PURPOSE

Currently, 40% of counties in the United States do not have an obstetrician or midwife, and in rural areas the likelihood of childbirth being attended to by a family medicine (FM) physician is increasing. We sought to characterize the effect of the FM presence on unit culture and a key perinatal quality metric in Iowa hospital intrapartum units.

METHODS

Using a cross-sectional design, we surveyed Iowa physicians, nurses, and midwives delivering intrapartum care at hospitals participating in a quality improvement initiative to decrease the incidence of cesarean delivery. We linked respondents with their hospital characteristics and outcomes data. The primary outcome was the association between FM physician, obstetrician (OB), or both disciplines’ presence on labor and delivery and hospital low-risk, primary cesarean delivery rate. Unit culture was compared by hospital type (FM-only, OB-only, or Both).

RESULTS

A total of 849 clinicians from 39 hospitals completed the survey; 13 FM-only, 11 OB-only, and 15 hospitals with both. FM-only hospitals were all rural, with <1,000 annual births. Among hospitals with <1,000 annual births, births at FM-only hospitals had an adjusted 34.3% lower risk of cesarean delivery (adjusted incident rate ratio = 0.66; 95% CI, 0.52-.0.98) compared with hospitals with both. Nurses endorsed unit norms more supportive of vaginal birth and stronger safety culture at FM-only hospitals (P <.05).

CONCLUSIONS

Birthing hospitals staffed exclusively by FM physicians were more likely to have lower cesarean rates and stronger nursing-rated safety culture. Both access and quality of care provide strong arguments for reinforcing the pipeline of FM physicians training in intrapartum care.

The developers who remade Half-Life as Black Mesa are working on a new roguelite co-op shooter. It will feature no physicists celebrating Bring Your Shotgun To Work Day, but instead let up to four players tactically breach oil rigs and airports occupied by corporate-sponsored mercenaries. In Rogue Point the richest CEO on earth has croaked it, causing various megacorps to compete in a violent bum rush for control of that wealth. Which is where your team of renegade shooterists come in. They don't want to win this contest, they just want everyone else to lose.

Read more

The European Space Agency's Hera spacecraft must be thoroughly tested before being sent to investigate the aftermath of the collision of NASA's DART probe with Dimorphos

The Supreme Court dealt a major legal blow to former White House Chief of Staff Mark Meadows on Tuesday, refusing to move the Georgia election interference charges against him to federal court.

Peruvanam Satheesan Marar recalls his initiation into the percussion ensemble and how he gained expertise in playing different instruments

Team17, the developer of the Worms and publisher of Dredge, Blasphemous and more, is working on Rogue Point, a new rogue-lite tactical FPS game. The studio has enlisted the help of Crowbar Collective, the team behind Black Mesa, the fan-made and Valve-approved Half-Life remake that needs no further introduction. Rogue Point is currently in development and slated to enter early access soon.

Rogue Point is set in a dystopian future where a single CEO had controlled everything. After his death, competing companies work to carve up his empire. To achieve this, they hire mercenaries using the MERX app, and it’s as simple as getting food using Uber Eats. Currently, only Rogue Point, a team of vigilantes, is fighting back against this dystopian state of affairs.

Team17/Crowbar Collective

The game pits teams of four against computer-controlled enemies of different classes, each offering unique challenges. Players must strategize and play with the right loadouts or risk losing. There’s plenty of gear to acquire, too, with some weapons only available in the mission field.

Maps are procedurally generated to ensure no two playthroughs are the same. Unlocked equipment may also be used in future runs. Besides the standard campaign missions where “high-octane tactical combat meets strategic planning,” there’s an endgame mission with maxed-out difficulty, promising a challenge for those craving it.

The developers have a rather extensive wishlist of features they hope to add to the game down the road. Those include new weapons (who doesn’t like new gear?), improved AI and new maps. There are currently four maps announced, but the procedural generation should make things less repetitive.

Rogue Point isn’t in early access yet, but you can wishlist it on Steam. The game is set to come out in 2025, but the developers have yet to announce a final release date.

This article originally appeared on Engadget at https://www.engadget.com/gaming/pc/rogue-point-is-a-tactical-shooter-from-the-teams-behind-worms-and-black-mesa-142959920.html?src=rss

When chemist Dora Richardson’s employer decided to terminate the breast cancer research on the drug Tamoxifen in the early 1970s, she and her colleagues continued the work in secret.

On October 8, 2024, Drug Channels Institute will release our 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. This report—our fifteenth edition—remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.

9 chapters, 350+ pages, 178 exhibits, 750+ endnotes: There is nothing else available that comes close to this valuable resource.

We are providing you with the opportunity to preorder this thoroughly updated, revised, and expanded 2024-25 edition at special discounted prices. This means that you can be among the first to access our new report. Those who preorder will receive a download link before October 8.

• Review pricing/license options and place a preorder

• Download a free pre-publication report overview (including key industry trends, What's New in this edition, the Table of Contents, and a List of Exhibits)

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to contact us if you would like to pay by corporate check or ACH.

Special preorder and launch pricing discounts will be valid through October 23, 2024.

Read on for more details.
Read more »

I am pleased to announce Drug Channels Institute's new 2024–25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.

• Download a free report overview (including key industry trends, the Table of Contents, and a List of Exhibits)

• Review pricing/license options and download the full 2024-25 report

We’re offering special discounted pricing if you order before October 23, 2024.

2024–25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our 15th edition--remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry. This 2024-25 edition includes substantial new material—outlined on page vii of the report overview.

9 chapters, 380+ pages, 178 exhibits, more than 750 endnotes: There is nothing else available that comes close to this valuable resource.

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to contact us if you would like to pay by corporate check or ACH.

Email Paula Fein (paula@drugchannels.net) if you’d like to bundle your report purchase with access to DCI’s video webinars.

If you preordered the report, you should have already received an email with download instructions last week. Please contact us if you did not receive your email.

Read on for some additional details.
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As regular readers of Drug Channels know, U.S. distribution and dispensing channels for prescription drugs are undergoing significant evolution and consolidation as the changing economics of pharmaceuticals challenge conventional business models.

During this period of volatility, the core business model of the Big Three public pharmaceutical distribution companies—Cardinal Health, Cencora, and McKesson—remains intact. Put simply: Buy low, sell high, collect early, and pay late.

But as I explain below, wholesalers continue to position themselves as essential intermediaries by expanding their industry position and strengthening their economic fundamentals.

Read on for five key pricing, pharmacy, provider, and manufacturer trends that are driving the U.S. drug wholesaling industry.

For even more, check out DCI's new 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, the fifteenth edition of our deep dive into wholesale distribution channels.Click here to download a free report overview (including key industry trends, the table of contents, and a list of exhibits)
Read more »

Singer Austin Mahone teams up with The Allstate Foundation to encourage smart teen driving through its #GetThereSafe program.

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IBM Watson is bringing cognitive computing to education to bring personalized learning to kids around the world - transforming early childhood education to help kids grow smarter, stronger and kinder.

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Esto es el por que :60

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medlinkNaloxone/medlink, a life-saving medication, is commonly administered by first responders to individuals who have overdosed on opioids and still have a pulse.

Giving a common antibiotic to medlinkchildren/medlink under five years old in Africa saves lives, finds a new study. When UC San Francisco research

A 12-week virtual yoga program can effectively treat chronic low back pain, according to Cleveland Clinic researchers. This safe and feasible treatment is detailed in iJAMA Network Open.

Respecting the regularity of growth and development of the child's birth, the proper selection of the best baby gifts has an important role in these processes. The reason for thisaas is found in the...

In an exclusive conversation with International Business Times, India, Rashami Desai spoke about her stint on BB 13, when things about her personal life were blown out of proportion, how the industry has changed over the years after the OTT boom, whether she will be part of any more reality shows, and more. Read on.

Fleek, an online marketplace that connects second-hand clothing wholesalers with those who sell it at retail, has raised a $20.4 million Series A.

© 2024 TechCrunch. All rights reserved. For personal use only.

The Court: Liberty is granted to the advocate-on-record for the claimant to correct the description of the application in the cause title.

By communication dated September 3, 2024, learned sole arbitrator appointed by the court informed the parties that he had resigned from the matter. He thus refused to act as the sole arbitrator. The petitioner prays for appointment of a substitute arbitrator.

2

Ms. Banerjee, learned advocate for the respondent submits that the respondent had filed a suit. An application under Section 8 of the Arbitration and Conciliation Act, 1996 (hereinafter referred to as the said Act,) is also pending before the learned Civil Court at the instance of the petitioner. As such, this Court must refrain from appointing an arbitrator as the issues involved in the suit are yet to be decided and the application under Section 8 of the said Act has been filed with similar prayers.

This Second Appeal has been preferred against the Judgment and Decree passed by the ‘learned Additional District Judge (Fast Track Court) Villupuram’ ['First Appellate Court' for short] in A.S.No.69 of 2011 modifying the Judgment and Decree passed in O.S.No.64 of 2009 on the file of the ‘Principal Sub Court, Villupuram’ ['Trial Court' for short].

2. For the sake of convenience, hereinafter, the parties will be referred to as per their array in the Original Suit. Case of the Plaintiffs:

3. The Suit Properties along with some other properties belonged to one Adhimoolam. The said Adhimoolam died intestate 40 years before the date of Plaint. Govindasamy and Krishnan were the sons of said Adhimoolam.

कई लोगों को मीठा खाना बहुत पसंद होता है। लेकिन अपने हेल्थ को देखते हुए वो मीठा खाने से परहेज करते हैं। कोई अपने डायबिटीज को लेकर मीठे को इग्नोर करता है, तो कोई वजन बढ़ने के डर से चीनी

Desai, a former journalist, is also a former racing steward and thoroughbred horse breeder, draws from his deep knowledge of the racing world and brings his signature storytelling style to craft a tale that combines authenticity with a Hitchcockian level of suspense.

Berlin ; Boston : De Gruyter, [2023]

'Sreesanth is genuine and has a rebellious attitude.'

'Sreesanth creates unnecessary drama.''I request viewers to help him get out of the house.'

'I came to survive in Bigg Boss, but ended up ruling it.'

'It's almost more than 6 years now that I lost my love and passion, which is cricket.''So it is high time that I make a bright career this year in the entertainment industry.'

Another awards night...

In his homily after Mother Teresa’s canonisation, Pope Francis admitted even he would find it hard to call her “St. Teresa” since her tenderness was so maternal.

WPI inflation trend to help retail inflation nearing RBI MPC’s target of 4%

While the eSanjeevani numbers are impressive, doctors and experts point out that unless a number of systemic issues -- including low doctor numbers on the platform are fixed -- telemedicine in the country will not be able to move past infancy

Traders claimed the central government's decision to impose 40% duty on the export of onions till December 31, 2023 will adversely affect the onion growers and its export

London ; Philadelphia : Jessica Kingsley Publishers, 2024.

Cham, Switzerland : Springer, [2024]

Actor Nandamuri Balakrishna’s 108th film directed by Anil Ravipudi is titled ‘Bhagavanth Kesari’, also stars Kajal Aggarwal, Sree Leela and Arjun Rampal

The teaser of actor Nandamuri Balakrishna’s 108th film ‘Bhagavanth Kesari’, directed by Anil Ravipudi, has the actor mouthing fan-pleasing dialogues in Hindi and Telangana-laced Telugu

Washington, D.C. : ICS Publications, [2016]

Elmo, Cookie Monster, Grover, Abby Cadabby, Oscar the Grouch and Elmo's puppy Tango hang with WIRED to answer the Internet's most searched questions about 'Sesame Street' and themselves in this hilarious WIRED Autocomplete Interview. Can they tell us how to get to Sesame Street? How did Elmo get his name? Director: Katherine Wzorek Director of Photography: Francis Bernal Editor: Eric Bigman Line Producer: Joseph Buscemi Associate Producer: Kameryn Hamilton Production Manager: D. Eric Martinez Production Coordinator: Fernando Davila Talent Booker: Jenna Caldwell; Meredith Judkins Camera Operator: Jake Robbins Gaffer: Mar Alfonso Sound Mixer: Mike Guggino Production Assistant: Caleb Clark; Justine Ramirez Post Production Supervisor: Alexa Deutsch Post Production Coordinator: Ian Bryant Supervising Editor: Doug Larsen Assistant Editor: Billy Ward

L’industrie dieses assurances multirisques est algun secteur significant de la société canadienne. Elle offre votre protection adéquate aux professionnels qui s’exposent au risque de perdre leurs biens professionnels ou y compris leur plan. Toute ouvrage ecological research problem solving methodology industrielle est promote à différents risques et à la majorité des formes d’accidents pouvant entraver […]

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After BookMyShow anounced that shows were sold out, tickets, originally priced between ₹2,500 and ₹35,000, were being offered for ₹55,000 to ₹1,89,000 on platforms like Viagogo

Anand qualified for the international tournament on his first try competing in a riding event

"Before her visit to India, Theresa May must come clean about the role played by the UK in the attack on the Golden Temple in 1984 and subsequent events," Mr. Watson said

Though offered a chance to escape during the terror attack, he refused to leave his friends.