Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study

ObjectiveTo compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia.DesignProspective cohort study.SettingTwo maternity hospitals in Ireland.PopulationA total of 1221 nulliparous women who gave birth vaginally or by emergency caesarean section.MethodsMultinomial logistic regression was used to analyse categorical outcomes, with results presented as ratios of relative risks (RRR). For dichotomous outcomes we used logistic regression, with results presented as odds ratios (OR).Main outcome measuresMode of birth, IV syntocinon use, pyrexia (≥38 °C), antibiotic treatment, first stage labour ≥10 h, second stage labour ≥2 h, blood loss (≥500 mls, ≥1000 mls), perineal trauma. Neonatal outcomes included Apgar score ≥7 at 1 min and 5 min, admission to neonatal intensive care unit, and infant feeding method.ResultsWomen using EA were more likely to require a vacuum-assisted birth (RRR 3.35, p < 0.01) or forceps-assisted birth (RRR 11.69, p < 0.01). Exposure to EA was associated with significantly greater risk of ≥10 h first (OR 6.72, p = 0.01) and ≥2 h second (OR 2.25, p < 0.01) stage labour, increased likelihood of receiving IV syntocinon (OR 9.38, p < 0.01), antibiotics (OR 2.97, p < 0.01) and a greater probability of pyrexia (OR 10.26, p < 0.01). Women who used EA were half as likely to be breastfeeding at three months postpartum (OR 0.53, p < 0.01). No differences were observed between groups in neonatal outcomes.ConclusionsOur data shows significant associations between EA use and several intrapartum outcomes.     

Decision‐making under uncertainty in child protection: Creating a just and learning culture

The argument is made for having a positive error culture in child protection to improve decision‐making and risk management. This requires organizations to accept that mistakes are likely and to treat them as opportunities for learning and improving. In contrast, in many organizations, a punitive reaction to errors leads to workers hiding them and developing a defensive approach to their practice with children and families. The safety management literature has shown how human error is generally not simply due to a “bad apple” but made more or less likely by the work context that helps or hinders good performance. Improving safety requires learning about the weaknesses in the organization that contribute to poor performance. To create a learning culture, people need to feel that when they talk about mistakes or weak practice, there will be a constructive response from their organization. One aspect of reducing the blame culture is to develop a shared understanding of how practice will be judged and how those appraising practice will avoid the hindsight bias. To facilitate a positive error culture, a set of risk principles are presented that offer a set of criteria by which practice should be appraised.     

Politics in evaluation: Politically responsive evaluation in high stakes environments

The role of politics has often been discussed in evaluation theory and practice. The political influence of the situation can have major effects on the evaluation design, approach and methods. Politics also has the potential to influence the decisions made from the evaluation findings. The current study focuses on the influence of the political context on stakeholder decision making. Utilizing a simulation scenario, this study compares stakeholder decision making in high and low stakes evaluation contexts. Findings suggest that high stakes political environments are more likely than low stakes environments to lead to reduced reliance on technically appropriate measures and increased dependence on measures better reflect the broader political environment.     

Bi-objective multi-resource scheduling problem for emergency relief operations

Abstract

Resource scheduling for emergency relief operations is complex as it has many constraints. However, an effective allocation and sequencing of resources are crucial for the minimization of the completion times in emergency relief operations. Despite the importance of such decisions, only a few mathematical models of emergency relief operations have been studied. This article presents a bi-objective mixed integer programming (MIP) that helps to minimize both the total weighted time of completion of the demand points and the makespan of the total emergency relief operation. A two-phase method is developed to solve the bi-objective MIP problem. Additionally, a case study of hospital network in the Melbourne metropolitan area is used to evaluate the model. The results indicate that the model can successfully support the decisions required in the optimal resource scheduling of emergency relief operations.     

不同冷链服务模式下生鲜农产品供应链决策

基于单物流服务商、单供应商和单零售商构成的生鲜农产品供应链，构建3种冷链服务模式：承诺模式、提前要求模式与延后要求模式，探讨不同冷链服务模式对定价与冷链服务水平、企业绩效的影响。研究发现：某种冷链服务模式是否有利于消减数量与质量损耗依赖于产品易腐性、冷链服务成本及其分担比例。供应链成员无法在承诺模式与提前要求模式下形成统一的模式偏好。当物流服务商承担的冷链服务成本比例较低时，相比于提前要求模式，供应商偏好承诺模式，否则，偏好提前要求模式。承诺模式比提前要求模式更有利于物流服务商，然而对于零售商，结果正好相反。数值实验表明，虽然供应链成员无法对冷链服务模式形成整体的一致性偏好，但仍可实现局部的一致性偏好。     

新媒体影响力对雾霾风险感知的作用机制

基于“2017年中国城市化与新移民调查”随机调查数据，通过已有文献构建新媒体影响力和雾霾风险感知指标，采用中介效应模型验证并探索新媒体影响力对雾霾风险感知的影响及其作用机制。研究发现:提高新媒体影响力，能有效降低雾霾风险感知，而政府环保评价起着显著的中介效应的作用；并且新媒体影响力可划分为官方媒体影响力和非官方媒体影响力；官方媒体影响力不仅直接影响雾霾风险感知，而且通过政府环保评价间接对其产生影响；而非官方媒体影响力仅通过政府环保评价对雾霾风险感知产生间接影响。因此，媒体融合时代下，提升公众对官方媒体使用频率，拓宽官方媒体信息发布喋道，完善公开透明的信任机制，同时加强对非官方媒体的信息监督和信息反馈机制，完善政府风险沟通机制，对现阶段中国环境风险的源头治理具有现实意义。     

The renationalisation of migration policies in times of crisis: the case of Norway*

Securing collective action in the field of asylum regulation is high on the European political agenda. In this article, we look at one country's partial pullback from the regional cooperation during the high influx of asylum seekers in 2015. We use Norway as a case to analyse the challenges to common European asylum regulations and the drivers of a region-wide tendency of what we call renationalisation. Against this background, we seek to contribute to the discussion on the dynamics of Europeanisation and the future of the Common European Asylum System. While the Europeanisation of migration policies has been well covered in the literature, tendencies of renationalisation have been less so. To contribute to the knowledge base, we create a typology of the drivers of renationalisation. These drivers include necessary political and institutional preconditions, resource limitations, triggers, expectations and aspects of time.     

关于高校中层副职干部几个基本问题的思考

高校中层副职干部具有高校干部、中层干部和副职干部的群体特征，应当具备相应的政治、思想、道德、业务、能力和身体等方面的基本素质。高校应当按照现行干部配置规制，结合内部管理体制和工作机制任用干部。高校中层副职干部的日常活动涉及到社会、学校、家庭等多个层面，必须妥善处理好各种人事关系。     

基于人力资源管理价值链视角的“用工荒”现象分析

本文基于人力资源管理价值链的视角，分析了政府和企业在农民工这一特殊人力资源类型的价值创造、价值评价和价值分配的三个环节管理中存在的问题。这些问题最终导致了＂用工荒＂现象的产生。政府层面存在的主要问题有：在价值评创造环节中，缺乏对低端劳动力群体的规划、建立统一的劳动力市场和对农民工技能培训经费的投入不足；在价值评价环节，缺乏对技能人才的评价机制；在价值分配环节，对农民工利益保障的立法不完善且执法不严。企业层面存在的主要问题有：在价值创造环节，只重使用，不重培养；在价值评价环节，缺乏多种评价手段；在价值分配环节，企业发放给农民工的薪酬福利低，针对以上问题，从政府和企业两个层面，提出了相应的解决对策。     

The African Evaluation Guidelines: 2002. A checklist to assist in planning evaluations, negotiating clear contracts, reviewing progress and ensuring adequate completion of an evaluation

A review of the US ‘program evaluation standards’ (PES), undertaken in a series of workshops and meetings of networks of evaluators in Africa, resulted in modifications to those standards. The result was presented to a plenary session of the Inaugural Conference of the African Evaluation Association in September 1999, attended by over 300 evaluators from 35 countries. The AfrEA Conference decided that a systematic effort should be made to produce a list of African evaluation guidelines, similar to the PES, and that this checklist should be reviewed by national evaluation associations and networks in Africa and field tested in several countries. Ten national and regional networks and associations suggested modifications to the text and endorsed the final version of the guidelines.