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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   
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This paper investigates the relationships of the choice of philanthropic strategy with board capital (diversity and networks), board activities (board processes, internal board committees, and board effectiveness), and CEO leadership. Using a sample of 110 Italian foundations, the research shows that board processes have the strongest positive association with an evolved strategic approach to philanthropic institutional grant-giving, while board diversity and strong CEO leadership are associated with the strategic approach only under certain conditions. In particular, good governance processes (e.g., training the board, self-evaluation of trustees, setting the stage for effective board and committee meetings, implementing control software, and steering meetings to improve the board’s analysis) are positively associated with evolved strategic approaches to philanthropy (e.g., signaling other funders for the best grantees, improving the performance of grant recipients, and advancing selected social fields’ state of knowledge and practice).  相似文献   
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This article explores the recurring narratives on race, place and representation that emerged in the talk of Chicana/o and Latina/o sixth-graders at a middle school in East Los Angeles, California. Discourse analytic methods are used to closely examine how these narratives were constructed within the contexts of everyday classroom interactions. Drawing on the notion of counter-storytelling from critical race theory, the article highlights how these sixth-grade students articulated counter-narratives about who they were and what their community was like – often in direct opposition to what they perceived as white people’s stereotypical assumptions and misperceptions. It is argued that these narratives constitute a powerful and sophisticated critique of dominant narratives that frame working-class Chicana/o and Latina/o students in racist and pejorative terms. The article ends with a discussion of implications for understanding youth agency and the politics of representation.  相似文献   
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The main objective of this study is to evaluate the impact of school furniture and work surface lighting on the body posture of two public Middle School students from Paraíba (Brazil). The target population included 8th grade groups involving 31 students. Brazilian standards for lighting levels, the CEBRACE standards for furniture measurements and the Postural Assessment Software (SAPO) for the postural misalignment assay were adopted for the measurements comparison. The statistic analysis includes analyses of parametric and non-parametric correlations. The results show that the students' most affected parts of the body were the spine, the regions of the knees and head and neck and about 90% of the students presented postural misalignment. The lighting levels were usually found below 300 lux, below recommended levels. Such results indicate the need of investments in more suitable school furniture and structural reforms aimed at improving the lighting in the classrooms, which could fulfill the students' profile and reduce their complaints.  相似文献   
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The study investigated the role of recovery and detachment in the break period between two shifts for fatigue in the current shift. A time-based paper-and-pencil diary study was carried out observing sixty-four railway controllers over ten consecutive working shifts. The results demonstrated that fatigue in the current shift was not only affected by recovery and psychological detachment during break phases before a shift, but also by fatigue at shift onset and perceived workload during the shift.  相似文献   
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Modular product design and internal integration are commonly adopted by manufacturers to improve operational performance. A number of studies argue that the adoption of product modularity significantly alters organization design, which affects the impact of internal integration on competitive capabilities. This paper thus aims to empirically explore the individual effects as well as interaction effects of product modularity and internal integration on competitive capabilities. The competitive capabilities studied in this paper include product innovativeness, low price, product quality, delivery, flexibility and customer services. After analysing the data from 251 Hong Kong manufacturers through moderated multiple regression analysis, the study found that better internal integration can significantly improve product innovativeness, product quality, delivery, flexibility and customer services, while a high level of product modularity enhances product innovativeness, flexibility and customer services. More importantly, the study shows that internal integration and product modularity can interact to improve product innovativeness and product quality. These results enhance our understanding of the interaction of product design and organizational coordination.  相似文献   
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