bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of malnutrition in elderly residents in a warden-assisted setting compared with a home-living environment
Authors: Riches Kerry , Jeanes Yvonne
Published: July 2014

Malnutrition in elderly people is associated with many adverse clinical outcomes. However, few studies exist investigating malnutrition in the community setting. This study aimed to report the prevalence of malnutrition in elderly people living in warden-assisted (WA) accommodation compared with those living at home. A total of 20 WA and 20 home-living (HL) participants were assessed using hand-grip strength and the Mini Nutritional Assessment (MNA). Some 30% of the WA group were malnourished, compared with 10% of the HL group. This study demonstrates an alarmingly large proportion of individuals in WA accommodation to be either malnourished or at risk of malnutrition. This is a relatively small study, and further research into the key factors influencing malnutrition and interventions to minimise malnutrition with WA accommodation are clearly warranted.
Case management and long-term conditions: the evolution of community matrons
Authors: Bentley Allison
Published: July 2014

It is now 10 years since the NHS Improvement Plan described a new clinical role for nurses and introduced the concept of community matrons for long-term conditions. This included conditions such as chronic obstructive pulmonary disease, diabetes, dementia, neurological conditions, heart failure, stroke and people with long and enduring mental illness. Despite initial concerns and scepticism about the role, community matrons continue to work with people to provide advanced clinical nursing care, often within a case-management model. Community matrons have continued to shape and develop this role around the main aims of preventing unnecessary emergency admissions, improving quality of life and outcomes for patients, and coordinating all elements of care. This article reviews the evidence, implementation and evolvement of case management within the role of the community matron.
District nurse responsibilities in relation to ‘do not attempt resuscitation’ decisions
Authors: Griffith Richard
Published: July 2014

The Court of Appeal has ruled that patients and their relatives have the right to be consulted prior to a ‘do not attempt resuscitation’ notice being placed on file by a health professional. Failing to do so would be in breach of the patient's right to respect for a private and family life under the European Convention of Human Rights, article 8. This article sets out the steps that district nurses must take to ensure that ‘do not attempt resuscitation’ notices placed on the file of their patients are lawful.
Midwives and perinatology
Authors: Persad Prakie , Hiscock Claire , Mitchell Tessa
Published: July 2014

Changing patterns of maternity services place midwives as lead professionals. Their roles in perinatal enquiry now becomes a major one.
The changing face of supervision of midwives
Authors: Majes Glynnis
Published: July 2014

Supervision of midwives is in a state of flux. This article outlines some of the changes taking place within supervision and addresses some of the problems associated with those changes.
Supervision of midwives is alive and well in the North West
Authors: Duerden Jean M
Published: July 2014

Supervisors fulfill a wide range of roles and supply support from issues of security to practice. A recent audit of supervision of midwives in the North West Regional Health Authority confirms that midwives believe supervision is a necessity.
Challenging hospital policies: the management of prelabour rupture of membranes at term
Authors: Raymond Jane E
Published: July 2014

This article explores the considerable diversity of hospital policies which exist concerning the optimum management of prelabour rupture of membranes at term. It suggests that such an event is a normal prelude to labour in the majority of cases and disputes the necessity of immediate obstetric referral. Midwives are encouraged to challenge such protocols which do not reflect recent research and may involve inappropriate use of technology and resources.
The Cochrane Database: the way ahead
Authors: Shennan Cathy , Shennan Andrew
Published: July 2014

The Cochrane Database, launched in the last three years, has major implications for midwifery practitioners. This article explores the value of this contemporary database and discusses how to interpret the data presented. This innovative computerized database should prove to be invaluable for educationalists, practitioners, students and supervisors, as well as researchers extending the field of knowledge in midwifery and managers grappling with the implementation of Changing Childbirth.
Using the Internet to support midwifery practice
Authors: Bowles Nick
Published: July 2014

This article has been written for midwives who are complete beginners when it comes to the Internet, but who want to access the many resources available on this new mass medium with the minimum of fuss.
The future of midwifery regulation
Authors: Winship E Jane
Published: July 2014

This article outlines the history of midwifery regulation. The author promotes self-regulation among midwives and calls for all midwives to make a positive contribution to the politics of the profession and to the election of midwives in 1997 to the UKCC. The article originates from a talk given at the 1996 RCM student midwives conference. The views and opinions expressed are those of the author.
Climbing walls and leaping fences: women's issues in the West Bank and Gaza Strip
Authors: Rankin Sarah
Published: July 2014

Palestinians have experienced occupations of one kind or another for 2000 years. The tenuous peace that now exists presents a real opportunity for renewal of the neglected national infrastructure. This article explores some of the challenges facing midwives and other health professionals.
Midwifery values: part 1
Authors: Siddiqui Jeanne
Published: July 2014

Issues concerned with being a professional are raised in Part 1 of this article. Values such as advocacy and autonomy are discussed and the author considers the influence of other professions in practising midwifery values.
Creating change and reducing conflicts
Authors: Jackson Kate
Published: July 2014

Looking at the results of the English National Board survey of maternity units it is heartening to see the number of maternity units throughout England which are already well on the way to achieving, some, if not all, the indicators of success specified within Changing Childbirth (Department of Health, 1993).
Advanced midwifery practice: myth and reality
Authors: Sisto Sheila , Hillier Dawn
Published: July 2014

While the profession strives to define the exact role of the advanced midwifery practitioner, this article argues that all practising midwives should participate in the development of midwifery practice as a whole. The interrelationship of mastery with proficient, expert and advanced practice is explored.
Improving services in a Glasgow maternity hospital
Authors: Lees Ann
Published: July 2014

Economic evaluation shows that maternity services can be improved within existing resources: increased benefits and potential savings are possible through increasing the proportion of community-based care, relating maternity care more directly to need and increasing choice and continuity for women.
Are you working with a ‘real’ doctor?
Authors: Robinson Jean
Published: July 2014

One of the first things we do with any AIMS medical care complaint is to check the doctor's registration. If he or she is not in the Medical Register, I telephone the GMC to check temporary or limited registration on the day of the incident. I also check the grade they are allowed to work in; GMC training registration to work as a SHO does not allow a doctor to work as a registrar. If the doctor apparently has higher qualifications, I check those too. We have had a few cases where ‘doctors’ were not what they seemed.
New VICRYL* formulation: an improved method of perineal repair?
Authors: Gemynthe A , Langhoff-Roos J , Sahl S , Knudsen J
Published: July 2014

One of the most important aims of care during delivery is to try to reduce the risk of damage to the perineum at birth. Pain and discomfort from stitching troubles a substantial proportion of mothers. It is therefore important to find sutures with the best properties for perineal repair.
Racial discrimination, the law and equal access in maternity care
Authors: Schott Judith , Henley Alix
Published: July 2014

Although there is no scientific basis for dividing people into racial groups, discrimination on the basis of ‘race’ is widespread. This article looks at ways of combatting racism within the maternity services and beyond.
Psychotherapy following childbirth
Authors: Jones Alun
Published: July 2014

This article investigates the benefits of psychotherapy with a young mother experiencing emotional distress in response to the birth of her baby. Through the case study method it explores the work of a liaison mental health nurse and the creative support of clinical supervision. A case is made for the reporting of dreams to be viewed as an important and potentially rich means of understanding distress and planning intervention.
Midwifery service and practice in Malaysia
Authors: Stuart Chit Chai
Published: July 2014

The diverse cultural background of the various races in Malaysia requires midwives to be conversant with the varied racial beliefs and practices surrounding childbirth. Multilingual skills, multi-racial integration, understanding and acceptance ensures that women's needs are catered for.
Power and choice in birthgiving: a case study
Authors: Belbin Alison
Published: July 2014

Alison Belbin's first child Eddie was born in a pool at home. The experience was a very positive one and this article explores the choices she made and the support she received for them.
Power and choice in birthgiving: some thoughts
Authors: Lovell Alice
Published: July 2014

The previous article charts the emotional, physical, practical and spiritual preparation for the arrival of Alison Belbin's baby within an NHS context. This article analyses some of the issues which made this particular birth such a positive experience.
UKCC statement on practice nurses: RCM response
Authors: McCormick Catherine
Published: July 2014

There has been much confusion within the midwifery profession since the UKCC issued its guidance on the involvement of practice nurses in the provision of antenatal care. This confusion and concern led to the issue being debated at the recent AGM annual conference in Torquay.
Baby massage
Authors: Lim Pauline
Published: July 2014

The art of massage is becoming more acceptable and widespread within British culture and the clinical field. This article looks at the potential benefits of tactile stimulation for babies and discusses how to perform a baby massage using an appropriate medium.
Why are antenatal HIV testing policies in London failing?
Authors: MacDonagh Sandra E , Masters Janet , Helps Barbara A , Tookey Pat A , Gibb Diana M
Published: July 2014

The prevalence of human immunodeficiency virus (HIV) infection in women who have had live births has increased since 1988, particularly in London (Unlinked Anonymous HIV Surveys Steering Group, 1995). In 1994,1 in every 580 women delivering in London was infected with HIV and in some London maternity units this figure was as high as 1 in every 200 women. As HIV infection can be transmitted from mother to child during pregnancy, labour or breastfeeding (vertical transmission), this rising prevalence has particular relevance to the care of these women during pregnancy, labour and the puerperium.
Selection: a question of ‘fit for purpose’
Authors: Phillips Mari , Bharj Kuldip
Published: July 2014

This article examines three elements of the selection process utilized by the Division of Midwifery and Women's Health, within one institution, to ensure that students are ‘fit for purpose’, i.e. can effectively meet the theoretical and clinical demands of the midwifery education programme.
Choice, continuity and control from a cardiotocograph
Authors: Allen Rose , Gavin Jane L
Published: July 2014

It could be argued that all too often technology is used which inhibits choice, continuity and control for women. It is proposed that the Meridan 800 cardiotocograph machine facilitates to some extent woman centredness. Changing Childbirth (Department of Health, 1993) identified the need for ‘choice, continuity and control’ to be provided for women within the maternity services. Midwives can address these concepts in everyday practice, that all too often frustrates rather than facilitates the three Cs.
A comparison of routine antenatal care in Scotland in 1989 and 1994
Authors: Tucker Janet
Published: July 2014

As reports of studies arising from Changing Childbirth (Department of Health, 1993) continue, there is a need for information indicating the direction and extent of changes. This article reports on observed changes in staff deployment and the role of the midwife in routine antenatal shared care from Scotland-wide studies which took place before and after Cumberlege.
A survey of interprofessional communication in a labour suite
Authors: Brownlee Maureen , Mcintosh Claire , Wallace Euan , Johnstone Frank , Murphy-Black Tricia
Published: July 2014

Effective communication between care providers and recipients is acknowledged as an integral part of providing a quality maternity service. The relationship between care providers can have implications for care. This study examines interprofessional communication within a labour ward.
Between two stools
Authors: Chesney Margaret , Scattergood Sheelagh
Published: July 2014

Students undertaking a Pre-Registration Diploma in Midwifery (long) course receive a bursary but cannot claim either student or statutory benefits. This is an example of one student midwife, whose future as a midwife depends on whether to eat or pay for child care.
Midwifery education: Still in control?
Authors: Hunt Sheila C
Published: July 2014

At a recent RCM/UKCC collaborative conference, midwives from all over the UK were invited to consider issues surrounding ‘Partnership in Practice.’ It was quickly apparent that both organisations could reflect positively on the progress that had been made: midwives still controlled education. But not everyone agreed. A member of the invited audience took the opportunity to assert the view that jointly the UKCC and RCM had failed to protect midwifery, indeed they were responsible for its decline.
Aspects of care provided by midwives — part one: an overview
Authors: Pope Rosemary , Cooney Margaret , Graham Lesley , Holliday Mary , Patel Swatee
Published: July 2014

This is the first in a series of six articles presenting key findings from a national study that was undertaken to investigate the role and responsibilities of midwives and to identify continuing educational needs. The research findings were used to develop an open learning educational package for use by midwives nationally. The study was commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) and was carried out between March 1994 and February 1996. The series includes the following articles: (1) Aspects of care provided by midwives part 1 — A general overview, (2) Aspects of care provided by midwives part 2 — ‘Enhanced role’ activities and social and emotional care, (3) The organisation of midwifery care, (4) Perceptions of midwifery care – views of professionals and mothers, (5) Assessing the continuing educational needs of midwives, (6) Addressing the continuing educational needs of midwives.
When interpersonal skills fail
Authors: Sobolewski Anna , Davies Hilary
Published: July 2014

Mary was 25 years old and pregnant with her first baby. She was delighted to be pregnant and was intending to breastfeed. When she was 22 weeks pregnant, she discovered that her partner had had an affair with an HIV/AIDS infected woman who had died recently. Mary was convinced that her baby had developed an HIV infection and kept asking the midwives to do something with her baby. Mary needed information, advice and support. The midwives were at a loss about what to do or with whom Mary should discuss the situation.
Factors which influence women in their choice of DOMINO care
Authors: Mansion Elizabeth M , McGuire Margaret M
Published: July 2014

This exploratory qualitative study of what influences women in their choice of DOMINO (Domiciliary in and out) care attempted to identify why this system of maternity care had a particularly low uptake in central Scotland. Although not established for this purpose 30 years ago, DOMINO care theoretically provides choice, control and continuity, yet only 1–2% of all women in Scotland deliver within this system of care. The strongest themes to emerge from the interviews were previous negative birth experience, initial requests for home birth and the individualized care the women anticipated from their community midwives. The benefits of DOMINO care for these women can be encompassed in the term ‘Individualism’ and the trust and friendship invested in their community midwife was the vehicle to this objective. Despite the small sample, these findings raise many pertinent issues applicable to the provision of this and other systems of continuity of care.
Infant CPR: the effect on parental anxiety regarding SIDS
Authors: Clarke Kathryn
Published: July 2014

This study examines the relationship between an infant resuscitation training programme and its effect upon parental anxiety regarding cot death. By establishing a baseline of anxiety regarding cot death in parents of children less than 18 months old, prior to the demonstration and practice of the skill of infant resuscitation it could be determined whether the training programme had any effect upon anxiety regarding cot death. The study showed that by teaching parents the skill of infant resuscitation, anxiety levels regarding cot death were not influenced. Parental confidence was however increased regarding the baby's health and safety.
Tactile stimulation in the ventilated preterm: a single case study
Authors: Hayes Julie A , Adamson-Macedo Elvidina N
Published: July 2014

This study used a repeated measures counterbalanced design with a single case study to try and address whether deep or light stroking is of beneit to the ventilated preterm neonate. The neonate received three different touch conditions: a gentle and light systematic stroking therapy referred to as Touching and Caressing-Tender in Caring (TAC-TIC) therapy, TAC-TIC therapy performed with deep pressure, and comfort therapy which included containment behaviours. A control condition when the infant was lying alone with no intervention was also used. Cardiovascular responses remained stable throughout all of the conditions and the control period. In-depth video analysis indicated that significantly greater time was spent in behaviours indicative of distress during deep stroking. These results suggest that deep touch was not appropriate for the ventilated preterm infant. This infant responded with a significantly lower percentage of time spent in distress behaviours during light touch.
Pain management during pregnancy
Authors: McGeady Elaine
Published: July 2014

Maternal adaptations in pregnancy are attributed to the hormones of pregnancy and to mechanical pressures arising from the enlarging uterus and other tissues. These adaptations protect the woman's normal physiological functions, meet the metabolic demands pregnancy imposes on the body, and provide for fetal development and growth needs (Bowback et al, 1995).
Critical views of litigation 2: the legal process, and experts
Authors: Symon Andrew
Published: July 2014

Negotiations between lawyers for the two parties have the potential to produce perverse conclusions; in addition the legal process has been criticized for being slow and inefficient The conduct of experts in determining questions of negligence and causation has also been severely criticised in recent years.
An introduction to the report on maternal deaths
Authors: Sallah Kathryn
Published: July 2014

The 1994-96 Confidential Enquiry into Maternal Deaths is essential reading for all Midwives. The Report has a different format from previous years and a whole new approach, giving greater emphasis to multi-professional audit and public health issues. The mechanisms for case ascertainment have been improved and midwives have been increasingly involved In case assessment resulting in an additional dimension to the Report itself. Midwifery involvement has been enhanced in three ways: through the introduction of Local Midwifery Assessors; through case review by the Midwifery Officer at the Department of Health; and by the introduction of a chapter relating to midwifery practice. It is hoped that these changes; together with wider dissemination of the Reports' findings, will demonstrate the key role midwives play in ensuring safe outcomes of pregnancy for mother and baby. This can be achieved through the midwives increasing public health role, improved health education and surveillance, early recognition of complications and timely initiation of appropriate care. To assist in this there are other important additions to the Report, for example, a new chapter on psychiatric causes of death and guidelines for domestic violence and the correct use of seat belts.
Executive summary
Authors:   In association with the Department of Health
Published: July 2014

This booklet summarises the key findings and recommendations made in the full Report. These are based on the results of clinical audit of maternal deaths. References to sources of advice, current professional guidelines or other evidence are contained in the main Report. It is the first time such a summary has been produced, and its widespread distribution throughout the NHS should mean its recommendations will be available to many more professional staff than in the past, and enable the results to be incorporated into local care and audit plans and the further development and implementation of local guidelines.
Neuroendocrinology and birth 2: the role of oxytocin
Authors: Ginesi Laura , Niescierowicz Rose
Published: July 2014

Every sexual experience Is intensely personal. Intercourse can arouse a whole range of feelings. A fulfilling, orgasmic coming together for two loving partners might be described as eustress (see previous article: Br J Midwifery 6(10): 659–63) while intercourse may cause extreme distress in the case of rape victims. It may be somewhere between these two extremes depending on the circumstances and the environment in which intercourse takes place. So it is with birth (Kitzinger, 1995). As antenatal teachers we often find ourselves in a privileged position. While they may not always discuss their sexual experiences, women and their partners talk to us about their experiences of birth. The relationships we develop with our clients are different from those they develop with their midwives and other health professionals, but it is clear that the experience of birth can be very variable. For this article we use a psychophysiological model to explain the progress of labour and to review current research about oxytocin. Such a model can help to explain why the quality of midwifery care is so important for the birthing mother and how active management often fails to promote physiological labour.
Experience of a Changing Childbirth project
Authors: Warriner Sian , Pearce Linda , Fraser Amy , Ullman Roz
Published: July 2014

With national evidence on what women want from maternity services, and the benefits of continuity of carer schemes, this article describes the management, evaluation and results of a local project It is a triangulation of the significant and important results of three separate pieces of work undertaken as part of the evaluation of Stoke Mandeville Hospital NHS Trust's Changing Childbirth project.
Folate and pregnancy
Authors: Coutts Alison
Published: July 2014

Folate (of which one form is folic acid) is one of the B group of vitamins. Its main function is to act as a co-enzyme in the transfer of carbon atoms in the metabolism of several amino acids and in nucleic acid synthesis. Therefore, a lack of folate is most noticeable in rapidly dividing cells and growing tissues. Deficiency causes a macrocytic anaemia, which has been quite common in the past among the poorer members of the population.
The tide has turned: audit of water birth
Authors: Brown Lyn
Published: July 2014

In 1993 Good Hope NHS Trust in the Midlands responded to client demand for a birthing pool, and a temporary one was installed. Due to its popularity, a permanent pool was installed in 1994 with the number of women booking to use it rising from 5% to 12%. Over a three year period, 1082 women booked to use the pool, and out of the 541 who entered the pool, 343 delivered in it, including 10 women who had previously had a caesarean section. There was one neonatal death that was not attributed to the use of the pool. Evidence obtained over a three year period, 1994–1996, is presented alongside the observations and experiences of the midwives involved. Data from the audit suggests that labour and birth in water is no more dangerous for low risk women than ‘land birth.’ Women like it, as they feel in control of their labour, finding it a rewarding experience.
The vital components of a resuscitation kit
Authors: Maddy Brenda
Published: July 2014

The Royal College of Obstetricians and Gynaecologists Clinical Audit Unit outline auditable standards for neonatal resuscitation in their publication Effective Procedures in Maternity Care Suitable for Audit. Section 5.15, Neonatal Resuscitation, states:
Using ethnographic research to examine effects of ‘informed choice’
Authors: Machin D , Scamell A
Published: July 2014

Changing Childbirth emphasizes the notion of women having an ‘Informed choice’ through being aware of all the options open to them, knowledge of both the medicalized and demedicalized approaches to childbirth should open up the possibility for this choice. This research suggests that the ‘Informed choice’, as it 15 currently received, may not necessarily lead to any changes in childbirth experience due to certain fundamental cultural needs of women in our society.
A model of helping for labour ward midwives
Authors: Graham Liz
Published: July 2014

The author is a midwife working on the delivery suite of a NHS Hospital Trust. The maternity unit serves a mainly industrial area in the north-east of England where unemployment Is high and many of the women are Single parents from socially disadvantaged families. Some authors (Gould, 1986; Mclntosh, 1988), suggest that women In the lower socioeconomic groups — those unmarried and lacking in social support — would benefit the most from ante-natal education classes to empower them to make choices regarding their birth plan. Nationally, fewer than half of all pregnant women attend ante-natal classes. In the author's workplace it is mainly middle class, articulate women who attend ante-natal education classes. Women from the lower socioeconomic groups often arrive onto the delivery suite totally ignorant of the childbirth process.
Choices in childbirth: myth or reality
Authors: Ashcroft Brenda
Published: July 2014

Since the introduction of Changing Childbirth (Department of Health, 1993), it has generally been assumed that a woman has the right to choose the kind of treatment that is most suitable for her. However, the type of care she may in fact choose and the extent to which she may claim this as her right has been unclear and caused much confusion. The choices which may be open to her have therefore been explored in the light of the recommendations made by the Changing Childbirth report, together with the requirements of the UKCC. In addition to this, relevant and legal constraints have also been examined, as possible requests or demands for care in the future need to be considered. It is hoped that the end result will provide a comprehensive and working guide for women's rights to choose their care in childbirth.
Mothers and babies within the prison system
Authors: Scort Lynn , Blantern Sue
Published: July 2014

There has been an enormous amount of interest and controversy from the media, pressure groups and the midwifery profession, supported by the Royal College of Midwives, regarding both the ‘morality’ of imprisoning women who are pregnant and also regarding the quality of health and maternity care received by this group of women.
Birthmarks, man-made marks: their implications: part 3
Authors: Wheeler Heather MD
Published: July 2014

This paper is the final in a series of three. The two previous papers (Wheeler, 1997a; Wheeler, 1997b) examined the nature of birthmarks and argued that while some people regard them as beauty spots, others regard them as hideously disfiguring and would go to great lengths to remove them. While continuing to acknowledge that the subject of birthmarks is Important to practising midwives, the present paper provides an historical perspective on birthmarks as well as man-made marks. The article briefly discusses body image in terms of effects of skin blemishes on individuals and the wider society and acknowledges that disfigurement, however caused, can adversely affect self concept, with profound psychological, social, physical and economic consequences. Many midwives will be aware of the devastating effects skin blemishes on new born babies can have for parents.
How good is your bladder care?
Authors: Clarke Paula , Claridge Pauline
Published: July 2014

Urinary retention following an instrumental delivery, particularly for women who have had an epidural, is an identified issue of concern in our unit.
Management and leadership in midwifery: part 2
Authors: Pashley Glenys
Published: July 2014

Part 1 of this article in the previous issue addressed some of the theoretical perspectives regarding management and leadership and related relevant points to the context of midwifery. Part 2 focuses upon the development of management and leadership qualities and skills appropriate for senior practitioners and managers currently working in the challenging and constantly changing context of health care.
Candida albicans infection: predisposing factors
Authors: Lloyd Nicola
Published: July 2014

Vaginal candidiasis or thrush is one of the most frequent infections seen in women. Approximately 50% of women of child-bearing age will have experienced this condition at some time and up to one third will have had the condition more than once (Seal, 1997).
Is using the CTG defensive?
Authors: Symon Andrew
Published: July 2014

Claims have been made that practitioners are reacting defensively to the prosprect of litigation. An increase in the use of the CTG has been suggested as an example of this. While some midwives and obstetricians acknowledge over-use of the CTG, because of the imprecision of the concept of ‘defensive practice’ It is impossible to state how much CTG use is justified and how much is defensive.
Exploring same sex couples' experiences of maternity care
Authors: Hammond Claire
Published: July 2014

Same sex parenthood is becoming increasingly prevalent around the world. More same sex couples are engaging with maternity services, and as a ‘vulnerable’ group in health care it is imperative that their needs are met ( Burkholder and Burbank, 2012 ). This literature review explores research from around the world to evaluate the care that same-sex parents receive in the maternity sector. No articles were found to include gay men; however, 13 articles focused on lesbian parents. Three main themes arose from the review: the attitudes of health care professionals, the involvement of the co-mother and the invisibility of the lesbian mother due to heteronormativity. It was found that same sex couples receive overall positive care, however, some areas of subtle homophobia remain. Most same sex parents wish to be treated no differently to heterosexual parents, but with special recognition of their diverse family constellation. It is therefore essential that health professionals are educated on the unique needs of lesbian women and gay men.
Bridging the void with supervision: A collaboration between supervision, education and clinical practice
Authors: Gregory Colette
Published: July 2014

Current evidence suggests that there is a need to improve the understanding of both midwives and supervisors of midwives of the statutory framework and the role of the supervisor of midwives ( McDaid and Stewart-Moore, 2006 ; Henshaw et al, 2013 ). This article describes a collaborative initiative between a local NHS Trust's supervision team and its partner Approved Education Institution (AEI). It considers how to engage student midwives practically with the supportive mechanism of statutory supervision from the beginning of their programme of midwifery education, in order to enhance and further develop their understanding of statutory supervision gained through traditional theoretical learning. The overall aim of this initiative is to promote a greater understanding among student midwives, and ultimately midwives, of the statutory framework and the role of the supervisor of midwives.
Nursing and midwifery at the crossroads—new challenges, new successes
Authors: Richens Yana
Published: July 2014

In April this year I was invited by Stellenbosch University in South Africa to conduct two workshops and give a keynote speech at their first International Nursing Conference. The title of the conference was Nursing and midwifery at the crossroads—new challenges, new successes. The conference was certainly a great success, with inspirational speakers and great presentations. These are three presentations which were given during the conference. As Kofi Annan once said ‘Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family’. So I would like to share these with you, the speakers have given their permission.
Preregistration nurses' views on the delivery of tissue viability
Authors: Stephen-Haynes Jackie
Published: July 2014

This article outlines an evaluation of preregistration nursing students' views on the delivery of tissue viability during their preregistration education in preparation for registration with the Nursing and Midwifery Council ( NMC, 2010 ). Data were collected from two cohorts of preregistration (n=170) over a 2-year period by means of interactive voting keypads. The author concludes that preregistration preparation within the university was inadequate for both the prevention and provision of tissue viability care in clinical practice.
Interrater reliability of the Glamorgan Scale: overt and covert data
Authors: Willock Jane
Published: July 2014

The Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale (Glamorgan scale) had been developed using statistical analysis of patient data. The aim of this study was to assess the reliability of the Glamorgan scale using overt and covert methods. Method For the overt data collection, randomly selected trained nursing staff were invited to participate. Twenty-seven trained nursing staff assessed 27 children and young people within 10 minutes of an assessment by the researcher. For the covert part of the data collection the researcher and the paediatric tissue viability (TV) link nurse risk assessed inpatients on wards and units where the overt data collection had taken place, their findings were compared with the last recorded assessment by the clinical nurses. Results In the overt data collection 24 out of 27 nurses agreed with the researcher (88.9% agreement, kappa 0.867). In the covert data collection, 41 out of 55 risk assessments had been completed. Of the 41 completed assessments 34 agreed with the researcher and tissue viability link nurse (82.9% agreement, kappa 0.763). Conclusion The level of agreement was good for overt and covert interrater reliability data.
Hand burn management: minimising pain and trauma at dressing change
Authors: Edwards Jacky , Mason Sally
Published: July 2014

The aim of wound management in hand burn injuries is to restore function and prevent problem scars, so a key consideration in wound healing is the removal of dressings without causing pain and further trauma as well as preserving function. Conventionally, wound dressings such as paraffin gauze were used for burn injuries, but this led to pain and trauma on removal, as well as drying out. This study looks at the use of Mepitel® One on hand burns; this dressing incorporates all the benefits of Mepitel, however, it only has Safetac technology on the wound contact side, allowing easy handling and application.
Investigation of arrhythmia: recording and interpreting an electrocardiogram
Authors: Harris Joanne
Published: July 2014

The detection of an arrhythmia during routine cardiac auscultation is usually a significant finding that warrants further investigation. In this article, techniques for recording and interpreting electrocardiograms are discussed, along with a review of some common arrhythmias encountered in small animal practice. General principles regarding treatment of arrhythmias in veterinary patients are also considered.
Feline physiotherapy
Authors: Price Hannah
Published: July 2014

Feline physiotherapy is a growing field of veterinary physiotherapy, with many practitioners assessing and treating cats on a regular basis. This article looks at common conditions referred for physiotherapy, assessment and treatment options available to the physiotherapist, and follows the rehabilitation pathway of a cat following a femoral head and neck excision.
Squamous cell carcinoma in a central bearded dragon
Authors: Pellett Sarah , Pinborough Mary
Published: July 2014

A four-year-old, female central bearded dragon (Pogona vitticeps) was presented for evaluation of an ulcerated mass involving the left eyelid. Biopsies of the eyelid were performed and submitted for histopathology. Histopathology revealed a squamous cell carcinoma. Previous publications have described 12 cases of squamous cell carcinomas in bearded dragons, with nine located in the eyelids or periocular tissues. Imiquimod 5% cream (Aldara) is a novel immune response modifier that has been reported as a successful treatment for Bowen's disease in humans, and as a treatment option in cats with multicentric squamous cell carcinomas. In this case study, imiquimod 5% cream was applied to the lesion and clinical findings noted. Initial findings demonstrated a clinical response to imiquimod 5% cream, with a decrease in inflammation, tumour regression and the opening of the eyelids. A relapse occurred after 75 days with sudden deterioration, inflammation, closure of the eyelids and infection.
The psychology of sun protection: a variety of methods to change health behaviours
Authors: Williams Alison
Published: July 2014

Recent studies have highlighted that people's attitudes towards sun protection can change with the use of visual aids such as ultraviolet photography. Alison Williams, Lecturer in Psychology at Staffordshire University, discusses how aesthetic practitioners can help patients to protect their skin from sun damage by framing health messages, using image-based software and giving frequent reminders
FACE: a weekend of injectables, skincare and business management education
Authors: Devan Natasha
Published: July 2014

With five streams, hundreds of delegates and a high number of international speakers, FACE 2014 took over London's QEII Conference Centre for the second year in a row. In this review, the editor Natasha Devan and consultant editor Helena Collier discuss their event highlights from the three days in June and share a selection of some of the best tweets from the weekend's social media feed
Getting the most out of your appraisals: maintaining levels of staff satisfaction
Authors: Deakin Barbara
Published: July 2014

When staff feel listened to and appreciated, this can enhance their job satisfaction and increase the likelihood of them staying loyal to the company. To make the most out of this valuable opportunity, It is important for appraisals to be beneficial for both the manager and employee. Honesty, frequency and timing are key. Barbara Deakin offers aesthetic nurses her advice on conducting appraisals
Managing and developing a personal brand: actions, attitude and appearance
Authors: Ratcliffe Jason
Published: July 2014

Every clinic has a brand. Although you may not be aware of it or making a significant effort to develop it, personal branding is essential to every aesthetic practice. In this new practice management series, Founder of First Aesthetics and IT Consultant Jason Ratcliffe will discuss specific areas of marketing for nurse practitioners specialising in this field. The first paper will cover discovering your personal brand
Aesthetic Skin Centre, London: a vein treatment in a friendly, efficient clinic
Authors: Zadah Kate
Published: July 2014

When providing advice on running a successful clinic, nothing is better than experiencing the patient journey yourself, from the reception to the treatment room. In this practice management series, PR professional Kate Zadah travels the UK visiting clinics and reviewing their layouts, customer service, treatment menus and follow-up care. She will also highlight areas for improvement for each one
Practitioners engaging in narcissistic social media activity could damage their reputations
Authors: Collier Helena
Published: July 2014

It is now well recognised that the use of social media increases feelings of narcissism. Helena Collier believes some aesthetic practitioners' frequent use of networking sites such as Facebook and Twitter has given rise to a number of inflated egos, who could be damaging their reputations through their updates. She discusses the importance of being confident without being arrogant, and the beauty of humility
Counselling women on LARC: a practical guide
Authors: Kipps Sarah
Published: July 2014

The use of long-acting reversible contraception (LARC) has proven to be efficient and cost effective, but uptake continues to be low. Sarah Kipps provides practical tips for counselling women considering LARC
Understanding contemporary fatherhood: masculine care and the patriarchal deficit
Authors: Bailey Jemimah
Published: July 2014

The concept of ‘patriarchal dividend’ (Connell, 1995) assumes men’s privileged position in the gender order, and implies that men have more agency in their lives than women. However, this article argues that when it comes to contemporary fatherhood, structural influences of employment and culturally dominant normative ideas about gender place fathers at a disadvantage. Using data from a longitudinal qualitative study of first-time fathers in Ireland, the article examines how the new fathers sought to reconcile the tensions between their role as fathers, partners and workers and offers the concept of ‘patriarchal deficit’ as a lens through which a new understanding of men’s positions as fathers can be viewed.
Microsatellite Instability Detection by Next Generation Sequencing
Authors: Salipante Stephen J , Scroggins Sheena M , Hampel Heather L , Turner Emily H , Pritchard Colin C
Published: July 2014

BACKGROUND

Microsatellite instability (MSI) is a useful phenotype in cancer diagnosis and prognosis. Nevertheless, methods to detect MSI status from next generation DNA sequencing (NGS) data are underdeveloped.

METHODS

We developed an approach to detect the MSI phenotype using NGS (mSINGS). The method was used to evaluate mononucleotide microsatellite loci that were incidentally sequenced after targeted gene enrichment and could be applied to gene or exome capture panels designed for other purposes. For each microsatellite locus, the number of differently sized repeats in experimental samples were quantified and compared to a population of normal controls. Loci were considered unstable if the experimental number of repeats was statistically greater than in the control population. MSI status was determined by the fraction of unstable microsatellite loci.

RESULTS

We examined data from 324 samples generated using targeted gene capture assays of 3 different sizes, ranging from a 0.85-Mb to a 44-Mb exome design and incorporating from 15 to 2957 microsatellite markers. When we compared mSING results to MSI-PCR as a gold standard for 108 cases, we found the approach to be both diagnostically sensitive (range of 96.4% to 100% across 3 panels) and specific (range of 97.2% to 100%) for determining MSI status. The fraction of unstable microsatellite markers calculated from sequencing data correlated with the number of unstable loci detected by conventional MSI-PCR testing.

CONCLUSIONS

NGS data can enable highly accurate detection of MSI, even from limited capture designs. This novel approach offers several advantages over existing PCR-based methods.
Unstable grounds: Investigating ulterior spaces for practising
Authors: Robbins Felix
Published: July 2014

This article investigates alternative ways of working. It is a reflection on the contradictions of architectural practice and the opportunities for design that acknowledges these contradictions productively. The article continues an investigation into the construction of an architectural project – the contradictory requirements for the ‘construction’ of architecture and the opportunities in dissolving these requirements by design. It develops as an enquiry into the possibilities of actively acknowledging the contradictions and ambiguities of the discipline as a means to go on, as well as design that operates within the slippages, translations and movements between the ‘construction of a project’ to tentatively speculate on alternative and temporary locations and spaces of practice. It elaborates on ongoing design work of a ‘dwelling’ and the explicit processes, choices and techniques that move between the construction of narrative, site, material and space/time. The article argues that the discipline of architecture is unavoidably ungrounded – with the relevance and approach to practising lying exposed within the wider context of cultural production and a ‘deluge’ of multiple and relative shifting landscapes of ‘project’. It argues, however, that this does not justify merely reconstructing the grounds of the discipline in other terms – whether that be nostalgic, technological or superficial. Instead, it argues that other spaces for practising must be inhabited – spaces that make use of the ‘deluge’ and the ambiguities of practice and suggest alternative approaches to understanding and creating a sufficiency and productivity of making architecture.
Fabricating a New Image: Imperial Tents in the Late Ottoman Period
Authors: Dimmig Ashley
Published: July 2014

During the first centuries of Ottoman rule, sultans were constantly on the move and thus required transportable lodging in the form of the tent. As the nomadic dynasty grew into an empire, Ottoman tents quickly evolved into complex constructions that scholars often describe as ‘mobile palaces’. These extravagant tents continued to be used until the end of the Empire, and throughout the centuries, evolved stylistically in tandem with other imperial art forms such as permanent architecture and painting. In the eighteenth and nineteenth centuries, tentmakers had a fantastically rich and varied repertoire of visual elements at their disposal, some of which were adapted from international artistic milieus, and still others that developed domestically. In the sprawling landscape of late Ottoman Istanbul, tents functioned as transitional spaces between indoors and outdoors, like mobile pleasure pavilions, through which members of the court could enjoy the sensory pleasures of nature. Moreover, tents of all shapes and sizes functioned as interim palatial architecture and lavish silken stage settings for imperial ceremonies, which in the last centuries of Ottoman rule were employed to propagate the sultan’s power through his visibility.