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Perceived Reality and Subjective Importance of Shared Decision-Making During Perinatal Care
Get PDFAim: The aim of the study is to explore perceived reality and subjective importance of shared decision-making (SDM) during antenatal, intrapartum, and/or postpartum care, provided by the midwife and/or obstetrician. Methods: A cross-sectional study was conducted among women in Flanders, Belgium. SDM was measured with the Observing PatienT InvOlvemeNt scale. Tests examined the differences between perceived reality and subjective importance of SDM. A multivariate generalized linear model tested the main and interaction effects between SDM and the maternity care providers and the perinatal care periods. Bonferroni post hoc tests examined further significance. Results: A total of 1,216 pregnant and postpartum participants completed 1,987 self-reports of perceived reality and subjective importance of SDM. The community midwives' SDM was evaluated 924/1,987 times, the hospital midwives' SDM 309/1,987 times, and the obstetricians' SDM 754/1,987 times. Perceived reality and subjective importance of SDM showed significant differences between care professionals (p < .001; p < .001), explained by the differences between community and hospital midwives' SDM (p < .001, d .85; p < .001; d .28) and between community midwives and obstetricians' SDM (p < .001, d .72; p < .001; d .31). Conclusions: The findings indicate optimizing the decision-making process during perinatal care by aligning subjective importance and perceived reality of SDM throughou
Economic vulnerabilities and sustainability in energy utilities: Managing climate change in the face of geopolitical turmoil
Get PDFThis study investigates the implications of climate change on the environmental management strategies adopted by Chinese energy utility companies over the period from 2008 to 2021. The study highlights that an increase in temperatures correlates with a greater likelihood of these firms implementing environmental management strategies. This tendency is particularly pronounced among companies characterized by lower revenue levels, elevated operational costs, increased media scrutiny, or a comparatively weaker commitment to social responsibilities. Additionally, the analysis reveals that improved carbon performance mitigates this effect, whereas state ownership amplifies the observed trends. This research contributes to understanding the dynamic interplay between climate change and corporate environmental strategy within the context of Chinese energy utilities
Experiences of Nurses and Midwives Who Support Bereaved Parents During Perinatal Deaths in Ghana: A Descriptive Phenomenological Study
Get PDFIntroductionGlobally, perinatal death presents a profound challenge for healthcare and healthcare professionals, requiring enormous clinical expertise and mental fortitude. The complexity involved in balancing professionalism, empathy, and the human face pose significant emotional challenges for nurses and midwives. Perinatal deaths in Ghana remain high and have adversely impacted the achievement of Sustainable Development Goal 3. Nurses and midwives play a central role in the Ghanaian healthcare system, and understanding their experiences in providing care to grieving mothers can provide valuable data for enhancing bereavement support as well as promoting quality improvement in clinical care.ObjectiveTo explore the experiences of nurses and midwives who support bereaved parents during perinatal deaths in Ghana.MethodologyA descriptive-phenomenological approach was used to explore the lived experiences of the participants. Twelve participants were purposively recruited from the neonatal and intensive care unit of a District Hospital in northern Ghana. Interviews were conducted using a semi-structured interview guide. The data was analyzed iteratively using the thematic analysis approach.FindingsSix themes emerged from the interviews with the study participants. The six themes were personal experience of perinatal death, emotional impact on the nurses and midwives, parental reactions and coping, blame and guilt, the impact on work, and long-lasting psychological impact. The themes reflect the emotional and practical experiences encountered by the nurses and midwives when supporting bereaved parents and the impact of such experiences on their well-being.ConclusionPerinatal bereavement support is a core responsibility of the nurses and midwives who work in maternal and neonatal units. Despite an improvement in perinatal death globally, the rates are still of great concern in Sub-Saharan Africa. Ironically, the experiences of nurses and midwives who support parents in times of perinatal death are lacking in Sub-Saharan Africa. This study sheds light on the experiences of nurses and midwives who support parents during perinatal death in a Ghanaian context, highlighting the importance of supporting these healthcare professionals
Addressing inequalities in smart places: a primer for public administrations and third sector organisations
Get PDFOver the past 15 years, a variety of initiatives that claim to make places smarter have been launched at different geographic levels and scales, with smart cities and smart villages being just the most prominent examples of this phenomenon. Despite their promises to foster socio-economic development through the implementation of innovative solutions, these initiatives have also attracted several criticisms. One of the areas of major concern for scholars, policymakers and activists is the ambiguous impact of smart places on existing inequalities. Much attention has been paid to the effects of smart cities and smart villages on digital and spatial divides within and between urban and rural areas. Many have also emphasised how biases in the design and implementation of smart technologies may accentuate socio-economic, gender-based and racial discriminations.Drawing on this academic debate, this report presents the results of a multidisciplinary research project exploring how inequalities are conceived and assessed in the context of smart places. The analysis focuses on two second-tier cities in Italy and Scotland and highlights a series of shortcomings in how inequalities are dealt with by policymakers and practitioners. To address these shortcomings, the authors propose a set of recommendations targeting both public administrations at different geographic levels and civil society organisations committed to reducing inequalities in smart places
Addressing the traveling salesperson problem with frequency fitness assignment and hybrid algorithms
Get PDFThe traveling salesperson problem (TSP) is one of the most iconic hard optimization tasks. With frequency fitness assignment (FFA), a new approach to optimization has recently been proposed: instead of directing the search towards better solutions, the optimization process prefers those with rarely encountered objective values. FFA can be plugged into existing algorithms and can improve their performance on some problems that are hard for them. However, problems like the TSP, where the number of possible objective values (here: tour lengths) is high, cause the performance of FFA-based algorithms to deteriorate. We choose 56 symmetric instances from TSPLib as a testbed for our experiments. We plug FFA both into the (1+1) EA and simulated annealing (SA) and obtain the FEA and FSA, respectively. We find that the resulting FEA substantially outperforms the (1+1) EA and that FSA can reach the global optima more often than SA within our computational budget. We propose two ways to hybridize FFA and traditional optimization in a round-robin scheme where objective function evaluations are alternatingly assigned to both components. The FFA-based parts of the algorithms sometimes send a solution over to the traditional-optimization-based ones. This can lead to further performance improvements. In particular, the hybrids combining simulated annealing with the FEA solve most problems and find close-to-optimal solutions on other instances. Even for several instances with many possible different objective values, which are therefore not suited to FFA, hybrids combining FFA and traditional objective-guided optimization algorithms can offer substantial performance improvements
Affrontare le disuguaglianze negli smart places: una guida per le amministrazioni pubbliche e le organizzazioni del terzo settore
Get PDFNegli ultimi 15 anni sono state lanciate, a diversi livelli geografici, una varietà di iniziative che puntano a promuovere lo sviluppo socio-economico attraverso l’implementazione di soluzioni tecnologiche innovative. Smart cities e smart villages sono solo gli esempi più evidenti di questo fenomeno, che negli ultimi tempi ha attirato sia commenti entusiastici che diverse critiche. Una delle aree di maggiore preoccupazione per studiosi, amministrazioni pubbliche e esponenti della società civile è l’impatto ambiguo degli smart places in termini di disuguaglianze. Molta attenzione è stata dedicata agli effetti degli smart places sui divari digitali e sulle diseguaglianze territoriali già esistenti. Inoltre, è stato sottolineato come alcuni bias nella progettazione e nell’implementazione delle tecnologie digitali possano accentuare le discriminazioni socio-economiche, di genere e razziali. Prendendo spunto dal dibattito accademico in materia, questo report presenta i risultati di un progetto di ricerca multidisciplinare che esplora il modo in cui le disuguaglianze vengono concepite e valutate nel contesto delle iniziative legate agli smart places. L’analisi si concentra su due città di media grandezza in Italia e in Scozia e mette in luce una serie di carenze nel modo in cui le disuguaglianze vengono affrontate e valutate dagli attori locali coinvolti nelle iniziative di smart places. Per ovviare a queste carenze, il report propone una serie di raccomandazioni rivolte sia alle amministrazioni pubbliche sia alle organizzazioni della società civile impegnate a ridurre le disuguaglianze negli smart places
Digital transformation and the DIY artist: Balancing artistic integrity and economic sustainability in the digital domain
Get PDFThis study investigates the evolving role of do-it-yourself (DIY) artists in the context of digital transformation , analyzing the delicate balance between maintaining artistic integrity and achieving economic sustainability in the contemporary music industry. By exploring the innovative use of digital platforms, the research highlights the need to foster innovation and ensure sustainable growth as part of a pivotal strategy for these artists. The findings emphasize the complexities and challenges presented by digital platforms, particularly in terms of diverse groups and the potential disparity between artistic and commercial pressures. Drawing from global DIY music scenes, the study underlines the importance of expanding income sources, fostering community-driven growth, and prioritizing genuine artist-fan interactions. The results offer invaluable insights for independent musicians, industry stakeholders, and digital platform developers, emphasizing the interrelationship between artistry, identity, and sustainability in the digital domain
Stuck up, peeled off, covered up, shared and scribbled out: Doing ordinary politics with political stickers
Get PDFStickers are pervasive, if often small and subtle, tools of political activism. Despite their enduring popularity, stickers do not fit into popular models of political action that presume either a spectacle of protest or formal institutions and debate. In this paper, we argue that stickers enable and facilitate public interchange as a process of sociomaterial claims-making. However, in order to recognise how stickers are used to do politics, there is a need to shift from semiotic interpretations of stickers as representational signs in favour of an action-oriented, pragmatist approach that examine stickers in action in people’s lives and shared worlds. Connecting with recent calls in geography to reconceptualise political and communicative action as lively, emergent, and materially-mediated, we tour through the sticky, peeling, covered, shared, and scribbled geographies of stickers in everyday, ordinary political action
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