in the long term. The mother cohorts were followed up for 11 years. Labor market attachment was analyzed with latent class growth analysis, which makes it possible to identify subgroups with differing track and level of development. Lack of employment and having a temporary contract at baseline were associated with slower and weaker labor market attachment irrespective of mother’s age, socioeconomic status, and subsequent births. These findings suggest that the polarization of women into the core and periphery of the labor market structure tends to continue after the birth of the first child. Temporary employment might be an obstacle for having rights for a job-protected family leave and have long-term consequences on the continuity of employment and the division of paid and unpaid work in the family.

Preterm Labor and Birth

Science.gov (United States)

... Facebook Twitter Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about ... is called preterm labor (or premature labor). A birth that occurs before 37 weeks is considered a ...

76 FR 67104 - Child Labor Regulations, Orders and Statements of Interpretation; Child Labor Violations-Civil...

Science.gov (United States)

2011-10-31

... DEPARTMENT OF LABOR Wage and Hour Division 29 CFR Parts 570 and 579 RIN 1235-AA06 Child Labor Regulations, Orders and Statements of Interpretation; Child Labor Violations--Civil Money Penalties AGENCY... child labor regulations published on September 2, 2011. The Department of Labor (Department or DOL) is...

Relationship Banking in Labor Bank

OpenAIRE

三村, 聡

2012-01-01

As Labor bank is seemed as business partner of labor union, it contributes each community activities. For example, Labor bank helps retired employee, laborer and inhabitants. In addition, after the amendment of Money Lending Business Act of 2010, labor bank became clearly community based bank by consulting for heavily-indebted people and their education. This paper analyzes the new role of labor bank such as community contribution and enhancing financing service by collecting of the opinion o...

Propensity score method for analyzing the effect of labor induction in prolonged pregnancy.

Science.gov (United States)

Pyykönen, Aura; Tapper, Anna-Maija; Gissler, Mika; Haukka, Jari; Petäjä, Jari; Lehtonen, Lasse

2018-04-01

There is an ongoing debate on the optimal time of labor induction to reduce the risks associated with prolonged pregnancy. Registry-based study of 212 716 term, singleton cephalic deliveries between 2006 and 2012 in Finland comparing the outcomes of labor induction with those of expectant management in five, three-day gestational age periods between 40 and 42 weeks (group 1: 40 +0 -40 +2 ; group 2: 40 +3 -40 +5 ; group 3: 40 +6 -41 +1 ; group 4: 41 +2 -41 +4 ; group 5: 41 +5 -42 +0 ). Using Poisson regression, induced deliveries in each of the gestational age periods were compared with all ongoing pregnancies. Propensity score matching was applied to reduce confounding by indication. In the gestational age groups 1 and 2, labor induction significantly decreased the risk of meconium aspiration syndrome [relative risk (RR) 0.40, 95% confidence interval (CI) 0.18-0.91 (group 1), RR 0.44, 95% CI 0.21-0.91 (group 2)] but increased the risk for prolonged hospitalization of a neonate [RR 1.30, 95% CI 1.10-1.54 (group 1) and RR 1.23, 95% CI 1.03-1.47 (group 2)]. In groups 3 and 4, labor induction significantly increased the risk for emergency cesarean section [RR 1.17, 95% CI 1.06-1.28 (group 3) and RR 1.19, 95% CI 1.09-1.29 (group 4)] but still reduced the risk for meconium aspiration syndrome. In group 5, labor induction did not affect the risk for any of the studied outcomes (operative delivery, obstetric trauma, neonatal mortality, respirator treatment, Apgar <7). Propensity score matching is a novel approach to studying the effect of labor induction. It highlighted the conflicting maternal and neonatal risks and benefits of the intervention, and supported expectant management as a valid option, at least until close to 42 weeks. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

The Impact of Health Changes on Labor Supply: Evidence from Merged Data on Individual Objective Medical Diagnosis Codes and Early Retirement Behavior

DEFF Research Database (Denmark)

Christensen, Bent Jesper; Kallestrup-Lamb, Malene

with a host of demographic, labor market and financial regressors. The panel structure of the data allows following individuals year by year from the age of 50 and precisely measure changes in objectively measured health and other regressors, as well as labor market status. We consider 12 broad, mutually...

The Supply Chain Has No Clothes: Technology Adoption of Blockchain for Supply Chain Transparency

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Kristoffer Francisco

2018-01-01

Full Text Available Blockchain technology, popularized by Bitcoin cryptocurrency, is characterized as an open-source, decentralized, distributed database for storing transaction information. Rather than relying on centralized intermediaries (e.g., banks this technology allows two parties to transact directly using duplicate, linked ledgers called blockchains. This makes transactions considerably more transparent than those provided by centralized systems. As a result, transactions are executed without relying on explicit trust [of a third party], but on the distributed trust based on the consensus of the network (i.e., other blockchain users. Applying this technology to improve supply chain transparency has many possibilities. Every product has a long and storied history. However, much of this history is presently obscured. Often, when negative practices are exposed, they quickly escalate to scandalous, and financially crippling proportions. There are many recent examples, such as the exposure of child labor upstream in the manufacturing process and the unethical use of rainforest resources. Blockchain may bring supply chain transparency to a new level, but presently academic and managerial adoption of blockchain technologies is limited by our understanding. To address this issue, this research uses the Unified Theory of Acceptance and Use of Technology (UTAUT and the concept of technology innovation adoption as a foundational framework for supply chain traceability. A conceptual model is developed and the research culminates with supply chain implications of blockchain that are inspired by theory and literature review.

Influência da mobilidade materna na duração da fase ativa do trabalho de parto Influence of maternal mobility on duration of the active phase of labor

Directory of Open Access Journals (Sweden)

Eliane Bio

2006-11-01

Full Text Available OBJETIVOS: investigar a influência da mobilidade da parturiente durante a fase ativa do trabalho de parto. MÉTODOS: foi realizado ensaio clínico controlado prospectivo, com análise comparativa entre um grupo de tratamento (n=50 e um grupo controle (n=50, no Centro Obstétrico do Hospital Universitário da Universidade de São Paulo (USP. Os critérios de inclusão foram: primigestas com feto único em apresentação cefálica; idade gestacional entre 37 e 42 semanas; parturientes com pelo menos duas contrações a cada dez minutos e cérvico-dilatação de até 4 cm, além da concordância em assinar o termo de consentimento livre e esclarecido. A evolução para cesárea foi critério de exclusão. Foram acompanhadas por fisioterapeuta durante toda a fase ativa e orientadas a manterem-se em posição vertical e em movimento, de acordo com a fase da dilatação cervical e a descida fetal no canal de parto. O grupo controle teve acompanhamento obstétrico sem a presença do fisioterapeuta. Este grupo foi selecionado retrospectivamente, a partir dos registros de prontuário, seguindo os mesmos critérios de inclusão e exclusão. RESULTADOS: foram acompanhadas 58 primigestas entre 15 e 37 anos. Dessas, 50 mulheres (86,2% evoluíram para parto vaginal, sendo que oito (13,7% evoluíram para cesárea e foram excluídas do estudo. Entre as 50 parturientes acompanhadas, a média de duração da fase ativa foi de cinco horas e 16 minutos, enquanto no grupo controle foi de oito horas e 28 minutos (pPURPOSE: to investigate the influence of the maternal mobility during the active phase of labor. METHODS: a prospective clinical trial was conducted through comparative analysis among a treatment group (n=50 and a control group (n=50, in the Obstetric Center of the Hospital Universitário da Universidade de São Paulo (USP. The inclusion criteria were: primigravidae with a single fetus on cephalic presentation, with 37 to 42 weeks of pregnancy, with two

Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

Science.gov (United States)

Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

2010-02-01

We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.

Acoso laboral - daño psíquico Laboral abuse - psychological damage

Directory of Open Access Journals (Sweden)

Osvaldo Varela

2009-12-01

Full Text Available El escrito se enmarca en el proyecto UBACyT P433 El acoso laboral en la administración pública. Aportes de la psicología jurídica, de la Programación Científica 2008-2010, bajo la dirección del Profesor Osvaldo Varela. La temática abordaba en la actualidad constituye un área científica de vacancia a pesar de la importancia que día a día adquiere en el ámbito laboral y judicial. En esta ocasión se trabajará en la relación y articulación entre la noción de acoso laboral y la de daño psíquico, estimando que el acoso laboral provocaría en las personas que lo padecen un daño psíquico.This document is inserted in the UBACyT P433 project: The laboral abuse in the public administration. Juridic - psychology contribution, of 2008-2010 scientific program, under Professor Osvaldo Varela direction. The thematic approached in present days establish a scientific area of vacancy in front of the day by day importance in the laboral and judicial ambit. In this occasion the work will be done in the relation and articulation between the laboral abuse notion and the psychological damage, estimating that the laboral abuse will provoke in people that suffer it a psychological damage.

Influence of Gender Ideology on Married Women's Labor supply : A comparative Analysis of Four Countries

OpenAIRE

山谷, 真名

2011-01-01

I examine how gender ideology is associated with the levels of women's participation in work in Japan, the United States, France and Sweden. The 2005 international comparative survey on fertility decline by the Cabinet Office, Government of Japan was utilized. After controlling for age, wife's education, husband's education and age of the youngest child,\\\\r\\\\\\wife's gender role ideology is found to be related to the negative attitudes toward labor\\\\r\\\\\\force participation in the four countrie...