Relationship between duration of second stage of labour and postpartum anaemia

Aim

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

‘What Was I Thinking?!’ Rhetorical Questions as a Technique to Identify and Explore Impasses in Therapy

Rhetorical questions emerging spontaneously in consultations can be used as a tool for developing self‐reflexivity and exploring the therapeutic alliance in the process of therapy with couples and families. This paper presents a technique based on the enunciation of rhetorical questions, which can point to an impasse in the process of therapy and contain a key to its resolution. The technique focuses on the distinctive feature of rhetorical questions as convening a paradoxical injunction: a question not intended as a question, while uttered as such. The technique in four steps is illustrated by examples from therapy, supervision, consultation, and self‐supervision. Its focus is the interlink between the therapeutic relationship and the process of therapy and it is informed by a second‐order cybernetics approach, dialogical practice, and the systemic literature on emotion. The technique can help develop curiosity in working with families, lead to unforeseen developments, and touch on prejudices not made explicit in previous therapeutic encounters. Whether we are acting as supervisors, therapists, or clients, the creation of a ‘secure enough’ context for rhetorical questions becomes critical to allow freeform exploration.     

A feasibility approach for constructing combinatorial designs of circulant type

In this work, we propose an optimization approach for constructing various classes of circulant combinatorial designs that can be defined in terms of autocorrelation. The problem is formulated as a so-called feasibility problem having three sets, to which the Douglas–Rachford projection algorithm is applied. The approach is illustrated on three different classes of circulant combinatorial designs: circulant weighing matrices, D-optimal matrices of circulant type, and Hadamard matrices with two circulant cores. Furthermore, we explicitly construct two new circulant weighing matrices, a CW(126, 64) and a CW(198, 100), whose existence was previously marked as unresolved in the most recent version of Strassler’s table.     

The division problem with voluntary participation

The division problem consists of allocating a given amount of a homogeneous and perfectly divisible good among a group of agents with single-peaked preferences on the set of their potential shares. A rule proposes a vector of shares for each division problem. The literature has implicitly assumed that agents will find acceptable any share they are assigned to. In this article we consider the division problem when agents’ participation is voluntary. Each agent has an idiosyncratic interval of acceptable shares where his preferences are single-peaked. A rule has to propose to each agent either to not participate or an acceptable share because otherwise he would opt out and this would require to reassign some of the remaining agents’ shares. We study a subclass of efficient and consistent rules and characterize extensions of the uniform rule that deal explicitly with agents’ voluntary participation.     

Stress and musculoskeletal discomfort among hydrocarbon industry workers in Mexico

This study of 114 workers in the hydrocarbon industry was conducted to identify the relationship between stress and musculoskeletal discomfort, and to view the roles played by such factors as age, schooling, obesity, workplace and job seniority. All factors except seniority were found to affect the presence of musculoskeletal discomfort in some area of the body.     

Thermal comfort and personal protective equipment (PPE)

Personal Protective Equipment (PPE) is considered the last preferred solution to an Occupational Safety Health (OSH) system. Brazilian OSH legislation assumes and requires PPE usage to neutralize the possibility of pesticide contamination. This study examines the inadequacy of the PPE used in a tomato crop, particularly from the standpoint of thermal comfort. This study made observations regarding heart rate and body temperature in a controlled environment using a treadmill (with and without PPE) of 12 volunteers; and during the process of rural labor (at rest and in normal work routine) of 2 actual rural workers. Comparing the results of the treadmill test (with and without PPE) which tried to reproduce the same level of effort and environmental conditions of the actual rural work, this study demonstrated that PPE makes thermoregulation harder and tympanic temperature reaches higher values with the same level of effort. Moreover, body temperature increases quickly: with PPE it took 15 minutes to raise 1°C in body temperature, compared to 40 minutes without PPE. The results of this study indicated that the use inadequate PPE might pose thermoregulation risk to rural workers.     

Ergonomic factors and production target evaluation in eucalyptus timber harvesting operations in mountainous terrains

There are several forest operations involved in Eucalyptus timber harvesting. This study was carried out during brush-cutting; tree felling, bucking, delimbing, piling and manual extraction operations, with the following objectives: a) analyzing, ergonomically, two systems of brush-cutting: one manual and the other semi-mechanized, using two different machines; b) ergonomically evaluating three different brands of pruner machines used in delimbing felled trees. c) determining the feasible target of productivity as a function of ergonomic factors relevant to establish the time of resting pauses for workers in manual and semi-mechanized timber harvesting systems in mountainous terrain. Brush-cutting, either manual or semimechanized, is an activity carried out prior to timber harvesting. It is usually a hard work, with low productivity when compared with mechanized systems. Pruner machines have been used by forest companies, due to the great possibilities to improve productivity, quality and the health of workers. Ergonomics is a discipline that promotes the adequacy of work to the physical and mental characteristics of human beings, seeking to design production systems and products considering relevant aspects, including social, organizational and environmental factors. Companies should consider the ergonomic factor in the determination of daily worker production targets.     

Participatory ergonomics among female cashiers from a department store

The objective of this paper was to control ergonomic risks among female cashiers working in a department store belonging to the retail market. This study was conducted between May and November 2010. Participatory ergonomics was applied through knowing and understanding how the company works, establishing the work team (Ergo group), training the team in ergonomics-related topics, and making decisions and interventions. The sample was composed of 71 participants--mostly female cashiers--, and all of them have a musculoskeletal compromise, declaring pain or discomfort mainly in the neck, lower back, right wrist and shoulders. Among others, following problems were found: postural overload, repetitive work, manual load handling, mental fatigue, environmental discomfort, variable work schedules, extended working days, and absence of breaks. In the intervention, the main implemented changes were the redesign of workstation, complete change of chairs and keyboards, and the implementation of a rotation system, as well breaks for compensatory exercises. After that, an evident improvement of found problems was observed, therefore it can be concluded that participatory ergonomics is an attractive methodology, appropriate and efficient for solving and controlling ergonomic risks and problems.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.