Perineal care and outcomes in a birth center

Objective: to analyse the perineal outcomes in childbirth and post-partum perineal care in a freestanding birth centre. Method: a cross-sectional study, with data collection performed in the women’s birth records forms from Casa Angela, a freestanding birth centre, São Paulo, Brazil, in 2016-2017 (n=415). The following data was analysed: occurrence and perineal tear degree; maternal, neonatal and birth care-related variables; perineal suture prevalence; complications in wound healing and natural methods on perineal care. Data were subjected to descriptive, inferential and multiple analyses. Results: in 11.8% of women, the perineum was kept intact, 61.9% had spontaneous first-degree tear and 26.3% had second-degree tear. The variables related to the occurrence and higher spontaneous degree tears were maternal age and second period of childbirth >2 hours. The protective factors against the occurrence and higher degree tears were number of previous vaginal childbirths and maternal position different from vertical during childbirth. Perineal suture was performed in 16.0% and 70.6% of women with spontaneous first- and second-degree tears, respectively. The main perineal complications after birth were edema (53.6%) and pain (29.4%); and the perineal suture increased the chance for these complications (OR=2.5; 95%CI 1.5-4.3). Perineum icepack compress was used in 53.8% of women during post-partum period. Conclusion: maternal and health-care related factors were associated to the prevalence and degree of spontaneous perineal tear. First-degree spontaneous perineal tears were prevalent and sutured in a low number of women. There were more complications in the wound healing process when the perineal suture was performed, regardless the tear degree. The number of natural methods in post-partum perineal care was higher than the use of medicines

The first year of the ST Operation Committee: is there a future ?

The main objective of the ST Operation Committee (STOC) was to develop a proactive and homogeneous service of operation that satisfies the needs of the service users. Furthermore, the role of the Technical Control Room (TCR) should have been developed to a unique and competent entry point for ST operation by bringing the operation teams closer together on a daily basis. Have these objectives been achieved and to what extend? Is there a future for this committee and what could it look like? What are the implications of the first year of work on ST operation as a whole? This paper answers these questions and gives recommendations how to make best use of the STOC for the ST partners and ST, respectively

ESFuelCell2011-54173 NUMERICAL ANALYSIS OF A ROOFTOP VERTICAL AXIS WIND TURBINE

ABSTRACT A numerical analysis of a rooftop vertical axis wind turbine (VAWT) for applications in urban area is presented. The numerical simulations were developed to study the flow field through the turbine rotor to analyze the aerodynamic performance characteristics of the device. Three different blade numbers of wind turbine are studied, 2, 3 and 4, respectively. Each one of the models was built in a 3D computational model. The effects generated in the performance of turbines by the numbers of blades are considered. A Sliding Mesh Model (SMM) capability was used to present the dimensionless form of coefficient power and coefficient moment of the wind turbine as a function of the wind velocity and the rotor rotational speed. The numerical study was developed in CFD using FLUENT®. The results show the aerodynamic performance for each configuration of wind turbine rotor. In the cases of Rooftop rotor the power coefficient increases as the blade number increases, while in the case of Savonius rotor the power coefficient decrease as the blades number increases. K eywords: Wind energy, rooftop turbine, vertical axis wind turbine, torque coefficient and power coefficient

Adhesión de las mujeres embarazadas a los ejercicios para fortalecer el suelo pélvico

Objective: To analyse the adherence of pregnant women to pelvic floor muscle exercises (PFME) during pregnancy. Methods: Prospective study, with 315 pregnant women; data collection was performed by phone and face-to-face; data analysis was descriptive and inferential with 5% significance level. Results: In the first half of pregnancy, the total adherence was 36.5%; when gathered total adherence and partial adherence, the percentage reached was 54%; during pregnancy, there was a gradual decrease (from 46% to 39.7%) of women who reported no adherence; there was no significant association between adherence and the sociodemographic, obstetric and clinics characteristics. Conclusion: The majority of pregnant women in all trimesters of pregnancy reported total or partial adherence to PFME; it was highly positive the proportion of women who reported performing PFME

Food addiction in eating disorders and obesity: Analysis of clusters and implications for treatment

Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome

Complementary and Integrative Health Practices in a Brazilian Freestanding Birth Center: A Cross-Sectional Study

The study aimed to analyze the use of complementary and integrative health practices (CIHPs) during labor and birth in a freestanding birth center. A total of 28 different CIHPs were applied with or used by laboring women. The most adopted CIHPs were mind-body practices (99.9%) and natural products (35.5%), mostly used by primiparous women (P <.05). Adopting CIHPs can increase care quality, increase positive experiences during childbirth, and promote evidence-based choices

Modelo de atenção dos centros de parto normal peri-hospitalares: protocolo de revisão de escopo

Os centros de parto normal peri-hospitalares (CPNp) são instituições de saúde que oferecem atendimento pré, intra e pós-parto a mulheres e bebês saudáveis, destacando-se por sua filosofia e prática amparadas no modelo humanizado e biopsicossocial de cuidado. Apesar de apresentarem excelentes resultados e indicadores, estas instituições encontram dificuldades para sua manutenção e expansão no Brasil. Este artigo tem como objetivo descrever o protocolo da revisão de escopo que mapeará as características do modelo de atenção dos CPNp brasileiros. O protocolo foi registrado na plataforma Open Science Framework (OSF) e elaborado segundo recomendações do JBI Manual for Evidence Synthesis e PRISMA-ScR. As etapas da revisão são: a definição dos descritores e dos critérios de elegibilidade, a busca dos estudos nas bases de dados e repositórios, a seleção e a extração dos dados dos estudos e, finalmente, como os resultados serão apresentados. Com esta revisão, espera-se mapear o conhecimento científico existente sobre como os CPNp estão estruturados e organizados, como são acessados pela população, quais são os desfechos da assistência oferecida a mulheres e bebês e como usuários e profissionais vivenciam esse modelo de atenção. Além disso, este estudo tem o potencial de contribuir para o debate que se faz urgente frente à construção de estratégias voltadas a melhorias dos indicadores de saúde materno-infantil do país