The pain and behavior of women during labor and the different positions for childbirth

Avaliou-se a intensidade da sensação dolorosa e o comportamento, durante o trabalho de parto e parto, entre mulheres que tiveram parto normal, sem analgesia, nas posições semi-sentada, decúbito lateral esquerdo e litotomia. O estudo foi descritivo, transversal e correlacional. Foram usados um questionário validado que avalia dor e comportamento durante o trabalho de parto e parto, segundo a perspectiva da mulher, e duas escalas de dor: uma analógica e outra alfanumérica. Observou-se que a dor entre as mulheres que pariram em litotomia foi significativamente menor em comparação com decúbito lateral esquerdo (p=0,003), embora a posição tenha sido escolhida pela mulher. Houve associação entre dor e comportamento. A dor no trabalho de parto e parto estavam associadas entre si, assim como o comportamento nesses dois momentos. Os resultados indicam uma associação entre posição no parto e sensação dolorosa, mas não foi possível identificar fatores explicativos, sendo necessário desenvolver estudos longitudinais.Se evaluó intensidad de sensación dolorosa y comportamiento durante trabajo de parto y parto entre mujeres con parto normal, sin analgesia, en posiciones: semi-sentada, decúbito lateral izquierdo y litotomía. Estudio descriptivo, transversal, correlacional. Fueron usados un cuestionario validado que evalúa dolor y comportamiento durante trabajo de parto y parto según la perspectiva de la mujer, y dos escalas de dolor: una analógica y otra alfanumérica. Se observó que el dolor entre las mujeres que parieron por litotomía fue significativamente menor en comparación con decúbito lateral izquierdo (p=0,003), a pesar de ser la mujer quien eligió tal posición. Hubo asociación entre dolor y comportamiento. Los dolores en trabajo de parto y parto tuvieron mutua asociación, así como el comportamiento en tales momentos. Los resultados indican asociación entre posición de parto y sensación dolorosa, pero no fue posible identificar factores explicativos, determinándose necesidad de desarrollar estudios longitudinales.This study evaluated the pain intensity and behavior during labor and delivery, among women who had natural childbirth, without analgesia, in one of the following positions: semi-sitting, lying on the left side, and lithotomy. This is a descriptive, cross-sectional and correlational study. The instruments used were a validated questionnaire that evaluates pain and behavior during labor and childbirth, from the women's perspective, and two pain scales: one analog and one alphanumerical. It was observed that the pain among women who had childbirth in a lithotomy position was significantly smaller compared to those lying on the left side (p=0.003), though women chose the positions. There was an association between pain and behavior. Pain in labor and childbirth were associated among each other, as was the behavior in these two moments. The results point at an association between the position at childbirth and pain, but it was not possible to identify factors to explain this association; therefore, there is a need for longitudinal studies

A study of CP violation in B-+/- -> DK +/- and B-+/- -> D pi(+/-) decays with D -> (KSK +/-)-K-0 pi(-/+) final states

A first study of CP violation in the decay modes $B^\pm\to [K^0_{\rm S} K^\pm \pi^\mp]_D h^\pm$ and $B^\pm\to [K^0_{\rm S} K^\mp \pi^\pm]_D h^\pm$, where $h$ labels a $K$ or $\pi$ meson and $D$ labels a $D^0$ or $\overline{D}^0$ meson, is performed. The analysis uses the LHCb data set collected in $pp$ collisions, corresponding to an integrated luminosity of 3 fb$^{-1}$. The analysis is sensitive to the CP-violating CKM phase $\gamma$ through seven observables: one charge asymmetry in each of the four modes and three ratios of the charge-integrated yields. The results are consistent with measurements of $\gamma$ using other decay modes

Measurement of Upsilon production in collisions at root s=2.76 TeV

The production of $\Upsilon(1S)$, $\Upsilon(2S)$ and $\Upsilon(3S)$ mesons decaying into the dimuon final state is studied with the LHCb detector using a data sample corresponding to an integrated luminosity of 3.3 $pb^{-1}$ collected in proton-proton collisions at a centre-of-mass energy of $\sqrt{s}=2.76$ TeV. The differential production cross-sections times dimuon branching fractions are measured as functions of the $\Upsilon$ transverse momentum and rapidity, over the ranges $p_{\rm T} Upsilon(1S) X) x B(Upsilon(1S) -> mu+mu-) = 1.111 +/- 0.043 +/- 0.044 nb, sigma(pp -> Upsilon(2S) X) x B(Upsilon(2S) -> mu+mu-) = 0.264 +/- 0.023 +/- 0.011 nb, sigma(pp -> Upsilon(3S) X) x B(Upsilon(3S) -> mu+mu-) = 0.159 +/- 0.020 +/- 0.007 nb, where the first uncertainty is statistical and the second systematic

Study of forward Z + jet production in pp collisions at √s=7 TeV

A measurement of the $Z(\rightarrow\mu^+\mu^-)$+jet production cross-section in $pp$ collisions at a centre-of-mass energy $\sqrt{s} = 7$ TeV is presented. The analysis is based on an integrated luminosity of $1.0\,\text{fb}^{-1}$ recorded by the LHCb experiment. Results are shown with two jet transverse momentum thresholds, 10 and 20 GeV, for both the overall cross-section within the fiducial volume, and for six differential cross-section measurements. The fiducial volume requires that both the jet and the muons from the Z boson decay are produced in the forward direction ($2.0<\eta<4.5$). The results show good agreement with theoretical predictions at the second-order expansion in the coupling of the strong interaction.A measurement of the $Z(\rightarrow\mu^+\mu^-)$+jet production cross-section in $pp$ collisions at a centre-of-mass energy $\sqrt{s} = 7$ TeV is presented. The analysis is based on an integrated luminosity of $1.0\,\text{fb}^{-1}$ recorded by the LHCb experiment. Results are shown with two jet transverse momentum thresholds, 10 and 20 GeV, for both the overall cross-section within the fiducial volume, and for six differential cross-section measurements. The fiducial volume requires that both the jet and the muons from the Z boson decay are produced in the forward direction ($2.0<\eta<4.5$). The results show good agreement with theoretical predictions at the second-order expansion in the coupling of the strong interaction

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Análisis crítica de los beneficios del parto normal en distintas posiciones

Este trabajo es vencedor del premio Abramge de 2007. Como no hay unanimidad de criterios médicos sobre como deben ser atendidos los partos en seres humanos, el autor estudia el proceso de nacimiento comparando la posición supina con la vertical o de cuclillas, utilizando un modelo teórico con seis variables independientes - Acción de la gravedad; Compresión de los grandes vasos maternos; Diámetros del canal del parto; Ángulo de encaje de la presentación; Ventilación pulmonar y equilibrio ácido básico materno; y Eficiencia de las contracciones uterinas (en el trabajo de parto y período expulsivo) - y dos variables dependientes, una materna - pérdida de sangre – y otra neonatal – indique de Apgar al primer minuto de vida. La pérdida sanguínea, medida por la diferencia en las medidas de hematócrito y de hemoglobina antes y después del parto, fue significativamente menor en la posición cócoras-supino (cuando después del parto la madre es invitada a acostarse). La proporción de recién nacidos con Apgar más elevado (>8) al primer minuto fue significativamente mayor en el grupo en el que la posición para el parto fue de cuclillas. E inversamente encontramos significativamente menos recién nacidos con Apgar bajo (0 a 6) en los partos con la madre en posición de cuclillas. Debido a estos resultados, se sugiere que los protocolos oficiales y hospitalarios recomienden esa posición como práctica rutinaria

Kvindelige Kontorbetjente.

This study evaluated the pain intensity and behavior during labor and delivery, among women who had natural childbirth, without analgesia, in one of the following positions: semi-sitting, lying on the left side, and lithotomy. This is a descriptive, cross-sectional and correlational study. The instruments used were a validated questionnaire that evaluates pain and behavior during labor and childbirth, from the women's perspective, and two pain scales: one analog and one alphanumerical. It was observed that the pain among women who had childbirth in a lithotomy position was significantly smaller compared to those lying on the left side (p=0.003), though women chose the positions. There was an association between pain and behavior. Pain in labor and childbirth were associated among each other, as was the behavior in these two moments. The results point at an association between the position at childbirth and pain, but it was not possible to identify factors to explain this association; therefore, there is a need for longitudinal studies.Avaliou-se a intensidade da sensação dolorosa e o comportamento, durante o trabalho de parto e parto, entre mulheres que tiveram parto normal, sem analgesia, nas posições semi-sentada, decúbito lateral esquerdo e litotomia. O estudo foi descritivo, transversal e correlacional. Foram usados um questionário validado que avalia dor e comportamento durante o trabalho de parto e parto, segundo a perspectiva da mulher, e duas escalas de dor: uma analógica e outra alfanumérica. Observou-se que a dor entre as mulheres que pariram em litotomia foi significativamente menor em comparação com decúbito lateral esquerdo (p=0,003), embora a posição tenha sido escolhida pela mulher. Houve associação entre dor e comportamento. A dor no trabalho de parto e parto estavam associadas entre si, assim como o comportamento nesses dois momentos. Os resultados indicam uma associação entre posição no parto e sensação dolorosa, mas não foi possível identificar fatores explicativos, sendo necessário desenvolver estudos longitudinais.Se evaluó intensidad de sensación dolorosa y comportamiento durante trabajo de parto y parto entre mujeres con parto normal, sin analgesia, en posiciones: semi-sentada, decúbito lateral izquierdo y litotomía. Estudio descriptivo, transversal, correlacional. Fueron usados un cuestionario validado que evalúa dolor y comportamiento durante trabajo de parto y parto según la perspectiva de la mujer, y dos escalas de dolor: una analógica y otra alfanumérica. Se observó que el dolor entre las mujeres que parieron por litotomía fue significativamente menor en comparación con decúbito lateral izquierdo (p=0,003), a pesar de ser la mujer quien eligió tal posición. Hubo asociación entre dolor y comportamiento. Los dolores en trabajo de parto y parto tuvieron mutua asociación, así como el comportamiento en tales momentos. Los resultados indican asociación entre posición de parto y sensación dolorosa, pero no fue posible identificar factores explicativos, determinándose necesidad de desarrollar estudios longitudinales