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61.

Background

Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy.

Aims

To evaluate if a 10 min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2 h.

Methods

A randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6–24 h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10 min or standard care. The primary and secondary outcomes were a reduction ≥30% in perineal pain intensity, immediately after the application and the maintenance of the analgesic effect for up to 2 h, respectively.

Findings

Immediately post-intervention, the proportion of women whose perineal pain decreased ≥30% was significantly higher in the experimental group. Within 2 h, there was no significant difference in the pain levels in both groups. Within 2 h, for 61.9% and 89.3% of women in the experimental and control group, respectively, the perineal pain levels remained unchanged. For the remaining participants, perineal pain was increasing after an average time of 1 h 45 min and 1 h 56 min for the experimental and control groups, respectively.

Conclusion

By applying an ice-pack for 10 min to the perineum, effective pain relief is achieved, that is maintained for between 1 h 45 min and 2 h.  相似文献   
62.
Post-crisis, macro-prudential ideas have challenged the epistemic authority of private risk management technologies, declaring them to be pro-cyclical contributors to systemic risk. This discursive challenge has been most critical of the shadow banking system, where private risk management instruments are central. This challenge, however, has not been translated into regulatory tools which reflect these convictions. This paper studies this process of discursive challenge to (failed) regulatory intervention for the case of the repo-market, the heart of the current shadow banking system. It traces regulatory efforts on the global and EU level from regulatory statements to (lack of) action, documenting both the persistent articulation of macro-prudential ideas challenging private risk-management systems and timid to no regulatory intervention. It links this hiatus to international coordination problems, the need for macro-prudential action to span regulatory communities, involving banking and financial market authorities and disagreements between micro- and macro-prudentially oriented regulators. The lack of evidence and the difficulty to generate it are identified as major impediments for regulatory consensus, further aggravated by ambiguities about the goals of anti-cyclical regulation. Beyond governance problems and the persistent appeal of private risk-management systems, the paper thus points to difficulties operationalizing macro-prudential ideas as a major explanatory factor.  相似文献   
63.
A simple connected graph G with 2n vertices is said to be k-extendable for an integer k with \(0<k<n\) if G contains a perfect matching and every matching of cardinality k in G is a subset of some perfect matching. Lakhal and Litzler (Inf Process Lett 65(1):11–16, 1998) discovered a polynomial algorithm that decides whether a bipartite graph is k-extendable. For general graphs, however, it has been an open problem whether there exists a polynomial algorithm. The new result presented in this paper is that the extendability problem is co-NP-complete.  相似文献   
64.
We investigate the reasons why “adoption” of one set of globally accepted accounting standards is presently unachievable. By “adoption” we mean that a jurisdiction incorporates IFRS instantly as its national accounting as issued by the IASB. We state that the IASB has used a Legitimacy Theory strategy to gain acceptance of its standards by more than 120 countries across the globe but it has only gained pseudo-“adoption” (not as published by the IASB) of its standards by many countries. We contend that achieving policing and enforcement of its standards globally has proven to be empirically illusive. This legitimacy deficit may explain why convergence between the IASB and FASB is currently idle. We offer a possible solution to bridging the legitimacy gap of global adoption of IFRS. We propose an internationally respected regulator and suggest the IOSCO for this role through its participation in the IFRS Foundation Monitoring Board for policing and enforcement of IFRS for cross-listed firms reporting in compliance with IFRS so that the IASB’s output legitimacy may be achieved globally.  相似文献   
65.
Most studies that have examined whether a child’s death influences parental relationship stability have used small-scale data sets and their results are inconclusive. A likely reason is that child loss affects not only the risk of parental separation, but also the risk of having another child. Hence parity progression and separation must be treated as two competing events in relation to child loss. The analysis in this paper used Finnish register data from 1971 to 2003, covering over 100,000 married couples whose durations of both first marriage and parenthood could be observed. We ran parity-specific Cox regressions in which process time started from the birth of each additional child. All marriages included women of childbearing age, none of whom had experienced any child death on entering the analysis. We find that child loss only modestly influences the divorce risk, whereas its effect on the risk of parity progression is considerable.  相似文献   
66.
Jan Van Bavel 《Demography》2010,47(2):439-458
Theory suggests that the field of study may be at least as consequential for fertility behavior as the duration and level of education. Yet, this qualitative dimension of educational achievement has been largely neglected in demographic studies. This article analyzes the mechanisms relating the field of study with the postponement of motherhood by European college-graduate women aged 20–40. The second round of the European Social Survey is used to assess the impact of four features of study disciplines that are identified as key to reproductive decision making: the expected starting wage, the steepness of the earning profile, attitudes toward gendered family roles, and gender composition. The results indicate that the postponement of motherhood is relatively limited among graduates from study disciplines in which stereotypical attitudes about family roles prevail and in which a large share of the graduates are female. Both the level of the starting wage and the steepness of the earning profile are found to be associated with greater postponement. These results are robust to controlling for the partnership situation and the age at entry into the labor market.  相似文献   
67.
With data drawn from the second public release version of the “Survey of Health, Aging and Retirement in Europe” (SHARE), we scrutinize individual and contextual (regional) correlates of economic difficulties among older Europeans, aged 65 or more. A logistic multi-level regression model with random intercept shows that the risk of being relatively poor varies considerably among the aged. We verified that the factors affecting poverty in each area are not merely the weighted sum of the effect of the more disadvantaged people within the same area, which also exists: poverty appears also significantly influenced by the specific context of residence.  相似文献   
68.
This paper takes the theory of value change as developed by Inglehart as a point of departure and tests its implications for the determinants of human happiness. It investigates whether the importance of post-material concerns for happiness, relative to that of materialist concerns, is indeed higher in rich post-industrial societies. Personal autonomy and job creativity serve as indicators for post-materialist concerns, the income domain as an indicator for materialist concerns. The main assumption is put against data for 48 countries from wave 5 of the World Values Survey, the most recent survey, which covers the full range from poor agrarian to rich post-industrial societies. Employing a multi-level design, the paper indeed reveals a quite consistent pattern towards post-materialist happiness as we move from poor to rich societies. This pattern seems to be driven by both a devalorization of material concerns and a valorization of post-materialist concerns, although the evidence suggests that the former trend is stronger and more linear than the latter.  相似文献   
69.
Same parliaments, to form a committee of size $q$ , use a voting process like the following: every parliamentary member votes for one out of a fixed set of candidates, and those $q$ candidates receiving more votes are elected for the committee. Assuming total discipline of vote, this is a game form in which players are the parliamentary groups. We investigate, according to some natural hypotheses about preferences, the likely distribution of the members of this committee. The main results are: (a) when fractional votes are allowed, there is a complete agreement between the distribution among the groups of the elected candidates that are outcomes of a Nash equilibrium and the distribution that, according to the size of the groups, would compute the Jefferson-d’Hondt allocation rule, and (b) when fractional votes are not allowed, there is a near agreement for a majority of situations.  相似文献   
70.
The number of occupational diseases in Mexico is alarming and clearly it is important to do studies with the purpose of improving the design of workstations. The objective of this research is to determine the maximum force levels in different positions of shoulder and elbow. An experiment was conducted with 16 subjects between 18 and 28 years old: 8 male and 8 female. We considered 16 different positions, working with the right and left arm to perform the tasks of pull and push. The tasks consisted of pushing or pulling a dynamometer for a period of 3 seconds as hard as possible. The results were presented in tables. The tables show the mean, standard deviation and range of force levels in different positions.  相似文献   
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