Compliance with venous thromboembolism guideline after delivery at Maternity Teaching Hospital, Erbil city, Iraq

Background and objective: Venous thromboembolism is a leading cause of maternal morbidity and mortality. Few published articles have evaluated obstetricians' compliance with thromboprophylaxis guidelines, especially after vaginal delivery. This study aimed to assess obstetricians’ adherence to postpartum thromboprophylaxis guidelines and correlate adherence with the risk factors for venous thromboembolism after vaginal and cesarean delivery. Methods: A cross-sectional study involving 981 women delivered at the Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, was conducted. Obstetricians' compliance with the thromboprophylaxis guideline regarding dose, duration, and indications were recorded. We assessed the risk factors for thromboembolism using the 2015 Royal College of Obstetricians and Gynecologists guideline. Results: Medical thromboprophylaxis was required but not given to 93.2% of the women who delivered vaginally compared with 6.7% of the women who delivered by cesarean section. Women who delivered vaginally had a higher rate of age ˃ 36 years, parity of 3 and more, varicose vein, and current infection (P <0.001). The rates of preeclampsia, preterm labor, and prolonged labor were highest in the emergency cesarean section group (P <0.001). Factors associated with making a wrong decision were having no preeclampsia (odds ratio=15.4; 95% confidence interval=3.4–68.6), post-partum hemorrhage (odds ratio=15.3; 95% confidence interval=2.0–114.2), and vaginal delivery (odds ratio=250.2; 95% confidence interval=110.6–566.0). Conclusion: Obstetricians' compliance with postpartum thromboprophylaxis in the hospital was low, especially after vaginal delivery. Keywords: Thromboprophylaxis; Postpartum; Compliance; Venous thromboembolism; Guideline.

PONIŠTAJ ARBITRAŽNE ODLUKE DONETE OD STRANE AGENCIJE ZA MIRNO REŠAVANjE RADNIH SPOROVA

Word of the dispute is primarily associated with the intervention of the court. This is a traditional way of resolving labor disputes. The tendency in the world is to get as many of these disputes resolved peacefully, fast and fair manner at low cost. Avoiding court decision increases the chance of finding a favorable solution to the two opposing sides. The content of an arbitration agreement is of great importance to the parties in the arbitration proceedings. An arbitration agreement express the contractual freedom of the parties and list of facultative elements of an arbitration. Main benefits from peaceful solving labor disputes are expediency and cheap costs of the arbitration process. The arbitratior represents quasi – judicial instance and him may be wrong in his decision. The decision process is single and there is no possibility of appeal. This option would slow down the process of resolving issues. But, it can not be situation that would not be any way to void the wrong decision of the arbitratior. It could be chance to avoid this situation. Exactly because of that case, it must be provided for the possibility of annulment decision from peaceful settlment labor disputes agency. Reasons for cancellation must be a procedural character. Courts should not enter into the merits because it would further slow the troubleshooting. This would replicate the slowness of the trial in arbitration deciding. This length of proceedings before the courts is contary to the idea of arbitration as a quick, cheap, efficient and above all peacefull methods of resolving labor disputes. Court in relation to arbitration should have only a supervisory function. Blending the merits of arbitartion decisions would be deprived of independence and efficiency.

INTERACTIVE TECHNOLOGIES OF TRAINING TEACHERS FOR ORGANIZING LEISURE ACTIVITY

Features of preparation of future teachers for carrying out of interactive training technologies in the course of the organization of leisure activity in the conditions of rest in summer camps are examined. It is noted that various forms of leisure activities in the summer camp can support the emotional health of children, overcome their own shortcomings, form the will and character. Advice and methods for conducting the case method are given: selection of material (material should be selected in such a way as to reflect the problems that participants may face in real life); the availability of alternatives (the situation around which the discussion takes place should have been sufficiently diverse and have several solutions). The advantages of the case method are described: realism (the use of this method significantly complemented the theoretical aspects of the problem); pressure reduction (case method gave a unique opportunity to study complex or emotionally significant issues in a safe training atmosphere, not in real life, with real threats and risks in case of making the wrong decision); active interaction (communicative nature of the method provided an opportunity to provide a quick but very important assessment of the issues under discussion and the proposed solution). It is proved that interactive pedagogical technology in the process of organizing leisure activities of a person (as a set of a series of consecutive actions aimed at achieving a result) was based on the principles of voluntariness, positivity, responsibility, partnership.

A Random Stroll Amongst Anthony Trollope's Lawyers

Anthony Trollope (1815–1882) resides in the pantheon of nineteenth century English literature. While working full time in his postal position until 1867, he still managed to publish 47 novels, travel books, biographies, short stories, collections of essays, and articles on various topics. Trollope has been described as the novelist of the ordinary for his realistic description of English society. Law and legal issues flow through Trollope's fiction. The legal system held a special importance to him as the skeleton upholding the social and political framework of the country. Over one hundred lawyers appear in his work and eleven of his novels feature trials or hearings. The law intrigued and exasperated him. Along with the lawyers and legal issues he depicts are ideas of the law and legal system that are part of elaborate philosophical and jurisprudential traditions, which he recognized. This article examines Trollope's changing attitude toward lawyers. It describes the structure of the Bar in terms of class, status and reputation. Trollope believed the legal system should ensure justice, and those who labored in the law should be the vehicle of that pursuit. Justice for Trollope was the meting out of rewards and punishments as the consequence of a right or wrong decision. However, the law, as he depicted it, was often an impediment to this process, and lawyers were unreliable guides. Initially Trollope portrayed lawyers critically as caricatures as evinced by such names as Alwinde, O’Blather, Slow & Bideawhile, Haphazard, and Chaffanbrass. He was outraged that barristers (lawyers who appear in court) put loyalty to their clients ahead of the search for truth and justice. The adversary system was flawed as the enactment of laws in accord with the laws of nature assumes an inbuilt moral compass in humans that contains self-evident truths of right and wrong. Trollope felt there was no reason why a right-minded person could not intuitively recognize the truth, so criminal law's adversary system was unnecessary. The legal system sought not the discovery of the truth but was more interested in aiding the guilty defendant to escape punishment. As he matured as a writer and achieved success, Trollope's understanding and appreciation of the legal profession changed. He met and become friends with leaders of the Bar, and they influenced his descriptions of lawyers, who became realistic and often admirable human beings. Beyond the legal problems of its characters, Trollope's later novels incorporated the social, political, and jurisprudential issues of the times and engaged the Victorian legal culture in a broader sense of history, traditions, continuity and change. Natural law principles were challenged during the Victorian era by positivist notions that law is what the statute books say. These divisions lurk in the background of his later portraits of lawyers and the legal system. In his later period Trollope created a realistic characterization of the legal profession at the time that offered universal insights into human nature.

UK Research Ethics Committee’s review of the global first SARS-CoV-2 human infection challenge studies

This paper describes the UK Research Ethics Committee’s (REC) preparations and review of the global first SARS-CoV-2 human infection challenge studies. To frame our review, we used the WHO guidance and our UK Health Research Authority ethical review framework. The WHO criteria covered most issues we were concerned about, but we would recommend one further criterion directing RECs to consider alternative research designs. Could research questions be equally well answered by less intrusive studies? The committee met virtually, ensuring broad representation across the UK nations and also ensuring applicants could attend easily. We worked in collaboration with the applicants but while we recognise that such proximity might raise the accusation of ‘collusion’, we made every effort to maintain ‘moral distance’ and all decisions were made by the committee alone. Prior existing processes and policy facilitated training and review but even with this preparation, review took time and this could have hindered a rapid response to the emergency. Review for the various follow-on studies will now be speedier and once the pandemic has subsided, our group could be reconvened in future emergencies. In conclusion, we have tried to make decisions in good faith. We know there is controversy and disagreement and reasonable people may feel we have made the wrong decision. A more detailed analysis, built on the WHO guidance, is provided in online supplemental material.

The 5 Dimensions of Problem Solving using Dinna: Case Study in the Electronics Industry

Based on the principle that perfection is a divine criterion, process management exists on the one hand to achieve excellence (near perfection) and on the other hand to avoid imperfection. In other words, Operational Excellence (EO) is one of the approaches, when used rigorously, aims to maximize performance. Therefore, the mastery of problem solving remains necessary to achieve such performance level. There are many tools that we can use whether in continuous improvement for the resolution of chronic problems (KAIZEN, DMAIC, Lean six sigma…) or in resolution of sporadic defects (8D, PDCA, QRQC ...). However, these methodologies often use the same basic tools (Ishikawa diagram, 5 why, tree of causes…) to identify potential causes and root causes. This result in three levels of causes: occurrence, no detection and system. The research presents the development of DINNA diagram [1] as an effective and efficient process that links the Ishikawa diagram and the 5 why method to identify the root causes and avoid recurrence. The ultimate objective is to achieve the same result if two working groups with similar skills analyse the same problem separately, to achieve this, the consistent application of a robust methodology is required. Therefore, we are talking about 5 dimensions; occurrence, non-detection, system, effectiveness and efficiency. As such, the paper offers a solution that is both effective and efficient to help practitioners of industrial problem solving avoid missing the real root cause and save costs following a wrong decision.

The 5 Dimensions of Problem Solving using Dinna: Case Study in the Electronics Industry

Based on the principle that perfection is a divine criterion, process management exists on the one hand to achieve excellence (near perfection) and on the other hand to avoid imperfection. In other words, Operational Excellence (EO) is one of the approaches, when used rigorously, aims to maximize performance. Therefore, the mastery of problem solving remains necessary to achieve such performance level. There are many tools that we can use whether in continuous improvement for the resolution of chronic problems (KAIZEN, DMAIC, Lean six sigma…) or in resolution of sporadic defects (8D, PDCA, QRQC ...). However, these methodologies often use the same basic tools (Ishikawa diagram, 5 why, tree of causes…) to identify potential causes and root causes. This result in three levels of causes: occurrence, no detection and system. The research presents the development of DINNA diagram [1] as an effective and efficient process that links the Ishikawa diagram and the 5 why method to identify the root causes and avoid recurrence. The ultimate objective is to achieve the same result if two working groups with similar skills analyse the same problem separately, to achieve this, the consistent application of a robust methodology is required. Therefore, we are talking about 5 dimensions; occurrence, non-detection, system, effectiveness and efficiency. As such, the paper offers a solution that is both effective and efficient to help practitioners of industrial problem solving avoid missing the real root cause and save costs following a wrong decision.

Impact of Internet Integrated Financial Education on Students’ Financial Awareness and Financial Behavior

In daily life, most people engage in money-related behavior. Adequate financial knowledge is required to successfully manage tasks, such as daily expenditure and the transformation of assets or debts, small, or large. However, the extent of financial knowledge may vary between individuals. With inadequate financial knowledge, people may easily fall into financial difficulties without having sufficient knowledge to redress them. A total of 217 students from departments of finance in universities in Fujian completed an 18-week educational course delivered via the Internet on integrated financial education (5h per week for a total of 90h). The conclusions were as follows: (1) The Internet can be used to provide education on making ends meet, cutting costs, and increasing profits. It is suitable for beginner students and new graduates who are rapidly accumulating money management experience. (2) Knowledge provided in the course includes the causes of investment, comprehensive changes in the market, unexpected risks, and wrong decision-making. As such, education provided through the Internet can assist in the teaching of money management and investment. (3) Providing teaching on integrated financial education through the Internet avoids the pitfalls of getting lost in the real-world investment market. We expected to cultivate students’ finance-related knowledge, skills, and attitudes through internalization of the financial literacy of money management.

INFLUENCE OF THE ENVIRONMENT TO MAGGIE'S BEHAVIOR IN CRANE'S "MAGGIE: A GIRL OF THE STREET"

The purpose of this research Is to reveal the infiuence of the environment to Maggie's behavior In Crane's “Maggie: A Giri of the Streets”. In conducting this research, the writer uses qualitative research In which the data are in the form of words rather than numbers. In analyzing data, the writer uses objective and psychological approach. The data collected in this research from two sources, primary and secondary sources. Primary source is Crane's “Maggie: A Girl of the Streets” and secondary source are the other books and data from internet that related to this research. The result of the research shows that Maggie has a miserable life that caused by her bad environment. It caused by her family condition, her Job, her neighborhood, her love relationship with Pete, and all the problems that she has to face in everyday of her life. She has to survive by anything ways in order to get a better life. But the conditions make her depressed. At the end of the story, Maggie chooses a wrong decision. She kilis her self.