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1.

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   
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The lack of comparison groups is a common problem for researchers conducting evaluations of small, specialized programs. When conventional comparison groups are not available, the authors suggest a possible alternative approach which involves: (a) locating a sub-group in a national study for whom relevant variables have been measured; (b) generating a statistical model which predicts the outcome of interest in the national data; and (c) applying the predictive model to program data, in order to estimate outcomes in the absence of progam intervention. The authors illustrate this new application by presenting the results of an analysis of data from Project Talent, a national manpower study, and discuss its application to the evaluation of a medical training program in New York City.  相似文献   
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Deforestation and detribalization in the Philippines: The Palawan case   总被引:1,自引:0,他引:1  
Palawan Island contains the largest remaining expanse of unbroken forest cover in the Philippines. The forest is currently threatened by agricultural colonization, as numerous migrants from throughout the Philippines settle annually in the island's forested uplands. Further, Palawan is being heavily logged and is, in consequence, the focus of an acrimonious national environmental debate. This paper examines how land alienation and other forms of socioeconomic marginalization attending these pressures have undermined the well-being of Palawan's indigenous tribal peoples. It also explains how lack of secure tenure and failure to achieve popular participation so distort the gap between the ideal and the practice of agroforestry programs aimed at these peoples that such programs not only fail to ameliorate the ecological situation but further undermine tribal well-being.Paper presented at the Annual Meeting of the American Association for the Advancement of Science, New Orleans, LA, February 15–20, 1990.  相似文献   
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Abstract

In this article, we propose a new model for binary time series involving an autoregressive moving average structure. The proposed model, which is an extension of the GARMA model, can be used for calculating the forecast probability of an occurrence of an event of interest in cases where these probabilities are dependent on previous observations in the near term. The proposed model is used to analyze a real dataset involving a series that contains only data 0 and 1, indicating the absence or presence of rain in a city located in the central region of São Paulo state, Brazil.  相似文献   
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While assignment to ability groups and curriculum tracks is ostensibly based on students' aptitude for learning, previous research has found that student aptitude explains only a small portion of the variance in curriculum placement. Likewise, while ability grouping has been described as very flexible, studies have found that little movement between groups actually occurs. This study examines ability grouping in a first-grade classroom in order to increase our understanding of the factors which influence ability group formation and maintenance. This investigation found that time and management constraints influenced the number and size of groups formed, independently of the range of aptitude in the classroom. Since these factors remained constant throughout the year, they also limited the amount of movement that occurred between groups. When across-classroom grouping is used, other, more stringent constraints are likely to affect allocation decisions. It will be argued that these constraints represent a problem which exists whenever there is an attempt to match individuals with positions in society.  相似文献   
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In this article, the author discusses the intersection between psychotherapy and social activism. She argues that activism is a form of empathy in action and is a natural extension of her work as a therapist. The author reviews the history of psychoanalysis and social activism, demonstrating that the roots of psychoanalysis were embedded in the work of social activism. She discusses some of the recent history of events in her state that led her to engage in activism and some issues this presents for clinical practice.  相似文献   
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The main purpose of this article is the presentation of a new class of time series models which is the merge output of the generalized normal distribution with ideas from the GARMA model. Symmetrically, tails that may be lighter or heavier than the Gaussian distribution, and Gaussian and Laplace distributions as special cases, are the main advantages of the use of generalized normal distribution. The proposed model is called generalized normal autoregressive moving average (GN-ARMA). We exemplify the application of the proposed model adjusting it to the three time series, which are from the areas of economy, hydrology, and public policy.  相似文献   
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