Mentorship experiences during registrar training: reflections of Black African specialists in the Western Cape

In order to meet the significant staffing challenges to health care provision in South Africa, the need to support the training and retention of Black medical specialists has been identified. This small qualitative study aimed to explore experiences of mentorship among a group of Black medical specialists in hopes of understanding the value and potential challenges that these relationships raise. Ten Black medical specialists were interviewed about their experiences of being mentored during their registrar training. The interview data was analysed using discourse analysis, and the results comprise of three main themes, namely: Difficulty accessing mentorship, a lack of Black and/or female role models and finally, experiences of feeling excluded from soft networks. The experiences explored in this study indicate the need for open dialogue within the mentorship dyad regarding certain taken-for-granted assumptions surrounding race, so as to aid the provision of more effective and satisfying mentorship outcomes.     

从主权国家的兴衰看权力博弈形态的转型

传统的国际关系理论,无论是现实主义、自由主义、建构主义还是科学行为主义理论,都是把主权国家抽象成一个统一的国际关系行为体。这一行为主体有一致的利益,也自然要有一致的对外政策目标和手段。在20世纪,尤其是在两次世界大战和冷战期间,这一概念抽象是非常准确的。但冷战结束以后,尤其是进入21世纪以后,这一概念抽象逐渐与国际关系的现实相违背。一方面,国家综合实力并不能直接转化为具体领域的竞争优势;另一方面,很多国家,包括超级大国在内,其对外政策的主要阻力可能不是所谓的竞争对手,而是其国内不同的利益集团。这导致传统的国际关系理论,从假设到概念和推理层面,都已经无法解释和预测今天的世界,而权力小博弈理论可以为认识多元复杂互动博弈时代的国际关系提供一个新的解释框架。     

Statistical testing strategies for assessing treatment efficacy and marker accuracy in phase III trials

When a candidate predictive marker is available, but evidence on its predictive ability is not sufficiently reliable, all‐comers trials with marker stratification are frequently conducted. We propose a framework for planning and evaluating prospective testing strategies in confirmatory, phase III marker‐stratified clinical trials based on a natural assumption on heterogeneity of treatment effects across marker‐defined subpopulations, where weak rather than strong control is permitted for multiple population tests. For phase III marker‐stratified trials, it is expected that treatment efficacy is established in a particular patient population, possibly in a marker‐defined subpopulation, and that the marker accuracy is assessed when the marker is used to restrict the indication or labelling of the treatment to a marker‐based subpopulation, ie, assessment of the clinical validity of the marker. In this paper, we develop statistical testing strategies based on criteria that are explicitly designated to the marker assessment, including those examining treatment effects in marker‐negative patients. As existing and developed statistical testing strategies can assert treatment efficacy for either the overall patient population or the marker‐positive subpopulation, we also develop criteria for evaluating the operating characteristics of the statistical testing strategies based on the probabilities of asserting treatment efficacy across marker subpopulations. Numerical evaluations to compare the statistical testing strategies based on the developed criteria are provided.     

When Working Hard Is Not Enough for Female and Racial/Ethnic Minority Apprentices in the Highway Trades

Drawing on employment records, qualitative interviews, and a survey, we explore the experiences of apprentices in the highway trades in Oregon. We demonstrate that female and racial/ethnic minority apprentices have lower rates of recruitment and retention and disproportionately face challenges with interpersonal interactions, hiring practices, and supervisory practices. Yet, we find a pervasive narrative that attributes apprentices' success to “hard work,” which contributes to the legitimacy of these inequalities. Consistent with the conceptualization of work organizations as inequality regimes, we argue that the apprenticeship system has policies, practices, and ideologies that are on the surface gender and race/ethnicity neutral, yet lead to the perpetuation of inequalities.     

Adherence to three different strategies to prevent early onset GBS infection in newborns

ProblemDespite the introduction of preventive guidelines, no decrease in the incidence of early onset infection was observed.BackgroundEarly onset group B streptococcal (EOGBS) infection is an important cause of neonatal morbidity and mortality.AimOur study was conducted to determine adherence to three guideline-based group B streptococcus (GBS) preventive strategies.MethodsA prospective experimental study clustered by obstetric collaboration region was performed between March 2013 and August 2014 among midwives, obstetricians and paediatricians in the Netherlands. At baseline, the three regions operated according to the Dutch preventive strategy (founded on the risk-based strategy) in order to prevent EOGBS infection, whereas in the study period they followed either the risk-based, the combination or the Dutch strategy. Adherence was measured prospectively per pregnant woman, using predefined core elements of each preventive strategy: identification of risk factors, maternal GBS screening, application of intrapartum antibiotic prophylaxis and observation of the child. Data about adherence to the core elements were collected from medical records, maternal questionnaires and laboratory test results.FindingsIn the three regions, a total of 121 care providers and 1562 women participated.We found an overall adherence of 90% to the risk-based strategy, 57% to the combination strategy and 89% to the Dutch strategy. Adherence to a strategy in case women had EOGBS risk factors was below 20% in all strategies.DiscussionThe majority of women with EOGBS risk factors did not receive the care prescribed by any of three preventive strategies and were not treated optimally.ConclusionThe risk-based and the Dutch strategy are the recommended strategies for implementation.     

On a class exhibiting trend change in average failure rate

Abstract

Weak convergence and moment convergence issues are investigated for the New Better than Average Failure Rate (NBAFR) family (introduced by Loh (1984 Loh, W. Y. 1984. A new generalization of the class of NBU distributions. IEEE Transactions on Reliability R-33 :97–113[Crossref], [Web of Science ®] , [Google Scholar])). We explore the validity of these results in the context of a more general ageing class that we introduce. We prove some new properties of this class and derive its interrelationships with other non-monotonic ageing families. Reliability and moment bounds are obtained and an interesting characterization of exponentiality is proved. Special cases of our results lead to new theorems for the NBAFR class. Finally weak convergence and related issues are established for this class.     

The impact of social power and influence on the implementation of innovation strategies: A case study of a UK mega infrastructure construction project

Influence plays a key role in reaching consensus among multiple actors involved in project-based decision-making processes. While prior literature devotes considerable attention to describing influence, little attention has been paid to influence at the individual level of the strategic project manager within the context of megaprojects. This research intended to fill this knowledge gap by identifying and describing the influence strategies that a strategic project manager applies when implementing innovation strategies on megaprojects. A qualitative case study was used to examine the complex social processes involved in a major UK capital investment programme. The findings underline a critical subset of influence strategies, notably higher-management support, inspirational appeal and bargaining. The study proposes a utilitarian structure of social power comprising selective, supportive and executory power bases.     

关于高校中层副职干部几个基本问题的思考

高校中层副职干部具有高校干部、中层干部和副职干部的群体特征，应当具备相应的政治、思想、道德、业务、能力和身体等方面的基本素质。高校应当按照现行干部配置规制，结合内部管理体制和工作机制任用干部。高校中层副职干部的日常活动涉及到社会、学校、家庭等多个层面，必须妥善处理好各种人事关系。