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71.

Background

Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.

Aim

The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.

Methods

An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.

Findings

Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.

Conclusions

Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education.  相似文献   
72.
Schumpeterian market disequilibrium marked by entrepreneurial entry and incumbent exit has long held an important place in management literature. The extant literature has overwhelmingly championed the newcomer, despite incumbents' obvious advantages in resources, experience and market knowledge. The current research provides evidence for the effectiveness of the incumbent's strategy of capability enhancement (along an established technological trajectory) while responding to radical technological innovations. We develop a cognitive process model that integrates managerial cognition with capability development and deployment views, depicting the dynamics of the incumbent's capability enhancement process. We analyze the cognitive drivers of organizational actions in all stages (rigidity, triggering event, and capability renewal) and elucidate the role of top management cognition in the processes of detecting and correcting errors in a strategic course of action. We ground our model in the case of a cork-stopper industry veteran's decline as corks ceded ground to screw tops and other stoppers in the wine industry. How a major company fought back in response to the emergence of these, in the industry context, radical technological innovations, provides the basis for our narrative. The proposed theoretical model contributes to literature on technology management (with regard to incumbent strategies in response to radical innovation threats) as well as the role of cognition in strategy (providing an explanation of the cognitive underpinnings of capability development).  相似文献   
73.
Psychosocial benefits of activism include increased empowerment, social connectedness, and resilience. Yet sexual minority women (SMW) and transgender individuals with multiple oppressed statuses and identities are especially prone to oppression-based experiences, even within minority activist communities. This study sought to develop an empirical model to explain the diverse meanings of social justice activism situated in SMW and transgender individuals’ social identities, values, and experiences of oppression and privilege. Using a grounded theory design, 20 SMW and transgender individuals participated in initial, follow-up, and feedback interviews. The most frequent demographic identities were queer or bisexual, White, middle-class women with advanced degrees. The results indicated that social justice activism was intensely relational, replete with multiple benefits, yet rife with experiences of oppression from within and outside of activist communities. The empirically derived model shows the complexity of SMW and transgender individuals’ experiences, meanings, and benefits of social justice activism.  相似文献   
74.
Open innovation and absorptive capacity are two concepts based on the idea that companies can leverage the knowledge generated externally to improve their innovation performance. The aim of this paper is to analyse the joint effect of open innovation and absorptive capacity on a firm's radical innovation. Open innovation is expressed in terms of external search breadth and depth strategies and absorptive capacity is described by distinguishing between potential and realized absorptive capacity. In order to test our hypotheses, we carried out empirical research in firms operating in high-technology industries. The results indicate that internal routines and processes for absorbing external knowledge help explain radical innovation as they show a significant effect of potential and realized absorptive capacity. Also, there is a moderating effect of absorptive capacity on open innovation. Specifically, potential absorptive capacity exerts a positive effect on the relationship between external search breadth and depth and radical innovation. Realized absorptive capacity moderates the influence of external search breadth. These findings confirm the complementary nature of absorptive capacity and open innovation search strategies on radical innovation.  相似文献   
75.
The generalized half-normal (GHN) distribution and progressive type-II censoring are considered in this article for studying some statistical inferences of constant-stress accelerated life testing. The EM algorithm is considered to calculate the maximum likelihood estimates. Fisher information matrix is formed depending on the missing information law and it is utilized for structuring the asymptomatic confidence intervals. Further, interval estimation is discussed through bootstrap intervals. The Tierney and Kadane method, importance sampling procedure and Metropolis-Hastings algorithm are utilized to compute Bayesian estimates. Furthermore, predictive estimates for censored data and the related prediction intervals are obtained. We consider three optimality criteria to find out the optimal stress level. A real data set is used to illustrate the importance of GHN distribution as an alternative lifetime model for well-known distributions. Finally, a simulation study is provided with discussion.  相似文献   
76.
The paper examines to what extent a player's market value depends on his skills. Therefore, a data set covering 28 performance measures and the market values of about 493 players from 1. and 2. German Bundesliga is analysed. Applying robust analysis techniques, we are able to robustly estimate market values of soccer players. The results show (1) that there are significantly underrated and overrated players and (2) that a player's affiliation to a certain team may contribute to his market value. We conclude that a club's reputation affects the market values of its players and that star players are in tendency overrated.  相似文献   
77.
Population Research and Policy Review - The welfare state can be perceived as a safety net which helps individuals adjust to situations of risk or transition. Starting from this idea of the welfare...  相似文献   
78.
Aggressive behavior in pet dogs is a serious problem for dog owners across the globe, with bite injuries representing a serious risk to both people and other dogs. The effective management of aggressive behavior in dogs represents a challenging and controversial issue. Although positive reinforcement training methods are now considered to be the most effective and humane technique to manage the risk of aggression, punishment‐based methods continue to be used. Unfortunately, there has been little scientific study into the various factors influencing whether dog owners choose to use positive reinforcement techniques to manage aggression in their dogs. As such, current understanding of how best to encourage and support dog owners to use these methods remains extremely limited. This article uses a survey methodology based on protection motivation theory (PMT) to investigate the factors that influence owner use of positive reinforcement methods to manage aggressive behavior, in an attempt to understand potential barriers and drivers of use. In addition, the article provides an initial exploration of the potential role of wider psychological factors, including owner emotional state, social influence, and cognitive bias. Findings show that the perceived efficacy of positive reinforcement methods and the perceived ability of owners to effectively implement the technique are both key factors predicting future intentions and current reported use. Future interventions should focus on enhancing owner confidence in the effective use of positive reinforcement techniques across multiple scenarios, as well as helping owners manage their own emotional responses when they encounter challenging situations and setbacks.  相似文献   
79.
China’s pension reform during the past three decades has allowed a majority of China’s population to be covered by a pension scheme. Of particular note has been the New Rural Pension Scheme (NRPS), a voluntary programme introduced starting in 2009. One goal of our analysis is to assess that pension scheme, using a variety of sources of information including data drawn from recent (2013 and 2015) nationwide China Health and Retirement Longitudinal Surveys (CHARLS). Our analysis involves an exploration of differences between the generosity and structure of the NRPS and other pension schemes currently in place. We also explore the feasibility of reforming the current “quasi-social pension” component of the NRPS by substituting a universal non-contributory social pension pillar. In connection with our assessment of the NRPS, we note the unusually low benefit levels for rural China.  相似文献   
80.
Journal of Risk and Uncertainty - Texas is the only state that does not mandate that employers carry workers’ compensation (WC) insurance coverage. In place of traditional WC, companies can...  相似文献   
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