Salutogenic qualities of midwifery care: A best-fit framework synthesis

BackgroundAlthough midwifery care is wellness-based and promotes normal physiology, it exists within a medical model that focuses on risk aversion and disease prevention. Salutogenic theory could provide an alternative approach to midwifery care, supporting health-promoting factors, rather than solely avoiding adverse events.AimsThe aim of this study was to explore women’s experiences of their midwifery care and identify salutogenic aspects of midwifery care.MethodsBest-fit framework synthesis was used to analyse 349 quotes about women’s experiences of midwifery care from 31 qualitative studies in ten high-income countries. Key salutogenic concepts of comprehensibility, manageability and meaningfulness were used as the basis for coding, and thematic analysis was used to expand and clarify the framework to best fit the data.FindingsDefinitions for the salutogenic aspects of midwifery care were developed. Comprehensibility (cognitive aspects of health): ways that midwives help women increase predictability and preparation during childbearing through apredictable caregiver, a predictable system and preparation for an unpredictable experience. Manageability (behavioural aspects of health): ways that midwives enhance and support a woman’s internal resilience, adding extra support when needed, and strengthen women’s external resources through connections to family, community and specialist care. Meaningfulness (emotional/spiritual aspects of health): ways that midwives encourage the commitment and engagement of childbearing women by providing care through a personalised relationship, by cultivating a woman’s autonomy.ConclusionFindings of this study may be used to further research into ways that salutogenic theory can bring a health and wellness-focused agenda to midwifery policy and practice.     

Women’s experiences of decision-making and attitudes in relation to induction of labour: A survey study

BackgroundRates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study was to identify women’s mode of birth preferences and experiences of shared decision-making for induction of labour.MethodAn antenatal survey of women booked for an induction at eight Sydney hospitals was conducted. A bespoke questionnaire was created assessing women’s demographics, indication for induction, pregnancy model of care, initial birth preferences, and their experience of the decision-making process.ResultsOf 189 survey respondents (58% nulliparous), major reported reasons for induction included prolonged pregnancy (38%), diabetes (25%), and suspected fetal growth restriction (8%). Most respondents (72%) had hoped to labour spontaneously. Major findings included 19% of women not feeling like they had a choice about induction of labour, 26% not feeling adequately informed (or uncertain if informed), 17% not being given alternatives, and 30% not receiving any written information on induction of labour. Qualitative responses highlight a desire of women to be more actively involved in decision-making.ConclusionA substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated.     

近代巴蜀诗人李士棻生卒年及别号考略

近代巴蜀诗人李士棻曾被曾国藩誉为“太白醉魂”，为曾府门下“四川三李”之一，其诗作有浓郁的巴蜀文化特色。然李氏仕宦不显，长期以来学界对其关注不足，学界近年不多的相关研究，多围绕国内所存的文献，对其诗歌创作进行艺术分析，对诗人的生平介绍多简单略过，没有严谨的考证，目前仍然很有争议。通过搜罗国内外现存典籍，综合目前所见李士棻本人著述，辅以晚清近代重要报刊《申报》和与李氏有交往的朝鲜文人文献，考证其生卒年及别号，冀为今后的相关研究解决基础问题。     

Children's experiences with an intervention aimed to prevent further physical abuse

Although many children across cultures are victims of physical abuse, few treatment models target these children and their parents. In Sweden, Combined Parent–Child Cognitive Behavioural Therapy for families at risk for child physical abuse has been successfully used according to pretreatment and posttreatment studies. However, few studies have explored how physically abused children experience treatment. This study includes 20 physically abused children aged 9–17 who completed Combined Parent–Child Cognitive Behavioural Therapy. Children had a positive overall impression of the treatment and highlighted addressing the abuse, as well as processing their experiences as particularly essential. Children described a positive transformation in their family life as a result of treatment, including violence cessation and bonding among family members. Children experienced the intervention as inclusive and child‐friendly. The implications of the promising findings are discussed.     

Maternal depression and children’s false belief understanding

Children of depressed mothers show substantial social impairment, which increases their risk for developing depression. Theory of mind understanding forms the basis of social functioning, and is impaired in children of currently depressed mothers. Models of risk emphasize that a history of any maternal depression confers risk to later psychopathology. Therefore, we tested a novel model of the impact of lifetime maternal depression on children’s false belief understanding that accounts for three primary factors that scaffold this understanding: maternal mental state talk, and children’s executive functioning and language abilities. Children aged 41–48 months with a maternal lifetime history of major depressive disorder (MDD; n = 19) performed significantly more poorly on the false belief battery compared to those without (n = 44). Further, lower levels of mental state talk, child executive functioning, and child language ability were significantly associated with poorer false belief scores. However, the relation between maternal MDD and children’s false belief performance was not mediated by any of these factors. These results indicate that maternal depression predicts poorer false belief understanding independently of other crucial scaffolding variables, and may be a social cognitive mechanism underlying the intergenerational transmission of depression.     

The impact of the European Youth Guarantee on active labour market policies: A convergence analysis

The European Union’s (EU) Youth Guarantee aims to improve the labour market situation of young people. Rather than prescribing a uniform policy model, it acknowledges that supportive measures need to align with national, regional and local circumstances. It thus seeks to promote mutual policy learning through the open method of coordination. As an innovative measure, the EU has deployed funding programmes to support the domestic measures related to the Youth Guarantee. We therefore examined in this study whether this mix of recommendations and financial incentives has entailed a convergence of member state policies. Our analysis of policy outputs for the period 2007?2014 yields a mixed empirical picture. There is catching‐up convergence regarding policies’ sectoral coverage but increasing divergence concerning the number of adopted policy instruments. The first two years of financial incentives did not produce any effect on enhancing policy experimentation among less active member states. We offer an optimistic and a pessimistic interpretation of these findings.     

Objective and subjective conditions for the continuity of the Peruvian extractive development model

ABSTRACT

The Peruvian economy depends for its growth on the export of its mineral resources. The core of the current economic development model is the export of the country's commodities and a free and (relatively) unregulated functioning of the markets. We argue that the continuity of the country's extractive development model is the consequence of the interplay between the objective and subjective conditions of Peruvian capitalist development. The analysis of the objective conditions is focused on the role of the country in the international division of labour, the relation between this role and the country’s economic and business structure, and the functionality of the extractive development model for the Peruvian State. In the case of the subjective conditions, the strength of the political Left, the labour movement and the social movements against mining capital are analyzed     

Statistical testing strategies for assessing treatment efficacy and marker accuracy in phase III trials

When a candidate predictive marker is available, but evidence on its predictive ability is not sufficiently reliable, all‐comers trials with marker stratification are frequently conducted. We propose a framework for planning and evaluating prospective testing strategies in confirmatory, phase III marker‐stratified clinical trials based on a natural assumption on heterogeneity of treatment effects across marker‐defined subpopulations, where weak rather than strong control is permitted for multiple population tests. For phase III marker‐stratified trials, it is expected that treatment efficacy is established in a particular patient population, possibly in a marker‐defined subpopulation, and that the marker accuracy is assessed when the marker is used to restrict the indication or labelling of the treatment to a marker‐based subpopulation, ie, assessment of the clinical validity of the marker. In this paper, we develop statistical testing strategies based on criteria that are explicitly designated to the marker assessment, including those examining treatment effects in marker‐negative patients. As existing and developed statistical testing strategies can assert treatment efficacy for either the overall patient population or the marker‐positive subpopulation, we also develop criteria for evaluating the operating characteristics of the statistical testing strategies based on the probabilities of asserting treatment efficacy across marker subpopulations. Numerical evaluations to compare the statistical testing strategies based on the developed criteria are provided.     

Value drivers of social businesses: A business model perspective

Hybrid organizational forms that combine commercial and welfare institutional logics play an increasingly important role in addressing the grand societal challenges we face today. Building on the literatures on hybrid organizations and social business models, we explore the characteristics of social businesses from a business model perspective. This study seeks to better understand the particularities and value drivers of hybrid social purpose in contrast to purely commercial business models. We follow a grounded theory approach and our findings are based on interview data from 17 social business firms. Building on social businesses' identified particularities, we propose four value drivers of social business models: 1) responsible efficiency, 2) impact complementarities, 3) shared values, and 4) integration novelties. We link our findings to the literature, contributing new insights into social businesses models and implications for practitioners.