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1.

Aim

To assess the relationship between the duration of the second stage of labour and postpartum anaemia during vaginal birth.

Methods

An observational, analytical retrospective cohort study was performed at the “Mancha-Centro Hospital” (Spain) during the 2013–2016 period. Data were collected from 3437 women who had a vaginal birth. Postpartum anaemia was defined as a haemoglobin level below 11 g/dL at 24 h postpartum. A univariate analysis was used for potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors.

Findings

The incidence of postpartum anaemia was 42.0%. The risk of postpartum anaemia did not increase in nulliparous women whose duration of the second stage of labour exceeded 4 h. Compared with multiparous women who delivered between 0 and 3 h, multiparous women with a duration of the second stage of labour beyond 3 h were at higher risk of postpartum anaemia (OR = 2.43 [1.30–4.52]).

Conclusion

The duration of the second stage of labour beyond 4 h is safe for postpartum anaemia in nulliparous women. However in multiparous women, monitoring should increase if the second stage of labour exceeds 3 h given the increased risk of postpartum anaemia.  相似文献   
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Urban Ecosystems - Urban streams provide important ecosystem services to cities’ population, from the maintenance of urban biodiversity, temperature, humidity and air quality to improving...  相似文献   
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This article is based on research about the daily lives of people living with chronic illnesses in England and Portugal. Through the first-person narratives of participants, I argue that the lives of people living with debilitating chronic illnesses are affected by disablism, discrimination and exclusion. These aspects affect them in several important realms of life such as lack of or poor social support, difficulties in obtaining reasonable adjustments or the inability to obtain any kind of state support at all. These aspects are also widespread and compound and greatly influence their lives, beyond or in addition to the physical experience of the illness itself. I conclude that it is fundamental to change these structural and policy aspects and that people should have access to what I have termed a paradigm of sustained well-being, despite the illness.  相似文献   
5.
The 2014 release of a new set of purchasing power parity (PPP) conversion factors (PPPs) for 2011 has prompted a revision of the World Bank’s international poverty line. In revising the line, we have sought to minimize changes to the real purchasing power of the earlier $1.25 line (in 2005 PPPs), so as to preserve the integrity of the goalposts for international targets such as the Sustainable Development Goals (SDGs) and the World Bank’s twin goals – which were set with respect to that line. In particular, the new line was obtained by inflating the same fifteen national poverty lines – originally used by Ravallion et al. (World Bank Econ. Rev. 23(2): 163–184 2009) to construct the $1.25 line – to 2011 prices in local currency units, and then converting them to US dollars using 2011 PPP conversion factors. With a small approximation, this procedure yields a new international poverty line of $1.90 per person per day. In combination with other changes described in the paper, this revision leads to relatively small changes in global poverty incidence for 2011: from 14.5 % using the old method to 14.1 % using the new method. In 2012, the new reference year for the global count, we find 12.7 % of the world’s population, or 897 million people, are living in extreme poverty. There are changes in the regional composition of poverty, but they are also relatively small. This paper documents methodological decisions taken in the process of updating both the poverty line and the consumption and income distributions at the country level, including issues of inter-temporal and spatial price adjustments. It also describes various caveats and limitations of the approach taken.  相似文献   
6.
In the areas of design, especially in architectural design, collaboration has become an important challenge. The specialization of skills increase, work teams are more and more extensive and the geographic distance between them increases too. The economic and ecological stakes related to remote collaboration are an evidence. This context involves the need to support most efficiently possible remote working meetings. We present the Distributed Collaborative Digital Studio (DSDC), a tool designed to recreate, in distant situations, the context of copresence meetings. This shared environment is created in the "invisible computer" approach [11]. The idea is that the tool should disappear from user's consciousness. Indeed, creative design activities require some fluidity in their process. Therefore, any involuntary interruption created by the system can potentially brake creativity. In this perspective, we investigate specifically the "invisibility" of our environment. To do this, we propose a framework for the operationalization of the concept and a methodology to test the system invisibility. This methodology was applied through a case study consisting of a corpus of 12 hours of remote collaborative design sessions with the DSDC. We highlight the learning effects while using our system, conclude on its effectiveness and discuss our methodology.  相似文献   
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This paper analyses welfare regime changes in Serbia and their impact on social enterprise development in the last two decades. We cover the period of significant transition-related reforms within the welfare state, with important implications on the position of these enterprises. Using data gathered from the qualitative field research, our study shows that there are two broad groups of factors that are important for development of the new generation of social enterprises, those that emerged in the last decade with an idea to foster entrepreneurial spirit and expanded into new domains other than those providing assistance to the marginalized groups. First, their decision to enter the social economy sector still depends on the environment created by the state. Secondly, their sustainability is affected by the factors typically found in any other enterprise of comparable scale like business skills, capacity to form networks and partner with relevant stakeholders.  相似文献   
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The application of ergonomics in product design is essential to its accessibility and usability. The development of manual devices should be based on ergonomic principles. Effort perception analysis is an essential approach to understand the physical and subjective aspects of the interface. The objective of the present study was to analyze the effort perception during a simulated task with different door handles by Portuguese subjects of both genders and different ages. This transversal study agreed with ethical aspects. 180 subjects of both genders pertaining to three age groups have participated. Five door handles with different shapes were evaluated. A subjective numeric rating scale of 5 levels was used to evaluate the effort. For statistical analysis it was applied the Friedman non-parametric test. The results have showed no significant differences of effort perception in door handles "A" and "B"; "A" and "D"; and "D" and "C". Door handle "E" presented the lowest values of all. In general, there's an inverse relationship between the results of biomechanical studies and the effort perception of the same task activity. This shows that door handles design influence directly these two variables and can interfere in the accessibility and usability of these kinds of products.  相似文献   
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