Circadian variation in biological rhythms has been identified as affecting both labour pain and the pharmacological properties of analgesics. In the context of pain, there is also a growing body of evidence suggesting the importance of adult attachment. The purpose of this study was to examine whether labour pain, analgesic consumption and pharmacological effect are significantly affected by the time of day, and to analyse whether this circadian variation is influenced by women's attachment style. This prospective observational study included a sample of 81 pregnant women receiving patientcontrolled epidural analgesia (PCEA). Attachment was assessed with the Adult Attachment ScaleRevised (AAS-R). The perceived intensity of labour pain in the early stage of labour (3 cm of cervical dilatation and before the administration of PCEA) was measured using a visual analogue scale (VAS).Pain was also indirectly assessed by measuring the consumption of anaesthetics. The latency period and the duration of effect were recorded for a chronopharmacology characterisation. Pain, as assessed with the VAS, was significantly higher in the night-time group than in the daytime group. An insecure attachment style was significantly associated with greater labour pain at 3 cm of cervical dilatation (p < 0.001) and before the beginning of analgesia (p < 0.001) as well as with higher analgesic consumption and lower pharmacological efficacy (p < 0.05). The time of day was significantly associated with the pharmacological effect: the latency period was longer at night, and the duration of the pharmacological effect was longer during the daytime. The interaction between time of day and attachment style was not significant for any of the study variables. Our results provide evidence of the importance of circadian variation in studying labour pain and the pharmacological effect of labour analgesia involving epidural blockage with a PCEA regimen. Moreover, although there was no evidence that attachment style influenced the circadian variation, these data emphasise that insecure attachment patterns are a risk factor for greater labour pain and analgesic consumption, which should be considered in pain management approaches.
VariaSobre o lugar e os usos das imagens na antropologia: notas críticas em tempos de audiovisualização do mundo
About the significance and the uses of images in anthropology: critical notes in times of the audio-visualization of the world
Objective: To examine the influence of attachment dimensions and sociodemographic and physical predictors in the experience of labour pain. Methods: Eighty-one pregnant women were assessed during their third trimester of pregnancy and during labour. The perceived intensity of pain in the early stages of labour (3 cm of cervical dilatation) and before the administration of patient-controlled epidural analgesia (PCEA) was measured using a visual analogue scale (VAS). Pain was also assessed based on the consumption of anaesthetics. Attachment was assessed using the Adult Attachment Scale -Revised (AAS-R). Results: Attachment anxiety and avoidance were positively and significantly correlated with labour pain and anaesthetic consumption. In the multivariate models, attachment anxiety was a significant predictor of higher pain at 3 cm of cervical dilatation (β = 0.36, p = .042) and before the administration of PCEA (β = 0.51, p = .002). Older age (β = 0.31, p = .005), a shorter duration of labour (β = -0.41, p = .001) and attachment avoidance (β = 0.41, p = .004) were significant predictors of higher anaesthetic consumption. Conclusions: The study findings suggest that perceived labour pain and anaesthetic consumption are strongly associated with attachment, rather than demographic and physical factors. These data support the importance of understanding the experience of labour pain within an attachment theoretical framework.
New designs for Magnetic Resonance Imaging contrast agents are presented. Essentially, they all are host-guest inclusion complexes between y-cyclodextrins and polyazamacrocycles of gadolinium (III) ion. Substitutions have been made to the host to optimise the host-guest association. Molecular mechanics calculations have been performed, using the UFF force field for metals, to decide on the suitability of the substitutions, and to evaluate the host-guest energies of association. Interesting general conclusions have been obtained, concerning the improvement of Magnetic Resonance Imaging contrast agents; namely, a set of rational methodologies have been deduced to improve the association between the gadolinium (III) chelates and the cyclodextrins, and their efficiency is demonstrated with a large set of substituted complexes, opening new doors to increase the diagnostic capabilities of Magnetic Resonance Imaging.
This article provides a bibliometric review based on 267 articles obtained from the Web of Science and SCOPUS databases. The objectives defined for this study were (1) to describe how the publications in this scientific area are organized concerning authors and the evolution of scientific production in the period under analysis; (2) to identify the most cited publications and authors; (3) to understand which scientific journals and countries have the highest scientific production in this area; and (4) to identify future research opportunities. To achieve the defined objectives, the database analysis focused on bibliometric indicators in the first phase. We conclude that ethnic entrepreneurship is a complex and multidimensional phenomenon, having implications in different communities and territories. Therefore, in addition to identifying and analyzing the main streams of the identified literature, this paper not only provides an overview of the state of the art and contributes to understanding ethnic entrepreneurship but also identifies an agenda for future research.
O artigo analisa o perfil e a importância econômica da indústria de transformação da mesorregião do Triângulo Mineiro e Alto Paranaíba (TMAP). O estudo apoia-se em pesquisa bibliográfica e em dados da Rais, enfocando sobretudo indicadores de emprego entre 2006 a 2016. Os resultados evidenciam um papel dinâmico da indústria de transformação no TMAP e seu desempenho relativamente bem-sucedido nos últimos anos, comparativamente ao estado e ao país.
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