[Application and comparison of three occupational health risk assessment methods in an automobile manufacturing industry].

Objective: Three occupational health risk assessment methods were used to assess the occupational health risk of noise exposed posts in an automobile manufacturing enterprise. According to the results, the selection of risk assessment methods and risk management of such occupational noise enterprises were provided. Methods: Form April to November 2021, The occupational health field survey was carried out in an automobile manufacturing industry in Tianjin. The occupational health MES risk assessment method, occupational health risk index risk assessment method and Australian occupational hazard risk assessment method were used to evaluate the occupational health risk of noise-exposed posts in this enterprise, and the evaluation results of different methods were analyzed and compared. Results: The average value of L(Aeq, 8 h) in the four workshops of automobile manufacturing industry was 82.95 dB (A) , and the noise detection exceeding rate was 22.41% (26/116) . The LAeq, 8h and exceeding rate noise of welding workshop were higher than those of other workshops (χ(2)=23.56, 32.94, P<0.01) . The three occupational health risk assessment methods have the same risk assessment results for the four major workshops. The assembly and painting workshops are level 4 risk (possible risk) , and the stamping and welding workshops are level 3 risk (significant risk) . Conclusion: Occupational noise has certain potential hazards to workers in automobile manufacturing enterprises. Therefore, in the future work, corresponding organizational management measures should be taken to improve the working environment and reduce the actual exposure level of workers in order to protect the health of occupational workers.

Mapping the Scientific Literature on Health Needs of Women with Same-Sex Attraction in Mainland China: A Scoping Review.

Purpose: This review study aimed to investigate how much and how well the unique health needs of women with same-sex attraction (WSSA) in mainland China have been studied. Methods: This review included published studies and gray reports between January 1, 1990, and March 31, 2022, regarding the health needs of Chinese WSSA. Chinese peer-reviewed journal articles, conference papers, theses, and dissertations were retrieved through the China National Knowledge Infrastructure. Studies with WSSA of mainland China as research participants were retrieved through PubMed, Embase, PsycInfo, LGBT Life, CINAHL, Web of Science, and International Bibliography of the Social Sciences. Gray reports were provided by two informaticists and eight Chinese WSSA who consented to be our stakeholders for consultation. Results: Of the 38 reviewed articles, unmet health needs of Chinese WSSA fell into three domains: mental health and substance abuse, sexual and reproductive health, and domestic, intimate partner, and dating violence, which were significantly associated with minority stress. Minority stigma was discovered to oppress Chinese WSSA by a covert and subtle pathway that makes Chinese WSSA culturally unintelligible and health care providers unprepared to provide them with respectful care. The barriers to the health care of Chinese WSSA were identified as health care providers' presumption of heterosexuality and Chinese WSSA's concealment of minority sexuality when discussing medical history. Conclusion: This scoping review is the first research effort to explore studies about the health needs of WSSA in mainland China. More research is needed with the guidance of minority stress theory to address the unique health needs of Chinese WSSA.

Cultural Unintelligibility and Marital Pressure: A Grounded Theory of Minority Stigma Against Women with Same-Sex Attraction in Mainland China.

Minority stigma against sexual minority women and its contributions to these women's health disparities have been widely investigated in Western countries. By contrast, little has been known about minority stigma against women with same-sex attraction (WSSA) in mainland China. This study aimed at exploring the nature, genesis, and pathways of minority stigma among this rarely studied minority group in terms of China's unique social and cultural organization of gender and sexuality. A grounded theory approach was applied to 28 participants of Chinese WSSA through in-depth telephone interviews to elicit their views and perspectives anchored in their daily experiences with gender hierarchy and normative heterosexuality. Findings of this study identified marital pressure and cultural unintelligibility as two principal components of minority stigma against Chinese WSSA. A conceptual framework was developed to illustrate how minority stigma relies on the mutually reinforcing loop of martial pressure and culturally unintelligible status of female same-sex attraction to oppress Chinese WSSA within and across intrapersonal, interpersonal, and structural levels. The parent-daughter relationship, laden with the Confucian value of filial piety, was highlighted as the major pathway of minority stigma to force Chinese women with same-sex attraction into heterosexual marriage and make female same-sex attraction culturally unintelligible. These findings lay a foundation for conceptualizing and measuring minority stigma of Chinese WSSA caused by the stigmatization of their same-sex attraction. Moreover, these findings would contribute greatly to understanding how cultural particularities critically affect the local process of stigmatization through which power relations and social control are practiced.

[Effects of double-catheter epidural analgesia by lidocaine injection respectively on the delivery outcomes and maternal-infant complications for persistent posterior or lateral occipital position of protracted active phase].

Objective: To evaluate the effect of dual-tube epidural segmental injection of lidocaine analgesia on the delivery outcome and maternal and infant complications of persistent posterior occipital position postpartum or lateral occipital position postpartum patients with protracted active phase. Methods: The full and single-term primiparas (n=216, 37 to 42 weeks gestation, 22 to 35 years) diagnosed as persistent posterior or lateral occipital position during the active period were selected from the Department of Obstetrics of Qingdao Municipal Hospital from January 2015 to October 2019. The subjects were randomly assigned into two groups: double-tube epidural block group (n=108) and single-tube epidural block group (n=108), 1% lidocaine was used for epidural analgesia respectively under ultrasound guidance. Senior midwife or obstetricians implement new partogram, and guide women to perform position management, and push or rotate the fetal head in a timely manner. Observation indicators: general condition, the use of non-pharmacological analgesic measures, analgesia related conditions and pain visual analogue scale (VAS) score, delivery-related indicator, cesarean section indication, anesthesia-related indicator, maternal and child complications. Results: (1) General condition: the age, weight, height, gestational age, the ratio of persistent lateral or posterior occipital position, cephalic score, and neonatal birth weight between the two groups of women were not statistically significant (all P>0.05). (2) The use of non-pharmacological analgesic measures: the women's Lamaze breathing method, Doula delivery companionship, percutaneous electrical stimulation, and other measures between two groups were compared, and there were not significant differences (all P>0.05). (3) Analgesia related conditions and VAS scores of women undergoing vaginal delivery: compared with the single-tube epidural block group (n=40), the second-partum time of the women in the double-tube epidural block group (n=59) was significantly shortened [(124±44) vs (86±33) minutes, P<0.01]; after 30 minutes of analgesia (4.4±0.5 vs 0.9±0.5, P<0.01), during forced labor in the second stage of labor (5.7±0.6 vs 1.3±0.4, P<0.01), the VAS scores of pain were also significantly reduced (P<0.01). (4) Labor-related indicators: compared with the single-tube epidural block group, the natural delivery rate (21.3% vs 49.1%) and the delivery experience satisfaction rate (51.9% vs 98.1%) of women in the double-tube epidural block group were significantly increased (all P<0.01), cesarean section rate (63.0% vs 45.4%), instrument assisted rate (15.7% vs 5.6%) decreased significantly (all P<0.05). (5) Cesarean section indications: compared with the single-tube epidural block group, the cesarean section rate caused by prolonged labor or protracted active phase of women in the double-tube epidural block group was significantly reduced (38.0% vs 22.2%； P<0.05), and the fetal distress, intrauterine infection, and social factors caused by cesarean section between the two groups were compared, while the differences were not statistically significant (all P>0.05).(6) Anesthesia related indexes: the block planes of the maternal upper tube administration in the double-tube epidural block group were mostly T7, T8, T9-L2 and L3,While,the block planes in the single-tube epidural block group were mostly T10, T11-S1, S2, S3, and the modified Bromage score were all 0. (7) Maternal and child complications: compared with the single-tube epidural block group, the postpartum hemorrhage rate (18.5% vs 7.4%), the perineal lateral cut rate (20.4% vs 5.6%), the neonatal asphyxia rate (12.0% vs 3.7%), ICU rate of transferred neonates (13.9% vs 4.6%) in the double-tube epidural block group were significantly reduced (all P<0.05). Soft birth canal injury rate, puerperal disease rate and neonatal birth rate between two groups were compared, and there were not statistically significant differences (all P>0.05). Conclusion: Dual-tube epidural segmental injection of lidocaine analgesia could increase the natural delivery rate of women with posterior occipital or lateral occipital position with active stagnation, reduce the rate of cesarean section and the rate of transvaginal instruments, and reduce the complications of mother and child.

Caesarean Sections in Beijing, China - Results from a Descriptive Study.

OBJECTIVE: Caesarean section rates are increasing dramatically in China. The predominant contributor to the increase in China was the unnecessary Caesarean section. The objective of this study was to estimate the excess economic burden caused by unnecessary Caesarean sections vs. vaginal delivery for Beijing and all China. METHODS: The 33 476 obstetric medical case files from randomly selected 17 hospitals of Beijing in 2011 were taken for our descriptive approach. Based on the individual medical files and on a definition of what necessary and unnecessary Caesarean sections are, we sampled also the data for costs and length of stay for comparisons with vaginal deliveries. The Mann-Whitney U test and Pearson chi-square test statistics were used to test for significant difference in the analysis. RESULTS: The Caesarean section rate was 58.5% among all deliveries and that rate of unnecessary Caesarean sections was 71.5% among all the Caesarean sections but 41.8% among all deliveries in Beijing. The hospitalisation expenses of unnecessary Caesarean sections were 472 US$ higher than that of a vaginal delivery on average. The total excess economic burden caused by unnecessary Caesarean sections can be estimated to 38.97 million US$ for Beijing and to 3.29 billion US$ all over China in 2011. This is equivalent to the annual health expenditure of over 139 575 residents in Beijing and of 11 783 120 residents in China, respectively. CONCLUSION: Socio-economic factors are possible reasons for the increase of unnecessary Caesarean section in China and more analytical attention should be paid to that problem in order to propose fitting practical reactions.

Computed tomographic and cytologic assessment of cystic pancreatic neoplasms: a difficult preoperative diagnosis.

The computed tomography (CT) findings or cytologic results, or both, for 21 patients with cystic pancreatic neoplasm (4 with microcystic cystadenoma, 6 with macrocystic mucinous cystadenoma, 10 with macrocystic mucinous cystadenocarcinoma and 1 with a papillary cystic neoplasm) were reviewed. CT scans for 14 of the patients were reviewed by two gastrointestinal radiologists who were blinded with respect to the patients' identities and the diagnoses. The radiologists used previously published criteria for distinguishing between microcystic and macrocystic neoplasms. Of the four cases of microcystic cystadenoma, two were correctly diagnosed by one radiologist, and one was correctly diagnosed by the other. Three and four cases respectively of five cases of macrocystic cystadenoma were correctly identified, as were three and five of five cases of macrocystic cystadenocarcinoma. Cytologic evaluation of samples from fine-needle aspiration biopsy had been performed for 15 of the patients, and these records were reviewed. One of three cases of microcystic cystadenoma, two of four cases of macrocystic cystadenoma, five of seven cases of macrocystic cystadenocarcinoma and the papillary cystic neoplasm were correctly diagnosed on the basis of the cytologic findings. The combination of CT and cytologic assessment is helpful in distinguishing different types of cystic pancreatic neoplasms, but there is significant overlap among the clinical and radiographic features of these lesions, and therefore operative assessment is often necessary.