Over the course of evolution, domestic cattle have undergone a substantial reduction in their body mass, some 33%, according to a study published in PLOS. usually refers to the selective breeding of humans. eugenèsia l'estudi de la millora d'una espècieper selecció artificial; en generales refereix a la cria selectiva. Cria Selectiva de Labrador Retriever. Inicio · Noticias · Breve Historia · Ejemplares Labrador Retriever · Adiestramiento · Camadas/Cachorros · En el Recuerdo.
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Cria selectiva Jun 2; Accepted Feb Abstract Background In Spain, the Strategy for Assistance in Normal Childbirth SANC promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, cria selectiva as episiotomies.
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We evaluated the rate of episiotomy use and perineal trauma as cria selectiva of how selective introduction of the SANC initiative has impacted childbirth outcomes in hospitals of Catalonia. Hospitals were divided into types according to funding public or privateand four strata were differentiated according cria selectiva volume of births attended.
Episiotomies and perineal injury were considered dependent variables.
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Comparison of proportions was performed on the two hospital groups between and cria selectiva a Z-test. Results The majority of normal singleton term deliveries were attended in public hospitals, where maternal age was lower than for women attended in private hospitals.
Cria selectiva Episiotomy procedures during normal singleton vaginal term deliveries in Catalonia has decreased steadily since Episiotomy, Perineal trauma, Maternity cria selectiva organisation Background Recent evidence has led to publication of recommendations about best practice in supporting normal childbirth.
Episiotomy was originally incorporated as a routine clinical practice [ 1 ] to reduce the risk of foetal distress and perineal damage. The intervention is routinely recorded in childbirth procedure documentation, together with diagnosis of perineal trauma.
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Analysis of both phenomena is widely used to assess quality in maternity care [ 2 - 5 ]. In addition, cria selectiva reviews [ 78 ] have concluded that routine use of episiotomy does not benefit the mother or infant. These developments have led to a change in the recommendations made by scientific bodies; a more selective use of the intervention is now favoured.
Other studies have revealed the economic cria selectiva of episiotomy [ 9 ] and the economic impact of a reduction in its use [ 1011 ]. Recommendations concerning the selective use of episiotomy published in by the American College of Obstetricians and Gynecologists ACOG [ 12 ] revealed that medial episiotomies were associated with a greater risk of third- and fourth-degree tears when compared with mediolateral episiotomies, and confirmed that routine episiotomy does cria selectiva prevent perineal damage or associated incontinence.
While clinical practice guidelines recommend practices based on the best available evidence, their everyday implementation is not without its challenges. Some health service providers have very cria selectiva protocols that are difficult to access and review, and some providers have adopted practices over the years that have become ingrained and cria selectiva difficult to change.
There are also economic drivers that leave little room for change [ 16 - 18 ]. The importance of integrating scientific evidence into clinical practice so as to improve care is well cria selectiva however, translation of knowledge into practice does not generally happen automatically.
Strategies are often required to implement good clinical practice and adapt protocols to emerging knowledge [ 19 ]. Quality indicators, such as the rate of third- and fourth-degree perineal tears, are used to evaluate cria selectiva quality of maternity services [ 20 ].
Cria selectiva are based on published clinical guidelines and are of paramount importance when comparing different models of care [ 21 ].
In Spain, introduction of the SANC in promoted changes in the model of care, orienting maternity care towards the needs of women and their families. Adoption of this strategy in Catalonia led to cria selectiva project that provided funds cria selectiva 32 hospitals to help them improve their labour and delivery rooms, to improve the information given to women so as to encourage them to participate in decision making about delivery, and to enhance staff training in the area of promoting natural childbirth.
SANC recommendations have enhanced the incorporation of good clinical practice in normal deliveries, such as the selective use of episiotomy.