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1.

Background

Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.

Aim

The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.

Methods

An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.

Findings

Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.

Conclusions

Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education.  相似文献   
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In the summer of 2015, the “cheating website” known as Ashley Madison came under scrutiny, as a group calling itself the Impact Team revealed users’ private information. This case study explores the controversy’s Canadian media coverage and sheds light on the main discourses about intimacy and the Internet that were made visible during this event. It interrogates how cheaters, hackers, and the company were represented. To varying degrees, the mainstream press condemns the cheaters, the hackers, and the company for their behaviour. The article also addresses the ways intimate practices are politicized and commercialized in the digital context, including a discussion of the emphasis on “privacy.” To conclude the article, I discuss the transparency and privacy issues implicated in digital intimacies and the power–knowledge (im)balance implied by hackers’ online anonymity.  相似文献   
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Historically, the life course has been constructed as an organized and linear temporal progression. This holds true in various disciplines from education, to psychology, to counseling. The foundation of a life unfolding through temporal categorizations is documented in textbooks and theories that straddle these disciplines as well as many others, including the sociology of health and illness, which has often conceptualized the illness experience as embedded in a recovery trajectory.Here, we take this to task. Using Gubrium and Holstein's [Sociol. Inq. 65 (1995) 207; Gubrium, J., & Holstein, J., (1997). The new language of qualitative method. New York: Oxford University Press] analytic vocabulary of biographical work, we analyze narratives of stroke survivors by emphasizing the ordinary resources used as discursive foundations for the narrative production of the future in illness. Ordinary resources focused on include God and spirituality, comorbidities, and activity and leisure. The discussion is embedded in overarching concerns with “healthy aging” in gerontology and geriatrics.  相似文献   
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European settlement in Quebec (Canada) began in the early 17th century, with the arrival of French pioneers. After the British Conquest in 1760, immigrants from the British Isles began to settle in some parts of Quebec. Many of these immigrants were Irish Catholics. Historians and genealogists have identified several names of Irish origin in the French Canadian population, and many scholars have wondered about the importance of the integration of Irish migrants and their descendants within this population. The purposes of this study are to identify and characterize the founders of Irish origin to estimate the importance of their genetic contribution to the contemporary Quebec population, and to measure the variability of this contribution according to the founders’ period of arrival and county of origin in Ireland. Data was obtained from a set of 2,223 ascending genealogies going back as far as the early 17th century. The average genealogical depth is a little more than 9 generations, with many branches reaching 16 or 17 generations. Although Irish founders explain less than 1% of the total Quebec gene pool, results show that nearly 21% of the genealogies contain at least one Irish founder. These founders contributed to the peopling of all regions of Quebec, but there are some important variations from one region to another. A majority of the Irish founders immigrated during the 19th century, and most of them came from the counties of Southern Ireland.  相似文献   
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The conceptualizations of power, traditionally associated with control, have been nuanced in the past decades by influential authors such as Michel Foucault, Hannah Arendt and Pierre Bourdieu. These authors offer a perspective on power focused on the agency of individuals, with an emphasis on the way the dynamics and relations of power operate. Relying on these conceptual frameworks, we argue that the theory of social representations is of particular relevance to an analysis of the construction of power relations, whether it be to criticize the effects of domination or examine those of emancipation. The results of our research on the social representations of depression illustrate the latter's role in the construction, continuity and transformation of the power dynamics at play in the area of access to healthcare services by people who have experienced a depressive episode.  相似文献   
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Prior research suggests that illness disrupts biographical self because of the resulting difficulty in continuing to draw on the same material and symbolic resources used in self‐construction. Recent literature suggests that constructing continuity is possible because of the multi‐faceted nature of self‐construction. One hundred and twenty‐two veterans who had been hospitalized after an acute stroke and discharged home were enrolled in the study. In‐depth interviews were collected from the veterans at one month post‐stroke. Results indicate that some of these individuals construct continuity through their use of personally accessible discursive resources such as expectations for aging and religious beliefs.  相似文献   
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