Updates on Delivery Room free essay sample

During the first stage of labor, what is the effect of maternal positioning on duration of the first stage of labor, type of delivery, maternal satisfaction, and neonatal and maternal outcomes? Evidence-Based Answer Upright positions include sitting, standing, walking, and kneeling. Based on heterogenous results, women who maintained upright positions had a first stage of labor that was about one hour less than women who were supine or reclined. There were no differences in type of delivery, and there were insufficient data on maternal satisfaction and maternal and neonatal outcomes. (Strength of Recommendation = A, based on consistent and good quality patient-oriented evidence). Practice Pointers Most women in the United States deliver their babies in hospitals. To facilitate intravenous infusions, epidurals, and maternal and fetal monitoring, women often spend much of the first stage of labor in supine or recumbent positions. In this Cochrane review, the authors found 21 studies (n = 3,706) comparing upright with recumbent maternal positions during the first stage of labor. We will write a custom essay sample on Updates on Delivery Room or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Overall, compared with recumbent positions, women who maintained upright positions had a duration that was approximately one hour less for the first stage of labor (mean difference = −0.99; 95% confidence interval [CI], −1.60 to −0.39). Participants in upright positions also were less likely to have epidural analgesia (risk ratio = 0.83; 95% CI, 0.72 to 0.96). In a related Cochrane review, assuming a hands and knees maternal position for 10 minutes at a time in late pregnancy did not appear to help rotate babies who presented in occipitoposterior positions, which was based on an analysis of three trials (n = 2,794) that found the maternal position rotates babies temporarily, but the babies do not maintain their occipitoanterior position. 1 Maternal positioning on hands and knees may be beneficial in labor to reduce backache, but there is insufficient evidence that it improves labor outcomes. Studies of maternal positioning in labor are challenging because it is not possible to have participants blinded to allocation groups, and it is difficult to standardize the intervention. Many women cannot easily maintain the position to which they were randomized once their cervical dilation is greater than 5 to 6 cm. Also, the measures taken to encourage adherence to protocols can vary by study. Other Cochrane reviews have documented the benefit of continuous intrapartum support from early labor in decreasing labor duration, likelihood of spontaneous vaginal birth, likelihood of intrapartum analgesia, and dissatisfaction with childbirth experiences.2,3 It is especially beneficial to have continuous support from a person who is not a member of the hospital staff.2 For low-risk deliveries, home-like birth settings in proximity to medical wards are associated with reduced medical intervention, higher rates of spontaneous vaginal birth, and increased maternal satisfaction. 3 These studies lend support to the recommendation that women should be encouraged to labor in the position they find most comfortable.1–3 CLARISSA KRIPKE, MD Author disclosure: Nothing to disclose. Source Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev. 2009;(2):CD003934. REFERENCES 1. Hunter S, Hofmeyr GJ, Kulier R. Hands and knees posture in late pregnancy or labour for fetal malposition (lateral or posterior). Cochrane Database Syst Rev. 2007;(4):CD001063. 2. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth.Cochrane Database Syst Rev. 2007;(3):CD003766. 3. Hodnett ED, Downe S, Edwards N, Walsh D. Home-like versus conventional institutional settings for birth. Cochrane Database Syst Rev. 2005;(1):CD000012. Instruments for Assisted Vaginal Delivery Am Fam Physician. 2011 Jul 1;84(1):26-27. Related letter: Increased Risks with Serial Vacuum Forceps for Assisted Vaginal Delivery. Clinical Question For assisted vaginal delivery, does the use of forceps or vacuum devices result in lower morbidity for the mother and newborn? Evidence-Based Answer Use of forceps is more likely to result in a vaginal delivery than use of vacuum devices (relative risk [RR] = 1.5; 95% confidence interval [CI], 1.1 to 2.2), but has a higher rate of perineal trauma, tears, pain, and incontinence, and a trend toward more cesarean deliveries. Use of metal-cup vacuum devices is more likely to result in a vaginal delivery than use of soft-cup devices, but is more likely to cause neonatal scalp injury and cephalohematoma. (Strength of Recommendation = A, based on consistent, good-quality patient-oriented evidence) Practice Pointers Assisted vaginal deliveries are recommended for fetal distress, failure to deliver after a prolonged second stage of labor, or maternal factors that would make pushing dangerous, such as exhaustion or medical problems. The choice of instrument depends on factors such as the training of the physician, fetal position, and the degree of anesthesia. Vacuum extraction does not require as much anesthesia for the mother as forceps.1 To determine the safest delivery method for the mother and newborn, the authors of this Cochrane review searched for randomized controlled trials comparing methods of assisted vaginal delivery at term. The authors found 32 studies including 6,597 women. Seventeen of the studies compared types of vacuum devices, and 13 studies compared forceps with vacuum devices. Although the failure rate was lower with forceps than with vacuum devices, third- and fourth-degree perineal tears were more common with forceps (RR = 1.9; 95% CI, 1.6 to 3.9). Facial injuries in newbor ns were also more common with forceps (RR = 5.1; 95% CI, 1.1 to 23). There were no differences between forceps and vacuum devices in Apgar score, shoulder dystocia, need for intubation, severe morbidity, death, or use of maternal analgesia. Compared with soft-cup vacuum devices, use of metal cups was more likely to result in a vaginal delivery but had higher rates of neonatal bruising, cephalohematoma, and scalp injury. There are risks and benefits with different assisted vaginal delivery methods, with no clear superiority of one device over another. However, this review supports the use of vacuum extraction with a soft cup as the first-line method because of its lower risk of harming the newborn. [corrected] CLARISSA KRIPKE, MD Author disclosure: No relevant financial affiliations to disclose. SOURCE OMahony F, Hofmeyr GJ, Menon V. Choice of instruments for assisted vaginal delivery. Cochrane Database Syst Rev. 2010;(11):CD005455. REFERENCE 1. Operative vaginal delivery. ACOG Technical Bulletin Number 196—August 1994 (replaces No. 152, February 1991). Int J Gynaecol Obstet. 1994;47(2):179–185. 7 Alternative ways to prepare for childbirth and cope with the intensity of labor. Carlsbad, CA (PRWEB) — As the shift toward self-education continues to grow, large numbers of American women are choosing   alternative ways to prepare for childbirth and cope with the intensity of labor. Instead of waiting for the doctor to tell them what they need to know, women are doing more research on their options and exploring ways to make pregnancy and birth less painful. Here is what they are choosing: 1. Birth Networks – These organized, regional groups of pregnant women and birthing professionals meet regularly to educate, empower and support each other and advocate for the improvement of maternity care in their communities. What started as a grassroots movement has exploded across the county. Evidence of a growing trend: Amy Romano of Lamaze International estimates that the number of birth networks has doubled in the past year. Since 2004, the Lamaze Institute for Normal Birth has awarded grants to form and expand birth networks. It also offers organizational resources for birth networks through their website, www.normalbirth.lamaze.org. 2. Birth Stories – Expectant women are hungry for information on labor and birth, and the mainstream media is responding with birth stories. These stories offer much more than entertainment; they provide information on birth options, tools, classes and techniques. The impact of birth stories on expectant parents is quickly coming to the attention of the birth professionals, and many are actively discouraging patients from watching the highly-dramatized birth programs on cable television. Because the level of fear in a laboring woman directly impacts the progression of her labor, birthing professionals are directing patients to read only empowering, inspiring birth stories, such as those found in Journey into Motherhood: Inspirational Stories of Natural Birth http://www.journeyintomotherhood.com (White Heart Publishing, 2005). Evidence of a growing trend: There are now 7 programs on cable television that highlight the experience of labor and delivery. Most pregnancy magazines now feature birth stories on a regular basis, and many birth networks and childbirth educators now sponsor birth-story nights. 3. Hypnosis for Childbirth – Since a 1999 segment on NBC’s Dateline featured hypnosis for childbirth, interest has steadily grown. The HypnoBirthing Method and Hypnobabies are two of the oldest and most popular programs, but with the growing interest in this method, there are now several different programs available, as well as supplemental products such as Journey into Childbirth: Hypnosis for Empowered Birthing by Sheri Menelli. While no program promises a pain-free birth, this is a frequent result. Evidence of a growing trend: In the late 19990s there were only a few hundred educators, and as of this year, there are over 3000. 4. Prenatal yoga – Prenatal yoga strengthens and stretches the muscles that are used in childbirth, and teaches breathing and focusing techniques that help women through labor. Evidence of a growing trend:In San Diego, California, prenatal yoga instructors are reporting an increase in class attendance of approximately 50% over the last three years. Much of the increase is attributed to growing support from doctors, midwives and childbirth educators who send their clients to yoga classes to relieve back pain, reduce tension, and cope with high blood pressure. A number of prenatal yoga videos are now available to women who prefer to practice at home. 5. Water-assisted labor – Widely known as â€Å"nature’s epidural,† warm water can ease the discomfort of labor by helping a woman relax. A â€Å"birthing tub† counters the effect of gravity on her contracting muscles, and even a warm shower can provide soothing comfort to tired and tense women. Evidence of a growing trend: In the last 10 years, water-assisted labor has grown exponentially. In 1995 there were only three hospitals in the country that offered it. Now it is offered in more than 260 hospitals – 15% of all U.S. hospitals. In the last year alone there was a 4% increase, and this number is expected to grow in the coming year. 6. Doulas – A doula is a professional who is trained to provide emotional and tactical support a family through pregnancy, labor, delivery, and newborn care. Studies show that the presence of a doula reduces the need for medication, as well as the possibility of a Cesarean-section birth. Evidence of a growing trend: Every doula organization reports phenomenal growth in membership, and in the number of students in doula training classes. Doulas of North America (DONA), just one of several doula organizations reported a 10-fold increase in the number of certified doulas in the last 7 years. 7. Pregnancy Massage – A specialized form of bodywork, pregnancy massage addresses the specialized needs of a rapidly changing body. It enhances the function and alignment of muscles and joints, improves circulation and muscle tone, and relieves mental and physical fatigue. These benefits translate to lower levels of stress hormones, as reported in a study by Dr. Tiffany Field at the University of Miami School of Medicine. Evidence of a growing trend: Instructor Elien Alexander from The School of Healing Arts in San Diego, California, reported a 10-fold increase in the number of students becoming certified in pregnancy massage in the last 5 years.

The Importance of Business Plan

The Importance of Business Plan Business Plan - What Is It? Business plans ought to be short and concise. Creating business plans beforehand can help to reach entrepreneurial objectives. Whether you're starting or growing your company, you want a business program. Every business should have a written business program. Every entrepreneur and startup provider requires a program. If you know your company and are passionate about any of this, writing a business program and then leveraging your plan for growth will be not quite as challenging as you might believe. Your plan will offer the roadmap to accomplish the success you desire. In the event the aim of your organization plan is to receive funding, it's sensible to ensure that your management plan involves an advisory board for a management resource. Therefore, our company plan preparation service is based on a relationship with our customers, together with your small business vision and goals to create a really remarkable and efficient document. Contrary to other services out there, our enterprise plan template makes it simple to begin, however you will still have to set aside a while to think through your ideas, even for the simplest small business plan. Top Business Plan Choices Every company is solving an issue for its clients and filling a need in the marketplace. A business program will be able to help you clarify your strategy, identify potential roadblocks, make a decision as to what you'll have to have in the manner of resources, and assess the viability of your idea or your g rowth plans before you begin. Your company program will be helpful in a variety of means. Contemplating that business plans serve many unique purposes, it's not surprising that they are available in many unique forms. Definitions of Business Plan The format of a company plan depends upon its presentation context. When the plan is totally written and modeled, you'll have ample time for a comprehensive review and to give us feedback. Deciding upon an action plan after a SWOT analysis is a complex process that is particular to every decision in every corporation. Whether you're writing a short and easy, one-page small business program or a detailed multi-page guide, building a business plan outline is almost always an excellent means to place your ideas down in draft form. The Definitive Approach to Business Plan A Business Plan isn't a one-time document only for obtaining investors or financing. The Operating Plan Section of the Business Plan will give you additional informatio n regarding your operating program. You are going to need a business plan if you would like to secure investment or a loan from a financial institution. Additionally, a business program is crucial for most new businesses seeking all sorts of financing. Your business plan should incorporate a summary of the sorts of advertising you intend to devote money on. ''... a fantastic business program can help make a great business credible, understandable, and attractive to someone who's unfamiliar with the small business. Also, in case you have any plans for future products that you'd love to investigate and develop, note them here. Equally important to discuss is technology licensingif you're licensing core technology from somebody else, you want to disclose that in your organization program and don't forget to include specifics of the financial relationship. The Basics of Business Plan You have to deliver a set of financial projections which translate what you've said about your company into numbers. You would like yo ur plan to be a helpful tool for starting a businessand getting funding if you require it. Every business plan involves these components that are key aspects in earning your organization plan fuller and more effective. A superior financial plan goes a very long approach to help determine when to employ new employees or purchase a new bit of equipment. Business Plan - What Is It? The initial one is a thorough instance of a fictitious airport cafe business seeking to open a new website. Whether you're just beginning your small business or you're searching to acquire serious about a business you've run for quite a while now, you require a business program. If you want to create a business program and have a question about what's perfect for your small company or organization, don't hesitate to ask an attorney. In its heart, a business program is only a plan for how your company is going to work, and the way you're likely to make it succeed.

Research Paper Topics For Ag Majors

Research Paper Topics For Ag MajorsResearch Paper Topics for Ag Majors: It is important to choose the topic of your paper in accordance with your interests and what you know about the subject matter. You can do this by reading some literature on the topic, attending lectures or forums related to the topic and other ways of self-examining the subject matter. Once you know what topic to choose, make sure to choose a topic that you are comfortable with.Finding materials to use for your paper is not an easy thing to do. However, there are some great sources available. The Internet is a good place to start, but some research will be necessary if you are to find useful research material that meets your needs. In your search for research paper topics for ag majors, you should first know how to look for them.Knowing how to find the right sources is the key to finding good topics. In fact, it is easier than finding a good research paper topic for ag majors. There are many resources available for finding subjects and topics related to a specific subject. If you know how to find them, you can save yourself a lot of time and effort.The first step in researching is to identify the appropriate sources. There are a number of resources online that offer information on the topics you are interested in. These sources often provide links to journals and books on the topic, along with details on how to get more information. Many of these resources are free, but you may need to pay for some of the material. Other sources are subscription-based, meaning you will need to pay a minimal fee to access their services.The best research paper topics for ag majors are available at the library. Check out the local library's databases to see what research materials they have available for your topic. You may also find books in local bookstores that have book reviews on the topic you are researching. Some libraries offer both free and subscription-based research materials for a small fee. If y ou are unable to find the materials you are looking for in the library, look online for books that offer those sources.There are public sources as well. You will need to contact local agencies to see what they have to offer. Governmental agencies are often a great resource, because they are usually the best source of information about the topic you are researching. The reason is because most of these organizations have a large amount of information on the topic. The best research paper topics for ag majors are found with these types of agencies because they are usually able to keep up with the latest developments in the field.As you can see, there are many options available for finding good research paper topics for ag majors. This information can help you narrow down your research. No matter where you decide to get your research materials, make sure you follow the above steps to make sure you don't waste your time and effort.Start by deciding which sources to use for your research. This will help you determine which topics to use and how to write your research paper. You can then begin making your final decisions about what topics you will focus on in your research paper.

Why Everyone Is Talking About Sample Argument Essay Topics and What You Need to Do

Why Everyone Is Talking About Sample Argument Essay Topics and What You Need to Do Sample Argument Essay Topics at a Glance You may continue to keep your argumentative essays for your upcoming job portfolio in case they're highly graded. At the conclusion of these list, you will discover links to a variety of argumentative paragraphs and essays. Besides general knowledge you have concerning the subject, you won't mind dedicating some opportunity to research, writing procedure, and other things essential for the high-quality essay. It's important to select debatable argumentative essay topics since you need opposing points that you may counter to your own points. What Sample Argument Essay Topics Is - and What it Is Not Thus do not feel overwhelmed with the quantity of writing assignments as it's inevitable, get over it. In any case, direct and indirect quotes are necessary to support your understanding of academic writing style. 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Sample Essay of Narrative Writing

Sample Essay of Narrative WritingA sample essay of narrative writing will help you write an essay that is full of style and clarity. It is important that you learn how to write a good essay by knowing the basic tips for writing an essay. There are several ways in which you can express your thoughts to convey your ideas and feelings clearly.o The first tip in writing a great essay is to list out the key points in the essay. You should write down the main points of the essay, so that the reader can easily understand what the topic of the essay is. After you have written the essay, it is essential that you note down all the key points that you want to include in the essay. Writing an essay of narrative writing involves writing a clear and concise essay that will be able to discuss a particular issue and describe what happened.o In writing an essay of narrative writing, it is imperative that you make a strong case for your essay. The best way to create a strong case is to make a comparis on between two issues that you want to discuss in the essay. Use facts and figures to support your points. You can also include sound examples to prove the point that you are making.o In writing an essay of narrative writing, you must not make the reader think that you are getting the information directly from the subject matter. You can ask the readers for some information about the topic you are writing about. They will feel comfortable enough to write the essay about their own interests.o It is always good to have your own judgment and opinion in writing an essay. If you find it difficult to write about your ideas, you can always write an essay that is based on a single fact or a well-known opinion.o A good essay of narrative writing will not be easily determined. Itis important that you gain knowledge about the most effective essays and samples. This will help you in understanding the basic tips for writing an essay of narrative writing.These tips for writing an essay will help you in writing an essay that is good in form and content. If you want to improve your writing skills, these tips for writing an essay will help you become a better writer.