Choice? Factors That Influence Women’s Decision Making for Childbirth

This article reports the findings from a mixed-methods study on factors that influence women’s decisions about birth, with the view that women’s decision making about birth can affect the use of cesarean surgery. Data was collected from focus groups and structured postpartum interviews and was analyzed using the Consensual Qualitative Research method. The findings relate specifically to the factors reported as influential in making decisions about birth including how the women categorized, prioritized, and/or favored certain types of knowledge about modes of birth. Four major information categories were identified but only stories about birth and/or attending a birth appeared to have a lasting effect on birth choices. These findings have implications for prenatal and perinatal education and nursing practice.     

A Family-Centered Cesarean Birth Story

This is the family-centered cesarean birth story of my twin grandchildren. Because of good prenatal education; a well-chosen, dedicated care provider; and parents with focus, I am able to share a beautiful birth story. I hope relating this story encourages other childbirth educators to present various options for cesarean in their classes, thereby educating the public about this beautiful opportunity if a cesarean birth is necessary.     

Video-assisted thoracoscopic surgery (VATS) for the treatment of hepatic hydrothorax: report of twelve cases

Background: Hepatic hydrothorax is defined as a significant pleural effusion in patients with liver cirrhosis and without underlying cardiopulmonary diseases. Treatment of hepatic hydrothorax remains a challenge at present. Methods: Herein we share our experiences in the treatment of 12 patients with hepatic hydrothorax by video-assisted thoracoscopic surgery (VATS).Repair of the diaphragmatic defects, or pleurodesis by focal pleureetomy, talc spray, mechanical abrasion, electro-cauterization or injection was administered intraoperatively, and tetracycline intrapleural injection was used postoperatively for patients with prolonged (＞7 d) high-output (＞300 ml/d) pleural effusion. Results: Out of the 12 patients, 8 (67%) had uneventful postoperative course and did not require tube for drainage more than 3 months after discharge. In 4 (33%) patients the pleural effusion still recurred after discharge due to end-stage cirrhosis with massive ascites. Conclusion: We conclude that the repair of the diaphragrnatic defect and pleurodesis through VATS could be an alternative of transjugular intrahepatic portal systemic shunt (TIPS) or a bridge to liver transplantation for patients with refractory hepatic hydrothorax. Pleurodesis with electrocauterization can be an alternative therapy if talc is unavailable.     

Safe,Healthy Birth: What Every Pregnant Woman Needs to Know

In spite of technology and medical science''s ability to manage complex health problems, the current maternity care environment has increased risks for healthy women and their babies. It comes as a surprise to most women that standard maternity care does not reflect best scientific evidence. In this column, evidence-based maternity care practices are discussed with an emphasis on the practices that increase safety for mother and baby, and what pregnant women need to know in order to have safe, healthy births is described.     

New Resources for Childbirth Educators and Parents

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and expectant and new parents. The books, CDs, DVDs, and kits reviewed in this issue''s column include the following topics: the birth experiences of mothers who survived childhood sexual abuse; lively teaching techniques and ideas to help energize and enhance childbirth education classes; breastfeeding in the workplace; expectant fathers; perspectives on motherhood; unique, helpful tools for childbirth educators to use in designing their class content, addressing the stages of labor, and discussing planned cesarean birth; exercises for pregnant women on bedrest; and a compilation of presentations featured at Birthing the Future''s international symposiums.     

A Vaginal Birth After Cesarean,Attended by a Family Member Midwife Serving as Doula

In this column, a mother and her doula describe the strategies used during pregnancy and labor to maximize the success of a vaginal birth after a previous cesarean surgery.     

基于微信群线上线下混合式外科临床技能教学模式的应用

目的:探讨基于微信群线上线下混合式外科临床技能教学模式的应用效果。方法:2019年1月—2019年11月共84名在胸心血管外科实习轮转的2015级临床医学专业实习医生作为研究对象,随机分为试验组和对照组,试验组采用基于微信群线上线下混合式外科临床技能教学模式,对照组采用传统示范教学,出科结束进行理论考核和技能考核,比较两组教学效果。结果:试验组实习医生理论学习成绩、外科技能及学习积极性均优于对照组。结论:基于微信群线上线下混合式外科临床技能教学模式能调动实习医生学习的积极性,提高外科操作自信,有效提高了教学质量,是值得推广的实习教学模式。     

护理教学查房在胃肠外科的应用分析

护理教学查房是临床教学的重要形式,是提高护理质量和护理技能的重要手段^[1]。为适应护理教学模式的改变,培养学生理论联系实际的能力,提高带教教师的整体素质,我们医院规范了护理教学查房流程及评分标准,加强了带教管理。现将护理教学查房在我院胃肠外科的应用加以分析。     

甲状腺微小癌16例诊治分析

[目的]研究甲状腺微小癌的临床特点、诊断及治疗方法.[方法]回顾性分析1992-10～2006-04手术治疗的甲状腺癌103例的临床资料,其中甲状腺微小癌16例,占同期甲状腺癌病人的15.53%,全部患者均经手术治疗并对其进行随访,随访2个月～10 a.[结果]①甲状腺微小癌与显性甲状腺癌在淋巴结转移上没有明显差异,甲状腺微小癌具有更多的多灶性生长特点,显性甲状腺癌有更多的外侵包膜现象.②B超在诊断甲状腺微小癌上有明显优势.[结论]甲状腺微小癌与显性甲状腺癌在生物学行为及淋巴结转移上没有明显差异,其治疗应遵循甲状腺癌的治疗原则.