Understanding long-term environmental risks

How well we manage long-term environmental risks depends on how well we understand them. Whether the risk managers are experts or laypeople, that understanding is typically limited. As a result, people must rely on judgment when making decisions about risks. Estimating how big risks are and how much reducing them is worth is an intellectual skill. After reviewing the behavioral principles that govern how people acquire such skills, this article offers several proposals for facilitating learning abut risks by improving the ways in which scientific data are created or presented. It also describes some pitfalls facing attempts to determine the quality of other people's understanding of risks, whether through direct study or more casual observation.Preparation of this article was supported by National Science Foundation Grant SES-8846459. It is gratefully acknowledged. The opinions expressed are those of the author.     

Mobile technologies and communication strategies in an urban Midwifery Group Practice setting. An exploratory study

BackgroundAround-the-clock access to a known midwife is a distinct feature of Midwifery Group Practice (MGP) and caseload midwifery settings; although the literature suggests this aspect of working life may hinder recruitment and retention to this model of care. Mobile technologies, known as mHealth where they are used in health care, facilitate access and hence communication, however little is known about this area of midwifery practice.Research questionWhich communication modalities are used, and most frequently, by MGP midwives and clients?MethodsA prospective, cross sectional design included a purposive sample of MGP midwives from an Australian tertiary maternity hospital. Data on modes of midwife–client contact were collected 24 h/day, for two consecutive weeks, and included: visits, phone-calls, texts and emails. Demographic data were also collected.FindingsDetails about 1442 midwife–client contacts were obtained. The majority of contact was via text, between the hours of 07:00 and 14:59, with primiparous women, when the primary midwife was on-call. An average of 96 contacts per fortnight occurred.ConclusionThe majority of contact was between the midwife and their primary clients, reiterating a key tenet of caseload models and confirming mobile technologies as a significant and evolving aspect of practice. The pattern of contact within social (or daytime) hours is reassuring for midwives considering caseload midwifery, who are concerned about the on-call burden. The use of text as the preferred communication modality raises issues regarding data security and retrieval, accountability, confidentiality and text management during off-duty periods. The development of Australian-wide guidelines to inform local policies and best practice is recommended.     

行业异质性视角下贸易便利化对出口贸易的影响研究——兼论中国加入CPTPP的机遇与挑战

受单边主义与保护主义的冲击,当前全球贸易大幅放缓,贸易便利化成为各国政府和国际经济组织探寻贸易持续平稳增长的新途径。基于2010—2014年世界银行的跨国企业调研数据,运用泊松伪最大似然估计法(PPML),从理论与实证两个方面考察贸易便利化对出口的影响。研究表明:出口国和目的国贸易便利化水平的提高对一国出口增长、出口结构优化有显著的推动作用,并且出口国贸易便利化的效果比目的国的更大; 分组回归的结果证实了上述影响在不同发展阶段的国家组之间存在显著差异,发展中国家贸易便利化水平的提高能更显著地促进出口增长; 出口国和目的国的贸易便利化水平是影响双边出口扩展边际和集约边际的关键因素,尤其是在外部融资依赖度高或者合约密集度大的行业,出口国、目的国贸易便利化水平的提高都将直接或者间接地促进高外部融资依赖、合约密集型行业的出口增长。贸易便利化水平对出口的直接影响能降低贸易成本、提高过境效率等,间接影响通过促进整体经济活动能带动出口,该影响在外部融资依赖度高或者合约密集度大的行业中更加显著。中国加入CPTPP将有利于进一步加强贸易便利化软环境建设、优化制度环境,能对CPTPP成员国基础设施建设、电子商务发展提供积极助益。     

Survivor of Suicide Loss Support Group Facilitators: Do Peers and Professionals Differ?

ABSTRACT

Suicide is a major public health issue affecting countless people each year worldwide. Support groups are one of the few resources available to survivors of suicide loss to aid the healing journey. This study examined differences among support group facilitators based on status as a peer, professional, or peer/professional. Differences emerged among the facilitator types, particularly on attitudes of group effectiveness, the role of sharing stories in the group, when loss survivors should attend, and who should facilitate groups. The results provide important insights about group facilitation differences, though further research is necessary to understand effective approaches. A degree in social work was the most common educational background for facilitators who identified as professionals. As social workers often facilitate groups or work alongside peers in the provision of support groups across a variety of areas, the findings provide insights regarding facilitation differences to which social workers may need to attend.     

金砖国家合作机制探索——基于贸易便利化的合作前景

现阶段金砖国家经贸合作深化发展的方向,在于如何扩大相互贸易,以推动金砖国家间贸易发展,而贸易便利化可能是实现这一目标的可行途径之一。本文根据全球竞争力报告等多种商业调查数据,对金砖国家的贸易便利化水平进行了测算,并评估了金砖国家在该领域进行合作的潜力。在此基础上,金砖国家应首先建立贸易便利化委员会及政府间协调机构,有效推进海关环境和国内规制环境方面的合作。     

‘A perfect fit’ – Swedish midwives’ interest in continuity models of midwifery care

BackgroundMidwifery continuity models of care are highly recommended yet rare in Sweden, although approximately 50% of pregnant women request them. Before introducing and scaling up continuity models in Sweden, midwives’ attitudes about working in continuity models must be investigated.Objectiveto investigate Swedish midwives’ interests in working in midwifery continuity models of care and factors influencing the midwifery workforce’s readiness for such models.MethodsA cross-sectional online survey was utilised and information collected from a national sample of midwives recruited from two unions regarding background and work-related variables. Crude and adjusted odds ratios and logistic regression analysis were used in the analysis.ResultsA total of 2084 midwives responded and 56.1% reported an interest. The logistic regression model showed that respondents’ ages 24–35 years (OR 1.73) or 35–45 years (OR 1.46); years of work experience 0–3 years (OR 5.81) and 3–10 years (OR 2.04); rotating between wards or between tasks (OR 2.02) and working temporary (OR 1.99) were related to interest in continuity models. In addition, working daytime only (OR 1.59) or on a two-shift schedule (OR 1.93) was associated with such interest.ConclusionA sufficient number of midwives in Sweden appear to be interested in working in continuity models of midwifery care to align with women’s interest in having a known midwife throughout pregnancy, birth and postpartum period. Developing strategies and continuity models that will address the preferences of women in various areas of Sweden is important for offering evidence-based maternity services.     

Supporting the midwifery workforce: An evaluation of an undergraduate midwifery student employment model at a large tertiary maternity service in Victoria,Australia

BackgroundIn 2020, in response to major maternity workforce challenges exacerbated by the COVID-19 pandemic, the Victorian Department of Health implemented a number of workforce maximisation strategies, one of which was employment of undergraduate midwifery students called ‘Registered Undergraduate Student Of Midwifery’ (RUSOM).AimTo evaluate the RUSOM model implemented in a tertiary maternity service in Melbourne, Australia.MethodsA cross-sectional online survey was distributed to all RUSOMs and midwives at the study site in August 2021.FindingsTwenty of 26 RUSOMs (77%) and 110 of 338 permanent midwives (33%) responded. Both groups considered the model to be a positive workforce strategy that contributed to work readiness of students, and increased confidence and competence to practise. RUSOMS and midwives reported positives for the organisation including improving workload for midwives on the postnatal ward, enhancing quality of care and outcomes for women and babies, and the value of RUSOMs as team members. RUSOMs felt well supported, supervised and clinically and theoretically prepared. Both groups considered RUSOMs were underutilised, and that they could undertake additional duties, and both thought that the RUSOM model should continue.ConclusionThe model was highly valued by both RUSOMs and midwives. There was strong agreement that the model should continue and that the list of duties could be expanded. Given these findings, further research should explore the expansion and sustainability of RUSOMs in the maternity workforce.     

A historical narrative of the development of midwifery education in Indonesia

AimTo describe the history of midwifery education, present the current education programmes and explore the ways that have been undertaken to advance the midwifery profession in Indonesia.MethodsHistorical and contemporary government documents were reviewed.FindingsThe history of midwifery education in Indonesia shows a complex picture during and since colonisation with government, education institutes and association proposing different ways in which midwives were to be educated. Advocacy from the midwifery profession in Indonesia meant increasingly it is midwives who are determining how midwifery education is provided. Recent initiatives have resulted in a diploma, advanced diploma, bachelor’s degree, and a master’s degree in midwifery. The work of the midwifery profession advocating for midwifery education culminated in the Midwifery Act 2019. These changes in this Act will ensure that midwifery education meets the needs of women and their families but also lead to competent midwives who have the knowledge and skills to provide midwifery services at all levels of health provision. The history of midwifery in Indonesia illustrates the importance of the ICM pillars of association, regulation, and education.ConclusionThe history of midwifery education in Indonesia shows that for too long midwifery education was decided, determined and even regulated by authorities and disciplines other than midwifery. However, when the midwifery association and regulation inform and regulate midwifery education then there is an opportunity to provide care that will make a difference in outcomes for women and their families. The historical analysis of the story of Indonesia midwifery gives insight into what is required for quality education.     

Embracing the continuity of care experience: A new Australian graduate entry master of midwifery course with a student caseload of 15 women per year

BackgroundWomen receiving continuity of midwifery care have increased satisfaction and improved outcomes. Preparation of midwifery students to work in continuity models from the point of graduation may provide an ongoing midwifery workforce that meets rising demand from women for access to such care.Aim of the paperThe aim of this paper is to describe an innovative midwifery course based on a continuity model, where students acquire more than 50 % of clinical hours through continuity of care experiences. Additional educational strategies incorporated in the course to enhance the CCE experience within the philosophy of midwifery care, include a virtual maternity centre, case-based learning and the Resources Activities Support Evaluation (RASE) pedagogical model of learning.DiscussionAustralian accredited midwifery courses vary in structure, format and philosophy; this new course provides students with an alternative option of study for those who have a particular interest in continuity of midwifery care.ConclusionA midwifery course which provides the majority of clinical hours through continuity of care may prepare graduates for employment within midwifery group practice models by demonstrating the benefits of relationship building, improved outcomes and the reality of an on-call lifestyle.