Early Pregnancy Assessment Services in Australia: What psychosocial support is available? A qualitative study

ProblemWomen commonly experience emotional distress following miscarriage but do not receive the support they need from healthcare providers.BackgroundMiscarriage can result in psychological morbidity; however, appropriate support at the time of a miscarriage can lead to better psychological outcomes. Early Pregnancy Assessment Services (EPASs) are dedicated outpatient services considered the “gold standard” for miscarriage care. Little is known about the psychosocial support EPASs provide in Australia.AimsThe aim of this study was to explore the provision of psychosocial support in Australian EPASs.MethodsSemi-structured interviews were conducted with 29 purposively sampled key-informants from 13 EPASs. Interviews were audio-recorded, transcribed, and thematically analysed.FindingsConsiderable variation was found in how EPASs functioned and their provision of psychosocial support. Many services were co-located with antenatal services, run by doctors with limited experience and most did not offer any psychosocial training to staff specific to EPAS. Referrals for additional support were generally not offered for first trimester miscarriages, and follow-up typically focused on physical management rather than emotional wellbeing. All EPAS staff demonstrated a strong commitment to providing best possible care to women within their own clinical setting and acknowledged the need for improved psychosocial support.ConclusionThis study provides the first exploration of Australian EPASs’ provision of psychosocial support. It has shown that while health care professionals working in EPASs are dedicated to providing the best possible care to women within their clinical setting, psychosocial support is very limited and could be improved.     

Sensitivity,uncertainty, and decision analyses in the prioritization of research

The evaluation of hazards from complex, large scale, technologically advanced systems often requires the construction of computer implemented mathematical models. These models are used to evaluate the safety of the systems and to evaluate the consequences of modifications to the systems. These evaluations, however, are normally surrounded by significant uncertainties related to the uncertainty inherent in natural phenomena such as the weather and those related to uncertainties in the parameters and models used in the evaluation.

Another use of these models is to evaluate strategies for improving information used in the modeling process itself. While sensitivity analysis is useful in defining variables in the model that are important, uncertainty analysis provides a tool for assessing the importance of uncertainty about these variables. A third complementary technique, is decision analysis. It provides a methodology for explicitly evaluating and ranking potential improvements to the model. Its use in the development of information gathering strategies for a nuclear waste repository are discussed in this paper.     

State of the Art in Risk Analysis of Workforce Criticality Influencing Disaster Preparedness for Interdependent Systems

The objective of this article is to discuss a needed paradigm shift in disaster risk analysis to emphasize the role of the workforce in managing the recovery of interdependent infrastructure and economic systems. Much of the work that has been done on disaster risk analysis has focused primarily on preparedness and recovery strategies for disrupted infrastructure systems. The reliability of systems such as transportation, electric power, and telecommunications is crucial in sustaining business processes, supply chains, and regional livelihoods, as well as ensuring the availability of vital services in the aftermath of disasters. There has been a growing momentum in recognizing workforce criticality in the aftermath of disasters; nevertheless, significant gaps still remain in modeling, assessing, and managing workforce disruptions and their associated ripple effects to other interdependent systems. The workforce plays a pivotal role in ensuring that a disrupted region continues to function and subsequently recover from the adverse effects of disasters. With this in mind, this article presents a review of recent studies that have underscored the criticality of workforce sectors in formulating synergistic preparedness and recovery policies for interdependent infrastructure and regional economic systems.     

关于量子控制系统的哲学思考

环境对量子控制系统的消相干揭示了一个事实,即量子世界里的系统将是一种全新的系统,它是某种开放的、数学的、并且是基于量子逻辑的系统。笔者认为,假如仍然还是立足经典思维,则系统的独立性将难以得到保证,传统的整体论也将变得自相矛盾。只有发展全新的"量子整体论",并在这种新的框架下去审视和建构量子系统,我们才有可能重新获得某种连贯一致的整体论。     

Community Resilience and Decision Theory Challenges for Catastrophic Events

Extreme and catastrophic events pose challenges for normative models of risk management decision making. They invite development of new methods and principles to complement existing normative decision and risk analysis. Because such events are rare, it is difficult to learn about them from experience. They can prompt both too little concern before the fact, and too much after. Emotionally charged and vivid outcomes promote probability neglect and distort risk perceptions. Aversion to acting on uncertain probabilities saps precautionary action; moral hazard distorts incentives to take care; imperfect learning and social adaptation (e.g., herd‐following, group‐think) complicate forecasting and coordination of individual behaviors and undermine prediction, preparation, and insurance of catastrophic events. Such difficulties raise substantial challenges for normative decision theories prescribing how catastrophe risks should be managed. This article summarizes challenges for catastrophic hazards with uncertain or unpredictable frequencies and severities, hard‐to‐envision and incompletely described decision alternatives and consequences, and individual responses that influence each other. Conceptual models and examples clarify where and why new methods are needed to complement traditional normative decision theories for individuals and groups. For example, prospective and retrospective preferences for risk management alternatives may conflict; procedures for combining individual beliefs or preferences can produce collective decisions that no one favors; and individual choices or behaviors in preparing for possible disasters may have no equilibrium. Recent ideas for building “disaster‐resilient” communities can complement traditional normative decision theories, helping to meet the practical need for better ways to manage risks of extreme and catastrophic events.     

Limit Theorems for Semi-Markov Queues and Their Applications

We begin by definition of semi-Markov flow and discussion of its properties. Asymptotic behavior of multi-server and single-server queueing systems is studied under assumption of time-compression or service time growth. The results obtained are used for calculation of large systems reliability. Statistical estimates of parameters involved are also provided.     

Comparing policy advisory systems beyond the OECD: models,dynamics and the second-generation research agenda

ABSTRACT

The concept of “policy advisory systems” was introduced by Halligan in 1995 as a way to characterize and analyze the multiple sources of policy advice utilized by governments in policy-making processes. The concept has proved useful and has influenced thinking about both the nature of policy work in different advisory venues as well as how these systems change over time. However, to date this work has examined mainly cases of developed countries and its application to developing and transitional countries is less certain. This paper sets out existing models of policy advisory systems based on Halligan’s original thinking on the subject and assesses the findings of many existing studies into OECD countries that advisory systems have been changing as a result of the dual effects of increased use of external consultants and others sources of advice – “externalization” – and the increased use of partisan advice inside government itself – “politicization”. Determining whether or not such changes have also characterized the situations found in developing and transitional countries and at the international-domestic and state-sub-state levels is the subject of the papers in this Special Issue.     

The competing risks analysis for parallel and series systems using Type-II progressive censoring

Abstract

Recently, the study of the lifetime of systems in reliability and survival analysis in the presence of several causes of failure (competing risks) has attracted attention in the literature. In this paper, series and parallel systems with exponential lifetime for each item of the system are considered. Several causes of failure independently affect lifetime distributions and observations of failure times of the systems are considered under progressive Type-II censored scheme. For series systems, the maximum likelihood estimates of parameters are computed and confidence intervals for parameters of the model are obtained using Fisher information matrix. For parallel systems, the generalized EM algorithm which uses the Newton-Raphson algorithm inside the EM algorithm is used to compute the maximum likelihood estimates of parameters. Also, the standard errors of the maximum likelihood estimates are computed by using the supplemented EM algorithm. The simulation study confirms the good performance of the introduced approach.     

HR systems and leadership attachment affecting idea generation and implementation: An experiment and two-source multi-level study

This paper focuses on the direct and interactive influence of leadership attachment styles (secure, anxious, and avoidant) and commitment HR system on two distinct stages of the individual innovation process—idea generation and implementation. We test our hypotheses in two studies. An experimental study of undergraduate students establishes a positive effect of secure attachment on idea implementation. The interplay between commitment HR system and avoidant attachment marginally predict idea generation; commitment HR system and neither secure nor anxious attachment predict implementation. A multisource multi-level field study in three EU-based private firms replicates the direct role of commitment HR system in stimulating idea implementation (but not generation) and suggests that secure attachment fosters both generation and implementation, whereas anxious attachment hinders both. Moderation analyses support only a marginal interaction between commitment HR system and secure attachment in fostering idea generation. We discuss theoretical, practical, and future research implications.