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71.
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73.

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   
74.

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   
75.
There is increasing interest among researchers in the effects of social capital on the health of older adults. One of the key policy question for an ageing population concerns how do we identify the factors that influence health. Very recently, an increasing interest on social capital as a key determinant for health has developed and, surprisingly, not much is known for the European population. This paper analyzes the association between social capital and self-perceived health among older adults in Europe using a mixed effects logistic model. Social capital is considered in its two components—bonding and bridging—in order to understand if the relations inside or outside an individual inner circle have a different association with health. Our results give empirical support to the role of individual social capital in preventing a poor self-perceived health. This means that social capital, especially the bridging component of it, can be one of the key factors of ageing in good health and should be fostered by policy makers in order to give an answer to one of the most compelling challenge of our century: population ageing.  相似文献   
76.
Based on the theoretical foundation of well-being measurement, the study explores differences in living standards by analysing the distribution of tourism expenditure. A mixture of regression models is used to explore the heterogeneity in tourism consumption by identifying groups of families with similar tourism consumption behaviour as a function of certain socio-demographic and economic factors. The empirical analysis, performed on Italian expenditure data, suggests that there are three different patterns of consumption behaviour conditional to the socio-demographic and economic covariates in the tourism market and that differences in tourism consumption between groups of households mirror inequalities in living standards.  相似文献   
77.
In New Zealand a simple pop-up message feature that provides gambling session information and forces a break in play is mandatory on all electronic gaming machines in all venues (EGMs). Previous research has demonstrated small effects of more sophisticated pop-up messages tested predominantly in laboratory environments. The present research examined gambler engagement with and views on the New Zealand pop-up messages and on the relationship between pop-up messages and EGM expenditure. A sample of gamblers was recruited at casino and non-casino (pub) EGM venues. Most participants were aware of pop-up messages (57 %) and many saw them often (38 %). Among gamblers who reported seeing pop-up messages, half read the message content, and a quarter believed that pop-up messages helped them control the amount of money they spend on gambling. Participants who reported being likely to stop gambling in response to pop-up messages spent significantly less money on gambling when variables that were independently associated with EGM expenditure were controlled for. A modest harm minimisation effect of the pop-up message feature that has been operating in New Zealand for 5 years was evident. Suggestions for improvement of the harm minimisation potential of the current pop-up message feature are discussed.  相似文献   
78.
Women’s groups have worked diligently to place gender and women’s vulnerability on the transnational security agenda. This article departs from the idea that negotiating and codifying gender and women’s vulnerability in terms of security represent a challenge to mainstream security contexts. By contrasting the UN Security Council resolutions on women, peace and security with feminist theory, this article aims to analyze what is considered to be threatened when women’s vulnerability is negotiated. The article identifies two approaches to the gender/security nexus: gendering security, which involves introducing ideas regarding gender-sensitive policies and equal representation, and securitizing gender, which proceeds by locating rape and sexual violence in the context of war regulations. We demonstrate that, although these measures are encouraged with reference to women’s vulnerability, they serve to legitimize war and the male soldier and both approaches depoliticize gender relations.  相似文献   
79.
The 2014 release of a new set of purchasing power parity (PPP) conversion factors (PPPs) for 2011 has prompted a revision of the World Bank’s international poverty line. In revising the line, we have sought to minimize changes to the real purchasing power of the earlier $1.25 line (in 2005 PPPs), so as to preserve the integrity of the goalposts for international targets such as the Sustainable Development Goals (SDGs) and the World Bank’s twin goals – which were set with respect to that line. In particular, the new line was obtained by inflating the same fifteen national poverty lines – originally used by Ravallion et al. (World Bank Econ. Rev. 23(2): 163–184 2009) to construct the $1.25 line – to 2011 prices in local currency units, and then converting them to US dollars using 2011 PPP conversion factors. With a small approximation, this procedure yields a new international poverty line of $1.90 per person per day. In combination with other changes described in the paper, this revision leads to relatively small changes in global poverty incidence for 2011: from 14.5 % using the old method to 14.1 % using the new method. In 2012, the new reference year for the global count, we find 12.7 % of the world’s population, or 897 million people, are living in extreme poverty. There are changes in the regional composition of poverty, but they are also relatively small. This paper documents methodological decisions taken in the process of updating both the poverty line and the consumption and income distributions at the country level, including issues of inter-temporal and spatial price adjustments. It also describes various caveats and limitations of the approach taken.  相似文献   
80.
Subaltern classes' internationalism has a long history. The 1990s and first decade of the twenty-first century saw the rise of a new internationalism because of the emergence of the antiglobalisation movement. It was a short-lived movement, but that gave birth to a new set of strong internationalist activity. In 2011, there emerged a new international wave of protest by both the Indignados and the Occupy movements. These new movements, however, have developed relatively low levels of cross-border activity compared to the antiglobalisation movement, although it has brought a new internationalist drive.  相似文献   
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