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.     

农地产权结构变迁视域下土地增值收益的公平分享

农地产权结构是搭建土地增值收益分配与宪法秩序有效链接的重要桥梁.从农地产权结构变迁的视角看,我国传统土地增值收益的国有化机制实际在很大程度上符合1982年宪法所确立的社会主义地租国有原则及地利共享秩序.然而,由于宪法土地条款一开始就被注入了地利分配具有倾向性的思想基因,长此以往便忽视了农民作为整体分享土地增值收益的"另一半宪法秩序".新型城镇化背景下,国家进行了"同地同权"、赋权于"民"的农村土地管理制度改革,其实质是宪法秩序的延续而非替代,我国土地增值收益分配的主要机制仍是征地补偿制度.要实现我国土地增值收益的公平分享,必须回到社会主义"国家—集体"一元论的完整地利共享秩序中来,并遵循实质平等的要求,通过以"人的城镇化"为目标对区片综合地价进行限定、采取倾向于农村及农业发展的"土地财政"政策、打破城乡户籍二元制实现城乡一体化发展等方案,推动农民全过程参与、共享土地利益.     

网络服务提供者著作权侵权中的双重注意义务

《民法典》侵权责任编对原有通知删除规则进行了科学修正，但事前保护缺位与事后救济程序失范的问题仍然存在。随着网络服务提供者完成角色转型和技术升级，其作为网络侵权风险的控制者和参与者，有必要且有能力承担未通知阶段的主动预防义务和已通知阶段的证明材料审查义务，以弥补著作权保护和用户利益保护的漏洞。双重注意义务应分别与网络服务提供者对侵权危险的预期和控制能力以及材料审查能力相适应。未通知阶段之注意义务以技术措施为主要履行方式，其注意标准的认定应综合考量技术水平、服务类型、内容介入程度、是否直接获取收益等要素，未尽该注意义务仅为过错认定的考量因素而非唯一标准，并不必然导致侵权责任。已通知阶段之注意义务仅限于对提交的证明材料进行形式审查和有限的实质审查，尽到此注意义务的，可以免于承担侵权责任。     

Rényi entropy of m-generalized order statistics

Abstract

Characterizing relations via Rényi entropy of m-generalized order statistics are considered along with examples and related stochastic orderings. Previous results for common order statistics are included.     

Loss and grief: The experience of transition to residential aged care

There is growing recognition of the experience of non-death-related loss and grief. One unexplored area of non-death-related loss and grief is associated with older people’s transition from home to residential aged care (RAC). This paper reports findings from a qualitative study that explored the experiences of people living in RAC, carer-relatives of people living in RAC and RAC staff. Using theories of loss and grief, the paper identifies features of the transition to RAC that are associated with unresolved loss and maladaptation to changed circumstances, and the types of support that would mitigate these. Using a series of focus groups with both residents and carer-relatives, as well as staff, the study found that residents and their families need more support to negotiate the multiple, often necessarily hasty decisions and bureaucratic requirements associated with transitioning to RAC, while simultaneously experiencing loss and grief. The types of support that families would welcome from service providers include facilitating shared decision making, valuing family and community carer expertise and providing practical information and assistance to fulfil administrative obligations.     

Caring for families experiencing stillbirth: Evidence-based guidance for maternity care providers

BackgroundEvidence-based guidance is needed to inform care provided to mothers and families who experience stillbirth. This paper focuses upon how meaningful and culturally appropriate care can be provided to mothers and families from when they are informed that their baby will be stillborn to many years after the experience. Avoidable suffering may be occurring in the clinical setting.AimsTo promote and inform meaningful and culturally appropriate evidence-informed practice amongst maternity care providers caring for mothers and families who experience stillbirth.MethodsA comprehensive systematic review was conducted which primarily synthesised relevant qualitative research studies. An expert advisory group comprised of stillbirth researchers, clinicians, and parents who have experienced stillbirth provided guidance for the review and the development of implications for practice.FindingsGrieving parents want staff to demonstrate sensitivity and empathy, validate their emotions, provide clear, information, and be aware that the timing of information may be distressing. Parents want support and guidance when making decisions about seeing and holding their baby. Sensitivity, respect, collaboration, and information are essential throughout the experience of stillbirth. Culturally appropriate care is important and may require staff to accommodate different cultural practices.ConclusionThe findings of the review and expert consensus inform the provision of meaningful and culturally appropriate care for mothers and families that have experienced stillbirth. Evidence informed implications for practice are provided to guide the actions, communication, and behaviours of maternity care providers.     

Catering to sex,sexual, and gender diversity: An exploratory study on the effects of LGBTI awareness training on aged care staff in Tasmania,Australia

The Australian National LGBTI Ageing and Aged Care Strategy seeks to address the lack of recognition of older lesbian, gay, bisexual, transgender, and intersex (LGBTI) adults living in aged care. Awareness training for aged care staff forms a crucial part of this strategy, but the impact of such educational programs are yet to be examined. In this article, we examine the effects of LGBTI awareness training on staff working in an Australian aged care facility. These staff perceived the awareness training as valuable, but the outcomes from it were limited. Therefore, we indicate changes that are necessary to support the translation of training into practice.     

Accurate computation of single and product moments of order statistics under progressive censoring

An accurate procedure is proposed to calculate approximate moments of progressive order statistics in the context of statistical inference for lifetime models. The study analyses the performance of power series expansion to approximate the moments for location and scale distributions with high precision and smaller deviations with respect to the exact values. A comparative analysis between exact and approximate methods is shown using some tables and figures. The different approximations are applied in two situations. First, we consider the problem of computing the large sample variance–covariance matrix of maximum likelihood estimators. We also use the approximations to obtain progressively censored sampling plans for log-normal distributed data. These problems illustrate that the presented procedure is highly useful to compute the moments with precision for numerous censoring patterns and, in many cases, is the only valid method because the exact calculation may not be applicable.     

Design selection for strong orthogonal arrays

Strong orthogonal arrays (SOAs) were recently introduced and studied as a class of space‐filling designs for computer experiments. An important problem that has not been addressed in the literature is that of design selection for such arrays. In this article, we conduct a systematic investigation into this problem, and we focus on the most useful SOA(n,m,4,2 + )s and SOA(n,m,4,2)s. This article first addresses the problem of design selection for SOAs of strength 2+ by examining their three‐dimensional projections. Both theoretical and computational results are presented. When SOAs of strength 2+ do not exist, we formulate a general framework for the selection of SOAs of strength 2 by looking at their two‐dimensional projections. The approach is fruitful, as it is applicable when SOAs of strength 2+ do not exist and it gives rise to them when they do. The Canadian Journal of Statistics 47: 302–314; 2019 © 2019 Statistical Society of Canada     

农村互助型社会养老:中国特色与发展路径

农村互助型社会养老是具有中国特色的社会养老的发展形式，是对农村传统家庭养老的重要补充。它扎根于农村传统的亲邻互助网络，其本质在于经济互助，表现为有组织地发动邻里、志愿等社会力量，充分利用以老年人为主的各类人力资源的闲置时间、资源低成本地相互帮助和服务。社会各界应将其作为重要实施方略，纳入积极应对人口老龄化战略和乡村振兴战略之中。其发展路径可以概括为：以资金互助为基础，以组织动员为抓手，以服务互助为重点，以社区居家养老为主要阵地，创新各类互助养老模式，着力形成稳定多元的资金来源，培育互助队伍，增加互助内容，从无偿到无偿、低偿相结合，探索建立标准规范的服务管理评估制度，机构养老与社区居家养老互联互通，最终尝试建立圈层化、整合化、网络化、制度化的农村互助型社会养老体系。