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71.
72.

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   
73.

Problem

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems.

Background

Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear.

Question

How do professionals develop competence and expertise in physiological breech birth?

Methods

Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition.

Results

Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners.

Discussion

The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices.

Conclusion

Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way.  相似文献   
74.
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   
75.
76.
This study theorizes and empirically tests a conceptual framework to understand how a company can better motivate its employees to carry out persistent prosocial behavior and develop positive organization-employee relationships through corporate social responsibility (CSR) involvement. A managerial approach, employee participative decision making in CSR, is examined for its impact on the prosocial behavioral outcome among employees and the relational outcome for the organization. Furthermore, a psychological mechanism that emphasizes employees’ perceived need satisfaction is examined as the underlying explanation that drives the effectiveness of the managerial approach. The study results support that empowering employees to co-construct CSR decisions with top management is effective in satisfying employees’ basic psychological needs for autonomy, competence, and relatedness. This in turn increases the employees’ intention to maintain long-lasting involvement in CSR and improves their relationships with the company. This study provides important implications for public relations professionals and organizational leaders on how to improve their internal CSR communication and involvement practice and cultivate desirable organization-employee relationships.  相似文献   
77.
Youth experience increased surveillance by and involuntary contact with police officers compared with other age groups. Studies that explore the experiences of youth during these encounters are scant and focus on youth with criminal histories. This research aims to explore the experiences of college-attending youth between 18 and 24 years old in two southern states. The study was designed and conducted according to the tenets of interpretative phenomenological analysis (IPA). Twelve Black youth were recruited and interviewed between April 2015 and April 2016. Three superordinate themes (and subthemes) were identified: (1) negative feelings towards the police; (2) precarity of police encounters (subthemes: police as a threat to welfare; it could be me; steps to follow during police encounters; behavior is irrelevant) and; (3) police response is part of structural racism (subthemes: racism is everywhere; media contributes to racism). The importance of these findings for social work practice and research will be discussed.  相似文献   
78.
In this article, we examine birth cohort differences in parents’ provision of monetary help to adult children with particular focus on the extent to which cohort differences in family structure and the transition to adulthood influence these changes. Using data from the Health and Retirement Study from 1994 to 2010, we compare financial help to children of three respondent cohorts as the parents in these birth cohorts from ages 53–58 to 57–62. We find that transfers to children have increased among more recent cohorts. Two trends—declining family size and children’s delay in marriage—account for part of the increase across cohorts. However, other trends, such as the increase in the number of stepchildren and increasing child’s income level, tend to decrease the observed cohort trend.  相似文献   
79.
20世纪50年代以来,藏传佛教在西方社会广泛传播,作为东方研究心灵的经验性科学与西方心理学逐步深入地展开对话,深刻影响了西方心理学的发展。首先,藏传佛教对人性的积极态度、对人类意识的深入认识,扩大了西方心理学的研究视野;第二,藏传佛教对自我、意识、情绪等复杂心理过程提供了新的研究方法;第三,藏传佛教推动了佛教冥想的传播,为心理治疗和心理自助提供了一种积极有效的方法和技术。  相似文献   
80.
Few studies have examined the effects of early life conditions on the timing of the onset of heart disease. We use the remarkable example of a representative sample of the population of older Puerto Ricans aged 60– 74 who lived in the countryside during childhood (n = 1,438) to examine the effects of seasonal exposures to poor nutrition and infectious diseases during late gestation on the timing of the onset and the probability of ever experiencing adult heart disease. Cox and log logistic hazard models controlling for childhood conditions (self-reported childhood health status and socioeconomic status [SES], rheumatic fever, and knee height) and adult risk factors (adult SES, obesity, smoking, texercise, and self-reported diabetes) showed that the risk of onset of heart disease was 65% higher among those born during high-exposure periods compared with unexposed individuals. However, there were no significant differences in median time of onset for those ever experiencing heart disease. As a comparison, we found that there were no significant seasonality effects for those who lived in urban areas during childhood. We conclude that early exposures in utero have important ramifications for adult heart disease among the older Puerto Rican population. We show, however, that while exposure is associated with the probability of ever experiencing adult heart disease, it is not associated with the timing of onset among those who do experience it.  相似文献   
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