Elevation of Uterine Basal Tone and Fetal Heart Rate Abnormalities After Labor Analgesia A Randomized Controlled Trial

OBJECTIVE: To estimate the effects of combined spinal-epidural and traditional epidural analgesia on uterine basal tone and its association with the occurrence of fetal heart rate (FHR) abnormalities. METHODS: Seventy-seven laboring patients who requested pain relief during labor were randomly assigned to combined spinal-epidural (n=41) or epidural analgesia (n=36). Uterine contractions and FHR were recorded 15 minutes before and after analgesia. Uterine tone was evaluated with intrauterine pressure catheter. Primary outcomes were the elevation of baseline uterine tone and occurrence of FHR prolonged decelerations or bradycardia after analgesia. The influence of other variables such as oxytocin use, hypotension, and speed of pain relief were estimated using a logistic regression model. RESULTS: The incidence of all outcomes was significantly greater in the combined spinal-epidural group compared with epidural: uterine hypertonus (17 compared with 6; P=.018), FHR abnormalities (13 compared with 2; P<.01), and both events simultaneously (11 compared with 1; P<.01). Logistic regression analysis showed the type of analgesia as the only independent predictor of uterine hypertonus (odds ratio 3.526, 95% confidence interval 1.21-10.36; P=.022). For the occurrence of FHR abnormalities, elevation of uterine tone was the independent predictor (odds ratio 18.624, 95% confidence interval 4.46-77.72; P<.001). Regression analysis also found a correlation between decrease on pain scores immediately after analgesia and the estimated probability of occurrence of hypertonus and FHR abnormalities. CONCLUSION: Combined spinal-epidural analgesia is associated with a significantly greater incidence of FHR abnormalities related to uterine hypertonus compared with epidural analgesia. The faster the pain relief after analgesia, the higher the probability of uterine hypertonus and FHR changes. CLINICAL TRIAL REGISTRATION: Umin Clinical Trials Registry, http://www.umin.ac.jp/ctr/index.htm, UMIN000001186

The role of affect and affective congruence in perceptions of leaders: an experimental study

Based on the idea that emotional exchanges determine symbolic meanings in interpersonal exchanges, we hypothesized that displays of positive and congruent affect determine members' ratings of leaders in a simulated performance appraisal context. To test the hypotheses, 537 participants viewed videotapes of four male and female leaders giving positive and negative feedback, and with facial expressions of affect that were either congruent or incongruent with the verbal message that they were delivering. Results supported hypotheses that positive and message-congruent leader affect results in more positive member ratings of the leader, assessed using a seven-item measure of members' perceptions of the leader's negotiating latitude. The least positive ratings of negotiating latitude were given when positive feedback was delivered with negative facial affect. (C) 2002 Elsevier Science Inc. All rights reserved.

Youth unemployment outflow rates and labor market programs: Australian evidence

A matching function methodology is used to investigate the macroeconomic effects of labor market program (LMP) commencements on youth unemployment outflows in Australia using unpublished data that classify commencements and outflows by duration of unemployment. The results indicate that LMPs have had significant effects on outflows from short-term unemployment. There is a net positive effect from LMP commencements on short-term unemployed female outflow rates. However; females experienced negative spillover effects from male LMP commencements. These spillover effects appear to be associated with wage subsidy programs and suggest the net impact Of such programs may have been overstated in previous studies.

Being attuned to intergroup differences in mergers: The role of aligned leaders for low-status groups

The present research focused on responses of low-status group members to a merger with a high-status group. A study was conducted (N = 153) in which the alignment of the leader for the merged group (ingroup vs. outgroup) and leader behavior (equality, outgroup favoritism, ingroup favoritism, complementarity) were manipulated. The authors predicted that the leader, by his or her behavior, would play an important role in defining the new relationship between premerger groups. Overall, low-status ingroup leaders were evaluated more positively than high-status outgroup leaders. Ingroup leaders were evaluated more favorably and were more likely to engender a common identity in the merged group than were outgroup leaders when leaders behaved in an ingroup-favoring or complementary fashion. In contrast, evaluations of ingroup and outgroup leaders did not differ when the leader stressed equality or was outgroup favoring. The findings demonstrate the important role leaders can play in accentuating or de-emphasizing premerger status differences.

Is emotional intelligence training for leaders justified?

In this paper, we present the results of a qualitative study of subordinate perceptions of leaders. The study represents a preliminary test of a model based on Affective Events Theory, which posits that leaders who are seen to be effective shape the affective events that determine employees' attitudes and behaviours in the workplace. Within this framework, we argue that effective leaders ameliorate employees' hassles by providing frequent, small emotional uplifts. The resulting positive affective states are then proposed to lead to more positive employee attitudes and behaviours, and more positive regard for the leader. Importantly, leaders who demonstrate these ameliorating behaviours are likely to require high levels of emotional intelligence, defined in terms of the ability to recognise, understand, and manage emotions in self and others. To investigate this model, we conducted interviews and focus groups with 10 leaders and 24 employees. Results confirmed that these processes do indeed exist in the workplace. In particular, leaders who were seen by employees to provide continuous small emotional uplifts were consistently held to be the most effective. Study participants were especially affected by negative events (or hassles). Leaders who failed to deal with hassles or, worse still, were the source of hassles, were consistently seen to be less effective. We conclude with a discussion of implications for practicing managers, and suggest that our exploratory findings provide justification for emotional intelligence training as a means to improve leader perceptions and effectiveness. [Abstract from author]

The over-production of US sports and the new International Division of Cultural Labor

This article focuses on how US professional sports utilize the New International Division of Cultural Labor to supplement an overly costly local labor pool and over-supplied local market. We argue that while the classic problem of over-production is slowly eroding the sealed-off nature of US culture, the forces of its hyper-protectionist capitalism continue to characterize sports, precluding equal exchange.

Obesity and gestational weight gain: cesarean delivery and labor complications

OBJECTIVE: To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications. METHODS: A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications were adjusted through logistic regression analysis. RESULTS: Obesity was present in 308 (6.9%) patients. Cesarean delivery was performed in 164 (53.2%) obese, 407 (43.1%) pre-obese, 1,045 (35.1%) normal weight and 64 (24.5%) underweight women. The relative risk for cesarean delivery in obese women was 1.8 (95% CI: 1.5-2.0) compared to normal weight women. Greater weight gain was particularly associated with cesarean among the obese (RR 4th vs 2nd weight gain quartile 2.2; 95% CI: 1.4-3.2). Increased weight at the beginning of pregnancy was associated with a significantly higher adjusted risk of meconium with vaginal delivery and perinatal death and infection in women submitted to cesarean section. Similarly, greater weight gain during pregnancy increased the risk for meconium and hemorrhage in women submitted to vaginal delivery and for prematurity with cesarean. CONCLUSIONS: Pre-gestational obesity and greater weight gain independently increase the risk of cesarean delivery, as well as of several adverse outcomes with vaginal delivery. These findings provide further evidence of the negative effects of prepregnancy obesity and greater gestational weight gain on pregnancy outcomes.

Social contextual factors contributing to child and adolescent labor: an ecological analysis

OBJECTIVE: To examine the relationship between social contextual factors and child and adolescent labor. METHODS: Population-based cohort study carried out with 2,512 families living in 23 subareas of a large urban city in Brazil from 2000 to 2002. A random one-stage cluster sampling was used to select families. Data were obtained through individual household interviews using questionnaires. The annual cumulative incidence of child and adolescent labor was estimated for each district. New child and adolescent labor cases were those who had their first job over the two-year follow-up. The annual cumulative incidence of child and adolescent labor was the response variable and predictors were contextual factors such as lack of social support, social deprivation, unstructured family, perceived violence, poor school quality, poor environment conditions, and poor public services. Pearson's correlation and multiple linear regression were used to assess the associations. RESULTS: There were selected 943 families corresponding to 1,326 non-working children and adolescents aged 8 to 17 years. Lack of social support, social deprivation, perceived violence were all positively and individually associated with the annual cumulative incidence of child and adolescent labor. In the multiple linear regression model, however, only lack of social support and perceived violence in the neighborhood were positively associated to child and adolescent labor. No effect was found for poor school quality, poor environment conditions, poor public services or unstructured family. CONCLUSIONS: Poverty reduction programs can reduce the contextual factors associated with child and adolescent labor. Violence reduction programs and strengthening social support at the community level may contribute to reduce CAL.