Non-regional labour analgesia

2020 ◽  
pp. 161-180
Author(s):  
Matthew Turner ◽  
Graeme Lilley
Keyword(s):  
Risk Assessment ◽  
Complementary Therapies ◽  
Water Immersion ◽  
Evidence Base ◽  
Labour Analgesia ◽  
Maternal Satisfaction ◽  
Patient Controlled Analgesia ◽  
Short Acting ◽  
The Way ◽  
At Home

Women may choose to deliver their baby in different places, e.g. obstetric-led units, midwife-led units, or at home, depending on their risk assessment and the mother’s own wishes. The way they manage their pain during labour will depend on where they deliver; however, it is essential that they are fully informed about the available options. This chapter explores the evidence base for both non-pharmacological and pharmacological options, e.g. complementary therapies, water immersion, TENS, inhalational analgesia, and systemic opioids. The use of patient-controlled analgesia (PCA) with ultra-short acting opioids, e.g. remifentanil, has been shown to be safe when used in a monitored environment and has high maternal satisfaction scores. The typical regimens and safe monitoring conditions for PCA remifentanil use are described.

PERANAN PEREMPUAN DALAM MEMBINA KESADARAN BERAGAMA ANAK

2019 ◽  
Vol 10 (1) ◽  
pp. 83-104
Author(s):  
Nursyam Nursyam
Keyword(s):  
Religious Education ◽  
Negative Impact ◽  
Muslim World ◽  
First Person ◽  
Good Care ◽  
Religious Dimension ◽  
The Gift ◽  
The Way ◽  
At Home

Children are a gift from Allah SWT that is always expected by every family. However, not everyone (parents) can take good care of their children according to what is commanded by Allah through religious teachings. For various reasons and reasons, parents no longer pay attention to children's religious education. In the end, the negative impact will be felt by parents even more so for their own children. To be able to form a religious awareness of children, the mother as the first person known to the child, then the mother needs to provide an understanding of the religious dimension of children is important, the child is essentially a mandate from Allah SWT that must be grateful, and we as Muslims must carry out the mandate with good and right. The way to be grateful for the gift of God in the form of children is through caring for, caring for, and educating and coaching the characters properly and correctly, so that they will not become weak children, both physically and mentally, and weak in faith and weak in their worldly lives. The aim of education is to be a perfect Muslim, who has faith and fear Allah. Mother as a parent is the first primary educator for children, before the child knows the outside world, first the child knows the mother and after that his father is the closest person to the child. As for women's efforts in fostering religious awareness as follows: to destroy personality, to form good habits , forming civilizations in the Muslim world and helping to encourage them to encourage things that lead to obedience to God and educate them with different ways of worship. Like prayer, recitation, prayer at home and at school.

An Open Letter to Physicians

1994 ◽  
Vol 3 (1) ◽  
pp. 7-9
Author(s):  
Shana Alexander
Keyword(s):  
Esophageal Cancer ◽  
Good Friend ◽  
Good Death ◽  
Open Letter ◽  
Her Family ◽  
The Way ◽  
At Home

Some weeks ago, we learned that the matriarch of a family, my good friend Anna, is dying. She is 75 and has inoperable esophageal cancer, and the doctors say it will only take a few more weeks or months. Anna is dying the way I want to die–at home, surrounded and lovingly tended by her family: her devoted husband of 54 years, her three daughters, her three worshipful sons-in-law, her adoring granddaughters. All of them see her every day. All of them are a part of a mutual struggle to give Anna a “good death” Anna, too, is a part of it. And, in a very small way, I am part of it, because I have been invited to be. Every few days, I walk next door and spend a few minutes talking to Anna.

scholarly journals Rates of violence in patients classified as high risk by structured risk assessment instruments

2014 ◽  
Vol 204 (3) ◽  
pp. 180-187 ◽  
Author(s):  
Jay P. Singh ◽  
Seena Fazel ◽  
Ralitza Gueorguieva ◽  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Groups ◽  
Evidence Base ◽  
Assessment Tools ◽  
Current Evidence ◽  
Assessment Instruments ◽  
Individual Liberty ◽  
Current Evidence Base ◽  
Study Heterogeneity

BackgroundRates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.AimsTo analyse the variation in rates of violence in individuals identified as high risk by SRAIs.MethodA systematic search of databases (1995–2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.ResultsInformation was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.ConclusionsAfter controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.

Papacy, Crusade, and Christian-Muslim Relations

2018 ◽  
Keyword(s):  
Personal Experience ◽  
Religious Life ◽  
Trade Agreements ◽  
Muslim World ◽  
Peace Movements ◽  
The Stability ◽  
The Way ◽  
At Home

This book examines the role of the papacy and the crusade in the religious life of the late twelfth through late thirteenth centuries and beyond. Throughout the book, the contributors ask several important questions. Was Innocent III more theologian than lawyer-pope and how did his personal experience of earlier crusade campaigns inform his own vigorous promotion of the crusades? How did the outlook and policy of Honorius III differ from that of Innocent III in crucial areas including the promotion of multiple crusades (including the Fifth Crusade and the crusade of William of Montferrat) and how were both pope’s mindsets manifested in writings associated with them? What kind of men did Honorius III and Innocent III select to promote their plans for reform and crusade? How did the laity make their own mark on the crusade through participation in the peace movements which were so crucial to the stability in Europe essential for enabling crusaders to fulfill their vows abroad and through joining in the liturgical processions and prayers deemed essential for divine favor at home and abroad? Further essays explore the commemoration of crusade campaigns through the deliberate construction of physical and literary paths of remembrance. Yet while the enemy was often constructed in a deliberately polarizing fashion, did confessional differences really determine the way in which Latin crusaders and their descendants interacted with the Muslim world or did a more pragmatic position of ‘rough tolerance’ shape mundane activities including trade agreements and treaties?

scholarly journals Education in times of covid-19: are students learning in ergonomic conditions?

2021 ◽  
Vol 342 ◽  
pp. 01016
Author(s):  
Maria-Elena Boatca ◽  
Diana Robescu ◽  
Romulus Corlan ◽  
Nicoleta Mirea
Keyword(s):  
Quality Of Life ◽  
Online Learning ◽  
Learning System ◽  
Improve Quality ◽  
Sources Of Information ◽  
The Impact ◽  
Ergonomic Intervention ◽  
The Way ◽  
At Home

For more than a year, the way people work and learn witnessed dramatic changes on the back of the Covid-19 pandemic. While workers were supported and provided with trainings and a variety of sources of information, students did not benefit from the same ‘privilege’. In Romania, students had to adapt to online learning system since March 2020. To properly assess the impact of online learning on students’ health (both physical and mental), the authors conducted a study on students at Politehnica University of Timisoara. As part of this study, subjects were assessed using ‘Rapid Office Strain Assessment’ (ROSA). While some of them learn in ergonomic conditions, there are others exposed to high postural risk (primarily generated by use of inappropriate furniture). This assessment is part of a larger ergonomic intervention focused on educating students on the importance of creating ergonomic conditions at home with the aim to improve quality of life.

scholarly journals Renal stones

2018 ◽  
Vol 56 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Adie Viljoen ◽  
Rabia Chaudhry ◽  
John Bycroft
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Renal Stone ◽  
Surgical Intervention ◽  
Recurrent Disease ◽  
Renal Stones ◽  
Evidence Base ◽  
Stone Disease ◽  
Significant Morbidity ◽  
Renal Stone Disease

Renal stone disease is a worldwide problem which carries significant morbidity. It frequently requires specialist urology intervention. Patients with recurrent disease and those at high risk require specialist investigations and review. Certain cases benefit from medical and surgical intervention. In this review, we discuss the pathophysiology, risk assessment, specialist investigations and various interventions, their rationale and evidence base. This review aims to provide an update of the previous publication in 2001 in this journal on this topic.

On the Way to Econstruction

2019 ◽  
pp. 29-49
Author(s):  
David Wood
Keyword(s):  
Environmental Concern ◽  
Environmental Concerns ◽  
The Way ◽  
Guiding Questions ◽  
At Home

This chapter discusses eco-deconstruction. It highlights two guiding questions: (1) Might not an econstruction—a living, developing, and materially informed deconstruction—find itself quite at home thinking through the quandaries of environmental concern? (2) Might not environmentalism provoke a certain materialistic mutation within deconstruction? This can be argued both ways—that environmentalism finds itself in an often problematic and aporetic space of posthumanistic displacement where deconstruction is particularly well equipped to offer guidance. Equally, environmental concerns can embolden deconstruction to embrace what can be called a strategic materialism, or the essential interruptibility of any and every idealization. Moreover, deconstruction's critique of presence leads effortlessly to the strange temporalities of environmentalism. The dangers people currently face are from the accumulated impacts of past practices.

Prevention of postpartum venous thromboembolism (VTE)

2021 ◽  
pp. 33-38
Author(s):  
Roseann O’Doherty ◽  
Fionnuala Ní Ainle
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Low Molecular Weight Heparin ◽  
Optimal Strategies ◽  
Developed Countries ◽  
Evidence Base ◽  
Emergency Caesarean Section ◽  
International Guideline ◽  
Pregnancy And Delivery

Venous thromboembolism (VTE) is a leading cause of maternal mortality in developed countries. The baseline pregnancy-associated VTE (PA-VTE) risk is further increased by additional maternal, pregnancy, and delivery characteristics. In a recently developed risk prediction model for postpartum VTE, emergency caesarean section, stillbirth, postpartum haemorrhage, pre-eclampsia/eclampsia, infection, and medical comorbidities were the strongest VTE predictors. While the evidence base supporting optimal strategies for reducing the risk of postpartum VTE in general is weak, for women with prior VTE it appears that this risk may be reduced by up to 75% with low-molecular-weight heparin (LMWH). VTE prevention in women with more common VTE risk factors is a knowledge gap in 2020, with widely varying international guideline recommendations. However, there is no debate surrounding the requirement to perform systematic VTE risk assessment in pregnant and postpartum women.

Right at home

2019 ◽  
Vol 21 (6) ◽  
pp. S2-S3
Author(s):  
Karen Hart
Keyword(s):  
Lasting Effect ◽  
The Way ◽  
At Home

The experience children take from their first days at pre-school can have a lasting effect on the way they anticipate future transitions. Communicating effectively – and helping them to do the same – is key to success.

scholarly journals The clinical assessment of acts of violence: mental mechanisms and subjectivity

2019 ◽  
Vol 26 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Rajan Nathan ◽  
Peter Wilson
Keyword(s):  
Risk Assessment ◽  
Risk Management ◽  
Clinical Practice ◽  
Clinical Assessment ◽  
Clinical Utility ◽  
Individual Case ◽  
Evidence Base ◽  
Routine Clinical Practice ◽  
Factors Associated ◽  
The Individual

SUMMARYApproaches to assessing violence in clinical practice have been influenced by developments in the field of risk assessment. As a result, there has been a focus on identifying and describing factors associated with violence. However, a factor-based approach to assessing violence in individual cases has limited clinical utility. In response, the benefits of a formulation-based approach have been promoted. This approach is enhanced by an understanding of the specific mental mechanisms that increase the likelihood of violence in the individual case. Although there is an empirical evidence base for mental mechanisms associated with violence, this literature has not been distilled and synthesised in a way that informs routine clinical practice. In this article the authors present the key mechanisms that are known to be associated with violence in a way that is relevant to the clinical assessment of violence and, in turn, can inform clinical and risk management.

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