Search

Objectives The Japan Academy of Midwifery published "2016 Evidence-based Guidelines for Midwifery Care" (hereinafter, this is called "2016 Guidelines"). The objective of this study was to search and clarify about maternity care policies based on 2016 Guidelines among Obstetric Institutions in Japan. Methods The participants of this survey were 3164 institutions; hospitals, clinics, and midwifery birth centers in Japan. This study was self-administered anonymously questionnaire survey and was conducted with mail or web surveys. The questionnaire included 11 maternity care policies that based on "2016 Guidelines". Data was collected through November to December 2016. The ethics committee of St. Luke's International University, Tokyo, Japan (No.16-A062) provided ethical approval. Results 362 institutions participated in the study (the response rate, 80.4%). Few institutions recommended or provided "Folic acid supplementation" (8.3%), "Screening for domestic violence" (6.9%) and "Antenatal perineal massage" (10.6%). Supplementation in pregnancy; Many institutions did not recommend "Vitamin supplementation" (60.1%) for pregnant women. Conversely, "Iron supplementation" was common (66.1%). The health guidance for discomforts in pregnancy; "Foot bath for leg edema" (74.9%), "Massage for leg edema" (78.4%), "Exercise for low back and pelvic pain" (92.5%) and "Taking dietary fibers for constipation" (96.1%) ware very common at each institutions. The health guidance of taking luxury grocery items; About half of the institutions provided "Health guidance for taking alcohols" (52.6%), but "Health guidance for taking caffeins" were provided still 29.0%. There was significant difference about "Antenatal perineal massage" (χ2: 8.870, OR: 1.385, 95%CI: 1.129-1.699, p=0.003) whether institutions provided midwifery care in ambulatory or not. Conclusion Our results demonstrated that there were some gaps between evidence and clinical practice about maternity care in Japan. This study suggested that necessity of diffusion about "2016 Guidelines" and evidence of maternity care. [ABSTRACT FROM AUTHOR]

Ecological efficiency is an important basis for evaluating the level of regional ecological civilization. It is also a common index and variable for the comprehensive study of resources and environment in geography and economics. The lack of research on the measure of ecological efficiency at the county level has restricted the above-mentioned problems to be researched at the county level. Constructing a scientific path for measuring ecological efficiency at the county level is conducive to accurately identifying the regional economic and social ecological development pattern and providing a possibility for county-level government green performance assessment. Under the national strategy of ecological priority and green development of the Yangtze River economic belt, taking the middle reaches of the Yangtze River as the research area and relying on the multi-source remote sensing data to construct the index system for estimating the ecological efficiency of the county scale, the ecological efficiency of the county area from 2000 to 2015 was calculated by using the non- consensual output EBM super efficiency model, and the GIS spatial analysis tool was used to reveal spatial differences and spatial correlation characteristics. A robust test scheme is designed to test the scientificity and robustness of the county- scale ecoefficiency measurement path. The results show that: (1) The ecological efficiency of the counties under the jurisdiction of Changsha- Zhuzhou-Xiangtan urban agglomeration and Poyang Lake urban agglomeration is better than that of the counties under the jurisdiction of Wuhan urban agglomeration. (2) During the study period, the ecological efficiency of 12 counties and cities such as Wuhan maintained a high level, while that of 7 counties and cities such as Ruichang maintained a low level. (3) The H-H concentration area of ecological efficiency in the early stage is mainly in Hengyang, Zhuzhou and its surrounding areas. By 2015, these areas had disappeared. The L-L agglomeration area of ecological efficiency follows the clockwise trend and gradually forms a closed circular area around the city of Wuhan. (4) The robustness test based on the comparison of city ecological efficiency rankings shows that the measurement path and results of county ecological efficiency constructed in this paper have high reliability. [ABSTRACT FROM AUTHOR]

The water resources system is closely related to the regional economy. It is more intuitive to use economic value to reflect the losses caused by water system risks such as water resource imbalance and mismatch. In order to evaluate the risk of water resources system through quantitative economic value, this paper firstly constructed the water loss risk economic loss model, and used the EBM model to calculate the water use efficiency, and combined the water price and per capita wage in Heilongjiang Province to determine the water resource risk value. Then, based on the EBM, a two-stage Tobit model was added to analyze the causes of the risk economic loss of the water resources system. The results show that the least economic loss caused by insufficient water resources investment in Heilongjiang Province from 2000 to 2020 is 7.52 billion yuan (2008), the highest is 42.51 billion yuan (2013); the economic loss of minimum output of water resources is 111.9 billion yuan (2000), the highest is 1 106.8 million yuan (2012). From 2000 to 2015, the economic loss of water resources in Heilongjiang Province increased year by year, and the economic loss of water resources output accounted for more than 90% of the economic loss of water resources system. It is estimated that the economic loss of water resources risk in 2020 is 813.87 billion yuan. Jixi, Suihua, Qiqihar, Harbin, Daqing, Jiamusi, Shuangyashan, Qitaihe and Hegang have lower economic losses caused by input and better water resources allocation. The cities with large economic losses caused by output are Yichun, Mudanjiang and Suihua, which require the government to pay more attention to the utilization of water resources in the region. It is necessary to rationally allocate water resources, improve water use efficiency, and reduce the risk economic loss of water resources systems. Hegang, Qitaihe, Jiamusi and other major grain producing areas have greater risk of water resources, greater economic losses and lower water use efficiency. In general, the agricultural water use efficiency in Heilongjiang Province is low, and the phenomenon of flood irrigation is still serious. It is necessary for the government and farmers to cooperate with each other to improve water use efficiency. During the research period, the risk economic loss of water resources system in Heilongjiang Province was large, and the water use efficiency was low. The water use efficiency in most areas was only in the medium range. From the perspective of spatial distribution, water use efficiency is high in the north-south direction and low in the east-west direction. The water use efficiency in the eastern region is lower than that in the other regions. The water resources system of Heilongjiang Province is affected by industrial structure, per capita GDP, per capita water resources and water resources investment. Water price is correlated with water use efficiency in only a few cities, indicating that the government's purpose of regulating water resources through water prices has not been met, and the government needs to introduce relevant policies to change in the future. This article will support the development of risk aversion measures for subsequent water resources systems. [ABSTRACT FROM AUTHOR]