Perceptions of paternal involvement and labour pain management in Chinese couples during childbirth: A qualitative study

BackgroundLabour pain is an individual experience embedded in a socio-cultural context. In childbirth, the father’s involvement provides important support to the mother during labour. However, few published studies have evaluated couples’ experiences of paternal involvement and labour pain management in the Chinese context.AimThis study aimed to understand the experience of labour pain management and the father’s involvement in childbirth from the perspectives of women and their partners in Hong Kong.MethodsAn exploratory qualitative design was adopted. A purposive sample of 45 Chinese parents was recruited at the postnatal unit of a regional hospital. Data were collected through semi-structured face-to-face interviews within 1 month after birth. The data were subjected to content analysis.FindingsThe findings revealed six major themes: the mothers’ experience of labour pain, effectiveness of pain relief measures, mothers’ perceptions of support from their partners, mothers’ perceptions of support from healthcare professionals, fathers’ experience of involvement in childbirth and suggested improvements to maternity services.DiscussionChinese mothers experienced intense labour pain and used various pain relief measures. Both parents considered the involvement of fathers and support from healthcare professionals to be highly significant during childbirth.ConclusionsThis study highlights the need for a family-centred model of care during childbirth that involves both parents in the decision-making process. Chinese maternity services should implement individualised birth plans that acknowledge both parents’ expectations and preferences, thus promoting a positive childbirth experience for the parents.     

Risking safety and rights: online sex work,crimes and ‘blended safety repertoires’

It has been well established that those working in the sex industry are at various risks of violence and crime depending on where they sell sex and the environments in which they work. What sociological research has failed to address is how crime and safety have been affected by the dynamic changing nature of sex work given the dominance of the internet and digital technologies, including the development of new markets such as webcamming. This paper reports the most comprehensive findings on the internet‐based sex market in the UK demonstrating types of crimes experienced by internet‐based sex workers and the strategies of risk management that sex workers adopt, building on our article in the British Journal of Sociology in 2007. We present the concept of ‘blended safety repertoires’ to explain how sex workers, particularly independent escorts, are using a range of traditional techniques alongside digitally enabled strategies to keep themselves safe. We contribute a deeper understanding of why sex workers who work indoors rarely report crimes to the police, reflecting the dilemmas experienced. Our findings highlight how legal and policy changes which seek to ban online adult services advertising and sex work related content within online spaces would have direct impact on the safety strategies online sex workers employ and would further undermine their safety. These findings occur in a context where aspects of sex work are quasi‐criminalized through the brothel keeping legislation. We conclude that the legal and policy failure to recognize sex work as a form of employment, contributes to the stigmatization of sex work and prevents individuals working together. Current UK policy disallows a framework for employment laws and health and safety standards to regulate sex work, leaving sex workers in the shadow economy, their safety at risk in a quasi‐legal system. In light of the strong evidence that the internet makes sex work safer, we argue that decriminalisation as a rights based model of regulation is most appropriate.     

Quality management as a tool for job satisfaction improvement in low-level technology organizations: the case of Ethiopia

Human resources are an important determinant of operational performances as it is crucial for quality improvement. Research suggests that issues related to quality of work life of employees are often overlooked in low technology level organizations in the developing countries. This article aims to investigate the relationship between quality management (QM) practices and job satisfaction (JS) in relation with the Ethiopian manufacturing organizations. Data were collected using a structured survey questionnaire and face-to-face interviews of shop-floor workers. Exploratory and confirmatory factor analysis was used to validate the survey instrument and structural equation modelling was used for the analysis. The findings provide evidence that top management commitment, participation of employees and continuous improvement are significantly and positively associated with JS. However, customer focus has insignificant relationship and surprisingly, teamwork showed unexpected negative relationship with JS. The study provides important insights into the true worth of QM implementation in which it enforces the belief that its practices are the decisive factor in enhancing workplace satisfaction of employees.     

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.     

HDDA: DataSifter: statistical obfuscation of electronic health records and other sensitive datasets

There are no practical and effective mechanisms to share high-dimensional data including sensitive information in various fields like health financial intelligence or socioeconomics without compromising either the utility of the data or exposing private personal or secure organizational information. Excessive scrambling or encoding of the information makes it less useful for modelling or analytical processing. Insufficient preprocessing may compromise sensitive information and introduce a substantial risk for re-identification of individuals by various stratification techniques. To address this problem, we developed a novel statistical obfuscation method (DataSifter) for on-the-fly de-identification of structured and unstructured sensitive high-dimensional data such as clinical data from electronic health records (EHR). DataSifter provides complete administrative control over the balance between risk of data re-identification and preservation of the data information. Simulation results suggest that DataSifter can provide privacy protection while maintaining data utility for different types of outcomes of interest. The application of DataSifter on a large autism dataset provides a realistic demonstration of its promise practical applications.     

The Practical Significance of Measurement Error in Pulmonary Function Testing Conducted in Research Settings

Conventional spirometry produces measurement error by using repeatability criteria (RC) to discard acceptable data and terminating tests early when RC are met. These practices also implicitly assume that there is no variation across maneuvers within each test. This has implications for air pollution regulations that rely on pulmonary function tests to determine adverse effects or set standards. We perform a Monte Carlo simulation of 20,902 tests of forced expiratory volume in 1 second (FEV₁), each with eight maneuvers, for an individual with empirically obtained, plausibly normal pulmonary function. Default coefficients of variation for inter‐ and intratest variability (3% and 6%, respectively) are employed. Measurement error is defined as the difference between results from the conventional protocol and an unconstrained, eight‐maneuver alternative. In the default model, average measurement error is shown to be ～5%. The minimum difference necessary for statistical significance at p < 0.05 for a before/after comparison is shown to be 16%. Meanwhile, the U.S. Environmental Protection Agency has deemed single‐digit percentage decrements in FEV₁ sufficient to justify more stringent national ambient air quality standards. Sensitivity analysis reveals that results are insensitive to intertest variability but highly sensitive to intratest variability. Halving the latter to 3% reduces measurement error by 55%. Increasing it to 9% or 12% increases measurement error by 65% or 125%, respectively. Within‐day FEV₁ differences ≤5% among normal subjects are believed to be clinically insignificant. Therefore, many differences reported as statistically significant are likely to be artifactual. Reliable data are needed to estimate intratest variability for the general population, subpopulations of interest, and research samples. Sensitive subpopulations (e.g., chronic obstructive pulmonary disease or COPD patients, asthmatics, children) are likely to have higher intratest variability, making it more difficult to derive valid statistical inferences about differences observed after treatment or exposure.     

网络外部性对双渠道供应链信息分享的影响

研究了网络外部性对双渠道供应链信息分享的影响。分别建立了存在网络外部性和不存在网络外部性下的双渠道供应链模型，通过比较零售商信息分享和不分享下其与制造商的期望利润。研究发现：当未考虑产品的网络外部性时，零售商不与制造商分享其市场需求信息，与已有研究一致。当考虑了产品网络外部性且网络外部性较小时，零售商仍不与制造商分享市场需求信息；然而，当网络外部性较大时，零售商与制造商分享其市场需求信息。此外，零售商与制造商共享其市场需求信息有助于增加制造商和供应链利润。     

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.     

基于HHM-RFRM的船舶航行风险评估方法研究

船舶航行风险是由各种风险因素交互作用产生。综合 HHM-RFRM 理论，构建船舶航行多维风险情景危险度测度模型，以风险因素耦合视角探讨船舶航行风险管理问题。在船舶航行多维风险情景危险度测度模型中结合贝叶斯定理，对船舶航行风险情景进行了定性与定量化过滤、评级。最后以大连港某从事商务活动的货船为例，验证了所提出方法的可行性。传统的风险评估方法只能评估单个风险因素对系统的影响，此评估方法克服了这一局限性，为船舶航行风险管理提供新的视角。     

Comfort with discussions about death,religiosity, and attitudes about end‐of‐life care

In end‐of‐life (EOL) care research, death anxiety and religiosity are often overlooked. Terror management theory (TMT) may provide a useful conceptual model with which to examine how comfort discussing death and religiosity influence attitudes related to EOL care. A telephone‐based survey was conducted among community‐dwelling adults in the Unites States. Via random sampling, with over‐sampling of Hispanics/African Americans, 123 completed survey interviews (response rate = 46%) were analyzed. Respondents were more likely to have better attitudes toward EOL care if they were older or white, religiously active, and comfortable with the subject of death. Religiosity and comfort discussing death were correlated with each other and remained significant predictors of attitudes about EOL care even without demographic covariates. Findings suggest that promoting an open dialogue about mortality may improve attitudes about EOL care and utilization of palliative care services. The study also provides evidence about the utility and applicability of TMT for EOL care.