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81.

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   
82.
83.
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   
84.
This article outlines a republican perspective on disability. We argue that a commitment to ensuring the republican freedom of disabled citizens offers a promising account of what disabled citizens are owed as a matter of justice. A republican perspective offers a particular diagnosis of the injustice of disability disadvantage, both in relation to individuals (dominium) and the state (imperium), that is congenial to prominent concerns voiced by the disability rights movement. This article also offers a brief outline of three republican remedies: the right of social participation, the right of opportunities for civic contribution, and the right of democratic contestation. These remedies constitute key guidelines for the robust institutional protection of disabled citizens’ republican freedom.  相似文献   
85.
This paper collects the experience for both, academic and professional practice, and deal with the stages and level of involvement from different elements in the organization. The work is focused in some kind of concentric cycles, the very outside circle is formed by those that interact with ergonomic process in a year period, and the inner cycles are those that acts in a daily or weekly intervention. The success of the program still depending on the good will of the managers, but any action directed on benefit of the people at work, enable the moral as well as indicators for health and safety.  相似文献   
86.
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   
87.
The objective of the study was to evaluate the occurrence of Burnout Syndrome in 100 teachers of six public high schools and its correlation with working conditions in a southeast city of Brazil. Characterization of the sample occurred after application of a socio-demographic questionnaire. Evaluation of the working conditions was done by means of an Ergonomic Working Analysis. The presence of Burnout Syndrome was evaluated by means of the Maslach Burnout Inventory. The sample presented the predominance of women, with an average age of 40.4 and the majority married with children. Roughly 50% had less than 10 years of service, and more than half of the teachers taught more than 18 classes per week. Hoarseness after work was principally reported among women, which required many days off for health treatment. Environmental conditions reflect inadequacy in relation to noise, light, humidity and temperature. Presence of pain in the upper limbs was especially high among women. Risk of musculoskeletal disorders in the upper limbs predominated as moderately important to significant. We also identified an average distance walked by teachers of 1.5 Km and an average of 4.2 Kg of school supplies carried between classes. The Burnout Syndrome presented a high score for depersonalization principally among men, but it has association with both sexes. Emotional exhaustion correlates with noise, depersonalization, and personal fulfillment, in addition to the high number of weekly lessons. It can be concluded that Burnout syndrome is present among teachers, principally in terms of depersonalization, deserving the attention of government officials and the schools, as well as the teachers themselves.  相似文献   
88.
The aim of this paper is to highlight how ergonomics contributes to risk analysis and risk management in a design project for a new reactor, the French EPR (European Pressurized Reactor). An iterative ergonomics design process has been conducted over the last 10 years through a Human Factors Engineering program at the French energy company EDF. A parallel has been drawn between a risk management process and this ergonomics process based on International Organization for Standardization (ISO) publications such as ISO/IEC Guide 73, ISO Guide 51, etc. The contribution of ergonomics to risk analysis is illustrated by an example: the automatic diagnosis, which is a very important technical device for safety. Five main types of risk have been identified via ergonomic analyses during the different design stages. Counter-measures have been implemented and their efficacy tested within the scope of new campaigns to assess human factors. However, the management of risks in such a design project requires the participation both of the different design entities involved in the project and of other experts in aspects of risk management, such as human reliability. The organization of collaborative participation remains a challenge to be addressed.  相似文献   
89.
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   
90.
Based on the Social Representations Theory (SRT) applied to the social construction of risk and the role played by group identities, this study examines the construction of risk created by the mass media in health epidemics. An experimental design with split-ballot questionnaire and 319 participants was used in which message framing (human interest vs. attribution of responsibility) and proximity (high vs. low) were manipulated for a high invulnerability identity (youth) vs. a low invulnerability identity (elderly) population. Results showed that the human interest framing increased the perception of risk, especially when the proximity of the epidemic was high; this effect was explained by people’s emotional response. Furthermore, youth projected the risk towards ‘the other’ in order to protect their invulnerability identity. Finally, we stress the importance of the SRT on a theoretical and applied level for risk communication in health crises.  相似文献   
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