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.     

Adolescent Protective Factors Promoting Resilience in Young Adults at Risk for Depression

In a longitudinal, community-based study, adolescent protective factors for those at risk for depression were identified that were associated with resilient outcomes in young adulthood. For those with childhood risk factors for major depression, significant protective factors included family cohesion, positive self appraisals, and good interpersonal relations. Findings may help inform the development of prevention and treatment programs for adolescents vulnerable to depression. Implications for future research and clinical practice are discussed.     

Factors Affecting Children’s Adjustment to the Death of a Parent: The Social Work Professional’s Viewpoint

This study investigated factors affecting the adjustment of parentally bereaved children by reviewing existing literature and comparing it to observations made by professional social workers. Interviewees had between 1 1/2 and 22 years of experience in counseling bereaved children. The specific factors examined were age and sex of the bereaved child, circumstances of the death, and adjustment of remaining caregiver. Participants (n = 5) responded to an interview instrument specifically designed for this study which contained seven in-depth, open-ended questions. Participants’ replies were mostly in accordance with the literature, but also generated some new perspectives that had not been previously considered for this study and had not appeared in the literature. This study has implications for practice with parentally bereaved children and their surviving caregivers.Rebecca M. Hope, LCSW, Outpatient Clinician, New River Valley Community Services, 700 University City Boulevard, Blacksburg, VA 24060.Diane M. Hodge, Ph.D. is an Associate Professor of Social Work, Radford University, P.O. Box 6958, Radford, VA 24141; e-mail: dmhodge@radford.eduAddress correspondence to Rebecca M. Hope, LCSW, Outpatient Clinician, New River Valley Community Services, 700 University City Boulevard, Blacksburg, VA 24060; e-mail: rmhope@verizon.net     

贵州健康老龄化的非经济制约因素

贵州省人口老龄化具有农村人口老龄化程度高于城镇、性别比偏低、文化水平较低,且民族、地区差异明显的特点。目前制约健康老龄化的非经济因素主要有法制环境问题,政府、社区组织老年工作问题,以及养老文化面临冲击的问题。针对存在问题提出三条相应对策。     

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.     

影响我国都市圈经济总量的因素分析——基于12大都市圈的面板数据

借助当前我国发展较成熟的12个都市圈的相关数据，通过建立多元回归模型，考察分析都市圈经济发展背后的影响因素，研究表明：都市圈中心城市辐射力、都市圈联系力和设施水平等因素对经济发展较快的都市圈经济总量有显著影响；经济发展较慢的都市圈的经济总量则主要受到都市圈消费能力和教育水平的影响，还受到一些都市圈软实力因素的影响。     

因子模型门槛效应的LM和Wald检验及其统计性质研究

门槛因子模型可以有效地刻画高维度时间序列的共变特征和区制转换行为,具有良好的可解释性和预测能力。针对因子载荷矩阵存在的门槛效应,本文提出了拉格朗日乘子和沃尔德检验方法,并给出了渐近分布,相关结果表明以上检验统计量具有良好的大样本性质和有限样本表现。在实证部分,以我国股市的行业指数作为研究对象,通过构建门槛因子模型来刻画我国股票市场波动的共变性特征和非对称效应。实证结果表明基于门槛因子模型可以很好地刻画中国股市行业收益率波动的共变特征和区制转换行为。     

论情感因素在公文写作中的效用

现代公文被认为是一种处理公务的工具,情感因素的作用往往被公文写作者忽视。从古代和现代的一些公文的分析和探讨中可以看到,情感因素在公文写作中有着特殊的效果和作用;因此,我们可以恰如其分地给公文注入一些情感因素,以增添其情感效用。     

民办高等教育发展的动因分析与对策

从制度安排论、需要驱动论和机制优势论三个方面对民办高等教育发展的主要动因进行了分析,在此基础上对民办高等教育的今后发展提出了建议。笔者认为,在充分认识市场和民办高校的作用、要求、特征、规律的基础上,政府对民办高等教育发展合理规划,以适当的方式促进和规范民办高校的运行,对民办高等教育的发展至关重要。     

西部地区产业升级的推动力分析

产业结构是重要的经济结构 ,产业升级对经济发展有积极的促进作用。本文着重分析了西部地区产业升级的影响因素 ,指出技术进步和政策因素是其产业升级最基本的推动力 ,西部地区应通过发展技术和制度创新来促进产业结构优化