Background: A major problem of the first moments of childbirth, especially in “prolonged labor,” is perinatal asphyxia which necessitates neonatal resuscitation. This study aimed at evaluating the ALERT LINE of the partogram in recognizing the need for neonatal resuscitation 20–30 s after delivery.Materials and Methods: 140 full-term pregnant women were kept under surveillance through using a partogram. In order to decide on the onset of resuscitation, the three indicators of fetal respiration, heart rate, and skin color were used 20-30 s after delivery.The findings from the evaluation of fetal conditions were compared to the position of the ultimate cervical dilatation graph to the ALERT LINE of the partogram, and through using appropriate statistical procedures, sensitivity, specificity, and positive and negative prediction values of the ALERT LINE to recognize the need for neonatal resuscitation were computed.Results: There was a significant relationship between the need for neonatal resuscitation within 20–30 seconds after delivery and the graph of the cervical dilatations on the partogram (P=0.001). The indices of the ALERT LINE for predicting the need for resuscitation 20-30 s after birth had a sensitivity of 97.5%, specificity of 80.2%, positive prediction value of 97.2%, and negative prediction value of 98.7%.Conclusions: In mothers who had normal vaginal delivery, with normal fetal heart rate, and with no oxytocin administration or omniotomy, the ALERT LINE showed appropriate sensitivity, specificity, and negative prediction value. So, it can assist in predicting the necessity of action for neonatal resuscitation 20-30 s after delivery.

Background and aim: The early diagnosis of abnormal progress of labour and prevention of long term delivery are the main keys to reduce fetal mortality rate due to hypoxia and tissue ischemia. One of the WHO’s proposed methods for prevention of abnormal delivery is using partogram. Therefore, this survey was conducted to evaluate WHO's partogram ALERT LINE for APGAR score at the first minute after birth.Methods: This descriptive–analytical study was performed on 140 pregnant women under partogram in Shahrood Fatemieh hospital. Using the partogram ALERT LINE, the progress of labour, mother's and infant's condition started to be controled from 3 cm dilation of the cervix. Decision for resuscitation was made based on respiration, heart rate and skin color of the infant 20 to 30 seconds after the birth. Tools of this research were a questionnaire, inspection form consisted of WHO's partogram and step by step resuscitation form. χ2, t–test and analytical methods of sensitivity, specificity and negative and positive values were used for data analysis.Results: The results showed that 68.8% of the subject's cervical dilatation remained on or to the left side of the ALERT LINE and 28.6% was on the right side and 2.9% was on or to the right side of the active LINE.According to χ2 test, there was a significant relationship between the first minute APGAR score after delivery and the location of cervical dilation. The value of ALERT LINE for surveying of APGAR score at the first minute after birth had a sensitivity of 25%, specificity of 96.87%, negative and positive predictive value of 75.6% and 76.92%, respectively.Conclusion: Our results showed that using WHO's partogram prevents long term delivery, helps for on time diagnosis of fetal distress and reduction in stillbirth and fetal mortality. So, partogram should be a part and parcel of fetal and maternal health care.

Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis, there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

The main purpose of the political systems from establishing and providing a license to the security institutions is to use these intelligence activities to protect policy makers from the loss of security or security threats. In this regard, the main philosophy of the intelligence cycle is to warn against future anti-security events; on this basis, intelligence defeat is defined as surprise and unpredictable crisis. The purpose of this study is to explain the 'optimal warning cycle' in intelligence – security activities and to answer the main question of “ what stages form the optimal warning cycle? ” . In order to answer this question, this study uses library study and the Delphi method in three phases and the idea of 7 experts in intelligence and security field to reach a theoretical stability and consensus. As a result, the proposed optimal cycle was formed with five peripheral stages: need assessment, warning, vigilance and prevention and a connecting core in the form of assessment and production of 'knowledge'.