Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study

ObjectiveTo compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia.DesignProspective cohort study.SettingTwo maternity hospitals in Ireland.PopulationA total of 1221 nulliparous women who gave birth vaginally or by emergency caesarean section.MethodsMultinomial logistic regression was used to analyse categorical outcomes, with results presented as ratios of relative risks (RRR). For dichotomous outcomes we used logistic regression, with results presented as odds ratios (OR).Main outcome measuresMode of birth, IV syntocinon use, pyrexia (≥38 °C), antibiotic treatment, first stage labour ≥10 h, second stage labour ≥2 h, blood loss (≥500 mls, ≥1000 mls), perineal trauma. Neonatal outcomes included Apgar score ≥7 at 1 min and 5 min, admission to neonatal intensive care unit, and infant feeding method.ResultsWomen using EA were more likely to require a vacuum-assisted birth (RRR 3.35, p < 0.01) or forceps-assisted birth (RRR 11.69, p < 0.01). Exposure to EA was associated with significantly greater risk of ≥10 h first (OR 6.72, p = 0.01) and ≥2 h second (OR 2.25, p < 0.01) stage labour, increased likelihood of receiving IV syntocinon (OR 9.38, p < 0.01), antibiotics (OR 2.97, p < 0.01) and a greater probability of pyrexia (OR 10.26, p < 0.01). Women who used EA were half as likely to be breastfeeding at three months postpartum (OR 0.53, p < 0.01). No differences were observed between groups in neonatal outcomes.ConclusionsOur data shows significant associations between EA use and several intrapartum outcomes.     

社会转型与观念变迁--以“道德缺失”为中心的考察

尽管“道德缺失”是转型期中国一个不容忽视的社会问题，但当代的“道德缺失”现象并非严重到了危机阶段，中国古代也不是“道德天堂”。今天的道德困境可以归因于社会环境的巨大变化。这种问题的解决，需依靠有效的维护机制作为保障。落实到根本，还是要大力发展经济，建设市民社会。     

Decision‐making under uncertainty in child protection: Creating a just and learning culture

The argument is made for having a positive error culture in child protection to improve decision‐making and risk management. This requires organizations to accept that mistakes are likely and to treat them as opportunities for learning and improving. In contrast, in many organizations, a punitive reaction to errors leads to workers hiding them and developing a defensive approach to their practice with children and families. The safety management literature has shown how human error is generally not simply due to a “bad apple” but made more or less likely by the work context that helps or hinders good performance. Improving safety requires learning about the weaknesses in the organization that contribute to poor performance. To create a learning culture, people need to feel that when they talk about mistakes or weak practice, there will be a constructive response from their organization. One aspect of reducing the blame culture is to develop a shared understanding of how practice will be judged and how those appraising practice will avoid the hindsight bias. To facilitate a positive error culture, a set of risk principles are presented that offer a set of criteria by which practice should be appraised.     

页岩气开发环境风险的法律规制思考

目前，我国在页岩气开发的环境保护方面存在着大量的法律空白，往往只能参照环境保护法和矿产资源法中的相关规定进行规制，无法有效解决页岩气开发暴露出来的环境问题。页岩气开发环境风险的法律规制，核心目的就是解决当前页岩气开发中的环境风险，促进页岩气开发与环境保护相协调，实现能源开发的可持续发展。在页岩气开发环境风险的法律规制方面，英美两国已经探索出一些经验和制度。积极借鉴国外有益经验，努力改进和完善我国应对页岩气开发环境风险的法律规制，对实现我国页岩气开采的经济效益、社会效益和环境效益三者的统一具有重要的现实意义。     

进化论思潮与唯物史观的传播——近代中国两大思想关系刍议

进化论思想与唯物史观同为近代中国影响广泛的思想。二者的传入时间接近，并且都经历了中国化的过程。随着进化论思想在现代遭到了越来越多的批判和质疑，唯物史观早期传播和发展的历程也经历了重新的审视。文章从近代思想史发展的事实出发，重新厘清两种思想的关系，并具体论证马克思的唯物史观能否从广义上归结为一种进化论的思想，以及进化论思想在中国是否经历了一个向唯物史观转变的历程。     

查尔斯·泰勒的脱嵌理论及其影响

嵌入和脱嵌在泰勒的思想体系中扮演着关键性的角色。在“大脱嵌”之后，现代世俗社会才最终形成。从前现代社会到现代社会的转型涉及到三个不同的方面:自我认同的转型、社会想象的转型和宇宙想象的转型。前现代的“可渗透的自我”深深的嵌入到迷魅的宇宙和社会之中，并通过这种嵌入而获得对自身身份的认同。随着大脱嵌的到来，自我脱嵌于旧有的宇宙与社会，对自身、社会和宇宙的想象模式都发生了根本性的变化。大脱嵌不但带来了自我认同的转型，同时也带来了社会想象和宇宙想象的转型。因此，追溯大脱嵌的最初的源头也就具有了重要的意义。其实，早在轴心时期的宗教中就已经隐含了脱嵌的源头，个体性的自我已经初具雏形。     

Maternal and paternal reactions to child sadness predict children's psychosocial outcomes: A family‐centered approach

Parents' reactions to children's emotions shape their psychosocial outcomes. Extant research on emotion socialization primarily uses variable‐centered approaches. This study explores family patterns of maternal and paternal responses to children's sadness in relation to psychosocial outcomes in middle childhood. Fifty‐one families with 8‐ to 12‐year‐old children participated. Mothers and fathers reported their reactions to children's sadness and children's social competence and psychological adjustment. Cluster analyses revealed three family patterns: Supportive (high supportive and low non‐supportive reactions from both parents), Not Supportive (low supportive reactions from both parents), and Father Dominant (high paternal supportive and non‐supportive reactions, low maternal supportive and non‐supportive reactions). Supportive families had children with higher social competence and more internalizing symptoms whereas Father Dominant families had children with lower social competence and fewer internalizing symptoms. Not Supportive families had children with average social competence and fewer internalizing symptoms. Findings are discussed in relation to the “divergence model” which proposes that a diverse range of parental responses to children's sadness, rather than a uniformly supportive approach, may facilitate children's psychosocial adjustment.     

Homosexual Discretion and Good Taste: Two Rules That Govern Homosexual Sociability Space in Santiago de Chile

Homosexual sociability space in Santiago is not socially homogenous. Beyond non-heterosexual identities segmentation (gay, lesbian, queer, BDSM, etc.), the present article proposes a reflection observing certain social distinctions or differences that come into play to create a hierarchy among gay and lesbian individuals within that space. Using a qualitative approximation, we analyze the discourse of homosexual men and women about ways to display homosexuality in different places in the city, as well as some sociability practices used in homosexual venues. The resulting social hierarchy is understood through two central subjective rules: discretion and good taste, dynamic mechanisms that perpetuate the distance among groups within the same sociability space, and to some extent reproduce the city’s class structure. Given that material means to privatize and sophisticate homosexual expression are unequally distributed in Santiago, the resulting differentiated social networks end up configuring the visibility strategies of homosexual identity played out in the city in the last years.     

Overcoming Old in Age-Friendliness

In this article, we explore views on an age-friendly space in the Netherlands by analysing the responses of older individuals (N = 54) in focus groups and by examining the perspectives around an age-friendly zone in the Netherlands, Parkstad Limburg. We found that a central issue in the wishes for living at a later age are adjustments to envisioned physical limitations that come with the ageing process; this includes adjustments to ensure safety, accessibility and mobility, in order to facilitate older individuals' efforts to stay engaged with the world around them. In their wishes, the older participants constructed ideal dwelling places that closely resembled a senior home, but at the same time they rejected wishing to live in a place that was identified as a senior home. We explain this paradox by the representation of such a space as being for old people, i.e. needy older individuals, which was not how the older participants wished to be identified. We conclude that the conception of age-friendly environments will have to face the difficult challenge of overcoming the association with old age, while simultaneously taking into account adjustments that signify and relate to the ageing process and that seem inescapably tied to oldness.     

The disembedded digital economy: Social protection for new economy employment in China

This research focuses upon employment in the new economy, exploring labour protection and social protection in the digital age in China. Through an empirical survey conducted in three Chinese cities, social insurance and the labour rights of employees in the digital economic sector, such as gig employment, e-commerce, and various other forms of online employment, have been examined in-depth. This study reveals new regulatory loopholes in the digital labour market, which have substantially eroded the basis of social policy arrangements in China, “softening” participation in social insurance branches and compliance with labour regulations remarkably. Drawing upon the theoretical concepts of Polanyi on embeddedness and disembeddedness, we argue that the digital employment sector in China has been increasingly disembedded from social institutions and social control. The new configuration in the digital field of social policy requires novel conceptual models and institutional settings to cope with increasing social risks in virtual spaces.