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.     

从主权国家的兴衰看权力博弈形态的转型

传统的国际关系理论,无论是现实主义、自由主义、建构主义还是科学行为主义理论,都是把主权国家抽象成一个统一的国际关系行为体。这一行为主体有一致的利益,也自然要有一致的对外政策目标和手段。在20世纪,尤其是在两次世界大战和冷战期间,这一概念抽象是非常准确的。但冷战结束以后,尤其是进入21世纪以后,这一概念抽象逐渐与国际关系的现实相违背。一方面,国家综合实力并不能直接转化为具体领域的竞争优势;另一方面,很多国家,包括超级大国在内,其对外政策的主要阻力可能不是所谓的竞争对手,而是其国内不同的利益集团。这导致传统的国际关系理论,从假设到概念和推理层面,都已经无法解释和预测今天的世界,而权力小博弈理论可以为认识多元复杂互动博弈时代的国际关系提供一个新的解释框架。     

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.     

"指标困局":农村贫困治理的实践与反思

在国家的扶贫实践中，地方政府的行为策略是影响扶贫绩效的关键变量。通过对精准扶贫政策实践的调研发现，中央政府不断升级的治理手段为重构央地关系创造了条件，地方政府对国家扶贫理念转型认知的偏差以及在形成路径依赖之后的策略行为不仅容易产生对总体局势的误判，还为后期的政策困局埋下了伏笔。在此背景下，地方扶贫工作遭遇“指标困局”，即地方政府很难实事求是去识别贫困户，只能在既有的指标约束下进行精准识别，扶贫工作陷入了反复识别，却仍难实现精准的怪圈。     

先秦的“法治”思想和实践考量

先秦法家在与儒家“礼治”的争论中提出“法治”思想,并与战国时期富国强兵的国家策略结合,变法图存的“法治”实践此起彼伏。其中最为成功的是秦国的商鞅变法,秦国由此迅速崛起并最终吞并六国,建立起统一的封建国家。秦帝国的建立是“法治”思想和实践的里程碑,大秦将集权专制和“法治”相互糅合,将法家重刑思想发展到极端,走向了崇尚暴力和滥刑滥杀的野蛮恐怖境地,导致天下怨叛,秦王朝二世而亡,君权至上最终将法治引向了集权专制的死胡同。     

以环境哲学为研究视域的文化自觉

以环境哲学为研究视域的文化自觉是站在明确的生态整体主义立场的学科文化自觉。它以哲学为衔接点，把环境与广义的文化联系在一起，努力为环境哲学寻求新的增长点。而弱的非人类中心主义观念作为观念侧翼，更细致地修复破碎染尘之人心。让人类有效地从社会走向自然，又从自然回归社会。审视以环境哲学为研究视域能否实现文化自觉？它必须立足以环境哲学的语境与方式思考文化自觉的可能与必然，并应用环境哲学的方法与逻辑阐释文化自觉的内涵与趋向。环境哲学所固有的自然之翼，是其学科存在的本质特征。但如若停滞于自然界的现象，而无文化元素的参与和交融，环境哲学的困顿将会在现象与抽象之间迷失。而文化元素的加入，又必须在自觉的前提下进行，它一方面是为融合确定边界，另一方面是为渗透找到根据。以对人类与自然界高度负责的精神，文化自觉与环境哲学都有着共同的使命：欣赏人与自然的和谐相处。     

Institutional evolution and abrupt change: Reforming the administration of social assistance in Finland

Historical institutionalist studies have explained institutional change as resulting from critical junctures that interrupt long periods of stability or from endogenous, incremental evolution. Building on these theories, discursive institutionalists have focused on the roles of agency, ideas and discourse as explainers of change. Combining these approaches, this article analyses Finland’s decision in 2014 to transfer the administration of basic social assistance from municipalities to the central government. This study demonstrates that institutional change can be both abrupt and evolutionary. Due to sudden, exceptional political circumstances, the decision in question was made quickly and under pressure, circumventing possible veto players. However, it was possible only because of the incremental, endogenous change that had occurred in the way in which social assistance was administered at the municipal level. It enabled a change in political discourse, which eroded the credibility of the ideational frames that policy actors had previously utilised to reject the centralised model.     

State work and the testing concours of citizenship

Anyone trying to be a citizen has to pass through a set of practices trying to be a state. This paper investigates some of the ways testing practices calibrate citizens, and in doing so, perform “the state.” The paper focuses on three forms of citizenship testing, which it considers exemplary forms of “state work,” and which all, in various ways, concern “migration.” First, the constitution of a “border crossing,” which requires an identity test configured by deceptibility. Second, the Dutch asylum process, in which “being gay” can, in certain cases, be reason for being granted asylum, but where “being gay” is also the outcome of an examination organized by suspicion. And third, the Dutch measurement of immigrants’ “integration,” which is comprised of a testing process in which such factishes as “being a member of society” and “being modern” surface. Citizenship is analyzed in this paper as accrued and (re)configured along a migration trajectory that takes shape as a testing concours, meaning that subjects become citizens along a trajectory of testing practices. In contributing both to work on states and citizenship, and to work on testing, this paper thus puts forward the concept of citizenship testing as state work, where “state work is the term for that kind of labor that most knows itself as comparison, equivalency, and exchange in the social realm” (Harney, 2002, pp. 10–11). Throughout the testing practices discussed here, comparison, equivalency, and exchange figure prominently as the practical achievements of crafting states and citizens.