Maternal and perinatal outcome in rupture of unscarred uterus: a case series

Uterine rupture is one of the main contributory factors of maternal morbidity and fetal mortality. The aim of this study was to study the maternal and perinatal outcome in rupture of unscarred uterus and to identify the etiology, risk factors, diagnosis and management in a tertiary care centre. This case series study was often cases of rupture of unscarred uterus conducted at the department of obstetrics and gynecology, Nazareth hospital, Shillong, Meghalaya from July 2018 to February 2021. During the study period there were 7840 deliveries and ten patients presented with rupture of unscarred uterus, the incidence being 0.127 %. The patients were referred from different primary health centres and all patients presented with history of trial of home delivery. All patients were multigravida and the highest parity was a patient with para 11. The cases were between the gestational age of 39 to 41 weeks. Rupture was observed in the lower uterine segment in 5 patients, left lateral wall in 3 and right lateral wall in 2 patients. Five patients underwent hysterectomy, and 4 patients had repair of the rupture. There was one maternal death. Grand multipara and trial of home delivery were the most common identifiable risk factors along with obstructed labour. Identifying high risk women, prompt diagnosis, early referral from periphery and active management is the key factor to avoid adverse maternal and perinatal outcome

Social innovation, social enterprise, and local public services: undertaking transformation?

This article discusses some of the challenges encountered in embedding effective and sustainable social enterprise and social innovation within established political institutional systems to deliver local welfare services. It draws upon evidence analyzing social innovation and social enterprise in Scotland to contribute to the debate over whether social innovations and social enterprises are able to meet expectations in addressing the significant challenges faced by welfare systems. The article clarifies the meaning of both these contested concepts and explains how social innovation and social enterprise relate to similar ideas in social and public policy. The evidence suggests that actually operating social enterprises and social innovations do not embrace the image of them promoted by enthusiasts as either “entrepreneurial” or “innovative”. Furthermore, they bring distinctive challenges in delivering local welfare services, including potential tensions or rivalry with existing public agencies. The article suggests that social enterprises and social innovations are not themselves instigators nor catalysts for systemic change, but that their impact is constrained by structural conditions and institutional factors beyond their control

Stakeholder theory in social entrepreneurship: a descriptive case study

In this paper, a descriptive case study of a social entrepreneurial firm is used to demonstrate stakeholder salience and stakeholder social issue management valence. The methodology is to use a semi structured interview with a social entrepreneur to identify and map the firm's stakeholders' salience and stakeholders' social issue management valence. The resulting map uses spheres, sized proportionally to social issue management valence, to represent the various stakeholder groups. Each map shows the positioning of stakeholders according to their salience at critical points in the life of the social entrepreneurship. This paper contributes to stakeholder theory through its use of an innovative methodology to combine and view the stakeholders and their importance to the social entrepreneur on a single map. This map incorporates the elements of stakeholder salience with stakeholder social issue management valence. This mapping approach enables us to visualize how salience and valence positions change at critical times. Social entrepreneurs applying this mapping method can balance the allocation of their time and attention to stakeholders while simultaneously keeping with their social mission

Trading Futures: Sadaqah, Social Enterprise, and the Polytemporalities of Development Gifts

In this article, we explore what happens when idea(l)s of Islamic charity (sadaqah) and social enterprise converge within a low-cost public health clinic in Colombo, Sri Lanka. For both the clinic's wealthy sponsors and the urban poor who use it, interpreting the intervention as a pious expression of care toward the poor or as a for-profit humanitarian venture meant extending different futures to the poor. The ambiguous temporalities of gifts and commodities anticipated by benefactors and beneficiaries involved in this challenges anthropological assumptions concerning the marketizing effects of neoliberal development interventions. Our ethnography revealed a hesitancy among the clinic's sponsors, managers, and users to endow the intervention with a final interpretation, undermining its stated goal of promoting health care privatization and “responsibilization” of the poor