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Online journalism

CTG structure and analysis:

1. Basal fetal HR is a mean of instantaneous values of fetal HR nonregistering accelerations and decelerations. BHR is calculated in intervals in 10 min. Normal fetal BHR (normocardia) is the frequency from 110tol70bpm.

2. HR variability is a complex parameter of fetal cardiac function. It can be assessed by the width of CTG record (HR amplitude) and by oscillations frequency.

Record width (amplitude) is measured between the absolute maxi­mum and minimum of all oscillations nonregistering accelerations and decelerations, i.e. the amount of deflection from the basal rhythm (Fig. 32).

In the given example the amplitude will make 150-135 = = 15(bpm).

There are differentiated 4 variants of amplitude:

— monotonic — with deflections from the basal rhythm up to 5 bpm;

— flattened (extremely wave-like, with deflections from 5 to 9 bpm);

— wave-like — from 10 to 25 bpm;

— pulsating (saltatory rhythm) — more than 25 bpm.
Oscillations frequency is their quantity per minute.

By frequency there are differentiated low (less than 3 per min), medium (3—6 per min), and high frequency (more than 6 per min) oscillations.

By the character of origination accelerations and decelerations may be sporadic, periodical, and regular, by duration — typical and prolonged.

Sporadic— appear in response to fetal movements, are not regular.

Regular— are registered in approximately equal intervals of time and are connected with fetal movements.

Periodical— are connected with fetal vital activity, e.g. accelera­tions and decelerations arising after a labor pain or caused by umbili­cal cord compression.

Typicalaccelerations and decelerations last more than 15 sec, but not longer than 2 min.

Accelerations and decelerations are prolongedif basal rhythm change lasts more than 2 min.

3. Accelerations are temporary BHR changes characterised by BHR increase during more than 15 sec (weak HR changes from 10 to 30 bpm, medium — 30—60 bpm, considerable — more than 60 bpm; Fig. 34).

4. Decelerations — temporary BHR changes characterised by BHR decrease.

4.1. Spontaneous decelerations (dip 0). Short-term decelera­tions, last not more than 30 sec, the amplitude of 30—40 beats from the basal level. These changes have no practical meaning. De­celerations of this type may be sporadic, regular, and periodical.

4.2. Early decelerations (dip I) are periodical, i.e. are detected only if the uterus is active. Deceleration duration and amplitude correspond to the duration and intensity of parodynia.

4.3. Late decelerations (dip II) are periodical, i.e. also con­nected with parodynia, but arise later (up to 30 sec after begin­ning) and reach their high after the maximum uterine tension.

4.4. Variable decelerations (dip III) are also referred to periodical. This is a stable form of HR reduction, a combination of dip I and dip II. They are characterised by unsteady time of emer­gence relative to labor pains, different duration and form. During delivery fetal condition is assessed by the W. Fisher's scale (1976).



At normal fetal condition CTG is characterized by: BHR within 110—170 bpm (normocardia), variability (record width) — 10— 25 bpm with oscillation frequency of 3—6 cycles per min (undulating type), presence of HR accelerations and no decelerations.

Non-stress test (NST) is assessment of fetal cardiac function re­activity with the help of CTG during pregnancy in response to spon­taneous movements. The pregnant woman is in comfortable position during CTG.

NST may be reactive (norm) when during 20 min there are 2 or more accelerations of fetal heartbeats by. more than 15 bpm and last­ing not less than 15 sec connected with fetal movements. The test is areactive if there are less than 2 accelerations of fetal heartbeats by less than 15 bpm, lasting less than 15 sec, connected with fetal move­ments during 40 min of monitoring.

Stress test is assessment of fetal cardiac function reactivity by means of CTG during pregnancy in response to functional tests: oxy­tocin introduction, breath-holding, physical load of the mother, nip­ples stimulation, thermal irritation of the belly skin, or acoustic stimu­lation. This method has low predictive value concerning the fetus and a very high frequency of error-positive results.

Biophysical fetal profile (BFP) is a change of biophysical indices controlled by the central nervous system at fetal hypoxia.

Biophysical indices include: frequency of fetal respiratory move­ments, fetal motion activity, fetal tone, fetal cardiac function reacti­vity and NST, amniotic fluid volume, placenta maturity (Table 3).

Modified BFP combines NST with amniotic fluid index.

Amniotic fluid index is a total of maximal recesses with fluid in 4 quadrants of the uterine cavity: 0—5 cm — evident oligohydram­nios, 5.1—8 cm — moderate oligohydramnios, 8.1 — 18 cm — normal index, more than 18 cm — hydramnion.

Each index is assessed in points from 0 (pathology) to 2 (norm), then the total of points of all biophysical parameters is analyzed. Thus, BFP is found.

BFP is detected beginning from 30 weeks of pregnancy.

Indications to BFP:

1. Areactive NST of the fetus at CTG recording.

2. Syndrome of fetal development delay.

3. Chronic fetoplacental insufficiency.

4. A high degree of risk in the pregnant woman at some extra­genital pathology.

V. Organizational structure of lesson:

Organizational moments-2%;

Topic motivation -3%;

Checking the initial level of knowledge -20%;

Independent work of students under supervision of a lecturer -35%;

Checking the final level of knowledge -20%;

The rating of students` knowledge -15%;

Lecturer`s summary/conclusion, home task-5%.

 

 

VI. Methodical support:

The place of practical training: department of pathology pregnant, gynecology department, intensive care department, low operating, classroom.

Visual aids: tables, slides, results of laboratory examinations, case histories of pregnant women with early and late gestosis, a set of tools for abortion.

Checking questions for the assessment of the final level of knowledge

1. The structure of female pelvis, its changes before delivery.

2. The names of (four) bones that constitute the female pelvis.

3. The boundaries and planes of the small pelvis, their form and dimensions.

4. The main external and internal female pelvis dimensions.

5. Additional measurements of the pelvis.

6. Methods of true conjugate determination.

7. Muscles of superficial (external) layer of the pelvic floor.

8. Muscles of middle layer of the pelvic floor.

9. Muscles of internal layer of the pelvic floor.

10. Function of urogenical diaphragm.

11. Osteocranum structure of the newborn.

12. Configuration of sutures and fontanels of fetus head, notion of head configuration.

13. Dimensions of a head, shoulders, buttocks of a full-term newborn.

14. Mass and length of a full-term newborn.

15. Parameters of a full-term and mature fetus.

Case studies for the assessment of the final level of knowledge

On pelvimetry there is noted that the diagonal conjugate equals 12.5 cm and carpus circumference is 15 cm.

· How to determine true conjugate?

Which suture can be determined on the presenting part during internal examination if under the pubic it is conjugated with a triangular shape fontanel and at sacrum – with rhomb-shaped fontanel? Reproduce this situation on the phantom.

Which suture can be determined on the presenting part if in front under the pubic it is conjugated with a hornlike fontanel and at sacrum – with a triangular shape fontanel? Reproduce this situation on the phantom.

The newborn boy weighs 2, 500 grams, 45 cm long.

· Is it a full term infant?

· What are the other necessary signs of this?

On measuring the main pelvis dimensions there was noted that the interspinal distance Distantia spinarum equals 26 cm, intercrista one Distantia cristarum equals 28 cm, intertrochanteric Distantia trochanterica one is equal 31 cm, external conjugate is 20 cm. On internal examination the promontory was not approached.

· Are there any indications for additional measurements of the pelvis?

On pelvimetry there is noted that the diagonal conjugate equals 12 cm. The circumference of the radiocar­pal articulation is 14 cm.

· What is true conjugate equal to?

On pelvimetry there is noted that the diagonal conjugate equals 12.5 cm and carpus circumference is 15 cm.

· What is true conjugate equal to?

True conjugate equals 10.5 cm

On measuring the main pelvis dimensions there is noted that the interspinal distance Distantia spinarum equals 24 cm, intercrista one Distantia cristarum equals 25 cm, intertrochanteric one Distantia tro-chanterica is equal 29 cm. External conjugate is 20 cm. On internal examination there is noted that the diagonal conjugate equals 12 cm.

 

· Are there any indications for additional pelvic measurements?

On measuring the main pelvis dimensions there is noted that the interspinal distance Distantia spinarum equals 26 cm, intercrista one Distantia cristarum equals 28 cm, intertrochanteric one Distantia tro-chanterica is equal 31 cm, external conjugate is 20 cm. On internal examination the promontory was not approached.

· Are there any indications for additional pelvic measurements?

There are no indications for additional pelvic measurements.

Which suture can be determined on the presenting part on internal examination if in front it is conjugated with a triangular shape fontanel and at the back – with a rhomb-shaped fontanel? Reproduce this situation on the phantom, when the small fontanel is under the pubic and the big one is at the sacrum bone.

One can determine saggital suture

The newborn boy weighs 2, 500 grams, 45 cm long.

· Is it a full term infant?

· What are the other signs necessary to be taken into consideration for answering this question?

The infant is immature. For diagnostic adjustments one should consider the following signs: the position of umbilical ring, skin coloration, presence and amount of lubricant, length of nails, hair, and consistency of nose and ear cartilage, the condition of external genitals.

 

Test questions for the assessment of final level of knowledge

On pelvimetry it is found out that the diagonal conjugate equals 12 cm. The circumference of the radio carpal articulation is 14 cm.

· What is true conjugate equal to?

A.10.5 cm

B.10 cm

C. 11 cm

D. 9.5 cm

On the presenting head one can palpate the triangular shape conjunctive tissue plate where three sutures come together.

· Which fontanel is being palpated?

A. Big fontanel

B. Side front fontanel

C. Small fontanel

D. Side back fontanel

Methodical support:

The place of practical training: classroom, delivery room, compartment of pregnant pathology, children’s compartment.

 

Visual aids: tables, model of pelvis, centimeter tape, pelviometr, case studies and test questios.

 

 

Appoved at the chair meeting from “___” _____________________ 200__ year,

minutes ¹ ___ .

 

Revised at the chair meeting from “___” _____________________ 200__year,

minutes ¹ ___

 

 

Online journalism

"Blogging is not structured in the way journalism is. People are putting their views out in a relatively unprocessed manner. The two main things that separate blogging from journalism are the personalisation of the voice of the blogger and the lack of the subbing workflow you would expect to see for any print or online publication”.

Lloyd Shepherd, chief producer for Guardian Unlimited

Task 1. Comment upon the quotation above. What does the author think of online journalism? What is online journalism from your point of view?

Task 2. Read the Encyclopaedia article below and form your own definition of online journalism.

Online journalism is defined as the reporting of facts produced and distributed via the Internet. The simple answer is, of course, journalism as it is practiced online.

Journalism is any non-fiction or documentary narrative that reports or analyzes facts and events firmly rooted in time (either topical or historical) which are selected and arranged by reporters, writers, and editors to tell a story from a particular point of view. Journalism has traditionally been published in print, presented on film, and broadcast on television and radio. "Online" includes many venues. Most prominent is the World Wide Web, plus commercial online information services like America Online. Simple Internet email also plays a big role. Also important are CD-ROMs (often included with a book) linked to a web site or other online venue, plus intranets and private dial-up bulletin board systems.

From the Wikipedia Encyclopaedia

Task 3. Read the article about online journalism written in the form of questions and answers (Q&A).

Q. What are the distinguishing characteristics of online journalism as compared to traditional journalism?

Online = real time

Online journalism can be published in real time, updating breaking news and events as they happen. Nothing new here -- we've had this ability with telegraph, teletype, radio, and TV. Just as we gather around the TV or radio, so we can gather and attend real-time events online in chat rooms and auditorium facilities.

Online = shifted time

Online journalism also takes advantage of shifted time. Online publications can publish and archive articles for viewing now or later, just as print, film, or broadcast publications can. WWW articles can be infinitely easier to access, of course.

Online = multimedia

Online journalism can include multimedia elements: text and graphics (newspapers and books), plus sound, music, motion video, and animation (broadcast radio, TV, film), 3D, etc.

Online = interactive

Online journalism is interactive. Hyperlinks represent the primary mechanism for this interactivity on the Web, linking the various elements of a lengthy, complex work, introducing multiple points of view, and adding depth and detail. A work of online journalism can consist of a hyperlinked set of web pages; these pages can themselves include hyperlinks to other web sites.

Traditional journalism guides the reader through a linear narrative. The online journalist lets readers become participants, as they click their way through a hyperlinked set of pages. A web of interlinked pages is also an ideal mechanism to give reader/participants access to a library of source documents and background information that form the foundation of an extensive journalistic investigation.

Readers/participants can respond instantly to material presented by the online journalist; this response can take several forms. Email to the reporter or editor resembles the traditional letter to editor of print publications, but email letters can be published much sooner online than in print. Online journalists can also take advantage of threaded discussions that let readers respond immediately to an article, and to the comments of other readers, in a bulletin board-style discussion that can be accessed at any time. Readers can become participants in the ongoing co-creation of an editorial environment that evolves from the online journalist's original reporting and the initial article. Blogs (short for "Web log", a Web-based journal) make this easy.

Much of the journalism published on the Web and elsewhere online amounts to nothing more than traditional magazine or newspaper articles and graphics, perhaps with some added links to related web sites. By providing an instant, ubiquitous, cheap distribution medium, the Internet adds tremendous value to such articles. Journalists are still experimenting and discovering how best to take advantage of interactivity and hyperlinking to create distinctive works that take advantage of the benefits of the online medium.

The papers from the International Symposium on Online Journalism are a good starting point for understanding the current state of play in online journalism. The USC Annenberg Online Journalism Review also provides good, ongoing coverage.

Q. How has the Internet affected print journalism?

The Internet is a time-saving research resource for journalists and editors, especially for reporters looking for background, if they care to dig and look. You also see a lot of articles, columns, syndicated features now about the Internet in print and broadcast publications.

Q. What influences do online journalists have on their audiences, in comparison to mass media journalists?

While audiences for online journalism remain smaller than the audiences for mass media journalism, online journalists have the same influence on their audiences that mass media journalists have -- by choosing which stories to report; by choosing which facts, quotes, and other story elements to include and which to exclude; by choosing to tell the story from a particular point of view. A crime story told from the point of view of the victim will elicit a different reaction from the same story told from the point of view of the criminal, for example, whether that story is presented in the morning newspaper, on the 6 o'clock TV news, or on the Web. The Web's interactivity and hyperlinking gives the journalist more opportunities to examine multiple points of view in a particular piece than traditional, analogue media. The lack of serious space limitations permits online journalists to develop a story more fully and to publish source documents and background material.

Q. How reliable is online information?

It's a mixed bag, and should be treated the same way that professional journalists treat any other information that they find in the course of reporting a story. Good, reliable editing and filtering of information becomes ever more important on the Web, where anybody can publish anything and make it look substantial. Editorial "branding" becomes crucial.

Q. What is the future of online journalism?

Traditional news gathering organizations, publishers, and broadcasters will continue to enlarge their efforts on the Web, and this big money journalism will take advantage of higher Internet bandwidth and new technologies (streaming audio and video, "push", etc.) to recreate the traditional broadcast approach on the Web. Blogs have also become a popular venue for ordinary people to engage in online journalism. Meanwhile, both within those big organizations and outside them, journalists will continue to experiment and discover how best to use the native capabilities of the Web -- hyperlinks, interactivity, personalization, community, threaded discussions, etc. -- to create new, hybrid editorial environments in which readers become "co-creators" along with the journalist, bringing their responses, questions, experience, to add to the story threads that the professional journalist launches.

The Web will continue to enable publications for smaller, more specialized audiences. The ultimate outcome of this trend will be publications for audiences of one, completely personalized according to individual preferences, served out of large editorial databases or assembled on the fly by intelligent agent software that scans the Web for news and information that meet the individual's profile of interests.

Q. How can I develop a career as an online journalist?

Journalism remains a field that is open to newcomers and outsiders -- all you really have to do is write the kinds of articles that publications want to publish.

You can help yourself by learning the basics of journalism. Find and read the books that are currently used in beginning journalism courses, to learn about the basic kinds of articles that journalists produce, and the techniques they use to produce them. Online journalists may also want to learn a few Web basics: how to use the Internet for research (you'll want to learn how to do library research, too, plus basic investigative and reporting techniques); basic HTML coding to produce Web pages; digital audio and video production and related Web programming techniques if you want to add multimedia elements to your online journalism works.

Obviously, you need to develop good, basic writing skills. The best way to do this is to practice writing the kinds of articles you like, and find an editor (or somebody with appropriate editorial skills) to give you feedback and show you how to improve your articles. You should also learn about the history of journalism in order to appreciate the power and privileges that journalists enjoy, and read classic journalistic works to get a deep understanding of what journalists have done.

Once you've developed an understanding of journalism practice and a basic repertoire of skills, it's time to start work. Here's the process:

1. Choose the subject material and type of article (feature, news, interview, etc. -- a journalism textbook will show you all the basic types) you want to write.

2. Find publications that publish the kinds of articles (type and subject matter) you want to write.

3. Write some sample articles that you think will fit into this publication's profile. Create a professional-looking Web site of your own where you can publish your sample articles. It's very easy to do this with a blog (short for "Web log", a Web-based journal), if you're lacking Web design and coding skills.

4. Once you've located publications that publish the kind of articles you want to write, identify the editor (or editors) responsible for assigning articles to freelance writers.

5. Send a letter to this editor, introducing yourself and asking if he or she would be interested in giving you story assignments to work on. Contact the editors (by telephone, email, or snail mail) and propose specific story ideas, suggesting articles that you would like to write. Send along copies of your sample articles, and provide the url of your web site where the editor can see your work published on the Web.

6. Continue to find other publications that may be interested in the articles you want to write, identify the editors who assign freelance work, and contact them to see if they'll give you a chance. At the same time, continue to research and write articles that you can publish in your Web site -- you'll be sharpening your journalistic skills while developing a body of work that will demonstrate what you can do.

You will have to be persistent in order to find editors who will give you assignments, but if you persist, and if you develop the ability to research and write the kinds of articles that editors want to publish, eventually you will get work. by Doug Millison


Date: 2014-12-28; view: 1071


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