Postpartum Hemorrhage: Prevention and Treatment Evensen, Ann, MD; Anderson, Janice M., MD; Fontaine, Patricia, MD, MS
American family physician,
04/2017, Letnik:
95, Številka:
7
Journal Article
Recenzirano
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of ...oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration. Appropriate management of postpartum hemorrhage requires prompt diagnosis and treatment. The Four T's mnemonic can be used to identify and address the four most common causes of postpartum hemorrhage (uterine atony Tone; laceration, hematoma, inversion, rupture Trauma; retained tissue or invasive placenta Tissue; and coagulopathy Thrombin). Rapid team-based care minimizes morbidity and mortality associated with postpartum hemorrhage, regardless of cause. Massive transfusion protocols allow for rapid and appropriate response to hemorrhages exceeding 1,500 mL of blood loss. The National Partnership for Maternal Safety has developed an obstetric hemorrhage consensus bundle of 13 patient- and systems-level recommendations to reduce morbidity and mortality from postpartum hemorrhage.
The purpose of this work is to share our findings in using video gaming technology to facilitate the understanding of basic electromagnetism with middle school students. To this end, we explored the ...impact of using a game called Supercharged! on middle school students' understanding of electromagnetic concepts compared to students who conducted a more traditional inquiry-oriented investigation of the same concepts. This study was a part of a larger design experiment examining the pedagogical potential of Supercharged! The control group learned through a series of guided inquiry methods while the experimental group played Supercharged! during the laboratory sections of the science course. There was significant difference, F(2,91) = 3.6, p < 0.05, η² = 0.77, between the control and experimental groups on the gains from pre- to post-assessment. Additionally, students in the experimental group were able to give more nuanced responses about the descriptions of electric fields and the influence of distance on the forces that charges experience due to their interactions with the Supercharged! game. Results of this study show that video games can lead to positive learning outcomes, as demonstrated by the increase in test scores from pre- to post-assessment and the student interviews. This study also suggests that a complementary approach, in which video games and hands-on activities are integrated, with each activity informing the other, could be a very powerful technique for supporting student scientific understanding. Further, our findings suggest that game designers should embed metacognitive activities such as reflective opportunities into educational video games in order to provide scaffolds for students and to reinforce that they are engaged in an educational learning experience.
Models and modeling are central to both scientific literacy and practices as demonstrated by the Next Generation Science Standards. Through a design-based research framework, we developed a ...model-based assessment (MBA) and associated rubric as tools for teachers to understand and support students in their conceptualization of the flow of energy and matter within ecosystems. The MBA was piloted with four middle school students (n = 4) and implemented in two sixth grade student cohorts (
n
= 89 &
n
= 98)
.
The MBA and rubrics went through several design iterations in order to best capture student understanding of complex systems. The design of the MBA allows students to express conceptual understanding while also capturing the transformation of their understanding as they are exposed to new information and experiences within the curricular content.
This study examined children's drawings to explain children's conceptual understanding of plant structure and function. The study explored whether the children's drawings accurately reflect their ...conceptual understanding about plants in a manner that can be interpreted by others. Drawing, survey, interview, and observational data were collected from 182 students in grades K and 1 in rural southeastern United States. Results demonstrated the children held a wide range of conceptions concerning plant structure and function. These young children held very simple ideas about plants with respect to both their structure and function. Consistent with the drawings, the interviews presented similar findings.
The purpose of this work was to share our findings in using the Kinect technology to facilitate the understanding of basic kinematics with middle school science classrooms. This study marks the first ...three iterations of this design-based research that examines the pedagogical potential of using the Kinect technology. To this end, we explored the impact of using the Kinect in conjunction with an SDK Physical Virtual Graphing program on students' understanding of displacement, velocity and acceleration compared to students who conducted more traditional inquiry of the same concepts. Results of this study show that, while there may be some affordances to be gained from integrating this technology, there is a need for a scaffolded approach that helps students to understand the "messiness" of the data collected. Further, meta-cognitive activities, such as reflective opportunities, should be integrated into the inquiry experiences in order to scaffold student learning and reinforce concepts being presented. While the Kinect did work to generate large-scale visualization and embodied interactions that served as a mechanism for student understanding, this study also suggests that a complementary approach that includes both the use of hands-on inquiry and the use of the Kinect sensor, with each activity informing the other, could be a powerful technique for supporting students' learning of kinematics.
Conceptions of ecological processes such as the flow of energy and cycling of matter in an ecosystem are increasingly important understandings in a rapidly changing world. This study utilizes a ...p-prims, or knowledge in pieces, lens to examine understandings and disconnections in students' conceptualizations of energy flow and matter cycling specific to our context. Findings from our analysis drove continued refinement of our ＂Compost＂ curriculum through modifications designed to build on students' p-prims and foster deeper understanding of ecological processes.
This paper begins the exploration of disruption as an analytical construct that allows for the investigation of how individual learning and changes in local practice mutually influence the other ...within a purposefully designed learning context. We seek to describe the types of learning experiences that emerged using disruptive pedagogies and tools within a series of methods courses in an undergraduate elementary teacher education program. The intent of the designed context was to disrupt the traditional practices of teacher education courses by creating a participatory environment where students participated in the creation of course content through their engagement with social media and each other. We define disruption as an innovation that requires students to challenge or change their epistemologies and participation in their learning. This paper addresses a designed disruption that was created in the context of an elementary methods course. The results demonstrated diverse consequences for participants, their activity, and our understanding of their learning. These findings provide a starting point for examining the implications of disruptive practices within pre-service teacher education programs.
Abstract Charcot–Marie–Tooth disease type 4J (CMT4J), a rare form of demyelinating CMT, caused by recessive mutations in the phosphoinositide phosphatase FIG4 gene, is characterised by progressive ...proximal and distal weakness and evidence of chronic denervation in both proximal and distal muscles. We describe a patient with a previous diagnosis of CMT1 who presented with a two year history of rapidly progressive weakness in a single limb, resembling an acquired inflammatory neuropathy. Nerve conduction studies showed an asymmetrical demyelinating neuropathy with conduction block and temporal dispersion. FIG4 sequencing identified a compound heterozygous I41T/K278YfsX5 genotype. CMT4J secondary to FIG4 mutations should be added to the list of inherited neuropathies that need to be considered in suspected cases of inflammatory demyelinating neuropathy, especially if there is a background history of a more slowly progressive neuropathy.
Praise for IT Best Practices "The work of the financial manager revolves around a company's financial systems. Ms. Roehl-Anderson's latest offering addresses the two key aspects of these systems—how ...to buy and install them. The book covers every conceivable aspect of these systems, including ERP, software as a service, shared services, and supporting controls. As a bonus, the book contains substantial coverage of information technology considerations in an acquisition. This is a definitive desk reference." —Steve Bragg, CFO, XeDAR Corporation, and author of Accounting Best Practices "Sage advice from one of the most adept project managers in the industry! Jan and team have delivered a practical, yet comprehensive guidebook for software selection, implementation, rollout, and ongoing updates. This guidebook will become a valuable reference for every financial manager and IT project manager undertaking ERP implementation."—Valerie Borthwick, former senior vice president, Oracle Consulting "Written by one of the best in the IT business, this book is a must-read for all CFOs and controllers. In one volume, it addresses everything a financial executive needs to know about IT and its impact on the financial function, while also featuring practical guidelines, current hot topics, and IT best practices. This book covers it all."—Jo Marie Dancik, Regional Managing Partner (Retired), Ernst & Young
Add value to your organization via the mergers & acquisitions IT function As part of Deloitte Consulting, one of the largest mergers and acquisitions (M ) consulting practice in the world, author ...Janice Roehl-Anderson reveals in M Information Technology Best Practices how companies can effectively and efficiently address the IT aspects of mergers, acquisitions, and divestitures. Filled with best practices for implementing and maintaining systems, this book helps financial and technology executives in every field to add value to their mergers, acquisitions, and/or divestitures via the IT function. * Features a companion website containing checklists and templates * Includes chapters written by Deloitte Consulting senior personnel * Outlines best practices with pragmatic insights and proactive strategies Many M fail to meet their expectations. Be prepared to succeed with the thorough and proven guidance found in M Information Technology Best Practices. This one-stop resource allows participants in these deals to better understand the implications of what they need to do and how
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