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.     

论我国刑事诉讼中“非法证据”的界定标准

在刑事非法证据排除规则的具体运用中,"非法证据"的界定是当然前提。非法证据并非是任一证据合法性要件欠缺的广义非法证据,而专指取证主体通过严重非法的手段或者侵犯公民基本权利的方式所获取的证据材料。我国刑事非法证据包括非法言词证据和非法实物证据两类,两类非法证据在实际判断中虽存在差异,但都应围绕取证手段的非法性展开,分别考察取证手段是否违反法律规定以及违法的严重程度,以准确界定刑事非法证据的范围。     

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.     

Inference and Decision Making for 21st-Century Drug Development and Approval

ABSTRACT

The cost and time of pharmaceutical drug development continue to grow at rates that many say are unsustainable. These trends have enormous impact on what treatments get to patients, when they get them and how they are used. The statistical framework for supporting decisions in regulated clinical development of new medicines has followed a traditional path of frequentist methodology. Trials using hypothesis tests of “no treatment effect” are done routinely, and the p-value < 0.05 is often the determinant of what constitutes a “successful” trial. Many drugs fail in clinical development, adding to the cost of new medicines, and some evidence points blame at the deficiencies of the frequentist paradigm. An unknown number effective medicines may have been abandoned because trials were declared “unsuccessful” due to a p-value exceeding 0.05. Recently, the Bayesian paradigm has shown utility in the clinical drug development process for its probability-based inference. We argue for a Bayesian approach that employs data from other trials as a “prior” for Phase 3 trials so that synthesized evidence across trials can be utilized to compute probability statements that are valuable for understanding the magnitude of treatment effect. Such a Bayesian paradigm provides a promising framework for improving statistical inference and regulatory decision making.     

体验型产品消费行为的羊群效应及机理研究——基于电影行业消费行为的实证解释

互联网环境下消费者购买体验型产品时对网络信息的依赖性很大。因此，研究社交媒体影响下体验型产品的消费者决策选择行为具有现实意义。本文以电影行业的票房偏离及消费跟风现象为切入点，探究体验型产品的羊群效应并对其产生的内在机理进行解释。采集艺恩资讯的票房数据以及豆瓣的电影基本信息及影评等数据作为研究样本，从消费者"羊群行为"视角分析其对电影票房的影响。研究发现：在控制了质量等内生性影响之后，消费者羊群效应依然存在；产品特征信息对羊群效应起到了调节作用，从而形成理性跟随；采用预期差异模型可以解释消费者实现理性跟随的过程。研究结论对于电影行业宏观政策制定及对体验型产品合理进行营销推广提供了理论基础与实证依据。     

Estimation of the marginal expected shortfall under asymptotic independence

We study the asymptotic behavior of the marginal expected shortfall when the two random variables are asymptotic independent but positively associated, which is modeled by the so-called tail dependent coefficient. We construct an estimator of the marginal expected shortfall, which is shown to be asymptotically normal. The finite sample performance of the estimator is investigated in a small simulation study. The method is also applied to estimate the expected amount of rainfall at a weather station given that there is a once every 100 years rainfall at another weather station nearby.     

Uniform consistency rate of kNN regression estimation for functional time series data

In this paper, we investigate the k-nearest neighbours (kNN) estimation of nonparametric regression model for strong mixing functional time series data. More precisely, we establish the uniform almost complete convergence rate of the kNN estimator under some mild conditions. Furthermore, a simulation study and an empirical application to the real data analysis of sea surface temperature (SST) are carried out to illustrate the finite sample performances and the usefulness of the kNN approach.     

娄底市实现农业和农村可持续发展的探索

可持续农业和农村发展”(SARD)是联合国粮农组织倡导的世界未来农业和农村发展的大趋向。本文探究了可持续农业和农村发展的内涵及来源 ;立足娄底地情 ,分析了其农业和农村可持续发展中存在的问题 ;提出了实现娄底可持续农业和农村发展的目标和对策