The quality of maternity care services as experienced by women in the Netherlands

<p>Abstract</p> <p>Background</p> <p>Maternity care is all care in relation to pregnancy, childbirth and the postpartum period. In the Netherlands maternity care is provided by midwives and general practitioners (GPs) in primary care and midwives and gynecologists in secondary care. To be able to interpret women's experience with the quality of maternity care, it is necessary to take into account their 'care path', that is: their route through the care system.</p> <p>In the Netherlands a new tool is being developed to evaluate the quality of care from the perspective of clients. The tool is called: 'Consumer Quality Index' or CQI and is, within a standardized and systematic framework, tailored to specific health care issues.</p> <p>Within the framework of developing a CQI Maternity Care, data were gathered about the care women in the Netherlands received during pregnancy, childbirth, and the postpartum period. In this paper the quality of maternity care in the Netherlands is presented, as experienced by women at different stages of their care path.</p> <p>Methods</p> <p>A sample of 1,248 pregnant clients of four insurance companies, with their due date in early April 2007, received a postal survey in the third trimester of pregnancy (response 793). Responders to the first questionnaire received a second questionnaire twelve weeks later, on average four weeks after delivery (response 632). Based on care provider and place of birth the 'care path' of the women is described. With factor analysis and reliability analysis five composite measures indicating the quality of treatment by the care provider at different stages of the care path have been constructed. Overall ratings relate to eight different aspects of care, varying from antenatal care by a midwife or GP to care related to neonatal screening.</p> <p>Results</p> <p>41.5 percent of respondents remained in primary care throughout pregnancy, labor, birth and the postpartum period, receiving care from a midwife or general practitioner, 31.3% of respondents gave birth at home. The majority of women (58.5%) experienced referral from one care provider to another, i.e. from primary to secondary care or reverse, at least once. All but two percent of women had one or more ultrasound scans during pregnancy. The composite measures for the quality of treatment in different settings and by different care providers showed that women, regardless of parity, were very positive about the quality of the maternity care they received. Quality-of-treatment scores were high: on average 3.75 on a scale ranging from 1 to 4. Overall ratings on a 0 – 10 scale for quality of care during the antenatal period and during labor, birth and the postpartum period were high as well, on average 8.36.</p> <p>Conclusion</p> <p>The care path of women in maternity care was seldom straight forward. The majority of pregnant women switched from primary to secondary care and back at least once, during pregnancy or during labor and birth or both.</p> <p>The results of the quality measures indicate that the quality of care as experienced by women is high throughout the care system. But with regard to the care during labor and birth the quality of care scores are higher when women know their care provider, when they give birth at home, when they give birth in primary care and when they are assisted by their own midwife.</p

Suppression in Pb-Pb Collisions at the LHC.

The production of the ψ(2S) charmonium state was measured with ALICE in Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV, in the dimuon decay channel. A significant signal was observed for the first time at LHC energies down to zero transverse momentum, at forward rapidity (2.5<y<4). The measurement of the ratio of the inclusive production cross sections of the ψ(2S) and J/ψ resonances is reported as a function of the centrality of the collisions and of transverse momentum, in the region p_{T}<12  GeV/c. The results are compared with the corresponding measurements in pp collisions, by forming the double ratio [σ^{ψ(2S)}/σ^{J/ψ}]_{Pb-Pb}/[σ^{ψ(2S)}/σ^{J/ψ}]_{pp}. It is found that in Pb-Pb collisions the ψ(2S) is suppressed by a factor of ∼2 with respect to the J/ψ. The ψ(2S) nuclear modification factor R_{AA} was also obtained as a function of both centrality and p_{T}. The results show that the ψ(2S) resonance yield is strongly suppressed in Pb-Pb collisions, by a factor of up to ∼3 with respect to pp. Comparisons of cross section ratios with previous Super Proton Synchrotron findings by the NA50 experiment and of R_{AA} with higher-p_{T} results at LHC energy are also reported. These results and the corresponding comparisons with calculations of transport and statistical models address questions on the presence and properties of charmonium states in the quark-gluon plasma formed in nuclear collisions at the LHC

Multiplicity dependence of charged-particle production in pp, p–Pb, Xe–Xe and Pb–Pb collisions at the LHC

Multiplicity (Nch) distributions and transverse momentum (pT) spectra of inclusive primary charged particles in the kinematic range of |η|<0.8 and 0.15 GeV/c<pT<10 GeV/c are reported for pp, p–Pb, Xe–Xe and Pb–Pb collisions at centre-of-mass energies per nucleon pair ranging from sNN=2.76 TeV up to 13 TeV. A sequential two-dimensional unfolding procedure is used to extract the correlation between the transverse momentum of primary charged particles and the charged-particle multiplicity of the corresponding collision. This correlation sharply characterises important features of the final state of a collision and, therefore, can be used as a stringent test of theoretical models. The multiplicity distributions as well as the mean and standard deviation derived from the pT spectra are compared to state-of-the-art model predictions. Providing these fundamental observables of bulk particle production consistently across a wide range of collision energies and system sizes can serve as an important input for tuning Monte Carlo event generators

Measurement of the radius dependence of charged-particle jet suppression in Pb–Pb collisions at <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" altimg="si1.svg"><mml:msqrt><mml:mrow><mml:msub><mml:mrow><mml:mi>s</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="normal">NN</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:msqrt><mml:mo linebreak="goodbreak" linebreakstyle="after">=</mml:mo><mml:mn>5.02</mml:mn><mml:mspace width="0.25em"/><mml:mtext>TeV</mml:mtext></mml:math>

The ALICE Collaboration reports a differential measurement of inclusive jet suppression using pp and Pb–Pb collision data at a center-of-mass energy per nucleon–nucleon collision sNN=5.02 TeV. Charged-particle jets are reconstructed using the anti-kT algorithm with resolution parameters R=0.2, 0.3, 0.4, 0.5, and 0.6 in pp collisions and R=0.2, 0.4, 0.6 in central (0–10%), semi-central (30–50%), and peripheral (60–80%) Pb–Pb collisions. A novel approach based on machine learning is employed to mitigate the influence of jet background. This enables measurements of inclusive jet suppression in new regions of phase space, including down to the lowest jet pT≥40 GeV/c at R=0.6 in central Pb–Pb collisions. This is an important step for discriminating different models of jet quenching in the quark–gluon plasma. The transverse momentum spectra, nuclear modification factors, derived cross section, and nuclear modification factor ratios for different jet resolution parameters of charged-particle jets are presented and compared to model predictions. A mild dependence of the nuclear modification factor ratios on collision centrality and resolution parameter is observed. The results are compared to a variety of jet-quenching models with varying levels of agreement

Measurement of the low-energy antitriton inelastic cross section

In this Letter, the first measurement of the inelastic cross section for antitriton–nucleus interactions is reported, covering the momentum range of 0.8≤p<2.4 GeV/c. The measurement is carried out using data recorded with the ALICE detector in pp and Pb–Pb collisions at a centre-of-mass energy per nucleon of 13 TeV and 5.02 TeV, respectively. The detector material serves as an absorber for antitriton nuclei. The raw yield of (anti)triton nuclei measured with the ALICE apparatus is compared to the results from detailed ALICE simulations based on the [Formula presented] toolkit for the propagation of (anti)particles through matter, allowing one to quantify the inelastic interaction probability in the detector material. This analysis complements the measurement of the inelastic cross section of antinuclei up to A=3 carried out by the ALICE Collaboration, and demonstrates the feasibility of the study of the isospin dependence of inelastic interaction cross section with the analysis techniques presented in this Letter

Measurement of the Lifetime and <math display="inline"><mi mathvariant="normal">Λ</mi></math> Separation Energy of <math display="inline"><mmultiscripts><mrow><mi mathvariant="normal">H</mi></mrow><mprescripts/><mrow><mi mathvariant="normal">Λ</mi></mrow><mn>3</mn></mmultiscripts></math>

International audienceThe most precise measurements to date of the HΛ3 lifetime τ and Λ separation energy BΛ are obtained using the data sample of Pb-Pb collisions at sNN=5.02  TeV collected by ALICE at the LHC. The HΛ3 is reconstructed via its charged two-body mesonic decay channel (HΛ3→He3+π- and the charge-conjugate process). The measured values τ=[253±11(stat)±6(syst)]  ps and BΛ=[102±63(stat)±67(syst)]  keV are compatible with predictions from effective field theories and confirm that the HΛ3 structure is consistent with a weakly bound system