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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   
84.

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   
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Children require considerable resources such as time and money to be raised. Still, despite the heavy costs involved, most people do decide to have children, a fact that raises the question of what motivates them to do so. Moreover, after having one or more children, people decide not to have additional ones, even though they might still be fertile. This raises the question of what motivates people to terminate procreation. The present paper aims to address these questions using a combination of qualitative and quantitative research methods. In Study 1, we used in-depth interviews and open-ended questionnaires that lead to the identification of 66 reasons for which people have children and 23 reasons for which people stop having children. In Study 2, we used principal component analysis that classified these reasons in broader motivation domains, 15 for procreating and 4 for terminating procreation. Sex differences were examined in each domain. By placing procreation in an evolutionary framework, this study aims to provide a deeper understanding of the motives that drive people toward and away from the process of having children.  相似文献   
88.
This study aims to calculate a scaled risk-taking behavior index and to test a model in which maternal and paternal parenting styles affect risk-taking behavior with a mediation of adolescents’ regulatory self-efficacy. Participants were 816 adolescents (44% males) responding to a self-report questionnaire about their risk-taking behavior, regulatory self-efficacy, and retrospective memories of paternal and maternal parenting styles. Results suggested an item rating in the index showing that behaviors considered less risky referred to alcohol use and the unplanned first sexual intercourse, whereas behaviors considered more risky referred to the lack of use of contraceptives and the age of the first sexual intercourse. Results revealed a significant indirect effect of authoritative and authoritarian styles on risk-taking behavior. These styles shaped the adolescents’ regulatory self-efficacy, which in turn predicted adolescent risk-taking behavior. Results underline the complex interplay of relationships between parents and their children.  相似文献   
89.
In this article, we aim to introduce the special JMFT section on discursive research methodologies for couple and family therapy research. These are qualitative research methodologies which resonate with the systemic emphasis on the semantics and the pragmatics of therapy discourse. First, we provide a brief overview of such methodologies and their use in the family therapy field. We then introduce the context and the content of the special section, where four approaches, including conversation analysis, discursive psychology type of discourse analysis, poststructurally informed discourse analysis (subject positioning analysis), and semantic analysis, are introduced by means of analyzed extracts from a Tom Andersen consultation session with a couple in distress and their therapist. We conclude with implications for the field. For Tom and Michael  相似文献   
90.
This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor–partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed.  相似文献   
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