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Objective Episiotomy is associated with an increased risk of postpartum pain, bleeding, and dyspareunia. The hypothesis of this trial was that in women with singleton pregnancy, and spontaneous labor at term, use of calendula ointment would reduce pain after episiotomy.Methods This was a single-center parallel group randomized trial of women with singleton pregnancies and spontaneous labor at term who were randomized to either use of calendula ointment (i.e. intervention group) or standard care (i.e. control group) after episiotomy. Eligible women were those with singleton gestations in spontaneous labor and vertex presentation at term. Women with premature rupture of membranes were excluded from the study. Women in the intervention group were recommended use of calendula ointment 4 h after the episiotomy and then every 8 h for 10 days. The primary outcome was the pain level. Pain level was self-reported and recorded using the verbal rating scale (VRS). The effect of the calendula ointment was quantified as mean difference (MD) with 95% confidence interval (CI).Results During the study, 100 women agreed to take part in the study, underwent randomization, and were enrolled in this trial. Of the 100 randomized women, 50 were randomized to the calendula ointment group, and 50 to the control group. No women were excluded after randomization or lost to follow up.Women who received calendula ointment after episiotomy compared to standard care had a significantly lower pain level starting from day two and during all the follow-up. Calendula ointment also improve wound healing in terms of redness and edema.Conclusions Use of calendula ointment significantly reduce pain after episiotomy.Purpose We have summarized key studies regarding the assessment of subclinical macroangiopathic target organ damage (TOD) in type 1 diabetes mellitus (T1DM).Results Although chronic complications resulting from hyperglycemia, in particular macroangiopathies, are still the first cause of death in T1DM, there has been growing recognition of the role of hypoglycemia in cardiovascular morbidity and mortality. Subclinical TOD diagnosis ensures early implementation of the complex management aiming at either partial reversal of these complications or at least its downturn. To better identify patients with early TODs, several non-invasive diagnostic techniques are employed, including the ultrasonographic assessment of the intima-media thickness (IMT), computed tomography (CT) for coronary artery calcium (CAC) scores, and pulse wave velocity (PWV) measurement for arterial stiffness evaluation. Various studies reported that T1DM patients present an increased IMT. An increasing IMT fairly correlates with the cardiovascuimplementation of aggressive treatment would reduce mortality excess from CVD in T1DM.In recent years, nanocellulose (NC) obtained by defibrating cellulose to the nanometer level has been developed, and its development for various applications, e.g. as an additive for cosmetics and as a component of structural elements, is progressing. However, because NC has unique physico-chemical properties that are not found in conventional nanomaterials, particularly when inhaled, there are concerns about unexpected effects on organisms. This review summarizes the progress of in vivo experiments on the effects of NC on the respiratory system by inhalation. In addition, this review will provide new insights into NC toxicity studies by comparing the effects of fibrous nanomaterials.Introduction. The Health Education Specialist Practice Analysis II 2020 (HESPA II 2020) described the contemporary practice of health education specialists across work settings at entry and advanced levels. The purpose of the HESPA II 2020 manuscript was to report the research process and resulting data associated with the HESPA II 2020 and to provide recommendations for future practice analyses in health education. Method. Two data collection instruments were developed with the assistance of a 17-member Health Education Practice Panel to survey practicing health education specialists on the knowledge and skills needed in their ongoing roles. The instruments were designed to assess the degree to which the elements of the model had importance to practice (Importance), how often health education specialists performed the elements of the model (Frequency), and the point in time that health education specialists were expected to perform the various elements of the model (Performance Expectation). Composite scores for Sub-Competencies were calculated and subgroup comparisons were conducted to distinguish between levels of practice. Results. A total of 3,851 health education specialists provided usable responses. https://www.selleckchem.com/products/acetylcysteine.html The final validated hierarchical model included eight Areas of Responsibility, 35 Competencies, and 193 Sub-Competencies. Of the Sub-Competencies, 114 were Entry level, 59 Advanced 1 level, and 20 Advanced 2 level. In addition, 145 knowledge items were verified. Discussion. HESPA II 2020 produced a validated hierarchical model descriptive of current practice of health education specialists across work settings. The results have implications for professional preparation, professional development, and certification.Objectives In Portugal, a country with strong Catholic roots, elective termination of pregnancy at women's request is still stigmatised, especially if it is a repeat abortion. The objectives of this study were to determine the incidence of repeat abortion, taking into account the contraceptive method chosen after the index abortion event, and characterise the risk factors for repeat abortion.Methods This was a retrospective cohort study of 988 women who requested termination of pregnancy during 2015 in a Portuguese tertiary care public hospital. Contraception was given free of charge after the index event. The occurrence of a repeat induced abortion was evaluated during a 24 month follow-up period.Results Forty-nine (5.0%) of the 988 women had a repeat abortion. Users of long-acting reversible contraception (LARC) had fewer repeat abortions compared with users of non-LARC methods. Overall repeat abortion was 0.8% in subcutaneous contraceptive implant users, 1.5% in intrauterine contraceptive device (IUCD) users, 2.