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1.
BackgroundHaving a positive childbirth experience is an increasingly valued outcome. Few studies evaluated the women’s satisfaction with childbirth through face-to-face interviews out of the health service environment. The objective of this study was to identify factors associated with a higher level of satisfaction with the childbirth experience among Brazilian women.MethodsThis cross-sectional study involved 287 women giving birth in two hospitals in southern Brazil. Women who gave birth to healthy newborns at term were randomly selected. Face-to-face interviews were conducted 31–37 days after delivery, at the mothers’ homes, using a structured questionnaire. Satisfaction with the childbirth experience was measured using a Likert-type scale ranging from very satisfied to very dissatisfied. Prevalence ratios (PR) were estimated using Poisson regression with robust variance.ResultsFollowing hierarchical multivariate analysis, the following factors remained associated with a higher level of satisfaction with the childbirth experience: being satisfied with antenatal care (PR = 1.30; 95% confidence interval [95%CI] = 1.06−1.59), understanding the information provided by health professionals during labor and delivery (PR = 1.40; 95%CI = 1.01−1.95), not having reported disrespect and abuse (PR = 1.53; 95%CI = 1.01−2.31), and having had the baby put to the breast within the first hour of life (PR = 1.63; 95%CI = 1.26−2.11). No association was observed with type of delivery or hospital status (public or private).ConclusionsA higher level of satisfaction with the childbirth experience is related to satisfactory antenatal care, a non-abusive, respectful, and informative environment during childbirth, and to the opportunity to breastfeed the baby within the first hour of life. In clinical practice, greater attention to these basic principles of care during pregnancy and delivery could provide more positive experiences during birth.  相似文献   
2.
针对高职学生网上评教存在的问题,采用评教验证机制设置不合理评教的限制。对学生评教数据先剔除异常值,再分别对不同班级、不同课程和不同院系之间的学生评教数据进行修正与优化处理,得出最终的修正分值,降低了因班级、课程和院系的不同而导致的评教数据的差异性,使学生的网上评教能更准确有效的反应出教师的教学水平。  相似文献   
3.
The goal of this study is to provide a cross-lagged examination of the relationships between engaging leadership, job resources and employee work engagement. We propose a mediation model and we postulate that engaging leadership can increase perceptions of three specific job resources (i.e. autonomy, support from colleagues and opportunities for learning and development) which theoretically correspond to the three facets of engaging leadership (i.e., inspiring, connecting and strengthening, respectively). Subsequently, in keeping with the extant body of Job Demands-Resources (JD-R) research, we link job resources to employee work engagement. Our hypotheses were tested on data collected at two time-points – T1 (N = 759) and T2 (N = 273) –from employees working for a hotel chain in the Netherlands. In line with our expectations, engaging leadership showed a significant cross-lagged relationship with autonomy and support from colleagues, but did not predict learning opportunities and work engagement across time. While we formulated specific hypotheses, we also tested reversed causation relationships. We found no direct effect from engaging leadership on employee work engagement, however, the reversed effect was significant; employee perceptions of engaging leadership were shaped by their own engagement experiences. Importantly, engaged employees at T1 reported more job resources at T2. By providing a cross-lagged examination of our model, we showed that engaging leaders as well as employees’ positive affective state of being engaged, are essential to shaping a resourceful work context. A comprehensive view on the triggers and outcomes of work engagement and engaging leadership is needed, as the traditional unidirectional cause-effect rationale fails to explain how these concepts relate to one another and to employee experiences of job resources.  相似文献   
4.
机械产品的设计一直注重于市场需求和产品功能的开发,随着科学和技术的发展,环境因素变得越来越重要。 提出一种基于功能一环境一结构分析( FESA)与TRIZ的机械产品创新设计方法,通过分析机械产品结构之间的功能要素 以及功能要素与环境要素的相互作用关系,确定机械产品中存在的问题。建立根原因模型图,寻找结构设计上的不足和 缺陷,利用TRIZ创新理论来实现机械产品的改进创新。通过污水处理系统的创新设计实例验证了该方法的可行性。  相似文献   
5.
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。  相似文献   
6.
每当先进的发展制度开始取代落后的发展制度时,整个世界格局就会进入重大的转换阶段。在中国五千年的发展历史中,有两次重大的历史变局完全改变了中国历史发展轨迹并深远地影响了当前中国的发展模式。新时代下的中国作为前两次历史变局影响的客体,曾经既是先进发展制度取代落后发展制度的受益者,也经历过作为落后发展制度主体而被先进发展制度冲击的过程。目前世界正处于第三次先进发展制度与落后发展制度交替的历史变局阶段,作为第三次重大历史变局的主体,在三次千年历史变局叠加的背景下,能否有效地认识、适应并改造利用前两次历史变局的经验与教训,构建系统性、科学性、可行性、领先性的中国特色社会主义制度,将决定中国在本次历史变局中能否顺利成为先进发展制度的主体从而实现民族复兴。  相似文献   
7.
Managing risk in infrastructure systems implies dealing with interdependent physical networks and their relationships with the natural and societal contexts. Computational tools are often used to support operational decisions aimed at improving resilience, whereas economics‐related tools tend to be used to address broader societal and policy issues in infrastructure management. We propose an optimization‐based framework for infrastructure resilience analysis that incorporates organizational and socioeconomic aspects into operational problems, allowing to understand relationships between decisions at the policy level (e.g., regulation) and the technical level (e.g., optimal infrastructure restoration). We focus on three issues that arise when integrating such levels. First, optimal restoration strategies driven by financial and operational factors evolve differently compared to those driven by socioeconomic and humanitarian factors. Second, regulatory aspects have a significant impact on recovery dynamics (e.g., effective recovery is most challenging in societies with weak institutions and regulation, where individual interests may compromise societal well‐being). And third, the decision space (i.e., available actions) in postdisaster phases is strongly determined by predisaster decisions (e.g., resource allocation). The proposed optimization framework addresses these issues by using: (1) parametric analyses to test the influence of operational and socioeconomic factors on optimization outcomes, (2) regulatory constraints to model and assess the cost and benefit (for a variety of actors) of enforcing specific policy‐related conditions for the recovery process, and (3) sensitivity analyses to capture the effect of predisaster decisions on recovery. We illustrate our methodology with an example regarding the recovery of interdependent water, power, and gas networks in Shelby County, TN (USA), with exposure to natural hazards.  相似文献   
8.
In this paper, we consider the deterministic trend model where the error process is allowed to be weakly or strongly correlated and subject to non‐stationary volatility. Extant estimators of the trend coefficient are analysed. We find that under heteroskedasticity, the Cochrane–Orcutt‐type estimator (with some initial condition) could be less efficient than Ordinary Least Squares (OLS) when the process is highly persistent, whereas it is asymptotically equivalent to OLS when the process is less persistent. An efficient non‐parametrically weighted Cochrane–Orcutt‐type estimator is then proposed. The efficiency is uniform over weak or strong serial correlation and non‐stationary volatility of unknown form. The feasible estimator relies on non‐parametric estimation of the volatility function, and the asymptotic theory is provided. We use the data‐dependent smoothing bandwidth that can automatically adjust for the strength of non‐stationarity in volatilities. The implementation does not require pretesting persistence of the process or specification of non‐stationary volatility. Finite‐sample evaluation via simulations and an empirical application demonstrates the good performance of proposed estimators.  相似文献   
9.
This article considers statistical inference for the heteroscedastic partially linear varying coefficient models. We construct an efficient estimator for the parametric component by applying the weighted profile least-squares approach, and show that it is semiparametrically efficient in the sense that the inverse of the asymptotic variance of the estimator reaches the semiparametric efficiency bound. Simulation studies are conducted to illustrate the performance of the proposed method.  相似文献   
10.
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.  相似文献   
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