The Social Impact of Social Funds in Jamaica: A ‘Participatory Econometric’ Analysis of Targeting,Collective Action,and Participation in Community-Driven Development

Qualitative data from a case study of the Jamaica social investment fund reveal that the social fund process is elite-driven and decision-making tends to be dominated by a small group of motivated individuals. However, there is broad-based satisfaction with the outcome. Quantitative data from 500 households mirror these findings by showing that, ex-ante, the social fund does not address the expressed needs of the majority of individuals in the majority of communities. By the completion of the project, however, 80 per cent of the community expresses satisfaction with the outcome. An analysis of the determinants of participation reveals that better educated and better networked individuals dominate the process. Propensity-score analysis demonstrates that JSIF has had a causal impact on improvements in trust and the capacity for collective action, but these gains are greater for elites.     

医学生对医疗损害法律制度的认知现状调研

为了提高医学生的法律意识,谨慎地对待患者的生命权与健康权,防范医疗纠纷和医疗事故的发生。本文以《侵权责任法》医疗损害责任制度及相关卫生法规为切入点,评估医学院校学生对医疗损害法律制度的认知现状,对学生进行医学法学知识测评和问卷调查,结果表明,学生对法律条文的理解与临床实践存在很大差异,在校生与实习生、西医类专业与中医类专业学生医学法学成绩存在显著差异,实习可有效提高学生的认知。本研究提示,学生对医疗损害法律制度的认知不足与教师卫生法学知识的不足、学时有限、医学与法学课程缺乏学科间的交叉整合、缺少复合型师资、专业类别等密切相关。     

Descending thoracic aortic aneurysm rupture during postpartum period

Aortic aneurysm refers to the pathological dilatation of the normal aortic lumen involving one or several segments. Thoracic aortic aneurysms are much less common than aneurysms of the abdominal aorta. Descending thoracic aortic aneurysm leading to dissection and spontaneous rupture is a potentially catastrophic illness. Although rare, dissection and rupture of a preexisting aortic aneurysm have been reported during pregnancy and early puerperium. To the best of our knowledge, such cases among young pregnant women are rarely reported in literature. Herein, an autopsy case of spontaneous rupture of a clinically undiagnosed descending thoracic aortic aneurysm during early puerperium in a young woman is presented along with the review of relevant literature. The victim was found dead on her hospital bed on the seventh day of puerperium. Autopsy with ancillary investigations revealed that the young woman died because of hemothorax from a ruptured dissecting descending thoracic aortic aneurysm secondary to chronic aortitis.