Factors associated with a positive childbirth experience in Brazilian women: A cross-sectional study

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.     

人工智能时代企业管理变革的逻辑与分析框架

人工智能作为社会发展和技术创新的产物,已经成为新一轮科技创新和产业变革的核心驱动力,正在对世界经济、社会进步和人民生活产生极其深刻的影响。人工智能的商业应用会改变企业内部运作和生产经营的过程,为企业管理带来了诸多挑战和变革机遇。本文结合人工智能的特征与发展趋势,从管理对象、管理属性、管理决策和管理伦理四个方面对人工智能时代企业管理变革的逻辑进行了梳理,得出如下推论:第一,人工智能时代,被管理者将出现越来越多的"人工智能员工",以"社会人"为中心的管理理论和管理手段的适用性降低,如何管理"人工智能员工"以及协调人类员工与智能机器人的关系将对管理者提出挑战;第二,人工智能时代,管理属性不仅包括管理理论的科学性、管理实践的艺术性,还包括管理过程的技术性;第三,人工智能时代,将出现一批优秀的技术管理者,此时,技术管理者指的不是管理技术的人,而是掌握智能技术的管理者;第四,人工智能时代,管理者的决策环境得到优化,管理活动中的决策准则将由"满意决策"过渡为"最优决策";第五,人工智能时代,管理手段的智能化发展可能会加剧管理效率和管理伦理的冲突,管理者必须提升管理道德,经营过程中强化社会责任的履行;第六,随着人工智能技术发展,政府、社会团体和行业协会有必要从政策、法律与行业标准等多个方面构建人工智能发展伦理的多层次约束机制。     

基于犹豫模糊语言信息的前景决策方法

本文首先回顾了模糊信息下前景理论研究的现状，发现犹豫模糊语言这一决策中常见的信息表达形式在前景理论框架中的研究被忽略，同时犹豫模糊环境下的前景决策方法具有一定的应用背景；基于此，本文考虑到决策者在实际决策过程中惯用的信息表达以及面对收益和损失时不同的风险态度，试图在犹豫模糊语言环境下构造新的前景理论决策框架，建立基于犹豫模糊语言信息的前景决策方法，并给出具体的决策步骤；最后通过算例分析展示了该方法的实际应用过程，并与犹豫模糊语言环境下的期望效用决策结果进行对比，说明了该方法更符合实际决策情景。     

Engaging leader – Engaged employees? A cross-lagged study on employee engagement

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.     

历史变局、国家兴衰与发展之路——三次千年变局叠加下的中国特色社会主义发展道路

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。     

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.     

Adherence to three different strategies to prevent early onset GBS infection in newborns

ProblemDespite the introduction of preventive guidelines, no decrease in the incidence of early onset infection was observed.BackgroundEarly onset group B streptococcal (EOGBS) infection is an important cause of neonatal morbidity and mortality.AimOur study was conducted to determine adherence to three guideline-based group B streptococcus (GBS) preventive strategies.MethodsA prospective experimental study clustered by obstetric collaboration region was performed between March 2013 and August 2014 among midwives, obstetricians and paediatricians in the Netherlands. At baseline, the three regions operated according to the Dutch preventive strategy (founded on the risk-based strategy) in order to prevent EOGBS infection, whereas in the study period they followed either the risk-based, the combination or the Dutch strategy. Adherence was measured prospectively per pregnant woman, using predefined core elements of each preventive strategy: identification of risk factors, maternal GBS screening, application of intrapartum antibiotic prophylaxis and observation of the child. Data about adherence to the core elements were collected from medical records, maternal questionnaires and laboratory test results.FindingsIn the three regions, a total of 121 care providers and 1562 women participated.We found an overall adherence of 90% to the risk-based strategy, 57% to the combination strategy and 89% to the Dutch strategy. Adherence to a strategy in case women had EOGBS risk factors was below 20% in all strategies.DiscussionThe majority of women with EOGBS risk factors did not receive the care prescribed by any of three preventive strategies and were not treated optimally.ConclusionThe risk-based and the Dutch strategy are the recommended strategies for implementation.     

地方政府重大决策机制存在问题及优化路径

地方政府作为地方公共事务管理者，决策正确与否直接关系到公共管理活动的成败，并且在一定程度上影响地方经济发展的水平及其核心竞争力。由于我国地方政府现阶段决策主体多元性及其职能模糊性，一些重大决策失误现象屡屡发生，造成了有限资源的巨大浪费，严重影响了地方政府在人民群众中的威信和形象。对此，我国地方政府迫切需要优化重大决策机制，包括明晰体制内外决策主体的职能、第三方评估、公众参与、决策终身责任追究及倒查机制等，以推进地方政府决策的民主化、科学化和法治化。     

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。     

民族记忆与文化基因--瑶族民族记忆中“中华民族共同体”文化基因的表征及其价值阐释

民族记忆既是传承民族文化基因的载体,也是彰显民族文化基因的重要文化表征。民族记忆作为延续民族历史和文化基因的内在根基,通过传承民族历史文化、建构民族身份、塑造民族形象等形式传承和彰显民族文化基因的内在特征。以瑶族为代表的少数民族文化基因是中华民族文化基因的重要组成部分,深入挖掘瑶族民族记忆中蕴含的“中华民族共同体”文化基因,并阐释其内在的价值与意义,对培育和铸牢我国各民族的“中华民族共同体”意识有着重要的理论价值与现实意义。