A script concordance test was developed as an innovative tool for assessing ethical reasoning ability. An SCT of 12 medical ethical vignettes were constructed from the UNESCO Casebook on Human Dignity and Human Rights. The vignettes were reviewed by a panel of 15 medical experts before administration to a panel of 18 clinicians. The clinician’s answers were used to constitute the scoring key. The SCT was then administered to first and final year medical students. Data were analysed using SPSS. Internal (...) consistency was assessed using Cronbach’s alpha. SCT performance was tested for association with sex, year of study and race by comparing the mean SCT scores between categories within each variable. Internal consistency as measured by Cronbach’s alpha values, ranging from 0.597 to 0.902, indicated high intra-vignette reliability for 10 of the vignettes. Inter-vignette reliability was high at 0.797. Mean SCT scores were not significantly different between students of different gender, year of study and ethnicity. However, each vignette was able to distinguish between overall poor and good test performers. The SCT was able to differentiate between students with varying degrees of ethical reasoning ability. (shrink)

Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use (...) the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women’s experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births with a lay attendant or dai. The proportion of women who planned for an ANM to assist was 49%, as compared with the actual occurrence, which was less than half of this proportion. Perceived quality of care was found to be an important factor in health seeking behaviour, as was wealth, caste, education and experience of previous problems in pregnancy. Actual care given by a range of practitioners was found to contain both beneficial and undesirable elements. As a response to serious morbidities experienced within the study period, many women were able to seek care although sometimes after a long delay. Those women who experienced inadequate progression of labour pains were most likely to proceed unexpectedly to a hospital delivery. (shrink)

In this thirteenth book of scilogs – one may find topics on Neutrosophy, Plithogeny, Physics, Mathematics, Philosophy – email messages to research colleagues, or replies, notes, comments, remarks about authors, articles, or books, spontaneous ideas, and so on. It presents new types of soft sets and new types of topologies. -/- Exchanging ideas with Mohammad Abobala, Ishfaq Ahmad, Ibrahim M. Almanjahie, Fatimah Alshahrani, Nizar Altounji, Muhammad Aslam, Said Broumi, Victor Christianto, R. Diksh, Feng Liu, Frank Julian Gelli, Erick Gonzalez Caballero, (...) Riad Hamido, Yaser Al-Hasan, Ahmed Hatip, Yasin Karmouta, Nivetha Martin, Preda Mihăilescu, V. Lakshmana Gomathi Nayagam, Ze Carlos Tiago de Oliveira, Alexey Platonov, Andrei Pogany, Shakti Prasad, Ranulfo Paiva Barbosa (Sobrinho), Dmitri Rabounski, Ackbar Rezaei, Constantin Sandu, A. Saraswathi, Usman Shahzad, Gocho V. Sharlanov, Stefan Spaarmann, Michael Voskoglou, Vinay Kumar Yadav, Tomasz Witczak, William H. Woodall, Mircea Zărnescu, Mohamed Bisher Zeina (in order of reference in the book). (shrink)