Vaginal births after caesarean: What does Google think about it?

AimVaginal birth after caesarean (VBAC) is a relatively safe alternative to repeat caesarean birth in the proper context. This important decision to undergo an elective caesarean versus VBAC is ultimately a decision of the mother. The purpose of our study was to assess the quality of online information in relation to VBAC collected using the most common search engine: Google.MethodsThe 10 most common hit sites for the keywords “VBAC” and “Vaginal birth after caesarean” were evaluated using the search engine Google. The quality of websites was rated based on the Silberg scale for accountability, the modified Abbott's criteria for presentation and the SMOG index for readability. The content of each website was compared to the Society of Obstetricians and Gynecologists of Canada (SOGC) guidelines for VBAC.Findings13 out of 20 identified websites met the adequate criteria for accountability, with 85% of the websites indicating authorship. 11 websites were deemed aesthetically agreeable. The target audience, assessed by the readability score, was notably above the non-medical population with an average SMOG index score of 14.75. Only half of the websites contained recommendations, as detailed by the SOGC guidelines.ConclusionAlmost all sites target a higher academic level, making it beyond the comprehension of the general population. Woman friendly web-assessment tools should be provided to enable pregnant women to take an active role in their decision making.     

Using concept mapping as a planning tool: Child welfare citizen review panels

Citizen Review Panels (CRPs) are groups of citizen volunteers authorized by U.S. federal law to examine state child welfare agencies. These groups inspect policies and practices related to child protection responsibilities and are tasked with making recommendations for systemic improvement. Despite the federal mandate for each state to develop a CRP and the potential of these groups to positively impact child welfare practices, there is a dearth in the literature related to CRPs. Consequently, planning and evaluation processes of these groups vary widely. This study reports on the use of concept mapping (CM) to outline a framework for planning and subsequently evaluating the CRP in one southeastern state. CM is a mixed-method research approach that uses multi-dimensional scaling and hierarchical cluster analyses to explore an area of study. Through these analyses, the method creates visual depictions of conceptual relationships between ideas. Data yielded a seven cluster concept map that CRP members (N = 36) utilized for planning processes, and subsequently for developing an internal evaluation tool. Results from this study offer a unifying framework by which CRPs, and similar groups in other areas can utilize for planning and evaluation purposes. After a review of pertinent literature on CRPs, this article explicates CM processes utilized in this study, describes results, discusses lessons learned, and outlines apposite areas for future CRP research.     

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.     

Integrating Family Resilience and Family Stress Theory

The construct, family resilience, has been defined and applied very differently by those who are primarily clinical practitioners and those who are primarily researchers in the family field. In thisarticle, the family resilience perspective is integrated with conceptual definitions from family stress theory using the Family Adjustment and Adaptation Response (FAAR) Model in an effort to clarify distinctions between family resiliency as capacity and family resilience as a process. The family resilience process is discussed in terms of (a) the meaning of significant risk exposure (vs. the normal challenges of family life) and (b) the importance of making conceptual and operational distinctions between family system outcomes and family protective processes. Recommendations for future family resilience research are discussed.     

Modelling heterogeneous space–time occurrences of earthquakes and its residual analysis

Summary. Earthquake intensities are modelled as a function of previous activity whose specific form is based on established empirical laws in seismology, but whose parameter values can vary from place to place. This model is used for characterizing regional features of seismic activities in and around Japan, and also for exploring regions where the actual seismicity rate systematically deviates from that of the modelled rate.     

Diagnostics for dependence within time series extremes

Summary. The analysis of extreme values within a stationary time series entails various assumptions concerning its long- and short-range dependence. We present a range of new diagnostic tools for assessing whether these assumptions are appropriate and for identifying structure within extreme events. These tools are based on tail characteristics of joint survivor functions but can be implemented by using existing estimation methods for extremes of univariate independent and identically distributed variables. Our diagnostic aids are illustrated through theoretical examples, simulation studies and by application to rainfall and exchange rate data. On the basis of these diagnostics we can explain characteristics that are found in the observed extreme events of these series and also gain insight into the properties of events that are more extreme than those observed.     

密度分布非均匀的反馈控制Logistic单种群模型平衡态的稳定性

本文对种群密度在非均匀分布情形下,考虑了具反馈控制的滞后 Logistic 生态模型平衡位置的稳定性;分别给出了在常时滞和弱连续时滞以及强连续时滞情况下的稳定性条件;其结果是对 Gopalsamy 在密度均匀分布情形下相应结果的推广.     

Residual analysis for spatial point processes (with discussion)

Summary.  We define residuals for point process models fitted to spatial point pattern data, and we propose diagnostic plots based on them. The residuals apply to any point process model that has a conditional intensity; the model may exhibit spatial heterogeneity, interpoint interaction and dependence on spatial covariates. Some existing ad hoc methods for model checking (quadrat counts, scan statistic, kernel smoothed intensity and Berman's diagnostic) are recovered as special cases. Diagnostic tools are developed systematically, by using an analogy between our spatial residuals and the usual residuals for (non-spatial) generalized linear models. The conditional intensity λ plays the role of the mean response. This makes it possible to adapt existing knowledge about model validation for generalized linear models to the spatial point process context, giving recommendations for diagnostic plots. A plot of smoothed residuals against spatial location, or against a spatial covariate, is effective in diagnosing spatial trend or co-variate effects. Q – Q -plots of the residuals are effective in diagnosing interpoint interaction.     

Consistent maximum likelihood estimation of a unimodal density using shape restrictions

It is well known that the unimodal maximum likelihood estimator of a density is consistent everywhere but at the mode. The authors review various ways to solve this problem and propose a new estimator that is concave over an interval containing the mode; this interval may be chosen by the user or through an algorithm. The authors show how to implement their solution and compare it to other approaches through simulations. They show that the new estimator is consistent everywhere and determine its rate of convergence in the Hellinger metric.