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21.

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   
22.
This study seeks to explain the influence of quality management on the relationship between open innovation and performance. We propose that, to contribute to open innovation performance, an organisation’s commitment to quality improvement must rely on the combination of its own resources and capabilities and its open innovation partners’ resources and capabilities. Specifically, we examine the moderating role of an interorganisational IT infrastructure and the complementarity of learning styles among an organisation committed to quality improvement and its supply network. Using data from 270 managers of European firms, our results show that the negative effects of quality management on open innovation performance can be overcome by complementing the organisation’s learning style with that of its open innovation partner, particularly, its supply network, and, most importantly, obtaining information technologies compatible with those of its supply network members.  相似文献   
23.
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   
24.
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   
25.
Personal Protective Equipment (PPE) is considered the last preferred solution to an Occupational Safety Health (OSH) system. Brazilian OSH legislation assumes and requires PPE usage to neutralize the possibility of pesticide contamination. This study examines the inadequacy of the PPE used in a tomato crop, particularly from the standpoint of thermal comfort. This study made observations regarding heart rate and body temperature in a controlled environment using a treadmill (with and without PPE) of 12 volunteers; and during the process of rural labor (at rest and in normal work routine) of 2 actual rural workers. Comparing the results of the treadmill test (with and without PPE) which tried to reproduce the same level of effort and environmental conditions of the actual rural work, this study demonstrated that PPE makes thermoregulation harder and tympanic temperature reaches higher values with the same level of effort. Moreover, body temperature increases quickly: with PPE it took 15 minutes to raise 1°C in body temperature, compared to 40 minutes without PPE. The results of this study indicated that the use inadequate PPE might pose thermoregulation risk to rural workers.  相似文献   
26.
The customization of a secretary workstation at a drama school was the objective of this case study. The investigation involved a 25-year-old illiterate woman with intellectual disabilities and low vision that had been been attending, for over 12 years, a state school for people with disabilities. The customization process, operationalized after a diagnosis was made, focused on environmental rearrangements, with the purpose of meeting the physical and social demands of the workstation. The results of this research are configured in an ergonomic analysis of work associated with an inventory of social skills, applied to people living directly with the participant. Preliminary evaluations indicated the degree of adjustment of labor demands to the personal characteristics of the participant in the customized job.  相似文献   
27.
The context of oil platform design is changing in order to increase competitiveness and be prepared for difficult operations, mainly in fields more distant from the coast, like pre-salt. The currently preceding context is marked by projects guidelines designed to reduce projects and operation costs, including an important reducing in the number of people on board. The main objective of this research is to verify and discuss if the experience of use in platforms designed in a previous context, in which the people on board is practically twice, can contribute and/or can be transferred to new projects. From the ergonomic intervention in the design of two oil platform, with the work of team on board investigated on previous projects as reference, it was possible analyze if the previous use is still applicable to new projects. As a result, about 90% of the recommendations based on use are applicable to the current context. The restrictions on the transfer or operational experience are mainly related to the time of entry of ergonomics in the design process, the subsequent transformations costs and the advance of the execution phase started with the detailed design.  相似文献   
28.
Team performance of the Mexican Football League (Liga MX), measured as the percentage of the total points obtained during each short tournament, is analyzed using Dynamic Factor Models (DFMs). The estimation of the common components is carried out with Principal Components and the stochastic nature of the DFM is studied through Panel Analysis of Non-stationarity in Idiosyncratic and Common Components. The results reveal that there are two common factors, one being possibly non-stationary. These factors show an interesting dynamic behavior in the league and allow to split the teams into two groups, namely, top competitors and emerging or relegated teams. Some discussion is given in this direction.  相似文献   
29.
In this paper, we discuss the bivariate Birnbaum-Saunders accelerated lifetime model, in which we have modeled the dependence structure of bivariate survival data through the use of frailty models. Specifically, we propose the bivariate model Birnbaum-Saunders with the following frailty distributions: gamma, positive stable and logarithmic series. We present a study of inference and diagnostic analysis for the proposed model, more concisely, are proposed a diagnostic analysis based in local influence and residual analysis to assess the fit model, as well as, to detect influential observations. In this regard, we derived the normal curvatures of local influence under different perturbation schemes and we performed some simulation studies for assessing the potential of residuals to detect misspecification in the systematic component, the presence in the stochastic component of the model and to detect outliers. Finally, we apply the methodology studied to real data set from recurrence in times of infections of 38 kidney patients using a portable dialysis machine, we analyzed these data considering independence within the pairs and using the bivariate Birnbaum-Saunders accelerated lifetime model, so that we could make a comparison and verify the importance of modeling dependence within the times of infection associated with the same patient.  相似文献   
30.
Lifetime Data Analysis - Frailty models are generally used to model heterogeneity between the individuals. The distribution of the frailty variable is often assumed to be continuous. However, there...  相似文献   
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