Woman-centred care and integrated electronic medical records within Australian maternity settings: Point prevalence audit and observational study

Objective: Transition to paperless records brings new challenges to midwifery practice across the continuum of woman-centred care. There is limited and conflicting evidence on the relative benefits of electronic medical records in maternity settings. This article aims to inform the use of integrative electronic medical records within the maternity services’ environment with attention to the midwife-woman relationship. Design: This descriptive two-part study includes 1) an audit of electronic records in the early period following implementation (2-time points); and 2) an observational study to observe midwives’ practice relating to electronic record use. Setting: Two regional tertiary public hospitals Participants: Midwives providing care for childbearing women across antenatal, intrapartum and postnatal areas. Findings: 400 integrated electronic medical records were audited for completeness. Most fields had high levels of complete data in the correct location. However, between time 1 (T1) and time 2 (T2), persistent missing data (foetal heart rate documented 30 minutely T1 36%; T2 42%), and incomplete or incorrectly located data (pathology results T1:63%; T2 54%; perineal repair T1 60%; T2 46%) were identified. Observationally, midwives were actively engaged with the integrative electronic medical record between 23% to 68% (median 46%; IQR 16) of the time. Conclusion: Midwives spent a significant amount of time completing documentation during clinical episodes of care. Largely, this documentation was found to be accurate, yet exceptions to data completeness, precision and location remained, indicating some concerns with software usability. Implications for practice: Time-intensive monitoring and documentation may hinder woman-centred midwifery care

Quantifying soil carbon stocks and greenhouse gas fluxes in the sugarcane agrosystem: point of view

Strategies to mitigate climate change through the use of biofuels (such as ethanol) are associated not only to the increase in the amount of C stored in soils but also to the reduction of GHG emissions to the atmosphere.This report mainly aimed to propose appropriate methodologies for the determinations of soil organic carbon stocks and greenhouse gas fluxes in agricultural phase of the sugarcane production. Therefore, the text is a piece of contribution that may help to obtain data not only on soil carbon stocks but also on greenhouse gas emissions in order to provide an accurate life cycle assessment for the ethanol. Given that the greenhouse gas value is the primary measure of biofuel product quality, biorefiners that can show a higher offset of their product will have an advantage in the market place

Selected papers from the symposium : the Contribution on Biological Nitrogen Fixation to Plant Production, Cisarua, Indonesia, 3-7 Aug. 1987

Meeting: Contribution on Biological Nitrogen Fixation to Plant Production, 3-7 Aug. 1987, Cisarua, I

Chronic lead nephropathy in Queensland. Alternative methods of diagnosis

Abstract Indices of past lead absorption were measured and compared in patients with chronic renal failure from many causes, including some with chronic lead nephropathy. X‐ray fluorescence (XRF) yielded finger bone lead concentrations by a new in vivo method. These correlated significantly with excess urinary lead following calcium di‐sodium EDTA (ethylenediamine tetra‐acetate) and erythrocyte lead concentration. Discriminant function analysis demonstrated that the patients in the study could be separated into two groups without any reference to the EDTA lead excretion test using the following variables, all of which contributed significantly to the discrimination. In order of importance, these were: a childhood history of acute lead poisoning, a history of gout, a family history of gout and detectable XRF finger bone lead. Although the XRF finger bone lead measurement is convenient and non‐invasive, its lack of sensitivity (48%) limits its usefulness as a screening test for chronic lead nephropathy