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Academic literature on the topic 'Delivery (Obstetrics) Case studies'

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Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Delivery (Obstetrics) Case studies"

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Johnson, John W. C., Douglas S. Richards, and Rebecca A. Wagaman. "The case for routine umbilical blood acid-base studies at delivery." American Journal of Obstetrics and Gynecology 162, no. 3 (March 1990): 621–25. http://dx.doi.org/10.1016/0002-9378(90)90970-i.

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Ray Chaudhuri Bhatta, Smriti, and Remon Keriakos. "Review of the Recent Literature on the Mode of Delivery for Singleton Vertex Preterm Babies." Journal of Pregnancy 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/186560.

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Choosing the safest method of delivery and preventing preterm labour are obstetric challenges in reducing the number of preterm births and improving outcomes for mother and baby. Optimal route of delivery for preterm vertex neonates has been a controversial topic in the obstetric and neonatal community for decades and continues to be debated. We reviewed 22 studies, most of which have been published over the last five years with an aim to find answers to the clinical questions relevant to deciding the mode of delivery. Findings suggested that the neonatal outcome does not depend on the mode of delivery. Though Caesarean section rates are increasing for preterm births, it does not prevent neurodisability and cannot be recommended unless there are other obstetric indications to justify it. Therefore, clinical judgement of the obstetrician depending on the individual case still remains important in deciding the mode of delivery.
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MEMON, NAILLA YOUSUF, FIRDOUS MUMTAZ, and SHAISTA FAROOQ. "INCIDENCE OF PLACENTAL ABRUPTION;." Professional Medical Journal 20, no. 03 (March 25, 2013): 422–28. http://dx.doi.org/10.29309/tpmj/2013.20.03.699.

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Objective: To determine the Incidence of Placental Abruption and the morbidity / mortality associated with it. Design:Prospective and Observational case Study. Setting & Duration: Department of Obstetrics & Gynecology, Liaquat University of Medicaland Health Sciences Hyderabad, for a period of 15 months from January 2007 to March 2008. Patients & Methods: Among all theantenatal patients delivered during the period under review, those suffering from Placental abruption were entered into this study bycompleting a proforma for each patient. After history, examination and initial management, investigations were carried out. These patientswere managed on case to case basis depending on the progression of abruption and delivery. After delivery whether spontaneous or bycesarean section the condition of mother and subsequent complications were recorded and results analyzed on SPSS version 10.Results: During the period 15 months, 2760 patients were admitted to labour room /labour ward and delivered. Among these, 100patients had abruption making an incidence of 2.89% per year. According to the degree of abruption 33 had mild, 50 had moderate and 17had severe abruption. 42% had spontaneous vaginal delivery, and 52% underwent cesarean section. 36% of Abruptio patients, developedcomplications like shock, PPH and DIC. One (1%) patient died in severe abruption. Conclusions: The incidence of Abruptio Placentae inthis study is comparable to local studies and studies from developing countries, but is high in comparison to studies from developedcountries. The maternal morbidity and mortality rate is not as high as in other studies.
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HERBST, ANDREAS, and KARIN KÄLLÉN. "TERM BREECH DELIVERY." Fetal and Maternal Medicine Review 16, no. 4 (November 2005): 289–322. http://dx.doi.org/10.1017/s0965539505001634.

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In October 2000, Hannah et al published a randomised controlled trial comparing perinatal and maternal outcome between planned vaginal and planned caesarean deliveries of term breech pregnancies. The study was closed after an interim analysis, showing a reduced perinatal morbidity and mortality with planned caesarean section. The result was not unexpected, although a trial like this had been called for over many years to resolve the issue. Many cohort- and case-control studies, and two small randomised studies had been performed since 1959, when Wright reported a reduced perinatal mortality and morbidity with CS. A few large registry studies had shown a better perinatal outcome with caesarean delivery, whereas smaller studies often showed no statistically significant difference in outcome, often with the conclusion that vaginal delivery (VD) is safe.
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Hosiani, Ali, James Brown, and Indika T. Alahakoon. "Delayed Interval Delivery in Preterm Premature Rupture of Membranes in Dichorionic Triamniotic Triplets: Ethical Considerations for Maternal Health Case Report." Case Reports in Obstetrics and Gynecology 2022 (July 21, 2022): 1–4. http://dx.doi.org/10.1155/2022/4766523.

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Background. Although there are numerous studies on delayed interval delivery in twins, this study is one of few reporting on preterm premature rupture of membranes in triplets and even fewer on dichorionic triamniotic triplet twins. The case presented here highlights the important interplay between informed consent and patient autonomy. Case Presentation. A 37-year-old woman gravida 1, para 0 with a dichorionic triamniotic triplet pregnancy experienced preterm premature rupture of membranes of the singleton triplet at 15 weeks and six days of gestation. Delayed interval delivery was offered to the parents, who chose to continue the pregnancy while acknowledging the risks for maternal and foetal health. The patient was treated with prophylactic intravenous antibiotics and discharged on oral antibiotics after an eight-day admission. Two days after being discharged, she was readmitted with clinical signs of chorioamnionitis. Within six hours, the preterm premature rupture of membranes singleton was delivered. Three days later, she again presented to the hospital with preterm premature rupture of membranes of one of the dichorionic twins. After discussion with the maternal foetal medicine team, the parents chose to terminate the pregnancy. Delayed interval delivery was not successful in this patient, and it is unclear at which gestational age it is too early to offer expectant management. Conclusions. The case affirmed the very poor foetal survival rate when the first delivery occurs at under 20 weeks’ gestation. A standardised management of delayed interval delivery should be established to assist with consistent parental counselling.
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Partab, Priya, Aneela Habib, Gulfishan Tariq, Urooj Naz, Sana Shameer, and Sarah Kazi. "The Outcome of Planned Breech Vaginal Delivery among Obstetrics Patients Presenting at Tertiary Care Hospital, Karachi." Pakistan Journal of Medical and Health Sciences 16, no. 4 (April 30, 2022): 617–19. http://dx.doi.org/10.53350/pjmhs22164617.

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Background: Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. The safest mode of delivery in case of breech presentation has long been a debate in obstetrics. Selective vaginal breech deliveries, proper technique of breech delivery, rigorous intrapartum monitoring and presence of experienced obstetrician and pediatricians are most important factors for good outcome in vaginal breech delivery without affecting the maternal and fetal well-being and helps in decreasing the caesarean section rate. Very few studies on the subject have been carried out in poor-resource settings. The aim of the study was to determine the outcome of planned breech vaginal delivery among obstetrics patients presenting at Tertiary Care Hospital, Karachi. Study Design: This Cross sectional study was conducted at Department of Gynaecology and Obstetrics, Civil Hospital, Karachi for the duration of Six months from November, 2019 to May, 2020. Subjects and Methods: Data was prospectively collected from patients after taking a verbal consent. 89 pregnant who met the diagnostic criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification chi square test was applied taking p-value of ≤0.05 as significant. Results: A total of 89 patients were included in this study. Mean age, gestational age and duration of labour in our study was 31.78±2.81 years, 37.72±1.58 weeks and 10.72±1.56 hours. Out of 89 patients, 11.2%, 23.6%, 12.4% neonates had had APGAR score < 7, NICU admission and brachial plexus injury. Conclusion: Vaginal delivery of term breech fetus is a safe option in a carefully selected group of women. Pre-delivery assessment, vigilant labour monitoring and delivery by trained doctors can minimize poor feto-maternal outcome. Keywords: Pregnancy, planned breech vaginal delivery, APGAR score.
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Morris, D. G. "Using telemedicine to facilitate training in cardiotocography (CTG) interpretation." Journal of Telemedicine and Telecare 6, no. 1_suppl (February 2000): 53–55. http://dx.doi.org/10.1258/1357633001934140.

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Electronic fetal monitoring is a controversial practice in modern obstetric care and is frequently an aspect of medicolegal cases involving the management of labour and delivery. The interpretation of the cardiotocograph (CTG) produced by such monitors is a skill required by those caring for the pregnant woman. Studies have shown that most ‘experts’ do not interpret CTGs in a consistent manner, when compared with either other experts or themselves. However, it has also been shown that consistency can be improved with training. Telemedicine has been used to advantage in the training of obstetrics and gynaecology registrars in CTG interpretation.
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Nicholson, James M., and Lisa C. Kellar. "The Active Management of Impending Cephalopelvic Disproportion in Nulliparous Women at Term: A Case Series." Journal of Pregnancy 2010 (2010): 1–5. http://dx.doi.org/10.1155/2010/708615.

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Background. The Active Management of Risk in Pregnancy at Term (AMOR-IPAT) protocol has been associated in several studies with significant reductions of group cesarean delivery rate. Present within each of these studies were nulliparous women with risk factors for cephalopelvic disproportion. Risk factors for cephalopelvic disproportion in nulliparous women are especially important because they represent the precursors for the most common indication for primary cesarean delivery.Cases. Three examples of exposure of urban nulliparous women to the AMOR-IPAT protocol are presented. Each woman's risk factor profile for Cephalopelvic Disproportion (CPD) was used to estimate her Upper Limit of Optimal Time of Vaginal Delivery for CPD (UL-OTDcpd). Labor management and clinical outcomes for each case are presented. A simple table summarizing induction rates and birth outcome rates of exposed versus nonexposed nulliparous women is also presented.Conclusion. Because the mode of delivery of the first birth substantially impacts birth options in later pregnancies, the impact of AMOR-IPAT on nulliparous patients is particularly important. Determining the UL-OTDcpd in nulliparous patients, and carefully inducing each patient who has not entered labor by her UL-OTDcpd, may be an effective way of lowering rates of cesarean delivery in nulliparous women.
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Ryazanova, Oksana V., Efim M. Shifman, Anna A. Olina, Yury S. Alexandrovich, Dzhaminat R. Medzhidova, Veronika O. Ezhova, and Igor Yu Kogan. "Application of enhanced recovery after cesarean delivery. A review." Journal of obstetrics and women's diseases 70, no. 6 (December 15, 2021): 127–38. http://dx.doi.org/10.17816/jowd65171.

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Caesarean section is the most common surgical intervention over the world, so the development of the enhanced recovery after cesarean delivery is turning out to be a vital problem. The practical application of the enhanced recovery after cesarean requires multidisciplinary collaboration and well-coordinated teamwork of an anesthesiologist, an obstetrician-gynecologist, nursing staff and other specialists. In this review, we have studied recent domestic and foreign articles dedicated to the enhanced recovery after cesarean. Particular attention was paid to the case management at all stages of the perioperative period, especially preoperative preparation, postoperative care and womens awareness raising. The presented studies included such program criteria as avoidance of prolonged preoperative fasting accompanied by early postoperative feeding, early breastfeeding attachment of the newborn, the use of multimodal analgesia in the postoperative period, the early activation of the postoperative patient, and the minimization of the detention period of hospital stay. The reviewed articles indicated the positive impact of this program on maternal and newborn outcomes and demonstrated the need for detailed further study of several issues and standardization of the enhanced recovery after cesarean methods.
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Wu, Michael, Jennifer Tang, Nicole Etherington, Mark Walker, and Sylvain Boet. "Interventions for improving teamwork in intrapartum care: a systematic review of randomised controlled trials." BMJ Quality & Safety 29, no. 1 (October 10, 2019): 77–85. http://dx.doi.org/10.1136/bmjqs-2019-009689.

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BackgroundThe labour and delivery environment relies heavily on interdisciplinary collaboration from anaesthesiologists, obstetricians and nurses or midwives to deliver optimal patient care. A large number of adverse events in obstetrics are associated with failure in communication and teamwork among team members, with substantive consequences. The objective of this study is to perform a systematic review of interventions aimed at improving teamwork in obstetrics.MethodsThis systematic review identified and assessed randomised controlled trials (RCTs) of interventions aimed at improving teamwork among interdisciplinary teams in obstetrical care. Medline, CENTRAL, CINAHL and Embase were searched for studies evaluating one of: patient outcomes, team performance or processes of clinical efficiency. Identified citations were reviewed in duplicate for eligibility.ResultsNine RCTs met the inclusion criteria; five of these RCTs were conducted under simulated clinical environments. Simulation-based teamwork training interventions were the most represented (n=7 studies, 3047 healthcare providers (HCPs), 107 782 births), followed by checklists (n=1 study, 136 HCPs) and an electronic-based decision support tool (n=1 study, 296 HCPs). Simulation-based teamwork training was found to improve team performance in 100% of relevant studies (3 of 3 studies assessing team performance) and patient morbidity in 75% of relevant studies (3 of 4 studies assessing patient morbidity). However, no direct mortality benefit was identified among all the studies reviewed. Studies were assessed to be of low-moderate quality and had significant limitations in their study designs.ConclusionWhile the evidence is still limited and from low to moderate quality RCTs, simulation-based teamwork interventions appear to improve team performance and patient morbidity in labour and delivery care.PROSPERO Trial registration numberCRD42018090452
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Dissertations / Theses on the topic "Delivery (Obstetrics) Case studies"

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Mitchell, Veronica. "The curriculum in medical education: a case study in Obstetrics related to students' delivery experience." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/12062.

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In this research project, the small sample of students displays varying experiences as they engage in the practical curricular tasks in Obstetrics. Their responses indicate the challenges they face which are exacerbated by uncertainty particularly when the university’s chosen values contrast with those confronted in the broader context in which any curriculum operates.
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Poku, Alfred Boateng 1974. "Decentralization and health service delivery : Uganda case study." Thesis, Massachusetts Institute of Technology, 1998. http://hdl.handle.net/1721.1/69394.

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Gyogluu, Sylvester Yinubah. "Infrastructure delivery in rapidly urbanising communal lands : case studies in Ghana." Thesis, Cape Peninsula University of Technology, 2006. http://hdl.handle.net/20.500.11838/1448.

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Thesis (MTech (Town and Regional Planning))--Cape Peninsula University of Technology, Cape Town, 2006
The research focuses on urbanising communities in the peri-urban areas of the Tamale Metropolitan Area (TAMA) of Ghana and the inability of the urban authorities to provide adequate basic infrastructure services. Using a mix of qualitative and quantitative research approaches, the author observed that the development planning paradigms practiced over the years placed urban planning and service delivery in a centralised paradigm which cannot respond adequately to the increasing pressures of urbanisation, nor offer opportunities for the involvement of communities due to this top-down planning approache. The research in fact identified that the communities, through their own initiatives have planned and executed service projects to improve their lives in some respects where the TAMA has failed. The communities have achieved this due to their spirit of social solidarity, self-help and communalism built around their traditional chiefs, which incorporates some of the principles of Local Agenda 21. The TAMA sees this development as an opportunity to henceforth forge collaboration and partnerships with the traditional authorities for improved service delivery in the urbanising communities. This represents innovative urban planning and management approaches, which in the context of low-income urban communities, includes participatory planning and service delivery. These innovative approaches have been initiated in the Habitat Agenda emanating from the UN Conference on Human Settlements in 1996. The study advocates the concept of sustainable development and Agenda 21, as a working model which presents a participatory and integrative process for local authorities and communities to work towards urban improvements. The Local Agenda 21 planning approach, it is argued, will integrate and strengthen the already existing local community initiatives and provide a basis for partnerships and improved service delivery. The case - studies examined are the Tamale Metropolitan Area and the peri-urban settlements Jusonayili and Gumah.
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Lukito, Lastyo Kuntoaji 1972. "Water service delivery in Indonesia : the case study of Greater Bandung." Thesis, Massachusetts Institute of Technology, 2000. http://hdl.handle.net/1721.1/68363.

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Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2000.
Includes bibliographical references (leaves 90-91).
Greater Bandung Area in Indonesia have taken the lead in a City Development Strategy (CDS) exercise. This exercise is supported by the World Bank and the government of Japan, and is partly aimed to improve urban planning and management capabilities of the local governments to ensure more efficient utilization of available resources. The exercise has identified water service delivery as a focus sector, thus creating the setting and background for this thesis research. Various problems faced by the two water companies (the PDAMs) in providing water service delivery to Greater Bandung are common in most PDAMs in Indonesia, leading to weak performance in water provision. The elements of substandard performance include low level of service coverage, poor reliability, low water production and the inability to meet current and future demands. Underlying these problems is a variety of technical, structural and procedural problems. These include inadequate water resource management, operation and maintenance problems (i.e. water production and unaccounted for water), and weak financial and human resource management. This study also identifies a series of legal, institutional and political factors that affect the ability and incentive for PDAMs to perform well. The alternatives to improve water service delivery in Greater Bandung involve implementation of technical reforms, management reforms and capacity building, and institutional reforms. Technical reforms include reforms in water resource management and in operations and maintenance. Management reforms include financial and human resource capacity building. Institutional restructuring, political reforms, private sector participation and improving investment strategies, are among the most important institutional reforms. Design and implementation of these reforms must be consistent with the decentralization policy that is currently evolving in Indonesia, a focal point of the CDS exercise.
by Lastyo Kuntoaji Lukito.
M.C.P.
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Ski, Samantha M. "Diffusion and Adoption of Policies for the Prevention of Mother-to-Child Transmission of HIV (PMTCT) and their Effect on the Delivery of Key PMTCT Services in Eastern and Southern Africa." Thesis, The George Washington University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10145741.

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With the goal of eliminating mother-to-child transmission by 2015, a wide range of governmental and other efforts within low- and middle-income countries have sought to provide services for the prevention of mother-to-child transmission of HIV (PMTCT) to the estimated 1.2 million pregnant women in need. In support of this goal, the World Health Organization (WHO), as the leading normative international body in the area of evidence-based clinical guidelines, issued policy recommendations on the use of antiretroviral drugs for PMTCT. Through various mechanisms, including guidance notes and dissemination workshops, WHO supports countries to adopt and adapt the guidelines within their national policy frameworks. Through three analyses, this dissertation examines the diffusion of WHO PMTCT guidelines in five Eastern and Southern African countries over a 16-year period (1998-2013) and estimates the effect of PMTCT policy adoption on delivery of key services.

The first analysis of the adoption of specific PMTCT guideline updates between 1998 and 2013 seeks to ascertain which internal factors may explain why and when countries decided to adopt new technical guidance. The policy analysis shows that the five countries adopted a majority of the key international PMTCT technical guidance updates. It can be concluded that international to national policy diffusion was taking place and that national policies converged to be more similar and more in line with international guidelines over the time period studied. Variation in adoption and in the internal determinants at play in each country was minimal, making it difficult to assess the influence of determinants qualitatively. The three internal determinants that appeared to most influence adoption of key PMTCT updates were: 1) the severity of the MTCT problem 2) governance effectiveness, and 3) prior PMTCT policy adoption. The lag between adoption and implementation in these countries is discussed. The findings indicate that in the countries studied, policies promoted by WHO and other international bodies can play a critical role in supporting national policy adoption for program advancement in the area of PMTCT.

The second and third analyses investigate whether the completeness of a country’s body of PMTCT-supporting policies was associated with the delivery of two key PMTCT services – the offer of an HIV test and the receipt of HIV counseling as a part of antenatal care (ANC) – in four of the five countries included in the first analysis. Two nationally representative surveys per country were used to conduct a quasi-experimental fixed-effects analysis of the role of policy in predicting a woman’s probability of being offered an HIV test or receiving HIV counseling in ANC, controlling for other key individual- and country-level covariates.

According to the ‘testing’ model, a one-unit increase in policy score was associated with a 0.042 (p<0.000) increase in the probability that a woman was offered an HIV test as a part of antenatal care. According to the ‘counseling’ model, a one-unit increase in policy score was associated with a 0.014 (p<0.001) increase in the probability that a woman received HIV counseling as a part of antenatal care. In both the testing and counseling models, the policy/education interaction was statistically significant in the final model, with a greater policy effect estimated at among those with higher education levels. Time statistically significantly influenced the probability of the outcome, as did government health spending, governance effectiveness, and donor health spending. Further study is needed to identify the policy elements that have the most impact on improving service delivery.

The three analyses presented here support the premise that international health policies influence national-level policy adoption, and that national-level policy adoption in turn influences national service outputs. As countries and their development partners mobilize for the Sustainable Development Goal era, policy adoption at the international level will continue to be an important influence in national policy adoption in the area of PMTCT. This research has described a number of potential internal and external determinants that will influence national adoption in this next round of global health policy advocacy. Looking forward, this study shows that countries and their development partners should continue to invest in the work of policy adoption to complement other efforts to reach health goals, including increased government health spending.

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Heslop, Liza. "An ethnography of patient and health care delivery systems : dialectics and (dis)continuity." Monash University, Faculty of Education, 2001. http://arrow.monash.edu.au/hdl/1959.1/8764.

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Yadoo, Annabel Leonie. "Delivery models for decentralised rural electrification : case studies in Nepal, Peru and Kenya." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610203.

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Coffee, Joyce E. (Joyce Elena) 1971. "Innovations in municipal service delivery : the case of Vietnam's Haiphong Water Supply Company." Thesis, Massachusetts Institute of Technology, 1999. http://hdl.handle.net/1721.1/65250.

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Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1999.
Includes bibliographical references (p. 63-67).
This thesis describes a state owned municipal water supply service company, the Haiphong Water Supply Company (HPWSCo), that improved its service delivery and successfully transformed itself into a profit making utility with metered consumers willing to pay for improved service. The thesis examines how HPWSCo tackled the typical problems of a developing country's municipal water supply company and succeeded in the eyes of the consumers, the local and national governments, and the wider development community. The thesis describes how and under what conditions HPWSCo has changed itself from a poorly performing utility to a successful one. It explores the characteristics of the local level service delivery 'ward model' that underpin HPWSCo's success, including: the structure of the ward water supply sub offices; the local procedures for responding to consumer need; and the management of local employees in a way that motivates exemplary performance. The thesis examines how HPWSCo used existing resources and scaled-out improvements ward by ward, learning lessons for subsequent ward enhancements. By focusing on what HPWSCo did the thesis attempts to illustrate the reform strategy of a government agency (state owned enterprise) previously riddled with problems and poor performance that became much more effective and efficient.
by Joyce E. Coffee.
M.C.P.
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Mathema, Ashna S. (Ashna Singh) 1972, and Nayana N. 1972 Mawilmada. "Decentralization and housing delivery : lessons from the case of San Fernando, La Union, Philippines." Thesis, Massachusetts Institute of Technology, 2000. http://hdl.handle.net/1721.1/68798.

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Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2000.
Includes bibliographical references (p. 140-147).
In this thesis, we argue that national policies (of housing and decentralization) when applied indiscriminately, without regard to the political, institutional, and capacity constraints of local governments, can have negative consequences, and sometimes end up being a regressive. This is particularly true when policies, designed in response to problems of large metropolitan areas, are applied randomly across entire nations. Our study analyzes the housing sector of the city of San Fernando, in the La Union Province of the Philippines, to draw lessons about the constraints that decentralized local government units face in practice. Our findings support the arguments for the differential treatment of local governments, in the implementation decentralization and housing policies. The Philippines decentralized its governance structure in 1991, with the passage of the Local Government Code. With this law, the responsibility of implementing housing projects was devolved to the local government level. Soon thereafter, in 1992, the Urban Development and Housing Act (UDHA) was adopted with the intent of transforming the role of government in the housing sector from that of a "provider" to one of an "enabler." These reforms have been hailed as successful and revolutionary by many. Our findings challenge the alleged success of efforts to decentralize the housing sector of the Philippines. We found a conflict between some of the policies set forth in the Local Government Code and the UDHA. This conflict, combined with the limited technical and administrative capacity of local government units, such as that of San Fernando, are resulting in the implementation of housing projects reminiscent of the failed public housing schemes of the 1950s and 1960s. Through our analysis of the case, we identify the various political, social, administrative, and institutional limitations that constrain the local government of San Fernando in its approach to the housing sector. Our study suggests ways to deal with these constraints, and highlights the need for the differential treatment of local governments, in order to successfully implement decentralization, and other policy reforms in the developing world.
by Ashna S. Mathema and Nayana N. Mawilmada.
M.C.P.
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Yin, Xiaoqi. "Resource Allocation in Smart Infrastructure: Case Studies in Video Delivery and Electric Power Networks." Research Showcase @ CMU, 2016. http://repository.cmu.edu/dissertations/861.

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Resource allocation schemes play an important role in large-scale smart infrastructures to ensure efficiency and fairness among users. However, designing good resource allocation schemes is challenging due to technical limitation, policy barriers, and cost of change. The goal of this thesis is to develop a methodology to design model-based, principled and practical resource allocation schemes. Given the diverse characteristics of infrastructures, it is difficult to design unified models and algorithms. Instead, we employ a case-study-based approach on two representative smart infrastructures: Internet video delivery and electric power networks. We further generalize the insights and develop a principled qualitative guideline to design resource allocation schemes in smart infrastructures. The Internet video delivery system employs a protocol-based resource allocation scheme: network bandwidth is implicitly allocated by transport layer protocol (TCP) while client- side video players adapt video quality based on application layer protocol (MPEG-DASH) to optimize users quality of experience (QoE).We study 1) how client-side video players improve users QoE by employing Model Predictive Control-based bitrate adaptation algorithms and 2) how to achieve multiplayer QoE fairness by router-side bandwidth allocation policies. We prototype and evaluate the algorithms in real video players. On the other hand, market-based schemes are adopted in real-time economic dispatch in electric power systems to satisfy demand by lowest-cost generation. However, such schemes can lead to power imbalances and market inefficiency when slow generators fail to follow system operators command. We study 1) how system operators can mitigate power imbalance by employing a centralized, two-stage robust dispatch and 2) how the market design can be improved by penalizing non-complying generators. Based on the lessons from the case studies, we develop a general methodology to design resource allocation schemes: First, develop a formal model capturing system objectives, dynamics, and constraints; Second, identify key practical constraints that have major impact on the choice of schemes; Finally, design model-based schemes that respect practical constraints for short-term and obtain insights to inform protocol or market improvement in the long run. We envision that a mathematical theory can significantly improve the future resource allocation ecosystems.
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Books on the topic "Delivery (Obstetrics) Case studies"

1

Near breathing: A memoir of a difficult birth. Pittsburgh, PA: Duquesne University Press, 1997.

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K, Neff Raymond, ed. Labor and delivery: Impact on offspring. Littleton, Mass: PSG Pub. Co., 1987.

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Miller, John B. Case Studies in Infrastructure Delivery. Boston, MA: Springer US, 2002.

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Miller, John B. Case Studies in Infrastructure Delivery. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3.

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Case studies in infrastructure delivery. Boston, MA: Kluwer, 2002.

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Beall, Marie H. Lippincott's obstetrics case-based review. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2011.

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Case presentations in obstetrics and gynaecology. Oxford: Butterworth-Heinemann, 1991.

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J, Steer Philip, and Woolfson Julian, eds. 100 case histories in obstetrics and gynaecology. Edinburgh: Churchill Livingstone, 1991.

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Arzou, Ahsan, ed. Obstetrics & gynecology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2007.

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C, Toy Eugene, ed. Case files. 3rd ed. New York: McGraw-Hill Medical, 2009.

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Book chapters on the topic "Delivery (Obstetrics) Case studies"

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Miller, John B. "Bridging the Golden Gate: Outsourcing to a New Public Entity." In Case Studies in Infrastructure Delivery, 1–14. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_1.

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Miller, John B. "Indianapolis Wastewater Treatment Works." In Case Studies in Infrastructure Delivery, 163–78. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_10.

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Miller, John B. "The Superaqueducto Project—Puerto Rico." In Case Studies in Infrastructure Delivery, 179–92. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_11.

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Miller, John B. "Managed Public/Private Competition for Waste Water Treatment Works." In Case Studies in Infrastructure Delivery, 193–209. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_12.

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Miller, John B. "The Strategic Goals of Public Infrastructure Procurement: Wilmington Delaware Wastewater Treatment Procurement." In Case Studies in Infrastructure Delivery, 211–31. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_13.

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Miller, John B. "The Strategic Goals of Public Infrastructure Procurement: Massachusetts Water Resources Authority." In Case Studies in Infrastructure Delivery, 233–50. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_14.

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Miller, John B. "Tolt River Water Treatment Project." In Case Studies in Infrastructure Delivery, 251–62. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_15.

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Miller, John B. "The Dulles Greenway." In Case Studies in Infrastructure Delivery, 15–31. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_2.

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Miller, John B. "International Arrivals Building at John F. Kennedy International Airport." In Case Studies in Infrastructure Delivery, 33–51. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_3.

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Miller, John B. "The SR 91 Express Lanes." In Case Studies in Infrastructure Delivery, 53–70. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0923-3_4.

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Conference papers on the topic "Delivery (Obstetrics) Case studies"

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Mukherjee, Nandini, Suman Sankar Bhunia, and Sunanda Bose. "Virtual Sensors in Remote Healthcare Delivery: Some Case Studies." In 9th International Conference on Health Informatics. SCITEPRESS - Science and and Technology Publications, 2016. http://dx.doi.org/10.5220/0005823204840489.

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Baumgartner, Ilse, and Venky Shankararaman. "Case studies in computing education: Presentation, evaluation and assessment of four case study-based course design and delivery models." In 2014 IEEE Frontiers in Education Conference (FIE). IEEE, 2014. http://dx.doi.org/10.1109/fie.2014.7044194.

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Marsh, Jack, and Joseph Kenny. "Wildcat Hills Gas Gathering System Case Studies: An Integrated Approach From Reservoir Development Through to Sales Pipeline Delivery." In SPE Gas Technology Symposium. Society of Petroleum Engineers, 2002. http://dx.doi.org/10.2118/75698-ms.

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Krywiak, Dave, Werner Kiefer, David Arnold, and Kirstine Hull. "Two Case Studies of Trenchless Technologies in the Urban Environment." In 2004 International Pipeline Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/ipc2004-0683.

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In 1998, EPCOR undertook an inspection program on the condition of 14 of their underground high voltage transmission lines where they crossed the riverbed of the North Saskatchewan River within the City of Edmonton. Based on the findings of this investigation, it was determined that two of the river crossings were at serious risk of mechanical damage. It was decided that they would be replaced by horizontal directional drilling (HDD) methods, at a sufficient depth into the bedrock below the river bottom to remove any risk of failure due to mechanical damage. This paper examines all phases of the work carried out from project inception to construction of the two crossings, first in the spring of 2003 and then in the dead of winter of 2004. Some of the technical considerations inherent in the design of the HDD installations included geotechnical concerns with potential drilling fluid frac-out and slope stability, as well as heat dissipation rates and operating constraints of the 72 kV oil-filled pipe type high voltage cables. This paper will focus on project constraints imposed by the existing urban (park and residential) locations, community and stakeholder concerns and the regulatory and approval requirements of three levels of government. In addition to the necessary geotechnical investigations, other investigations included addressing potential impacts on the river, vegetation, wildlife, archaeological, noise and construction concerns. An extensive public communications program was completed that included a number of open houses, delivery of construction notices to all surrounding residences, meetings with community league executives and other stakeholder groups. The paper will describe the challenges that the project team faced and how they were overcome and the amount of time and effort that went in to meeting those challenges. The paper will end with a discussion of the costs and time frames required to complete such a project.
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Smiarowski, Michael. "Fossil Steam Turbine Upgrades/Modernizations: Case Studies of Recently Completed Projects and the Industry Challenges Moving Forward." In ASME 2008 Power Conference. ASMEDC, 2008. http://dx.doi.org/10.1115/power2008-60118.

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Siemens Power Generation has recently completed a number of first time applications of Steam Turbine modernizations on its OEM fleet. This paper will discuss the R&D approach taken in developing these first-time solutions to help achieve and focus on case studies of completed projects that demonstrate the end result of this approach. Projects planned to be discussed are modernizations implemented in the last year (2007–2008) of a VHP/HP turbine steam path replacement, a full element HP/IP replacement, and applications on large fossil LP turbine replacements. Current industry challenges that will be discussed include resource constraints in engineering, material supply chain, and factory delivery slots that are escalating prices and increasing delivery times of replacement turbine equipment. Some of the actions the author’s company is taking to mitigate these issues, such as gaining earlier commitments, use of material indices, and others will be discussed to help utilities looking at undertaking a turbine modernization gain a better insight into vendor challenges.
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Keevy, Monique. "Effectiveness of delivery methods in the transfer of soft skills." In Sixth International Conference on Higher Education Advances. Valencia: Universitat Politècnica de València, 2020. http://dx.doi.org/10.4995/head20.2020.10994.

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Accounting education has in recent years increasingly emphasised the need for developing soft skills. To this end, various delivery methods have been advocated other than the conventional lecture format during the academic programme. This paper reports on a study of the perceptions of graduates on the effectiveness of delivery methods during the academic programme in transferring soft skills. A questionnaire with open and closed-ended questions was administered. Graduates reported that soft skills were most effectively developed when using case studies, followed by collaborative learning. Surprisingly, graduates also indicated lectures as an effective method in soft skills development, by ranking this method after collaborative learning. However, the method of computer-based activities, was reported as the least effective method in developing soft skills. This is a concern, given the prevalence and use of computers and technology in the accounting profession. Educators need to do more in inculcating soft skills, by using additional methods such as mentorship programmes and self-assessment.
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Barreto, Carolina V., Hamidreza Karami, Eduardo Pereyra, and Cem Sarica. "Effect of Surfactant (Foamer) Delivery Location on Horizontal Wells Deliquification." In ASME 2017 Fluids Engineering Division Summer Meeting. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/fedsm2017-69512.

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One of the methods to unload liquid from gas wells is foam-assisted lift. The applied surfactant reduces the liquid surface tension facilitating foam stability, and consequently, reducing mixture density and gas slippage. In this experimental study, a 2-in ID facility consisting of a 64-ft lateral section followed by a 41-ft vertical section is used to determine the optimum surfactant delivery location in horizontal wells. Water and compressed air are the liquid and gas phases, and an anionic surfactant is applied continuously with fixed concentration. Lateral section inclination is varied between ±1°, and four injection points are tested, including one with a static mixer, used as an external source of agitation. Recorded parameters are flow pattern, pressure gradient, liquid holdup, and foam quality. In the lateral section, the highest efficiency is obtained by using a static mixer causing significant drop in liquid holdup and increase in pressure drop due to frictional losses. All other injection points show similar behavior to the air-water case, due to negligible generated foam amid the existing flow pattern agitation. In the vertical section, all injection points show similar and significant drops in liquid holdup and delays in liquid loading onset compared to air-water case, and foam quality decreases as gas flow rate is reduced. Increasing the liquid flow rate causes increases in liquid holdup and pressure drop and shifts liquid loading onset to higher gas flow rates. The experimentally observed liquid loading onset is compared to the predictions of Turner et al. (1969), and a modification is proposed in this correlation to consider the effects of surfactant injection. The number of experimental studies investigating foam effects on liquid loading is limited especially for off-vertical configurations. The results of this study provide an experimental source to optimize foam lift in deviated wells.
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Ley, Obdulia, and Yildiz Bayazitoglu. "The Effect of Hypothermia on the Oxygen Delivery to Cerebral Tissue: Analysis Using a Compartmental Model." In ASME 2004 International Mechanical Engineering Congress and Exposition. ASMEDC, 2004. http://dx.doi.org/10.1115/imece2004-60733.

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This paper studies the effect of temperature in the cerebral oxygen absorption and delivery using a compartmental model of oxygen transport which introduces the temperature dependence of factors such as the cerebral blood flow, the oxygen dissociation curve, and the tissue metabolic activity. The variations of the oxygen delivered to the tissue for the case of normoxia and hypoxia are studied, as well as the tissue oxygen delivery during different cooling strategies. The goal of the present study is to understand the effects of temperature in the oxygen uptake, and to determine a safe temperature limits for hypothermic treatment maximizing tissue oxygen delivery. From the calculations it is seen that the oxygen content falls in the vascular and tissue compartments during hypothermia and that this effect is aggravated by hypoxia.
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Zauma, Luthfia, Uki Retno Budhiastuti, and Eti Poncorini Pamungkasari. "The Associations between Cigarette Smoke Exposure, Family History of Infertility, and the Risk of Infertility among Women in Reproductive Age, in Surakarta, Central Java." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.97.

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ABSTRACT Background: Previous studies suggest that tobacco use affects systems of the human body involved in the reproductive process. Tobacco smoke exposure affects uterine receptivity, which may lead the risk of infertility. This study aimed to investigate the associations between cigarette smoke exposure, family history of infertility, and the risk of infertility among women in reproductive age. Subjects and Method: A case control study was conducted at obstetrics and gynecology polyclinic and Sekar fertility clinic, in Dr. Moewardi hospital, Surakarta, Central Java, from October to November 2019. A sample of 200 reproductive age women was selected by fixed disease sampling. The dependent variable was infertility. The independent variables were age, body mass index (BMI), physical activity, endometriosis, family history of infertility, smoking exposure, and stress. The data were obtained from medical record and questionnaire. The data were analyzed by a multiple linear regression. Results: The risk of infertility increased with age ≥35 years (b= 1.24; 95% CI= 0.18 to 2.30; p= 0.012), BMI <18 or ≥25 (b= 2.76; 95% CI= 1.74 to 3.76; p<0.001), high physical activity (b= 1.44; 95% CI= 0.38 to 2.51; p= 0.009), endometriosis (b= 1.06; 95% CI= 0.06 to 2.05; p= 0.038), tobacco smoke exposure (b= 1.37; 95% CI= 0.30 to 2.43; p= 0.012), and severe stress (b= 1.07; 95% CI= 0.16 to 2.00; p= 0.022). Conclusion: The risk of infertility increases with age ≥35 years, BMI <18 or ≥25, high physical activity, endometriosis, smoke exposure, and severe stress. Keywords: infertility, women of reproductive age Correspondence: Luthfia Zauma. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: el.chizauma@gmail.com. Mobile: 081337977377. DOI: https://doi.org/10.26911/the7thicph.03.97
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Leong, Kristor J. K., Abdullah Aamir Hayat, Lim Yi, Mohan R. Elara, and Elangovan Karthikeyan. "Iterations in Design and Development Process Illustrated Using Reconfigurable Robot Case Study." In ASME 2022 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/detc2022-89857.

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Abstract Iterations in design is ubiquitous to drive constant innovation in the pursuit of excellence in product development, service delivery, systems, and subsystems integration. Within a given time frame of a design process, iteration can occur at different scales, forms, types, etc. Iteration was highlighted recently in the innovation framework using the four ‘D’s design scheme, i.e., Discover, Define, Develop, and Deliver. Iteration studies generally focus on its occurrence, modeling, classification, methods, and impact, among others, in the domain of software development, service providing, aesthetics, and functionality. However, aspects of an iteration involving complex systems like a reconfigurable system become more intriguing because of its overall morphology with changing features and the coupled design of several subsystems. This paper reports on the various factors influencing iteration and are illustrated using a case study of the development of a reconfigurable robotic system named Panthera and its subsystems designed for cleaning and maintenance tasks. The case study of Panthera is reported from its initial ideation phase to the three versions development over a span of three years. Following the journey of the system design of Panthera, it details the timeline, rationale, and insight into the iterative processes and how they are applied to the individual subsystems in consecutive design iterations. With no one solution that fits all approaches to the topic, we aim to highlight and stimulate concepts to aid designers in the design iteration.
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Reports on the topic "Delivery (Obstetrics) Case studies"

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Handayani, Sri Wening, Michelle Domingo-Palacpac, Peter Lovelock, and Clifford Chi Burkley. Improving the Delivery of Social Protection through ICT: Case Studies in Mongolia, Nepal, and Viet Nam. Asian Development Bank, November 2017. http://dx.doi.org/10.22617/wps179135-2.

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Fouad, Fouad H., Robert W. Peters, Virginia P. Sisiopiku, Andrew J. Sullivan, Jerry Gillette, Amgad Elgowainy, and Marianne Mintz. Global Assessment of Hydrogen Technologies – Tasks 3 & 4 Report Economic, Energy, and Environmental Analysis of Hydrogen Production and Delivery Options in Select Alabama Markets: Preliminary Case Studies. Office of Scientific and Technical Information (OSTI), December 2007. http://dx.doi.org/10.2172/923760.

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Mwamba, Isaiah C., Mohamadali Morshedi, Suyash Padhye, Amir Davatgari, Soojin Yoon, Samuel Labi, and Makarand Hastak. Synthesis Study of Best Practices for Mapping and Coordinating Detours for Maintenance of Traffic (MOT) and Risk Assessment for Duration of Traffic Control Activities. Purdue University, 2021. http://dx.doi.org/10.5703/1288284317344.

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Maintenance of traffic (MOT) during construction periods is critical to the success of project delivery and the overall mission of transportation agencies. MOT plans may include full road closures and coordination of detours near construction areas. Various state DOTs have designed their own manuals for detour mapping and coordination. However, very limited information is provided to select optimal detour routes. Moreover, closures or detours should provide not only measurable consequences, such as vehicle operating costs and added travel time, but also various unforeseen qualitative impacts, such as business impacts and inconvenience to local communities. Since the qualitative aspects are not easily measurable they tend to be neglected in systematic evaluations and decision-making processes. In this study, the current practices obtained based on an extensive literature review, a nation-wide survey, as well as a series of interviews with INDOT and other state DOTs are leveraged to (1) identify a comprehensive set of Key Performance Indicators (KPIs) for detour route mapping, (2) understand how other state DOTs address the qualitative criteria, (3) identify how the involved risks during the planning, service time, and closure of the detour routes are managed, and (4) recommend process improvements for INDOT detour mapping guidelines. As demonstrated by two sample case studies, the proposed KPIs can be taken as a basis for developing a decision-support tool that enables decision-makers to consider both qualitative and quantitative aspects for optimal detour route mapping. In addition, the current INDOT detour policy can be updated based on the proposed process improvements.
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Beach, Rachel, and Vanessa van den Boogaard. Tax and Governance in the Context of Scarce Revenues: Inefficient Tax Collection and its Implications in Rural West Africa. Institute of Development Studies (IDS), February 2022. http://dx.doi.org/10.19088/ictd.2022.005.

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In recent years, domestic and international policy attention has often focused on broadening the tax base in order to include a greater share of the population in the ‘tax net’. This is based, in part, on the hope that the expansion of taxation will result in positive ‘governance dividends’ for taxpayers. However, the implications of extending the tax base in rural areas in low-income countries has been insufficiently considered. Through the case studies of Togo, Benin, and Sierra Leone, we demonstrate that extending taxation to rural areas is often highly inefficient, leading to few, if any, revenue gains when factoring in the costs of collection. Where revenues exceed the costs of collection, they often only cover local government salaries with little remaining for the provision of public goods and services. The implications of rural tax collection inefficiency are thus significant for revenue mobilisation, governance and public service delivery, accountability relationships with citizens, and taxpayer expectations of the state. Accordingly, we question the rationale for extending taxation to rural citizens in low-income countries. Instead, we argue for a reconceptualisation of the nature of the fiscal social contract, disentangling the concept of the social contract from the individual. Rather, a collective social contract places greater emphasis on the taxation of wealth and redistribution and recognises that basic rights of citizenship are not, or should not, be contingent on paying direct taxes to the government. Rather than expanding taxation, we argue for the expansion of political voice and rights to rural citizens, through a ‘services-first’ approach.
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Muhoza, Cassilde, Wikman Anna, and Rocio Diaz-Chavez. Mainstreaming gender in urban public transport: lessons from Nairobi, Kampala and Dar es Salaam. Stockholm Environment Institute, May 2021. http://dx.doi.org/10.51414/sei2021.006.

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The urban population of Africa, the fastest urbanizing continent, has increased from 19% to 39% in the past 50 years, and the number of urban dwellers is projected to reach 770 million by 2030. However, while rapid urbanization has increased mobility and created a subsequent growth in demand for public transport in cities, this has not been met by the provision of adequate and sustainable infrastructure and services. The majority of low-income residents and the urban poor still lack access to adequate transport services and rely on non-motorized and public transport, which is often informal and characterized by poor service delivery. Lack of access to transport services limits access to opportunities that aren’t in the proximity of residential areas, such as education, healthcare, and employment. The urban public transport sector not only faces the challenge of poor service provision, but also of gender inequality. Research shows that, in the existing urban transport systems, there are significant differences in the travel patterns of and modes of transport used by women and men, and that these differences are associated with their roles and responsibilities in society. Moreover, the differences in travel patterns are characterized by unequal access to transport facilities and services. Women are generally underrepresented in the sector, in both its operation and decision-making. Women’s mobility needs and patterns are rarely integrated into transport infrastructure design and services and female users are often victims of harassment and assault. As cities rapidly expand, meeting the transport needs of their growing populations while paying attention to gender-differentiated mobility patterns is a prerequisite to achieving sustainability, livability and inclusivity. Gender mainstreaming in urban public transport is therefore a critical issue, but one which is under-researched in East Africa. This research explores gender issues in public transport in East Africa, focusing in particular on women’s inclusion in both public transport systems and transport policy decision-making processes and using case studies from three cities: Nairobi, Kampala and Dar es Salaam.
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.

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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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Estimating costs of post-abortion services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico. Population Council, 1999. http://dx.doi.org/10.31899/rh1999.1011.

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Health care systems around the world are facing problems providing quality care with increasingly constrained resources. While modern practices and diagnostic tests have made pregnancy a much less risky event than in the past, not all pregnancies have a favorable outcome. Spontaneous abortion occurs in 15–45% of all known pregnancies, and studies show that 25% of all obstetric/gynecology hospital admissions are for incomplete abortion. Given the high level of resources devoted to treating this condition, it is imperative to develop cost-effective methodologies to provide quality care. Unsafe abortion performed by untrained and inexperienced providers is the fourth leading cause of maternal mortality in Mexico. Strengthening the capacity of health care institutions to provide high-quality post-abortion care services that are cost-effective, accessible, and sustainable is a major public health objective. To improve its service-delivery model, the Aurelio Valdivieso General Hospital in Oaxaca implemented a redesigned service model for women seeking care for incomplete abortion. The study detailed in this report assesses the cost and quality implications of this new service model.
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