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1.
Robin S. Cronin Minglan Li Kate Culliney Robyn Maude Katherine Nelson 《Women and birth : journal of the Australian College of Midwives》2018,31(5):422-429
Background
Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.Aim
The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.Methods
An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.Findings
Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.Conclusions
Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education. 相似文献2.
Valuing environmental resources: A constructive approach 总被引:3,自引:1,他引:2
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4.
Higher education outcomes, graduate employment and university performance indicators 总被引:1,自引:0,他引:1
Massimiliano Bratti Abigail McKnight Robin Naylor Jeremy Smith 《Journal of the Royal Statistical Society. Series A, (Statistics in Society)》2004,167(3):475-496
Summary. Official employment-related performance indicators in UK higher education are based on the population of students responding to the 'First destination supplement' (FDS). This generates potentially biased performance indicators as this population of students is not necessarily representative of the full population of leavers from each institution. University leavers who do not obtain qualifications and those who do not respond to the FDS are not included within the official analysis. We compare an employment-related performance indicator based on those students who responded to the FDS with alternative approaches which address the potential non-random nature of this subgroup of university leavers. 相似文献
5.
The 'Tasmania Together' social futures plan for Tasmania is critically examined. Authored by a Tasmanian Government appointed Community Leaders Group, on behalf of the people of Tasmania, the plan is supposed to deliver a better Tasmanian society by 2020, based upon community consultation. Rather than a step-forward in democracy, the process serves to remove the democratic rights of people, especially those who are disadvantaged. A critique from a disability perspective is offered, which suggests that this social plan constitutes a form of institutionalised disablism. 相似文献
6.
Chris Dockins Robin R Jenkins Nicole Owens Nathalie B Simon Lanelle Bembenek Wiggins 《Risk analysis》2002,22(2):335-346
This article explores two problems analysts face in determining how to estimate values for children's health and safety risk reductions. The first addresses the question: Do willingness‐to‐pay estimates for health risk changes differ across children and adults and, if so, how? To answer this question, the article first examines the potential effects of age and risk preferences on willingness to pay. A summary of the literature reporting empirical evidence of differences between willingness to pay for adult health and safety risk reductions and willingness to pay for health and safety risk reductions in children is also provided. The second dimension of the problem is a more fundamental issue: Whose perspective is relevant when valuing children's health effects—society's, children's, adults‐as‐children, or parents'? Each perspective is considered, followed ultimately by the conclusion that adopting a parental perspective through an intrahousehold allocation model seems closest to meeting the needs of the estimation problem at hand. A policy example in which the choice of perspective affects the outcome of a regulatory benefit‐cost analysis rounds out the article and emphasizes the importance of perspective. 相似文献
7.
An individual measure of relative survival 总被引:2,自引:0,他引:2
Janez Stare Robin Henderson Maja Pohar 《Journal of the Royal Statistical Society. Series C, Applied statistics》2005,54(1):115-126
Summary. Relative survival techniques are used to compare survival experience in a study cohort with that expected if background population rates apply. The techniques are especially useful when cause-specific death information is not accurate or not available as they provide a measure of excess mortality in a group of patients with a certain disease. Whereas these methods are based on group comparisons, we present here a transformation approach which instead gives for each individual an outcome measure relative to the appropriate background population. The new outcome measure is easily interpreted and can be analysed by using standard survival analysis techniques. It provides additional information on relative survival and gives new options in regression analysis. For example, one can estimate the proportion of patients who survived longer than a given percentile of the respective general population or compare survival experience of individuals while accounting for the population differences. The regression models for the new outcome measure are different from existing models, thus providing new possibilities in analysing relative survival data. One distinctive feature of our approach is that we adjust for expected survival before modelling. The paper is motivated by a study into the survival of patients after acute myocardial infarction. 相似文献
8.
江泽民同志于 2 0 0 0年 6月在全国党校工作会议上的讲话 ,充满了实事求是的精神和深刻的辩证思维风格 ,体现了鲜明的时代特色。他对新时期干部德才基本要求所作出的新的规定 ,是对马克思主义人才理论的极大丰富。他提出的“重发现同时重培养”的原则、“使用、培养同一论”以及“德才具体说”、“辩证的台阶、资历观”等 ,是对传统的人才理论的突破和对马克思主义人才学说的丰富和发展 相似文献
9.
In this paper, we study implementation in “economic environments”. It is shown that there is a dense subset of the set of preference profiles such that given an arbitrary social choice function, f, and ε>0, there exists another social choice function, f ε, within ε of f uniformly and implementable in Nash equilibrium on the dense subset. 相似文献
10.
The number of studies examining racial and socioeconomic disparities in the geographic distribution of environmental hazards and locally unwanted land uses has grown considerably over the past decade. Most studies have found statistically significant racial and socioeconomic disparities associated with hazardous sites. However there is considerable variation in the magnitude of racial and socioeconomic disparities found; indeed, some studies have found none. Uncertainties also exist about the underlying causes of the disparities. Many of these uncertainties can be attributed to the failure of the most widely used method for assessing environmental disparities to adequately account for proximity between the hazard under investigation and nearby residential populations. In this article, we identify the reasons for and consequences of this failure and demonstrate ways of overcoming these shortcomings by using alternate, distance-based methods. Through the application of such methods, we show how assessments about the magnitude and causes of racial and socioeconomic disparities in the distribution of hazardous sites are changed. In addition to research on environmental inequality, we discuss how distance-based methods can be usefully applied to other areas of demographic research that explore the effects of neighborhood context on a range of social outcomes. 相似文献