Local cooling for relieving pain from perineal trauma sustained during childbirth

Background: Perineal trauma is common during childbirth and may be painful. Contemporary maternity practice includes offering women numerous forms of pain relief, including the local application of cooling treatments. Objectives: To evaluate the effectiveness and side effects of localised cooling treatments compared with no treatment, other forms of cooling treatments and non-cooling treatments. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2007), CINAHL (1982 to January 2007) and contacted experts in the field. Selection criteria: Published and unpublished randomised and quasi-randomised trials (RCTs) that compared localised cooling treatment applied to the perineum with no treatment or other treatments applied to relieve pain related to perineal trauma sustained during childbirth. Data collection and analysis: At least two independent authors performed data extraction for each study. Analyses were performed on an intention-to-treat basis where data allowed. We sought additional information from the authors of three trials. Main results: Seven published RCTs were included, comparing local cooling treatments (ice packs, cold gel pads or cold/iced baths) with no treatment, hamamelis water (witch hazel), pulsed electromagnetic energy (PET), hydrocortisone/pramoxine foam [Epifoam] or warm baths. The RCTs reported on a total of 859 women. Ice packs provided improved pain relief 24 to 72 hours after birth compared with no treatment (risk ratio (RR) 0.61, 95% confidence interval (CI) 0.41 to 0.91). Women preferred the utility of the gel pads compared with ice packs or no treatment, although no differences in pain relief were detected between the treatments. None of our comparisons of treatments resulted in differences detected in perineal oedema or bruising. Women reported more pain (RR 5.60, 95% CI 2.35 to 13.33) and used more additional analgesia (RR 4.00, 95% CI 1.44 to 11.13) following the application of ice packs compared with PET. Authors' conclusions: There is only limited evidence to support the effectiveness of local cooling treatments (ice packs, cold gel pads, cold/iced baths) applied to the perineum following childbirth to relieve pain

High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106966/1/jomf12103.pd

The symbiotic relationship of vulnerability and resilience in nursing

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. Background: Whilst the terms vulnerability and resilience are commonly used within professional nursing discourses, they are often poorly understood. Vulnerability is often framed negatively and linked to being at risk of harm, whilst resilience is often perceived as the ability to withstand challenges. Aim: The aim of this paper is to explore resilience and vulnerability; re-positioning them within the context of contemporary professional nursing practice. Design: Discussion paper. Method: Drawing upon historical and contemporary international literature, both concepts are de-constructed and then re-constructed, examining them from the position of patient care as well as from the perspective of nurses and the nursing profession. Conclusion: Resilience and vulnerability have an interdependent relationship as resilience comes into play in situations of vulnerability. Yet, contrary to the popular discourse they are multi-faceted, complex phenomena based on factors such as individual circumstances, supports, and resources

Superlattice barrier varactors

SBV (Single Barrier Varactor) diodes have been proposed as alternatives to Schottky barrier diodes for harmonic multiplier applications. However, these show a higher current than expected. The excess current is due to X valley transport in the barrier. We present experimental results showing that the use of a superlattice barrier and doping spikes in the GaAs depletion regions on either side of the barrier can reduce the excess current and improve the control of the capacitance vs. voltage characteristic. The experimental results consist of data taken from two types of device structures. The first test structure was used to study the performance of AlAs/GaAs superlattice barriers. The wafer was fabricated into 90 micron diameter mesa diodes and the resulting current vs. voltage characteristics were measured. A 10 period superlattice structure with a total thickness of approximately 400 A worked well as an electron barrier. The structure had a current density of about one A/sq cm at one volt at room temperature. The capacitance variation of these structures was small because of the design of the GaAs cladding layers. The second test structure was used to study cladding layer designs. These wafers were InGaAs and InAlAs layers lattice matched to an InP substrate. The layers have n(+) doping spikes near the barrier to increase the zero bias capacitance and control the shape of the capacitance vs. voltage characteristic. These structures have a capacitance ratio of 5:1 and an abrupt change from maximum to minimum capacitance. The measurements were made at 80 K. Based on the information obtained from these two structures, we have designed a structure that combines the low current density barrier with the improved cladding layers. The capacitance and current-voltage characteristics from this structure are presented

Nonlinear effects in the black hole ringdown: absorption-induced mode excitation

Gravitational-wave observations of black hole ringdowns are commonly used to characterize binary merger remnants and to test general relativity. These analyses assume linear black hole perturbation theory, in particular that the ringdown can be described in terms of quasinormal modes even for times approaching the merger. Here we investigate a nonlinear effect during the ringdown, namely how a mode excited at early times can excite additional modes as it is absorbed by the black hole. This is a third-order secular effect: the change in the black-hole mass causes a shift in the mode spectrum, so that the original mode is projected onto the new ones. Using nonlinear simulations, we study the ringdown of a spherically-symmetric scalar field around an asymptotically anti-de Sitter black hole, and we find that this "absorption-induced mode excitation" (AIME) is the dominant nonlinear effect. We show that this effect takes place well within the nonadiabatic regime, so we can analytically estimate it using a sudden mass-change approximation. Adapting our estimation technique to asymptotically-flat Schwarzschild black holes, we expect AIME to play a role in the analysis and interpretation of current and future gravitational wave observations

Health Impact and Risk Factors Affecting South and Southeast Asian Women Following Natural Disasters: A Systematic Review.

(1) Background: Following natural disasters, women have a higher prevalence of adverse physical and mental health outcomes. Given that the South and Southeast Asia regions are highly disaster prone, a review was undertaken to identify the potential health impact and key risk factors affecting women after disasters in the countries located in South and Southeast Asia regions. (2) Methods: A systematic literature search of four databases yielded 16 studies meeting the inclusion criteria. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, between July 2008 and March 2021. (3) Results: The majority of studies reported women's negative/poor mental health, identifying a significant association of socio-demographics, during disaster exposure, post-disaster, and pre-existing risk factors. The six most-cited influences on women's mental health found in the reviewed literature were being female, adult age group, having no formal education, poverty or low economic status, poor physical health/physical injuries, and death of family members. Women's health during the post-disaster period was generally reported as poor among all the countries of the South and Southeast Asia regions. (4) Conclusions: Appropriate social support and the availability of free healthcare access for women are warranted in disaster-affected areas. This review offers a valuable contribution to the knowledge of women's health complications/challenges and associated risk factors related to disasters, essential for the development of strategies to help reduce this burden in the future. Further research is required on natural disasters to identify ways to reduce women's health impacts after natural disasters, especially in the context of low-income and lower-middle-income countries

A qualitative study of men’s recollections of growing up with father absence: childhood father figures and family resilience

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Families come in many forms and single parent women headed households are common with nurses being well positioned to provide support for these women and their children. For children growing up in lone parent households, the nature of family relationships and the availability of a social support network are important factors in reducing developmental risks. Aim: The aim of this study was to explore adult men’s recollections of growing up in a father-absent home. Design: This study utilised a qualitative methodology. Methods: Semi-structured interviews were conducted with 21 adult men who grew up in a father-absent home due to family discord. Interview transcripts were thematically analysed using an inductive approach. Findings: Analysis of the interview transcripts revealed two themes relating to childhood father figures and family relational networks. For some men, ambivalent, violent or unavailable father figures stepped into the void created by the absent father. Others experienced positive father figures or multigenerational relationships, which provided positive relational supports and attachments. Conclusion: The findings illuminate the dynamics of family resilience and provide important insights for nurses and other family healthcare workers

“Being a father”: constructions of fatherhood by men with absent fathers

© 2018 Informa UK Limited, trading as Taylor & Francis Group Family dynamics and parenting styles are influential on children's wellbeing [Walsh, F. (2016). Strengthening family resilience (3rd ed.). New York: Guilford Press]. Additionally, childhood experiences and how an individual experienced being parented can impact on how individuals as mothers and fathers choose to parent their own children [Herland, M. D., Hauge, M.-I., & Helegland, I. M. (2015). Balancing fatherhood: Experiences of fatherhood among men with a difficult past. Qualitative Social Work, 14(2), 242–258]. However, growing up in a home with an absent parent may create challenges associated with parenting for individuals, due to not having these experiences themselves. Therefore, the article reports findings on men who grew up in a father-absent household and how their experiences influenced their understanding of fatherhood and becoming a father. Twenty-one men participated in this qualitative study. Findings revealed that although men felt unprepared for fatherhood they attempted to learn to be a father and expressed the importance of not wanting their children to experience father absence. The study findings provide important insights in the provision of support for fathers who have experienced father absence