3-[(Z)-(4-Diethyl­amino-6-oxocyclo­hexa-2,4-dien-1-yl­idene)methyl­amino]benzoic acid

The title compound, C18H20N2O3, crystallizes as the keto tautomer, unlike the vast majority of similar structures that have been reported that contain the hydr­oxy tautomer. There are two strong hydrogen bonds in the crystal structure, both accepted by the same carbonyl group: one intra­molecular N—H⋯O and one inter­molecular O—H⋯O. As a result, the carbonyl C=O distance is long, at 1.310 (2) Å, which may suggest the mol­ecule has a significant zwitterionic character. The dihedral angle between the benzene ring planes is 15.05 (7)°. As a result of the intramolecular hydrogen bond, the bridging C—C=N—C group is almost coplanar with the benzene ring that has the diethylamino substituent [dihedral angle 2.35 (15)°]

A Qualitative Analysis of Women's Short Accounts of Labour and Birth in a Western Australian Public Tertiary Hospital

This paper reports the findings of the postnatal qualitative arm of a larger study,which investigated women's prenatal and postnatal levels of childbirth fear. Women's expectations and experiences of labour and birth in a Western Australian public tertiary hospital were identified following thematic analysis of short written accounts from 141 participants who had given birth in the previous 6 to 14 weeks. Four major categories emerged to describe features and mediating factors in the trajectory of childbirth and the early puerperium "Anticipating Labour and Birth", "Labour and birth Depicted", "Mediating Factors and their consequences" and "Evaluating, Resolving, and Looking Ahead" portray women's comparative reflections on expectations and realities of birth, on mediating influences, and on moving on from their experience. These findings will provide maternity care professionals with insight into the personal and environmental features of the childbirth setting which colours women's recollections. Being aware of what women value during labour and birth will reinforce the need for professionals to provide care using a mindful approach that considers the potential psychological, emotional and behavioural implications of events

(E)-4-[(4-Bromo­benzyl­idene)amino]phenol

In the title compound, C13H10BrNO, the dihedral angle between the benzene rings is 35.20 (8)°. In the crystal, mol­ecules are linked by O—H⋯N hydrogen bonds, forming a zigzag chain along the a axis. A weak C—H⋯π inter­action is observed between the chains

1,2-Bis[(1,3-benzodioxol-5-yl)methyl­idene]hydrazine

The complete mol­ecule of the title compound, C16H12N2O4, is generated by the application of a centre of inversion. The (1,3-benzodioxol-5-yl)methyl­idene fused-ring system is approximately planar (r.m.s. deviation = 0.020 Å) and is essentially coplanar with the central hydrazine group [dihedral angle = 5.08 (9)°]. Weak π–π inter­molecular inter­actions are observed [centroid–centroid distance = 3.8553 (8) Å], providing some packing stability

Bis{4-[(Z)-N′-(4-hydroxy­benzyl­idene)hydrazino]-8-(trifluoro­meth­yl)quinolinium} sulfate dihydrate

The title compound, 2C17H13F3N3O+·SO4 2−·2H2O, crystallizes with four independent cations (A, B, C and D) in the asymmetric unit, which is composed of two groups of two cations, one anion and two water mol­ecules (Z′ = 2). The dihedral angle between the mean planes of the 4-hydroxy­phenyl and quinolinium groups is 8.9 (7)° in A, 30.1 (6)° in B, 28.8 (8)° in C and 12.8 (1)° in D. The crystal packing is stabilized by inter­molecular O—H⋯O and N—H⋯O hydrogen bonding between H atoms from 4-hydroxy­phenyl O atoms and the O atoms of nearby water molecules and sulfate anions, as well as H atoms from the N atom of the hydrazino group to O atoms of neighboring sulfate anions, linking the components into chains with the 4-hydroxy­phenyl and quinolinium rings parallel to the (011) plane. There is also an extensive array of inter­molecular hydrogen bonds between water mol­ecules themselves and with sulfate O atoms, as well as hydrogen-bond inter­actions between H atoms from the hydrazino group and sulfate O atoms. In addition, inter­molecular π–π stacking inter­actions occur between nearby 4-hydroxy­phenyl and quinolinium groups, with distances between the centroids of inter­acting rings in the range 3.4140 (9)–3.9659 (9) Å

1,2-Bis(3-phen­oxy­benzyl­idene)hydrazine

Mol­ecules of the title compound, C26H20N2O2, reside on crystallographic centres of inversion located at the mid-point of the N—N bond. The benzyl­idene ring is essentially coplanar with the central hydrazine group, with an inter­planar angle of 4.5 (2)°, whereas the phenyl ring is oriented at 34.0 (3)° with respect to the mean plane of the central 1,2-dibenzyl­idenehydrazine group. In the crystal, C—H⋯π(arene)-ring inter­actions link mol­ecules about inversion centres

A survey of healthcare providers’ knowledge and attitudes regarding pain relief in labor for women in Ethiopia

BACKGROUND: To explore healthcare providers' knowledge and attitudes to the need for pain relief for women in labor. METHODS: A structured questionnaire (n = 200) distributed to healthcare providers working in the obstetric departments, including theatres, of three public hospitals in different settings (rural, peri-urban and urban) in Ethiopia. Descriptive analysis was performed using Excel 2013 and SPSS version 22 for associations. RESULTS: The response rate was 81.5% with 164 questionnaires completed. The majority, 79% of respondents, understood that women can feel moderate to severe pain in labor and 77% were of the opinion that labor pain should be relieved. However, common practices included only supportive measures such as breathing and relaxation exercises, back massage and support from family. The general attitude of healthcare providers is that labor is a natural process, women should be able to cope and that pain relief is not a priority for women in labor. More than half, 52% of healthcare providers had safety concerns with using pharmacological methods to relieve pain in labor. CONCLUSION: The majority of healthcare providers understand that women suffer significant pain during labor. However, providing effective pain relief is currently not provided as part of routine intra-partum care in Ethiopia

The development and application of a new tool to assess the adequacy of the content and timing of antenatal care

Abstract Background: Current measures of antenatal care use are limited to initiation of care and number of visits. This study aimed to describe the development and application of a tool to assess the adequacy of the content and timing of antenatal care. Methods: The Content and Timing of care in Pregnancy (CTP) tool was developed based on clinical relevance for ongoing antenatal care and recommendations in national and international guidelines. The tool reflects minimal care recommended in every pregnancy, regardless of parity or risk status. CTP measures timing of initiation of care, content of care (number of blood pressure readings, blood tests and ultrasound scans) and whether the interventions were received at an appropriate time. Antenatal care trajectories for 333 pregnant women were then described using a standard tool (the APNCU index), that measures the quantity of care only, and the new CTP tool. Both tools categorise care into 4 categories, from ‘Inadequate’ (both tools) to ‘Adequate plus’ (APNCU) or ‘Appropriate’ (CTP). Participants recorded the timing and content of their antenatal care prospectively using diaries. Analysis included an examination of similarities and differences in categorisation of care episodes between the tools. Results: According to the CTP tool, the care trajectory of 10,2% of the women was classified as inadequate, 8,4% as intermediate, 36% as sufficient and 45,3% as appropriate. The assessment of quality of care differed significantly between the two tools. Seventeen care trajectories classified as ‘Adequate’ or ‘Adequate plus’ by the APNCU were deemed ‘Inadequate’ by the CTP. This suggests that, despite a high number of visits, these women did not receive the minimal recommended content and timing of care. Conclusions: The CTP tool provides a more detailed assessment of the adequacy of antenatal care than the current standard index. However, guidelines for the content of antenatal care vary, and the tool does not at the moment grade over-use of interventions as ‘Inappropriate’. Further work needs to be done to refine the content items prior to larger scale testing of the impact of the new measure

Gaining insight into how women conceptualize satisfaction: Western Australian women's perception of their maternity care experiences

BACKGROUND: The concept of maternal satisfaction is challenging, as women's and clinicians' expectations and experiences can differ. Our aim was to investigate women's experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum. METHODS: This mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes. RESULTS: A total of 54 % (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P?=?0.020); supported by a midwife if they had a caesarean (P?=?<0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P?=?<0.001). Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women's satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme 'how care was provided' encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme 'attributes of staff' included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme 'engaged in care' incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs. CONCLUSIONS: Quantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women's perception of being involved with their birth. Being able to explore the diversity of women's experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum