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Programs that use one-way ambulances must have procedures in place that identify the ambulance company, level of ambulance, and how to initiate the transport. Contingency plans should be in place to avoid a shortage of beds for patients needing tertiary or quaternary care. These plans should include provisions for accepting or transferring patients among the cooperating centers or to an alternate receiving center, rather than only the receiving center affiliated with the referral center, when special circumstances warrant (eg, patient census or need for specialized services, such as extracorporeal membrane oxygenation). Team members may include physicians, neonatal nurse practitioners, registered nurses, respiratory therapists, and emergency medical technicians. The composition of the transport team should be consistent with the expected level of medical need of the patient being transported. Transport personnel also should be thoroughly familiar with the transport equipment to ensure that any malfunction en route can be handled. Equipment Safe and successful patient transfer depends on the equipment available to the transport team. The kinds and amounts of equipment, medications, and supplies needed by the transport team depend on the type of transport (maternal or neonatal), the distance of the transfer, the type of transport vehicle used, and Maternal and Neonatal Interhospital Transfer 85 the resources available at the referring medical facility. The transport equipment and supplies should be based on the needs of the most seriously ill patients to be transported and should include essential medications and special supplies needed during stabilization and transfer. Additional specialized equipment and supplies may be needed for individual clinical situations. The performance characteristics of transport equipment should be tested for the most severe environmental conditions of air or ground transport that may be encountered. Equipment performance may be altered by a harsh electromagnetic environment, altitude changes, vibration, forces of acceleration, or extremes of temperature and humidity. Hospital-based equipment may cause electromagnetic interference with aircraft navigation or communication systems. Altered performance of medical or aircraft systems could affect the safety of the transport team and the patient. The Federal Aviation Administration has guidance for operators of emergency medical services/ helicopters on what may be used. The United States Department of Defense has discovered flaws in hospital-based medical equipment that could affect safety when used in air transport. The Department of Defense has comprehensive testing guidelines for electronic and electric component parts and electromagnetic interference characteristics of subsystems and equipment. The following organizations also can offer assistance in choosing medical equipment suitable for use in aircraft: Association of Air Medical Services 909 N. The use of airplanes allows for coverage of a large referral area but is more expensive, requires skilled operators and specially trained crews, and may actually prolong the time required for response and transport over relatively short distances because of the time needed to prepare for flight and the time required for transport to and from the airport.
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Figure 7: Percentage of babies born following embryo transfer cycles by gestational age, Australia and New Zealand, 2016 40 Assisted reproductive technology in Australia and New Zealand 2016 Birthweight of liveborn babies the average birthweight for liveborn babies to women who had autologous and recipient embryo transfer cycles was 3,218 grams. Assisted reproductive technology in Australia and New Zealand 2016 41 Perinatal mortality Perinatal mortality is a summary measure of stillbirths (fetal deaths) and neonatal deaths (defined as the death of liveborn infants within 28 days of birth). There were 148 reported perinatal deaths, including 106 stillbirths and 42 neonatal deaths. Table 33: Perinatal mortality of babies by type of death and plurality, Australia and New Zealand, 2016 Stillbirths(a) Neonatal Deaths Perinatal Deaths(b) Plurality All births Live births n Rate(c)(e) n Rate(d)(f) n Rate(c)(g) Singletons 14,039 13,927 79 5. There were 302 gestational surrogacy cycles in 2016, including 220 gestational carrier cycles and 82 commissioning cycles. Commissioning cycles include a variety of cycle types involved in the provision of oocytes or embryos by either the intended parents or donors. There were 663 babies born following assisted hatching cycles, including 596 singletons, 64 twins and 3 triplets. This was higher than the mean birthweight (3,218 grams) of liveborn babies following autologous and recipient embryo transfer cycles. The proportion of initiated fresh cycles reaching embryo transfer has decreased from 72. The live delivery rate per initiated fresh non freeze-all cycles decreased from 17. Assisted reproductive technology in Australia and New Zealand 2016 47 In comparison, 31,236 initiated thaw cycles were undertaken in 2016, an increase of 6. For the period 2012 to 2016 the clinical pregnancy and live delivery rate per embryo transfer has remained stable for fresh embryo transfers while increasing for thaw embryo transfers (Figure 7). Table 38: Number of thaw cycles by stage/outcome of treatment, Australia and New Zealand, 2012 to 2016 Stage/outcome of treatment 2012 2013 2014 2015 2016 Initiated cycles(a) 25,844 26,401 27,823 29,354 31,236 Embryo transfers 23,891 24,607 25,969 27,742 29,974 Clinical pregnancies 7,044 7,644 8,507 9,280 10,561 Live deliveries 5,246 5,767 6,470 7,412 8,440 Clinical pregnancy per embryo transfer (%) 29. The average age of women having autologous cycles remained relatively stable over the period ranging from 35. The proportion of thaw embryo transfer cycles that used vitrified embryos increased for both cleavage stage embryos and blastocysts (Table 43 and Figure 8). Table 44: Percentage of embryo transfer cycles by number of embryos transferred, Australia and New Zealand, 2012 to 2016 Number of embryos transferred 2012 2013 2014 2015 2016 One embryo 73. This allows reporting of the number of women undergoing treatment and the number of cycles per woman over time. For some women, if their fresh cycles were undertaken in previous years, only thaw cycles were reported and presented. Women who undertook autologous treatment There were 39,980 women who undertook 76,255 autologous fresh and/or thaw cycles in Australia and New Zealand in 2016.
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No two prints are ever of face recognition, which reveals not only the nature of identical; therefore, the task always requires some element the dimensions of faces but also provides a psychological of comparison and similarity computation. The way fngerprint examiners Steyvers and Busey (2001) demonstrated the matches and explain their conclusions, and the way they express their mismatches between a physical representation computed decisions, may vary from one place to another and may from images and psychological spaces computed from change over time; however, the cognitive processes that similarity ratings. This learning process occurs with very little the basis of intelligence and expertise, it also introduces conscious direction beyond the initial selection of relevant a multitude of elements that make humans vulnerable features. All that is required is a constant set of example to distorting information and thus making errors (Dror, in stimuli that provide the kinds of statistical regularities press). The next section shows how these phenomena should argue for more hours of training to provide the large relate to fngerprint identifcation. The active and Experts often ask the question, how much matching infordynamic nature of the perceptual system not only has the mation is enoughfi The perceptual learning literature does potential to distort the incoming data, as already illustrated, not provide a direct answer, but the tools from cognitive but it can also add information and make us perceive things science illustrate how different factors trade off. Furtherquality could be measured in several ways but, in general, more, this imaginary white square incorrectly seems to it represents the degree of visible print information relative be of a different shade than its surroundings (compare the to the amount of noise caused by dust or other artifacts shade in points A and B, which are in fact identical). Image quantity reprethese examples demonstrate that even the lower level sents the surface area of usable print information, which sensory mechanisms are not passive or isolated from a could be measured in units of ridge widths or square cenvariety of factors that can affect and distort what is pertimeters. Thus, much of what is perceived, even at the as going together, in principle it is possible to separate the lower level mechanisms, is dependent on the perceiver two factors. De facto, they disregard the context is not provided by the environment but rather and miss possibly critical information in an image. Because of these as well as other cognitive mechanisms, At a more scientifc level, this can be demonstrated by the same visual image can, in fact, get different interpretashowing that interpretation of the central image in Figure 8 tions depending on the context in which it is presented. For example, dent on psychological elements and processes rather than if fngerprint identifcation requires comparing the length purely on the relevant information.
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Anxiety Routine mental health screening in pregnancy is Past Y/N recommended by several organizations. Routine screening and intervention has the potential to improve mental health in pregnancy and decrease postpartum depression. Past history or current anxiety should be documented and include treatment/coping strategies. This tool can be used repeatedly throughout pregnancy; re-screen pregnant people at high risk of anxiety. Pregnant people identified as requiring follow-up regarding anxiety or depression should be referred to the most responsible primary care provider for appropriate medical treatment. Depression Past history or current depression should be Past Y/N documented and include treatment/coping Present Y/N strategies. This tool can be used repeatedly throughout pregnancy; rescreen pregnant people at high risk of depression. Smoked cig within past 6 Document any cigarette use in the last six months, months even prior to pregnancy or in early pregnancy. If still Current smoking cig/day smoking, the estimated number of cigarettes smoked daily is entered. Quitting is best, but even reducing smoking during pregnancy has an important impact on improving pregnancy outcomes. Non-prescribed substances / Include all illicit drugs and pharmaceuticals being drugs taken without a prescription. Marijuana Marijuana is of particular concern given the prevalence of its use and future legalization in Canada. Provide appropriate information or counsel regarding risk to pregnancy, the fetus and during breastfeeding, and consider referral as appropriate. Occupational risks Refers to work-related or other environmental situations, which are detrimental to pregnancy, examples include ionizing radiation, toxic chemicals, and infectious agents. Financial/housing issues Document any financial concerns, including housing stability.
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