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.     

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.     

从“以人为本”到政府“公信”--新世纪初政府公信力构建的进路评析

政府公信力是政府凭籍自身信用赢得公众信任的能力，十六大以来，党在施政理念上强调"以人为本"，在执政行为上关注"民生"；在绩效上彰显公平正义，施政方略渗透着人文关怀因素，政府公信力得到了有效提升。但由于腐败现象没有得到有效控制，党风廉政与制度化建设相对滞后，政府公信力也受到了冲击。在新一代领导集体治国理政中，"改革"成为新的常态，防腐败斗争与党风廉政建设取得了伟大成就，政府公信力的重振业已开启。     

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。     

论民族自治地方政府机构改革的深化——基于新中国成立初期探索的思考

民族自治地方政府在新一轮机构改革中进行了历史性变革和系统性重塑，然而顶层设计与分层对接机制优化、机构设置细化与整合、运转协同和效能提升仍未完全到位。回溯机构改革史，中华人民共和国成立初期作为政府顶层设计和系统性构建阶段，是民族自治地方政府机构建设最富成效的历史时期之一。这一时期的民族自治地方政府机构建设强调权能配置和人员构成的民族性，逐步差异化设置机构、探索单一制下政府机构平衡设置等历史经验，可以为进一步深化政府机构改革提供有益借鉴。在新的历史起点上深化民族自治地方政府机构改革应以新时代中国特色社会主义思想为引领，合理汲取历史养分，进一步深化理论研究，完善法制体系，明晰特殊性职权和民族性职能，健全顶层设计与分层对接机制，创新改革模式，强化地方参与性，切实破解改革难题，推动政府自身建设持续走向深入。     

People with disability and new disaster communications: access and the social media mash-up

This article explores how a lack of access to increasingly complex and overlapping digital communications platforms in times of disaster for people with disabilities has the potential to make already life-threatening situations considerably more dangerous. As we are increasingly coming to rely on a social media mash-up of digital platforms to assist in communications during disaster situations, the issue of accessibility for people with disabilities is as dire as if it was high ground during a tsunami or transport during a typhoon. The contemporary social media environment is characterised by a complex and overlapping network of complementary platforms, populated by user-generated content, where people communicate and exchange ideas. In this environment, YouTube videos are posted to Facebook and embedded in blogs, and Twitter is used to link to these other sites and is itself embedded in other platforms. These networks are increasingly supplementing and supplanting more traditional communication platforms, such as the television and radio, particularly in times of disaster. The concern of this paper is that the elements from which this mash-up of communications channels is made are not always accessible to people with disabilities. This evolving network of social media-based communication exposes the limits of existing Internet-based universal design.     

市场经济下政府与市场的关系

在市场经济中，市场必须在资源配置中发挥基础性或决定性的作用，但政府在市场失灵的地方又必须积极地发挥作用。本文分别从早期市场经济中政府的作用、现代市场经济中政府的作用等五个方面对这一问题进行论述。     

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.     

影子银行、地方政府债务及金融发展动态关系研究——基于省级面板VAR模型

基于2004—2017年中国省级面板数据,运用面板向量自回归(PVAR)模型,使用系统GMM估计、脉冲响应函数、方差分解以及格兰杰因果关系检验等方法分析了影子银行、地方政府债务及金融发展之间的动态关系.结果表明:影子银行、地方政府债务与金融发展水平三者之间存在动态耦合关系.在地方政府融资能力受到约束的情况下,影子银行为地方政府提供了多元的融资方式,在增加政府融资能力的同时提升了政府债务水平;而地方政府债务需求显著推动了影子银行规模的快速发展.同时,影子银行过度扩张危害了金融市场的健康发展,降低金融发展水平,继而使地方政府的融资渠道受到约束.但金融发展并不能有效约束影子银行规模,原因在于,政府融资需求是影子银行的主要动力,若不能控制地方政府的借贷行为则无法从源头解决问题.监管机构在去杠杆的过程中,应该综合考虑影子银行与地方政府债务、金融发展之间的动态关系,如此才能够实现预期的政策效果.     

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。