Perspectives on antenatal education associated with pregnancy outcomes: Systematic review and meta-analysis

BackgroundMany studies on the relation between maternal health and infant health, including the effect of structured antenatal education, have been published and expanded over the years.AimInvestigate the impact of various antenatal education programmes on pregnancy outcomes to aid the development of future guidelines related to maternal and foetal health.MethodsBibliographic databases (Cochrane, PubMed, EMBASE, CINAHL, Korean Studies Information Service System) were searched up to November 2018, following the PICO criteria: population (pregnant women), intervention (antenatal education), comparison (not specified), and outcome (maternal and foetal outcome including physical or mental health components).FindingsWe included 23 eligible studies consisting of 14 controlled trials and 9 observational studies. The maternal physical outcomes depending on participation in antenatal education were not significantly different; however, the caesarean birth rate was lower in the antenatal education group (relative risk, RR, 0.90; 95% confidence interval, CI, 0.82–0.99), as was the use of epidural anaesthesia (RR, 0.84; 95% CI, 0.74–0.96). The maternal mental health outcomes of stress and self-efficacy significantly improved in the antenatal education group, although there was no difference in anxiety and depression. The foetal outcomes of birth weight or gestational age at birth were also not different between the groups.ConclusionAntenatal education can reduce maternal stress, improve self-efficacy, lower the caesarean birth rate, and decrease the use of epidural anaesthesia; however, there is limited evidence of its effects on maternal or foetal physical outcomes. Therefore, antenatal education should be standardised to elucidate its actual mental and physical health effects.     

2005年以来马克思主义理论教育思想研究述论

自2005年中央实施马克思主义理论研究和建设工程以来,学术界对经典作家及中国化的理论教育思想进行了广泛的研究,取得了丰硕成果。今后应从研究的整体性、研究内容的深度和研究方法的多样性等方面加强马克思主义理论教育思想的研究。     

Evidence-Based Assessment and Application of Prognostic Markers: The Long Way from Single Studies to Meta-Analysis

In recent years, several attempts have been made to characterize the generalized Pareto distributions (GPD) based on the properties of order statistics and record values. In the present article, we give some characterization results on GPD based on order statistics and generalized order statistics. Some characterizations of uniform distribution based on expectation of some functions of order statistics are also given.     

On the Evaluation of the Kolmogorov Statistic

At least two computer program packages, SPSS and STRATA, use simulated Bernoulli trials to draw (without replacement) a random sample of records from a finite population of records. Therefore, the size of the sample is a random variable. Two estimators of a population total under this sampling procedure are compared with the usual estimator under simple random sampling. Conditions under which the Bernoulli sampling estimators have almost the same mean squared error as the simple random-sample estimator are illustrated.     

The Horvitz-Thompson Theorem as a Unifying Perspective for Probability Sampling: With Examples from Natural Resource Sampling

Courses in sampling often lack a coherent structure because many related sampling designs, estimators, variances, and variance estimators are presented as separate cases. The Horvitz-Thompson theorem offers a needed integrating perspective for teaching the methods and fundamental concepts of probability sampling. Development of basic concepts in sampling via this approach provides the student with tools to solve more complicated problems, and helps to avoid some common stumbling blocks of beginning students. Examples from natural resource sampling are provided to illustrate applications and insight gained from this approach.     

Quacks and Clerks: Historical and Contemporary Perspectives on the Structure and Function of the British Medical Civil Service

The British government's requirement for expert medical advice from the 1850s led to the development of a medical civil service, which reached its peak in size and authority in the 1970s. By this time the Chief Medical Officer (CMO) had direct management of a staff of over 170 medically qualified civil servants, who provided expertise on the development and implementation of new medical treatments as well as on broader health protection and promotion issues. The successive Whitehall efficiency reviews from 1979 onwards culminated in 1994 in the merger of the parallel medical and civil service reporting hierarchies in the Department of Health, effectively reducing the CMO's ability to call upon the support of medical civil servants, at a time of increasing new health threats such as AIDS and MRSA. This article uses government reports to chart the rise and fall of the British medical civil service. It discusses how, in the last ten years, the British government has become more imaginative in its use of temporary specialist medical advisers (tsars) brought in from the NHS, in relaxing the formal civil service hierarchies, and quietly abandoning the statutory Standing Medical Advisory Committee (SMAC). This article suggests that when the government has failed to give adequate support to its CMOs, the medical civil service has suffered from poor morale, experienced recruitment difficulties, and the ability to respond to health crises has been compromised. It highlights the chronic lack of historical awareness in the development of health policy in Britain.